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<form id="contact_form" action="contact.php" method="POST" enctype="multipart/form-data" ><br>
<div >
<label for="prenom" class="col-sm-4" >Prénom</label>
<div class="col-sm-8">
<input id="prenom" class="input" name="prénom" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div >
<label for="email" class="col-sm-4">Nom</label>
<div class="col-sm-8">
<input id="email" class="input" name="nom" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div>
<label for="email" class="col-sm-5">Nom de la société</label>
<div class="col-sm-4" style="margin-left: -12px;">
<input id="email" name="nom_soc" type="text" value="" size="30" /><br /><br />
</div>
</div><br>
<div >
<label for="email" class="col-sm-4">Email</label>
<div class="col-sm-8">
<input id="email" class="input" name="email" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div >
<label for="email" class="col-sm-4">Adresse</label>
<div class="col-sm-8">
<input id="email" class="input" name="adresse" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div ">
<label for="email" class="col-sm-4">Code postal</label>
<div class="col-sm-8">
<input id="email" class="input" name="code postal" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div >
<label for="email" class="col-sm-4">Ville</label>
<div class="col-sm-8">
<input id="email" class="input" name="ville" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div >
<label for="email" class="col-sm-4">Téléphone</label>
<div class="col-sm-8">
<input id="email" class="input" name="email" type="text" value="" size="30" /><br /><br />
</div>
</div>
<div >
<label for="email" class="col-sm-4">Objet</label><br /><br />
<select>
<option>Etre rappelé</option>
<option>Demande d'informations</option>
<option>Demande de démo</option>
</select><br /><br />
</div>
<div >
<label for="message" class="col-sm-4">Message :</label><br />
<div class="col-sm-8">
<textarea id="message" class="input" name="message" rows="7" cols="30"></textarea><br /><br />
</div>
</div>
<input id="submit_button" type="submit" value="Envoyer" />
<br /><br />
<input type="checkbox" name="choix"> <label>Accepter d'être abonné à la newsletter.</label><br /><br />
</div>
</form> |
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