<div id="supersub2"> <div class="form-style-10 form-style-11"> <h1> <span>Votre commande Carte N</span> </h1> <form> <div class="et_pb_module_etape"> <div class="section"> <h5> <span>1</span>Votre profil</h5> </div> <div class="et_pb_toggle_content clearfix inner-wrap" style="display: block;"> <form> <label> <span class="intitule">Ecole</span> <input name="school" required="" type="text" /></label> <label> <span class="intitule">Niveau d'études (en cours)</span> <select name="study_level" type="text" required=""> <option value="1">Seconde</option> <option value="2">Première</option> <option value="3">Terminale</option> <option value="4">BAC+1</option> <option value="5">BAC+2</option> <option value="6">BAC+3</option> <option value="7">BAC+4</option> <option value="8">BAC+5</option> <option value="10">BAC+5</option> <option value="11">3ème</option> <option value="12">4ème</option> </select></label> <label><span class="intitule">Date de naissance</span> <select class="intitule_tiers" name="birth_date" type="text" required=""> <option value="1">1</option> <option value="2">2</option> <option value="3">3</option> <option value="4">4</option> <option value="5">5</option> <option value="6">6</option> <option value="7">7</option> <option value="8">8</option> <option value="9">9</option> <option value="10">10</option> <option value="11">11</option> <option value="12">12</option> <option value="13">13</option> <option value="14">14</option> <option value="15">15</option> <option value="16">16</option> <option value="17">17</option> <option value="18">18</option> <option value="19">19</option> <option value="20">20</option> <option value="21">21</option> <option value="22">22</option> <option value="23">23</option> <option value="24">24</option> <option value="25">25</option> <option value="26">26</option> <option value="27">27</option> <option value="28">28</option> <option value="29">29</option> <option value="30">30</option> <option value="31">31</option> </select> <select class="intitule_tiers" name="birth_month" type="text" required=""> <option value="1">Janvier</option> <option value="2">Fevrier</option> <option value="3">Mars</option> <option value="4">Avril</option> <option value="5">Mai</option> <option value="6">Juin</option> <option value="7">Juillet</option> <option value="8">Aout</option> <option value="9">Septembre</option> <option value="10">Octobre</option> <option value="11">Novembre</option> <option value="12">Décembre</option> </select> <select class="intitule_tiers" name="birth_year" type="text" required=""> <option value="1">2005</option> <option value="2">2004</option> <option value="3">2003</option> <option value="4">2002</option> <option value="5">2001</option> <option value="6">2000</option> <option value="7">1999</option> <option value="8">1998</option> <option value="9">1997</option> <option value="10">1996</option> <option value="11">1995</option> <option value="12">1994</option> <option value="13">1993</option> <option value="14">1992</option> <option value="15">1991</option> <option value="16">1990</option> <option value="17">1989</option> <option value="18">1988</option> <option value="19">1987</option> <option value="20">1986</option> </select> </label> </form> </div> <div class="button-section"> <input name="Continuer" type="submit" /> </div> </div> <div class="et_pb_module et_pb_toggle et_pb_accordion_item_1 et_pb_toggle_close"> <div class="section"> <h5> <span>2</span>Informations de facturation</h5> </div> </div> <div class="et_pb_module et_pb_toggle et_pb_accordion_item_2 et_pb_toggle_close"> <div class="section"> <h5> <span>3</span>Résumé de votre commande</h5> </div> </div> <div class="et_pb_module et_pb_toggle et_pb_accordion_item_3 et_pb_toggle_close"> <div class="section"> <h5> <span>4</span>Paiement</h5> </div> </div> </form> </div> </div>