Formulaire d'inscription

<h3>Vous</h2>
<table border="0" cellspacing="10" cellpadding="10">
  <tr>
    <td>Prénom[text* prenom ""]</td>
    <td>Nom[text* nom""]</td>
  </tr>
  <tr>
    <td>E-mail[email* email-814 ""]</td>
    <td></td>
  </tr>
</table>
 
<h3>Votre organisation</h3>
<table border="0" cellspacing="10" cellpadding="10">
  <tr>
    <td>Dénomination[text* tiers""]</td>
    <td></td>
  </tr>
  <tr>
    <td>Adresse[text* adresse-1 ""]</td>
    <td>Complément[text adresse-2 ""]</td>
  </tr>
  <tr>
    <td>Code postal[text* cp ""]</td>
    <td>Ville[text ville ""]</td>
  </tr>
  <tr>
    <td>Téléphone[text tel ""]</td>
    <td></td>
  </tr>
</table>
 
[submit "Créer mon instance"]

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