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<form action="" https:="" mc9p00yvjggh40bsxwxk1hjplyh4.pub.sfmc-content.com="" qfojs2hvf4s?qs="9f78ffe2c47c292f0d6f0a2aeeda0dc10b7084787029b2c19ed78c33ce65f56a11fda24ca651e7a3&quot;&quot;" method="post" id="myForm">
  <div class="form-group">
    <h3 style="color:#428bca; font-weight:bold;margin-bottom:25px"> Informations personnelles </h3>
  </div>
  <div>
    <div class="form-group">
      <label for="firstName" style="font-size:12px">Prenom </label>
      <input type="text" style="font-size:12px;height:30px" name="firstName" class="form-control" id="firstName" value="">
    </div>
    <div class="form-group">
      <label for="lastName" style="font-size:12px">Nom </label>
      <input type="text" style="font-size:12px;height:30px" name="lastName" class="form-control" id="lastName" value="">
    </div>
  </div>
  <div class="form-group">
    <label for="email" style="font-size:12px">Email</label>
    <input type="text" style="font-size:12px;height:30px" name="email" class="form-control" id="email" value="">
  </div>
  <div class="form-group">
    <label style="font-size:12px">Civilite</label>
    <div>
      <label for="male" class="radio-inline" style="font-size:12px"><input type="radio" name="gender" id="male" value="male">M.</label>
      <!-- <label for="female" class="radio-inline" style="font-size:12px"><input type="radio" name="gender" id="female" value="female" >Mlle</label>-->
      <label for="other" class="radio-inline" style="font-size:12px"><input type="radio" name="gender" id="other" value="other">Mme</label>
    </div>
  </div>
  <div class="form-group">
    <label class="control-label" style="font-size:12px">Ville </label>
    <input type="text" style="font-size:12px;height:30px" class="form-control" id="city" name="city" value="">
  </div>
  <div class="form-group">
    <label class="control-label" style="font-size:12px">Code Postal </label>
    <input type="text" style="font-size:12px;height:30px" class="form-control" placeholder="" id="interest" name="Interest" value="">
  </div>
  <div class="form-group">
    <label class="control-label" style="font-size:12px">Departement</label>
    <input type="text" style="font-size:12px;height:30px" class="form-control" placeholder="" id="State" name="State" value="">
  </div>
  <div class="form-group">
    <h3 style="color:#428bca; font-weight:bold;margin-bottom:25px;margin-top:25px"> Préférences de Communication </h3>
  </div>
  <div>
    <label style="font-size:15px">Je suis interesse par:</label><br>
    <div>
      <div style="display:flex;">
        <input type="checkbox" id="chk1" name="chk1" value="Invitations à des évènements institutionnels(colloque, séminaire, vœux etc.)" style="align-items: start;">
        <label for="chk1" class="radio-inline" style="align-items: start;"> Invitations à des évènements institutionnels(colloque, séminaire, vœux etc.)</label><br>
      </div>
      <input type="checkbox" id="chk2" name="chk2" value="Suivi du programme ALLEZ LES BLEUS">
      <label for="chk2" class="radio-inline"> Suivi du programme ALLEZ LES BLEUS</label><br>
      <input type="checkbox" id="chk3" name="chk3" value="Suivi du programme Génération 2024">
      <label for="chk3" class="radio-inline"> Suivi du programme Génération 2024</label><br>
      <input type="checkbox" id="chk4" name="chk4" value="Communication institutionnelle (CP)">
      <label for="chk4" class="radio-inline"> Communication institutionnelle (CP)</label><br>
      <input type="checkbox" id="chk5" name="chk5" value="Communication de partenaires olympiques">
      <label for="chk5" class="radio-inline"> Communication de partenaires olympiques</label><br>
      <input type="checkbox" id="chk6" name="chk6" value="Autres programmes marketing du CNOSF (Z MPS, SEF etc)">
      <label for="chk6" class="radio-inline"> Autres programmes marketing du CNOSF (Z MPS, SEF etc)</label><br>
    </div>
  </div>
  <input type="hidden" name="SubscriberKey" value="003Jv00000KqkvcIAB">
  <input name="CreatedBy" type="hidden" value="737303689">
  <input name="ModifiedBy" type="hidden" value="737303689">
  <input name="PageID" type="hidden" value="0">
  <input name="TabID" type="hidden" value="239">
  <input name="ContentID" type="hidden" value="238">
  <input name="Source" type="hidden" value="3"><input name="IsMobile" type="hidden" value="">
  <div class="text-center">
    <input type="submit" id="mySubmission" name="submit" class="btn  btn-primary" onclick="submitForm();" value="Valider" style="margin-top:30px">
    <br>
    <input type="submit" id="mySubmission" name="unsubmit" class="btn " onclick="submitForm();" value="Se desinscrire de toutes les communications" style="margin-top:15px; font-size:12px;color:grey;border:1px solid black">
  </div>
</form>

Text Content

Registration Page


"OK!"


GESTION DES PREFERENCES


VOS PRÉFÉRENCES ONT BIEN ÉTÉ MISE À JOUR


INFORMATIONS PERSONNELLES

Prenom
Nom
Email
Civilite
M. Mme
Ville
Code Postal
Departement


PRÉFÉRENCES DE COMMUNICATION

Je suis interesse par:

Invitations à des évènements institutionnels(colloque, séminaire, vœux etc.)

Suivi du programme ALLEZ LES BLEUS
Suivi du programme Génération 2024
Communication institutionnelle (CP)
Communication de partenaires olympiques
Autres programmes marketing du CNOSF (Z MPS, SEF etc)



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