[gravityform id="415" title="false"]
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<div class='gf_browser_unknown gform_wrapper gravity-theme white-labels_wrapper' id='gform_wrapper_415' >
<div class='gform_heading'>
<span class='gform_description'></span>
</div><form method='post' enctype='multipart/form-data' id='gform_415' class='white-labels' action='/my-account/' novalidate autocomplete="off">
<input type='hidden' class='gforms-pum' value='{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}' />
<div class='gform_body gform-body'><div id='gform_fields_415' class='gform_fields top_label form_sublabel_below description_below'><fieldset id="field_415_1" class="gfield gfield_contains_required field_sublabel_hidden_label field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_415_1"><legend class='gfield_label gfield_label_before_complex' >Prénom<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_415_1'>
<span id='input_415_1_3_container' class='name_first' >
<input autocomplete="off" type='text' name='input_1.3' id='input_415_1_3' value='' aria-required='true' placeholder='Prénom' />
<label for='input_415_1_3' class='hidden_sub_label screen-reader-text'>First</label>
</span>
<span id='input_415_1_6_container' class='name_last' >
<input autocomplete="off" type='text' name='input_1.6' id='input_415_1_6' value='' aria-required='true' placeholder='Nom' />
<label for='input_415_1_6' class='hidden_sub_label screen-reader-text'>Last</label>
</span>
</div></fieldset><div id="field_415_2" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_415_2"><label class='gfield_label' for='input_415_2' >Courriel<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_email'>
<input autocomplete="off" name='input_2' id='input_415_2' type='email' value='' class='large' placeholder='Courriel' aria-required="true" aria-invalid="false" />
</div></div><div id="field_415_3" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_415_3"><label class='gfield_label' for='input_415_3' >Téléphone<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_phone'><input autocomplete="off" name='input_3' id='input_415_3' type='tel' value='' class='large' placeholder='Téléphone' aria-required="true" aria-invalid="false" /></div></div><div id="field_415_7" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_415_7"><label class='gfield_label' for='input_415_7' >Message<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label><div class='ginput_container ginput_container_textarea'><textarea autocomplete="off" name='input_7' id='input_415_7' class='textarea small' placeholder='Veuillez nous indiquer ce que vous recherchez.' aria-required="true" aria-invalid="false" rows='10' cols='50'></textarea></div></div></div></div>
<div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_415' class='gform_button button' value='Envoyer' onclick='if(window["gf_submitting_415"]){return false;} if( !jQuery("#gform_415")[0].checkValidity || jQuery("#gform_415")[0].checkValidity()){window["gf_submitting_415"]=true;} ' onkeypress='if( event.keyCode == 13 ){ if(window["gf_submitting_415"]){return false;} if( !jQuery("#gform_415")[0].checkValidity || jQuery("#gform_415")[0].checkValidity()){window["gf_submitting_415"]=true;} jQuery("#gform_415").trigger("submit",[true]); }' />
<input type='hidden' class='gform_hidden' name='is_submit_415' value='1' />
<input type='hidden' class='gform_hidden' name='gform_submit' value='415' />
<input type='hidden' class='gform_hidden' name='gform_unique_id' value='' />
<input type='hidden' class='gform_hidden' name='state_415' value='WyJbXSIsIjk4NmVhNmQ5ZDJlN2RjOWYyYmNiYTcxODAyNjU0NWEyIl0=' />
<input type='hidden' class='gform_hidden' name='gform_target_page_number_415' id='gform_target_page_number_415' value='0' />
<input type='hidden' class='gform_hidden' name='gform_source_page_number_415' id='gform_source_page_number_415' value='1' />
<input type='hidden' name='gform_field_values' value='' />
</div>
</form>
</div>
