<HTML> <HEAD>   <META NAME="GENERATOR" CONTENT="Adobe PageMill 2.0 Mac">   <TITLE>FORMULAIRE DE RESERVATION - PARADIS TROPICAL</TITLE> </HEAD> <BODY BGCOLOR="#ffffff">  <FORM ACTION="/cgi-bin/paradis.cgi" ENCTYPE="x-www-form-encoded" METHOD= "POST">   <P ALIGN=CENTER><A HREF="index.html"><IMG SRC="IMAGES/LOGO_PT2.GIF" WIDTH= "110" HEIGHT="107" ALIGN="BOTTOM" NATURALSIZEFLAG="3" BORDER="0"></A><BR>     <B><FONT SIZE=+1><A HREF="index.htm">PARADIS TROPICAL<BR>     ACCUEIL</A></FONT></B></P>   <P ALIGN=CENTER><b><font size="3" face="Arial, Helvetica, sans-serif">Si vous      d&eacute;sirez recevoir de plus amples renseignements et une proposition chiffr&eacute;e      par<br>     <a href="paradist@paradis-tropical.gp">e-mail</a>, fax ou courrier, veuillez      remplir le questionnaire suivant et nous le retourner.</font></b></P>  <P ALIGN=CENTER><TABLE WIDTH="100%" BORDER="0" CELLSPACING="0" CELLPADDING= "0"> <TR> <TD WIDTH="100%" ALIGN="CENTER" VALIGN="TOP">         <TABLE WIDTH="648" BORDER="1" CELLSPACING="2" CELLPADDING="0" HEIGHT="1119">           <TR>              <TD WIDTH="33%" ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Nom                :<BR>               <I>Name :</I></FONT></B></TD>             <TD WIDTH="67%" BGCOLOR="#ffcf0f">&nbsp;&nbsp;                <INPUT NAME="nom" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Pr&eacute;nom                :<BR>               <I>First name :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;&nbsp;                <INPUT NAME="prenom" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Profession                :<BR>               <I>Profession :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="profession" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="66">&nbsp;&nbsp;<B><FONT COLOR="#330099">Adresse                :<BR>               <I>Address :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <TEXTAREA NAME="adresse" ROWS="3" COLS="50" ></TEXTAREA>             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;<B><FONT COLOR="#330099">T&eacute;l.                personnel :<BR>               <I>Tel. personal :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="telpers" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;<B><FONT COLOR="#330099">T&eacute;l.                profession :<BR>               <I>Tel. profession :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="telprof" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;<B><FONT COLOR="#330099">Fax.                personnel :<BR>               <I>Fax. personal :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="faxpers" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Fax.                profession :<BR>               <I>Fax. profession :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="faxprof" TYPE="text" SIZE="30">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;<B><FONT COLOR="#330099">Votre                EMail :<BR>               <I>Your EMail :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="email" TYPE="text" SIZE="40">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Date                d'arriv&eacute;e :<BR>               <I>From</I> :</FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="datearr" TYPE="text" SIZE="15">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Date                d&eacute;part :<BR>               <I>To :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="datedep" TYPE="text" SIZE="15">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;&nbsp;<B><FONT COLOR="#330099">Nombre                de jour :<BR>               <I>Day :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="nbjour" TYPE="text" SIZE="4">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;<B><FONT COLOR="#330099">Nb                d'adulte :<BR>               <I>Number of adults :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <INPUT NAME="nbadult" TYPE="text" SIZE="8">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="30">&nbsp;&nbsp;&nbsp;<B><FONT COLOR="#330099">Nb                d'enfant :<BR>               <I>Number of childrens :</I></FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;&nbsp;                <INPUT NAME="nbenf" TYPE="text" SIZE="8">               <B><FONT COLOR="#330099">Age des enfants /<I>Age of children</I>                :</FONT></B>                <INPUT NAME="age" TYPE= "text" SIZE="10">             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="103">&nbsp;&nbsp;<B><FONT COLOR="#330099">Type                de g&icirc;te :</FONT></B></TD>             <TD ALIGN="CENTER" BGCOLOR="#ffcf0f">                <TABLE WIDTH="100%" BORDER="1" CELLSPACING="2" CELLPADDING="0" HEIGHT="43">                 <TR>                    <TD ROWSPAN="2" ALIGN="CENTER">&nbsp; &nbsp;                      <SELECT NAME="categorie">                       <OPTION VALUE="F2" SELECTED>F2                        <OPTION VALUE="F3">F3                      </SELECT>                   </TD>                   <TD WIDTH="33%" ALIGN="CENTER">&nbsp;<B><FONT COLOR="#330099">Lit                      suppl&eacute;mentaire</FONT></B></TD>                   <TD WIDTH="34%" ALIGN="CENTER">&nbsp;<B><FONT COLOR="#330099">Berceau</FONT></B></TD>                 </TR>                 <TR>                    <TD WIDTH="33%" ALIGN="CENTER">                      <TABLE WIDTH="90%" BORDER="0" CELLSPACING="0" CELLPADDING="0" HEIGHT="42">                       <TR>                          <TD WIDTH="50%" HEIGHT="17" ALIGN="CENTER"><B><FONT COLOR="#330099">OUI                            <BR>                           <I>YES</I></FONT></B></TD>                         <TD WIDTH="50%" ALIGN="CENTER"><B><FONT COLOR="#330099">NON<BR>                           <I>NO</I></FONT></B></TD>                       </TR>                       <TR>                          <TD HEIGHT="22" ALIGN="CENTER" VALIGN="TOP">                            <INPUT TYPE="radio" VALUE="OUI" NAME="litsupp">                           &nbsp;</TD>                         <TD ALIGN="CENTER" VALIGN="TOP">                            <INPUT TYPE="radio" VALUE="NON" NAME="litsupp" CHECKED="true">                           &nbsp;</TD>                       </TR>                     </TABLE>                   </TD>                   <TD WIDTH="34%" ALIGN="CENTER">                      <TABLE WIDTH="90%" BORDER="0" CELLSPACING="0" CELLPADDING="0" HEIGHT="42">                       <TR>                          <TD WIDTH="50%" HEIGHT="17" ALIGN="CENTER"><B><FONT COLOR="#330099">OUI                            <BR>                           <I>YES</I></FONT></B></TD>                         <TD WIDTH="50%" ALIGN="CENTER"><B><FONT COLOR="#330099">NON                            <BR>                           <I>NO</I></FONT></B></TD>                       </TR>                       <TR>                          <TD HEIGHT="22" ALIGN="CENTER" VALIGN="TOP">                            <INPUT TYPE="radio" VALUE="OUI" NAME="berceaux">                           &nbsp;</TD>                         <TD ALIGN="CENTER" VALIGN="TOP">                            <INPUT TYPE="radio" VALUE="NON" NAME="berceaux" CHECKED="true">                           &nbsp;</TD>                       </TR>                     </TABLE>                   </TD>                 </TR>               </TABLE>             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="55">&nbsp;&nbsp;<B><FONT COLOR="#330099">&nbsp;R&eacute;servation                voiture de location par nos soins :<BR>               <I>Rent a car :</I></FONT></B></TD>             <TD ALIGN="CENTER" BGCOLOR="#ffcf0f">                <TABLE WIDTH="90%" BORDER="1" CELLSPACING="0" CELLPADDING="0" HEIGHT="42">                 <TR>                    <TD WIDTH="50%" HEIGHT="17" ALIGN="CENTER"><B><FONT COLOR="#330099">OUI                      / <I>YES</I></FONT></B></TD>                   <TD WIDTH="50%" ALIGN="CENTER"><B><FONT COLOR="#330099">NON                      / <I>NO</I></FONT></B></TD>                 </TR>                 <TR>                    <TD HEIGHT="22" ALIGN="CENTER" VALIGN="TOP">                      <INPUT TYPE="radio" VALUE="OUI" NAME="locavoiture">                     &nbsp;</TD>                   <TD ALIGN="CENTER" VALIGN="TOP">&nbsp;                      <INPUT TYPE="radio" VALUE="NON" NAME="locavoiture" CHECKED="true">                   </TD>                 </TR>               </TABLE>               <br>               <b>Les voitures peuvent etre livr&eacute;es &agrave; l'a&eacute;roport.</b>              </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="78">&nbsp;&nbsp;<B><FONT COLOR="#330099">&nbsp;Observation                :</FONT></B></TD>             <TD BGCOLOR="#ffcf0f">&nbsp;                <TEXTAREA NAME="comments" ROWS="4" COLS="50" ></TEXTAREA>             </TD>           </TR>           <TR>              <TD ALIGN="RIGHT" BGCOLOR="#ffcf0f" HEIGHT="32">&nbsp;</TD>             <TD ALIGN="CENTER" BGCOLOR="#ffcf0f">&nbsp;&nbsp;                <INPUT NAME="name" TYPE="submit" VALUE="Envoyer">               &nbsp;                <INPUT NAME="name" TYPE="reset" VALUE="Effacer">             </TD>           </TR>         </TABLE> </TD></TR> </TABLE> <p></P>  <P ALIGN=CENTER><TABLE WIDTH="100%" BORDER="0" CELLSPACING="0" CELLPADDING= "0"> <TR> <TD WIDTH="100%" ALIGN="CENTER" VALIGN="TOP"><HR><BR> <I><FONT SIZE=-1>Conception , Infographie et D&eacute;veloppement <A HREF= "http://www.arapaho.gp/" TARGET="_blank">ARAPAHO</A><BR> Services Internet : <A HREF="http://www.systel.gp/" TARGET="_blank">SYSTEL</A><BR> &copy; 1997 Tous droits r&eacute;serv&eacute;s</FONT></I></TD></TR> </TABLE> </FORM> </BODY> </HTML> 
