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  1. <!DOCTYPE html>
  2. <html lang="en">
  3. <head>
  4. <meta charset="utf-8">
  5. <title>FAIMaison − contribution à l'expérimentation wifi</title>
  6. <script src="dist/js/bootstrap.js"></script>
  7. <link href="dist/css/bootstrap.min.css" rel="stylesheet">
  8. </head>
  9. <body>
  10. <nav class="navbar">
  11. <div class="navbar-brand">Coucou</div>
  12. </nav>
  13. <h1>Coucou</h1>
  14. <form>
  15. <p>
  16. <label for="name">Nom / Pseudo</label>
  17. <input name="name" type="text"/>
  18. </p>
  19. <h2>Moyen de contact</h2>
  20. <p>
  21. <label for="email">Email</label>
  22. <input name="email" type="email"/>
  23. et/ou
  24. <label for="email">Téléphone</label>
  25. <input name="email" type="tel"/>
  26. </p>
  27. <h2>Je souhaite</h2>
  28. <p>
  29. <input type="radio" name="contrib-type" value="share"/>
  30. Partager une partie de ma connexion <br />
  31. <input type="radio" name="contrib-type" value="connect"/>
  32. Me raccorder au réseau expérimental
  33. </p>
  34. <h2>Partager une connexion</h2>
  35. <h3>Ma connexion</h3>
  36. <p>
  37. <input type="radio" name="contrib-type" value="share"/>
  38. Fibre <br />
  39. <input type="radio" name="contrib-type" value="connect"/>
  40. VDSL <br />
  41. <input type="radio" name="contrib-type" value="share"/>
  42. ADSL <br />
  43. </p>
  44. <p>
  45. <label for="bandwidth">Débit (Mbps)</label>
  46. <input name="bandwidth" type="number"/>
  47. </p>
  48. <p>
  49. <label for="share-part">Je souhaite partager (au max.) (Mbps)</label>
  50. <input name="share-part" type="number"/>
  51. </p>
  52. <h2>Ma localisation</h2>
  53. <div style="background: #ccc; width:400px; height: 100px;">&nbsp;</div>
  54. <h3>Orientation(s) de mes fenêtres</h3>
  55. <input type="checkbox" name="vehicle" value="N">Nord<br />
  56. <input type="checkbox" name="vehicle" value="NO">Nord-Ouest<br />
  57. <input type="checkbox" name="vehicle" value="O">Ouest<br />
  58. <input type="checkbox" name="vehicle" value="SO">Sud-Ouest<br />
  59. <input type="checkbox" name="vehicle" value="S">Sud<br>
  60. <input type="checkbox" name="vehicle" value="SE">Sud-Est<br>
  61. <input type="checkbox" name="vehicle" value="E">Est<br>
  62. <input type="checkbox" name="vehicle" value="NE">Nord-Est<br>
  63. <p>
  64. <label for="floor">Étage</label>
  65. <input name="floor" type="number"/>
  66. </p>
  67. <input type="submit" value="Envoyer">
  68. </form>
  69. </body>
  70. </html>