<HTML> <HEAD> <TITLE>LA COMPETENCE DES FAMILLES. TEMPS, CHAOS, PROCESSUS. </TITLE> <META NAME="Description" CONTENT="""> <META NAME="Keywords" CONTENT="""> <META NAME="Author" CONTENT="PHILIPPE PIQU"> <META NAME="Generator" CONTENT="WebExpert"> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">  <script language="Javascript"> function imprimer(){window.print();} </script>  <link rel="StyleSheet" type="text/css" href="../../style.css"> </HEAD> <body bgcolor="#FFFFFF" text="#000000" link="#0000ff" vlink="#800080" alink="#ff0000" leftmargin="0" marginwidth="0" topmargin="0" marginheight="0"> <table body cellpadding="0" cellspacing="0" border="0"> <tr><td bgcolor="#800000"> <table width="120" height="100%" cellpadding="0" cellspacing="0" bgcolor="#800000" border="0"> <tr><td valign="top"> <table width="120" cellpadding="0" cellspacing="0" bgcolor="#FF9933" border="0"> <tr><td height="10"><td></tr> <tr><td bgcolor="#CC0000" align="Center" height="25"><a class="menu" href="../../presentation.php">Prsentation</a></td></tr> <tr><td height="10"><td></tr> <tr><td bgcolor="#3399FF" align="Center" height="25"><a class="menu" href="../../formation.php">Formations</a></td></tr> <tr><td height="10"><td></tr> <tr><td bgcolor="#006600" align="Center" height="25"><a class="menu" href="../../colloque.php">Colloques</a></td></tr> <tr><td height="10"><td></tr> <tr><td bgcolor="#660066" align="Center" height="25"><a class="menu" href="../../publication.php">Publications</a></td></tr> <tr><td height="10"><td></tr> <tr><td bgcolor="#FF0099" align="Center" height="25"><a class="menu" href="../../information.php">Informations</a></td></tr> <tr><td height="10"><td></tr> <tr><td bgcolor="#000000" align="Center" height="25"><a class="menu" href="../../contact.php">Contacts</a></td></tr> <tr><td height="10"><td></tr> </table> </td></tr> </table> </td> <td width="10"></td> <td valign="top"> <table cellpadding="10" cellspacing="0" border="0"> <tr> <td bgcolor="#800000" width="112" align="center"><img src="../../images/ecusson.jpg" border="0" width="93" height="140" alt="Institut d'Etude de la Famille de Lille"></td> <td width="365" valign="middle" class="texte"> <ul> <li><a href="index.php?choix=0" class="pre">Prsentation</a>  <li><a href="index.php?choix=1" class="pre">Mercredi</a>   <li><a href="index.php?choix=2" class="pre">Jeudi</a>   <li><a href="index.php?choix=3" class="pre">Informations</a>   <li><a href="index.php?choix=4" class="pre">S'inscrire</a>   </ul> </td> <td bgcolor="#FFFF33" height="140" valign="top" align="center"><img src="../../images/logo.gif" border="0" width="78" height="130" alt="Institut d'Etudes de la Famille de Lille"></td> <tr> <td bgcolor="#FF0000" colspan="3" height="80" class="accroche"> LA COMPETENCE DES FAMILLES.  TEMPS, CHAOS, PROCESSUS.  <br><font size="-1">par le Dr Guy AUSLOOS</font> </td> </tr> <tr> <td bgcolor="#FFCC00" colspan="3" align="center" class="soustitre"></td> </tr> <tr> <td colspan=2 class="texte" width="477">   <TABLE> <TR> <TD colSpan=2> <H2> <DIV align=center>FORMULAIRE D'INSCRIPTION</DIV></H2> <HR align=center width="60%" color=#ff9933> </TD></TR> <FORM> <TR> <TD>Nom :</TD> <TD><INPUT maxLength=256 size=40 name=nom></TD></TR> <TR> <TD>Prnom :</TD> <TD><INPUT maxLength=256 size=40 name=prenom></TD></TR> <TR> <TD>Adresse :</TD> <TD><INPUT maxLength=256 size=40 name=adresse></TD></TR> <TR> <TD>Code Postal :</TD> <TD><INPUT maxLength=6 size=6 name=cp></TD></TR> <TR> <TD>Ville :</TD> <TD><INPUT maxLength=256 size=40 name=ville></TD></TR> <TR> <TD>Pays :</TD> <TD><INPUT maxLength=40 size=40 name=pays></TD></TR> <TR> <TD vAlign=center colSpan=2 height=60><B>Prise en charge par :</B>  <TABLE cellSpacing=0 cellPadding=0 width="100%" border=0> <TBODY> <TR> <TD><INPUT type=checkbox value=participant name=paiement> Participant</TD> <TD><INPUT type=checkbox value=Institution name=paiement>  Institution</TD></TR></TBODY></TABLE></TD></TR> <TR> <TD>Institution :</TD> <TD><INPUT maxLength=256 size=40 name=nom_inst></TD></TR> <TR> <TD>Adresse :</TD> <TD><INPUT maxLength=256 size=40 name=adresse_inst></TD></TR> <TR> <TD>Code Postal :</TD> <TD><INPUT maxLength=6 size=6 name=cp_int></TD></TR> <TR> <TD>Ville :</TD> <TD><INPUT maxLength=256 size=40 name=ville_inst></TD></TR> <TR> <TD>Pays :</TD> <TD><INPUT maxLength=40 size=40 name=pays_inst></TD></TR> <TR> <TD class=commentaire align=middle colSpan=2>&nbsp; <p><DIV align=center>Inscription  la conference <BR>du mercredi 12 mars et jeudi  13 mars 2003<BR>avec le Dr Guy Ausloos </DIV></p>&nbsp;</TD></TR> <TR> <TD colSpan=2><INPUT type=checkbox  value="Paiement avant le 10 fevrier 2003 : 141 " name=paiement> Paiement avant  le 10 Fvrier 2003 : 141 <BR><INPUT type=checkbox  value="Paiement aprs le 10 fevrier 2003 : 175 " name=paiement> Paiement aprs  le 10 Fvrier 2003 : 175 <BR></TD></TR> <TR> <TD vAlign=bottom height=40>Date :</TD> <TD vAlign=bottom><INPUT maxLength=14 size=14 name=date></TD></TR> <TR> <TD colSpan=2>Cachet :</TD></TR></table></FORM> </td> <td bgcolor="#000080" class="presentation" valign="top">  <P>Secrtariat : <BR><B>Institut de la Famille de Toulouse</B> <BR>46 rue de  Metz <BR>31000 Toulouse </P> <P>Prire de remplir ce formulaire, <br />l'<A onclick=imprimer()  href="#"><font color="#ffffff">imprimer</font></A> et le renvoyer<br />avec le paiement<br />au secrtariat.</P> </td> </tr> </table> </body> </html>   
