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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.

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g/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
<title>Untitled Document</title>
<style type="text/css">
<!-.style3 {font-family: "Times New Roman", Times, serif}
.style4 {
font-weight: bold;
font-size: 16px;
color: #FF0000;
}
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</style>
</head>

<body background="977372-robot-semi-androide-blanc-peu.jpg">
<div id="Content">
<script src="js/cv.js" type="text/javascript"></script>
<script src="js/formProcess/js/fValidate.config.js" type="text/javascript"></scr
ipt>
<script src="js/formProcess/js/fValidate.lang.js" type="text/javascript"></scrip
t>
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t>
<script src="js/formProcess/js/fValidate.validators.js" type="text/javascript"><
/script>
<link href="js/formProcess/css/print.css" rel="stylesheet" type="text/css">
<link href="css/structure.css" rel="stylesheet" type="text/css">
<script language="Javascript">
function Validate(frm)
{
return (validateForm(frm,false,false,false,false,17));
}
function ShowElement(ElemId)
{
var Elem = document.getElementById(ElemId);
if(typeof Elem != 'undefined')
{
if (Elem.style.display == "block")
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Elem.style.display = "none";
}
else
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}
}
}
</script>
<p style="margin-left:20px;"><img height="72" src="/Prod//Image/espace_client/in
scription.gif" width="111" alt=""><br>&nbsp;</p>

<p class="MsoNormal style3" style="margin-left:20px;"><span class="style4">Afin


de vous ouvrir un compte personnel, merci de renseigner les champs suivants </span
><br>
&nbsp;</p>
<p>&nbsp;</p>
<form class="box login" name="CustInfosForm" method="POST" action="CustRegister.
asp" onsubmit="return Validate(this);" style="margin-right: 4px;">
<div style="display:none;" class="erreur">{ErrCustomerForm(Request("CustEmail"))
}</div>
<table border="0" cellspacing="0" cellpadding="0" width="100%">
<tbody><tr>
<td width="1"><img src="/imgs/common/transp2.gif" width="5" height="250"
></td>
<td>
<table border="0" cellspacing="0" cellpadding="0" width="100%">
<tbody><tr>
<td></td><td bgcolor="#cecece" style="vertical-align: to
p;"><img height="31" alt="" src="/Prod/Image/espace_client/nouv-client.gif" /><i
mg src="http://www.sbsinformatique.com/Prod/Image/espace_client/nouv-client.gif"
alt="" width="385" height="31" /></td>
</tr>
</tbody></table>
<br>

<script>
$(document).ready(function() {
$(".RevendeurInfo").hide();
$("input[name='CustType']").change(function(){
if ($("input[name='CustType']:checked").val() == '2') {
$(".RevendeurInfo").show();
}
else{
$(".RevendeurInfo").hide();
}
});
});
</script>
<div></div>
<table width="100%" border="0" cellspacing="6" cellpadding="0" align="center">
<tbody><tr>
<td><label for="CustCivilState">Civilit</label></td>
<td>
<input type="radio" name="CustCivilState" value="Mr" alt="radio">Mr.
<input type="radio" name="CustCivilState" value="Mme" alt="radio">Mme.
<input type="radio" name="CustCivilState" value="Mlle" alt="radio">Mlle.
</td>
</tr>
<tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustLastname">Nom :
</label></td>

<td><input type="text" alt="blank" class="logininput" name="CustLastname" value=


"" maxlength="255"></td>
</tr><tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustFirstname">Prnom
: </label></td>
<td><input type="text" alt="blank" class="logininput" name="CustFirstname" value
="" maxlength="255"></td>
</tr><tr>
</tr><tr>
<td style="padding-top:1em; padding-bottom:8px;">
<span style=" font: 14px/22px Arial,Helvetica,Sans-serif;margin: 10px 0
0 6px;">Vous tes : </span>
</td>
<td><input alt="radio" type="radio" name="CustType" value="1">un particu
lier &nbsp;
<input alt="radio" type="radio" name="CustType" value="2">un rev
endeur</td>
</tr>
<tr class="RevendeurInfo" style="display: none;">
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustSociete"> Socit :
</label></td>
<td><input type="text" alt="" class="logininput" name="CustSociete" value="" max
length="255"></td>
</tr>
<tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustRCode">Code d'a
vantage : </label></td>
<td><input type="text" alt="" class="logininput" name="CustRCode" value="" maxle
ngth="255"></td>
</tr>
<tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustEmail">E-mail :
</label></td>
<td><input type="text" alt="email" class="logininput" name="CustEmail" value=""
maxlength="255"></td>
</tr><tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustContactPhone">Tl
(facultatif) : </label></td>
<td><input type="text" class="logininput" name="CustContactPhone" value="" maxle
ngth="255"></td>
</tr><tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustPassword">Chois
issez un mot de passe : </label></td>
<td><input type="password" class="logininput" name="CustPassword" alt="blank" va
lue=""></td>
</tr><tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="DestCustPassword">C
onfirmer le mot de passe : </label></td>
<td><input type="password" class="logininput" name="DestCustPassword" alt="equal
to|CustPassword" value="" "=""></td>
</tr><tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustReferrerEmail">
E-mail de votre parrain : </label></td>
<td><input type="text" class="logininput" name="CustReferrerEmail" alt="email|bo
k" value=""></td>
</tr>
<tr>
<td style="padding-top:3px; padding-bottom:3px;"><label for="CustRemarque">Remar
que : </label></td>
<td><textarea alt="" name="CustRemarque" value="" maxlength="255"></textarea></t

d>
</tr>
<tr>
<td colspan="2" style="border-bottom: 1px solid #5B6372; padding-bottom:
13px;">
<label for="CustInMailngList"><input type="checkbox" name="CustI
nMailngList" value="1" checked=""> Je souhaite recevoir votre newsletter </label
>
</td>
</tr>
</tbody></table></td></tr></tbody></table>
<div style="text-align:right;"><span class="box login" style="margin-right: 4px;
">
<input type="submit" class="style5" id="submit_button" value="envoyer" />
</span></div>
</form>
</div>
</body>
</html>

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