Remplissez le formulaire pour demander un devis

Question

Accepted Answer

<p><div class="frm_forms  with_frm_style frm_style_style-formidable" id="frm_form_2_container" data-token="773443a6d730a072527401c87e6303fc">
<form enctype="multipart/form-data" method="post" class="frm-show-form " id="form_formulaire-de-demande-de-devis-testo"  data-token="773443a6d730a072527401c87e6303fc">
<div class="frm_form_fields ">
<fieldset>
<legend class="frm_screen_reader">formulaire de demande de devis HYGIENA</legend>

<div class="frm_fields_container">
<input type="hidden" name="frm_action" value="create" />
<input type="hidden" name="form_id" value="2" />
<input type="hidden" name="frm_hide_fields_2" id="frm_hide_fields_2" value="" />
<input type="hidden" name="form_key" value="formulaire-de-demande-de-devis-testo" />
<input type="hidden" name="item_meta[0]" value="" />
<input type="hidden" id="frm_submit_entry_2" name="frm_submit_entry_2" value="6e7c27a3f6" /><input type="hidden" name="_wp_http_referer" value="/produit/microsnap-detection-rapide-des-microorganismes/?add_to_wishlist=1689" /><div id="frm_field_7_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first">
    <label for="field_v9ogd" id="field_v9ogd_label" class="frm_primary_label">Nom
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_v9ogd" name="item_meta[7]" value=""  data-reqmsg="Nom cannot be blank." aria-required="true" data-invmsg="Nom est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_6_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6">
    <label for="field_j3t5l" id="field_j3t5l_label" class="frm_primary_label">Prénom 
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_j3t5l" name="item_meta[6]" value=""  data-reqmsg="Prénom  cannot be blank." aria-required="true" data-invmsg="Prénom  est non valide" aria-invalid="false"  /> 
    
    
</div>
<div id="frm_field_8_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first">
    <label for="field_nb4ey" id="field_nb4ey_label" class="frm_primary_label">Entreprise / Organisation
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_nb4ey" name="item_meta[8]" value=""  data-reqmsg="Entreprise / Organisation cannot be blank." aria-required="true" data-invmsg="Entreprise / Organisation est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_9_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6">
    <label for="field_oz2kk" id="field_oz2kk_label" class="frm_primary_label">La fonction
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_oz2kk" name="item_meta[9]" value=""  data-reqmsg="La fonction cannot be blank." aria-required="true" data-invmsg="La fonction est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_17_container" class="frm_form_field form-field  frm_top_container">
    <label for="field_32kgz" id="field_32kgz_label" class="frm_primary_label">Nom de produit 
        <span class="frm_required" aria-hidden="true"></span>
    </label>
    <input type="text" id="field_32kgz" name="item_meta[17]" value=""  data-invmsg="Nom de produit  est non valide" class="nmpro" style="color: black;" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_19_container" class="frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first">
    <label for="field_hj2bc" id="field_hj2bc_label" class="frm_primary_label">Téléphone
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="tel" id="field_hj2bc" name="item_meta[19]" value=""  data-reqmsg="Téléphone cannot be blank." aria-required="true" data-invmsg="Téléphone est non valide" aria-invalid="false" pattern="((\+\d{1,3}(-|.| )?$?\d$?(-| |.)?\d{1,5})|($?\d{2,6}$?))(-|.| )?(\d{3,4})(-|.| )?(\d{4})(( x| ext)\d{1,5}){0,1}$"  />
    
    
</div>
<div id="frm_field_12_container" class="frm_form_field form-field  frm_required_field frm_top_container">
    <label for="field_tqzrs" id="field_tqzrs_label" class="frm_primary_label">Email
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="email" id="field_tqzrs" name="item_meta[12]" value=""  data-reqmsg="Email cannot be blank." aria-required="true" data-invmsg="Email est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_14_container" class="frm_form_field form-field  frm_top_container">
    <label for="field_ufqaf" id="field_ufqaf_label" class="frm_primary_label">Message 
        <span class="frm_required" aria-hidden="true"></span>
    </label>
    <textarea name="item_meta[14]" id="field_ufqaf" rows="5"  data-invmsg="Message  est non valide" aria-invalid="false"  ></textarea>
    
    
</div>
<div id="frm_field_15_container" class="frm_form_field form-field  frm_none_container">
    <label for="g-recaptcha-response" id="field_89nru_label" class="frm_primary_label">Captcha
        <span class="frm_required" aria-hidden="true"></span>
    </label>
    <div  id="field_89nru" class="frm-g-recaptcha" data-sitekey="6LebJa0pAAAAABPD54PeMmIFwHk1D7SWY775x1hk" data-size="invisible" data-theme="light"></div>
    
    
</div>
<div id="frm_field_89_container" class="frm_form_field form-field ">
	<div class="frm_submit frm_flex">
<button class="frm_button_submit" type="submit"  >Envoyer</button>



</div>
</div>
	<input type="hidden" name="item_key" value="" />
				<div class="frm__660ca0987c12a">
				<label for="frm_email_2" >
					Si vous êtes un humain, ne remplissez pas ce champ.				</label>
				<input  id="frm_email_2" type="text" class="frm_verify" name="frm__660ca0987c12a" value="" autocomplete="false"  />
			</div>
		</div>
</fieldset>
</div>
</form>
</div>
</p>

Présentation

Organigramme

Offre d'emplois

Agroalimentaire

Eau et Environnement

energie et industriel

Pharmaceutique

Recherche Scientifique & Pédagogie

Médical

Microsnap DETECTION RAPIDE DES MICROORGANISMES

Remplissez le formulaire pour demander un devis

Produits similaires

Dualo 32 R2

Testeur de détection de l’ATP sur les surfaces Ultransap

Testeur de détection de l’ATP dans les eaux