<span class="huge-contact-form-part">1.</span>
<br />
<label> Courriel :* 
    [email* your-email] </label>

<label> Prénom : 
    [text firstname] </label>

<label> Nom : *
    [text* lastname] </label>

<label> Société : *
    [text* company] </label>

<label> Téléphone : *
    [text* telephone] </label>

<label> Pays : *
    [select* country "France" "États-Unis" "Canada" "Royaume-Uni" "Belgique" "Luxembourg" "(selectionez votre pays)" "Afghanistan" "Afrique du Sud" "Albanie" "Algérie" "Allemagne" "Andorre" "Angola" "Anguilla" "Antigua-et-Barbuda" "Antilles néerlandaises" "Arabie saoudite" "Argentine" "Arménie" "Aruba" "Australie" "Autriche" "Azerbaïdjan" "Bahamas" "Bahreïn" "Bangladesh" "Barbade" "Belau" "Belize" "Bénin" "Bermudes" "Bhoutan" "Biélorussie" "Birmanie" "Bolivie" "Bosnie-Herzégovine" "Botswana" "Brésil" "Brunei" "Bulgarie" "Burkina Faso" "Burundi" "Cambodge" "Cameroun" "Cap-Vert" "Chili" "Chine" "Chypre" "Colombie" "Comores" "Congo" "Congo (République démocratique du)" "Corée du Nord" "Corée du Sud" "Costa Rica" "Côte d'Ivoire" "Croatie" "Cuba" "Danemark" "Djibouti" "Dominique" "Égypte" "Émirats arabes unis" "Équateur" "Érythrée" "Espagne" "Estonie" "Éthiopie" "Fidji" "Finlande" "Gabon" "Gambie" "Géorgie" "Ghana" "Gibraltar" "Grèce" "Grenade" "Groenland" "Guadeloupe" "Guam" "Guatemala" "Guinée" "Guinée équatoriale" "Guinée-Bissao" "Guyana" "Guyane française" "Haïti" "Honduras" "Hong Kong" "Hongrie" "Ile Christmas" "Ile Norfolk" "Iles Cayman" "Iles Cook" "Iles des Cocos" "Iles Falkland" "Iles Féroé" "Îles Marshall" "Iles Pitcairn" "Iles Salomon" "Iles Svalbard et Jan Mayen" "Iles Turks-et-Caicos" "Iles Vierges américaines" "Iles Vierges britanniques" "Inde" "Indonésie" "Iran" "Iraq" "Irlande" "Islande" "Israël" "Italie" "Jamaïque" "Japon" "Jordanie" "Kazakhstan" "Kenya" "Kirghizistan" "Kiribati" "Koweït" "Laos" "Lesotho" "Lettonie" "Liban" "Liberia" "Libye" "Liechtenstein" "Lituanie" "Macao" "Macédoine" "Madagascar" "Malaisie" "Malawi" "Maldives" "Mali" "Malte" "Mariannes du Nord" "Maroc" "Martinique" "Maurice" "Mauritanie" "Mayotte" "Mexique" "Micronésie" "Moldavie" "Monaco" "Mongolie" "Montserrat" "Mozambique" "Namibie" "Nauru" "Népal" "Nicaragua" "Niger" "Nigeria" "Nioué" "Norvège" "Nouvelle-Calédonie" "Nouvelle-Zélande" "Oman" "Ouganda" "Ouzbékistan" "Pakistan" "Panama" "Papouasie-Nouvelle-Guinée" "Paraguay" "Pays-Bas" "Pérou" "Philippines" "Pologne" "Polynésie française" "Porto Rico" "Portugal" "Qatar" "République centrafricaine" "République dominicaine" "République tchèque" "Réunion" "Roumanie" "Russie" "Rwanda" "Sahara occidental35" "Saint-Christophe-et-Niévès" "Sainte-Hélène" "Sainte-Lucie" "Saint-Marin" "Saint-Pierre-et-Miquelon" "Saint-Siège" "Saint-Vincent-et-les-Grenadines" "Salvador" "Samoa" "Samoa américaines" "Sao Tomé-et-Principe" "Sénégal" "Serbie-et-Monténégro" "Seychelles" "Sierra Leone" "Singapour" "Slovaquie" "Slovénie" "Somalie" "Soudan" "Sri Lanka" "Suède" "Suisse" "Suriname" "Swaziland" "Syrie" "Tadjikistan" "Taïwan" "Tanzanie" "Tchad" "Thaïlande" "Timor oriental" "Togo" "Tokélaou" "Tonga" "Trinité-et-Tobago" "Tunisie" "Turkménistan" "Turquie" "Tuvalu" "Ukraine" "Uruguay" "Vanuatu" "Venezuela" "Viêt Nam" "Wallis-et-Futuna" "Yémen" "Zambie" "Zimbabwe"]
</label>

<label> Comment avez-vous entendu parler de nous ? : 
    [select hear-about-us "Vous êtes déjà client" "Par un collègue" "Brochure" "Recherche Internet" "Vous avez été contacté par notre équipe" "Magazine" "Autre"</label>

<span class="huge-contact-form-part">2.</span>
<br />

<label> Quel type de document voulez-vous traduire ? (juridique, scientifique, technique...) :
    [text job-type] </label>

<label> Langue(s) cible(s) : *
    [text* target-languages] </label>

<label> Quels sont vos délais pour ce projet ?
    [select* deadline "Délai standard (2000 mots / jour)" "Délai urgent – Service Fast Track"]</label>


<span class="huge-contact-form-part">3.</span>
<br />


<label> Joignez le document à traduire :
    [file* file-input limit:50331648 filetypes:doc|pdf|txt|gif|jpg|png|docx|ppt]</label>

<label> Précisez ici les spécificités de votre projet :
    [textarea special-instructions]</label>

[recaptcha size:compact]

[submit "Oui ! Envoyez moi un devis"]
1
Lexcelera Quote
[your-name] <no-reply@lexcelera.com>
lexcelera@lexcelera.com
Prénom :
[firstname]

Nom :
[lastname]
 
Société :
[company]

Téléphone :
[telephone]

Comment avez-vous entendu parler de nous ?
[hear-about-us]

Pays :
[country]

Quel type de document voulez-vous traduire?
[job-type]

Langue(s) Cible:
[target-languages]
 
Quels sont vos délais pour ce projet?
[deadline]

Précisez ici les spécificités de votre projet:
[special-instructions]
Reply-To: [your-email]
[file-input]



Lexcelera "[your-subject]"
Lexcelera <wordpress@51.15.134.16>
[your-email]
Message Body:
[your-message]

-- 
This e-mail was sent from a contact form on Lexcelera (http://51.15.134.16)
Reply-To: guylive@lycos.com



Thank you for your message. It has been sent.
There was an error trying to send your message. Please try again later.
One or more fields have an error. Please check and try again.
There was an error trying to send your message. Please try again later.
You must accept the terms and conditions before sending your message.
The field is required.
The field is too long.
The field is too short.
The date format is incorrect.
The date is before the earliest one allowed.
The date is after the latest one allowed.
There was an unknown error uploading the file.
You are not allowed to upload files of this type.
The file is too big.
There was an error uploading the file.
The number format is invalid.
The number is smaller than the minimum allowed.
The number is larger than the maximum allowed.
The answer to the quiz is incorrect.
Your entered code is incorrect.
The e-mail address entered is invalid.
The URL is invalid.
The telephone number is invalid.