|
@@ -28,91 +28,95 @@
|
|
</div>
|
|
</div>
|
|
</div><!-- end of header -->
|
|
</div><!-- end of header -->
|
|
<div class="main">
|
|
<div class="main">
|
|
-
|
|
|
|
-
|
|
|
|
|
|
+ <div class="menu">
|
|
|
|
+ <ul>
|
|
|
|
+ <li><a href="index.html">Accueil</a></li>
|
|
|
|
+ <li><a href="abonnes.html">Nos abonnés</a></li>
|
|
|
|
+ <li><a href="inscription.jsp">Inscription</a></li>
|
|
|
|
+
|
|
|
|
+ </ul>
|
|
|
|
+ </div><!--end menu -->
|
|
<div class="content">
|
|
<div class="content">
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
|
-
|
|
|
|
- </div><!-- end of main div -->
|
|
|
|
- <br>
|
|
|
|
- <h1>Inscription à l'espace microfolies</h1>
|
|
|
|
-
|
|
|
|
-<br>
|
|
|
|
-
|
|
|
|
- <form>
|
|
|
|
- <div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Nom* </label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Prénom*</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Genre*</label>
|
|
|
|
- <div class="col-3">
|
|
|
|
-<select class="form-control" required>
|
|
|
|
- <option>Homme</option>
|
|
|
|
- <option>Femmme</option>
|
|
|
|
- <option>Autre</option>
|
|
|
|
-</select>
|
|
|
|
-</div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Date de naissance*</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="date" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Ville*</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Situation*</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label">Email*</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label" >Téléphone *</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row">
|
|
|
|
- <label class="col-2 col-form-label" >Contact d'urgence* </label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="text" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
-<div class="form-group row" type="text">
|
|
|
|
- <label class="col-2 col-form-label" >Pièce jointe</label>
|
|
|
|
- <div class="col-10">
|
|
|
|
- <input class="form-control" type="file" required>
|
|
|
|
- </div>
|
|
|
|
-</div>
|
|
|
|
- <button type="submit" class="btn btn-primary">Submit</button>
|
|
|
|
-</form>
|
|
|
|
-</body>
|
|
|
|
-</body>
|
|
|
|
- <div class="clear"></div>
|
|
|
|
|
|
+ <header>
|
|
|
|
+ <h4>Inscription à l'espace microfolies</h4>
|
|
|
|
+ </header>
|
|
|
|
+ <main>
|
|
|
|
+ <form>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Nom* </label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Prénom*</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Genre*</label>
|
|
|
|
+ <div class="col-3">
|
|
|
|
+ <select class="form-control" required>
|
|
|
|
+ <option>Homme</option>
|
|
|
|
+ <option>Femmme</option>
|
|
|
|
+ <option>Autre</option>
|
|
|
|
+ </select>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Date de naissance*</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="date" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Ville*</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Situation*</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label">Email*</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label" >Téléphone *</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row">
|
|
|
|
+ <label class="col-2 col-form-label" >Contact d'urgence* </label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="text" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <div class="form-group row" type="text">
|
|
|
|
+ <label class="col-2 col-form-label" >Pièce jointe</label>
|
|
|
|
+ <div class="col-10">
|
|
|
|
+ <input class="form-control" type="file" required>
|
|
|
|
+ </div>
|
|
|
|
+ </div>
|
|
|
|
+ <button type="submit" class="btn btn-primary">Submit</button>
|
|
|
|
+ </form>
|
|
|
|
+ </main>
|
|
|
|
+ </div><!-- end of content div -->
|
|
|
|
+ </div><!-- end of main div -->
|
|
|
|
+ <br>
|
|
|
|
+ <div class="clear"></div>
|
|
<div class="footer"></div>
|
|
<div class="footer"></div>
|
|
</div>
|
|
</div>
|
|
|
|
+</body>
|
|
|
|
+
|
|
</html>
|
|
</html>
|
|
|
|
|
|
|
|
|