Remplissez le formulaire pour demander un devis

Question

Accepted Answer

<p><div class="frm_forms  with_frm_style frm_style_style-formidable" id="frm_form_6_container" data-token="8819025b00072055cb191025751caed0">
<form enctype="multipart/form-data" method="post" class="frm-show-form " id="form_formulaire-de-demande-de-devis-hach"  data-token="8819025b00072055cb191025751caed0">
<div class="frm_form_fields ">
<fieldset>
<legend class="frm_screen_reader">formulaire de demande de devis HACH</legend>

<div class="frm_fields_container">
<input type="hidden" name="frm_action" value="create" />
<input type="hidden" name="form_id" value="6" />
<input type="hidden" name="frm_hide_fields_6" id="frm_hide_fields_6" value="" />
<input type="hidden" name="form_key" value="formulaire-de-demande-de-devis-hach" />
<input type="hidden" name="item_meta[0]" value="" />
<input type="hidden" id="frm_submit_entry_6" name="frm_submit_entry_6" value="658862507d" /><input type="hidden" name="_wp_http_referer" value="/produit/analyseur-portable-parallele-sl1000/" /><div id="frm_field_44_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first">
    <label for="field_v9ogd4" id="field_v9ogd4_label" class="frm_primary_label">Nom
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_v9ogd4" name="item_meta[44]" value=""  data-reqmsg="Nom cannot be blank." aria-required="true" data-invmsg="Nom est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_45_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6">
    <label for="field_j3t5l4" id="field_j3t5l4_label" class="frm_primary_label">Prénom 
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_j3t5l4" name="item_meta[45]" value=""  data-reqmsg="Prénom  cannot be blank." aria-required="true" data-invmsg="Prénom  est non valide" aria-invalid="false"  /> 
    
    
</div>
<div id="frm_field_46_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first">
    <label for="field_nb4ey4" id="field_nb4ey4_label" class="frm_primary_label">Entreprise / Organisation
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_nb4ey4" name="item_meta[46]" value=""  data-reqmsg="Entreprise / Organisation cannot be blank." aria-required="true" data-invmsg="Entreprise / Organisation est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_47_container" class="frm_form_field form-field  frm_required_field frm_top_container frm6">
    <label for="field_oz2kk4" id="field_oz2kk4_label" class="frm_primary_label">La fonction
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="text" id="field_oz2kk4" name="item_meta[47]" value=""  data-reqmsg="La fonction cannot be blank." aria-required="true" data-invmsg="La fonction est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_48_container" class="frm_form_field form-field  frm_top_container">
    <label for="field_32kgz4" id="field_32kgz4_label" class="frm_primary_label">Nom de produit 
        <span class="frm_required" aria-hidden="true"></span>
    </label>
    <input type="text" id="field_32kgz4" name="item_meta[48]" value=""  data-invmsg="Nom de produit  est non valide" class="nmpro" style="color: black;" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_49_container" class="frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first">
    <label for="field_hj2bc4" id="field_hj2bc4_label" class="frm_primary_label">Téléphone
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="tel" id="field_hj2bc4" name="item_meta[49]" value=""  data-reqmsg="Téléphone cannot be blank." aria-required="true" data-invmsg="Téléphone est non valide" aria-invalid="false" pattern="((\+\d{1,3}(-|.| )?$?\d$?(-| |.)?\d{1,5})|($?\d{2,6}$?))(-|.| )?(\d{3,4})(-|.| )?(\d{4})(( x| ext)\d{1,5}){0,1}$"  />
    
    
</div>
<div id="frm_field_50_container" class="frm_form_field form-field  frm_required_field frm_top_container">
    <label for="field_tqzrs4" id="field_tqzrs4_label" class="frm_primary_label">Email
        <span class="frm_required" aria-hidden="true">*</span>
    </label>
    <input type="email" id="field_tqzrs4" name="item_meta[50]" value=""  data-reqmsg="Email cannot be blank." aria-required="true" data-invmsg="Email est non valide" aria-invalid="false"  />
    
    
</div>
<div id="frm_field_51_container" class="frm_form_field form-field  frm_top_container">
    <label for="field_ufqaf4" id="field_ufqaf4_label" class="frm_primary_label">Message 
        <span class="frm_required" aria-hidden="true"></span>
    </label>
    <textarea name="item_meta[51]" id="field_ufqaf4" rows="5"  data-invmsg="Message  est non valide" aria-invalid="false"  ></textarea>
    
    
</div>
<div id="frm_field_52_container" class="frm_form_field form-field  frm_none_container">
    <label for="g-recaptcha-response" id="field_89nru4_label" class="frm_primary_label">Captcha
        <span class="frm_required" aria-hidden="true"></span>
    </label>
    <div  id="field_89nru4" class="frm-g-recaptcha" data-sitekey="6LebJa0pAAAAABPD54PeMmIFwHk1D7SWY775x1hk" data-size="invisible" data-theme="light"></div>
    
    
</div>
	<input type="hidden" name="item_key" value="" />
				<div class="frm__660ca0987c12a">
				<label for="frm_email_6" >
					Si vous êtes un humain, ne remplissez pas ce champ.				</label>
				<input  id="frm_email_6" type="text" class="frm_verify" name="frm__660ca0987c12a" value="" autocomplete="false"  />
			</div>
		<div class="frm_submit frm_flex">
<button class="frm_button_submit" type="submit"  >Envoyer</button>



</div></div>
</fieldset>
</div>
</form>
</div>
</p>

Présentation

Organigramme

Offre d'emplois

Agroalimentaire

Eau et Environnement

energie et industriel

Pharmaceutique

Recherche Scientifique & Pédagogie

Médical

Analyseur portable paralléle SL1000

Remplissez le formulaire pour demander un devis

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