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<!DOCTYPE html PUBLIC '-//W3C//DTD XHTML 1.0 Transitional//EN' 'http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd'> <html xmlns='http://www.w3.org/1999/xhtml'> <head><link rel="icon" href="https://public.message-business.com/contents/sellsy/favicon-sendethic/favicon.ico"><meta http-equiv="Content-Security-Policy" content="default-src 'self'; img-src * data:; media-src *; style-src * 'unsafe-inline'; script-src 'self' 'unsafe-inline' https://*.message-business.com https://*.mkgop.net https://code.jquery.com; frame-src 'self' https://*.message-business.com https://*.mkgop.net;" /> <META HTTP-EQUIV='Content-Type' CONTENT='text/html; charset=utf-8'> <meta name='viewport' content='width=device-width, initial-scale=1.0'> <title>Formulaire inscription Pro FR</title> <script language='javascript' type='text/javascript' src='/Javascript/jquery-1.12.4.min.js?v=20171012'></script> <script language='javascript' type='text/javascript' src='/Javascript/form/intlTelInput.min.js?v=20171012'></script> <script language='javascript' type='text/javascript' src='/Javascript/form/intlTelInput.utils.min.js?v=20171012'></script> <script language='javascript' type='text/javascript' src='/Javascript/form/form.js?v=20171012'></script> <link type='text/css' href='/Javascript/form/form.css?v=20171012' rel='stylesheet' media='all' /> <style type='text/css'> #labelOf-formItem-mbmultiple-28, #labelOf-formItem-mbmultiple-41, #labelOf-formItem-mbmultiple-42 { font-weight: normal !important;} html,body{padding:0;margin:0;width:100%;background:#f4f4f4;} a img {border:none;text-decoration:none;} html,body,input,textarea,select{font-family:Arial, Helvetica, sans-serif; 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margin: 0 20px; } #be, #bgz {border-width: 0px;border-style: solid;max-width: 100%;height: auto;} #titre {color: white;text-align: center;font-weight:bold;font-size: 22px;padding: 10px;} @media (min-width: 450px) { #titre {font-size: 28px;} } @media (min-width: 750px) { #titre {font-size: 36px;} } </style> </head> <body onload='javascript:scriptOnLoad();'><div class='formHeader'><div id="fond_vert"> <div id="titre"><span style="font-family:Arial,Helvetica,sans-serif;">Newsletter BEES - Inscription</span></div> <img id="be" src="/contents/2/115/25115/Images/BEES-Bio360-2024-bann_960x130_subscribe_form-01-FR.png" style="width: 100%;" /></div></div> <div class='formContent'><form name='mbform' method='POST' action='form.aspx'><input type='hidden' name='accountSetting-MobilePrefix' value='FR' /> <div class='formTitle' id='divItem-0-1'>Newsletter BEES - Inscription</div> <div class='formParagraph' id='divItem-0-2'>Les champs marqu茅s d'un ast茅risque doivent 锚tre remplis. <br />Respecter la confidentialit茅 de vos donn茅es personnelles nous est important. Pour plus d'informations sur notre politique en mati猫re de protection des donn茅es, veuillez lire ici notre <a href="https://www.bees.biz/telechargement/Politique_de_Confidentialite_BEES.pdf" target="_blank" style="color:blue">Politique de Confidentialit茅</a>.</div> <div class='formText' id='divItem-0-3'> <div class='formTextLabel' id='labelOf-formItem-mbtext-email'><label for="formItem-mbtext-email">Mon adresse email *</label></div> <input type='hidden' name='nameOf-formItem-mbtext-email' value='Mon adresse email *' /> <input type='hidden' name='required-formItem-mbtext-email' value='true' /> <div class='formTextInput'><input type='text' id="formItem-mbtext-email" name='formItem-mbtext-email' value='' /></div> </div> <div class='formText' id='divItem-0-4'> <div class='formTextLabel' id='labelOf-formItem-mbtext-31'><label for="formItem-mbtext-31">Mon adresse email 脿 nouveau (pour confirmation) *</label></div> <input type='hidden' name='nameOf-formItem-mbtext-31' value='Mon adresse email 脿 nouveau (pour confirmation) *' /> <input type='hidden' name='required-formItem-mbtext-31' value='true' /> <div class='formTextInput'><input type='text' id="formItem-mbtext-31" name='formItem-mbtext-31' value='' /></div> </div> <div class='formSelectionSingle' id='divItem-0-5'> <div class='formSelectionSingleLabel' id='labelOf-formItem-mbsingle-emailoptin'></b>Newsletter Bio360</b> : je souhaite recevoir la newsletter du salon Bio360 *</div> <div class='formSelectionSingleValues'> <input type='hidden' name='nameOf-formItem-mbsingle-emailoptin' value='Newsletter Bio360 : je souhaite recevoir la newsletter du salon Bio360 *' /> <input type='hidden' name='required-formItem-mbsingle-emailoptin' id='formItem-mbsingle-emailoptin' value='true' /> <div class='formSelectionSingleValueForSingleLine'><label for="formItem-mbsingle-emailoptin_yes1"><input type='radio' id="formItem-mbsingle-emailoptin_yes1" name='formItem-mbsingle-emailoptin' value='yes1' checked='checked' /> <b><span style="color: green; font-size: 20px;">OUI</span></b></label><input type='hidden' name='nameOf-formItem-mbsingle-emailoptin_yes1' value='OUI' /></div><div class='formSelectionSingleValueForSingleLine'><label for="formItem-mbsingle-emailoptin_no"><input type='radio' id="formItem-mbsingle-emailoptin_no" name='formItem-mbsingle-emailoptin' value='no' /> <b><span style="color:red">Non, me d茅sinscrire </span> de <span style="color:red"> TOUTES </span> les Newsletters de BEES </b> <i>(newsletters Exposer et Partenaire inclus)</i></label><input type='hidden' name='nameOf-formItem-mbsingle-emailoptin_no' value='Non, me d茅sinscrire de TOUTES les Newsletters de BEES (newsletters Exposer et Partenaire inclus)' /></div> </div> </div> <input type='hidden' name='defaultOf_formItem-mbsingle-emailoptin' value='yes1' /> <div class='formSelectionSingle' id='divItem-0-6'> <div class='formSelectionSingleLabel' id='labelOf-formItem-mbsingle-30'>Langue de pr茅f茅rence *</div> <div class='formSelectionSingleValues'> <input type='hidden' name='nameOf-formItem-mbsingle-30' value='Langue de pr茅f茅rence *' /> <div class='formSelectionSingleValueForSingleLine'><label for="formItem-mbsingle-30_22"><input type='radio' id="formItem-mbsingle-30_22" name='formItem-mbsingle-30' value='22' checked='checked' /> Fran莽ais</label><input type='hidden' name='nameOf-formItem-mbsingle-30_22' value='Fran莽ais' /></div><div class='formSelectionSingleValueForSingleLine'><label for="formItem-mbsingle-30_21"><input type='radio' id="formItem-mbsingle-30_21" name='formItem-mbsingle-30' value='21' /> English</label><input type='hidden' name='nameOf-formItem-mbsingle-30_21' value='English' /></div> </div> </div> <input type='hidden' name='defaultOf_formItem-mbsingle-30' value='22' /> <div class='formText' id='divItem-0-7'> <div class='formTextLabel' id='labelOf-formItem-mbtext-salutation'><label for="formItem-mbtext-salutation">Civilit茅 (M., Mme, Dr, etc.) *</label></div> <input type='hidden' name='nameOf-formItem-mbtext-salutation' value='Civilit茅 (M., Mme, Dr, etc.) *' /> <input type='hidden' name='required-formItem-mbtext-salutation' value='true' /> <div class='formTextInput'><input type='text' id="formItem-mbtext-salutation" name='formItem-mbtext-salutation' value='' /></div> </div> <div class='formText' id='divItem-0-8'> <div class='formTextLabel' id='labelOf-formItem-mbtext-firstname'><label for="formItem-mbtext-firstname">Pr茅nom *</label></div> <input type='hidden' name='nameOf-formItem-mbtext-firstname' value='Pr茅nom *' /> <input type='hidden' name='required-formItem-mbtext-firstname' value='true' /> <div class='formTextInput'><input type='text' id="formItem-mbtext-firstname" name='formItem-mbtext-firstname' value='' /></div> </div> <div class='formText' id='divItem-0-9'> <div class='formTextLabel' id='labelOf-formItem-mbtext-lastname'><label for="formItem-mbtext-lastname">Nom *</label></div> <input type='hidden' name='nameOf-formItem-mbtext-lastname' value='Nom *' /> <input type='hidden' name='required-formItem-mbtext-lastname' value='true' /> <div class='formTextInput'><input type='text' id="formItem-mbtext-lastname" name='formItem-mbtext-lastname' value='' /></div> </div> <input type='hidden' name='nameOf-formItem-mbtext-source' value='Pro FR' /> <input type='hidden' name='formItem-mbtext-source' id='formItem-mbtext-source' value='Pro FR' /> <div class='formCaptcha'><div class='formCaptchaImage'><img src='/Captcha.ashx?width=150&height=50&id=r16fpgiabvavhbmoeeaoyfvsfaougsiusheohgpvzaymvmugpisuuuubhbsvhasjyyejyvzouhmsagfigygzsmyoyvbfpaofbibaezpvagiagaszpejhaymghmbyfibzssb' width='150' height='50' /><input type='hidden' name='formItem-captcha-key' value='r16fpgiabvavhbmoeeaoyfvsfaougsiusheohgpvzaymvmugpisuuuubhbsvhasjyyejyvzouhmsagfigygzsmyoyvbfpaofbibaezpvagiagaszpejhaymghmbyfibzssb' /></div><div class='formCaptchaLabel' id='labelOf-formItem-captcha-text'>Veuillez indiquer le code affich茅 dans l'image</div><div class='formCaptchaInput'><input type='text' name='formItem-captcha-text' id='formItem-captcha-text' /></div></div><div class='formPager'><div class='formSubmit'><a onclick='javascript:scriptOnSubmit();'>Valider le formulaire</a></div></div><input type='hidden' name='status' id='status' value='submit' /><input type='hidden' name='accountidhidden' id='accountidhidden' value='25115' /><input type='hidden' name='anonid' id='anonid' value='a-fa07aa72-95b7-4bd3-b4df-a741c515f26b' /></form></div><div class='formFooterContainer'><div class='formFooter'> </div></div></body></html>