je voudrais recevoir ce formulaire sur mon adresse email. mon site est un site oscommerce. j'ai essayer plusieur methode mais rien n'y fait si quelqu'un peu m'aider merci d'avance
Code : Tout sélectionner
<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv="Content-Language" content="fr">
<meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
<title>Dépannage</title>
</head>
<form name="contact_us" method="post" action="[email protected]">
<tr>
<table cellSpacing="0" cellPadding="0" width="100%" border="0">
<tr>
<td>
<table cellSpacing="0" cellPadding="0" width="776" align="center" border="0">
<tr>
<td>
<table width="100%" border="0">
<tr>
<td>
<table class="centertable" cellSpacing="0" cellPadding="3" width="100%" bgColor="#798ccc" border="0">
<tr>
<td vAlign="top" width="100%">
<table cellSpacing="0" cellPadding="8" width="100%" border="0">
<tr>
<td>
<table cellSpacing="3" cellPadding="3" width="100%" border="0">
<tr>
<td>
<table class="templateinfoBox" cellSpacing="0" cellPadding="0" width="100%" border="0">
<tr>
<td>
<table class="infoBoxContents" cellSpacing="0" cellPadding="3" width="100%" border="0">
<tr>
<td class="main">
<table style="BORDER-COLLAPSE: collapse" borderColor="#111111" cellSpacing="0" cellPadding="2" width="100%" align="right" border="0">
<tr>
<td class="main" vAlign="top" width="100%">
<img height="56" src="http://singeroyonnax.free.fr/images/logo.gif" width="800" border="0">
<p><b>
Bonjour
et
bienvenue
au
centre
de
dépannage
d'Oyonnax</b></p>
<p>
Depuis
35 ans
nous
proposons
a nos
clients
des
dépannages
<b>de
qualité</b>.
<br>
Maintenant
c'est ce
service
que nous
vous
proposons
par le
biais
d'Internet.
<br>
Nous
avons
mis à
votre
service
un
forum,
vous
pourrez
y poser
toutes
vos <br>
questions
afin
d'essayer
de vous
dépanner
en
ligne.
Si le
problème
persiste
<br>
nous
vous
proposons
d'établir
un <b>
devis
gratuit
</b>
suivant
les
problème
que <br>
vous
avais
constater.</p>
<p><b>
Voici la
marche à
suivre.</b></p>
<p>
<b>1 </b>
Poser
votre
question
sur le
forum en
définissent
le plus
clairement
<br>
possible
votre
problème.</p>
<p>
<b>2</b>
Si le
problème
persiste
nous
vous
poserons
plusieurs
question
afin <br>
d'établir
un
devis.</p>
<p><b>3</b>
Si le
devis
vous
convient
remplissez
la fiche
qui ce
trouve
ci
dessous</p>
<p><b>Fiche de prise en charge.
N°0002464564 </b></p>
<font size="2">
<table cellSpacing="0" cellPadding="2" width="100%" border="0">
<tr>
<td class="main"><b>Vos informations personnelles
</b>* Informations nécessaire</td>
<td class="inputRequirement" align="right"> </td>
</tr>
</table>
<font size="1">
<table cellSpacing="2" cellPadding="2" border="0">
<tr>
<td class="main">Votre Prénom:</td>
<td class="main"><input name="firstname"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">Votre Nom:</td>
<td class="main"><input name="name"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">
<p align="center">Votre adresse email:</td>
<td class="main"><input name="email"> <span class="inputRequirement">*</span></td>
</tr>
</table>
<table style="BORDER-COLLAPSE: collapse" borderColor="#111111" cellSpacing="0" cellPadding="2" width="100%" align="right" border="0">
<tr>
<td class="main"><b>Information société</b></td>
</tr>
<tr>
<td>
<table class="infoBox" cellSpacing="1" cellPadding="2" width="100%" border="0">
<tr class="infoBoxContents">
<td>
<table cellSpacing="2" cellPadding="2" border="0">
<tr>
<td class="main">Nom de la société:</td>
<td class="main"><input name="company"> <span class="inputRequirement">Seulement
dans le cas d'une facturation au nom de cette société</span></td>
</tr>
<!-- Ajout pour TVA_INTRACOM_v3.0 //-->
<tr>
<td class="main">N° TVA intracom :</td>
<td class="main"><input name="tva_intracom"> <span class="inputRequirement">Obligatoire
si vous avez indiqué une société de la CEE</span></td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
<p> </p>
<p> </p>
<p> </p>
<table style="BORDER-COLLAPSE: collapse" borderColor="#111111" cellSpacing="0" cellPadding="2" width="100%" align="right" border="0">
<tr>
<td class="main"><b>Votre adresse</b></td>
</tr>
<tr>
<td>
<table class="infoBox" cellSpacing="1" cellPadding="2" width="100%" border="0">
<tr class="infoBoxContents">
<td>
<table cellSpacing="2" cellPadding="2" border="0">
<tr>
<td class="main">Rue:</td>
<td class="main"><input name="street_address"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">Quartier:</td>
<td class="main"><input name="suburb"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">Code postal:</td>
<td class="main"><input name="postcode"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">Ville:</td>
<td class="main"><input name="city"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">N° départ./Etat:</td>
<td class="main"><input name="state"> <span class="inputRequirement">*
</span></td>
</tr>
<tr>
<td class="main">Pays:</td>
<td class="main"><select name="country">
<option value selected>Veuillez sélectionner</option>
<option value="1">Afghanistan</option>
<option value="2">Albania</option>
<option value="3">Algeria</option>
<option value="4">American Samoa</option>
<option value="5">Andorra</option>
<option value="6">Angola</option>
<option value="7">Anguilla</option>
<option value="8">Antarctica</option>
<option value="9">Antigua and Barbuda</option>
<option value="10">Argentina</option>
<option value="11">Armenia</option>
<option value="12">Aruba</option>
<option value="13">Australia</option>
<option value="14">Austria</option>
<option value="15">Azerbaijan</option>
<option value="16">Bahamas</option>
<option value="17">Bahrain</option>
<option value="18">Bangladesh</option>
<option value="19">Barbados</option>
<option value="20">Belarus</option>
<option value="21">Belgium</option>
<option value="22">Belize</option>
<option value="23">Benin</option>
<option value="24">Bermuda</option>
<option value="25">Bhutan</option>
<option value="26">Bolivia</option>
<option value="27">Bosnia and Herzegowina</option>
<option value="28">Botswana</option>
<option value="29">Bouvet Island</option>
<option value="30">Brazil</option>
<option value="31">British Indian Ocean Territory
</option>
<option value="32">Brunei Darussalam</option>
<option value="33">Bulgaria</option>
<option value="34">Burkina Faso</option>
<option value="35">Burundi</option>
<option value="36">Cambodia</option>
<option value="37">Cameroon</option>
<option value="38">Canada</option>
<option value="39">Cape Verde</option>
<option value="40">Cayman Islands</option>
<option value="41">Central African Republic</option>
<option value="42">Chad</option>
<option value="43">Chile</option>
<option value="44">China</option>
<option value="45">Christmas Island</option>
<option value="46">Cocos (Keeling) Islands</option>
<option value="47">Colombia</option>
<option value="48">Comoros</option>
<option value="49">Congo</option>
<option value="50">Cook Islands</option>
<option value="51">Costa Rica</option>
<option value="52">Cote D'Ivoire</option>
<option value="53">Croatia</option>
<option value="54">Cuba</option>
<option value="55">Cyprus</option>
<option value="56">Czech Republic</option>
<option value="57">Denmark</option>
<option value="58">Djibouti</option>
<option value="59">Dominica</option>
<option value="60">Dominican Republic</option>
<option value="61">East Timor</option>
<option value="62">Ecuador</option>
<option value="63">Egypt</option>
<option value="64">El Salvador</option>
<option value="65">Equatorial Guinea</option>
<option value="66">Eritrea</option>
<option value="67">Estonia</option>
<option value="68">Ethiopia</option>
<option value="69">Falkland Islands (Malvinas)</option>
<option value="70">Faroe Islands</option>
<option value="71">Fiji</option>
<option value="72">Finland</option>
<option value="73">France</option>
<option value="74">France, Metropolitan</option>
<option value="75">French Guiana</option>
<option value="76">French Polynesia</option>
<option value="77">French Southern Territories</option>
<option value="78">Gabon</option>
<option value="79">Gambia</option>
<option value="80">Georgia</option>
<option value="81">Germany</option>
<option value="82">Ghana</option>
<option value="83">Gibraltar</option>
<option value="84">Greece</option>
<option value="85">Greenland</option>
<option value="86">Grenada</option>
<option value="87">Guadeloupe</option>
<option value="88">Guam</option>
<option value="89">Guatemala</option>
<option value="90">Guinea</option>
<option value="91">Guinea-bissau</option>
<option value="92">Guyana</option>
<option value="93">Haiti</option>
<option value="94">Heard and Mc Donald Islands</option>
<option value="95">Honduras</option>
<option value="96">Hong Kong</option>
<option value="97">Hungary</option>
<option value="98">Iceland</option>
<option value="99">India</option>
<option value="100">Indonesia</option>
<option value="101">Iran (Islamic Republic of)</option>
<option value="102">Iraq</option>
<option value="103">Ireland</option>
<option value="104">Israel</option>
<option value="105">Italy</option>
<option value="106">Jamaica</option>
<option value="107">Japan</option>
<option value="108">Jordan</option>
<option value="109">Kazakhstan</option>
<option value="110">Kenya</option>
<option value="111">Kiribati</option>
<option value="112">Korea, Democratic People's Republic
of</option>
<option value="113">Korea, Republic of</option>
<option value="114">Kuwait</option>
<option value="115">Kyrgyzstan</option>
<option value="116">Lao People's Democratic Republic
</option>
<option value="117">Latvia</option>
<option value="118">Lebanon</option>
<option value="119">Lesotho</option>
<option value="120">Liberia</option>
<option value="121">Libyan Arab Jamahiriya</option>
<option value="122">Liechtenstein</option>
<option value="123">Lithuania</option>
<option value="124">Luxembourg</option>
<option value="125">Macau</option>
<option value="126">Macedonia, The Former Yugoslav
Republic of</option>
<option value="127">Madagascar</option>
<option value="128">Malawi</option>
<option value="129">Malaysia</option>
<option value="130">Maldives</option>
<option value="131">Mali</option>
<option value="132">Malta</option>
<option value="133">Marshall Islands</option>
<option value="134">Martinique</option>
<option value="135">Mauritania</option>
<option value="136">Mauritius</option>
<option value="137">Mayotte</option>
<option value="138">Mexico</option>
<option value="139">Micronesia, Federated States of
</option>
<option value="140">Moldova, Republic of</option>
<option value="141">Monaco</option>
<option value="142">Mongolia</option>
<option value="143">Montserrat</option>
<option value="144">Morocco</option>
<option value="145">Mozambique</option>
<option value="146">Myanmar</option>
<option value="147">Namibia</option>
<option value="148">Nauru</option>
<option value="149">Nepal</option>
<option value="150">Netherlands</option>
<option value="151">Netherlands Antilles</option>
<option value="152">New Caledonia</option>
<option value="153">New Zealand</option>
<option value="154">Nicaragua</option>
<option value="155">Niger</option>
<option value="156">Nigeria</option>
<option value="157">Niue</option>
<option value="158">Norfolk Island</option>
<option value="159">Northern Mariana Islands</option>
<option value="160">Norway</option>
<option value="161">Oman</option>
<option value="162">Pakistan</option>
<option value="163">Palau</option>
<option value="164">Panama</option>
<option value="165">Papua New Guinea</option>
<option value="166">Paraguay</option>
<option value="167">Peru</option>
<option value="168">Philippines</option>
<option value="169">Pitcairn</option>
<option value="170">Poland</option>
<option value="171">Portugal</option>
<option value="172">Puerto Rico</option>
<option value="173">Qatar</option>
<option value="174">Reunion</option>
<option value="175">Romania</option>
<option value="176">Russian Federation</option>
<option value="177">Rwanda</option>
<option value="178">Saint Kitts and Nevis</option>
<option value="179">Saint Lucia</option>
<option value="180">Saint Vincent and the Grenadines
</option>
<option value="181">Samoa</option>
<option value="182">San Marino</option>
<option value="183">Sao Tome and Principe</option>
<option value="184">Saudi Arabia</option>
<option value="185">Senegal</option>
<option value="186">Seychelles</option>
<option value="187">Sierra Leone</option>
<option value="188">Singapore</option>
<option value="189">Slovakia (Slovak Republic)</option>
<option value="190">Slovenia</option>
<option value="191">Solomon Islands</option>
<option value="192">Somalia</option>
<option value="193">South Africa</option>
<option value="194">South Georgia and the South Sandwich
Islands</option>
<option value="195">Spain</option>
<option value="196">Sri Lanka</option>
<option value="197">St. Helena</option>
<option value="198">St. Pierre and Miquelon</option>
<option value="199">Sudan</option>
<option value="200">Suriname</option>
<option value="201">Svalbard and Jan Mayen Islands
</option>
<option value="202">Swaziland</option>
<option value="203">Sweden</option>
<option value="204">Switzerland</option>
<option value="205">Syrian Arab Republic</option>
<option value="206">Taiwan</option>
<option value="207">Tajikistan</option>
<option value="208">Tanzania, United Republic of
</option>
<option value="209">Thailand</option>
<option value="210">Togo</option>
<option value="211">Tokelau</option>
<option value="212">Tonga</option>
<option value="213">Trinidad and Tobago</option>
<option value="214">Tunisia</option>
<option value="215">Turkey</option>
<option value="216">Turkmenistan</option>
<option value="217">Turks and Caicos Islands</option>
<option value="218">Tuvalu</option>
<option value="219">Uganda</option>
<option value="220">Ukraine</option>
<option value="221">United Arab Emirates</option>
<option value="222">United Kingdom</option>
<option value="223">United States</option>
<option value="224">United States Minor Outlying Islands
</option>
<option value="225">Uruguay</option>
<option value="226">Uzbekistan</option>
<option value="227">Vanuatu</option>
<option value="228">Vatican City State (Holy See)
</option>
<option value="229">Venezuela</option>
<option value="230">Viet Nam</option>
<option value="231">Virgin Islands (British)</option>
<option value="232">Virgin Islands (U.S.)</option>
<option value="233">Wallis and Futuna Islands</option>
<option value="234">Western Sahara</option>
<option value="235">Yemen</option>
<option value="236">Yugoslavia</option>
<option value="237">Zaire</option>
<option value="238">Zambia</option>
<option value="239">Zimbabwe</option>
</select> <span class="inputRequirement">*</span></td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td>
<img height="10" alt="" src="pixel_trans.gif" width="100%" border="0"></td>
</tr>
<tr>
<td class="main"><b>Vos informations de contact</b></td>
</tr>
<tr>
<td>
<table class="infoBox" cellSpacing="1" cellPadding="2" width="100%" border="0">
<tr class="infoBoxContents">
<td>
<table cellSpacing="2" cellPadding="2" border="0">
<tr>
<td class="main">Numéro de téléphone:</td>
<td class="main"><input name="telephone"> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main">Numéro de Fax:</td>
<td class="main"><input name="fax"> </td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
<p> </p>
</font>
<p><b>Vos informations sur le matériel</b></p>
<font size="1"> <table >
<tr>
<td class="main" width="168">Type du matériel:</td>
<td class="main"><font size="3"><input name="street_address0"></font> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main" width="168">Quantité:</td>
<td class="main"><font size="3"><input name="suburb0"></font> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main" width="168">Référence:</td>
<td class="main"><font size="3"><input name="postcode0"></font> <span class="inputRequirement">*</span></td>
</tr>
<tr>
<td class="main" width="168">Composant présent avec le produit :</td>
<td class="main"><font size="3"><input name="city0" size="41"></font> <span class="inputRequirement">*</span></td>
</tr>
</table>
</font>
<ul>
<li>Attention nous ne prenons en charge que le produit nu (sans
accessoires,modes d'emploi,bras libre,etc..)</li>
<li>En revanche pour les machines à coudre ne pas oublier le rhéostat
(pédale).</li>
</ul>
</font>
<p><b>4</b>puis imprimer cette page en double garder <br>
le première exemplaire puis mettre le deuxième <br>
avec le produit. </p>
<p><b>5 </b>Emballer le tout le plus <br>
solidement possible(1) dans un carton avec du <br>
papier bulle et le tout bien scotché.</p>
<p align="left"><b>6 </b>Envoyer le tout par ups(2) à <br>
l'adresse suivante:<font size="2"><b><br>
<span style="FONT-FAMILY: Verdana; br: black">SINGER OYONNAX</span></b></p>
<p class="MsoNormal" align="left"><b>
<span style="FONT-FAMILY: Verdana; br: black">16 RUE DU 8 MAI 45</span></b></p>
<p class="MsoNormal" align="left"><b>
<span style="FONT-FAMILY: Verdana; br: black">01100 OYONNAX </span></b></p>
<p class="MsoNormal" align="left"><b>
<span style="FONT-FAMILY: Verdana; br: black">FRANCE</span></b></p>
</font>
<p class="MsoNormal" align="left"><b>Je certifie avoir prie connaissance des
conditions présente sur cette page.</b></p>
<p class="MsoNormal">
<b>Date
et
signature
suivie
de la
mention
(lu et
approuvé)
:
</b><font size="2">
<img border="0" src="images/box_write_review.gif" width="33" height="32">
</font></p>
<font size="1">
<p class="MsoNormal"><span style="FONT-FAMILY: Verdana"><br>
</span></font><span style="FONT-FAMILY: Verdana"><font size="1">(1) Nous ne
somme pas responsable des dégât endommager pour cause D'emballage
insuffisant. L'envoie reste au risque et périls du client.<br>
(2)Les frais de port reste à la charge du client. <!--
--></font></span>
<p class="MsoNormal">
<span style="FONT-FAMILY: Verdana">
<font size="1" style="font-weight: 700"><br>
</font></span>
<a href="index.php">
<img border="0" src="http://singeroyonnax.free.fr/templates/Pixame_v1/images/buttons/french/button_continue.gif" width="120" height="20"></a> <input type="hidden" value="Visiteur" name="sendertype">
<input title=" Envoyer " type="image" alt="Envoyer" src="templates/Pixame_v1/images/buttons/french/button_send.gif" border="0" name="I1"></td>
<td width="10">
<img height="1" alt="" src="images/pixel_trans.gif" width="10" border="0"></td>
</p></td>
</tr>
</table>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
<font size="1">
<p> voilla merci d'avance et bonne rentré a tous
