generated from Templates_CodeFirst/templateHtmlCss
You can not select more than 25 topics
Topics must start with a letter or number, can include dashes ('-') and can be up to 35 characters long.
70 lines
2.8 KiB
70 lines
2.8 KiB
<!DOCTYPE html>
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<html>
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<head>
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<meta charset="Utf-8">
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<link type="text/css" rel="stylesheet" href="Css.css">
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<link rel="stylesheet" type="text/css" href="impression.css" media="print">
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</head>
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<body>
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<nav>
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<ul>
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<li><a href="TP1Web.html">Accueil</a></li>
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<li><a href="page_web_4.html">Mes activités</a></li>
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<li><a href="page_web_3.html">Mon parcours scolaire</a></li>
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<li class="deroul"><a>Médias</a>
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<ul class="sousli">
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<li><a href="page_web_5.html">Ma page image</a></li>
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<li><a href="page_web_6.html">Ma page vidéo</a></li>
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</ul>
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</li>
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<li><a href="meContacter.html">Me contacter</a></li>
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</ul>
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</nav>
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<form action="php.php" method="post">
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<div>
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<label for="prenom">Votre prénom</label>
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<input id="prenom" placeholder="Franck" type="text" required>
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</div>
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<div>
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<label for="mail">Votre adresse mail</label>
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<input id="mail" placeholder="mailexemple@monmail.com" type="email" required>
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</div>
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<div>
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<label for="nom">Votre nom</label>
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<input id="nom" placeholder="Dubois" type="text" required>
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</div>
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<div>
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<label for="tel">Votre numéro de téléphone(facultatif)</label>
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<input id="tel" placeholder="0708090405" type="tel">
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</div>
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<div>
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<label for="Motif">Motif de contact</label>
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<select name="Motif" id="Motif" required>
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<option value="rt">Retour technique</option>
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<option value="co">Collaboration</option>
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<option value="au">Autre</option>
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</select>
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</div>
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<div>
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<label for="date">Date du créneau</label>
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<input id="date" type="datetime-local" placeholder="1999-01-01"required/>
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</div>
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<div>
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<span>Première demande </span>
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<input type="radio" id="radio_btn" value="Oui" checked>
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<span>Pas la première demande</span>
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<input type="radio" id="radio_btn" value="Non">
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</div>
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<div>
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<textarea id="description" rows="5" cols="30" placeholder="Détaillez..." required></textarea>
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</div>
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<div>
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<input type="submit" value="Send!"/>
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</div>
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<div>
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<input type="reset" value="Reset!"/>
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</div>
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</form>
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</body>
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</html>
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