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| <script type="text/javascript">
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<p> </p>
<p>* Champ requis</p>
<form method="post" action="http://www.multi-grafe.com/autosphere/send-fr.asp" onSubmit="toggleDisplay(false, 'sub2', 'sub3', 'sub4', 'sub5', 'sub6', 'sub7', 'sub1', 'sub8');replaceSpec(Texte)" name="Contact">
<fieldset class="fieldset-01"><legend><span style="display: none" id="1272986600670S"> </span>S'il vous plaît m'inscrire ou renouveler mon abonnement à la revue ci-après:</legend>
<ul>
<li><label>Carcare Business </label> <input type="radio" onclick="toggleDisplay(true, 'sub1', 'sub8');toggleDisplay(false, 'sub2', 'sub3', 'sub4', 'sub5', 'sub6', 'sub7')" name="choix" value="1" /></li>
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<li><label>Le Garagiste</label> <input type="radio" onclick="toggleDisplay(true, 'sub4', 'sub8');toggleDisplay(false, 'sub2', 'sub3', 'sub1', 'sub5', 'sub6', 'sub7')" name="choix" value="4" /></li>
<li><label>Le Carrossier</label> <input type="radio" onclick="toggleDisplay(true, 'sub5', 'sub8');toggleDisplay(false, 'sub2', 'sub3', 'sub4', 'sub1', 'sub6', 'sub7')" name="choix" value="5" /></li>
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</ul>
</fieldset> <fieldset class="fieldset-02"><legend>Informations Générales</legend>
<ul>
<table border="0">
<tbody>
<tr>
<td>
<li><label>* Prénom: </label><input name="firstName" type="text" /></li>
</td>
<td>
<li><label>* Nom: </label><input name="name" type="text" /></li>
</td>
</tr>
<tr>
<td>
<li><label>* Adresse: </label><input name="address" type="text" /></li>
</td>
<td>
<li><label>* Ville: </label><input name="city" type="text" /></li>
</td>
</tr>
<tr>
<td>
<li><label>* Province: </label><input name="province" type="text" /></li>
</td>
<td>
<li><label>* Code postal: </label><input name="postalCode" type="text" /></li>
</td>
</tr>
<tr>
<td>
<li><label>Téléphone: </label><input name="phone" type="text" /></li>
</td>
<td>
<li><label>Télécopieur: </label><input name="fax" type="text" /></li>
</td>
</tr>
<tr>
<td>
<li><label>* Courriel: </label><input id="email" name="email" type="text" /></li>
</td>
<td>
<li><label style="width: 213px; height: 22px">Couleur de votre véhicule:</label> <select name="colors">
<option value="choix" selected="selected"></option>
<option value="Rouge">Rouge</option>
<option value="Vert">Vert</option>
<option value="Jaune">Jaune</option>
<option value="Noir">Noir</option>
<option value="Blanc">Blanc</option>
<option value="Bleu">Bleu</option>
<option value="Orange">Orange</option>
<option value="Beige">Beige</option>
<option value="Gris / Argent">Grey / Silver</option>
<option value="Or">Or</option>
<option value="Bronze">Bronze</option>
</select></li>
</td>
</tr>
<tr>
<td colspan="2">
<li><label>* Compagnie: </label><input name="company" type="text" /></li>
</td>
</tr>
<tr>
<td colspan="2">
<li><label>Titre/Occupation: </label><select name="occupation">
<option value="" selected="selected"></option>
<option value="(1) Administrateur et proprietaire">(1) Administrateur et proprietaire</option>
<option value="(2) Gestion">(2) Gestion</option>
<option value="(3) Ventes">(3) Ventes</option>
<option value="(4) Formation">(4) Formation</option>
<option value="(5) Service et réparations ">(5) Service et réparations</option>
<option value="(6) Autre">Autre</option>
</select> <input id="specify" name="specify" type="text" /></li>
</td>
</tr>
</tbody>
</table>
</ul>
</fieldset>
<ol id="sub1"><fieldset class="fieldset-03"><legend>Please indicate your company's line of business</legend>
<p><label>* Please select: </label><select id="business_ccb" name="business_ccb">
<option value="" selected="selected"></option>
<option value="(1a) General Service and Repair Shops - Chain">(1a) General Service and Repair Shops - Chain</option>
<option value="(1b) General Service and Repair Shops - Independent">(1b) General Service and Repair Shops - Independent</option>
<option value="(2a) Specialized Service and Repair Shops - Chain">(2a) Specialized Service and Repair Shops - Chain</option>
<option value="(2b) Specialized Service and Repair Shops - Independent">(2b) Specialized Service and Repair Shops - Independent</option>
<option value="(2c) Specialized Service and Repair Shops - Specify">(2c) Specialized Service and Repair Shops - Specify</option>
<option value="(3) Vehicle Wholesalers and Jobbers">(3) Vehicle Wholesalers and Jobbers</option>
<option value="(4) Manufacturers and Distributors">(4) Manufacturers and Distributors</option>
<option value="(5) Car and Truck Dealers">(5) Car and Truck Dealers</option>
<option value="(6) Fleet with Repair Facilities">(6) Fleet with Repair Facilities</option>
<option value="(7) Automotive training">(7) Automotive training</option>
<option value="(8) Other allied to the Field">(8) Other allied to the Field</option>
</select> <input id="specify_ccb" name="specify_ccb" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-04"><legend>QUESTIONNAIRE</legend>
<p><label>* Number of enployees ? </label><select id="employees_ccb" onblur="employees_ccbcheck()" name="employees_ccb">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 and more</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Number of service bays ? </label><select id="bays_ccb" onblur="bays_ccbcheck()" name="bays_ccb">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 and more</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* How much do you invest in training annually ? </label><select id="training_ccb" onblur="training_ccbcheck()" name="training_ccb">
<option value="" selected="selected"></option>
<option value="$0-500">$0-500</option>
<option value="$501-2000">$501-2000</option>
<option value="$2001 and over">$2001 and over</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* How much do you invest in tools & equipment annually ? </label><select id="equipment_ccb" onblur="equipment_ccbcheck()" name="equipment_ccb">
<option value="" selected="selected"></option>
<option value="$0-5000">$0-5000</option>
<option value="$5001-15 000">$5001-15 000</option>
<option value="$15 001 and over">$15 001 and over</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* How many people have access to your magazine? </label><input id="magazine_ccb" onblur="magazines_ccbcheck()" name="magazine_ccb" type="text" /></p>
<p><label>* Comments </label><textarea id="comment_ccb" cols="30" name="comment_ccb"></textarea></p>
</fieldset> </ol>
<ol id="sub2"><fieldset class="fieldset-05"><legend>Please indicate your company's line of business</legend>
<p><label>* Please select: </label><select id="business_tire" name="business_tire">
<option value="" selected="selected"></option>
<option value="(1) Tire Dealers, Wholesalers, and Distributors">(1) Tire Dealers, Wholesalers, and Distributors</option>
<option value="(2) General Service and Repair Shops">(2) General Service and Repair Shops</option>
<option value="(3) Specialized Service and Repair Shops">(3) Specialized Service and Repair Shops</option>
<option value="(4) Car and Truck Dealer">(4) Car and Truck Dealer</option>
<option value="(5) Fleet">(5) Fleet</option>
<option value="(6) Other allied to the Field">(6) Other allied to the Field"</option>
</select> <input id="specify_tire" name="specify_tire" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-06"><legend>QUESTIONNAIRE</legend>
<p><label>* Number of enployees ? </label><select id="employees_tire" name="employees_tire">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 and more</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Number of service bays ? </label><select id="bays_tire" name="bays_tire">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 and more</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* What percentage of your sales is related to tire ? </label><select id="sales_tire" name="sales_tire">
<option value="" selected="selected"></option>
<option value="1-20%">1-20%</option>
<option value="21-50%">21-50%</option>
<option value="51-100%">51-100%</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* How much do you invest in tools & equipment per year ? </label><select id="equipment_tire" name="equipment_tire">
<option value="" selected="selected"></option>
<option value="$0-5000">$0-5000</option>
<option value="$5001-15 000">$5001-15 000</option>
<option value="$15 001 and over">$15 001 and over</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* How many people have access to your magazine? </label><input id="magazine_tire" name="magazine_tire" type="text" /></p>
<p><label>* Comments </label><textarea id="comment_tire" cols="30" name="comment_tire"></textarea></p>
</fieldset> </ol>
<ol id="sub3"><fieldset class="fieldset-07"><legend>Please indicate your company's line of business</legend>
<p><label>* Please select: </label><select id="business_fleet" name="business_fleet">
<option value="" selected="selected"></option>
<option value="(1a) Corporate and Commercial Fleets - Construction">(1a) Corporate and Commercial Fleets - Construction</option>
<option value="(1b) Corporate and Commercial Fleets - Manufacturing Industries and Transformation">(1b) General Service and Repair Shop - Manufacturing Industries and Transformation</option>
<option value="(1c) Corporate and Commercial Fleets - Energy and Telecommunications">(1c) General Service and Repair Shop - Energy and Telecommunications</option>
<option value="(1d) Corporate and Commercial Fleets - Wholesalers and Retail Stores">(1d) General Service and Repair Shop - Wholesalers and Retail Stores</option>
<option value="(1e) Corporate and Commercial Fleets - Transportation, Storage and Courier">(1e) General Service and Repair Shop - Transportation, Storage and Courier</option>
<option value="(1f) Corporate and Commercial Fleets - Agriculture, Forest and Mines">(1f) General Service and Repair Shop - Agriculture, Forest and Mines</option>
<option value="(1g) Corporate and Commercial Fleets - Service and Consultation">(1g) General Service and Repair Shop - Service and Consultation</option>
<option value="(1g) Corporate and Commercial Fleets - Other (Specify)">(1g) General Service and Repair Shop - Other (Specify)</option>
<option value="(2a) Governement and Utilities - Federal">(2a) Governement and Utilities - Federal</option>
<option value="(2b) Governement and Utilities - Provincial">(2b) Governement and Utilities - Provincial</option>
<option value="(2c) Governement and Utilities - Municipalities">(2c) Governement and Utilities - Municipalities</option>
<option value="(2d) Governement and Utilities - Utilities">(2d) Governement and Utilities - Utilities</option>
<option value="(3a) Leasing and Rental - Fleet lessors">(3A) Leasing and Rental - Fleet lessors</option>
<option value="(3a) Leasing and Rental - Short-term Rental">(3A) Leasing and Rental - Short-term Rental</option>
<option value="(4) Fleet Maintenance">(4) Fleet Maintenance</option>
<option value="(5) Car and Truck Dealers">(5) Car and Truck Dealers</option>
<option value="(8) Other allied to the Field">(4) Other allied to the Field"</option>
</select> <input id="specify_fleet" name="specify_fleet" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-08"><legend>QUESTIONNAIRE</legend>
<p><label>* Number of enployees ? </label><select id="employees_fleet" name="employees_fleet">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 and more</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Number of vehicles in your fleet ? </label><select id="vehicule_fleet" name="vehicule_fleet">
<option value="" selected="selected"></option>
<option value="0-5">0-5</option>
<option value="6-20">6-20</option>
<option value="21 and more">21 and more</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Percentage of cars (versus trucks) in your fleet ? </label><input id="truckvscars_fleet" name="truckvscars_fleet" type="text" /></p>
<p><label>* Percentage of vehicles in your fleet changed yearly ? </label><input id="pc_fleet" name="pc_fleet" type="text" /></p>
<p><label>* Is the enviromental footprint important to your organization ? </label><select id="enviromental_fleet" name="enviromental_fleet">
<option value="" selected="selected"></option>
<option value="not important">not important</option>
<option value="somewhat important">somewhat important</option>
<option value="very important">very important</option>
</select></p>
<p><label>* How many people have access to your magazine?</label><input id="magazine_fleet" name="magazine_fleet" type="text" /></p>
<p><label>* Comments </label><textarea id="comment_fleet" cols="30" name="comment_fleet"></textarea></p>
</fieldset> </ol>
<ol id="sub4"><fieldset class="fieldset-09"><legend>Veuillez indiquer votre secteur d'activité</legend>
<p><label>* Selectionner: </label><select id="business_lg" name="business_lg">
<option value="" selected="selected"></option>
<option value="(1a) Centres de service et de reparations generales - Chaine">(1a) Centres de service et de reparations generales- Chaine</option>
<option value="(1b) Centres de service et de reparations generales- Independant">(1b) Centres de service et de reparations generales- Independent</option>
<option value="(2a) Centres de service et de reparations specialisees- Chaine">(2a) Centres de service et de reparations specialisees - Chaine</option>
<option value="(2b) Centres de service et de reparations specialisees- Independant">(2b) Centres de service et de reparations specialisees- Independent</option>
<option value="(2c) Centres de service et de reparations specialisees - Autre (Preciser)">(2c) Centres de service et de reparations specialisees - Autre (Preciser)</option>
<option value="(3) Grossistes et revendeurs de vehicules">(3) Grossistes et revendeurs de vehicules</option>
<option value="(4) Manufacturiers et distributeurs">(4) Manufacturiers et distributeurs</option>
<option value="(5) Concessionnaires automobiles et camions">(5) Concessionnaires automobiles et camions</option>
<option value="(6) Parcs avec installation de reparations">(6) Parcs avec installation de reparations</option>
<option value="(7) Centres de formation automobile">(7) Centres de formation automobile</option>
<option value="(8) Autres relies à l'industrie (Preciser)">(4) Autres relies à l'industrie (Preciser)</option>
</select> <input id="specify_lg" name="specify_lg" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-10"><legend>QUESTIONNAIRE</legend>
<p><label>* Nombre d'employés ? </label><select id="employees_lg" name="employees_lg">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 et plus">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Nombre d'aires de service ? </label><select id="bays_lg" name="bays_lg">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 et plus">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Quel est votre budget annuel de formation ? </label><select id="formation_lg" name="formation_lg">
<option value="" selected="selected"></option>
<option value="$0-500">$0-500</option>
<option value="$501-2000">$5001-2000</option>
<option value="$2001 et plus">$2001 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Quelle est la somme investie annuellement pour les outils et l'équipement ? </label><select id="equipment_lg" name="equipment_lg">
<option value="" selected="selected"></option>
<option value="$0-5000">$0-5000</option>
<option value="$5001-15 000">$5001-15 000</option>
<option value="$15 001 et plus">$15 001 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Combien de personnes ont accèes a votre magazine ? </label><input id="magazine_lg" name="magazine_lg" type="text" /></p>
<p><label>* Commentaires </label><textarea id="comment_lg" cols="30" name="comment_lg"></textarea></p>
</fieldset> </ol>
<ol id="sub5"><fieldset class="fieldset-11"><legend>Veuillez indiquer votre secteur d'activité</legend>
<p><label>* Selectionner: </label><select id="business_lc" name="business_lc">
<option value="" selected="selected"></option>
<option value="(1a) Carrosserie - Chaine">(1a) Carrosserie - Chaine</option>
<option value="(1b) Carrosserie - Independant">(1b) Carrosserie - Independant</option>
<option value="(2) Centres de service et de reparations specialisees(Preciser)">(2) Centres de service et de reparations specialisees (Preciser)</option>
<option value="(3) Assurance">(3) Assurance</option>
<option value="(4) Concessionaires automobiles et camions ">(4) Concessionaires automobiles et camions</option>
<option value="(5) Parcs automobiles">(5) Parcs automobiles</option>
<option value="(6) Ventes au detail et grossistes">(6) Ventes au detail et grossistes</option>
<option value="(7) Manufacturiers et distributeurs">(7) Manufacturiers et distributeurs</option>
<option value="(8) Centres de formation">(7) Centres de formation</option>
<option value="(9) Autre relies a l'industrie">(4) Autre relies a l'Industrie"</option>
</select> <input id="specify_lc" name="specify_lc" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-12"><legend>QUESTIONNAIRE</legend>
<p><label>* Nombre d'employés ? </label><select id="employees_lc" name="employees_lc">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Nombre de postes de travail ? </label><select id="bays_lc" name="bays_lc">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and More">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Quel est votre budget annuel de formation ? </label><select id="formation_lc" name="formation_lc">
<option value="" selected="selected"></option>
<option value="$0-500">$0-500</option>
<option value="$501-2000">$501-2000</option>
<option value="$2001 and over">$2001 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Quelle est la somme investie annuellement pour les outils et l'équipement ? </label><select id="equipment_lc" name="equipment_lc">
<option value="" selected="selected"></option>
<option value="$0-5000">$0-5000</option>
<option value="$5001-15 000">$501-15 000</option>
<option value="$15 001 and over">$15 001 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Combien de personnes ont accèes a votre magazine ? </label><input id="magazine_lc" name="magazine_lc" type="text" /></p>
<p><label>* Commentaires </label><textarea id="comment_lc" cols="30" name="comment_lc"></textarea></p>
</fieldset> </ol>
<ol id="sub6"><fieldset class="fieldset-13"><legend>Veuillez indiquer votre secteur d'activité</legend>
<p><label>* Selectionner: </label><select id="business_pneu" name="business_pneu">
<option value="" selected="selected"></option>
<option value="(1) Detaillants, distributeurs et manufacturiers de pneus">(1) Detaillants, distributeurs et manufacturiers de pneus</option>
<option value="(2) Centre de Service et de Reparation Generale">(2) Centre de Service et de Reparation Generale</option>
<option value="(3) Centre de Service et de Reparation Specialisee">(3) Centre de Service et de Reparation Specialisee</option>
<option value="(4) Concessionaires automobiles et camions">(4) Concession de Voitures et de Camions</option>
<option value="(5) Parcs de vehicules">(5) Parc Automobile</option>
<option value="(6) Autre relies a l'industrie">(6) Autre relies a l'industrie</option>
</select> <input id="specify_pneu" name="specify_pneu" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-14"><legend>QUESTIONNAIRE</legend>
<p><label>* Nombre d'employés ? </label><select id="employees_pneu" name="employees_pneu">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Nombre d'aires de service ? </label><select id="bays_pneu" name="bays_pneu">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Quel est le % de vos ventes relié aux pneus ? </label><select id="ventes_pneu" name="ventes_pneu">
<option value="" selected="selected"></option>
<option value="1-20%">1-20%</option>
<option value="21-50%">21-50%</option>
<option value="51-100%">51-100%</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Quelle est la somme investie annuellement pour les outils et l'équipement ? </label><select id="equipment_pneu" name="equipment_pneu">
<option value="" selected="selected"></option>
<option value="$0-5000">$0-5000</option>
<option value="$5001-15 000">$5001-15 000</option>
<option value="$15 001 and over">$15 001 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Combien de personnes ont accès à votre magazine ? </label><input id="magazine_pneu" name="magazine_pneu" type="text" /></p>
<p><label>* Comments </label><textarea id="comment_pneu" cols="30" name="comment_pneu"></textarea></p>
</fieldset> </ol>
<ol id="sub7"><fieldset class="fieldset-15"><legend>Veuillez indiquer votre secteur d'activité</legend>
<p><label>* Selectionnez: </label><select id="business_cam" name="business_cam">
<option value="" selected="selected"></option>
<option value="(1a) Parcs de vehicules, commerciaux et administratifs - Construction">(1a) Parcs de vehicules, commerciaux et administratifs - Construction</option>
<option value="(1b) Parcs de vehicules, commerciaux et administratifs - Industries manufacturières et de transformation">(1b) Parcs de vehicules, commerciaux et administratifs - Industries manufacturieres et de transformation</option>
<option value="(1c) Parcs de vehicules, commerciaux et administratifs - Énergie et télécommunications">(1c) Parcs de vehicules, commerciaux et administratifs - Energie et telecommunications</option>
<option value="(1d) Parcs de vehicules, commerciaux et administratifs - Grossistes et vente au dtail">(1d) Parcs de vehicules, commerciaux et administratifs - Grossistes et vente au dtail</option>
<option value="(1e) Parcs de vehicules, commerciaux et administratifs - Transport de biens, entreposage et messagerie">(1e) Parcs de vehicules, commerciaux et administratifs - Transport de biens, entreposage et messagerie</option>
<option value="(1f) Parcs de vehicules, commerciaux et administratifs - Agriculture, forets et mines">(1f) Parcs de véhicules, commerciaux et administratifs - Agriculture, forets et mines</option>
<option value="(1g) Parcs de vehicules, commerciaux et administratifs - Service et consultation">(1g) Parcs de vehicules, commerciaux et administratifs - Service et consultation</option>
<option value="(1g) Parcs de vehicules, commerciaux et administratifs - Autres (Preciser)">(1g) Parcs de véhicules, commerciaux et administratifs - Autres (Preciser)</option>
<option value="(2a) Gouvernement et services parapublics - Federal">(2a) Gouvernement et services parapublics - Federal</option>
<option value="(2b) Gouvernement et services parapublics - Provincial">(2b) Gouvernement et services parapublics - Provincial</option>
<option value="(2c) Gouvernement et services parapublics - Municipal">(2c) Gouvernement et services parapublics - Municipal</option>
<option value="(2d) Gouvernement et services parapublics - Services parapublics">(2d) Gouvernement et services parapublics - Services parapublics</option>
<option value="(3a) Credit-bail et location - Credit-bail a moyen et long terme">(3a) Credit-bail et location - Credit-bail a moyen et long terme</option>
<option value="(3b) Credit-bail et location - Location à court terme">(3b) Credit-bail et location - Location a court terme</option>
<option value="(4) Service et reparation pour parcs de vehicules">(4) Service et reparation pour parcs de vehicules</option>
<option value="(5) Concessionaires automobiles et camions">(5) Concessionaires automobiles et camions</option>
<option value="(6) Other allied to the Field">(6) Other allied to the Field"</option>
</select> <input id="specify_cam" name="specify_cam" type="text" /></p>
</fieldset> <br />
<fieldset class="fieldset-16"><legend>QUESTIONNAIRE</legend>
<p><label>* Nombre d'employés ? </label><select id="employees_cam" name="employees_cam">
<option value="" selected="selected"></option>
<option value="1-3">1-3</option>
<option value="4-10">4-10</option>
<option value="11 and more">11 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Nombre de véhicules de votre parc ? </label><select id="parc_cam" name="parc_cam">
<option value="" selected="selected"></option>
<option value="0-5">0-5</option>
<option value="6-20">6-20</option>
<option value="21 and more">21 et plus</option>
<option value="N/A">N/A</option>
</select></p>
<p><label>* Pourcentage d'automobiles vs camions de votre parc ?</label> <input id="truckvscar_cam" name="truckvscar_cam" type="text" /></p>
<p><label>* Pourcentage de véhicules de votre parc remplacés annuellement ?</label> <input id="vehicule_cam" name="vehicule_cam" type="text" /></p>
<p><label>* Pourcentage d'automobiles vs camions de votre parc ?</label> <input id="truckvscar_cam" name="truckvscar_cam" type="text" /></p>
<p><label>* Pourcentage de véhicules de votre parc remplacés annuellement ?</label> <input id="vehicule_cam" name="vehicule_cam" type="text" /></p>
<p><label>* L'empreinte ecologique est-elle importante pour l'entreprise ? </label><select id="eco_cam" name="eco_cam">
<option value="" selected="selected"></option>
<option value="Pas important">Pas importantt</option>
<option value="quelque peu important">quelque peu important</option>
<option value="tres important">tres important</option>
</select></p>
<p><label>* Combien de personnes ont accès à votre magazine ? </label><input id="magazine_cam" name="magazine_cam" type="text" /></p>
<p><label>* Comments </label><textarea id="comment_cam" cols="30" name="comment_cam"></textarea></p>
</fieldset> </ol>
<ol id="sub8">
<div align="center"><input id="submit" type="submit" name="submit" value="Envoyer" /> <input id="reset" type="reset" name="reset" value="Effacer" /></div>
</ol>
</form>
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