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<select name="menu"><option value="excellent">Excellent</option><option value="bon"
selected="selected">Bon</option><option value="moyen">Moyen</option><option value="faible">Faible</option><option
value="debutant">Débutant</option></select>
</td>
</tr>
<tr><td>Num carte </td>
<!--forms 0 elements 2--> <td><input name="carte" value="" size="20" maxlength="15" type="text"></td>
</tr>
<tr>
<td>Email</td>
<!--forms 0 elements 5--> <td><input name="Email" value="" size="20" maxlength="64" type="text"></td>
</tr>
<tr>
<!--forms 0 elements 6--> <td><input name="menu" value="Envoyer" type="submit"></td>
<!--forms 0 elements 7--> <td><input name="menu" value="Annuler" type="reset"></td>
</tr>
<tr>
</tr>
<tr>
<td colspan="2"><br>
<br>
Renseignez le formulaire et cliquez sur Envoyer.<br>
<br>
</td>
</tr>
</tbody>
</table>
</form>
</fieldset>
</body></html>

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