| 535
| <![CDATA[<fieldset class="formContainer formHorizontal" id="rsform_5_page_0">
<div class="formRow">
<div class="formSpan7">
<div class="rsform-block rsform-block-nome">
<label class="formControlLabel" for="Nome"><strong class="formRequired">(*)</strong></label>
<div class="formControls">
<div class="formBody">
<input type="text" value="" size="20" placeholder="Nome" name="form[Nome]" id="Nome" class="rsform-input-box" aria-required="true" />
<span class="formValidation"><span id="component35" class="formNoError">Entrada Inválida</span></span>
<p class="formDescription"></p>
</div>
</div>
</div>
<div class="rsform-block rsform-block-email">
<label class="formControlLabel" for="Email"><strong class="formRequired">(*)</strong></label>
<div class="formControls">
<div class="formBody">
<input type="text" value="" size="20" placeholder="Email" name="form[Email]" id="Email" class="rsform-input-box" aria-required="true" />
<span class="formValidation"><span id="component36" class="formNoError">Entrada Inválida</span></span>
<p class="formDescription"></p>
</div>
</div>
</div>
<div class="rsform-block rsform-block-assunto">
<label class="formControlLabel" for="Assunto"><strong class="formRequired">(*)</strong></label>
<div class="formControls">
<div class="formBody">
<input type="text" value="" size="20" placeholder="Assunto" name="form[Assunto]" id="Assunto" class="rsform-input-box" aria-required="true" />
<span class="formValidation"><span id="component37" class="formNoError">Entrada Inválida</span></span>
<p class="formDescription"></p>
</div>
</div>
</div>
<div class="rsform-block rsform-block-mensagem">
<label class="formControlLabel" for="Mensagem"><strong class="formRequired">(*)</strong></label>
<div class="formControls">
<div class="formBody">
<textarea cols="50" rows="5" placeholder="Mensagem" name="form[Mensagem]" id="Mensagem" class="rsform-text-box" aria-required="true"></textarea>
<span class="formValidation"><span id="component38" class="formNoError">Entrada Inválida</span></span>
<p class="formDescription"></p>
</div>
</div>
</div>
<div class="rsform-block rsform-block-documentos">
<label class="formControlLabel" for="Documentos">Envio de Documentos<strong class="formRequired">(*)</strong></label>
<div class="formControls">
<div class="formBody">
<div class="rsfp-field-multiple-plus"><input type="file" name="form[Documentos][]" id="Documentos" data-rsfp-skip-ajax="true" class="rsform-upload-box" aria-required="true" data-rsfp-required="true" data-rsfp-minfiles="1" data-rsfp-maxfiles="3" data-rsfp-exts="["doc","docx","pdf","jpg"]" data-rsfp-size="10240000" /></div><button type="button" class="rsfp-field-multiple-plus-button" data-rsfp-maxfiles="3" data-rsfp-formid="5" onclick="RSFormPro.addMoreFiles(this);">Adic.+ arquivos</button>
<span class="formValidation"><span id="component42" class="formNoError">Entrada Inválida</span></span>
<p class="formDescription">Enviar até 3 documentos para protocolo emergencial em Word, PDF ou Imagem, com tamanho máximo de 10 MB. </p>
</div>
</div>
</div>
<div class="rsform-block rsform-block-recaptcha">
<label class="formControlLabel"><strong class="formRequired">(*)</strong></label>
<div class="formControls">
<div class="formBody">
<div id="g-recaptcha-39"></div>
<noscript>
<div style="width: 302px; height: 352px;">
<div style="width: 302px; height: 352px; position: relative;">
<div style="width: 302px; height: 352px; position: absolute;">
<iframe src="https://www.google.com/recaptcha/api/fallback?k=6Lc0kxITAAAAAO3Gs8gECbAWD734IxSZmROewmik" frameborder="0" scrolling="no" style="width: 302px; height:352px; border-style: none;"></iframe>
</div>
<div style="width: 250px; height: 80px; position: absolute; border-style: none; bottom: 21px; left: 25px; margin: 0px; padding: 0px; right: 25px;">
<textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response" style="width: 250px; height: 80px; border: 1px solid #c1c1c1; margin: 0px; padding: 0px; resize: none;"></textarea>
</div>
</div>
</div>
</noscript>
<span class="formValidation"><span id="component39" class="formNoError">Entrada Inválida</span></span>
<p class="formDescription"></p>
</div>
</div>
</div>
<div class="rsform-block rsform-block-enviar">
<label class="formControlLabel" for="Enviar"></label>
<div class="formControls">
<div class="formBody">
<button type="submit" name="form[Enviar]" id="Enviar" class="rsform-submit-button" >Enviar</button> <button type="reset" class="rsform-reset-button" onclick="RSFormPro.resetElements(5)" >Limpar</button>
<span class="formValidation"></span>
<p class="formDescription"></p>
</div>
</div>
</div>
</div>
<div class="formSpan5">
<div class="rsform-block rsform-block-info">
<strong>Câmara Municipal de Bebedouro - SP<br /> Endereço: </strong>Rua Lucas Evangelista, 652, Centro<br /> <strong>Cidade: </strong>Bebedouro/S.P.<br /> <strong>C.E.P.: </strong>14700-425 <br /> <strong>Telefone/fax:</strong> <br /> (17) 3345-9200 / (17) 3345-9201<br /> <strong>C.N.P.J.: </strong>49.159.668/0001-75<br /> <strong>Site: </strong>www.camarabebedouro.sp.gov.br<br /> <strong>Email:</strong> protocoloemergencial@camarabebedouro.sp.gov.br<br /> <strong>Natureza Jurídica: </strong><br /> Poder Legislativo Municipal <br /> <strong>Ramo de Atividade:</strong> <br /> Prestação de Serviços<br /> <strong>Horário de Funcionamento:</strong><br /> 09 ás 12 e 14 ás 17 horas
</div>
</div>
</div>
</fieldset>]]>
|
