53 lines
3.5 KiB
PHP
Executable File
53 lines
3.5 KiB
PHP
Executable File
<form id="formData">
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<legend id="titre_formData"><?= _("Modification des données") ?></legend>
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<INPUT class="sr-only" TYPE="text" id = "id" name = "id" value="<?=$intermediaire['id']?>">
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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" >Code</td>
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<td width="20%" ><INPUT class="form-control majuscule" TYPE="text" id="codeApporteur" NAME="codeApporteur" value="<?= $this->nettoyer($intermediaire['codeApporteur']); ?>" disabled></td>
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<td width="5%" align="center" class="required">Type</td>
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<td width="20%">
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<select name="codeTypeApporteur" id="codeTypeApporteur" class="form-select" required AUTOCOMPLETE="OFF" autofocus>
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<?= liste_options($typeinter,$this->nettoyer($intermediaire['codeTypeApporteur']),true) ?>
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</select>
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</td>
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<td width="5%" align="center" class="required"><?= _("Raison Sociale") ?></td>
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<td width="20%" ><INPUT class="form-control majuscule" TYPE="text" id="libelle" NAME="libelle" required AUTOCOMPLETE="OFF" value="<?= $this->nettoyer($intermediaire['libelle']); ?>"></td>
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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" value="<?= $this->nettoyer($intermediaire['nomResponsable']); ?>"></td>
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</tr>
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<tr>
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<td width="5%" align="center"><?= _("Téléphone") ?></td>
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<td width="20%" ><INPUT class="form-control" TYPE="tel" id="telephone" NAME="telephone" value="<?= $this->nettoyer($intermediaire['telephone']); ?>"></td>
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<td width="5%" align="center">E-mail</td>
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<td width="20%" ><INPUT class="form-control" TYPE="email" id="email" NAME="email" value="<?= $this->nettoyer($intermediaire['email']); ?>"></td>
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<td width="5%" align="center"><?= _("Bureau") ?></td>
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<td width="20%">
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<select name="codeBureau" id="codeBureau" class="form-select" value="<?= $this->nettoyer($intermediaire['codeBureau']); ?>">
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<?= liste_options($bureau,$this->nettoyer($intermediaire['codeBureau']),true) ?>
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</select>
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</td>
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<td width="5%" align="center"><?= _("Déduire Commission") ?></td>
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<td width="5%">
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<select name="deduireComm" id="deduireComm" class="form-select">
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<?= liste_options($ouinonplafondmodifiable,$this->nettoyer($intermediaire['deduireComm']),true) ?>
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</select>
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</td>
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</tr>
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<tr>
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<td width="5%" align="center"><?= _("Mobile Payer") ?></td>
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<td ><INPUT class="form-control" TYPE="number" id="mobilePaiement" NAME="mobilePaiement" value="<?= $this->nettoyer($intermediaire['mobilePaiement']); ?>" title="<?= _("L'indicatif est obligatoire")?>"></td>
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<td width="5%" align="center"><?= _("Adresse Géo.") ?></td>
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<td ><INPUT class="form-control majuscule" TYPE="text" id="adresseGeo" NAME="adresseGeo" value="<?= $this->nettoyer($intermediaire['adresseGeo']); ?>"></td>
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<td width="5%" align="center"><?= _("Adresse Postale") ?></td>
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<td colspan="3" ><INPUT class="form-control majuscule" TYPE="text" id="adressePost" NAME="adressePost" value="<?= $this->nettoyer($intermediaire['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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