Subversion Repositories Applications.annuaire

Rev

Rev 154 | Rev 190 | Go to most recent revision | Details | Compare with Previous | Last modification | View Log | RSS feed

Rev Author Line No. Line
4 aurelien 1 
<h2> Inscription </h2>
21 aurelien 2 
 
3 
<p> <h3> Devenez Tela botaniste <br />
4 
	Rejoignez le réseau de la botanique francophone</h3>
5 
</p>
4 aurelien 6 
<div id="contenu">
103 aurelien 7 
	<form method="post" id="inscription" action="<?php $url_form = clone($base_url);
4 aurelien 8 
				$url_form->setVariableRequete('m','annuaire_ajout_inscription');
9 
				echo $url_form;
10 
	 		?>">
11 
			<div><?=$champs['nom'] ?></div><br />
12 
 
13 
			<div><?=$champs['prenom'] ?></div><br />
14 
 
15 
			<div><?=$champs['mail'] ?></div><br />
16 
 
17 
			<div><?=$champs['pass'] ?></div><br />
18 
 
19 
			<div><?=$champs['pays'] ?></div><br />
20 
 
39 aurelien 21 
			<div><?=$champs['ville'] ?></div><br />
22 
 
4 aurelien 23 
			<div><?=$champs['code_postal'] ?></div><br />
7 aurelien 24 
 
4 aurelien 25 
			<div><?=$champs['experience_bota'] ?></div><br />
26 
 
27 
			<div><?=$champs['lettre_actu'] ?></div><br />
28 
 
159 aurelien 29 
			<div> J'ai pris connaissance des <?=$champs['conditions_utilisation'] ?></div> <br />
4 aurelien 30 
 
7 aurelien 31 
			<input type="hidden" name="aa_id_annuaire" id="aa_id_annuaire" value="<?=$aa_id_annuaire ?>">
4 aurelien 32 
 
33 
		<input type="submit" value="Valider" />
34 
	</form>
35 
</div>