document.write('<form method="post" action="//newsletter.infomaniak.com/external/submit" class="inf-form" target="_blank"><input type="email" name="email" style="display:none" /><input type="hidden" name="key" value="eyJpdiI6ImpQdlwvelVkRys0R2JXN291YVJ0Y2JRcWlDdjJKMkhsYlwveWxqaHU5bFBVOD0iLCJ2YWx1ZSI6IjJneEdcL1JZMERWcjRzQTcrSWZLWjR6ZkFERk4rRnUzRHNtNXBvN1NDZDRVPSIsIm1hYyI6IjRmODUzN2I0MGEwZDVlODZmNzk5YTRlY2Y4MzJkY2JmOWE4YjY5NzdjMWVmMTgyYTMyZDM0MTVjZGRkNGYwYTYifQ=="><input type="hidden" name="webform_id" value="9424"><style> .inf-main_f3304160fbf7c5dc12beccceae3cd839{ background-color:#B68183; padding:25px 20px; margin:25px auto; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-content { margin-top:13px;} .inf-main_f3304160fbf7c5dc12beccceae3cd839 h4, .inf-main_f3304160fbf7c5dc12beccceae3cd839 span, .inf-main_f3304160fbf7c5dc12beccceae3cd839 label, .inf-main_f3304160fbf7c5dc12beccceae3cd839 input, .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-submit, .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-success p a { color:#ffffff; font-size:14px; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 h4{ font-size:18px; margin:0px 0px 13px 0px; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 h4, .inf-main_f3304160fbf7c5dc12beccceae3cd839 label{ font-weight:bold; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-input { margin-bottom:7px; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 label { display:block;} .inf-main_f3304160fbf7c5dc12beccceae3cd839 input{ height:35px; color:#999999; border: 1px solid #E9E9E9; padding-left:7px; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-input.inf-error label, .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-input.inf-error span.inf-message{ color: #cc0033; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-input.inf-error input{ border: 1px solid #cc0033; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-input input { width:100%;} .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-input.inf-error span.inf-message { display: block; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-submit { text-align:right;} .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-submit input{ background-color:#74626E; color:#ffffff; border:none; font-weight: normal; height:auto; padding:7px; } .inf-main_f3304160fbf7c5dc12beccceae3cd839 .inf-submit input.disabled{ opacity: 0.4; } .inf-btn { color: rgb(85, 85, 85); border: medium none; font-weight: normal; height: auto; padding: 7px; display: inline-block; background-color: white; box-shadow: 0px 1px 1px rgba(0, 0, 0, 0.24); border-radius: 2px; line-height: 1em; } .inf-rgpd { margin:25px 0px 15px 0px; color:#ffffff; } </style> <div class="inf-main_f3304160fbf7c5dc12beccceae3cd839"> <h4>Newsletter sur la Formation de la Pratique consciente de l\'Oeuf de JAde</h4> <span>indiquez vos coordonnées pour recevoir les informations d\'ouverture du programme et de la Certification de ce printemps</span> <div class="inf-success" style="display:none"> <h4>Votre inscription a été enregistrée avec succès !</h4> <p> <a href="#" class="inf-btn">&laquo;</a> </p> </div> <div class="inf-content"> <div class="inf-input inf-input-text"> <input type="text" name="inf[3]" data-inf-meta = "3" data-inf-error = "Merci de renseigner une chaine de caractère" required="required" placeholder="Nom" > </div> <div class="inf-input inf-input-text"> <input type="text" name="inf[2]" data-inf-meta = "2" data-inf-error = "Merci de renseigner une chaine de caractère" required="required" placeholder="Prénom" > </div> <div class="inf-input inf-input-text"> <input type="text" name="inf[1]" data-inf-meta = "1" data-inf-error = "Merci de renseigner une adresse email" required="required" placeholder="Email" > </div> <div class="inf-input inf-input-text"> <input type="text" name="inf[508]" data-inf-meta = "508" data-inf-error = "Merci de renseigner une chaine de caractère" required="required" placeholder="adresse" > </div> <div class="inf-input inf-input-text"> <input type="text" name="inf[9681]" data-inf-meta = "9681" data-inf-error = "Merci de renseigner une chaine de caractère" placeholder="code postal et ville" > </div> <div class="inf-input inf-input-text"> <input type="text" name="inf[575]" data-inf-meta = "575" data-inf-error = "Merci de renseigner une chaine de caractère" required="required" placeholder="n° natel" > </div> <div class="inf-input inf-input-text"> <input type="text" name="inf[507]" data-inf-meta = "507" data-inf-error = "Merci de renseigner une chaine de caractère" placeholder="date de naissance" > </div> <div class="inf-rgpd">Vos données sont uniquement utilisées pour vous contacter à propos du programme de formation et de certification de la pratique consciente de l\'oeuf de JAde enseignée au Templenergetique. 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