[text* your-name placeholder “VOTRE NOM”]
[text* your-prenom placeholder “VOTRE PRENOM”]
[email* your-email placeholder “VOTRE EMAIL”]
[tel* tel-contact placeholder “VOTRE TELEPHONE”]
[select* recipient “CHOIX CONCESSION|contact@store4one.com” “Urgence Scooters Etoile|jonas@urgence-scooters.com” “Urgence Scooters Bastille|bastille@urgence-scooters.com” “Urgence Scooters Boulogne|regis@urgence-scooters.com” “Urgence Scooters Grenelle|yoni@urgence-scooters.com” “Urgence Scooters Levallois|geraldine@urgence-scooters.com” “Urgence Scooters Nanterre|johanna@urgence-scooters.com” “Urgence Scooters Saussure|talie@urgence-scooters.com” “Urgence Scooters Porte de Saint Cloud|jonathan@urgence-scooters.com”]


[select Horaire default:1 “CHOIX HORAIRE” “11:00-12:00” “12:00-13:00” “13:00-14:00” “14:00-15:00” “15:00-16:00” “16:00-17:00” “17:00-18:00” “18:00-19:00”]

PERMIS OBTENU
——————————-
[checkbox PERMIS
“Permis AM/BSR”
“Permis B”
“Permis A1”
“Permis A/A2”]
——————————-

Veuillez sélectionner la gamme et le modèle du scooter :
[select* gamme multiple “MP3 300cm3 – 500cm3” “MP3 Hpe” “Piaggio Zip” “Piaggio Typhoon” “Piaggio NRG” “Piaggio Liberty” “Piaggio Medley” “Piaggio Beverly” “Vespa Primavera” “Vespa Sprint” “Vespa Gts” “Aprilia” “Gilera”]

* 2 Pièces sont à fournir obligatoirement le jour de l’essai : Votre carte d’identité et votre permis de conduire en cours de validité.
* ATTENTION : Certains modèles de scooters nécessitent un permis spécial.
Je vérifie que j’ai le bon permis de conduire.

En remplissant ce formulaire, j’autorise URGENCE SCOOTERS à entrer en contact avec moi dans le but de me proposer des offres en relation avec ma demande initiale.

Cochez la case pour accepter
[acceptance acceptance-762]

[submit “ENVOYER LA DEMANDE D’ESSAI”]
1
RESERVATION ESSAI
jonas@urgence-scooters.com
[recipient]
De : [your-name] <[your-email]>
[_date] [_time]
[_url]
Objet : RÉSERVER UN ESSAI SCOOTER NEUF
Formulaire de réservation URGENCE SCOOTERS

[your-name] [your-prenom]
[your-email]
[PERMIS]
téléphone : [tel-contact]
Date souhaitée : [datesouhaite]

Horaire souhaitée : [Horaire]

Gamme Choisie :
[gamme]

Votre message

Votre message optionnel ———————————
[your-message]

[acceptance-762]

Cet e-mail a été envoyé via le formulaire de contact de URGENCE MOTOS (https://www.urgence-scooters.com)
Reply-To: [your-email]
cc:jonas@urgence-scooters.com,samuel.m@urgence-scooters.com,contact@soft4one.com

1

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