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src="http://www.brulures.be/data/images/sm_square.gif" width="8" height="9"> <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/home/fr/textID=40/">Adresses utiles</a></td> </tr>  <tr>  	<td width="6%">&nbsp;</td> 	<td><img src="http://www.brulures.be/data/images/sm_square.gif" width="8" height="9"> <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/steunen/fr/">Aidez la Fondation</a></td> </tr>  <tr>  	<td width="6%">&nbsp;</td> 	<td><img src="http://www.brulures.be/data/images/sm_square.gif" width="8" height="9"> <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/doc/fr/">Demande documentation</a></td> </tr>    <tr>        	<td width="6%">&nbsp;</td>       	<td>&nbsp;</td>   </tr> </table>                                	<br><div align="center"><table border="0" cellspacing="0" cellpadding="3">   <tr>      <td valign="bottom"><a href="http://www.cbc.be" target="_blank"><img src="http://www.brulures.be/data/images/partner_kbc_fr.gif" width="55" height="40" border="0"></a></td>     <td>&nbsp;</td>     <td valign="bottom"><a href="http://www.ajaxfire.nl/" target="_blank"><img src="http://www.brulures.be/data/images/partner_ajax_fr.gif" width="55" height="40" border="0"></a></td>   </tr>     <tr>      <td valign="bottom"><a href="http://www.grohe.be/fr_home.cfm" target="_blank"><br><img src="http://www.brulures.be/data/images/grohe_logo1.jpg" border="0"></a></td>     <td>&nbsp;</td>     <td valign="bottom"></td>   </tr> </table>  </div>     </td>     <td width="1" rowspan="2" align="left" valign="top"><img src="http://www.brulures.be/data/images/spacer.gif" width="1" height="357">      </td>     <td rowspan="2" align="left" valign="top" class="content"><form action="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/steunen/fr/" method="POST"> <table>   <tr>      <td colspan=5><h1>Aidez la fondation</h1></td>   </tr>   <tr>      <td colspan=5><b>Je souhaite aider les grands brls</b></td>   </tr>   <tr>      <td colspan=5 class="error"><b></b></td>   </tr>   <tr>      <td width="110"></td>     <td>&nbsp;</td>     <td width="175">&nbsp;</td>     <td width="61" rowspan="2"><div align="right"><img src="http://www.brulures.be/data/images/EF.gif" width="57" height="60"></div></td>     <td>&nbsp;</td>   </tr>   <tr>      <td valign="top">als</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td><input type="radio" class="checkbox" name="source" value="persoon" checked>        persoon<br> <input type="radio" class="checkbox" name="source" value="bedrijf" >        bedrijf / organisatie</td>     <td class="error"></td>   </tr></tr>   <tr>      <td colspan=5><hr size=1 width=100% color="black"></td>   </tr>   <tr>      <td>Organisatie</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" size=40 name="orga" value="" class="option"></td>     <td class="error"></td>   </tr>   <tr>      <td>Jurid. vorm</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" size=40 name="vorm" value="" class="option"></td>     <td class="error"></td>   </tr>   <tr>      <td>Departement</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" size=40 name="dep" value="" class="option"></td>     <td class="error"></td>   </tr>   <tr>      <td>BTWnr</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" size=20 name="btw" value="" class="option"></td>     <td class="error"></td>   </tr>   <tr>      <td colspan=5><hr size=1 width=100% color="black"></td>   </tr>   <tr>      <td>Titre</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><select name="sex" id="sex" size="1"><option value="Mr">Mr</option><option value="Mevr">Mevr</option><option value="Juffr">Juffr</option></select></td>     <td class="error"></td>   </tr>   <tr>      <td>Prnom</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" name="firstName" id="firstName" value="" size="30" maxlength="" /></td>     <td class="error"></td>   </tr>   <tr>      <td>Nom</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" name="name" id="name" value="" size="30" maxlength="" /></td>     <td class="error"></td>   </tr>   <tr>      <td>Adres</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" name="street" id="street" value="" size="30" maxlength="" class="option" /></td>     <td class="error"></td>   </tr>   <tr>      <td>Ville</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" name="city" id="city" value="" size="30" maxlength="" class="option" /></td>     <td class="error"></td>   </tr>   <tr>      <td>Code postale</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" name="zip" id="zip" value="" size="6" maxlength="" class="option" /></td>     <td class="error"></td>   </tr>   <tr>      <td colspan=5><hr size=1 width=100% color="black"></td>   </tr>   <tr>      <td>Email</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" size=40 name="email" value=""></td>     <td class="error" width=199></td>   </tr>   <tr>      <td>Telefoon</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" name="phone" id="phone" value="" size="20" maxlength="" class="option" /></td>     <td class="error"></td>   </tr>   <tr>      <td colspan=5><hr size=1 width=100% color="black"></td>   </tr>   <tr>      <td>Bedrag</td>     <td width=3><img src="http://www.brulures.be/data/images/spacer.gif" width="3" height="20"></td>     <td colspan="2"><input type="text" size=10 name="bedrag" value="">       EUR</td>     <td class="error"></td>   </tr>   <tr>      <td colspan=5><hr size=1 width=100% color="black"></td>   </tr>   <TR>      <td colspan=5> <INPUT TYPE="submit" VALUE="Envoyer"> <INPUT TYPE="hidden" name="send_steun" value="1"></tD>   </TR></tr>   <tr>      <td colspan=5><img src="http://www.brulures.be/data/images/spacer.gif" width="20" height="20"></td>   </tr>   <TR>      <td colspan=6> U ontvangt eerlang een overschrijvingsformulier waarmee U het vermeld bedrag kunt overschrijven op de rekening van de Stichting. Vous pouvez recevoir une attestation fiscale pour tout versement de plus de 30. Nous vous remercions pour votre intrt. <br>Johan de Jager, Administrateur dlgu de la fondation.</td>   </TR> </table></td>   </tr>   <tr>      <td valign="bottom" bgcolor="#E1EBF0"></td>   </tr> </table> <table width="100%" border="0" cellspacing="0" cellpadding="0">   <tr>     <td><table width="740" border="0" cellspacing="0" cellpadding="0">         <tr>           <td width="196" bgcolor="#E1EBF0"><img src="http://www.brulures.be/data/images/spacer.gif" width="196" height="8"></td>           <td>&nbsp;</td>           <td class="footer"><div align="right"><a href="#top"><img src="http://www.brulures.be/data/images/top.gif" name="Image1" width="55" height="20" border="0" id="Image1" onMouseOver="MM_swapImage('Image1','','http://www.brulures.be/data/images/top_over.gif',1)" onMouseOut="MM_swapImgRestore()"></a><a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/steunen/fr//printable=1"><img src="http://www.brulures.be/data/images/print_bottom.gif" width="55" height="20" border="0"></a></div></td>         </tr>       </table></td>   </tr>   <tr>     <td class="footer_bl"><table width="740" border="0" cellspacing="0" cellpadding="0">         <tr>           <td width="196"><img src="http://www.brulures.be/data/images/spacer.gif" width="131" height="20"></td>           <td class="footer_bl">  <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/mainpage/fr/" class="footer_bl">Accueil</a> |   <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/Contactpersonen/fr/textID=14/" class="footer_bl">Contact</a> |   <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/Contactpersonen/fr/textID=17/" class="footer_bl">Conditions de consultation</a> |   <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/Contactpersonen/fr/textID=17/#privacy" class="footer_bl">Vie prive</a> |   <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/home/fr/#privacy" class="footer_bl">FAQ</a> |   <a href="http://www.brulures.be/index.php/PHPSESSID=120f5eddcb8582e7ca4c3d2eb78bdefd/home/fr/textID=82/" class="footer_bl">Partenariat</a> |   </td>         </tr>       </table></td>   </tr>   <tr>     <td><table width="740" border="0" cellspacing="0" cellpadding="0">         <tr>           <td class="footer">developed by UniWeb</td>         </tr>       </table></td>   </tr> </table>    </body> </html> 
