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| <form name="inscription">
<div class="qcm" id="questions0">
<li>Nom............ <input id="NomDeFamille" type="text" name="champ1" /> ...Prenom ..........<input id="Prenom" class="1er" type="text" /></li><br>
<li>Courriel....... <input class="1er" id="courriel" type="text" /> ...Telephone...... <input id="Tel" class="1er" type="text" /></li><br>
<li>Rue............. <input id="rue" class="1er" type="text" /> ...Numero.......... <input id="Numero" class="1er" type="text" /></li><br>
<li>Code Postal <input id="CodePostal" class="1er" type="text" /> ...Ville................ <input id="Ville" class="1er" type="text" /></li><br>
<li>Entreprise ...<input type="text" class="1er" id="Entreprise" /> ...Mot de Passe. <input id="motdepasse" class="mpd" type="password" /></li>
<input type="radio" name="question0" id="reponse0a" >
</div>
</form> |