0byt3m1n1
Path:
/
home
/
kassiope
/
www
/
utilisateurs
/
modeles
/
[
Home
]
File: change_param_form.php
<?=header_page(CHANGE_PARAMS); ?> <? $fleche_gauche = '<font color="#CC0000"><b><=</b></font>'; if (!empty($message_erreur)) { echo '<div class="alert alert-danger">'.$message_erreur."</div>\n"; } ?> <form name="entryform" id="contact-form" method="post" action="<?=$_SERVER['PHP_SELF']?>"> <input type="hidden" name="id_utilisateur" value="<?=$_SESSION['utilisateur']['id_utilisateur']?>" /> <div class="row"> <div class="form-group col-sm-6 col-md-4 col-lg-4 civilite"> <div class="form-check form-check-inline"> <input class="form-check-input" type="radio" name="civilite" id="inlineRadio1" value="Mlle" <?php if(vb($frm['civilite'])=="Mlle") echo "checked" ?>> <label class="form-check-label" for="inlineRadio1">Mlle</label> </div> <div class="form-check form-check-inline"> <input class="form-check-input" type="radio" name="civilite" id="inlineRadio2" value="Mme" <?php if(vb($frm['civilite'])=="Mme") echo "checked" ?>> <label class="form-check-label" for="inlineRadio2">Mme</label> </div> <div class="form-check form-check-inline"> <input class="form-check-input" type="radio" name="civilite" id="inlineRadio3" value="M." <?php if(vb($frm['civilite'])=="M.") echo "checked" ?>> <label class="form-check-label" for="inlineRadio3">M.</label> </div> </div> <div class="form-group col-sm-6 col-md-4 col-lg-4"> <label for="username"><?echo FIRST_NAME?> <span class="required">*</span></label> <input type="text" class="form-control" name="prenom" value="<?=stripslashes(vb($frm['prenom']))?>" required> <? if (isset($erreurs['prenom'])) echo $message_erreur['prenom'] ?> </div> <div class="form-group col-sm-6 col-md-4 col-lg-4"> <label for="username"><?echo NAME?> <span class="required">*</span></label> <input type="text" class="form-control" name="nom_famille" value="<?=stripslashes(vb($frm['nom_famille']))?>" required> <? if (isset($erreurs['nom_famille'])) echo $message_erreur['nom_famille'] ?> </div> <!-- <div class="form-group col-sm-6 col-md-4 col-lg-4"> <label for="username"><?echo NAISSANCE?></label> <?php $frm['naissance'] = preg_replace('<^([0-9]{4})-([0-9]{2})-([0-9]{2})$>' , '\\3/\\2/\\1', vb($frm['naissance'])); ?> <input class="form-control" type="text" name="naissance" value="<?=vb($frm['naissance'])?>" placeholder="JJ/MM/AAAA"> </div> --> <div class="form-group col-sm-6 col-md-6 col-lg-6"> <label for="username"><?echo EMAIL?> <span class="required">*</span></label> <input type="email" class="form-control" name="email" value="<?=stripslashes(vb($frm['email']))?>" required> <? if (isset($erreurs['email'])) echo $message_erreur['email'] ?> </div> <div class="form-group col-sm-6 col-md-6 col-lg-6"> <label for="username"><?echo TELEPHONE?> <span class="required">*</span></label> <input type="text" class="form-control" name="telephone" value="<?=stripslashes(vb($frm['telephone']))?>" required> <? if (isset($erreurs['telephone'])) echo $message_erreur['telephone'] ?> </div> <div class="col-12"></div> <div class="form-group col-sm-6 col-md-6 col-lg-6"> <label for="username"><?echo CLUB?> <span class="required">*</span></label> <input type="text" class="form-control" name="societe" value="<?=stripslashes(vb($frm['societe']))?>" required> </div> <div class="form-group col-sm-6 col-md-6 col-lg-6"> <label for="username"><?echo FONCTION?> <span class="required">*</span></label> <input type="text" class="form-control" name="portable" value="<?=stripslashes(vb($frm['portable']))?>" required> </div> <div class="form-group col-sm-6 col-md-12 col-lg-12"> <label for="username"><?echo ADDRESS?> <span class="required">*</span></label> <input type="text" class="form-control" name="adresse" value="<?=stripslashes(vb($frm['adresse']))?>" required> <? if (isset($erreurs['adresse'])) echo $message_erreur['adresse'] ?> </div> <div class="form-group col-sm-6 col-md-4 col-lg-4"> <label for="username"><?echo ZIP?> <span class="required">*</span></label> <input type="text" class="form-control" name="code_postal" oninput="this.value = this.value.replace(/[^0-9.]/g, '').replace(/(\..*?)\..*/g, '$1');" value="<?=stripslashes(vb($frm['code_postal']))?>" required> <? if (isset($erreurs['code_postal'])) echo $message_erreur['code_postal'] ?> </div> <div class="form-group col-sm-6 col-md-4 col-lg-4"> <label for="username"><?echo TOWN?> <span class="required">*</span></label> <input type="text" class="form-control" name="ville" value="<?=stripslashes(vb($frm['ville']))?>" required> <? if (isset($erreurs['ville'])) echo $message_erreur['ville'] ?> </div> <div class="form-group col-sm-6 col-md-4 col-lg-4"> <label for="username"><?echo COUNTRY?></label> <select class="form-select" name="pays"> <?php $sql_pays = "SELECT id, pays_".$_SESSION['langue']." FROM gaia_pays WHERE etat = '1' ORDER BY position asc"; $res_pays = mysql_query_override($sql_pays); if ($res_pays) { if (mysql_num_rows_override($res_pays)) { while ($tab_pays = mysql_fetch_array_override($res_pays)) { echo "<option value=\"".$tab_pays['id']."\""; if (vb($frm['pays_'.$_SESSION['langue'].'']) == $tab_pays['id']) echo "selected"; echo ">".stripslashes($tab_pays['pays_'.$_SESSION['langue'].''])."</option>"; } } } ?> </select> </div> <div class="form-group col-sm-12 col-md-12 col-lg-12"> <input type="hidden" name="format" value="html"> <input type="checkbox" name="newsletter" <?=frmvalide($frm['newsletter'])?> > <?echo NEWSLETTER_YES; ?> </div> <div class="form-group col-sm-12 col-md-12 col-lg-12"> <input type="checkbox" name="commercial" <?=frmvalide($frm['commercial'])?> > <?echo COMMERCIAL_YES; ?> </div> </div> <div class="form-action1"> <div class="text-end actions-log"> <br /><br /> <input type="submit" class="button" name="connexion" value="<?echo VALIDE?>"> <p><sup>*</sup> <?=MANDATORY?></p> </div> </div> </form> <p><?echo CNIL; ?></p> <?=footer_page(); ?>