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|
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<head>
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<meta name=Generator content="Microsoft Word 12 (filtered medium)">
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</head>
<body lang=FR link=blue vlink=purple>
<div class=WordSection1>
<p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>Remplissez
ce formulaire avec ce message et renvoyez-le-moi.</span><br>
<w:Sdt ContentLocked="t" SdtGroup="t" ID="1143504283"><br>
<br>
</w:Sdt><w:Sdt ContentLocked="t" SdtGroup="t" ID="1143504284"></w:Sdt><o:p></o:p></p>
<div class=MsoNormal align=center style='text-align:center'>
<hr size=2 width="100%" align=center>
</div>
<p class=MsoNormal><br>
<w:Sdt ContentLocked="t" SdtGroup="t" ID="1143504285"><b>Remarque :</b>
Tapez uniquement dans les zones destinées à la saisie de données. Votre
réponse sera traitée automatiquement. C'est pourquoi il est <b>important</b>
que le formulaire ou le message ne soit <b>pas modifié</b>.<br>
</w:Sdt><br>
<w:Sdt ContentLocked="t" SdtGroup="t" ID="1143504286"><br>
<br>
</w:Sdt><o:p></o:p></p>
<table class=MsoNormalTable border=0 cellspacing=5 cellpadding=0 width="85%"
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name="{3A299120-AED5-4BB6-B014-15000AE6861E}">
<w:Sdt ContentLocked="t" SdtGroup="t" ID="1143504300">
<tr>
<td width="100%" style='width:100.0%;padding:.75pt .75pt .75pt .75pt'><span
style='font-size:12.0pt;font-family:"Times New Roman","serif"'><w:sdtPr></w:sdtPr></span>
<table class=MsoNormalTable border=1 cellpadding=0 width="100%"
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id="_DataElement_" name="_DataElement_">
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><b><span style='font-size:13.5pt;font-family:"Arial","sans-serif";
color:#336699'>Ajouter le formulaire tableau dispo journaliere<o:p></o:p></span></b></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
uniquement dans les zones destinées à la saisie de données. Votre réponse
sera traitée automatiquement. C'est pourquoi il est important que le
formulaire ou le message ne soit pas modifié. Pour plus d'informations sur
le remplissage de ce formulaire, lisez ce qui suit :<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field1><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>jour:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field1}" name="_DataItem_{name:table1field1}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504287">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Entrer
une date, une heure ou une combinaison des deux au format suivant :
28/10/2010 22:19:07<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field2><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>matricule:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field2}" name="_DataItem_{name:table1field2}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504288">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Taper
une valeur numérique.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field3><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>0h00 - 5h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field3}" name="_DataItem_{name:table1field3}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504289">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field4><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>5h30 - 7h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field4}" name="_DataItem_{name:table1field4}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504290">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field5><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>07h30 - 09h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field5}" name="_DataItem_{name:table1field5}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504291">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field6><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>09h30 -11h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field6}" name="_DataItem_{name:table1field6}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504292">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field7><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>11h30 - 13h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field7}" name="_DataItem_{name:table1field7}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504293">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field8><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>13h30 - 15h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field8}" name="_DataItem_{name:table1field8}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504294">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field9><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>15h30 - 17h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field9}" name="_DataItem_{name:table1field9}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504295">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field10><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>17h30 - 19h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field10}" name="_DataItem_{name:table1field10}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504296">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field11><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>19h30 - 21h30:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field11}" name="_DataItem_{name:table1field11}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504297">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field12><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>21h30 - 24h00:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field12}" name="_DataItem_{name:table1field12}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504298">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
Oui ou Non.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
<tr>
<td width="25%" valign=top style='width:25.0%;border:none;padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=MsoNormal><a name=table1field13><span style='font-size:10.0pt;
font-family:"Arial","sans-serif";color:#666666'>mdp:</span></a><span
style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#666666'><o:p></o:p></span></p>
</td>
<td width="75%" style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'
id="_DataItem_{name:table1field13}" name="_DataItem_{name:table1field13}">
<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
width="100%" style='width:100.0%'>
<tr>
<w:Sdt Text="t" ID="1143504299">
<td style='border:solid #999999 1.0pt;background:white;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p><w:sdtPr></w:sdtPr></p>
</td>
</w:Sdt>
</tr>
</table>
</td>
</tr>
<tr>
<td width="25%" style='width:25.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal> <o:p></o:p></p>
</td>
<td width="75%" valign=top style='width:75.0%;border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'>Tapez
toute combinaison de chiffres et de lettres jusqu'à 255 caractères.<o:p></o:p></span></p>
</td>
</tr>
<tr>
<td colspan=2 style='border:none;padding:.75pt .75pt .75pt .75pt'>
<p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial","sans-serif"'> <o:p></o:p></span></p>
</td>
</tr>
</table>
<p class=MsoNormal><o:p></o:p></p>
</td>
</tr>
</w:Sdt>
</table>
<p class=MsoNormal style='margin-bottom:12.0pt'><br>
<b><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>Terminé ?
</span></b><span style='font-size:10.0pt;font-family:"Arial","sans-serif"'>Cliquez
sur Envoyer pour soumettre vos informations.</span><o:p></o:p></p>
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