Differences

This shows you the differences between two versions of the page.

--- software:surgplan [2020/05/13 15:17]
ahuaulme
+++ software:surgplan [2020/05/13 16:46]
ahuaulme old revision restored
@@ Line 3: / Line 3: @@
 <html>
-<form role="form" action="https://enquetes-partenaires.univ-rennes1.fr/index.php/884848" target="_self" method="post">
+<form role="form" action="https://docs.google.com/forms/u/0/d/e/1FAIpQLSc5-88iY1qbpheC8bjswfNHO3B7IdH2ETU0df7G8wVrYlMGoQ/formResponse" target="_self" method="post">
                     <div class="form-group">
                         <label for="fname">First Name: <span class="text-danger">* </span></label>
-                        <input type="text" class="form-control" name="884848X9169X113656" placeholder="Enter your first name here." required>
+                        <input type="text" class="form-control" name="entry.1621723030" placeholder="Enter your first name here." required>
                     </div>
                     <br></br>
                     <div class="form-group">
                         <label for="lname">Last Name: <span class="text-danger">* </span></label>
-                        <input type="text" class="form-control" name="884848X9169X113657" placeholder="Enter your last name here." required>
+                        <input type="text" class="form-control" name="entry.569451349" placeholder="Enter your last name here." required>
                     </div>
                     <br></br>
                     <div class="form-group">
                         <label for="email">Email address: <span class="text-danger">* </span></label>
-                        <input type="email" class="form-control" name="884848X9169X113658" placeholder="Enter your email address." required>
+                        <input type="email" class="form-control" name="entry.343075552" placeholder="Enter your email address." required>
                     </div>
                     <br></br>
                     <div class="form-group">
                         <label for="institute">Institute/Organization: <span class="text-danger">* </span></label>
-                        <input type="text" class="form-control" name="884848X9169X113659" placeholder="Institute / Organization name." required>
+                        <input type="text" class="form-control" name="entry.81017266" placeholder="Institute / Organization name." required>
                     </div>
                     <br></br>
@@ Line 31: / Line 31: @@
                     </div>
                     <center>
-                        <input  type="submit" value="Submit">
+                    <input  type="submit" value="Submit">
-                    <center>
+                    </center>
                 </form>
 </html>