{"id":8436,"date":"2024-04-24T17:20:52","date_gmt":"2024-04-24T21:20:52","guid":{"rendered":"\/site\/?page_id=8436"},"modified":"2024-04-24T17:20:53","modified_gmt":"2024-04-24T21:20:53","slug":"slg-menfp-formulaire-de-declaration-des-eleves","status":"publish","type":"page","link":"\/site\/slg-menfp-formulaire-de-declaration-des-eleves\/","title":{"rendered":"SLG-MENFP-Formulaire de d\u00e9claration des \u00e9l\u00e8ves"},"content":{"rendered":"\n<style>\n        div.entry-content.clearfix {\n            \/* Set a background image for the body *\/\n            background-image: url('\/site\/wp-content\/uploads\/2024\/01\/Slg_logo-10perc.png');\n            \n            \/* Set the background image to cover the entire body *\/\n            background-size: cover;\n            background-size: fit-content;\n            \/* Make the image semi-transparent for a watermark effect *\/\n            opacity: 1;\n            \/* Adjust other properties based on your requirements *\/\n            \/* For example, position the image at the bottom right corner *\/\n            background-position: center;\n            \/* Repeat the image across the entire body *\/\n            background-repeat: no-repeat;\n        }\n<\/style>\n\n\n<div class='fluentform ff-default fluentform_wrapper_13  ff_guten_block ff_guten_block-13 ffs_default_wrap'><form data-form_id=\"13\" id=\"fluentform_13\" class=\"frm-fluent-form fluent_form_13 ff-el-form-top ff_form_instance_13_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_13_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">SLG-MENFP-Formulaire de d\u00e9claration des \u00e9l\u00e8ves<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='8436' \/><input type=\"hidden\" id=\"_fluentform_13_fluentformnonce\" name=\"_fluentform_13_fluentformnonce\" value=\"34d702f8e2\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/site\/wp-json\/wp\/v2\/pages\/8436\" \/><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_1 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 100%;'><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_1\" ><p><img decoding=\"async\" class=\"aligncenter\" src=\"https:\/\/sigeee.menfp.gouv.ht\/census\/assets\/img\/logo.svg\" width=\"10%\" height=\"10%\" align=\"CENTER\" \/><\/p><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_2\" ><h4 style=\"text-align: center\"><small class=\"text-uppercase font-weight-bold\">REPUBLIQUE D&rsquo;HA\u00cfTI<br \/><\/small>Minist\u00e8re de l&rsquo;\u00c9ducation Nationale<br \/>et de la Formation Professionnelle<\/h4><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_3\" ><div class=\"text-center\">\n<h2 class=\"mb-3 ls-tight text-primary\" style=\"text-align: center\">Formulaire de d\u00e9claration des \u00e9l\u00e8ves<\/h2>\n<p style=\"text-align: center\">Veuillez enregistrer l&rsquo;\u00e9l\u00e8ve pour<br \/><strong>INSTITUTION SAINT LOUIS DE GONZAGUE<\/strong><\/p>\n<p style=\"text-align: center\"><img decoding=\"async\" src=\"https:\/\/islghaiti.org\/site\/wp-content\/uploads\/2023\/06\/SeparatorSLG1-1024x102.png\" \/><\/p>\n<\/div>\n<hr \/><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_4\" ><p style=\"text-align: center\"><em><span style=\"color: #ff0000\">Tous les champs avec un ast\u00e9risque (*) sont obligatoires<\/span><\/em><\/p><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_5\" ><h2><p><img decoding=\"async\" src=\"https:\/\/img.icons8.com\/?size=30&amp;id=kDoeg22e5jUY&amp;format=png\" align=\"left\" \/><b><\/b><\/p>\nInformations personnelles<\/h2>\n<hr \/><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_3 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 33.33%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text' id='label_ff_13_input_text' aria-label=\"Nom\">Nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" placeholder=\"Nom de l&#039;\u00e9l\u00e8ve\" data-name=\"input_text\" id=\"ff_13_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text_1' id='label_ff_13_input_text_1' aria-label=\"Pr\u00e9nom\">Pr\u00e9nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" placeholder=\"Pr\u00e9nom de l&#039;&#039;\u00e9l\u00e8ve\" data-name=\"input_text_1\" id=\"ff_13_input_text_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_datetime' id='label_ff_13_datetime' aria-label=\"Date de naissance\">Date de naissance<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Date de naissance Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime\" id=\"ff_13_datetime\" class=\"ff-el-form-control ff-el-datepicker\" data-name=\"datetime\"  aria-invalid='false' aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 34.11%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown' id='label_ff_13_dropdown' aria-label=\"D\u00e9partement de naissance\">D\u00e9partement de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown\" id=\"ff_13_dropdown\" class=\"ff-el-form-control\" data-name=\"dropdown\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"OUEST\"  >OUEST<\/option><option value=\"SUD-EST\"  >SUD-EST<\/option><option value=\"NORD\"  >NORD<\/option><option value=\"NORD-EST\"  >NORD-EST<\/option><option value=\"ARTIBONITE\"  >ARTIBONITE<\/option><option value=\"CENTRE\"  >CENTRE<\/option><option value=\"SUD\"  >SUD<\/option><option value=\"GRANDE-ANSE\"  >GRANDE-ANSE<\/option><option value=\"NORD-OUEST\"  >NORD-OUEST<\/option><option value=\"NIPPES\"  >NIPPES<\/option><option value=\"AUTRES\"  >AUTRES<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_1' id='label_ff_13_dropdown_1' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_1\" id=\"ff_13_dropdown_1\" class=\"ff-el-form-control\" data-name=\"dropdown_1\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_1\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"P\u00e9tion-Ville\"  >P\u00e9tion-Ville<\/option><option value=\"Port-au-Prince\"  >Port-au-Prince<\/option><option value=\"Delmas\"  >Delmas<\/option><option value=\"Carrefour\"  >Carrefour<\/option><option value=\"Kenscoff\"  >Kenscoff<\/option><option value=\"Cit\u00e9 Soleil\"  >Cit\u00e9 Soleil<\/option><option value=\"Tabarre\"  >Tabarre<\/option><option value=\"L\u00e9ogane\"  >L\u00e9ogane<\/option><option value=\"Petit-Goave\"  >Petit-Goave<\/option><option value=\"Grand Goave\"  >Grand Goave<\/option><option value=\"Gressier\"  >Gressier<\/option><option value=\"Croix des bouquets\"  >Croix des bouquets<\/option><option value=\"Thomazeau\"  >Thomazeau<\/option><option value=\"Ganthier\"  >Ganthier<\/option><option value=\"Cornillon\"  >Cornillon<\/option><option value=\"Fond-Verrettes\"  >Fond-Verrettes<\/option><option value=\"Arcahaie\"  >Arcahaie<\/option><option value=\"Cabaret\"  >Cabaret<\/option><option value=\"Anse \u00e0 Galets\"  >Anse \u00e0 Galets<\/option><option value=\"Pointe \u00e0 Raquette\"  >Pointe \u00e0 Raquette<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_2' id='label_ff_13_dropdown_2' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_2\" id=\"ff_13_dropdown_2\" class=\"ff-el-form-control\" data-name=\"dropdown_2\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_2\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Jacmel\"  >Jacmel<\/option><option value=\"Marigot\"  >Marigot<\/option><option value=\"Cayes Jacmel\"  >Cayes Jacmel<\/option><option value=\"La Vall\u00e9e Jacmel\"  >La Vall\u00e9e Jacmel<\/option><option value=\"Bainet\"  >Bainet<\/option><option value=\"Cotes de Fer\"  >Cotes de Fer<\/option><option value=\"Belle-Anse\"  >Belle-Anse<\/option><option value=\"Grand Gossier\"  >Grand Gossier<\/option><option value=\"Thiotte\"  >Thiotte<\/option><option value=\"Anse \u00e0 Pitre\"  >Anse \u00e0 Pitre<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_3' id='label_ff_13_dropdown_3' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_3\" id=\"ff_13_dropdown_3\" class=\"ff-el-form-control\" data-name=\"dropdown_3\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_3\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Cap-Ha\u00eftien\"  >Cap-Ha\u00eftien<\/option><option value=\"Quartier-Morin\"  >Quartier-Morin<\/option><option value=\"Limonade\"  >Limonade<\/option><option value=\"L&#039;Acul du Nord\"  >L&rsquo;Acul du Nord<\/option><option value=\"Plaine du Nord\"  >Plaine du Nord<\/option><option value=\"Milot\"  >Milot<\/option><option value=\"Grande Rivi\u00e8re du Nord\"  >Grande Rivi\u00e8re du Nord<\/option><option value=\"Bahon\"  >Bahon<\/option><option value=\"Saint-Raphael\"  >Saint-Raphael<\/option><option value=\"Dondon\"  >Dondon<\/option><option value=\"Ranquitte\"  >Ranquitte<\/option><option value=\"Pignon\"  >Pignon<\/option><option value=\"La Victoire\"  >La Victoire<\/option><option value=\"Borgne\"  >Borgne<\/option><option value=\"Port Margot\"  >Port Margot<\/option><option value=\"Limb\u00e9\"  >Limb\u00e9<\/option><option value=\"Bas-Limb\u00e9\"  >Bas-Limb\u00e9<\/option><option value=\"Plaisance\"  >Plaisance<\/option><option value=\"Pilate\"  >Pilate<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_4' id='label_ff_13_dropdown_4' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_4\" id=\"ff_13_dropdown_4\" class=\"ff-el-form-control\" data-name=\"dropdown_4\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_4\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Fort-Libert\u00e9\"  >Fort-Libert\u00e9<\/option><option value=\"Ferrier\"  >Ferrier<\/option><option value=\"Perches\"  >Perches<\/option><option value=\"Ouanaminthe\"  >Ouanaminthe<\/option><option value=\"Capotille\"  >Capotille<\/option><option value=\"Mont-Organis\u00e9\"  >Mont-Organis\u00e9<\/option><option value=\"Trou du Nord\"  >Trou du Nord<\/option><option value=\"Sainte Suzanne\"  >Sainte Suzanne<\/option><option value=\"Terrier Rouge\"  >Terrier Rouge<\/option><option value=\"Caracol\"  >Caracol<\/option><option value=\"Valli\u00e8res\"  >Valli\u00e8res<\/option><option value=\"Carice\"  >Carice<\/option><option value=\"Mombin Crochu\"  >Mombin Crochu<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_5' id='label_ff_13_dropdown_5' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_5\" id=\"ff_13_dropdown_5\" class=\"ff-el-form-control\" data-name=\"dropdown_5\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_5\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Dessalines (Marchand)\"  >Dessalines (Marchand)<\/option><option value=\"Petite Rivi\u00e8re de L&#039;Artibonite\"  >Petite Rivi\u00e8re de L&rsquo;Artibonite<\/option><option value=\"Grande Saline\"  >Grande Saline<\/option><option value=\"Desdunes\"  >Desdunes<\/option><option value=\"St Michel de L&#039;Attalaye\"  >St Michel de L&rsquo;Attalaye<\/option><option value=\"Marmelade\"  >Marmelade<\/option><option value=\"Liancourt\"  >Liancourt<\/option><option value=\"Montrouis\"  >Montrouis<\/option><option value=\"Gona\u00efves\"  >Gona\u00efves<\/option><option value=\"Ennery\"  >Ennery<\/option><option value=\"L&#039;Est\u00e8re\"  >L&rsquo;Est\u00e8re<\/option><option value=\"Gros-Morne\"  >Gros-Morne<\/option><option value=\"Terre-Neuve\"  >Terre-Neuve<\/option><option value=\"Anse Rouge\"  >Anse Rouge<\/option><option value=\"Saint-Marc\"  >Saint-Marc<\/option><option value=\"Verrettes\"  >Verrettes<\/option><option value=\"La Chapelle\"  >La Chapelle<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_6' id='label_ff_13_dropdown_6' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_6\" id=\"ff_13_dropdown_6\" class=\"ff-el-form-control\" data-name=\"dropdown_6\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_6\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Hinche\"  >Hinche<\/option><option value=\"Baptiste\"  >Baptiste<\/option><option value=\"Ma\u00efssade\"  >Ma\u00efssade<\/option><option value=\"Thomonde\"  >Thomonde<\/option><option value=\"Cerca Cavajal\"  >Cerca Cavajal<\/option><option value=\"Mirbalais\"  >Mirbalais<\/option><option value=\"Saut D&#039;Eau\"  >Saut D&rsquo;Eau<\/option><option value=\"Boucan Carr\u00e9\"  >Boucan Carr\u00e9<\/option><option value=\"Lascahobas\"  >Lascahobas<\/option><option value=\"Bellad\u00e8re\"  >Bellad\u00e8re<\/option><option value=\"Savanette\"  >Savanette<\/option><option value=\"Cerca La Source\"  >Cerca La Source<\/option><option value=\"Thomassique\"  >Thomassique<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_7' id='label_ff_13_dropdown_7' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_7\" id=\"ff_13_dropdown_7\" class=\"ff-el-form-control\" data-name=\"dropdown_7\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_7\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Cayes\"  >Cayes<\/option><option value=\"Torbeck\"  >Torbeck<\/option><option value=\"Chantal\"  >Chantal<\/option><option value=\"Camp-P\u00e9rin\"  >Camp-P\u00e9rin<\/option><option value=\"Maniche\"  >Maniche<\/option><option value=\"L&#039;Ile \u00e0 Vache\"  >L&rsquo;Ile \u00e0 Vache<\/option><option value=\"Port-Salut\"  >Port-Salut<\/option><option value=\"St Jean du Sud\"  >St Jean du Sud<\/option><option value=\"Arniquet\"  >Arniquet<\/option><option value=\"Aquin\"  >Aquin<\/option><option value=\"Saint Louis du Sud\"  >Saint Louis du Sud<\/option><option value=\"Cavaillon\"  >Cavaillon<\/option><option value=\"Coteaux\"  >Coteaux<\/option><option value=\"Port-\u00e0-Piment\"  >Port-\u00e0-Piment<\/option><option value=\"Roche-\u00e0-Bateau\"  >Roche-\u00e0-Bateau<\/option><option value=\"Chardonni\u00e8res\"  >Chardonni\u00e8res<\/option><option value=\"Les Anglais\"  >Les Anglais<\/option><option value=\"Tiburon\"  >Tiburon<\/option><option value=\"Fonds des Blancs\"  >Fonds des Blancs<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_8' id='label_ff_13_dropdown_8' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_8\" id=\"ff_13_dropdown_8\" class=\"ff-el-form-control\" data-name=\"dropdown_8\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_8\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"\u00cele Cayemites\"  >\u00cele Cayemites<\/option><option value=\"Marfranc\"  >Marfranc<\/option><option value=\"J\u00e9r\u00e9mie\"  >J\u00e9r\u00e9mie<\/option><option value=\"Abricots\"  >Abricots<\/option><option value=\"Bonbon\"  >Bonbon<\/option><option value=\"Moron\"  >Moron<\/option><option value=\"Chambellan\"  >Chambellan<\/option><option value=\"Anse d&quot;Hainault\"  >Anse d\u00a0\u00bbHainault<\/option><option value=\"Dame Marie\"  >Dame Marie<\/option><option value=\"Les Irois\"  >Les Irois<\/option><option value=\"Corail\"  >Corail<\/option><option value=\"Roseaux\"  >Roseaux<\/option><option value=\"Beaumont\"  >Beaumont<\/option><option value=\"Pestel\"  >Pestel<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_9' id='label_ff_13_dropdown_9' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_9\" id=\"ff_13_dropdown_9\" class=\"ff-el-form-control\" data-name=\"dropdown_9\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_9\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"La Pointe\"  >La Pointe<\/option><option value=\"Port-de-Paix\"  >Port-de-Paix<\/option><option value=\"La Tortue\"  >La Tortue<\/option><option value=\"Bassin Bleu\"  >Bassin Bleu<\/option><option value=\"Chansolme\"  >Chansolme<\/option><option value=\"Saint Louis du Nord\"  >Saint Louis du Nord<\/option><option value=\"Anse \u00e0 Foleur\"  >Anse \u00e0 Foleur<\/option><option value=\"Mole Saint Nicolas\"  >Mole Saint Nicolas<\/option><option value=\"Baie de Henne\"  >Baie de Henne<\/option><option value=\"Bombardopolis\"  >Bombardopolis<\/option><option value=\"Jean Rabel\"  >Jean Rabel<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_11' id='label_ff_13_dropdown_11' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_11\" id=\"ff_13_dropdown_11\" class=\"ff-el-form-control\" data-name=\"dropdown_11\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_11\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Miragoane\"  >Miragoane<\/option><option value=\"Petite Rivi\u00e8re de Nippes\"  >Petite Rivi\u00e8re de Nippes<\/option><option value=\"Fonds des N\u00e8gres\"  >Fonds des N\u00e8gres<\/option><option value=\"Paillant\"  >Paillant<\/option><option value=\"Anse \u00e0 Veau\"  >Anse \u00e0 Veau<\/option><option value=\"Petit Trou de Nippes\"  >Petit Trou de Nippes<\/option><option value=\"L&#039;Asile\"  >L&rsquo;Asile<\/option><option value=\"Arnaud\"  >Arnaud<\/option><option value=\"Barad\u00e8res\"  >Barad\u00e8res<\/option><option value=\"Grand Boucan\"  >Grand Boucan<\/option><option value=\"Plaissance du Sud\"  >Plaissance du Sud<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_10' id='label_ff_13_dropdown_10' aria-label=\"Commune de naissance\">Commune de naissance<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_10\" id=\"ff_13_dropdown_10\" class=\"ff-el-form-control\" data-name=\"dropdown_10\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_10\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Departement d&#039;Outre Mer\"  >Departement d&rsquo;Outre Mer<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_13_input_text_2' id='label_ff_13_input_text_2' aria-label=\"Lieu de naissance\">Lieu de naissance<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_2\" class=\"ff-el-form-control\" data-name=\"input_text_2\" id=\"ff_13_input_text_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-3' style='flex-basis: 32.56%;'><div class='ff-el-group ff-el-form-left'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Y a-t-il un handicap ? (Moteur, Sensoriel, Cognitif, Psychique)\">Y a-t-il un handicap ? (Moteur, Sensoriel, Cognitif, Psychique)<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9735db7388d02bf86332d5cc3bf0db09'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"OUI\"  id='input_radio_9735db7388d02bf86332d5cc3bf0db09' aria-label='OUI' aria-invalid='false' aria-required=true> <span>OUI<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_75adf15280b17bd84b091cde7097c9bd'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"NON\"  id='input_radio_75adf15280b17bd84b091cde7097c9bd' aria-label='NON' aria-invalid='false' aria-required=true> <span>NON<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Quel type d&#039;handicap ?\">Quel type d&rsquo;handicap ?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_b77002bda6ee93ebda62248b9728b8f6'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Moteur\"  id='input_radio_1_b77002bda6ee93ebda62248b9728b8f6' aria-label='Moteur' aria-invalid='false' aria-required=true> <span>Moteur<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_519f229714d4c2b3a843a35e1636a346'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Sensoriel\"  id='input_radio_1_519f229714d4c2b3a843a35e1636a346' aria-label='Sensoriel' aria-invalid='false' aria-required=true> <span>Sensoriel<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_11f61818f87884d23258c2a16522c9ff'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Cognitif\"  id='input_radio_1_11f61818f87884d23258c2a16522c9ff' aria-label='Cognitif' aria-invalid='false' aria-required=true> <span>Cognitif<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_be348440bfd418d2487980792f8d934f'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Psychique\"  id='input_radio_1_be348440bfd418d2487980792f8d934f' aria-label='Psychique' aria-invalid='false' aria-required=true> <span>Psychique<\/span><\/label><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_6\" ><h2><p><img decoding=\"async\" src=\"https:\/\/img.icons8.com\/?size=30&amp;id=nbsqAaIAMGig&amp;format=png\" align=\"left\" \/><b>Informations acad\u00e9miques<\/b><\/p><\/h2>\n<hr \/><\/div><div data-name=\"ff_cn_id_3\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_12' id='label_ff_13_dropdown_12' aria-label=\"Niveau d&#039;enseignement\">Niveau d&rsquo;enseignement<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_12\" id=\"ff_13_dropdown_12\" class=\"ff-el-form-control\" data-name=\"dropdown_12\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_12\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"FONDAMENTAL 1\"  >FONDAMENTAL 1<\/option><option value=\"FONDAMENTAL 2\"  >FONDAMENTAL 2<\/option><option value=\"FONDAMENTAL 3\"  >FONDAMENTAL 3<\/option><option value=\"SECONDAIRE\"  >SECONDAIRE<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_15' id='label_ff_13_dropdown_15' aria-label=\"Niveau d&#039;\u00e9tudes\">Niveau d&rsquo;\u00e9tudes<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_15\" id=\"ff_13_dropdown_15\" class=\"ff-el-form-control\" data-name=\"dropdown_15\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_15\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1 AF\"  >1 AF<\/option><option value=\"2 AF\"  >2 AF<\/option><option value=\"3 AF\"  >3 AF<\/option><option value=\"4 AF\"  >4 AF<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_16' id='label_ff_13_dropdown_16' aria-label=\"Niveau d&#039;\u00e9tudes\">Niveau d&rsquo;\u00e9tudes<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_16\" id=\"ff_13_dropdown_16\" class=\"ff-el-form-control\" data-name=\"dropdown_16\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_16\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"5 AF\"  >5 AF<\/option><option value=\"6 AF\"  >6 AF<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_17' id='label_ff_13_dropdown_17' aria-label=\"Niveau d&#039;\u00e9tudes\">Niveau d&rsquo;\u00e9tudes<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_17\" id=\"ff_13_dropdown_17\" class=\"ff-el-form-control\" data-name=\"dropdown_17\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_17\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"7 AF\"  >7 AF<\/option><option value=\"8 AF\"  >8 AF<\/option><option value=\"9 AF\"  >9 AF<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_19' id='label_ff_13_dropdown_19' aria-label=\"Niveau d&#039;\u00e9tudes\">Niveau d&rsquo;\u00e9tudes<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_19\" id=\"ff_13_dropdown_19\" class=\"ff-el-form-control\" data-name=\"dropdown_19\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_19\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"NSI\"  >NSI<\/option><option value=\"NSII\"  >NSII<\/option><option value=\"NSIII\"  >NSIII<\/option><option value=\"NSIV\"  >NSIV<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_184' id='label_ff_13_dropdown_184' aria-label=\"Salle \u00e0 SLG\">Salle \u00e0 SLG<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_184\" id=\"ff_13_dropdown_184\" class=\"ff-el-form-control\" data-name=\"dropdown_184\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_184\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"BLEUE\"  >BLEUE<\/option><option value=\"JAUNE\"  >JAUNE<\/option><option value=\"MAUVE\"  >MAUVE<\/option><option value=\"ROUGE\"  >ROUGE<\/option><option value=\"VERTE\"  >VERTE<\/option><option value=\"WAX\"  >WAX<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_13_email' id='label_ff_13_email' aria-label=\"Veuillez fournir si possible, l&#039;adresse \u00e9l\u00e9ctronique de l&#039;\u00e9l\u00e8ve pour toute communication \u00e9ducative\">Veuillez fournir si possible, l&rsquo;adresse \u00e9l\u00e9ctronique de l&rsquo;\u00e9l\u00e8ve pour toute communication \u00e9ducative<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_13_email\" class=\"ff-el-form-control\" placeholder=\"Email\" data-name=\"email\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_7\" ><h2><p><img decoding=\"async\" src=\"https:\/\/img.icons8.com\/?size=30&amp;id=30622&amp;format=png\" align=\"left\" \/><b>Adresse<\/b><\/p><\/h2>\n<hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text_5' id='label_ff_13_input_text_5' aria-label=\"Adresse\">Adresse<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_5\" class=\"ff-el-form-control\" data-name=\"input_text_5\" id=\"ff_13_input_text_5\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div data-name=\"ff_cn_id_4\"  class='ff-t-container ff-column-container ff_columns_total_3 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 33.33%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_20' id='label_ff_13_dropdown_20' aria-label=\"D\u00e9partement\">D\u00e9partement<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_20\" id=\"ff_13_dropdown_20\" class=\"ff-el-form-control\" data-name=\"dropdown_20\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_20\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"OUEST\"  >OUEST<\/option><option value=\"SUD-EST\"  >SUD-EST<\/option><option value=\"NORD\"  >NORD<\/option><option value=\"NORD-EST\"  >NORD-EST<\/option><option value=\"ARTIBONITE\"  >ARTIBONITE<\/option><option value=\"CENTRE\"  >CENTRE<\/option><option value=\"SUD\"  >SUD<\/option><option value=\"GRANDE-ANSE\"  >GRANDE-ANSE<\/option><option value=\"NORD-OUEST\"  >NORD-OUEST<\/option><option value=\"NIPPES\"  >NIPPES<\/option><option value=\"AUTRES\"  >AUTRES<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 56.67%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_21' id='label_ff_13_dropdown_21' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_21\" id=\"ff_13_dropdown_21\" class=\"ff-el-form-control\" data-name=\"dropdown_21\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_21\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-\u00e0-Galets\"  >Anse-\u00e0-Galets<\/option><option value=\"Arcahaie\"  >Arcahaie<\/option><option value=\"Cabaret\"  >Cabaret<\/option><option value=\"Carrefour\"  >Carrefour<\/option><option value=\"Cit\u00e9 Soleil\"  >Cit\u00e9 Soleil<\/option><option value=\"Cornillon\"  >Cornillon<\/option><option value=\"Croix-des-Bouquets\"  >Croix-des-Bouquets<\/option><option value=\"Delmas\"  >Delmas<\/option><option value=\"Fond-Verettes\"  >Fond-Verettes<\/option><option value=\"Ganthier\"  >Ganthier<\/option><option value=\"Grand Goave\"  >Grand Goave<\/option><option value=\"Gressier\"  >Gressier<\/option><option value=\"Kenscoff\"  >Kenscoff<\/option><option value=\"L\u00e9og\u00e2ne\"  >L\u00e9og\u00e2ne<\/option><option value=\"Petit-Go\u00e2ve\"  >Petit-Go\u00e2ve<\/option><option value=\"Pointe \u00e0 Raquette\"  >Pointe \u00e0 Raquette<\/option><option value=\"Port-au-Prince\"  >Port-au-Prince<\/option><option value=\"P\u00e9tion-Ville\"  >P\u00e9tion-Ville<\/option><option value=\"Tabarre\"  >Tabarre<\/option><option value=\"Thomazeau\"  >Thomazeau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_22' id='label_ff_13_dropdown_22' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_22\" id=\"ff_13_dropdown_22\" class=\"ff-el-form-control\" data-name=\"dropdown_22\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_22\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-\u00e0-Pitres\"  >Anse-\u00e0-Pitres<\/option><option value=\"Bainet\"  >Bainet<\/option><option value=\"Belle-Anse\"  >Belle-Anse<\/option><option value=\"Cayes-Jacmel\"  >Cayes-Jacmel<\/option><option value=\"Cotes de Fer\"  >Cotes de Fer<\/option><option value=\"Grand Gossier\"  >Grand Gossier<\/option><option value=\"Jacmel\"  >Jacmel<\/option><option value=\"La Vall\u00e9e-de-Jacmel\"  >La Vall\u00e9e-de-Jacmel<\/option><option value=\"Marigot\"  >Marigot<\/option><option value=\"Thiotte\"  >Thiotte<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_23' id='label_ff_13_dropdown_23' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_23\" id=\"ff_13_dropdown_23\" class=\"ff-el-form-control\" data-name=\"dropdown_23\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_23\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Acul-du-Nord\"  >Acul-du-Nord<\/option><option value=\"Bahon\"  >Bahon<\/option><option value=\"Bas-Limb\u00e9\"  >Bas-Limb\u00e9<\/option><option value=\"Borgne\"  >Borgne<\/option><option value=\"Cap-Ha\u00eftien\"  >Cap-Ha\u00eftien<\/option><option value=\"Caracol\"  >Caracol<\/option><option value=\"Dondon\"  >Dondon<\/option><option value=\"Ferrier\"  >Ferrier<\/option><option value=\"Fort-Libert\u00e9\"  >Fort-Libert\u00e9<\/option><option value=\"Grande Rivi\u00e8re du Nord\"  >Grande Rivi\u00e8re du Nord<\/option><option value=\"Gros-Morne\"  >Gros-Morne<\/option><option value=\"La Victoire\"  >La Victoire<\/option><option value=\"L&#039;Acul du Nord\"  >L&rsquo;Acul du Nord<\/option><option value=\"Limb\u00e9\"  >Limb\u00e9<\/option><option value=\"Limonade\"  >Limonade<\/option><option value=\"Milot\"  >Milot<\/option><option value=\"Mont-Organis\u00e9\"  >Mont-Organis\u00e9<\/option><option value=\"Ouanaminthe\"  >Ouanaminthe<\/option><option value=\"Perches\"  >Perches<\/option><option value=\"Pignon\"  >Pignon<\/option><option value=\"Pilate\"  >Pilate<\/option><option value=\"Plaine-du-Nord\"  >Plaine-du-Nord<\/option><option value=\"Plaisance\"  >Plaisance<\/option><option value=\"Port Margot\"  >Port Margot<\/option><option value=\"Quartier-Morin\"  >Quartier-Morin<\/option><option value=\"Ranquitte\"  >Ranquitte<\/option><option value=\"Saint-Raphael\"  >Saint-Raphael<\/option><option value=\"Valli\u00e8res\"  >Valli\u00e8res<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_24' id='label_ff_13_dropdown_24' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_24\" id=\"ff_13_dropdown_24\" class=\"ff-el-form-control\" data-name=\"dropdown_24\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_24\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Capotille\"  >Capotille<\/option><option value=\"Caracol\"  >Caracol<\/option><option value=\"Carice\"  >Carice<\/option><option value=\"Ferrier\"  >Ferrier<\/option><option value=\"Fort-Libert\u00e9\"  >Fort-Libert\u00e9<\/option><option value=\"Mombin Crochu\"  >Mombin Crochu<\/option><option value=\"Mont-Organis\u00e9\"  >Mont-Organis\u00e9<\/option><option value=\"Ouanaminthe\"  >Ouanaminthe<\/option><option value=\"Perches\"  >Perches<\/option><option value=\"Sainte-Suzanne\"  >Sainte-Suzanne<\/option><option value=\"Terrier-Rouge\"  >Terrier-Rouge<\/option><option value=\"Trou-du-Nord\"  >Trou-du-Nord<\/option><option value=\"Valli\u00e8res\"  >Valli\u00e8res<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_25' id='label_ff_13_dropdown_25' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_25\" id=\"ff_13_dropdown_25\" class=\"ff-el-form-control\" data-name=\"dropdown_25\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_25\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-Rouge\"  >Anse-Rouge<\/option><option value=\"Desdunes\"  >Desdunes<\/option><option value=\"Dessalines (Marchand)\"  >Dessalines (Marchand)<\/option><option value=\"Ennery\"  >Ennery<\/option><option value=\"Grande-Saline\"  >Grande-Saline<\/option><option value=\"Gona\u00efves\"  >Gona\u00efves<\/option><option value=\"Gros-Morne\"  >Gros-Morne<\/option><option value=\"La Chapelle\"  >La Chapelle<\/option><option value=\"L&#039;Est\u00e8re\"  >L&rsquo;Est\u00e8re<\/option><option value=\"Liancourt\"  >Liancourt<\/option><option value=\"Marchand-Dessalines\"  >Marchand-Dessalines<\/option><option value=\"Marmelade\"  >Marmelade<\/option><option value=\"Montrouis\"  >Montrouis<\/option><option value=\"Petite-Rivi\u00e8re-de-l&#039;Artibonite\"  >Petite-Rivi\u00e8re-de-l&rsquo;Artibonite<\/option><option value=\"Saint-Marc\"  >Saint-Marc<\/option><option value=\"Saint-Michel-de-l&#039;Attalaye\"  >Saint-Michel-de-l&rsquo;Attalaye<\/option><option value=\"Terre-Neuve\"  >Terre-Neuve<\/option><option value=\"Verrettes\"  >Verrettes<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_26' id='label_ff_13_dropdown_26' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_26\" id=\"ff_13_dropdown_26\" class=\"ff-el-form-control\" data-name=\"dropdown_26\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_26\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Baptiste\"  >Baptiste<\/option><option value=\"Bellad\u00e8re\"  >Bellad\u00e8re<\/option><option value=\"Boucan-Carr\u00e9\"  >Boucan-Carr\u00e9<\/option><option value=\"Cerca Cavajal\"  >Cerca Cavajal<\/option><option value=\"Cerca-la-Source\"  >Cerca-la-Source<\/option><option value=\"Hinche\"  >Hinche<\/option><option value=\"Lascahobas\"  >Lascahobas<\/option><option value=\"Ma\u00efssade\"  >Ma\u00efssade<\/option><option value=\"Malanga\"  >Malanga<\/option><option value=\"Mirebalais\"  >Mirebalais<\/option><option value=\"Saut-d&#039;Eau\"  >Saut-d&rsquo;Eau<\/option><option value=\"Savanette\"  >Savanette<\/option><option value=\"Thomassique\"  >Thomassique<\/option><option value=\"Thomonde\"  >Thomonde<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_27' id='label_ff_13_dropdown_27' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_27\" id=\"ff_13_dropdown_27\" class=\"ff-el-form-control\" data-name=\"dropdown_27\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_27\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Aquin\"  >Aquin<\/option><option value=\"Arniquet\"  >Arniquet<\/option><option value=\"Camp-Perrin\"  >Camp-Perrin<\/option><option value=\"Cavaillon\"  >Cavaillon<\/option><option value=\"Cayes\"  >Cayes<\/option><option value=\"Chantal\"  >Chantal<\/option><option value=\"Chardonni\u00e8res\"  >Chardonni\u00e8res<\/option><option value=\"C\u00f4teaux\"  >C\u00f4teaux<\/option><option value=\"\u00cele-\u00e0-Vache\"  >\u00cele-\u00e0-Vache<\/option><option value=\"Fonds des Blancs\"  >Fonds des Blancs<\/option><option value=\"Les Anglais\"  >Les Anglais<\/option><option value=\"Maniche\"  >Maniche<\/option><option value=\"Port-\u00e0-Piment\"  >Port-\u00e0-Piment<\/option><option value=\"Port-Salut\"  >Port-Salut<\/option><option value=\"Roche-\u00e0-Bateau\"  >Roche-\u00e0-Bateau<\/option><option value=\"Saint-Jean-du-Sud\"  >Saint-Jean-du-Sud<\/option><option value=\"Saint-Louis-du-Sud\"  >Saint-Louis-du-Sud<\/option><option value=\"Tiburon\"  >Tiburon<\/option><option value=\"Torbeck\"  >Torbeck<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_28' id='label_ff_13_dropdown_28' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_28\" id=\"ff_13_dropdown_28\" class=\"ff-el-form-control\" data-name=\"dropdown_28\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_28\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Abricots\"  >Abricots<\/option><option value=\"Anse-d&#039;Hainault\"  >Anse-d&rsquo;Hainault<\/option><option value=\"Beaumont\"  >Beaumont<\/option><option value=\"Bonbon\"  >Bonbon<\/option><option value=\"Chambellan\"  >Chambellan<\/option><option value=\"Corail\"  >Corail<\/option><option value=\"Dame-Marie\"  >Dame-Marie<\/option><option value=\"\u00eele Cayemites\"  >\u00eele Cayemites<\/option><option value=\"J\u00e9r\u00e9mie\"  >J\u00e9r\u00e9mie<\/option><option value=\"Les Irois\"  >Les Irois<\/option><option value=\"Marfranc\"  >Marfranc<\/option><option value=\"Moron\"  >Moron<\/option><option value=\"Pestel\"  >Pestel<\/option><option value=\"Roseaux\"  >Roseaux<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_29' id='label_ff_13_dropdown_29' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_29\" id=\"ff_13_dropdown_29\" class=\"ff-el-form-control\" data-name=\"dropdown_29\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_29\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-\u00e0-Foleur\"  >Anse-\u00e0-Foleur<\/option><option value=\"Baie-de-Henne\"  >Baie-de-Henne<\/option><option value=\"Bassin Bleu\"  >Bassin Bleu<\/option><option value=\"Bombardopolis\"  >Bombardopolis<\/option><option value=\"Chansolme\"  >Chansolme<\/option><option value=\"Jean-Rabel\"  >Jean-Rabel<\/option><option value=\"La Pointe\"  >La Pointe<\/option><option value=\"La Tortue\"  >La Tortue<\/option><option value=\"M\u00f4le-Saint-Nicolas\"  >M\u00f4le-Saint-Nicolas<\/option><option value=\"Port-de-Paix\"  >Port-de-Paix<\/option><option value=\"Saint-Louis-du-Nord\"  >Saint-Louis-du-Nord<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_30' id='label_ff_13_dropdown_30' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_30\" id=\"ff_13_dropdown_30\" class=\"ff-el-form-control\" data-name=\"dropdown_30\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_30\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-\u00e0-Veau\"  >Anse-\u00e0-Veau<\/option><option value=\"Arnaud\"  >Arnaud<\/option><option value=\"Barad\u00e8res\"  >Barad\u00e8res<\/option><option value=\"Fonds des N\u00e8gres\"  >Fonds des N\u00e8gres<\/option><option value=\"Grand Boucan\"  >Grand Boucan<\/option><option value=\"L&#039;Asile\"  >L&rsquo;Asile<\/option><option value=\"Mirago\u00e2ne\"  >Mirago\u00e2ne<\/option><option value=\"Paillant\"  >Paillant<\/option><option value=\"Petite-Rivi\u00e8re-de-Nippes\"  >Petite-Rivi\u00e8re-de-Nippes<\/option><option value=\"Petit Trou de Nippes\"  >Petit Trou de Nippes<\/option><option value=\"Plaisance-du-Sud\"  >Plaisance-du-Sud<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_31' id='label_ff_13_dropdown_31' aria-label=\"Commune\">Commune<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_31\" id=\"ff_13_dropdown_31\" class=\"ff-el-form-control\" data-name=\"dropdown_31\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_31\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"D\u00e9partement d&#039;Outre Mer\"  >D\u00e9partement d&rsquo;Outre Mer<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-3' style='flex-basis: 10%;'><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_32' id='label_ff_13_dropdown_32' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_32\" id=\"ff_13_dropdown_32\" class=\"ff-el-form-control\" data-name=\"dropdown_32\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_32\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de P\u00e9tion-Ville\"  >Ville de P\u00e9tion-Ville<\/option><option value=\"Quartier de Thomassin\"  >Quartier de Thomassin<\/option><option value=\"1\u00e8re Sect. Montagne Noire\"  >1\u00e8re Sect. Montagne Noire<\/option><option value=\"2\u00e8me Sect. Aux Cadets\"  >2\u00e8me Sect. Aux Cadets<\/option><option value=\"3\u00e8me Sect. Etang du Jonc\"  >3\u00e8me Sect. Etang du Jonc<\/option><option value=\"4\u00e8me Sect. Bellevue La Montagne\"  >4\u00e8me Sect. Bellevue La Montagne<\/option><option value=\"5\u00e8me Sect. Bellevue Chardonni\u00e8re\"  >5\u00e8me Sect. Bellevue Chardonni\u00e8re<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_33' id='label_ff_13_dropdown_33' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_33\" id=\"ff_13_dropdown_33\" class=\"ff-el-form-control\" data-name=\"dropdown_33\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_33\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Turgeau\"  >1\u00e8re Sect. Turgeau<\/option><option value=\"3\u00e8me Sect. Martissant\"  >3\u00e8me Sect. Martissant<\/option><option value=\"2\u00e8me Sect. Morne L&#039;H\u00f4pital\"  >2\u00e8me Sect. Morne L&rsquo;H\u00f4pital<\/option><option value=\"Ville de Port-au-Prince\"  >Ville de Port-au-Prince<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_34' id='label_ff_13_dropdown_34' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_34\" id=\"ff_13_dropdown_34\" class=\"ff-el-form-control\" data-name=\"dropdown_34\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_34\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Delmas\"  >Ville de Delmas<\/option><option value=\"1\u00e8re Sect. St-Martin\"  >1\u00e8re Sect. St-Martin<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_35' id='label_ff_13_dropdown_35' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_35\" id=\"ff_13_dropdown_35\" class=\"ff-el-form-control\" data-name=\"dropdown_35\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_35\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Carrefour\"  >Ville de Carrefour<\/option><option value=\"1\u00e8re Sect. Morne Chandelle\"  >1\u00e8re Sect. Morne Chandelle<\/option><option value=\"2\u00e8me Sect. Platon Dufrene\"  >2\u00e8me Sect. Platon Dufrene<\/option><option value=\"3\u00e8me Sect. Taifer\"  >3\u00e8me Sect. Taifer<\/option><option value=\"4\u00e8me  Sect. Procy\"  >4\u00e8me  Sect. Procy<\/option><option value=\"5\u00e8me Sect. Coupeau\"  >5\u00e8me Sect. Coupeau<\/option><option value=\"6\u00e8me Sect. Bouvier\"  >6\u00e8me Sect. Bouvier<\/option><option value=\"7\u00e8me Sect. Lavalle\"  >7\u00e8me Sect. Lavalle<\/option><option value=\"8\u00e8me Sect. Berly\"  >8\u00e8me Sect. Berly<\/option><option value=\"9\u00e8me Sect. Bizoton\"  >9\u00e8me Sect. Bizoton<\/option><option value=\"10\u00e8me Sect. Thor\"  >10\u00e8me Sect. Thor<\/option><option value=\"11\u00e8me Sect. Rivi\u00e8re Froide\"  >11\u00e8me Sect. Rivi\u00e8re Froide<\/option><option value=\"12\u00e8me Sect. Malanga\"  >12\u00e8me Sect. Malanga<\/option><option value=\"13\u00e8me Sect. Corail Thor\"  >13\u00e8me Sect. Corail Thor<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_36' id='label_ff_13_dropdown_36' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_36\" id=\"ff_13_dropdown_36\" class=\"ff-el-form-control\" data-name=\"dropdown_36\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_36\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Kenscoff\"  >Ville de Kenscoff<\/option><option value=\"1\u00e8re Sect. Nouvelle Tourraine\"  >1\u00e8re Sect. Nouvelle Tourraine<\/option><option value=\"2\u00e8me Sect. Bongars\"  >2\u00e8me Sect. Bongars<\/option><option value=\"3\u00e8me Sect. Sourcailles\"  >3\u00e8me Sect. Sourcailles<\/option><option value=\"4\u00e8me Sect. Belle Fontaine\"  >4\u00e8me Sect. Belle Fontaine<\/option><option value=\"5\u00e8me Sect. Grand Fond\"  >5\u00e8me Sect. Grand Fond<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_37' id='label_ff_13_dropdown_37' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_37\" id=\"ff_13_dropdown_37\" class=\"ff-el-form-control\" data-name=\"dropdown_37\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_37\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Cit\u00e9 Soleil\"  >Ville de Cit\u00e9 Soleil<\/option><option value=\"1\u00e8re Sect. Varreux\"  >1\u00e8re Sect. Varreux<\/option><option value=\"2\u00e8me Sect. Varreux\"  >2\u00e8me Sect. Varreux<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_38' id='label_ff_13_dropdown_38' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_38\" id=\"ff_13_dropdown_38\" class=\"ff-el-form-control\" data-name=\"dropdown_38\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_38\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Tabarre\"  >Ville de Tabarre<\/option><option value=\"Quartier de la Croix-Des-Missions\"  >Quartier de la Croix-Des-Missions<\/option><option value=\"3\u00e8me Sect. Bellevue\"  >3\u00e8me Sect. Bellevue<\/option><option value=\"4\u00e8me Sect. Bellevue\"  >4\u00e8me Sect. Bellevue<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_39' id='label_ff_13_dropdown_39' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_39\" id=\"ff_13_dropdown_39\" class=\"ff-el-form-control\" data-name=\"dropdown_39\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_39\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de L\u00e9ogane\"  >Ville de L\u00e9ogane<\/option><option value=\"Quartier de Trouin\"  >Quartier de Trouin<\/option><option value=\"1\u00e8re Sect. Dessources\"  >1\u00e8re Sect. Dessources<\/option><option value=\"2\u00e8me Sect. Petite Rivi\u00e8re\"  >2\u00e8me Sect. Petite Rivi\u00e8re<\/option><option value=\"3\u00e8me Sect. Grande Rivi\u00e8re\"  >3\u00e8me Sect. Grande Rivi\u00e8re<\/option><option value=\"4\u00e8me Sect. Fond de Boudin\"  >4\u00e8me Sect. Fond de Boudin<\/option><option value=\"5\u00e8me Sect. Palmiste \u00e0 Vin\"  >5\u00e8me Sect. Palmiste \u00e0 Vin<\/option><option value=\"6\u00e8me Sect. Orangers\"  >6\u00e8me Sect. Orangers<\/option><option value=\"7\u00e8me Sect. Parques\"  >7\u00e8me Sect. Parques<\/option><option value=\"8\u00e8me Sect. Beausejour\"  >8\u00e8me Sect. Beausejour<\/option><option value=\"9\u00e8me Sect. Citronniers\"  >9\u00e8me Sect. Citronniers<\/option><option value=\"10\u00e8me Sect. Fond d&#039;Oie\"  >10\u00e8me Sect. Fond d&rsquo;Oie<\/option><option value=\"11\u00e8me Sect. Gros Morne\"  >11\u00e8me Sect. Gros Morne<\/option><option value=\"12\u00e8me Sect. Cormiers\"  >12\u00e8me Sect. Cormiers<\/option><option value=\"13\u00e8me Sect. Petit Harpon\"  >13\u00e8me Sect. Petit Harpon<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_40' id='label_ff_13_dropdown_40' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_40\" id=\"ff_13_dropdown_40\" class=\"ff-el-form-control\" data-name=\"dropdown_40\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_40\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Moussamb\u00e9\"  >3\u00e8me Sect. Moussamb\u00e9<\/option><option value=\"Ville de Grand-G\u00f4ave\"  >Ville de Grand-G\u00f4ave<\/option><option value=\"1\u00e8re Sect. T\u00eate-\u00e0-Boeuf\"  >1\u00e8re Sect. T\u00eate-\u00e0-Boeuf<\/option><option value=\"2\u00e8me Sect. T\u00eate-\u00e0-Boeuf\"  >2\u00e8me Sect. T\u00eate-\u00e0-Boeuf<\/option><option value=\"4\u00e8me Sect. Moussamb\u00e9\"  >4\u00e8me Sect. Moussamb\u00e9<\/option><option value=\"5\u00e8me Sect. Grande Colline\"  >5\u00e8me Sect. Grande Colline<\/option><option value=\"6\u00e8me Sect. Grande Colline\"  >6\u00e8me Sect. Grande Colline<\/option><option value=\"7\u00e8me Sect. G\u00e9rard\"  >7\u00e8me Sect. G\u00e9rard<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_41' id='label_ff_13_dropdown_41' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_41\" id=\"ff_13_dropdown_41\" class=\"ff-el-form-control\" data-name=\"dropdown_41\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_41\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Petit G\u00f4ave\"  >Ville de Petit G\u00f4ave<\/option><option value=\"Quartier de vialet\"  >Quartier de vialet<\/option><option value=\"1\u00e8re Sect. Bino(Premi\u00e8re Plaine)\"  >1\u00e8re Sect. Bino(Premi\u00e8re Plaine)<\/option><option value=\"2\u00e8me Sect. Delatre(2\u00e8me Plaine)\"  >2\u00e8me Sect. Delatre(2\u00e8me Plaine)<\/option><option value=\"3\u00e8me Sect. Trou Chouchou\"  >3\u00e8me Sect. Trou Chouchou<\/option><option value=\"4\u00e8me Sect. Fond Arabie\"  >4\u00e8me Sect. Fond Arabie<\/option><option value=\"5\u00e8me Sect. Trou Canari\"  >5\u00e8me Sect. Trou Canari<\/option><option value=\"6\u00e8me Sect. Trou Canari\"  >6\u00e8me Sect. Trou Canari<\/option><option value=\"7\u00e8me Sect. Des Platons\"  >7\u00e8me Sect. Des Platons<\/option><option value=\"8\u00e8me Sect. Des Platons\"  >8\u00e8me Sect. Des Platons<\/option><option value=\"9\u00e8me Sect. Des Palmes\"  >9\u00e8me Sect. Des Palmes<\/option><option value=\"10\u00e8me Sect. Des Palmes\"  >10\u00e8me Sect. Des Palmes<\/option><option value=\"11\u00e8me Sect. Ravine S\u00e8che\"  >11\u00e8me Sect. Ravine S\u00e8che<\/option><option value=\"12\u00e8me Sect. Des Fourques\"  >12\u00e8me Sect. Des Fourques<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_42' id='label_ff_13_dropdown_42' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_42\" id=\"ff_13_dropdown_42\" class=\"ff-el-form-control\" data-name=\"dropdown_42\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_42\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Gressier\"  >Ville de Gressier<\/option><option value=\"1\u00e8re Sect. Morne \u00e0 Bateau\"  >1\u00e8re Sect. Morne \u00e0 Bateau<\/option><option value=\"2\u00e8me Sect. Morne Chandelle\"  >2\u00e8me Sect. Morne Chandelle<\/option><option value=\"3\u00e8me Sect. Petit Boucan\"  >3\u00e8me Sect. Petit Boucan<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_43' id='label_ff_13_dropdown_43' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_43\" id=\"ff_13_dropdown_43\" class=\"ff-el-form-control\" data-name=\"dropdown_43\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_43\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville la Croix des Bouquets\"  >Ville la Croix des Bouquets<\/option><option value=\"1\u00e8re Sect. Des Varreux\"  >1\u00e8re Sect. Des Varreux<\/option><option value=\"2\u00e8me Sect. des Varreux\"  >2\u00e8me Sect. des Varreux<\/option><option value=\"3\u00e8me Sect. Petit Bois\"  >3\u00e8me Sect. Petit Bois<\/option><option value=\"4\u00e8me Sect. Petit Bois\"  >4\u00e8me Sect. Petit Bois<\/option><option value=\"5\u00e8me Sect. Petit Bois\"  >5\u00e8me Sect. Petit Bois<\/option><option value=\"6\u00e8me Sect. Belle Fontaine\"  >6\u00e8me Sect. Belle Fontaine<\/option><option value=\"7\u00e8me Sect. Belle Fontaine\"  >7\u00e8me Sect. Belle Fontaine<\/option><option value=\"8\u00e8me Sect. Belle Fontaine\"  >8\u00e8me Sect. Belle Fontaine<\/option><option value=\"9\u00e8me Sect. des Crochus\"  >9\u00e8me Sect. des Crochus<\/option><option value=\"10\u00e8me Sect. des Orangers\"  >10\u00e8me Sect. des Orangers<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_44' id='label_ff_13_dropdown_44' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_44\" id=\"ff_13_dropdown_44\" class=\"ff-el-form-control\" data-name=\"dropdown_44\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_44\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Thomazeau\"  >Ville de Thomazeau<\/option><option value=\"1\u00e8re Sect. Grande Plaine\"  >1\u00e8re Sect. Grande Plaine<\/option><option value=\"2\u00e8me Sect. Grande Plaine\"  >2\u00e8me Sect. Grande Plaine<\/option><option value=\"3\u00e8me Sect. Trou d&#039;Eau\"  >3\u00e8me Sect. Trou d&rsquo;Eau<\/option><option value=\"4\u00e8me Sect. des Crochus\"  >4\u00e8me Sect. des Crochus<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_45' id='label_ff_13_dropdown_45' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_45\" id=\"ff_13_dropdown_45\" class=\"ff-el-form-control\" data-name=\"dropdown_45\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_45\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Ganthier\"  >Ville de Ganthier<\/option><option value=\"Quartier Fond Parisien\"  >Quartier Fond Parisien<\/option><option value=\"1\u00e8re Sect. Galette Chambon\"  >1\u00e8re Sect. Galette Chambon<\/option><option value=\"2\u00e8me Sect. Balan\"  >2\u00e8me Sect. Balan<\/option><option value=\"3\u00e8me Sect. Fond Parisien\"  >3\u00e8me Sect. Fond Parisien<\/option><option value=\"4\u00e8me Sect. Pays Pourri\"  >4\u00e8me Sect. Pays Pourri<\/option><option value=\"5\u00e8me Sect. Mare Roseaux\"  >5\u00e8me Sect. Mare Roseaux<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_46' id='label_ff_13_dropdown_46' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_46\" id=\"ff_13_dropdown_46\" class=\"ff-el-form-control\" data-name=\"dropdown_46\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_46\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Cornillon\"  >Ville de Cornillon<\/option><option value=\"1\u00e8re Sect. Plaine C\u00e9leste\"  >1\u00e8re Sect. Plaine C\u00e9leste<\/option><option value=\"2\u00e8me Sect. Plaine C\u00e9leste\"  >2\u00e8me Sect. Plaine C\u00e9leste<\/option><option value=\"3\u00e8me Boucan Bois Pin\"  >3\u00e8me Boucan Bois Pin<\/option><option value=\"4\u00e8me Boucan Bois Pin\"  >4\u00e8me Boucan Bois Pin<\/option><option value=\"5\u00e8me G\u00e9nipailler\"  >5\u00e8me G\u00e9nipailler<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_47' id='label_ff_13_dropdown_47' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_47\" id=\"ff_13_dropdown_47\" class=\"ff-el-form-control\" data-name=\"dropdown_47\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_47\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Fonds-Verrettes\"  >Ville de Fonds-Verrettes<\/option><option value=\"1\u00e8re Sect. Fonds-Verrettes\"  >1\u00e8re Sect. Fonds-Verrettes<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_48' id='label_ff_13_dropdown_48' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_48\" id=\"ff_13_dropdown_48\" class=\"ff-el-form-control\" data-name=\"dropdown_48\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_48\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Archahaie\"  >Ville de l&rsquo;Archahaie<\/option><option value=\"Quartier de Saintard\"  >Quartier de Saintard<\/option><option value=\"1\u00e8re Boucassin\"  >1\u00e8re Boucassin<\/option><option value=\"2\u00e8me Sect. Fonds Baptiste\"  >2\u00e8me Sect. Fonds Baptiste<\/option><option value=\"3\u00e8me Sect. Des Vases\"  >3\u00e8me Sect. Des Vases<\/option><option value=\"4\u00e8me Sect. D\u00e9lices\"  >4\u00e8me Sect. D\u00e9lices<\/option><option value=\"5\u00e8me Sect. Matheux\"  >5\u00e8me Sect. Matheux<\/option><option value=\"6\u00e8me Sect. Carri\u00e8s\"  >6\u00e8me Sect. Carri\u00e8s<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_49' id='label_ff_13_dropdown_49' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_49\" id=\"ff_13_dropdown_49\" class=\"ff-el-form-control\" data-name=\"dropdown_49\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_49\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Cabaret\"  >Ville de Cabaret<\/option><option value=\"1\u00e8re Sect. Boucassin\"  >1\u00e8re Sect. Boucassin<\/option><option value=\"2\u00e8me Sect. Boucassin\"  >2\u00e8me Sect. Boucassin<\/option><option value=\"3\u00e8me Sect. Source-Matelas\"  >3\u00e8me Sect. Source-Matelas<\/option><option value=\"4\u00e8me Sect. Fonds-des-Blancs(Casale)\"  >4\u00e8me Sect. Fonds-des-Blancs(Casale)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_50' id='label_ff_13_dropdown_50' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_50\" id=\"ff_13_dropdown_50\" class=\"ff-el-form-control\" data-name=\"dropdown_50\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_50\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Anse \u00e0 Galets\"  >Ville de l&rsquo;Anse \u00e0 Galets<\/option><option value=\"1\u00e8re Sect. Palma\"  >1\u00e8re Sect. Palma<\/option><option value=\"2\u00e8me Sect. Petite Source\"  >2\u00e8me Sect. Petite Source<\/option><option value=\"3\u00e8me Sect. Grande Source\"  >3\u00e8me Sect. Grande Source<\/option><option value=\"4\u00e8me Sect. Grand Lagon\"  >4\u00e8me Sect. Grand Lagon<\/option><option value=\"5\u00e8me Sect. Picmy\"  >5\u00e8me Sect. Picmy<\/option><option value=\"6\u00e8me Sect. Petit Anse\"  >6\u00e8me Sect. Petit Anse<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_51' id='label_ff_13_dropdown_51' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_51\" id=\"ff_13_dropdown_51\" class=\"ff-el-form-control\" data-name=\"dropdown_51\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_51\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. La Source\"  >1\u00e8re Sect. La Source<\/option><option value=\"2\u00e8me Sect. Grand Vide\"  >2\u00e8me Sect. Grand Vide<\/option><option value=\"3\u00e8me Sect. Trou Louis\"  >3\u00e8me Sect. Trou Louis<\/option><option value=\"4\u00e8me Sect. Pointe \u00e0 Raquette\"  >4\u00e8me Sect. Pointe \u00e0 Raquette<\/option><option value=\"5\u00e8me Sect. Gros Mangle\"  >5\u00e8me Sect. Gros Mangle<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_52' id='label_ff_13_dropdown_52' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_52\" id=\"ff_13_dropdown_52\" class=\"ff-el-form-control\" data-name=\"dropdown_52\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_52\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Jacmel\"  >Ville de Jacmel<\/option><option value=\"Quartier de Marbial\"  >Quartier de Marbial<\/option><option value=\"1\u00e8re Sect. Bas Cap Rouge \"  >1\u00e8re Sect. Bas Cap Rouge<\/option><option value=\"2\u00e8me Sect. Fond-Melon-Selle\"  >2\u00e8me Sect. Fond-Melon-Selle<\/option><option value=\"3\u00e8me Sect. Cochon Gras\"  >3\u00e8me Sect. Cochon Gras<\/option><option value=\"4\u00e8me Sect. La Gosseline\"  >4\u00e8me Sect. La Gosseline<\/option><option value=\"5\u00e8me Sect. Marbial\"  >5\u00e8me Sect. Marbial<\/option><option value=\"6\u00e8me Sect. Montagne la Voute\"  >6\u00e8me Sect. Montagne la Voute<\/option><option value=\"7\u00e8me Sect. Grande Rivi\u00e8re de Jacmel\"  >7\u00e8me Sect. Grande Rivi\u00e8re de Jacmel<\/option><option value=\"8\u00e8me Sect. Bas Coq Chante\"  >8\u00e8me Sect. Bas Coq Chante<\/option><option value=\"9\u00e8me Sect. Haut Coq qui Chante\"  >9\u00e8me Sect. Haut Coq qui Chante<\/option><option value=\"10\u00e8me Sect. La Vanneau\"  >10\u00e8me Sect. La Vanneau<\/option><option value=\"11\u00e8me Sect. La Montagne\"  >11\u00e8me Sect. La Montagne<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_53' id='label_ff_13_dropdown_53' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_53\" id=\"ff_13_dropdown_53\" class=\"ff-el-form-control\" data-name=\"dropdown_53\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_53\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Marigot\"  >Ville de Marigot<\/option><option value=\"Quartier de Seguin\"  >Quartier de Seguin<\/option><option value=\"1\u00e8re Sect. Corail Soult\"  >1\u00e8re Sect. Corail Soult<\/option><option value=\"2\u00e8me Sect. Grande Rivi\u00e8re Fesles\"  >2\u00e8me Sect. Grande Rivi\u00e8re Fesles<\/option><option value=\"3\u00e8me Sect. Macary\"  >3\u00e8me Sect. Macary<\/option><option value=\"4\u00e8me Sect. Fond Jean-No\u00ebl\"  >4\u00e8me Sect. Fond Jean-No\u00ebl<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_54' id='label_ff_13_dropdown_54' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_54\" id=\"ff_13_dropdown_54\" class=\"ff-el-form-control\" data-name=\"dropdown_54\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_54\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville Cayes Jacmel\"  >Ville Cayes Jacmel<\/option><option value=\"1\u00e8re Sect. Ravine Normande\"  >1\u00e8re Sect. Ravine Normande<\/option><option value=\"2\u00e8me Sect. Gaillard\"  >2\u00e8me Sect. Gaillard<\/option><option value=\"3\u00e8me Sect. Haut Cap Rouge\"  >3\u00e8me Sect. Haut Cap Rouge<\/option><option value=\"4\u00e8me Fond-Melon Michineau\"  >4\u00e8me Fond-Melon Michineau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_55' id='label_ff_13_dropdown_55' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_55\" id=\"ff_13_dropdown_55\" class=\"ff-el-form-control\" data-name=\"dropdown_55\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_55\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Muzac ou La Vall\u00e9e\"  >1\u00e8re Sect. Muzac ou La Vall\u00e9e<\/option><option value=\"Ville La Vall\u00e9e\"  >Ville La Vall\u00e9e<\/option><option value=\"3\u00e8me Sect. Morne-\u00e0 Br\u00fbler\"  >3\u00e8me Sect. Morne-\u00e0 Br\u00fbler<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_56' id='label_ff_13_dropdown_56' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_56\" id=\"ff_13_dropdown_56\" class=\"ff-el-form-control\" data-name=\"dropdown_56\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_56\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Bainet\"  >Ville de Bainet<\/option><option value=\"1\u00e8re Sect. Br\u00e9silienne\"  >1\u00e8re Sect. Br\u00e9silienne<\/option><option value=\"2\u00e8me Sect. Trou Mahot\"  >2\u00e8me Sect. Trou Mahot<\/option><option value=\"3\u00e8me Sect. La Vall\u00e9e de Bainet\"  >3\u00e8me Sect. La Vall\u00e9e de Bainet<\/option><option value=\"4\u00e8me Sect. Haut Grandou\"  >4\u00e8me Sect. Haut Grandou<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_57' id='label_ff_13_dropdown_57' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_57\" id=\"ff_13_dropdown_57\" class=\"ff-el-form-control\" data-name=\"dropdown_57\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_57\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Cotes de Fer\"  >Ville de Cotes de Fer<\/option><option value=\"1\u00e8re Sect. Gris Gris\"  >1\u00e8re Sect. Gris Gris<\/option><option value=\"2\u00e8me Sect. Labiche\"  >2\u00e8me Sect. Labiche<\/option><option value=\"3\u00e8me Sect. Bras Gauche\"  >3\u00e8me Sect. Bras Gauche<\/option><option value=\"4\u00e8me Sect. Amazone\"  >4\u00e8me Sect. Amazone<\/option><option value=\"5\u00e8me Sect. Boucan B\u00e9lier\"  >5\u00e8me Sect. Boucan B\u00e9lier<\/option><option value=\"6\u00e8me Sect. Jamais Vu\"  >6\u00e8me Sect. Jamais Vu<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_58' id='label_ff_13_dropdown_58' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_58\" id=\"ff_13_dropdown_58\" class=\"ff-el-form-control\" data-name=\"dropdown_58\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_58\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Belle Anse\"  >Ville de Belle Anse<\/option><option value=\"Quartier de Mapou\"  >Quartier de Mapou<\/option><option value=\"1\u00e8re sect. Baie d&#039;Orange\"  >1\u00e8re sect. Baie d&rsquo;Orange<\/option><option value=\"2\u00e8me Sect. Mabriole\"  >2\u00e8me Sect. Mabriole<\/option><option value=\"3\u00e8me Sect. Callumette\"  >3\u00e8me Sect. Callumette<\/option><option value=\"4\u00e8me Sect. Corail Lamothe\"  >4\u00e8me Sect. Corail Lamothe<\/option><option value=\"5\u00e8me Sect. Bel Air\"  >5\u00e8me Sect. Bel Air<\/option><option value=\"6\u00e8me Sect. Pichon\"  >6\u00e8me Sect. Pichon<\/option><option value=\"7\u00e8me Sect. Mapou\"  >7\u00e8me Sect. Mapou<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_59' id='label_ff_13_dropdown_59' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_59\" id=\"ff_13_dropdown_59\" class=\"ff-el-form-control\" data-name=\"dropdown_59\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_59\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Grand Gosier\"  >Ville de Grand Gosier<\/option><option value=\"Quartier de Bodarie\"  >Quartier de Bodarie<\/option><option value=\"1\u00e8re Sect. Colline des Ch\u00e8nes ou Bodarie\"  >1\u00e8re Sect. Colline des Ch\u00e8nes ou Bodarie<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_60' id='label_ff_13_dropdown_60' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_60\" id=\"ff_13_dropdown_60\" class=\"ff-el-form-control\" data-name=\"dropdown_60\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_60\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Thiotte\"  >Ville de Thiotte<\/option><option value=\"1\u00e8re Sect. Thiotte\"  >1\u00e8re Sect. Thiotte<\/option><option value=\"2\u00e8me Sect. Pot de Chambre\"  >2\u00e8me Sect. Pot de Chambre<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_61' id='label_ff_13_dropdown_61' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_61\" id=\"ff_13_dropdown_61\" class=\"ff-el-form-control\" data-name=\"dropdown_61\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_61\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Anse \u00e0 Pitre\"  >Ville de l&rsquo;Anse \u00e0 Pitre<\/option><option value=\"Quartier de Banane\"  >Quartier de Banane<\/option><option value=\"1\u00e8re Sect. Boucan Guillaume\"  >1\u00e8re Sect. Boucan Guillaume<\/option><option value=\"2\u00e8me Sect. Bois d&#039;Orme\"  >2\u00e8me Sect. Bois d&rsquo;Orme<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_62' id='label_ff_13_dropdown_62' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_62\" id=\"ff_13_dropdown_62\" class=\"ff-el-form-control\" data-name=\"dropdown_62\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_62\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville du Cap-Ha\u00eftien\"  >Ville du Cap-Ha\u00eftien<\/option><option value=\"Quartier de Petit Anse\"  >Quartier de Petit Anse<\/option><option value=\"1\u00e8re Sect. Bande du Nord\"  >1\u00e8re Sect. Bande du Nord<\/option><option value=\"2\u00e8me Sect. Haut du Cap\"  >2\u00e8me Sect. Haut du Cap<\/option><option value=\"3\u00e8me Sect. Petit Anse\"  >3\u00e8me Sect. Petit Anse<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_63' id='label_ff_13_dropdown_63' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_63\" id=\"ff_13_dropdown_63\" class=\"ff-el-form-control\" data-name=\"dropdown_63\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_63\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Quartier-Morin\"  >Ville de Quartier-Morin<\/option><option value=\"1\u00e8re Sect. Basse Plaine\"  >1\u00e8re Sect. Basse Plaine<\/option><option value=\"2\u00e8me Sect. Morne Pel\u00e9\"  >2\u00e8me Sect. Morne Pel\u00e9<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_64' id='label_ff_13_dropdown_64' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_64\" id=\"ff_13_dropdown_64\" class=\"ff-el-form-control\" data-name=\"dropdown_64\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_64\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Limonade\"  >Ville de Limonade<\/option><option value=\"Quartier de Bord de Mer Limonade\"  >Quartier de Bord de Mer Limonade<\/option><option value=\"1\u00e8re sect. Basse Plaine\"  >1\u00e8re sect. Basse Plaine<\/option><option value=\"2\u00e8me Sect. Bois de Lance\"  >2\u00e8me Sect. Bois de Lance<\/option><option value=\"3\u00e8me Sect. Roucou\"  >3\u00e8me Sect. Roucou<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_65' id='label_ff_13_dropdown_65' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_65\" id=\"ff_13_dropdown_65\" class=\"ff-el-form-control\" data-name=\"dropdown_65\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_65\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Acul du Nord\"  >Ville de l&rsquo;Acul du Nord<\/option><option value=\"Quartier la Soufri\u00e8re\"  >Quartier la Soufri\u00e8re<\/option><option value=\"Quartier Camp-Louise\"  >Quartier Camp-Louise<\/option><option value=\"1\u00e8re Sect. Camp Louise\"  >1\u00e8re Sect. Camp Louise<\/option><option value=\"2\u00e8me Sect. Bas de l&#039;Acul (Basse Plaine)\"  >2\u00e8me Sect. Bas de l&rsquo;Acul (Basse Plaine)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_66' id='label_ff_13_dropdown_66' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_66\" id=\"ff_13_dropdown_66\" class=\"ff-el-form-control\" data-name=\"dropdown_66\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_66\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de la Plaine du Nord\"  >Ville de la Plaine du Nord<\/option><option value=\"Quartier Robillard\"  >Quartier Robillard<\/option><option value=\"1\u00e8re Sect. Morne Rouge\"  >1\u00e8re Sect. Morne Rouge<\/option><option value=\"2\u00e8me Sect. Basse Plaine\"  >2\u00e8me Sect. Basse Plaine<\/option><option value=\"3\u00e8me Sect. Grand Boucan\"  >3\u00e8me Sect. Grand Boucan<\/option><option value=\"4\u00e8me Sect. Bassin Diamant\"  >4\u00e8me Sect. Bassin Diamant<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_67' id='label_ff_13_dropdown_67' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_67\" id=\"ff_13_dropdown_67\" class=\"ff-el-form-control\" data-name=\"dropdown_67\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_67\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Milot\"  >Ville de Milot<\/option><option value=\"Quartier Carrefour des P\u00e8res\"  >Quartier Carrefour des P\u00e8res<\/option><option value=\"1\u00e8re Sect. Perches de Bonnet\"  >1\u00e8re Sect. Perches de Bonnet<\/option><option value=\"2\u00e8me Sect. Bonnet \u00e0 l&#039;Ev\u00e8que\"  >2\u00e8me Sect. Bonnet \u00e0 l&rsquo;Ev\u00e8que<\/option><option value=\"3\u00e8me Sect. G\u00e9nipailler\"  >3\u00e8me Sect. G\u00e9nipailler<\/option><option value=\"Sanyago\"  >Sanyago<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_68' id='label_ff_13_dropdown_68' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_68\" id=\"ff_13_dropdown_68\" class=\"ff-el-form-control\" data-name=\"dropdown_68\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_68\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Grande Rivi\u00e8re du Nord\"  >Ville de Grande Rivi\u00e8re du Nord<\/option><option value=\"1\u00e8re Sect. Grand Gilles\"  >1\u00e8re Sect. Grand Gilles<\/option><option value=\"2\u00e8me Sect. Solon\"  >2\u00e8me Sect. Solon<\/option><option value=\"3\u00e8me Sect. Caracol\"  >3\u00e8me Sect. Caracol<\/option><option value=\"4\u00e8me Sect. Gambade\"  >4\u00e8me Sect. Gambade<\/option><option value=\"5\u00e8me Sect. Joli-trou\"  >5\u00e8me Sect. Joli-trou<\/option><option value=\"6\u00e8me Sect. Cormiers\"  >6\u00e8me Sect. Cormiers<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_69' id='label_ff_13_dropdown_69' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_69\" id=\"ff_13_dropdown_69\" class=\"ff-el-form-control\" data-name=\"dropdown_69\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_69\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Bahon\"  >Ville de Bahon<\/option><option value=\"1\u00e8re Sect. de Bois Pin\"  >1\u00e8re Sect. de Bois Pin<\/option><option value=\"2\u00e8me Sect. Bailla ou Bailly\"  >2\u00e8me Sect. Bailla ou Bailly<\/option><option value=\"3\u00e8me Sect. Montagne Noire\"  >3\u00e8me Sect. Montagne Noire<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_70' id='label_ff_13_dropdown_70' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_70\" id=\"ff_13_dropdown_70\" class=\"ff-el-form-control\" data-name=\"dropdown_70\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_70\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Saint-Rapha\u00ebl\"  >Ville de Saint-Rapha\u00ebl<\/option><option value=\"1\u00e8re Sect. Bois-Neuf\"  >1\u00e8re Sect. Bois-Neuf<\/option><option value=\"2\u00e8me Sect. Mathurin\"  >2\u00e8me Sect. Mathurin<\/option><option value=\"3\u00e8me Sect. Bouyaha\"  >3\u00e8me Sect. Bouyaha<\/option><option value=\"4\u00e8me Sect. San Yago\"  >4\u00e8me Sect. San Yago<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_71' id='label_ff_13_dropdown_71' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_71\" id=\"ff_13_dropdown_71\" class=\"ff-el-form-control\" data-name=\"dropdown_71\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_71\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Dondon\"  >Ville de Dondon<\/option><option value=\"1\u00e8re Sect. Brostage\"  >1\u00e8re Sect. Brostage<\/option><option value=\"2\u00e8me Sect. Bassin Ca\u00efman\"  >2\u00e8me Sect. Bassin Ca\u00efman<\/option><option value=\"3\u00e8me Sect. Matador\"  >3\u00e8me Sect. Matador<\/option><option value=\"4\u00e8me Sect. Laguille\"  >4\u00e8me Sect. Laguille<\/option><option value=\"5\u00e8me Sect. Haut du trou\"  >5\u00e8me Sect. Haut du trou<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_72' id='label_ff_13_dropdown_72' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_72\" id=\"ff_13_dropdown_72\" class=\"ff-el-form-control\" data-name=\"dropdown_72\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_72\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Ranquitte\"  >Ville de Ranquitte<\/option><option value=\"1\u00e8re Sect. de Bac \u00e0 Soude\"  >1\u00e8re Sect. de Bac \u00e0 Soude<\/option><option value=\"2\u00e8me Sect. Bois de Lance\"  >2\u00e8me Sect. Bois de Lance<\/option><option value=\"3\u00e8me Sect. Cracaraille\"  >3\u00e8me Sect. Cracaraille<\/option><option value=\"La Victoire\"  >La Victoire<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_73' id='label_ff_13_dropdown_73' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_73\" id=\"ff_13_dropdown_73\" class=\"ff-el-form-control\" data-name=\"dropdown_73\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_73\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Pignon\"  >Ville de Pignon<\/option><option value=\"1\u00e8re Sect. de Savannette\"  >1\u00e8re Sect. de Savannette<\/option><option value=\"2\u00e8me Sect. La Belle M\u00e8re\"  >2\u00e8me Sect. La Belle M\u00e8re<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_74' id='label_ff_13_dropdown_74' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_74\" id=\"ff_13_dropdown_74\" class=\"ff-el-form-control\" data-name=\"dropdown_74\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_74\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de La Victoire\"  >Ville de La Victoire<\/option><option value=\"1\u00e8re Sect. de La Victoire\"  >1\u00e8re Sect. de La Victoire<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_75' id='label_ff_13_dropdown_75' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_75\" id=\"ff_13_dropdown_75\" class=\"ff-el-form-control\" data-name=\"dropdown_75\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_75\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville du Borgne\"  >Ville du Borgne<\/option><option value=\"Quartier du Petit Bourg de Borgne\"  >Quartier du Petit Bourg de Borgne<\/option><option value=\"1\u00e8re Sect. Margot\"  >1\u00e8re Sect. Margot<\/option><option value=\"2\u00e8me Sect. Boucan Michel\"  >2\u00e8me Sect. Boucan Michel<\/option><option value=\"3\u00e8me Sect. Petit Boug de Borgne\"  >3\u00e8me Sect. Petit Boug de Borgne<\/option><option value=\"4\u00e8me Sect. Trou d&#039;Enfer\"  >4\u00e8me Sect. Trou d&rsquo;Enfer<\/option><option value=\"5\u00e8me Sect. Champagne\"  >5\u00e8me Sect. Champagne<\/option><option value=\"6\u00e8me Sect. Molas\"  >6\u00e8me Sect. Molas<\/option><option value=\"7\u00e8me Sect. C\u00f4tes de Fer et Lagrange\"  >7\u00e8me Sect. C\u00f4tes de Fer et Lagrange<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_76' id='label_ff_13_dropdown_76' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_76\" id=\"ff_13_dropdown_76\" class=\"ff-el-form-control\" data-name=\"dropdown_76\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_76\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Port Margot\"  >Ville de Port Margot<\/option><option value=\"Quartier de Bayeux\"  >Quartier de Bayeux<\/option><option value=\"Quartier Petit Bourg de Port-Margot\"  >Quartier Petit Bourg de Port-Margot<\/option><option value=\"1\u00e8re Sect. de Grande Plaine\"  >1\u00e8re Sect. de Grande Plaine<\/option><option value=\"2\u00e8me Sect. Bas Petit Borgne\"  >2\u00e8me Sect. Bas Petit Borgne<\/option><option value=\"3\u00e8me Sect. de Corail\"  >3\u00e8me Sect. de Corail<\/option><option value=\"4\u00e8me Sect. Haut Petit Borgne\"  >4\u00e8me Sect. Haut Petit Borgne<\/option><option value=\"5\u00e8me Sect. Bas Quartier\"  >5\u00e8me Sect. Bas Quartier<\/option><option value=\"6\u00e8me Sect. Bras Gauche\"  >6\u00e8me Sect. Bras Gauche<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_77' id='label_ff_13_dropdown_77' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_77\" id=\"ff_13_dropdown_77\" class=\"ff-el-form-control\" data-name=\"dropdown_77\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_77\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Limb\u00e9\"  >Ville de Limb\u00e9<\/option><option value=\"Quartier de Camp-Coq\"  >Quartier de Camp-Coq<\/option><option value=\"1\u00e8re Sect. Haut Limb\u00e9 ou Acul Jeannot\"  >1\u00e8re Sect. Haut Limb\u00e9 ou Acul Jeannot<\/option><option value=\"2\u00e8me Sect. Chabotte\"  >2\u00e8me Sect. Chabotte<\/option><option value=\"3\u00e8me Sect. Camp Coq\"  >3\u00e8me Sect. Camp Coq<\/option><option value=\"4\u00e8me Sect. Soufri\u00e8re\"  >4\u00e8me Sect. Soufri\u00e8re<\/option><option value=\"5\u00e8me Sect. Ravine Desroches\"  >5\u00e8me Sect. Ravine Desroches<\/option><option value=\"6\u00e8me Sect. Ilot-\u00e0-Corne\"  >6\u00e8me Sect. Ilot-\u00e0-Corne<\/option><option value=\"Massabiel\"  >Massabiel<\/option><option value=\"2\u00e8me Sect. Section Bas-Limb\u00e9\"  >2\u00e8me Sect. Section Bas-Limb\u00e9<\/option><option value=\"1\u00e8re Section Bas-Limb\u00e9\"  >1\u00e8re Section Bas-Limb\u00e9<\/option><option value=\"7\u00e8me Section\"  >7\u00e8me Section<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_78' id='label_ff_13_dropdown_78' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_78\" id=\"ff_13_dropdown_78\" class=\"ff-el-form-control\" data-name=\"dropdown_78\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_78\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Garde Champ\u00e8tre (Bas-Limb\u00e9)\"  >1\u00e8re Sect. Garde Champ\u00e8tre (Bas-Limb\u00e9)<\/option><option value=\"2\u00e8me Sect. Petit Howars (La Fange)\"  >2\u00e8me Sect. Petit Howars (La Fange)<\/option><option value=\"Ville de Bas-Limb\u00e9\"  >Ville de Bas-Limb\u00e9<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_79' id='label_ff_13_dropdown_79' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_79\" id=\"ff_13_dropdown_79\" class=\"ff-el-form-control\" data-name=\"dropdown_79\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_79\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Plaisance\"  >Ville de Plaisance<\/option><option value=\"1\u00e8re Sect. Gobert ou Colline Gobert\"  >1\u00e8re Sect. Gobert ou Colline Gobert<\/option><option value=\"2\u00e8me Sect. Champagne\"  >2\u00e8me Sect. Champagne<\/option><option value=\"3\u00e8me Sect. Haut Martineau\"  >3\u00e8me Sect. Haut Martineau<\/option><option value=\"4\u00e8me Sect. Mapou\"  >4\u00e8me Sect. Mapou<\/option><option value=\"5\u00e8me Sect. La Trouble\"  >5\u00e8me Sect. La Trouble<\/option><option value=\"6\u00e8me Sect. La Ville\"  >6\u00e8me Sect. La Ville<\/option><option value=\"7\u00e8me Sect. Bassin\"  >7\u00e8me Sect. Bassin<\/option><option value=\"8\u00e8me Sect. Grande Rivi\u00e8re\"  >8\u00e8me Sect. Grande Rivi\u00e8re<\/option><option value=\"2\u00e8me Section Lilette\"  >2\u00e8me Section Lilette<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_80' id='label_ff_13_dropdown_80' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_80\" id=\"ff_13_dropdown_80\" class=\"ff-el-form-control\" data-name=\"dropdown_80\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_80\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Pilate\"  >Ville de Pilate<\/option><option value=\"1\u00e8re Sect. Ballon\"  >1\u00e8re Sect. Ballon<\/option><option value=\"2\u00e8me Sect. Baudin\"  >2\u00e8me Sect. Baudin<\/option><option value=\"3\u00e8me Sect. Ravine Trompette\"  >3\u00e8me Sect. Ravine Trompette<\/option><option value=\"4\u00e8me Sect. Joly\"  >4\u00e8me Sect. Joly<\/option><option value=\"5\u00e8me Sect. Dubourg\"  >5\u00e8me Sect. Dubourg<\/option><option value=\"6\u00e8me Sect. Piment\"  >6\u00e8me Sect. Piment<\/option><option value=\"7\u00e8me Sect. Rivi\u00e8re Laporte\"  >7\u00e8me Sect. Rivi\u00e8re Laporte<\/option><option value=\"8\u00e8me Sect. Margot\"  >8\u00e8me Sect. Margot<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_81' id='label_ff_13_dropdown_81' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_81\" id=\"ff_13_dropdown_81\" class=\"ff-el-form-control\" data-name=\"dropdown_81\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_81\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Fort-Libert\u00e9\"  >Ville de Fort-Libert\u00e9<\/option><option value=\"Ville de D\u00e9rac\"  >Ville de D\u00e9rac<\/option><option value=\"Quartier Acul-Samedi\"  >Quartier Acul-Samedi<\/option><option value=\"1\u00e8re sect. Dumas\"  >1\u00e8re sect. Dumas<\/option><option value=\"2\u00e8me Sect. Bayaha\"  >2\u00e8me Sect. Bayaha<\/option><option value=\"3\u00e8me Sect. Loiseau\"  >3\u00e8me Sect. Loiseau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_82' id='label_ff_13_dropdown_82' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_82\" id=\"ff_13_dropdown_82\" class=\"ff-el-form-control\" data-name=\"dropdown_82\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_82\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"4\u00e8me Sect. Haut-Madeleine\"  >4\u00e8me Sect. Haut-Madeleine<\/option><option value=\"Ville de Ferrier\"  >Ville de Ferrier<\/option><option value=\"1\u00e8re Sect. Bas-Maribahoux\"  >1\u00e8re Sect. Bas-Maribahoux<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_83' id='label_ff_13_dropdown_83' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_83\" id=\"ff_13_dropdown_83\" class=\"ff-el-form-control\" data-name=\"dropdown_83\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_83\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Perches\"  >Ville de Perches<\/option><option value=\"1\u00e8re Sect. Haut des Perches\"  >1\u00e8re Sect. Haut des Perches<\/option><option value=\"2\u00e8me Sect. Bas des Perches\"  >2\u00e8me Sect. Bas des Perches<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_84' id='label_ff_13_dropdown_84' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_84\" id=\"ff_13_dropdown_84\" class=\"ff-el-form-control\" data-name=\"dropdown_84\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_84\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Ouanaminthe\"  >Ville de Ouanaminthe<\/option><option value=\"1\u00e8re sect. Haut Maribahoux\"  >1\u00e8re sect. Haut Maribahoux<\/option><option value=\"2\u00e8me Sect. Acul des Pins\"  >2\u00e8me Sect. Acul des Pins<\/option><option value=\"3\u00e8me Sect. Savane Longue\"  >3\u00e8me Sect. Savane Longue<\/option><option value=\"4\u00e8me Sect. Savane au lait\"  >4\u00e8me Sect. Savane au lait<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_85' id='label_ff_13_dropdown_85' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_85\" id=\"ff_13_dropdown_85\" class=\"ff-el-form-control\" data-name=\"dropdown_85\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_85\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Capotille \"  >Ville de Capotille<\/option><option value=\"1\u00e8re Sect. de Capotille\"  >1\u00e8re Sect. de Capotille<\/option><option value=\"2\u00e8me Sect. Lamine\"  >2\u00e8me Sect. Lamine<\/option><option value=\"Welsh\"  >Welsh<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_86' id='label_ff_13_dropdown_86' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_86\" id=\"ff_13_dropdown_86\" class=\"ff-el-form-control\" data-name=\"dropdown_86\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_86\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Mont-Organis\u00e9\"  >Ville de Mont-Organis\u00e9<\/option><option value=\"1\u00e8re Sect. Savanette\"  >1\u00e8re Sect. Savanette<\/option><option value=\"2\u00e8me Sect. Bois Poux\"  >2\u00e8me Sect. Bois Poux<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_87' id='label_ff_13_dropdown_87' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_87\" id=\"ff_13_dropdown_87\" class=\"ff-el-form-control\" data-name=\"dropdown_87\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_87\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Roucou\"  >2\u00e8me Sect. Roucou<\/option><option value=\"3\u00e8me Sect. Roche-Plate\"  >3\u00e8me Sect. Roche-Plate<\/option><option value=\"Ville du Trou du Nord\"  >Ville du Trou du Nord<\/option><option value=\"1\u00e8re Sect. Garcin\"  >1\u00e8re Sect. Garcin<\/option><option value=\"Monsignac\"  >Monsignac<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_88' id='label_ff_13_dropdown_88' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_88\" id=\"ff_13_dropdown_88\" class=\"ff-el-form-control\" data-name=\"dropdown_88\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_88\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Bois Blanc\"  >2\u00e8me Sect. Bois Blanc<\/option><option value=\"3\u00e8me Sect. Cotelette\"  >3\u00e8me Sect. Cotelette<\/option><option value=\"Ville de Sainte Suzanne\"  >Ville de Sainte Suzanne<\/option><option value=\"4\u00e8me Sect. Sarazin\"  >4\u00e8me Sect. Sarazin<\/option><option value=\"Quartier Dupity\"  >Quartier Dupity<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_89' id='label_ff_13_dropdown_89' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_89\" id=\"ff_13_dropdown_89\" class=\"ff-el-form-control\" data-name=\"dropdown_89\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_89\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Terrier-Rouge\"  >Ville de Terrier-Rouge<\/option><option value=\"2\u00e8me Sect. Grand Bassin\"  >2\u00e8me Sect. Grand Bassin<\/option><option value=\"Ville Industrielle de Pha\u00e9ton\"  >Ville Industrielle de Pha\u00e9ton<\/option><option value=\"Ville Industrielle de Paulette\"  >Ville Industrielle de Paulette<\/option><option value=\"Quartier Grand Bassin\"  >Quartier Grand Bassin<\/option><option value=\"1\u00e8re Sect. Fond Blanc\"  >1\u00e8re Sect. Fond Blanc<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_90' id='label_ff_13_dropdown_90' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_90\" id=\"ff_13_dropdown_90\" class=\"ff-el-form-control\" data-name=\"dropdown_90\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_90\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Caracol\"  >Ville de Caracol<\/option><option value=\"1\u00e8re Sect. Champin\"  >1\u00e8re Sect. Champin<\/option><option value=\"2\u00e8me Sect. Glaudine ou Jacquesy\"  >2\u00e8me Sect. Glaudine ou Jacquesy<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_91' id='label_ff_13_dropdown_91' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_91\" id=\"ff_13_dropdown_91\" class=\"ff-el-form-control\" data-name=\"dropdown_91\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_91\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Trois Palmistes\"  >1\u00e8re Sect. Trois Palmistes<\/option><option value=\"2\u00e8me Sect. Ecrevisse ou Grosse Roche\"  >2\u00e8me Sect. Ecrevisse ou Grosse Roche<\/option><option value=\"3\u00e8me Sect. Corosse\"  >3\u00e8me Sect. Corosse<\/option><option value=\"Ville de Vali\u00e8res\"  >Ville de Vali\u00e8res<\/option><option value=\"Quartier Grosse Roche\"  >Quartier Grosse Roche<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_92' id='label_ff_13_dropdown_92' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_92\" id=\"ff_13_dropdown_92\" class=\"ff-el-form-control\" data-name=\"dropdown_92\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_92\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Rose Bonite\"  >2\u00e8me Sect. Rose Bonite<\/option><option value=\"Ville de Carice\"  >Ville de Carice<\/option><option value=\"1\u00e8re Sect. Bois Gamelle\"  >1\u00e8re Sect. Bois Gamelle<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_93' id='label_ff_13_dropdown_93' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_93\" id=\"ff_13_dropdown_93\" class=\"ff-el-form-control\" data-name=\"dropdown_93\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_93\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Mombin Crochu\"  >Ville de Mombin Crochu<\/option><option value=\"Quartier de Bois Laurence\"  >Quartier de Bois Laurence<\/option><option value=\"1\u00e8re Sect. Sans-Souci\"  >1\u00e8re Sect. Sans-Souci<\/option><option value=\"2\u00e8me Sect. Bois Laurence\"  >2\u00e8me Sect. Bois Laurence<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_94' id='label_ff_13_dropdown_94' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_94\" id=\"ff_13_dropdown_94\" class=\"ff-el-form-control\" data-name=\"dropdown_94\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_94\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"4\u00e8me Sect. Poste-Pierrot\"  >4\u00e8me Sect. Poste-Pierrot<\/option><option value=\"Ville de Dessalines (ou Marchand)\"  >Ville de Dessalines (ou Marchand)<\/option><option value=\"5\u00e8me Sect. Fi\u00e9fi\u00e9 ou Petit Cahos\"  >5\u00e8me Sect. Fi\u00e9fi\u00e9 ou Petit Cahos<\/option><option value=\"1\u00e8re Sect. Villars\"  >1\u00e8re Sect. Villars<\/option><option value=\"6\u00e8me Sect. La Croix ou Grand Cahos\"  >6\u00e8me Sect. La Croix ou Grand Cahos<\/option><option value=\"2\u00e8me Sect. Foss\u00e9 Naboth ou Duvallon\"  >2\u00e8me Sect. Foss\u00e9 Naboth ou Duvallon<\/option><option value=\"3\u00e8me Sect. Og\u00e9\"  >3\u00e8me Sect. Og\u00e9<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_95' id='label_ff_13_dropdown_95' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_95\" id=\"ff_13_dropdown_95\" class=\"ff-el-form-control\" data-name=\"dropdown_95\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_95\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Bas-Coursin I\"  >1\u00e8re Sect. Bas-Coursin I<\/option><option value=\"6\u00e8me Sect. M\u00e9dor\"  >6\u00e8me Sect. M\u00e9dor<\/option><option value=\"2\u00e8me Sect. Bas-Coursin II\"  >2\u00e8me Sect. Bas-Coursin II<\/option><option value=\"3\u00e8me Sect. Labady\"  >3\u00e8me Sect. Labady<\/option><option value=\"Ville de Petite rivi\u00e8re de l&#039;Artibonite\"  >Ville de Petite rivi\u00e8re de l&rsquo;Artibonite<\/option><option value=\"4\u00e8me Sect. Savane \u00e0 Roch\"  >4\u00e8me Sect. Savane \u00e0 Roch<\/option><option value=\"5\u00e8me Sect. P\u00e9rodin\"  >5\u00e8me Sect. P\u00e9rodin<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_96' id='label_ff_13_dropdown_96' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_96\" id=\"ff_13_dropdown_96\" class=\"ff-el-form-control\" data-name=\"dropdown_96\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_96\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Grand Saline\"  >Ville de Grand Saline<\/option><option value=\"1\u00e8re SEct. Poteneau\"  >1\u00e8re SEct. Poteneau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_97' id='label_ff_13_dropdown_97' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_97\" id=\"ff_13_dropdown_97\" class=\"ff-el-form-control\" data-name=\"dropdown_97\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_97\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Saint-Michel de l&#039;Attalaye\"  >Ville de Saint-Michel de l&rsquo;Attalaye<\/option><option value=\"4\u00e8me Sect. Lalomas\"  >4\u00e8me Sect. Lalomas<\/option><option value=\"Quartier Mamont (ou Nan Paul)\"  >Quartier Mamont (ou Nan Paul)<\/option><option value=\"5\u00e8me Sect. l&#039;Ermite\"  >5\u00e8me Sect. l&rsquo;Ermite<\/option><option value=\"1\u00e8re Sect. Platana\"  >1\u00e8re Sect. Platana<\/option><option value=\"6\u00e8me Sect. Lacedras\"  >6\u00e8me Sect. Lacedras<\/option><option value=\"2\u00e8me Sect. Camathe\"  >2\u00e8me Sect. Camathe<\/option><option value=\"7\u00e8me Sect. Mamont\"  >7\u00e8me Sect. Mamont<\/option><option value=\"3\u00e8me Sect. Bas de Sault\"  >3\u00e8me Sect. Bas de Sault<\/option><option value=\"8\u00e8me Sect. l&#039;Attalaye\"  >8\u00e8me Sect. l&rsquo;Attalaye<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_98' id='label_ff_13_dropdown_98' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_98\" id=\"ff_13_dropdown_98\" class=\"ff-el-form-control\" data-name=\"dropdown_98\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_98\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Desdunes\"  >Ville de Desdunes<\/option><option value=\"1\u00e8re Sect. de desdunes\"  >1\u00e8re Sect. de desdunes<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_99' id='label_ff_13_dropdown_99' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_99\" id=\"ff_13_dropdown_99\" class=\"ff-el-form-control\" data-name=\"dropdown_99\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_99\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Marmelade\"  >Ville de Marmelade<\/option><option value=\"1\u00e8re Sect. Cr\u00e8te \u00e0 Pins\"  >1\u00e8re Sect. Cr\u00e8te \u00e0 Pins<\/option><option value=\"2\u00e8me Sect. Bassin ou Billier\"  >2\u00e8me Sect. Bassin ou Billier<\/option><option value=\"3\u00e8me Sect. Platon\"  >3\u00e8me Sect. Platon<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_100' id='label_ff_13_dropdown_100' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_100\" id=\"ff_13_dropdown_100\" class=\"ff-el-form-control\" data-name=\"dropdown_100\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_100\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Vlle Liancourt\"  >Vlle Liancourt<\/option><option value=\"1\u00e8re Liancourt\"  >1\u00e8re Liancourt<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_101' id='label_ff_13_dropdown_101' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_101\" id=\"ff_13_dropdown_101\" class=\"ff-el-form-control\" data-name=\"dropdown_101\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_101\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me D\u00e9lug\u00e9\"  >2\u00e8me D\u00e9lug\u00e9<\/option><option value=\"Ville de Montrouis\"  >Ville de Montrouis<\/option><option value=\"1\u00e8re Montrouis\"  >1\u00e8re Montrouis<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_102' id='label_ff_13_dropdown_102' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_102\" id=\"ff_13_dropdown_102\" class=\"ff-el-form-control\" data-name=\"dropdown_102\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_102\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville des Gona\u00efves\"  >Ville des Gona\u00efves<\/option><option value=\"4\u00e8me Sect. Poteaux\"  >4\u00e8me Sect. Poteaux<\/option><option value=\"Quartier Pte Rivi\u00e8re des Bayonnais\"  >Quartier Pte Rivi\u00e8re des Bayonnais<\/option><option value=\"5\u00e8me Sect. Labranle\"  >5\u00e8me Sect. Labranle<\/option><option value=\"1\u00e8re Sect. Pont Tamarin\"  >1\u00e8re Sect. Pont Tamarin<\/option><option value=\"2\u00e8me Sect. Bassin\"  >2\u00e8me Sect. Bassin<\/option><option value=\"3\u00e8me Sect. Pte Rivi\u00e8re de  Bayonnais\"  >3\u00e8me Sect. Pte Rivi\u00e8re de  Bayonnais<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_103' id='label_ff_13_dropdown_103' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_103\" id=\"ff_13_dropdown_103\" class=\"ff-el-form-control\" data-name=\"dropdown_103\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_103\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Passe-Reine ou bas d&#039;Ennery\"  >2\u00e8me Sect. Passe-Reine ou bas d&rsquo;Ennery<\/option><option value=\"2\u00e8me Sect. Passe-Reine ou bas d&#039;Ennery\"  >2\u00e8me Sect. Passe-Reine ou bas d&rsquo;Ennery<\/option><option value=\"Ville d&#039;Ennery\"  >Ville d&rsquo;Ennery<\/option><option value=\"3\u00e8me Sect. Chemin Neuf\"  >3\u00e8me Sect. Chemin Neuf<\/option><option value=\"1\u00e8re Sect. Savane Carr\u00e9e\"  >1\u00e8re Sect. Savane Carr\u00e9e<\/option><option value=\"4\u00e8me Sect. Puilboreau\"  >4\u00e8me Sect. Puilboreau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_104' id='label_ff_13_dropdown_104' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_104\" id=\"ff_13_dropdown_104\" class=\"ff-el-form-control\" data-name=\"dropdown_104\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_104\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Lacroix-P\u00e9risse\"  >1\u00e8re Sect. Lacroix-P\u00e9risse<\/option><option value=\"2\u00e8me Sect. Petite Desdunes\"  >2\u00e8me Sect. Petite Desdunes<\/option><option value=\"Ville de l&#039;Est\u00e8re\"  >Ville de l&rsquo;Est\u00e8re<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_105' id='label_ff_13_dropdown_105' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_105\" id=\"ff_13_dropdown_105\" class=\"ff-el-form-control\" data-name=\"dropdown_105\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_105\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Rivi\u00e8re Mancelle\"  >2\u00e8me Sect. Rivi\u00e8re Mancelle<\/option><option value=\"7\u00e8me Sect. Moulin\"  >7\u00e8me Sect. Moulin<\/option><option value=\"3\u00e8me Sect. Rivi\u00e8re Blanche\"  >3\u00e8me Sect. Rivi\u00e8re Blanche<\/option><option value=\"8\u00e8me Sect. Ravine Gros-Morne\"  >8\u00e8me Sect. Ravine Gros-Morne<\/option><option value=\"Ville de Gros-Morne\"  >Ville de Gros-Morne<\/option><option value=\"4\u00e8me Sect. l&#039;Acul\"  >4\u00e8me Sect. l&rsquo;Acul<\/option><option value=\"1\u00e8re Sect. Boucan Richard\"  >1\u00e8re Sect. Boucan Richard<\/option><option value=\"5\u00e8me Sect. Pendu\"  >5\u00e8me Sect. Pendu<\/option><option value=\"2\u00e8me Sect. Rivi\u00e8re Mancelle\"  >2\u00e8me Sect. Rivi\u00e8re Mancelle<\/option><option value=\"6\u00e8me Sect. Savane Carr\u00e9e\"  >6\u00e8me Sect. Savane Carr\u00e9e<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_106' id='label_ff_13_dropdown_106' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_106\" id=\"ff_13_dropdown_106\" class=\"ff-el-form-control\" data-name=\"dropdown_106\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_106\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Lagon\"  >3\u00e8me Sect. Lagon<\/option><option value=\"Ville de Terre-Neuve\"  >Ville de Terre-Neuve<\/option><option value=\"1\u00e8re Sect. Doland\"  >1\u00e8re Sect. Doland<\/option><option value=\"2\u00e8me Sect. Bois Neuf\"  >2\u00e8me Sect. Bois Neuf<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_107' id='label_ff_13_dropdown_107' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_107\" id=\"ff_13_dropdown_107\" class=\"ff-el-form-control\" data-name=\"dropdown_107\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_107\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Anse Rouge\"  >Ville de l&rsquo;Anse Rouge<\/option><option value=\"Quartier Sources Chaudes\"  >Quartier Sources Chaudes<\/option><option value=\"1\u00e8re Sect. l&#039;Arbre\"  >1\u00e8re Sect. l&rsquo;Arbre<\/option><option value=\"2\u00e8me Sect. Sources Chaudes\"  >2\u00e8me Sect. Sources Chaudes<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_109' id='label_ff_13_dropdown_109' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_109\" id=\"ff_13_dropdown_109\" class=\"ff-el-form-control\" data-name=\"dropdown_109\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_109\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Saint-Marc\"  >Ville de Saint-Marc<\/option><option value=\"5\u00e8me Sect. Charrette\"  >5\u00e8me Sect. Charrette<\/option><option value=\"1\u00e8re Sect. Bois Neuf\"  >1\u00e8re Sect. Bois Neuf<\/option><option value=\"2\u00e8me Sect. Goyavier\"  >2\u00e8me Sect. Goyavier<\/option><option value=\"3\u00e8me Sect. Lalou\u00e8re\"  >3\u00e8me Sect. Lalou\u00e8re<\/option><option value=\"4\u00e8me Sect. Bocozelle\"  >4\u00e8me Sect. Bocozelle<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_108' id='label_ff_13_dropdown_108' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_108\" id=\"ff_13_dropdown_108\" class=\"ff-el-form-control\" data-name=\"dropdown_108\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_108\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. D\u00e9sarmes\"  >3\u00e8me Sect. D\u00e9sarmes<\/option><option value=\"Ville de Verrettes\"  >Ville de Verrettes<\/option><option value=\"4\u00e8me Sect. Bastien\"  >4\u00e8me Sect. Bastien<\/option><option value=\"Quartier D\u00e9sarmes\"  >Quartier D\u00e9sarmes<\/option><option value=\"5\u00e8me Sect. Terre Nette\"  >5\u00e8me Sect. Terre Nette<\/option><option value=\"1\u00e8re Sect. B\u00e9langer\"  >1\u00e8re Sect. B\u00e9langer<\/option><option value=\"2\u00e8me Sect. Guillaume-Mog\u00e9\"  >2\u00e8me Sect. Guillaume-Mog\u00e9<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_110' id='label_ff_13_dropdown_110' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_110\" id=\"ff_13_dropdown_110\" class=\"ff-el-form-control\" data-name=\"dropdown_110\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_110\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Bossous\"  >2\u00e8me Sect. Bossous<\/option><option value=\"Ville de La Chapelle\"  >Ville de La Chapelle<\/option><option value=\"1\u00e8re Sect. Martineau\"  >1\u00e8re Sect. Martineau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_111' id='label_ff_13_dropdown_111' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_111\" id=\"ff_13_dropdown_111\" class=\"ff-el-form-control\" data-name=\"dropdown_111\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_111\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Quartier Los Palis\"  >Quartier Los Palis<\/option><option value=\"1\u00e8re Sect. Juanaria\"  >1\u00e8re Sect. Juanaria<\/option><option value=\"2\u00e8me Sect. Marmont\"  >2\u00e8me Sect. Marmont<\/option><option value=\"3\u00e8me Sect. Aguah\u00e9dionde (Rive Droite)\"  >3\u00e8me Sect. Aguah\u00e9dionde (Rive Droite)<\/option><option value=\"Ville de Hinche\"  >Ville de Hinche<\/option><option value=\"4\u00e8me Sect. Aguah\u00e9dionde (Rive gauche)\"  >4\u00e8me Sect. Aguah\u00e9dionde (Rive gauche)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_112' id='label_ff_13_dropdown_112' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_112\" id=\"ff_13_dropdown_112\" class=\"ff-el-form-control\" data-name=\"dropdown_112\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_112\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville Baptiste\"  >Ville Baptiste<\/option><option value=\"1\u00e8re Sect. Riaribes\"  >1\u00e8re Sect. Riaribes<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_113' id='label_ff_13_dropdown_113' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_113\" id=\"ff_13_dropdown_113\" class=\"ff-el-form-control\" data-name=\"dropdown_113\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_113\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Ma\u00efssade\"  >Ville de Ma\u00efssade<\/option><option value=\"Quartier Louverture\"  >Quartier Louverture<\/option><option value=\"1\u00e8re Sect. Savane Grande\"  >1\u00e8re Sect. Savane Grande<\/option><option value=\"2\u00e8me Sect. Narang\"  >2\u00e8me Sect. Narang<\/option><option value=\"3\u00e8me Sect. Hatty\"  >3\u00e8me Sect. Hatty<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_114' id='label_ff_13_dropdown_114' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_114\" id=\"ff_13_dropdown_114\" class=\"ff-el-form-control\" data-name=\"dropdown_114\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_114\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Thomonde\"  >Ville de Thomonde<\/option><option value=\"1\u00e8re Sect. Cabral\"  >1\u00e8re Sect. Cabral<\/option><option value=\"2\u00e8me Sect. Tierra Muscady\"  >2\u00e8me Sect. Tierra Muscady<\/option><option value=\"3\u00e8me Sect. Baille Tourrible\"  >3\u00e8me Sect. Baille Tourrible<\/option><option value=\"4\u00e8me Sect. La Hoye\"  >4\u00e8me Sect. La Hoye<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_115' id='label_ff_13_dropdown_115' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_115\" id=\"ff_13_dropdown_115\" class=\"ff-el-form-control\" data-name=\"dropdown_115\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_115\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Cerca Carvajal\"  >Ville de Cerca Carvajal<\/option><option value=\"1\u00e8re Section Rand\"  >1\u00e8re Section Rand<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_116' id='label_ff_13_dropdown_116' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_116\" id=\"ff_13_dropdown_116\" class=\"ff-el-form-control\" data-name=\"dropdown_116\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_116\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Grand-Boucan\"  >3\u00e8me Sect. Grand-Boucan<\/option><option value=\"4\u00e8me Sect. Cr\u00eate Br\u00fbl\u00e9e\"  >4\u00e8me Sect. Cr\u00eate Br\u00fbl\u00e9e<\/option><option value=\"Ville de Mirebalais\"  >Ville de Mirebalais<\/option><option value=\"1\u00e8re Sect. Gascogne\"  >1\u00e8re Sect. Gascogne<\/option><option value=\"2\u00e8me Sect. Sarazin\"  >2\u00e8me Sect. Sarazin<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_117' id='label_ff_13_dropdown_117' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_117\" id=\"ff_13_dropdown_117\" class=\"ff-el-form-control\" data-name=\"dropdown_117\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_117\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Coupe Mardi-Gras\"  >3\u00e8me Sect. Coupe Mardi-Gras<\/option><option value=\"4\u00e8me Sect. Montagne Terrible\"  >4\u00e8me Sect. Montagne Terrible<\/option><option value=\"Ville de Saut d&#039;Eau\"  >Ville de Saut d&rsquo;Eau<\/option><option value=\"1\u00e8re Sect. Canot\"  >1\u00e8re Sect. Canot<\/option><option value=\"2\u00e8me Sect. la Selle\"  >2\u00e8me Sect. la Selle<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_118' id='label_ff_13_dropdown_118' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_118\" id=\"ff_13_dropdown_118\" class=\"ff-el-form-control\" data-name=\"dropdown_118\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_118\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Boucan Carr\u00e9\"  >2\u00e8me Sect. Boucan Carr\u00e9<\/option><option value=\"3\u00e8me Sect. des Bayes\"  >3\u00e8me Sect. des Bayes<\/option><option value=\"Ville de Boucan Carr\u00e9\"  >Ville de Boucan Carr\u00e9<\/option><option value=\"Quartier Dufailly\"  >Quartier Dufailly<\/option><option value=\"1\u00e8re Sect. Petite Montagne\"  >1\u00e8re Sect. Petite Montagne<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_119' id='label_ff_13_dropdown_119' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_119\" id=\"ff_13_dropdown_119\" class=\"ff-el-form-control\" data-name=\"dropdown_119\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_119\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Lascahobas\"  >Ville de Lascahobas<\/option><option value=\"1\u00e8re Sect. Petit Fond\"  >1\u00e8re Sect. Petit Fond<\/option><option value=\"2\u00e8me Sect. Juampas\"  >2\u00e8me Sect. Juampas<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_120' id='label_ff_13_dropdown_120' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_120\" id=\"ff_13_dropdown_120\" class=\"ff-el-form-control\" data-name=\"dropdown_120\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_120\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Bellad\u00e8re\"  >Ville de Bellad\u00e8re<\/option><option value=\"1\u00e8re Sect. Renthe-Mathe\"  >1\u00e8re Sect. Renthe-Mathe<\/option><option value=\"2\u00e8me Sect. Roye-Sec\"  >2\u00e8me Sect. Roye-Sec<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_121' id='label_ff_13_dropdown_121' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_121\" id=\"ff_13_dropdown_121\" class=\"ff-el-form-control\" data-name=\"dropdown_121\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_121\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Savanette \"  >Ville de Savanette<\/option><option value=\"1\u00e8re Sect. Savanette\/Colombier\"  >1\u00e8re Sect. Savanette\/Colombier<\/option><option value=\"2\u00e8me Sect. La Haye\"  >2\u00e8me Sect. La Haye<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_122' id='label_ff_13_dropdown_122' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_122\" id=\"ff_13_dropdown_122\" class=\"ff-el-form-control\" data-name=\"dropdown_122\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_122\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Acajou Br\u00fbl\u00e9 No. 2\"  >2\u00e8me Sect. Acajou Br\u00fbl\u00e9 No. 2<\/option><option value=\"3\u00e8me Sect. Lamielle\"  >3\u00e8me Sect. Lamielle<\/option><option value=\"Ville de Cerca-La-Source\"  >Ville de Cerca-La-Source<\/option><option value=\"1\u00e8re Sect. Acajou Br\u00fbl\u00e9 No. 1\"  >1\u00e8re Sect. Acajou Br\u00fbl\u00e9 No. 1<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_123' id='label_ff_13_dropdown_123' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_123\" id=\"ff_13_dropdown_123\" class=\"ff-el-form-control\" data-name=\"dropdown_123\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_123\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Matelgate\"  >1\u00e8re Sect. Matelgate<\/option><option value=\"2\u00e8me Sect. Lociane\"  >2\u00e8me Sect. Lociane<\/option><option value=\"Ville de Thomassique\"  >Ville de Thomassique<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_124' id='label_ff_13_dropdown_124' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_124\" id=\"ff_13_dropdown_124\" class=\"ff-el-form-control\" data-name=\"dropdown_124\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_124\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville des Cayes\"  >Ville des Cayes<\/option><option value=\"4\u00e8me Sect. Laurent\"  >4\u00e8me Sect. Laurent<\/option><option value=\"Quartier Laborde\"  >Quartier Laborde<\/option><option value=\"5\u00e8me Sect. Mercy\"  >5\u00e8me Sect. Mercy<\/option><option value=\"1\u00e8re Sect. Bourdet\"  >1\u00e8re Sect. Bourdet<\/option><option value=\"6\u00e8me Sect. Boulmier\"  >6\u00e8me Sect. Boulmier<\/option><option value=\"2\u00e8me Sect. Fonfr\u00e8de\"  >2\u00e8me Sect. Fonfr\u00e8de<\/option><option value=\"3\u00e8me Sect. Laborde\"  >3\u00e8me Sect. Laborde<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_125' id='label_ff_13_dropdown_125' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_125\" id=\"ff_13_dropdown_125\" class=\"ff-el-form-control\" data-name=\"dropdown_125\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_125\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Quartier Ducis\"  >Quartier Ducis<\/option><option value=\"1\u00e8re Sect. Boury\"  >1\u00e8re Sect. Boury<\/option><option value=\"2\u00e8me Sect. B\u00e9rault\"  >2\u00e8me Sect. B\u00e9rault<\/option><option value=\"Ville de Torbeck\"  >Ville de Torbeck<\/option><option value=\"3\u00e8me Sect. Solon\"  >3\u00e8me Sect. Solon<\/option><option value=\"Quartier Ferme Leblanc\"  >Quartier Ferme Leblanc<\/option><option value=\"4\u00e8me Sect. Moreau\"  >4\u00e8me Sect. Moreau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_126' id='label_ff_13_dropdown_126' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_126\" id=\"ff_13_dropdown_126\" class=\"ff-el-form-control\" data-name=\"dropdown_126\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_126\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Chantal\"  >Ville de Chantal<\/option><option value=\"1\u00e8re Sect. Fond-Palmiste\"  >1\u00e8re Sect. Fond-Palmiste<\/option><option value=\"2\u00e8me Sect. Meloni\u00e8re\"  >2\u00e8me Sect. Meloni\u00e8re<\/option><option value=\"3\u00e8me Sect. Carrefour Canon\"  >3\u00e8me Sect. Carrefour Canon<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_127' id='label_ff_13_dropdown_127' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_127\" id=\"ff_13_dropdown_127\" class=\"ff-el-form-control\" data-name=\"dropdown_127\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_127\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Levy-Mersan\"  >1\u00e8re Sect. Levy-Mersan<\/option><option value=\"2\u00e8me Sect. Champlois\"  >2\u00e8me Sect. Champlois<\/option><option value=\"3\u00e8me Sect. Tibi-Davezac\"  >3\u00e8me Sect. Tibi-Davezac<\/option><option value=\"Ville de Camp-Perrin\"  >Ville de Camp-Perrin<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_128' id='label_ff_13_dropdown_128' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_128\" id=\"ff_13_dropdown_128\" class=\"ff-el-form-control\" data-name=\"dropdown_128\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_128\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Maniche\"  >1\u00e8re Sect. Maniche<\/option><option value=\"2\u00e8me Sect. Dory\"  >2\u00e8me Sect. Dory<\/option><option value=\"3\u00e8me Sect. Melon\"  >3\u00e8me Sect. Melon<\/option><option value=\"Ville de Maniche\"  >Ville de Maniche<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_129' id='label_ff_13_dropdown_129' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_129\" id=\"ff_13_dropdown_129\" class=\"ff-el-form-control\" data-name=\"dropdown_129\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_129\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Ile-\u00e0-vache\"  >Ville de l&rsquo;Ile-\u00e0-vache<\/option><option value=\"1\u00e8re Sect. Ile-\u00e0-vache\"  >1\u00e8re Sect. Ile-\u00e0-vache<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_130' id='label_ff_13_dropdown_130' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_130\" id=\"ff_13_dropdown_130\" class=\"ff-el-form-control\" data-name=\"dropdown_130\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_130\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Port-Salut\"  >Ville de Port-Salut<\/option><option value=\"1\u00e8re Sect. Barbois\"  >1\u00e8re Sect. Barbois<\/option><option value=\"2\u00e8me Sect. Dumont\"  >2\u00e8me Sect. Dumont<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_131' id='label_ff_13_dropdown_131' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_131\" id=\"ff_13_dropdown_131\" class=\"ff-el-form-control\" data-name=\"dropdown_131\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_131\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. D\u00e9bouchette\"  >2\u00e8me Sect. D\u00e9bouchette<\/option><option value=\"3\u00e8me Sect. Trichet\"  >3\u00e8me Sect. Trichet<\/option><option value=\"Ville de Saint-Jean du Sud\"  >Ville de Saint-Jean du Sud<\/option><option value=\"1\u00e8re Sect. Tapion\"  >1\u00e8re Sect. Tapion<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_132' id='label_ff_13_dropdown_132' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_132\" id=\"ff_13_dropdown_132\" class=\"ff-el-form-control\" data-name=\"dropdown_132\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_132\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. d&#039;Arniquet\"  >3\u00e8me Sect. d&rsquo;Arniquet<\/option><option value=\"Ville de Arniquet\"  >Ville de Arniquet<\/option><option value=\"1\u00e8re Sect. Lazarre\"  >1\u00e8re Sect. Lazarre<\/option><option value=\"2\u00e8me Sect. Anse \u00e0 Drick\"  >2\u00e8me Sect. Anse \u00e0 Drick<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_133' id='label_ff_13_dropdown_133' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_133\" id=\"ff_13_dropdown_133\" class=\"ff-el-form-control\" data-name=\"dropdown_133\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_133\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Brodequin\"  >3\u00e8me Sect. Brodequin<\/option><option value=\"9\u00e8me Sect. Guirand\"  >9\u00e8me Sect. Guirand<\/option><option value=\"Ville d&#039;Aquin\"  >Ville d&rsquo;Aquin<\/option><option value=\"4\u00e8me Sect. Flamands\"  >4\u00e8me Sect. Flamands<\/option><option value=\"Quartier Vieux Bourg d&#039;Aquin\"  >Quartier Vieux Bourg d&rsquo;Aquin<\/option><option value=\"5\u00e8me Sect. Mare \u00e0 Coiffe\"  >5\u00e8me Sect. Mare \u00e0 Coiffe<\/option><option value=\"1\u00e8re Sect. Mac\u00e9an\"  >1\u00e8re Sect. Mac\u00e9an<\/option><option value=\"6\u00e8me Sect. la Colline\"  >6\u00e8me Sect. la Colline<\/option><option value=\"2\u00e8me Sect. Bellevue\"  >2\u00e8me Sect. Bellevue<\/option><option value=\"7\u00e8me Sect. Colline \u00e0 Mongons\"  >7\u00e8me Sect. Colline \u00e0 Mongons<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_134' id='label_ff_13_dropdown_134' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_134\" id=\"ff_13_dropdown_134\" class=\"ff-el-form-control\" data-name=\"dropdown_134\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_134\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"4\u00e8me Sect. Zanglais\"  >4\u00e8me Sect. Zanglais<\/option><option value=\"Ville de Saint-Louis du Sud\"  >Ville de Saint-Louis du Sud<\/option><option value=\"5\u00e8me Sect. Sucrerie-Henri\"  >5\u00e8me Sect. Sucrerie-Henri<\/option><option value=\"1\u00e8re Sect. de grand Fonds\"  >1\u00e8re Sect. de grand Fonds<\/option><option value=\"6\u00e8me Sect. Solon\"  >6\u00e8me Sect. Solon<\/option><option value=\"2\u00e8me Sect. Baie Dumesle\"  >2\u00e8me Sect. Baie Dumesle<\/option><option value=\"7\u00e8me Sect. Ch\u00e9rette\"  >7\u00e8me Sect. Ch\u00e9rette<\/option><option value=\"3\u00e8me Sect. Grenodi\u266a8re\"  >3\u00e8me Sect. Grenodi\u266a8re<\/option><option value=\"8\u00e8me Sect. Corail-Henri\"  >8\u00e8me Sect. Corail-Henri<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_135' id='label_ff_13_dropdown_135' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_135\" id=\"ff_13_dropdown_135\" class=\"ff-el-form-control\" data-name=\"dropdown_135\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_135\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Cavaillon\"  >Ville de Cavaillon<\/option><option value=\"5\u00e8me Sect. Laroque\"  >5\u00e8me Sect. Laroque<\/option><option value=\"1\u00e8re Sect. Boileau\"  >1\u00e8re Sect. Boileau<\/option><option value=\"2\u00e8me Sect. Martineau\"  >2\u00e8me Sect. Martineau<\/option><option value=\"3\u00e8me Sect. Gros-Marin\"  >3\u00e8me Sect. Gros-Marin<\/option><option value=\"4\u00e8me Sect. Mare-Henri\"  >4\u00e8me Sect. Mare-Henri<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_136' id='label_ff_13_dropdown_136' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_136\" id=\"ff_13_dropdown_136\" class=\"ff-el-form-control\" data-name=\"dropdown_136\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_136\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Quartier de Damassin\"  >Quartier de Damassin<\/option><option value=\"1\u00e8re Sect. Cond\u00e9\"  >1\u00e8re Sect. Cond\u00e9<\/option><option value=\"2\u00e8me Sect. Despas\"  >2\u00e8me Sect. Despas<\/option><option value=\"3\u00e8me Sect. Quentin\"  >3\u00e8me Sect. Quentin<\/option><option value=\"Ville des C\u00f4teaux\"  >Ville des C\u00f4teaux<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_137' id='label_ff_13_dropdown_137' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_137\" id=\"ff_13_dropdown_137\" class=\"ff-el-form-control\" data-name=\"dropdown_137\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_137\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Paricot\"  >1\u00e8re Sect. Paricot<\/option><option value=\"2\u00e8me Sect. Balais\"  >2\u00e8me Sect. Balais<\/option><option value=\"Ville de Port-\u00e0-Piment\"  >Ville de Port-\u00e0-Piment<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_138' id='label_ff_13_dropdown_138' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_138\" id=\"ff_13_dropdown_138\" class=\"ff-el-form-control\" data-name=\"dropdown_138\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_138\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Beauclos\"  >3\u00e8me Sect. Beauclos<\/option><option value=\"1\u00e8re sEct. Beaulieu\"  >1\u00e8re sEct. Beaulieu<\/option><option value=\"2\u00e8me Sect. Renaudin\"  >2\u00e8me Sect. Renaudin<\/option><option value=\"Ville de Roche-\u00e0-Bateau\"  >Ville de Roche-\u00e0-Bateau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_139' id='label_ff_13_dropdown_139' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_139\" id=\"ff_13_dropdown_139\" class=\"ff-el-form-control\" data-name=\"dropdown_139\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_139\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Bony\"  >3\u00e8me Sect. Bony<\/option><option value=\"Ville de Chardonni\u00e8res\"  >Ville de Chardonni\u00e8res<\/option><option value=\"Quartier Randel\"  >Quartier Randel<\/option><option value=\"1\u00e8re Sect. Randel\"  >1\u00e8re Sect. Randel<\/option><option value=\"2\u00e8me Sect. D\u00e9joie\"  >2\u00e8me Sect. D\u00e9joie<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_140' id='label_ff_13_dropdown_140' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_140\" id=\"ff_13_dropdown_140\" class=\"ff-el-form-control\" data-name=\"dropdown_140\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_140\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville des Anglais\"  >Ville des Anglais<\/option><option value=\"1\u00e8re Sect. V\u00e9rone\"  >1\u00e8re Sect. V\u00e9rone<\/option><option value=\"2\u00e8me Sect. Edelin\"  >2\u00e8me Sect. Edelin<\/option><option value=\"3\u00e8me Sect. Cosse\"  >3\u00e8me Sect. Cosse<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_141' id='label_ff_13_dropdown_141' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_141\" id=\"ff_13_dropdown_141\" class=\"ff-el-form-control\" data-name=\"dropdown_141\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_141\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Tiburon \"  >Ville de Tiburon<\/option><option value=\"3\u00e8me Sect. Loby\"  >3\u00e8me Sect. Loby<\/option><option value=\"Quartier La Cahouane\"  >Quartier La Cahouane<\/option><option value=\"4\u00e8me Sect. Dalmette\"  >4\u00e8me Sect. Dalmette<\/option><option value=\"1\u00e8re Sect. Blactote\"  >1\u00e8re Sect. Blactote<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_142' id='label_ff_13_dropdown_142' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_142\" id=\"ff_13_dropdown_142\" class=\"ff-el-form-control\" data-name=\"dropdown_142\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_142\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Fonds des Blancs\"  >Ville de Fonds des Blancs<\/option><option value=\"1\u00e8re Sect. Fonds des Blancs\"  >1\u00e8re Sect. Fonds des Blancs<\/option><option value=\"2\u00e8me Sect. Frangipane\"  >2\u00e8me Sect. Frangipane<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_143' id='label_ff_13_dropdown_143' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_143\" id=\"ff_13_dropdown_143\" class=\"ff-el-form-control\" data-name=\"dropdown_143\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_143\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-\u00e0-Ma\u00e7on\"  >Anse-\u00e0-Ma\u00e7on<\/option><option value=\"Boucan philippe\"  >Boucan philippe<\/option><option value=\"Nan Sous\"  >Nan Sous<\/option><option value=\"Z\u00e8b Ginen\"  >Z\u00e8b Ginen<\/option><option value=\"Pointe Sable\"  >Pointe Sable<\/option><option value=\"Anse du Nord\"  >Anse du Nord<\/option><option value=\"Nan Palmis\"  >Nan Palmis<\/option><option value=\"Mav\u00e8t\"  >Mav\u00e8t<\/option><option value=\"Bayeux\"  >Bayeux<\/option><option value=\"Nan Fredi\"  >Nan Fredi<\/option><option value=\"Plaine David\"  >Plaine David<\/option><option value=\"Nan Kajou\"  >Nan Kajou<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_144' id='label_ff_13_dropdown_144' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_144\" id=\"ff_13_dropdown_144\" class=\"ff-el-form-control\" data-name=\"dropdown_144\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_144\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Anse-\u00e0-Ma\u00e7on\"  >Anse-\u00e0-Ma\u00e7on<\/option><option value=\"Boucan philippe\"  >Boucan philippe<\/option><option value=\"Nan Sous\"  >Nan Sous<\/option><option value=\"Z\u00e8b Ginen\"  >Z\u00e8b Ginen<\/option><option value=\"Pointe Sable\"  >Pointe Sable<\/option><option value=\"Anse du Nord\"  >Anse du Nord<\/option><option value=\"Nan Palmis\"  >Nan Palmis<\/option><option value=\"Mav\u00e8t\"  >Mav\u00e8t<\/option><option value=\"Bayeux\"  >Bayeux<\/option><option value=\"Nan Fredi\"  >Nan Fredi<\/option><option value=\"Plaine David\"  >Plaine David<\/option><option value=\"Nan Kajou\"  >Nan Kajou<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_145' id='label_ff_13_dropdown_145' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_145\" id=\"ff_13_dropdown_145\" class=\"ff-el-form-control\" data-name=\"dropdown_145\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_145\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Iles Blanches\"  >3\u00e8me Sect. Iles Blanches<\/option><option value=\"Ville Marfranc\"  >Ville Marfranc<\/option><option value=\"1\u00e8re Sect. Marfranc\"  >1\u00e8re Sect. Marfranc<\/option><option value=\"2\u00e8me Sect. Ravine \u00e0 Charles\"  >2\u00e8me Sect. Ravine \u00e0 Charles<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_146' id='label_ff_13_dropdown_146' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_146\" id=\"ff_13_dropdown_146\" class=\"ff-el-form-control\" data-name=\"dropdown_146\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_146\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Basse Voldrogue\"  >1\u00e8re Sect. Basse Voldrogue<\/option><option value=\"5\u00e8me Sect. Fond Rouge Dah\u00e8re\"  >5\u00e8me Sect. Fond Rouge Dah\u00e8re<\/option><option value=\"2\u00e8me Sect. Haute Voldrogue\"  >2\u00e8me Sect. Haute Voldrogue<\/option><option value=\"6\u00e8me Sect. Fond Rouge Torbeck\"  >6\u00e8me Sect. Fond Rouge Torbeck<\/option><option value=\"Ville de J\u00e9r\u00e9mie\"  >Ville de J\u00e9r\u00e9mie<\/option><option value=\"3\u00e8me Sect. Haute Guinaud\u00e9e\"  >3\u00e8me Sect. Haute Guinaud\u00e9e<\/option><option value=\"Quartier de L\u00e9on\"  >Quartier de L\u00e9on<\/option><option value=\"4\u00e8me Sect. Basse Guinaud\u00e9e\"  >4\u00e8me Sect. Basse Guinaud\u00e9e<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_147' id='label_ff_13_dropdown_147' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_147\" id=\"ff_13_dropdown_147\" class=\"ff-el-form-control\" data-name=\"dropdown_147\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_147\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Balisiers\"  >2\u00e8me Sect. Balisiers<\/option><option value=\"3\u00e8me Sect. Danglise\"  >3\u00e8me Sect. Danglise<\/option><option value=\"Ville des Abricots\"  >Ville des Abricots<\/option><option value=\"4\u00e8me Sect. La Seringue\"  >4\u00e8me Sect. La Seringue<\/option><option value=\"1\u00e8re sect. Anse du Clerc\"  >1\u00e8re sect. Anse du Clerc<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_148' id='label_ff_13_dropdown_148' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_148\" id=\"ff_13_dropdown_148\" class=\"ff-el-form-control\" data-name=\"dropdown_148\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_148\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. de D\u00e9sormeau ou Bonbon\"  >1\u00e8re Sect. de D\u00e9sormeau ou Bonbon<\/option><option value=\"Ville de Bonbon\"  >Ville de Bonbon<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_149' id='label_ff_13_dropdown_149' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_149\" id=\"ff_13_dropdown_149\" class=\"ff-el-form-control\" data-name=\"dropdown_149\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_149\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Sources Chaudes\"  >2\u00e8me Sect. Sources Chaudes<\/option><option value=\"3\u00e8me Sect. L&#039;Assise ou Chameau\"  >3\u00e8me Sect. L&rsquo;Assise ou Chameau<\/option><option value=\"Quartier Sources Chaudes\"  >Quartier Sources Chaudes<\/option><option value=\"1\u00e8re Sect. Anote ou 1\u00e8re Tapion\"  >1\u00e8re Sect. Anote ou 1\u00e8re Tapion<\/option><option value=\"Ville de Moron\"  >Ville de Moron<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_150' id='label_ff_13_dropdown_150' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_150\" id=\"ff_13_dropdown_150\" class=\"ff-el-form-control\" data-name=\"dropdown_150\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_150\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. de Boucan\"  >2\u00e8me Sect. de Boucan<\/option><option value=\"Ville de Chambellan\"  >Ville de Chambellan<\/option><option value=\"1\u00e8re Sect. de D\u00e9jean\"  >1\u00e8re Sect. de D\u00e9jean<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_151' id='label_ff_13_dropdown_151' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_151\" id=\"ff_13_dropdown_151\" class=\"ff-el-form-control\" data-name=\"dropdown_151\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_151\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"3\u00e8me Sect. Ilet \u00e0 Pierre Joseph\"  >3\u00e8me Sect. Ilet \u00e0 Pierre Joseph<\/option><option value=\"Ville d&#039;Anse d&#039;hainault\"  >Ville d&rsquo;Anse d&rsquo;hainault<\/option><option value=\"4\u00e8me Sect. Mandou\"  >4\u00e8me Sect. Mandou<\/option><option value=\"1\u00e8re Sect. Grandoit\"  >1\u00e8re Sect. Grandoit<\/option><option value=\"2\u00e8me Sect. Boudon\"  >2\u00e8me Sect. Boudon<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_152' id='label_ff_13_dropdown_152' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_152\" id=\"ff_13_dropdown_152\" class=\"ff-el-form-control\" data-name=\"dropdown_152\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_152\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Quartier de Lesson\"  >Quartier de Lesson<\/option><option value=\"3\u00e8me Sect. D\u00e9sormeau\"  >3\u00e8me Sect. D\u00e9sormeau<\/option><option value=\"1\u00e8re sect. Bariadelle\"  >1\u00e8re sect. Bariadelle<\/option><option value=\"4\u00e8me Sect. Petite Rivi\u00e8re\"  >4\u00e8me Sect. Petite Rivi\u00e8re<\/option><option value=\"Ville de Dame Marie\"  >Ville de Dame Marie<\/option><option value=\"2\u00e8me Sect. Dallier\"  >2\u00e8me Sect. Dallier<\/option><option value=\"5\u00e8me Sect. Baliverne\"  >5\u00e8me Sect. Baliverne<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_153' id='label_ff_13_dropdown_153' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_153\" id=\"ff_13_dropdown_153\" class=\"ff-el-form-control\" data-name=\"dropdown_153\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_153\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville des Irois\"  >Ville des Irois<\/option><option value=\"2\u00e8me Sect. Belair\"  >2\u00e8me Sect. Belair<\/option><option value=\"Quartier de Garcasse\"  >Quartier de Garcasse<\/option><option value=\"3\u00e8me Sect. Garcasse\"  >3\u00e8me Sect. Garcasse<\/option><option value=\"1\u00e8re Sect. Matador (Jorgue)\"  >1\u00e8re Sect. Matador (Jorgue)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_154' id='label_ff_13_dropdown_154' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_154\" id=\"ff_13_dropdown_154\" class=\"ff-el-form-control\" data-name=\"dropdown_154\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_154\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Duquillon\"  >1\u00e8re Sect. Duquillon<\/option><option value=\"2\u00e8me Sect. Fonds d&#039;Icaque\"  >2\u00e8me Sect. Fonds d&rsquo;Icaque<\/option><option value=\"Ville de Corail\"  >Ville de Corail<\/option><option value=\"3\u00e8me Sect. Champy (Nan Camp\u00e8che)\"  >3\u00e8me Sect. Champy (Nan Camp\u00e8che)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_155' id='label_ff_13_dropdown_155' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_155\" id=\"ff_13_dropdown_155\" class=\"ff-el-form-control\" data-name=\"dropdown_155\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_155\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Roseaux\"  >Ville de Roseaux<\/option><option value=\"1\u00e8re Sect. Carrefour Charles ou Jacquin\"  >1\u00e8re Sect. Carrefour Charles ou Jacquin<\/option><option value=\"3\u00e8me Sect. Grand-Vincent\"  >3\u00e8me Sect. Grand-Vincent<\/option><option value=\"2\u00e8me Sect. Fond-Cochon ou Lopineau\"  >2\u00e8me Sect. Fond-Cochon ou Lopineau<\/option><option value=\"4\u00e8me Sect. Les Gommiers\"  >4\u00e8me Sect. Les Gommiers<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_156' id='label_ff_13_dropdown_156' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_156\" id=\"ff_13_dropdown_156\" class=\"ff-el-form-control\" data-name=\"dropdown_156\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_156\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Baumont\"  >Ville de Baumont<\/option><option value=\"3\u00e8me Sect. Mouline\"  >3\u00e8me Sect. Mouline<\/option><option value=\"1\u00e8re Sect. Beaumont\"  >1\u00e8re Sect. Beaumont<\/option><option value=\"2\u00e8me Sect. Chardonnette\"  >2\u00e8me Sect. Chardonnette<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_158' id='label_ff_13_dropdown_158' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_158\" id=\"ff_13_dropdown_158\" class=\"ff-el-form-control\" data-name=\"dropdown_158\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_158\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"2\u00e8me Sect. Esp\u00e8re\"  >2\u00e8me Sect. Esp\u00e8re<\/option><option value=\"5\u00e8me Sect. Duchity\"  >5\u00e8me Sect. Duchity<\/option><option value=\"Ville de Pestel\"  >Ville de Pestel<\/option><option value=\"3\u00e8me Sect. Jn Bellune\"  >3\u00e8me Sect. Jn Bellune<\/option><option value=\"1\u00e8re Sect. Bernagousse\"  >1\u00e8re Sect. Bernagousse<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_157' id='label_ff_13_dropdown_157' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_157\" id=\"ff_13_dropdown_157\" class=\"ff-el-form-control\" data-name=\"dropdown_157\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_157\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville La Pointe\"  >Ville La Pointe<\/option><option value=\"1\u00e8re Sect. La Pointe\"  >1\u00e8re Sect. La Pointe<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_159' id='label_ff_13_dropdown_159' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_159\" id=\"ff_13_dropdown_159\" class=\"ff-el-form-control\" data-name=\"dropdown_159\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_159\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Port-de-Paix\"  >Ville de Port-de-Paix<\/option><option value=\"1\u00e8re sect. Baudin\"  >1\u00e8re sect. Baudin<\/option><option value=\"2\u00e8me Sect. Aubert\"  >2\u00e8me Sect. Aubert<\/option><option value=\"3\u00e8me Sect. Mahoti\u00e8re\"  >3\u00e8me Sect. Mahoti\u00e8re<\/option><option value=\"4\u00e8me Sect. Bas des moustiques\"  >4\u00e8me Sect. Bas des moustiques<\/option><option value=\"5\u00e8me Sect. La Corne\"  >5\u00e8me Sect. La Corne<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_160' id='label_ff_13_dropdown_160' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_160\" id=\"ff_13_dropdown_160\" class=\"ff-el-form-control\" data-name=\"dropdown_160\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_160\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"1\u00e8re Sect. Pointe des Oiseaux\"  >1\u00e8re Sect. Pointe des Oiseaux<\/option><option value=\"2\u00e8me Sect. Mare Rouge\"  >2\u00e8me Sect. Mare Rouge<\/option><option value=\"Ville de la tortue\"  >Ville de la tortue<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_161' id='label_ff_13_dropdown_161' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_161\" id=\"ff_13_dropdown_161\" class=\"ff-el-form-control\" data-name=\"dropdown_161\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_161\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Bassin Bleu\"  >Ville de Bassin Bleu<\/option><option value=\"1\u00e8re Sect. La Plate\"  >1\u00e8re Sect. La Plate<\/option><option value=\"3\u00e8me Sect. Haut des Moustiques\"  >3\u00e8me Sect. Haut des Moustiques<\/option><option value=\"2\u00e8me Sect. Carreau Datty\"  >2\u00e8me Sect. Carreau Datty<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_162' id='label_ff_13_dropdown_162' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_162\" id=\"ff_13_dropdown_162\" class=\"ff-el-form-control\" data-name=\"dropdown_162\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_162\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Chansolme\"  >Ville de Chansolme<\/option><option value=\"1\u00e8re Section Chansolme\"  >1\u00e8re Section Chansolme<\/option><option value=\"3\u00e8me Sect. Audouin-Ti Chansolme\"  >3\u00e8me Sect. Audouin-Ti Chansolme<\/option><option value=\"2\u00e8me Sect. Source Beauvoir\"  >2\u00e8me Sect. Source Beauvoir<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_163' id='label_ff_13_dropdown_163' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_163\" id=\"ff_13_dropdown_163\" class=\"ff-el-form-control\" data-name=\"dropdown_163\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_163\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Saint-Louis du Nord\"  >Ville de Saint-Louis du Nord<\/option><option value=\"4\u00e8me Sect. Rivi\u00e8re des Barres\"  >4\u00e8me Sect. Rivi\u00e8re des Barres<\/option><option value=\"6\u00e8me Sect. Lafargue (Charmoise)\"  >6\u00e8me Sect. Lafargue (Charmoise)<\/option><option value=\"Quartier de Bonneau \"  >Quartier de Bonneau<\/option><option value=\"Quartieer Guichard\"  >Quartieer Guichard<\/option><option value=\"5\u00e8me Sect. Bonneau\"  >5\u00e8me Sect. Bonneau<\/option><option value=\"2\u00e8me Sect. Derouvray\"  >2\u00e8me Sect. Derouvray<\/option><option value=\"3\u00e8me Sect. Desgranges\"  >3\u00e8me Sect. Desgranges<\/option><option value=\"1\u00e8re Sect. Rivi\u00e8re des N\u00e8gres\"  >1\u00e8re Sect. Rivi\u00e8re des N\u00e8gres<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_164' id='label_ff_13_dropdown_164' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_164\" id=\"ff_13_dropdown_164\" class=\"ff-el-form-control\" data-name=\"dropdown_164\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_164\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville d&#039;Anse-\u00e0-Foleur\"  >Ville d&rsquo;Anse-\u00e0-Foleur<\/option><option value=\"1\u00e8re Sect. Bas de Sainte-Anne\"  >1\u00e8re Sect. Bas de Sainte-Anne<\/option><option value=\"2\u00e8me Sect. Mayance\"  >2\u00e8me Sect. Mayance<\/option><option value=\"3\u00e8me Sect. C\u00f4tes de Fer\"  >3\u00e8me Sect. C\u00f4tes de Fer<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_165' id='label_ff_13_dropdown_165' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_165\" id=\"ff_13_dropdown_165\" class=\"ff-el-form-control\" data-name=\"dropdown_165\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_165\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville du M\u00f4le Saint-Nicolas\"  >Ville du M\u00f4le Saint-Nicolas<\/option><option value=\"2\u00e8me Sect. Mare-Rouge\"  >2\u00e8me Sect. Mare-Rouge<\/option><option value=\"1\u00e8re Sect. de C\u00f4tes de Fer\"  >1\u00e8re Sect. de C\u00f4tes de Fer<\/option><option value=\"3\u00e8me Sect. Dam\u00e9\"  >3\u00e8me Sect. Dam\u00e9<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_166' id='label_ff_13_dropdown_166' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_166\" id=\"ff_13_dropdown_166\" class=\"ff-el-form-control\" data-name=\"dropdown_166\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_166\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Baie de Henne\"  >Ville de Baie de Henne<\/option><option value=\"1\u00e8re Sect. Citerne R\u00e9my\"  >1\u00e8re Sect. Citerne R\u00e9my<\/option><option value=\"2\u00e8me Sect. Dos d&#039;Ane\"  >2\u00e8me Sect. Dos d&rsquo;Ane<\/option><option value=\"3\u00e8me Sect. R\u00e9serve (Ti Paradis)\"  >3\u00e8me Sect. R\u00e9serve (Ti Paradis)<\/option><option value=\"4\u00e8me Sect. L&#039;Est\u00e8re D\u00e9r\u00e9\"  >4\u00e8me Sect. L&rsquo;Est\u00e8re D\u00e9r\u00e9<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_167' id='label_ff_13_dropdown_167' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_167\" id=\"ff_13_dropdown_167\" class=\"ff-el-form-control\" data-name=\"dropdown_167\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_167\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Bombardopolis\"  >Ville de Bombardopolis<\/option><option value=\"1\u00e8re Sect. Plate Forme\"  >1\u00e8re Sect. Plate Forme<\/option><option value=\"2\u00e8me Sect. des Forges\"  >2\u00e8me Sect. des Forges<\/option><option value=\"3\u00e8me Sect. Plaine d&#039;Orange\"  >3\u00e8me Sect. Plaine d&rsquo;Orange<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_168' id='label_ff_13_dropdown_168' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_168\" id=\"ff_13_dropdown_168\" class=\"ff-el-form-control\" data-name=\"dropdown_168\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_168\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Jean Rabel\"  >Ville de Jean Rabel<\/option><option value=\"Quartier Bord de Mer\"  >Quartier Bord de Mer<\/option><option value=\"1\u00e8re Sect. Lacoma\"  >1\u00e8re Sect. Lacoma<\/option><option value=\"2\u00e8me Sect. Guinaud\u00e9e\"  >2\u00e8me Sect. Guinaud\u00e9e<\/option><option value=\"3\u00e8me Sect. Vieille Hatte\"  >3\u00e8me Sect. Vieille Hatte<\/option><option value=\"4\u00e8me Sect. La Montagne\"  >4\u00e8me Sect. La Montagne<\/option><option value=\"5\u00e8me Sect. Dessources \"  >5\u00e8me Sect. Dessources<\/option><option value=\"6\u00e8me Sect. Grande Source\"  >6\u00e8me Sect. Grande Source<\/option><option value=\"7e Diondion\"  >7e Diondion<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_169' id='label_ff_13_dropdown_169' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_169\" id=\"ff_13_dropdown_169\" class=\"ff-el-form-control\" data-name=\"dropdown_169\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_169\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Miragoane\"  >Ville de Miragoane<\/option><option value=\"Quartier Saint Michel du Sud\"  >Quartier Saint Michel du Sud<\/option><option value=\"1\u00e8re Sect. Chalon\"  >1\u00e8re Sect. Chalon<\/option><option value=\"2\u00e8me Sect. Belle-Rivi\u00e8re\"  >2\u00e8me Sect. Belle-Rivi\u00e8re<\/option><option value=\"3\u00e8me Sect. Dessources\"  >3\u00e8me Sect. Dessources<\/option><option value=\"4\u00e8me Sect. Saint-Michel\"  >4\u00e8me Sect. Saint-Michel<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_170' id='label_ff_13_dropdown_170' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_170\" id=\"ff_13_dropdown_170\" class=\"ff-el-form-control\" data-name=\"dropdown_170\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_170\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Petite-Rivi\u00e8re de Nippes\"  >Ville de Petite-Rivi\u00e8re de Nippes<\/option><option value=\"Quartier Charlier\"  >Quartier Charlier<\/option><option value=\"1\u00e8re Sect. Fond-des-Lianes\"  >1\u00e8re Sect. Fond-des-Lianes<\/option><option value=\"2\u00e8me Sect. Cholette\"  >2\u00e8me Sect. Cholette<\/option><option value=\"3\u00e8me Sect. Sil\u00e8gue\"  >3\u00e8me Sect. Sil\u00e8gue<\/option><option value=\"4\u00e8me Sect. B\u00e9zin\"  >4\u00e8me Sect. B\u00e9zin<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_171' id='label_ff_13_dropdown_171' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_171\" id=\"ff_13_dropdown_171\" class=\"ff-el-form-control\" data-name=\"dropdown_171\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_171\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Fonds-des-N\u00e8gres\"  >Ville de Fonds-des-N\u00e8gres<\/option><option value=\"Quartier Bouzi\"  >Quartier Bouzi<\/option><option value=\"1\u00e8re Sect. Bouzi\"  >1\u00e8re Sect. Bouzi<\/option><option value=\"2\u00e8me Sect. Fonds-des-N\u00e8gres ou Morne Brice\"  >2\u00e8me Sect. Fonds-des-N\u00e8gres ou Morne Brice<\/option><option value=\"3\u00e8me Sect. P\u00e9merie\"  >3\u00e8me Sect. P\u00e9merie<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_172' id='label_ff_13_dropdown_172' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_172\" id=\"ff_13_dropdown_172\" class=\"ff-el-form-control\" data-name=\"dropdown_172\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_172\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Paillant\"  >Ville de Paillant<\/option><option value=\"1\u00e8re Sect. Salagnac\"  >1\u00e8re Sect. Salagnac<\/option><option value=\"2\u00e8me Sect. B\u00e9zin II\"  >2\u00e8me Sect. B\u00e9zin II<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_173' id='label_ff_13_dropdown_173' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_173\" id=\"ff_13_dropdown_173\" class=\"ff-el-form-control\" data-name=\"dropdown_173\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_173\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Anse \u00e0 Veau\"  >Ville de l&rsquo;Anse \u00e0 Veau<\/option><option value=\"Quartier de Baconnois\"  >Quartier de Baconnois<\/option><option value=\"Quartier Saut du Baril\"  >Quartier Saut du Baril<\/option><option value=\"1\u00e8re Sect. Baconnois-Grand-Fond\"  >1\u00e8re Sect. Baconnois-Grand-Fond<\/option><option value=\"2\u00e8me Sect. Grande-Rivi\u00e8re-Joly\"  >2\u00e8me Sect. Grande-Rivi\u00e8re-Joly<\/option><option value=\"3\u00e8me Sect. Saut du Baril\"  >3\u00e8me Sect. Saut du Baril<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_174' id='label_ff_13_dropdown_174' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_174\" id=\"ff_13_dropdown_174\" class=\"ff-el-form-control\" data-name=\"dropdown_174\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_174\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Petit Trou de Nippes\"  >Ville de Petit Trou de Nippes<\/option><option value=\"Quartier de Grande-Ravine\"  >Quartier de Grande-Ravine<\/option><option value=\"Quartier Li\u266a8vre\"  >Quartier Li\u266a8vre<\/option><option value=\"1\u00e8re Sect. Raymond\"  >1\u00e8re Sect. Raymond<\/option><option value=\"2\u00e8me Sect. Tiby\"  >2\u00e8me Sect. Tiby<\/option><option value=\"3\u00e8me Sect. Li\u00e8vre\"  >3\u00e8me Sect. Li\u00e8vre<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_175' id='label_ff_13_dropdown_175' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_175\" id=\"ff_13_dropdown_175\" class=\"ff-el-form-control\" data-name=\"dropdown_175\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_175\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de l&#039;Asile\"  >Ville de l&rsquo;Asile<\/option><option value=\"Quartier Changieux\"  >Quartier Changieux<\/option><option value=\"Quartier Morisseau\"  >Quartier Morisseau<\/option><option value=\"1\u00e8re Section l&#039;Asile ou Nan Paul\"  >1\u00e8re Section l&rsquo;Asile ou Nan Paul<\/option><option value=\"2\u00e8me Section Changieux\"  >2\u00e8me Section Changieux<\/option><option value=\"3\u00e8me Sect. Tournade\"  >3\u00e8me Sect. Tournade<\/option><option value=\"4\u00e8me Sect. Morisseau\"  >4\u00e8me Sect. Morisseau<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_176' id='label_ff_13_dropdown_176' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_176\" id=\"ff_13_dropdown_176\" class=\"ff-el-form-control\" data-name=\"dropdown_176\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_176\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville d&#039;Arnaud\"  >Ville d&rsquo;Arnaud<\/option><option value=\"1\u00e8re Sect. Baconnois-Barreau\"  >1\u00e8re Sect. Baconnois-Barreau<\/option><option value=\"2\u00e8me Sect. Baquet\"  >2\u00e8me Sect. Baquet<\/option><option value=\"3\u00e8me Sect. Arnaud (Morcou)\"  >3\u00e8me Sect. Arnaud (Morcou)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_177' id='label_ff_13_dropdown_177' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_177\" id=\"ff_13_dropdown_177\" class=\"ff-el-form-control\" data-name=\"dropdown_177\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_177\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville des Barad\u00e8res\"  >Ville des Barad\u00e8res<\/option><option value=\"Quartier Fond-Tortue\"  >Quartier Fond-Tortue<\/option><option value=\"1\u00e8re Sect. G\u00e9rin ou Mouton\"  >1\u00e8re Sect. G\u00e9rin ou Mouton<\/option><option value=\"2\u00e8me Sect. T\u00eate d&#039;Eau\"  >2\u00e8me Sect. T\u00eate d&rsquo;Eau<\/option><option value=\"3\u00e8me Sect. Fond-Tortue\"  >3\u00e8me Sect. Fond-Tortue<\/option><option value=\"4\u00e8me Sect. La Plaine\"  >4\u00e8me Sect. La Plaine<\/option><option value=\"5\u00e8me Sect. Rivi\u00e8re Sal\u00e9e\"  >5\u00e8me Sect. Rivi\u00e8re Sal\u00e9e<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_178' id='label_ff_13_dropdown_178' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_178\" id=\"ff_13_dropdown_178\" class=\"ff-el-form-control\" data-name=\"dropdown_178\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_178\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Grand Boucan\"  >Ville de Grand Boucan<\/option><option value=\"Quartier Eaux Basses\"  >Quartier Eaux Basses<\/option><option value=\"1\u00e8re Sect. Grand Boucan\"  >1\u00e8re Sect. Grand Boucan<\/option><option value=\"2\u00e8me Sect. Eaux Basses\"  >2\u00e8me Sect. Eaux Basses<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_179' id='label_ff_13_dropdown_179' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_179\" id=\"ff_13_dropdown_179\" class=\"ff-el-form-control\" data-name=\"dropdown_179\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_179\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Ville de Plaisance du Sud\"  >Ville de Plaisance du Sud<\/option><option value=\"1\u00e8re Sect. Plaisance (ou Ti Fran\u00e7ois)\"  >1\u00e8re Sect. Plaisance (ou Ti Fran\u00e7ois)<\/option><option value=\"2\u00e8me Sect. Anse-aux-Pins\"  >2\u00e8me Sect. Anse-aux-Pins<\/option><option value=\"3\u00e8me Sect. Vassal Labiche (avec S\u00e9n\u00e9ac et Dupuy)\"  >3\u00e8me Sect. Vassal Labiche (avec S\u00e9n\u00e9ac et Dupuy)<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_180' id='label_ff_13_dropdown_180' aria-label=\"Section communale \/ ville \/ quartier\">Section communale \/ ville \/ quartier<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_180\" id=\"ff_13_dropdown_180\" class=\"ff-el-form-control\" data-name=\"dropdown_180\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_180\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"Pays Etrangers\"  >Pays Etrangers<\/option><\/select><\/div><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_8\" ><h2><p><img decoding=\"async\" src=\"https:\/\/img.icons8.com\/?size=30&amp;id=kDoeg22e5jUY&amp;format=png\" align=\"left\" \/><b>Parents<\/b><\/p><\/h2>\n<hr \/><\/div><div data-name=\"ff_cn_id_5\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"M\u00e8re Connue\">M\u00e8re Connue<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_c9f923f0e7e48b464747441557c6c0d4'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"OUI\"  id='input_radio_2_c9f923f0e7e48b464747441557c6c0d4' aria-label='OUI' aria-invalid='false' aria-required=true> <span>OUI<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_c6277a0aa5c599f5e94197ecd91153be'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"NON\"  id='input_radio_2_c6277a0aa5c599f5e94197ecd91153be' aria-label='NON' aria-invalid='false' aria-required=true> <span>NON<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text_3' id='label_ff_13_input_text_3' aria-label=\"Nom de la M\u00e8re\">Nom de la M\u00e8re<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_3\" class=\"ff-el-form-control\" data-name=\"input_text_3\" id=\"ff_13_input_text_3\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Statut M\u00e8re\">Statut M\u00e8re<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_ab45cb46952730cda1a63c6b20ae4594'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"D\u00e9c\u00e9d\u00e9e\"  id='input_radio_3_ab45cb46952730cda1a63c6b20ae4594' aria-label='D\u00e9c\u00e9d\u00e9e' aria-invalid='false' aria-required=true> <span>D\u00e9c\u00e9d\u00e9e<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_09c8c6f19408d5cf6079d67ab1de6485'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Vivante\"  id='input_radio_3_09c8c6f19408d5cf6079d67ab1de6485' aria-label='Vivante' aria-invalid='false' aria-required=true> <span>Vivante<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_181' id='label_ff_13_dropdown_181' aria-label=\"Occupation M\u00e8re\">Occupation M\u00e8re<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_181\" id=\"ff_13_dropdown_181\" class=\"ff-el-form-control\" data-name=\"dropdown_181\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_181\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"ADMINISTRATION PUBLIQUE\"  >ADMINISTRATION PUBLIQUE<\/option><option value=\"SECTEUR PRIVE\"  >SECTEUR PRIVE<\/option><option value=\"SECTEUR INFORMEL\"  >SECTEUR INFORMEL<\/option><option value=\"ENTREPRENEUR INDEPENDANT\"  >ENTREPRENEUR INDEPENDANT<\/option><option value=\"CULTIVATEUR\"  >CULTIVATEUR<\/option><option value=\"OUVRIER AGRICOLE\"  >OUVRIER AGRICOLE<\/option><option value=\"TECHNICIEN\"  >TECHNICIEN<\/option><option value=\"CADRE\"  >CADRE<\/option><option value=\"AUTRES\"  >AUTRES<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"P\u00e8re Connu\">P\u00e8re Connu<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_f6fc4eef49d916effc9321a5534b2800'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"OUI\"  id='input_radio_4_f6fc4eef49d916effc9321a5534b2800' aria-label='OUI' aria-invalid='false' aria-required=true> <span>OUI<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_0689682366ae8051c9612788121d06c5'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"NON\"  id='input_radio_4_0689682366ae8051c9612788121d06c5' aria-label='NON' aria-invalid='false' aria-required=true> <span>NON<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text_4' id='label_ff_13_input_text_4' aria-label=\"Nom du P\u00e8re\">Nom du P\u00e8re<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_4\" class=\"ff-el-form-control\" data-name=\"input_text_4\" id=\"ff_13_input_text_4\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Statut P\u00e8re\">Statut P\u00e8re<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5_dc41a8d2bb8933ad25f4a60188e74288'><input  type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"D\u00e9c\u00e9d\u00e9e\"  id='input_radio_5_dc41a8d2bb8933ad25f4a60188e74288' aria-label='D\u00e9c\u00e9d\u00e9e' aria-invalid='false' aria-required=true> <span>D\u00e9c\u00e9d\u00e9e<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5_42d8f3909cf00f1ef13d3f6e356ca761'><input  type=\"radio\" name=\"input_radio_5\" data-name=\"input_radio_5\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Vivante\"  id='input_radio_5_42d8f3909cf00f1ef13d3f6e356ca761' aria-label='Vivante' aria-invalid='false' aria-required=true> <span>Vivante<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_182' id='label_ff_13_dropdown_182' aria-label=\"Occupation\">Occupation<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_182\" id=\"ff_13_dropdown_182\" class=\"ff-el-form-control\" data-name=\"dropdown_182\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_182\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"ADMINISTRATION PUBLIQUE\"  >ADMINISTRATION PUBLIQUE<\/option><option value=\"SECTEUR PRIVE\"  >SECTEUR PRIVE<\/option><option value=\"SECTEUR INFORMEL\"  >SECTEUR INFORMEL<\/option><option value=\"ENTREPRENEUR INDEPENDANT\"  >ENTREPRENEUR INDEPENDANT<\/option><option value=\"CULTIVATEUR\"  >CULTIVATEUR<\/option><option value=\"OUVRIER AGRICOLE\"  >OUVRIER AGRICOLE<\/option><option value=\"TECHNICIEN\"  >TECHNICIEN<\/option><option value=\"CADRE\"  >CADRE<\/option><option value=\"AUTRES\"  >AUTRES<\/option><\/select><\/div><\/div><\/div><\/div><div class='ff-el-group  ff-custom_html' tabindex='-1' data-name=\"custom_html-13_9\" ><h2><p><img decoding=\"async\" src=\"https:\/\/img.icons8.com\/?size=30&amp;id=kDoeg22e5jUY&amp;format=png\" align=\"left\" \/><b>Personne responsable<\/b><\/p><\/h2>\n<hr \/><\/div><div data-name=\"ff_cn_id_6\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group ff-el-form-left'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_dropdown_183' id='label_ff_13_dropdown_183' aria-label=\"Lien de parent\u00e9\">Lien de parent\u00e9<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_183\" id=\"ff_13_dropdown_183\" class=\"ff-el-form-control\" data-name=\"dropdown_183\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_13_dropdown_183\"><option value=\"\">&#8211; Selectionner &#8211;<\/option><option value=\"P\u00e8re\"  >P\u00e8re<\/option><option value=\"M\u00e8re\"  >M\u00e8re<\/option><option value=\"Cousin\"  >Cousin<\/option><option value=\"Tante\"  >Tante<\/option><option value=\"Oncle\"  >Oncle<\/option><option value=\"Fr\u00e8re\"  >Fr\u00e8re<\/option><option value=\"Soeur\"  >Soeur<\/option><option value=\"Autre\"  >Autre<\/option><\/select><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text_6' id='label_ff_13_input_text_6' aria-label=\"Nom\">Nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_6\" class=\"ff-el-form-control\" placeholder=\"Nom du responsable\" data-name=\"input_text_6\" id=\"ff_13_input_text_6\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_13_input_text_7' id='label_ff_13_input_text_7' aria-label=\"Pr\u00e9nom\">Pr\u00e9nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_7\" class=\"ff-el-form-control\" placeholder=\"Pr\u00e9nom du responsable\" data-name=\"input_text_7\" id=\"ff_13_input_text_7\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group ff-el-form-left'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Num\u00e9ro\">Num\u00e9ro<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6082f7024db03871b030623217e99966'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"NIF\"  id='checkbox_6082f7024db03871b030623217e99966' aria-label='NIF' aria-invalid='false' aria-required=true> <span>NIF<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6cf8f3e5e50823e4c8c7597046eb6bd6'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"NINU\"  id='checkbox_6cf8f3e5e50823e4c8c7597046eb6bd6' aria-label='NINU' aria-invalid='false' aria-required=true> <span>NINU<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group has-conditions'><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field\" id=\"ff_13_numeric-field\" class=\"ff-el-form-control\" placeholder=\"NIF\" data-name=\"numeric-field\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group has-conditions'><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_1\" id=\"ff_13_numeric-field_1\" class=\"ff-el-form-control\" placeholder=\"NINU\" data-name=\"numeric-field_1\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_13_email_1' id='label_ff_13_email_1' aria-label=\"E-mail\">E-mail<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email_1\" id=\"ff_13_email_1\" class=\"ff-el-form-control\" data-name=\"email_1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group'><div class='ff-el-input--content'><div class=\"ff_input-group\"><div class=\"ff_input-group-prepend\"><span class=\"ff_input-group-text\">+509<\/span><\/div><input type=\"number\" name=\"numeric-field_2\" id=\"ff_13_numeric-field_2\" class=\"ff-el-form-control\" placeholder=\"T\u00e9l\u00e9phone\" data-name=\"numeric-field_2\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-el-group'><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_3\" id=\"ff_13_numeric-field_3\" class=\"ff-el-form-control\" placeholder=\"T\u00e9l\u00e9phone additionel\" data-name=\"numeric-field_3\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-el-group    ff-el-input--content'><div class='ff-el-form-check ff-el-tc'><label aria-label='\u00a0 J&#039;ACCEPTE que mes donn\u00e9es soient utilis\u00e9es dans le cadre du processus de d\u00e9claration des \u00e9coles, \u00e9l\u00e8ves et enseignants lanc\u00e9 par le Minist\u00e8re de l&#039;\u00c9ducation Nationale et de la Formation Professionnelle et qu&#039;elles soient trait\u00e9es \u00e0 caract\u00e8re personnel de mani\u00e8re confidentielle en soumettant ce formulaire. (Veuillez cocher la case si acceptation!)' class='ff-el-form-check-label ff_tc_label' for=terms-n-condition_bb4affc5119cc51e8793f96186ceeb4d><span class='ff_tc_checkbox'><input type=\"checkbox\" name=\"terms-n-condition\" class=\"ff-el-form-check-input\" data-name=\"terms-n-condition\" id=\"terms-n-condition_bb4affc5119cc51e8793f96186ceeb4d\"  value='on' aria-invalid='false' aria-required=false><\/span> <div class='ff_t_c'><p style=\"text-align: left;font-size: 15px\"><strong>\u00a0 J&rsquo;ACCEPTE <\/strong>que mes donn\u00e9es soient utilis\u00e9es dans le cadre du processus de d\u00e9claration des \u00e9coles, \u00e9l\u00e8ves et enseignants lanc\u00e9 par le Minist\u00e8re de l&rsquo;\u00c9ducation Nationale et de la Formation Professionnelle et qu&rsquo;elles soient trait\u00e9es \u00e0 caract\u00e8re personnel de mani\u00e8re confidentielle en soumettant ce formulaire. <br \/><em>(Veuillez cocher la case si acceptation!)<\/em><\/p><\/div><\/label><\/div><\/div><div 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