<![CDATA[
<body marginheight="0" topmargin="0" marginwidth="0" leftmargin="0" bgcolor="#FFFFFF" onLoad="">
<table border="0" cellspacing="0" cellpadding="0" width="610">
<tr valign="bottom" align="center">
<td colspan="3"><img src="../img/pages/titre_contactez.gif" width="292" height="22"></td>
</tr>
</table>
<br>
<table border="0" cellspacing="0" cellpadding="0" width="610">
<tr valign="bottom" align="center">
<td colspan="3">
<table border="0" cellspacing="0" cellpadding="0" width="610">
<tr valign="bottom" align="center">
<td colspan="3">
<form method="post" action="../cgi-bin/sendit.htm">
<table border="0" cellpadding="0" cellspacing="0" align="center" width="95%">
<tr>
<td align="left" valign="top" rowspan="6"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Nom</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Nom">
</td>
<td align="left" valign="middle"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Tel</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Téléphone">
</td>
</tr>
<tr>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Prénom</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Prenom">
</td>
<td align="left" valign="middle"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Fax</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Fax">
</td>
</tr>
<tr>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Entreprise</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="entreprise">
</td>
<td align="left" valign="middle"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Adresse</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Adresse_ligne2">
</td>
</tr>
<tr>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Activité</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="activite">
</td>
<td align="left" valign="middle"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Code
postal</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="10"
maxlength="255" name="Code_postal">
</td>
</tr>
<tr>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">E-mail</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Email">
</td>
<td align="left" valign="middle"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Ville</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Ville">
</td>
</tr>
<tr>
<td align="right" valign="middle"> </td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle"> </td>
<td align="right" valign="middle"><b><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2">Pays</font></b></td>
<td align="left" valign="middle"> </td>
<td align="left" valign="middle">
<input type="text" size="20"
maxlength="255" name="Pays">
</td>
</tr>
<tr>
<td colspan="8" align="right" valign="middle"><img src="../img/vide2x2.gif" width="5" height="5"></td>
</tr>
<tr>
<td valign="middle" align="right" colspan="2"><font color="#E55129" face="Arial, Helvetica, sans-serif" size="2"><b>Votre
message</b></font><font color="#00B700"> </font></td>
<td valign="middle" align="center"> <font color="#00B700"><br>
</font> </td>
<td valign="middle" align="left" colspan="5">
<textarea name="message"
rows="5" cols="50"></textarea>
</td>
</tr>
<tr>
<td colspan="8" align="right" valign="middle"><img src="../img/vide2x2.gif" width="5" height="5"></td>
</tr>
<tr>
<td align="right" valign="middle"> </td>
<td align="right" valign="middle"> </td>
<td align="center" valign="middle"> </td>
<td colspan="5" align="left" valign="middle">
<input
type="submit" value="Envoyer" name="submit">
<img
src="../img/vide2x2.gif" width="20"
height="1">
<input type="reset"
value="Effacer" name="reset">
</td>
</tr>
</table>
</form>
</td>
</tr>
</table>
</td>
</tr>
</table><p><font color="#2E8B2E"><a href="..default.htm">Accueil</a></p>
</body>]]>