"; if (!eregi("^[_\.0-9a-z-]+@([0-9a-z][0-9a-z-]+\.)+[a-z]{2,5}$", $email)) $warning .= "Incorrect e-mail address !
"; if(!isset($warning)){ $subject="Commande de publications"; $body .= "> Demande en anglais

"; $body .="Nom: ".$name."
"; $body .="Organisation: ".$org."
"; $body .="Adresse: ".$address."
"; $body .="NPA / Ville: ".$city."
"; $body .="Pays: ".$country."
"; $body .="T�l�phone: ".$phone."
"; $body .="Email: ".$email."

"; $body .="Commande:
".stripslashes(str_replace(chr(13),"
",$order))."

"; $body .="Membre CETIM: "; if ($member==1) $body .= "OUI
"; else $body .= "NON
"; $body .="Mode d'envoi: "; if ($post==1) $body .= "Tarif �conomique
"; elseif ($post==2) $body .= "Tarif prioritaire
"; elseif ($post==3) $body .= "Recommand� (Suisse uniquement, 5.-)
"; $body .="Mode de paiement: "; if ($invoice==1) $body .= "Facture d�finitive par poste avec BV
"; elseif ($invoice==2) $body .= "Ch�que (France uniquement)
"; elseif ($invoice==3) $body .= "Virement bancaire ou postal (euros)
"; elseif ($invoice==4) $body .= "Facture �l�ctronique Paypal (francs suisses)
"; elseif ($invoice==5) $body .= "Facture �l�ctronique Hipay (euros)
"; mail($email_default,$subject,$body,"From: contact@cetim.ch\r\n"."MIME-Version: 1.0\r\n"."Content-type: text/html; charset=iso-8859-1\r\n","-r contact@cetim.ch"); $status = "ok"; } } ?> CETIM - Centre Europe - Tiers Monde
Order Form

Your order has been sent

Close



Name & firstname *
Organization
Address *
Postcode & Town *
Country *
Phone *
Email *
Order *

> CETIM Member

Shipping mode *
> Economic
> Priority
> Registered (Switzerland only, 5.-)


Method of payment from Switzerland
> Postal bill with postal payment coupon


Method of payment from Europe
> Cheque (France only)
> Wire transfer (Euros)


Payment by credit card
> Paypal electronic invoice (Swiss francs)
> Hipay electronic invoice (Euros)
(*) obligatory fields