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<a title="plan" target="plan" href="/archive/PlanVideGrenierSuperU.pdf">plan</a> </td> <td> <select name='num' size="1"> <!-- <option value = 'A2'>A2</option> --> <option value = 'A3'>A3</option> <option value = 'A4'>A4</option> <option value = 'A5'>A5</option> <option value = 'A6'>A6</option> <option value = 'A11'>A11</option> <option value = 'A13'>A13</option> <option value = 'A15'>A15</option> <option value = 'A17'>A17</option> <option value = 'B3'>B3</option> <option value = 'B5'>B5</option> <option value = 'B6'>B6</option> <option value = 'B7'>B7</option> <option value = 'B10'>B10</option> <option value = 'B11'>B11</option> <option value = 'B14'>B14</option> <option value = 'B15'>B15</option> <option value = 'B16'>B16</option> <option value = 'B17'>B17</option> <option value = 'B18'>B18</option> <option value = 'B19'>B19</option> <option value = 'B20'>B20</option> <option value = 'C4'>C4</option> <option value = 'C5'>C5</option> <option value = 'C6'>C6</option> <option value = 'C7'>C7</option> <option value = 'C8'>C8</option> <option value = 'C9'>C9</option> <option value = 'D2'>D2</option> <option value = 'D3'>D3</option> <option value = 'D4'>D4</option> <option value = 'D5'>D5</option> <option value = 'D8'>D8</option> <option value = 'E4'>E4</option> <option value = 'E9'>E9</option> <option value = 'E10'>E10</option> <option value = 'E15'>E15</option> <option value = 'E17'>E17</option> <option value = 'E18'>E18</option> <option value = 'E19'>E19</option> <option value = 'E20'>E20</option> <option value = 'E21'>E21</option> <option value = 'E22'>E22</option> <option value = 'F2'>F2</option> <option value = 'F3'>F3</option> <option value = 'F4'>F4</option> <option value = 'F5'>F5</option> <option value = 'F7'>F7</option> <option value = 'F8'>F8</option> <option value = 'F9'>F9</option> <option value = 'F13'>F13</option> <option value = 'F18'>F18</option> <option value = 'F19'>F19</option> <option value = 'F20'>F20</option> <option value = 'F21'>F21</option> <option value = 'F22'>F22</option> <option value = 'G1'>G1</option> <option value = 'G2'>G2</option> <option value = 'G3'>G3</option> <option value = 'G4'>G4</option> <option value = 'G10'>G10</option> <option value = 'G11'>G11</option> <option value = 'G12'>G12</option> <option value = 'G13'>G13</option> <option value = 'G14'>G14</option> <option value = 'G15'>G15</option> <option value = 'G16'>G16</option> <option value = 'G17'>G17</option> <option value = 'G18'>G18</option> <option value = 'G19'>G19</option> <option value = 'G20'>G20</option> <option value = 'G21'>G21</option> </select></td> </tr> <tr> <td><font face=verdana size=2>Nom</font></td> <td><input type=text name=nom size=30 maxlength="64" value=""></td> </tr> <tr> <td><font face=verdana size=2>Prénom</font></td> <td><input type=text name=prenom size=30 maxlength="64" value=""></td> </tr> <tr> <td><font face=verdana size=2><br>Adresse complète</font></td> <td><input type=text name="Adresse1" size=30 maxlength="128" value=""></td> </tr> <tr> <td><font face=verdana size=2>&nbsp;</font></td> <td><input type=text name="Adresse2" size=30 maxlength="128" value=""></td> </tr> <tr> <td><font face=verdana size=2>Code Postal</font></td> <td><input type=text name="codepostal" size=30 maxlength="16" value=""></td> </tr> <tr> <td><font face=verdana size=2>Ville</font></td> <td><input type=text name="ville" size=30 maxlength="128" value=""></td> </tr> <tr> <td><font face=verdana size=2>E-mail</font></td> <td><input type=text name="email" size=30 maxlength="128" value=""></td> </tr> <tr> <td><font face=verdana size=2 colspan=2><br>Type de pièce d'identité</font></td> </tr> <tr> <td align=center colspan=2> <input type="radio" name="TypePieceIdentite" value="Carte Identite"> Carte Identité &nbsp; <input type="radio" name="TypePieceIdentite" value="Permis Conduire"> Permis Conduire &nbsp; <input type="radio" name="TypePieceIdentite" value="Carte Sejours"> Carte de Séjours<br><br> </td> </tr> <tr> <td><font face=verdana size=2>Numéro de pièce d'identié</font></td> <td><input type=text name="nci" size=30 maxlength="64" value=""></td> </tr> <tr> <td><font face=verdana size=2>Date de Validé</font></td> <td><input type=text name="DateValide" size=30 maxlength="64" value=""></td> </tr> <tr> <td><font face=verdana size=2>N° Carte grise du véhicule</font></td> <td><input type=text name="numCG" size=30 maxlength="64" value=""></td> </tr> <tr> <td colspan=2><br>Pour valider votre réservation, vous devrez nous adresser :<br> - votre règlement par chèque 12 ¬/emplacement<br> - photocopie de votre pièce d'identité.<br> - photocopie de la carte grise du véhicule transportant vos marchandises pour accès au parking.<br> - attestation sur l'honneur que vous agissez à titre de particulier (<a title="attestation" href="/archive/AttestationParticulier.pdf" target="docpdf">cliquer ici</a>).<br> à :<br> &nbsp;&nbsp;&nbsp;<b>Monsieur PROU Alex<br> &nbsp;&nbsp;&nbsp;35 rue de la Savarière<br> &nbsp;&nbsp;&nbsp;44230 St Sébastien s/Loire<br> &nbsp;&nbsp;&nbsp;tel : 09.54.27.17.76<br> &nbsp;&nbsp;&nbsp;port. : 06.99.86.99.44</b> <br> en cas d'absence de Mr PROU, merci d'adresser à :<br> &nbsp;&nbsp;&nbsp;<b>Monsieur TRAMART Christian<br> &nbsp;&nbsp;&nbsp;4, rue des Platanes<br> &nbsp;&nbsp;&nbsp;44230 St Sébastien s/Loire<br> &nbsp;&nbsp;&nbsp;tel : 02.40.03.33.51<br></b> <br> Nous confirmons votre inscription par retour e-mail.<br> Nous vous invitons prendre connaissance du <a title="attestation" href="/archive/ReglementVideGrenier.pdf" target="docpdf">règlement joint</a> avant valider votre inscription<br> </td> </tr> <tr> <td align=center colspan=2><br><input type="submit" value="Envoyer"> <input type="reset" name="Submit" value="Effacer"></td> </tr> <tr> <td colspan=2><br><image src="/archive/PlanVideGrenierSuperU.jpg"></image> </td> </tr> </font></form></table></center> </body> </html>