69 lines
2.5 KiB
HTML
69 lines
2.5 KiB
HTML
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<!DOCTYPE html>
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<!--
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To change this license header, choose License Headers in Project Properties.
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To change this template file, choose Tools | Templates
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and open the template in the editor.
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-->
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<html>
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<head>
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<title>Formulaire</title>
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<meta charset="UTF-8">
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<meta name="viewport" content="width=device-width, initial-scale=1.0">
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</head>
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<body>
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<form action="www.example.com" method="get">
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<div>
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<label for="nom">Nom :</label>
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<input type="text" id="nom" />
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</div>
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<div>
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<label for="prenom">Prenom :</label>
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<input type="text" id="prenom" />
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</div>
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<div>
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<label for="adresse">Adresse :</label>
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<input type="text" id="adresse" />
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</div>
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<div>
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<label for="code_postal">Code Postal :</label>
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<input type="text" id="code_postal" />
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</div>
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<div>
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<label for="ville">Ville :</label>
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<input type="text" id="ville" />
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</div>
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<div>
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<label for="telephone">Téléphone :</label>
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<input type="text" id="telephone" />
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</div>
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<div>
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<label for="profession">Profession</label>
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<select id="profession">
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<option> Web Designer </option>
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<option> Patissier</option>
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<option> Boulanger</option>
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</select>
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</div>
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<div>
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<a>Niveau d'études</a><br />
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<input type="checkbox" name="etude1" value="1" />Bac<br />
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<input type="checkbox" name="etude2" value="2" />Bac+3<br />
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<input type="checkbox" name="etude3" value="3" />Bac+5<br />
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</div>
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<div>
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<a>Cochez cette case pour autoriser le transfert de vos coordonnées </a>
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<input type="checkbox" name="donnees" value="4" />
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</div>
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<div>
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<a>Compétences</a><br />
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<input type="checkbox" name="competences1" value="5" />Vidéo<br />
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<input type="checkbox" name="competences2" value="6" />Son<br />
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<input type="checkbox" name="competences3" value="7" />Informatique<br />
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</div>
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<div>
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<input type="submit" name="envoyer" value="Envoyer" />
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</div>
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</form>
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</body>
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</html>
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