<%@include file="jspf/enteteJSPF.jspf" %> <br /><br /> <table style='border: 0px solid white;'> <tr> <td style='border :0px;'> <fieldset><legend>Coordonnées Pompier</legend> <table> <tr><th><label for="nom">Nom :</label><input type="text" name="ztNom" size="20" maxlength="30"></th></tr> <tr><th><label for="prenom">Prénom :</label><input type="text" name="ztPrenom" size="20" maxlength="30"></th></tr> <tr><th>Adresse :<input type="text" name="ztAdr" size="20" maxlength="30"></th></tr> <tr><th>Ville :<input type="text" name="ztVille" size="20" maxlength="30"></th></tr> <tr><th>Code postal :<input type="text" name="ztCp" size="20" maxlength="30"></th></tr> <tr><th>Téléphone :<input type="text" name="ztTel" size="20" maxlength="30"></th></tr> <tr><th>Mail :<input type="text" name="ztMail" size="20" maxlength="30"></th></tr> <tr><th>Statut :<input type="text" name="ztStatut" size="20" maxlength="30"></th></tr> <tr><th>Grade :<input type="text" name="ztGrade" size="20" maxlength="30"></th></tr> </table> </fieldset> <fieldset><legend>Coordonnées Employeur</legend> <table> <tr><th>Nom employeur : <input type="text" name="ztNomEmp" size="20" maxlength="30"></th></tr> <tr><th>Téléphone employeur : <input type="text" name="ztTelEmp" size="20" maxlength="30"></th></tr> <tr><th>Adresse employeur : <input type="text" name="ztadrEmp" size="20" maxlength="30"></th></tr> <tr><th>Mail employeur : <input type="text" name="ztMailEmp" size="20" maxlength="30"></th></tr> </table> </fieldset>