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<script src="<?= $base_url_styles ?>squelettes/scripts/jquery.js" type="text/javascript"></script>
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<script src="<?= $base_url_styles ?>squelettes/scripts/inscription.js" type="text/javascript"></script>
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<h2> Inscription </h2>
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<p> <h3> Devenez Tela botaniste <br />
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Rejoignez le réseau de la botanique francophone</h3>
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</p>
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aurelien |
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<div id="form_inscription">
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<form method="post" id="inscription" action="<?php $url_form = clone($base_url);
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$url_form->setVariableRequete('m','annuaire_ajout_inscription');
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echo $url_form;
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?>">
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<div><?=$champs['nom'] ?></div><br />
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<div><?=$champs['prenom'] ?></div><br />
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<div><?=$champs['mail'] ?></div><br />
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<div><?=$champs['pass'] ?></div><br />
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<div><?=$champs['pays'] ?></div><br />
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23 |
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<div><?=$champs['ville'] ?></div><br />
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<div><?=$champs['code_postal'] ?></div><br />
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27 |
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<div><?=$champs['experience_bota'] ?></div><br />
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29 |
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<div><?=$champs['lettre_actu'] ?></div><br />
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<div><label> J'ai pris connaissance des </label> <?=$champs['conditions_utilisation'] ?></div> <br />
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<input type="hidden" name="aa_id_annuaire" id="aa_id_annuaire" value="<?=$aa_id_annuaire ?>">
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<input type="submit" value="Valider" />
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</form>
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</div>
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