56 lines
2.7 KiB
PHP
Executable File
56 lines
2.7 KiB
PHP
Executable File
<form id="formData">
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<legend id="titre_formData">Ajouter des données</legend>
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<table class="table table-responsive table-condensed">
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<tbody>
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<tr>
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<td width="5%" align="center" class="required">Code</td>
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<td width="20%"><INPUT class="form-control majuscule" TYPE="text" id="codeApporteur" NAME="codeApporteur" required AUTOCOMPLETE="OFF" autofocus ></td>
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<td width="5%" align="center" class="required">Libellé</td>
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<td width="30%"><INPUT class="form-control majuscule" TYPE="text" id="libelle" NAME="libelle" required AUTOCOMPLETE="OFF" ></td>
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<td width="5%" align="center" class="required">Type</td>
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<td width="25%">
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<select name="codeTypeApporteur" id="codeTypeApporteur" class="form-control">
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<?= liste_options($typeapp,'',false) ?>
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</select>
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</td>
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<td width="5%" align="center">Déduire Commission</td>
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<td width="5%">
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<INPUT class="form-control" TYPE="checkbox" id="deduireComm" NAME="deduireComm" value="1" onclick="if (this.checked) this.value=1; else this.value=0;" required AUTOCOMPLETE="OFF" >
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</td>
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</tr>
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<tr>
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<td width="5%" align="center" class="required">Bureau</td>
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<td width="20%">
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<select name="codeBureau" id="codeBureau" class="form-control" required AUTOCOMPLETE="OFF" >
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<?= liste_options($bureau,'',false) ?>
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</select>
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</td>
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<td width="5%" align="center">Email</td>
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<td width="30%"><INPUT class="form-control" TYPE="email" id="email" NAME="email"></td>
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<td width="5%" align="center">Téléphone</td>
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<td width="25%"><INPUT class="form-control" TYPE="tel" id="telephone" NAME="telephone"></td>
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<td width="5%" align="center">Type Système</td>
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<td width="5%">
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<INPUT class="form-control" TYPE="checkbox" id="typeSysteme" NAME="typeSysteme" value="0" onclick="if (this.checked) this.value=1; else this.value=0;" >
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</td>
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</tr>
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<tr>
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<td width="5%" align="center">Responsable</td>
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<td width="20%"><INPUT class="form-control majuscule" TYPE="text" id="nomResponsable" NAME="nomResponsable"></td>
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<td width="5%" align="center">Adr. Géo.</td>
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<td width="30%"><INPUT class="form-control majuscule" TYPE="text" id="adresseGeo" NAME="adresseGeo" value=" "></td>
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<td width="5%" align="center">Adr. Post.</td>
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<td colspan="3"><INPUT class="form-control majuscule" TYPE="text" id="adressePost" NAME="adressePost"></td>
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</tr>
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</tbody>
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</table>
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</form>
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