Files
dolibarr/htdocs/public/dons/don.xhtml
2002-12-22 15:37:58 +00:00

98 lines
2.1 KiB
HTML

<?xml version="1.0" encoding="iso-8859-1" ?>
<!DOCTYPE html
PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"
>
<html lang="fr">
<head>
<!-- $Id$ -->
<title>Dons FSF France Projet EUCD.INFO</title>
</head>
<body>
<div class="main">
<h1>Formulaire de promesse de don.</h1>
<p>
Vous pouvez faire une promesse de don à la FSF France pour aider à la création dun fond de secours pour la copie privée.
</p>
<form action="index.php" method="post">
<table id="formulaire">
<input type="hidden" name="action" value="add" />
<tr id="date">
<script language="php">
$a = setlocale("LC_TIME", "FRENCH");
print strftime("%d %B %Y", time());
</script>
</tr>
<tr id="projet">
</tr>
<tr id="prenom">
<input type="text" name="prenom" size="30" />
</tr>
<tr id="nom">
<input type="text" name="nom" size="40" />
</tr>
<tr id="societe">
<input type="text" name="societe" size="40" />
</tr>
<tr id="adresse">
<textarea name="adresse" wrap="soft" cols="40" rows="3"></textarea>
</tr>
<tr id="cp">
<input type="text" name="cp" size="8" />
</tr>
<tr id="ville">
<input type="text" name="ville" size="30" />
</tr>
<tr id="pays">
<input type="text" name="pays" size="25" value="France"/>
</tr>
<tr id="email">
<input type="text" name="email" size="50" />
</tr>
<tr id="montant">
<input type="text" name="montant" size="10" />
</tr>
<tr id="public">
<select name="public">
<option value="1">oui/yes</option>
<option value="0">non/no</option>
</select>
</tr>
<tr id="commentaire">
<textarea name="commentaire" wrap="soft" cols="40" rows="6"></textarea>
</tr>
<tr>
<td colspan="3" align="center" class="titre">
<input type="submit" value="Enregistrer / Submit" />
</td>
</tr>
</table>
</form>
</div>
</body>
</html>
<!--
Local Variables: ***
mode: xml ***
End: ***
-->