mirror of
https://github.com/Dolibarr/dolibarr.git
synced 2026-02-03 06:43:23 +01:00
98 lines
2.1 KiB
HTML
98 lines
2.1 KiB
HTML
<?xml version="1.0" encoding="iso-8859-1" ?>
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<!DOCTYPE html
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PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
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"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"
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>
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<html lang="fr">
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<head>
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<!-- $Id$ -->
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<title>Dons FSF France Projet EUCD.INFO</title>
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</head>
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<body>
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<div class="main">
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<h1>Formulaire de promesse de don.</h1>
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<p>
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Vous pouvez faire une promesse de don à la FSF France pour aider à la création dun fond de secours pour la copie privée.
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</p>
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<form action="index.php" method="post">
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<table id="formulaire">
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<input type="hidden" name="action" value="add" />
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<tr id="date">
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<script language="php">
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$a = setlocale("LC_TIME", "FRENCH");
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print strftime("%d %B %Y", time());
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</script>
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</tr>
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<tr id="projet">
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</tr>
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<tr id="prenom">
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<input type="text" name="prenom" size="30" />
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</tr>
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<tr id="nom">
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<input type="text" name="nom" size="40" />
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</tr>
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<tr id="societe">
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<input type="text" name="societe" size="40" />
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</tr>
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<tr id="adresse">
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<textarea name="adresse" wrap="soft" cols="40" rows="3"></textarea>
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</tr>
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<tr id="cp">
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<input type="text" name="cp" size="8" />
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</tr>
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<tr id="ville">
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<input type="text" name="ville" size="30" />
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</tr>
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<tr id="pays">
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<input type="text" name="pays" size="25" value="France"/>
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</tr>
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<tr id="email">
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<input type="text" name="email" size="50" />
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</tr>
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<tr id="montant">
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<input type="text" name="montant" size="10" />
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</tr>
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<tr id="public">
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<select name="public">
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<option value="1">oui/yes</option>
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<option value="0">non/no</option>
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</select>
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</tr>
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<tr id="commentaire">
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<textarea name="commentaire" wrap="soft" cols="40" rows="6"></textarea>
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</tr>
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<tr>
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<td colspan="3" align="center" class="titre">
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<input type="submit" value="Enregistrer / Submit" />
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</td>
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</tr>
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</table>
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</form>
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</div>
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</body>
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</html>
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<!--
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Local Variables: ***
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mode: xml ***
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End: ***
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-->
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