// JavaScript Document
document.write('<form id="due" name="due" method="post" action="http://apps.wesa.info/Formulaires/due.php">');
document.write('<table width="400" border="0" cellspacing="0" cellpadding="6">');
document.write('<tr>');
document.write('<td colspan="2"><strong>Entreprise : </strong></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td width="33%">Nom : </td>');
document.write('<td><input name="entreprise" type="text" id="matricule" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td width="33%">Matricule : </td>');
document.write('<td><input name="matricule" type="text" id="matricule" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>E-mail : </td>');
document.write('<td><input name="email" type="text" id="email" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>&nbsp;</td>');
document.write('<td>&nbsp;</td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td colspan="2">		<strong>Futur salari&eacute; : </strong> </td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Nom : </td>');
document.write('<td><input name="nom" type="text" id="nom" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Pr&eacute;noms : </td>');
document.write('<td><input name="prenoms" type="text" id="prenoms" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>N&deg; de S&eacute;curit&eacute; Sociale  : </td>');
document.write('<td valign="top"><input name="numero_secu" type="text" id="numero_secu" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Nationalit&eacute; : </td>');
document.write('<td><input name="nationalite" type="text" id="nationalite" value="Fran&ccedil;aise" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Date de naissance :  </td>');
document.write('<td><input name="date_naissance" type="text" id="date_naissance" value="JJ/MM/AAAA" size="15" onFocus="if(this.value==\'JJ/MM/AAAA\')this.value=\'\';"/></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Lieu de naissance : </td>');
document.write('<td><input name="lieu_naissance" type="text" id="lieu_naissance" value="Dept, Commune, Arr, Pays" size="40" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td valign="top">Adresse Compl&egrave;te : </td>');
document.write('<td><textarea name="adresse_complete" id="adresse_complete"></textarea></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>&nbsp;</td>');
document.write('<td>&nbsp;</td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td colspan="2">		<strong>Emploi occupp&eacute; </strong> </td>');
document.write('</tr><tr>');
document.write('<td>Date &amp; heure pr&eacute;visible d\'embauche : </td>');
document.write('<td valign="top"><input name="date_embauche" type="text" value="JJ/MM/AAAA" size="15" onFocus="if(this.value==\'JJ/MM/AAAA\')this.value=\'\';" />');
document.write('<input name="heure_embauche" type="text" id="1_heuresabsences2" value="HH:MM" size="10" maxlength="10" onFocus="if(this.value==\'HH:MM\')this.value=\'\';"/></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Nature de l\'emploi et qualification :</td>');
document.write('<td><textarea name="nature_emploi" id="nature_emploi"></textarea></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Dur&eacute;e de la periode d\'essai : </td>');
document.write('<td valign="top"><input name="duree_essai" type="text" id="duree_essai" size="6" maxlength="10" /> ');
document.write('(jours) </td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Dur&eacute;e de travail  : </td>');
document.write('<td><input name="duree_travail" type="text" id="duree_travail" size="6" maxlength="10" />');
document.write('<input name="echelle_duree_travail" type="text" id="echelle_duree_travail" value="Heures/Mois" /></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td valign="top">Type de contrat  : </td>');
document.write('<td><input name="type_contrat" type="text" id="type_contrat" value="CDD, CDI, etc." />');
document.write('<br />');
document.write('<br />');
document.write('Si CDD, date de fin de contrat :<br />');
document.write('<input name="date_fin_cdd" type="text" id="date_fin_cdd" value="JJ/MM/AAAA" size="15" onFocus="if(this.value==\'JJ/MM/AAAA\')this.value=\'\';"/></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>Salaire brut mensuel  : </td>');
document.write('<td><input name="salaire_brut" type="text" id="salaire_brut" size="6" maxlength="10" />');
document.write('&euro; </td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>&nbsp;</td>');
document.write('<td>&nbsp;</td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td colspan="2"><strong>Observations : </strong></td>');
document.write('</tr>');
document.write('<tr valign="top"><td colspan="2"><textarea name="observations" cols="55" rows="4" id="observations"></textarea></td>');
document.write('</tr>');
document.write('<tr>');
document.write('<td>&nbsp;</td>');
document.write('<td align="center"><input type="hidden" name="destinataire" value="' + destinataire + '" /><input type="hidden" name="societe" value="' + societe + '" /><input type="hidden" name="siteinternet" value="' + siteinternet + '" /><input type="submit" name="Submit" value="Envoyer" /></td>');
document.write('</tr>');
document.write('</table>');
document.write('</form>');