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<form action="envoiTest.php" method="post" name="formulaire" onSubmit="return (ConForm(this));">
<table width="783" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="4" height="450"> </td>
<td width="773"><fieldset style="border: 1px solid #AFD3F3;background-color:#ffffff;">
<legend style="border: 0px solid #AFD3F3;background-color:#ffffff;font-family:Arial; font-size:16px; color:#155a97;"></legend>
<table width="752" height="112" border="0" cellpadding="0" cellspacing="0">
<tr>
<td colspan="2" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"></td>
<td width="456" colspan="3"></td>
</tr>
<tr>
<td width="206" rowspan="4" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"> </td>
<td width="90" height="21" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;">Company<span class="Style2">*</span> :</td>
<td colspan="3"><input name="company" value="" size="90" type="text" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 12px;border: thin dashed #B5D2E8;background-color:#F0F7FB;" lang="nom:;erreurfond:#E0ECF5;mini:2;maxi:100;type:obligatoire;erreur:- Thank you for completing your company"/></td>
</tr>
<tr>
<td height="21" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;">Tel.<span class="Style2">*</span> :</td>
<td colspan="3"><input name="tel" value="" size="30" type="text" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 11px;border: thin dashed #B5D2E8;background-color:#F0F7FB;" lang="nom:;erreurfond:#E0ECF5;mini:2;maxi:30;type:obligatoire;erreur:- Thank you for completing your tele"/></td>
</tr>
<tr>
<td height="21" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;">E-mail<span class="Style2">*</span> : </td>
<td colspan="3"><input name="mail" type="text" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 11px;border: thin dashed #B5D2E8;background-color:#F0F7FB;" lang="nom:;erreurfond:#E0ECF5;mini:2;maxi:30;type:obligatoire;erreur:- Thank you for completing your tele" value="" size="30" xml:lang="nom:;erreurfond:#E0ECF5;mini:2;maxi:30;type:obligatoire;erreur:- Thank you for completing your tele"/></td>
</tr>
<tr>
<td height="20" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"><em>Country :</em></td>
<td colspan="3" valign="middle" >
</td>
</tr>
<tr>
<td style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"> </td>
<td colspan="4" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"><span class="Style1 Style2">* required fields </span></td>
</tr>
<tr>
<td colspan="5" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"> </td>
</tr>
</table>
<div id="contenu21">
<div id="top_actu_list1" >
<legend style="border: 0px solid #AFD3F3;background-color:#ffffff;font-family:Arial; font-size:16px; color:#155a97;"></legend>
<div id="ajoutSupprimerArticle1"></div>
<div id="contenu23">
<div id="top_actu_list2" >
<br /><br />
<legend style="border: 0px solid #AFD3F3;background-color:#ffffff;font-family:Arial; font-size:16px; color:#155a97;"><strong>test : </strong></legend>
<div class="article2" style="border: thin dashed #0094CC;font-family:Arial; font-size:16px; background-color:#ffffff;">
<table width="742">
<TR>
<TD colspan="10" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 12px;background-color:#ffffff;"></TD>
</TR>
<TR>
<TD colspan="5" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#ffffff;font-size: 12px;background-color:#0095CD;"><div align="center"><strong>taille</strong> </div></TD>
<TD colspan="2" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#ffffff;font-size: 12px;background-color:#0095CD;"><div align="center"><strong>Type </strong> </div></TD>
<TD colspan="3" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#ffffff;font-size: 12px;background-color:#0095CD;"><div align="center"><strong>Materiel </strong></div></TD>
</TR>
<TR>
<TD width="37" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">1</div></TD>
<TD width="38" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">2</div></TD>
<TD width="38" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">3</div></TD>
<TD width="38" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">4</div></TD>
<TD width="38" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">5</div></TD>
<TD width="104" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#EDF8FC;"><div align="center">6</div></TD>
<TD width="103" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#EDF8FC;"><div align="center">7</div></TD>
<TD width="100" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">8</div></TD>
<TD width="94" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">9</div></TD>
<TD width="108" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;background-color:#d9eef7;"><div align="center">10 </div></TD>
</TR>
<TR>
<TD valign="top"><div align="center">
<INPUT type="radio" name="un[]" value="test11"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="un[]" value="test9"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="un[]" value="test8"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="un[]" value="test7"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="un[]" value="test6"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="deux[]" value="test5"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="deux[]" value="test4"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="trois[]" value="test3"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="trois[]" value="test2"/>
</div></TD>
<TD valign="top"><div align="center">
<INPUT type="radio" name="trois[]" value="test1"/>
</div></TD>
</TR>
<TR>
<TD height="97" colspan="10" valign="top" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 9px;"><table >
<tr>
<td height="2" style="font-family: Arial, Helvetica, sans-serif;color:#0095CD;font-size: 12px;"> </td>
<td colspan="3"></td>
</tr>
<tr>
<td width="238" height="21">Others : </td>
<td width="470" colspan="3"><input name="test15[]" value="" size="90" type="text" /></td>
</tr>
<tr>
<td height="21" >Annual consumption : </td>
<td colspan="3"><input name="test16[]" value="" size="90" /></td>
</tr>
<tr>
<td height="21">Part number : </td>
<td colspan="3"><input name="test17[]" value="" size="90" type="text"/></td>
</tr>
</table></TD>
</TR>
</table>
</div>
<div id="ajoutSupprimerArticle2">
<br />
<a href="javascript:;" title="Ajouter un article" class="ajoutArticle2 button blue small2" rel="article">Add </a>
<a href="javascript:;" title="Supprimer un article" class="supprimerArticle2 button blue small2" rel="article">Delete</a>
</div>
<table width="765" height="37" border="0" cellpadding="0" cellspacing="0">
<tr>
<td width="761"> </td>
</tr>
<tr>
<td width="761" colspan="3" style="font-family: Arial, Helvetica, sans-serif;color:#000099;font-size: 12px;"><div align="center"><br />
<input class="button blue small" name="submit" type="submit" value="SUBMIT">
<input class="button blue small" name="reset" type="reset" value="RESET" >
</div>
</form> |
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