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Formulaire d’urgence
Formulaire d'urgence
${ parent.decodeEntities(`Nom`) } *
{ parent.activateValidation({"message":"Le champs est obligatoire !","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} />
${ parent.decodeEntities(`Prénom`) } *
{ parent.activateValidation({"message":"Le champs est obligatoire !","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} />
${ parent.decodeEntities(`Segment de clientèle`) } *
item.value === parent.getValue("mf-select"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-select")} ref=${() => { register({ name: "mf-select" }, parent.activateValidation({"message":"Le champs est obligatoire !","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-select") === '' && false ) { parent.setValue( 'mf-select', '', true ); parent.handleChange({ target: { name: 'mf-select', value: '' } }); } }} />
${ parent.decodeEntities(`Nom de la Société`) } *
{ parent.activateValidation({"message":"Le champs est obligatoire !","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el) }} />
${ parent.decodeEntities(`Email`) } *
parent.activateValidation({"message":"Le champs est obligatoire !","emailMessage":"Veuillez saisir une adresse de messagerie valide","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} /> ${ parent.decodeEntities(`Example: user@website.com`) }
${ parent.decodeEntities(`Code postal`) } *
{ parent.activateValidation({"message":"Le champs est obligatoire !","minLength":5,"maxLength":5,"type":"by_character_length","required":true,"expression":"null"}, el) }} />
${ parent.decodeEntities(`Motif de la demande`) } *
item.value === parent.getValue("mf-select"))[0] : []} onChange=${(e)=> parent.handleSelect(e, "mf-select")} ref=${() => { register({ name: "mf-select" }, parent.activateValidation({"message":"Le champs est obligatoire !","minLength":1,"maxLength":"","type":"none","required":true})); if ( parent.getValue("mf-select") === '' && false ) { parent.setValue( 'mf-select', '', true ); parent.handleChange({ target: { name: 'mf-select', value: '' } }); } }} />
${ parent.decodeEntities(`Message`) } *
parent.activateValidation({"message":"Le champs est obligatoire !","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)} >
${ parent.decodeEntities(``) }
parent.activateValidation({"message":"Ce champ est nu00e9cessaire.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el) } /> En cliquant sur « Envoyer », vous acceptez
notre politique d’utilisation des données
.
${ parent.decodeEntities(`Envoyer`) }