document.write('<form id=\"frenc\" method=\"post\" action=\"http://www.city-rencontre.com/annonce/inscription_coquine.php\"><select name=\"ville\" id=\"ville\" style=\"width:130px;\"><option value=\"au\">Votre ville ?</option><option value=\"Aix-en-provence\">Aix-en-provence</option><option value=\"Ajaccio\">Ajaccio</option><option value=\"Amiens\">Amiens</option><option value=\"Angers\">Angers</option><option value=\"Angouleme\">Angoul&ecirc;me</option><option value=\"Annecy\">Annecy</option><option value=\"Avignon\">Avignon</option><option value=\"Besancon\">Besan&ccedil;on</option><option value=\"Biarritz\">Biarritz</option><option value=\"Bordeaux\">Bordeaux</option><option value=\"Brest\">Brest</option><option value=\"Caen\">Caen</option><option value=\"Cannes\">Cannes</option><option value=\"Chartres\">Chartres</option><option value=\"Clermont-Ferrand\">Clermont-Ferrand</option><option value=\"Grenoble\">Grenoble</option><option value=\"La-Rochelle\">La Rochelle</option><option value=\"Le-Havre\">Le Havre</option><option value=\"Le-Mans\">Le Mans</option><option value=\"Lille\">Lille</option><option value=\"Limoges\">Limoges</option><option value=\"Lyon\">Lyon</option><option value=\"Marseille\">Marseille</option><option value=\"Metz\">Metz</option><option value=\"Montpellier\">Montpellier</option><option value=\"Mulhouse\">Mulhouse</option><option value=\"Nancy<\">Nancy</option><option value=\"Nantes\">Nantes</option><option value=\"Nice\">Nice</option><option value=\"Nimes\">N&icirc;mes</option><option value=\"Orleans\">Orleans</option><option value=\"Paris\">Paris</option><option value=\"Pau\">Pau</option><option value=\"Perpignan\">Perpignan</option><option value=\"Poitiers\">Poitiers</option><option value=\"Reims\">Reims</option><option value=\"Rennes\">Rennes</option><option value=\"Rouen\">Rouen</option><option value=\"Strasbourg\">Strasbourg</option><option value=\"Toulouse\">Toulouse</option><option value=\"Tours\">Tours</option><option value=\"au\">Autres villes </option></select><select name=\"sexe\" style=\"width:153px;\"><option>Vous recherchez ?</option><option value=\"f\">Une femme</option><option value=\"h\">Un homme</option><option value=\"c\">Un couple</option></select><select name=\"rencontre\" id=\"rencontre\" style=\"width:153px;\"><option value=\"\">Type de rencontres ?</option><option value=\"amoureuse\">Amoureuse</option><option value=\"amitie\">Amiti&eacute;</option><option value=\"rapide\">Rapide</option><option value=\"coquine\">Coquine</option><option value=\"gay\">Gay</option><option value=\"echangiste\">Echangiste</option><option value=\"sexeatrois\">Plan &agrave; trois</option><option value=\"sexfriend\">Sex Friend</option><option value=\"cybersexe\">Cyber Sexe</option></select><input type=\"submit\" name=\"submit\" value=\"valider\"></form>')