<HTML> <head> <object classid="clsid:d27cdb6e-ae6d-11cf-96b8-444553540000" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,0,0" width="468" height="60" id="d.swf" align="middle"> <param name="allowScriptAccess" value="sameDomain"> <param name="movie" value="d.swf"> <param name="quality" value="high"> <param name="bgcolor" value="#ffffff"> src="d.swf" quality="high" bgcolor="#ffffff" width="468" height="60" name="d.swf" align="middle" allowScriptAccess="sameDomain" type="application/x-shockwave-flash" pluginspage="http://www.macromedia.com/go/getflashplayer"> </object> <body> <FORM METHOD="POST" ACTION="/cgi-bin/questionnaire.cmd?xxx"> <p> <h4><CENTER>Essai Formulaire </CENTER></H4> <pre><b> <LI>NOM: <input type="text"name="name" size=30> <LI>ADRESSE: <input type="text" name="street.address" size=30> <LI>VILLE :<input type="text" name="city" size=30> <LI>PROVINCE: <input type="text" size=15 name="state"> <LI>CODE POSTAL: <input type="text name="zip" size=10> <LI>PAYS:<input type="text" name="country" size=20> <LI>TELEPHONE: <input type="text" name="phone" size=10> <LI>COURRIER ELECTRONIQUE: <input type="text" name="email" size=30> </b></pre> <input type="submit" value="Soumettre"> <input type="reset" value="Effacer et recommencer"><P> </form><p> </BODY> </head> </html>
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