1:  <!-- NAME: reservar.tpl -->
   2:  <script type="text/javascript" src="js/reservar.js"></script>
   3:  <div class="bloque1">
   4:    <h3>Completar dades reserva</h3>
   5:    A continuaci&oacute; introdueix les dades d'usuari per a completar la reserva.
   6:  </div>
   7:  <div class="bloque1">
   8:  <p>&nbsp;</p>
   9:  <form  name="formulari" action="index.php" method="post">
  10:  <table width="449" border="0" cellspacing="3">
  11:    <tr>
  12:      <td width="220"><div align="right"><strong>Dades personals</strong></div></td>
  13:      <td width="280">&nbsp;</td>
  14:    </tr>
  15:    <tr>
  16:      <td width="220"><div align="right">Nom * </div></td>
  17:      <td width="280"><input name="rnom" type="text" size="25" maxlength="25"></td>
  18:    </tr>
  19:    <tr>
  20:      <td><div align="right">Cognom 1 * </div></td>
  21:      <td><input name="rcognom1" type="text" size="25" maxlength="25"></td>
  22:    </tr>
  23:    <tr>
  24:      <td><div align="right">Cognom 2 </div></td>
  25:      <td><input name="rcognom2" type="text" size="25" maxlength="25"></td>
  26:    </tr>
  27:    <tr>
  28:      <td><div align="right">NIF * </div></td>
  29:      <td><input name="rnif" type="text" size="8" maxlength="8"> - <input name="rniflletra" type="text" size="2" maxlength="1"></td>
  30:    </tr>
  31:    <tr>
  32:      <td><div align="right">Tel&egrave;fon * </div></td>
  33:      <td><input name="rtel" type="text" size="9" maxlength="9"></td>
  34:    </tr>
  35:    <tr>
  36:      <td><div align="right">Adre&ccedil;a * </div></td>
  37:      <td><input name="radreca" type="text" size="35" maxlength="100"></td>
  38:    </tr>
  39:    <tr>
  40:      <td><div align="right">Codi Postal * </div></td>
  41:      <td><input name="rcodipostal" type="text" size="5" maxlength="5"></td>
  42:    </tr>
  43:    <tr>
  44:      <td><div align="right">Poblaci&oacute; * </div></td>
  45:      <td><input name="rpoblacio" type="text" size="35" maxlength="50"></td>
  46:    </tr>
  47:    <tr>
  48:      <td><div align="right">Provincia * </div></td>
  49:      <td>
  50:        <select name="rprovincia">
  51:          <option value="0" selected>Selecciona provincia</option>
  52:          <option value="01-ALAVA">&Aacute;lava</option>
  53:          <option value="02-ALBACETE">Albacete</option>
  54:          <option value="03-ALICANTE">Alicante</option>
  55:          <option value="04-ALMERIA">Almer&iacute;a</option>
  56:          <option value="33-ASTURIAS">Asturias</option>
  57:          <option value="05-AVILA">&Aacute;vila</option>
  58:          <option value="06-BADAJOZ">Badajoz</option>
  59:          <option value="08-BARCELONA">Barcelona</option>
  60:          <option value="09-BURGOS">Burgos</option>
  61:          <option value="10-CACERES">C&aacute;ceres</option>
  62:          <option value="11-CADIZ">C&aacute;diz</option>
  63:          <option value="39-CANTABRIA">Cantabria</option>
  64:          <option value="12-CASTELLON">Castell&oacute;n</option>
  65:          <option value="51-CEUTA">Ceuta</option>
  66:          <option value="13-CIUDAD-REAL">Ciudad Real</option>
  67:          <option value="14-CORDOBA">C&oacute;rdoba</option>
  68:          <option value="15-CORUNA">Coru&ntilde;a</option>
  69:          <option value="16-CUENCA">Cuenca</option>
  70:          <option value="17-GIRONA">Girona</option>
  71:          <option value="18-GRANADA">Granada</option>
  72:          <option value="19-GUADALAJARA">Guadalajara</option>
  73:          <option value="20-GUIPUZCOA">Guip&uacute;zcoa</option>
  74:          <option value="21-HUELVA">Huelva</option>
  75:          <option value="22-HUESCA">Huesca</option>
  76:          <option value="07-ILLES-BALEARS">Illes Balears</option>
  77:          <option value="23-JAEN">Ja&eacute;n</option>
  78:          <option value="24-LEON">Le&oacute;n</option>
  79:          <option value="25-LLEIDA">Lleida</option>
  80:          <option value="27-LUGO">Lugo</option>
  81:          <option value="28-MADRID">Madrid</option>
  82:          <option value="29-MALAGA">M&aacute;laga</option>
  83:          <option value="52-MELILLA">Melilla</option>
  84:          <option value="30-MURCIA">M&uacute;rcia</option>
  85:          <option value="31-NAVARRA">Navarra</option>
  86:          <option value="32-OURENSE">Ourense</option>
  87:          <option value="34-PALENCIA">Palencia</option>
  88:          <option value="35-PALMAS">Palmas</option>
  89:          <option value="36-PONTEVEDRA">Pontevedra</option>
  90:          <option value="26-RIOJA">Rioja</option>
  91:          <option value="37-SALAMANCA">Salamanca</option>
  92:          <option value="38-SANTA-CRUZ-TENERIFE">Santa Cruz de Tenerife</option>
  93:          <option value="40-SEGOVIA">Segovia</option>
  94:          <option value="41-SEVILLA">Sevilla</option>
  95:          <option value="42-SORIA">Soria</option>
  96:          <option value="43-TARRAGONA">Tarragona</option>
  97:          <option value="44-TERUEL">Teruel</option>
  98:          <option value="45-TOLEDO">Toledo</option>
  99:          <option value="46-VALENCIA">Valencia</option>
 100:          <option value="47-VALLADOLID">Valladolid</option>
 101:          <option value="48-VIZCAYA">Vizcaya</option>
 102:          <option value="49-ZAMORA">Zamora</option>
 103:          <option value="50-ZARAGOZA">Zaragoza</option>
 104:        </select></td>
 105:    </tr>
 106:    <tr>
 107:      <td><div align="right">E-mail * </div></td>
 108:      <td><input name="remail" type="text" size="35" maxlength="60"></td>
 109:    </tr>
 110:    <tr>
 111:      <td><div align="right">Targeta de pagament * </div></td>
 112:      <td><input name="rtargeta" type="text" size="18" maxlength="16"></td>
 113:    </tr>
 114:    <tr>
 115:<input type="hidden" name="idcr" value="{IDCR}">
 116:<input type="hidden" name="idall" value="{IDALL}">
 117:<input type="hidden" name="dataini" value="{DATAINI}">
 118:<input type="hidden" name="datafi" value="{DATAFI}">
 119:<input type="hidden" name="cost" value="{COST}">
 120:      <td><div align="right">
 121:        <input type="submit" value="Enviar"  onclick="return validar(this.form)">
 122:      </div></td>
 123:      <td><input type="reset" value="Esborrar"></td>
 124:    </tr>
 125:  </table>
 126:  </form>
 127:</div>
 128:  <!-- END: reservar.tpl -->