<!--{*
/*
* This file is part of EC-CUBE
*
* Copyright(c) 2000-2011 LOCKON CO.,LTD. All Rights Reserved.
*
* http://www.lockon.co.jp/
*
* This program is free software; you can redistribute it and/or
* modify it under the terms of the GNU General Public License
* as published by the Free Software Foundation; either version 2
* of the License, or (at your option) any later version.
*
* This program is distributed in the hope that it will be useful,
* but WITHOUT ANY WARRANTY; without even the implied warranty of
* MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
* GNU General Public License for more details.
*
* You should have received a copy of the GNU General Public License
* along with this program; if not, write to the Free Software
* Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA 02111-1307, USA.
*/
*}-->
<!--▼CONTENTS-->
<div id="mypagecolumn">
<h2 class="title"><!--{$tpl_title|h}--></h2>
<!--{include file=$tpl_navi}-->
<div id="mycontents_area">
<h3><!--{$tpl_subtitle|h}--></h3>
<form name="form1" method="post" action="?">
<input type="hidden" name="<!--{$smarty.const.TRANSACTION_ID_NAME}-->" value="<!--{$transactionid}-->" />
<input type="hidden" name="mode" value="confirm" />
<div id="complete_area">
<div class="message">会員を退会された場合には、現在保存されている購入履歴や、<br />
お届け先などの情報は、すべて削除されますがよろしいでしょうか?</div>
<div class="message_area">
<p>退会手続きが完了した時点で、現在保存されている購入履歴や、<br />
お届け先等の情報はすべてなくなりますのでご注意ください。</p>
<div class="btn_area">
<ul>
<li>
<input type="image" onmouseover="chgImgImageSubmit('<!--{$TPL_URLPATH}-->img/button/btn_refuse_on.jpg',this);" onmouseout="chgImgImageSubmit('<!--{$TPL_URLPATH}-->img/button/btn_refuse.jpg',this);" src="<!--{$TPL_URLPATH}-->img/button/btn_refuse.jpg" alt="会員退会を行う" name="refusal" id="refusal" />
</li>
</ul>
</div>
</div>
</div>
</form>
</div>
</div>
<!--▲CONTENTS-->
僕のほうで使ったものです。
----------------
何分知識が浅いですが・・・
出来得る限り協力したいと思っています