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72 lines
2.1 KiB
72 lines
2.1 KiB
<!DOCTYPE html>
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<html>
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<head>
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<link rel="stylesheet" href="zelda.css" type="text/css">
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<meta charset="utf-8">
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<meta name="viewport" content="width=device-width, initial-scale=1">
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<title>Contact</title>
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</head>
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<body>
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<a class="button" href="index.html">Home</a>
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<h1>Formulaire de contact</h1>
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<form action="contact.php" method="POST">
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<label for="nom">Nom : </label>
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<input type="text" required name="nom" id="nom"/>
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<br/>
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<br/>
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<label for="prénom">Prénom : </label>
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<input type="text" name="prénom" id="prénom"/>
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<br/>
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<br/>
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<label for="mail">Email : </label>
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<input type="email" required name="mail" id="mail"/>
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<br/>
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<br/>
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<label for="tel">Téléphone : </label>
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<input type="tel" name="tel" id="tel"/>
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<br/>
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<br/>
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<label>Motif de contact :</label>
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<select name="mode">
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<option value="feedback" id="feedback" name="feedback">Feedback</option>
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<option value="plainte" id="plainte" name="plainte">Plainte</option>
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<option value="bug" id="bug" name="bug">Report un bug</option>
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<option value="suggestion" id="suggestion" name="suggestion">Suggestion</option>
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<option value="autre" id="autre" name="autre">Autre</option>
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</select>
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<br/>
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<br/>
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<label for="jour">Jour de préférence : </label>
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<input type="date" id="date" name="date">
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<br/>
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<br/>
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<label for="time">Horaire de préférence : </label>
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<input type="time" id="time" name="time">
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<br/>
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<br/>
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<label>S'agit-il de votre première demande? :</label>
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<label for="oui"> Oui</label>
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<input type="radio" name="choix"/>
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<label for="non"> Non</label>
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<input type="radio" name="choix">
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<br>
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<br>
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<p>
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<textarea required cols="55" rows="17">Votre message ici</textarea>
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</p>
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<label>Souhaitez-vous recevoir des informations par mail ?</label>
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<select name="infos">
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<option value="Oui" id="Oui">Oui</option>
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<option value="Non" id="Non">Non</option>
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</select>
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<br/>
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<br/>
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<input required type="submit" value="Valider"/>
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<input required type="reset" value="Reset"/>
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</form>
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</body>
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</html> |