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<form name="formulaire_encodage" action="encodage_clients.php" method="post">
<br>
<input name="edit_id" type="hidden" />
<input name="edit_codeaffiliation" type="hidden" />
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:35px; color:#000000;">Code consultant</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:35px;"><input name="edit_codeconsultant" type="text" size="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:70px; color:#000000;">Nom</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:70px;"><input name="edit_nom" type="text" size="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:105px; color:#000000;">Prénom</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:105px;"><input name="edit_prenom" type="text" size="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:140px; color:#000000;">Adresse</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:140px;"><input name="edit_adresse" type="text" size="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:175px; color:#000000;">Code postal</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:175px;"><input name="edit_codepostal" type="text" size="2" maxlength="4" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:153px; margin-top:175px; color:#000000;">Localité</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:208px; margin-top:175px;"><input name="edit_localite" type="text" size="24" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:245px; color:#000000;">Téléphone</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:245px;"><input name="edit_telephone" type="text" size="12" maxlength="12" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:208px; margin-top:245px; color:#000000;">Gsm</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:246px; margin-top:245px;"><input name="edit_gsm" type="text" size="12" maxlength="12" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:280px; color:#000000;">Email</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:280px;"><input name="edit_email" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:315px; color:#000000;">Login</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:315px;"><input name="edit_login" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:350px; color:#000000;">pass_md5</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:350px;"><input name="edit_pass_md5" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:385px; color:#000000;">Date entrée</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:385px;"><input name="edit_dateentree" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:420px; color:#000000;">Echéance</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:420px;"><input name="edit_echeance" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:455px; color:#000000;">Acces au forum</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:455px;"><input name="edit_accesforum" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:490px; color:#000000;">Nbre de questions</span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:103px; margin-top:490px;"><input name="edit_questions" type="text" size="45" maxlength="45" style="font-family:Arial, Helvetica, sans-serif; font-size:12px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:18px; margin-top:525px; color:#000000;"><input name="bouton_envoyer" type="submit" value="Envoyer" style="font-family:Arial, Helvetica, sans-serif; width:85px; height: 22px; background-color:#cccccc; color:#000000; font-weight:bold; cursor:pointer; border:1px solid #000000; padding-bottom:2px;"/></span>
<span style="font-family:Arial, Helvetica, sans-serif; font-size:12px; position:absolute; margin-left:108px; margin-top:525px; color:#000000;"><input name="bouton_initialiser" type="reset" value="Initialiser" style="font-family:Arial, Helvetica, sans-serif; width:85px; height: 22px;background-color:#cccccc; color:#000000; font-weight:bold; cursor:pointer; border:1px solid #000000; padding-bottom:2px;"/></span>
</form> |
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