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<form method="post" action="<? echo $_SERVER['PHP_SELF']; ?>?nat=<? echo $nat; ?>&lang=<? echo $lang; ?>&r=<? echo $r; ?>">
<label>Profil de contact*</label><input type="text" name="profil" class="form3" size="40" value="<? echo $row_rslistemail["typeprofil"]; ?>"><br />
<label>Téléphone*</label><input type="text" name="telephone" class="form3" size="20" value="<? if (!empty($_POST["telephone"])) {echo stripslashes(htmlentities(trim($_POST["telephone"],ENT_QUOTES))); } ?>"><br />
<label>Email*</label><input type="text" name="email" class="form3" size="40" value="<? if (!empty($_POST["email"])) {echo stripslashes(htmlentities(trim($_POST["email"],ENT_QUOTES))); } ?>"><br />
<label>Commentaire*</label><input type="text" name="commentaire" class="form3" size="40" value="<? if (!empty($_POST["commentaire"])) {echo stripslashes(htmlentities(trim($_POST["commentaire"],ENT_QUOTES))); } ?>"><br />
<? echo "<div class=erreur>".$msg."</div>"; ?>
<input type="image" name="envoyer" src="images/btn_tts-tickets-closed_bg.gif" alt="<? echo TXT_valider; ?>" />
<input type="hidden" name="envoyer" value="envoyer">
<input type="hidden" name="r">
<input type="hidden" name="lang">
</form> |
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