57 lines
2.2 KiB
HTML
57 lines
2.2 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>Inscription</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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<link href="css/stylesheet.css" rel="stylesheet" type="text/css"/>
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<link href="css/jquery-ui.min.css" rel="stylesheet" type="text/css"/>
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<script src="js/libs/jquery/jquery.js" type="text/javascript"></script>
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<script src="js/libs/jquery-ui.min.js" type="text/javascript"></script>
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<script src="js/main.js" type="text/javascript"></script>
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</head>
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<body>
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<div>
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<form method="post">
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<label for="nom">Nom</label>
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<input type="text" name="nom" id="nom">
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<br/>
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<label for="prenom">Prénom</label>
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<input type="text" name="prenom" id="prenom">
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<br/>
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<label for="ddn">Date de naissance</label>
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<input type="text" name="ddn" id="ddn">
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<br/>
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<label for="adresse">Adresse</label>
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<input type="text" name="adresse" id="adresse">
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<br/>
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<label for="cp">Code Postal</label>
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<input type="text" name="cp" id="cp" maxlength="5">
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<br/>
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<label for="ville">Ville</label>
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<select name="ville" class="ville" id="ville">
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</select>
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<br/>
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<label for="mail">Email</label>
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<input type="text" name="mail" id="mail">
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<br/>
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<label for="photo">Photo</label>
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<input type="file" name="photo" id="photo">
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<br/>
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<label for="ddi">Discipline d'inscription</label>
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<select name="ddi" id="ddi" class="ddi">
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</select>
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<br/>
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<button type="submit">Envoyer</button>
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</form>
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</div>
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</body>
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</html>
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