document.write("<br /><form method='post' action='traitement/voter.php'><input type='hidden' name='lid_sondage' value='70540'><table border='0' cellpadding='2' cellspacing='0' width='500'><tr><td align='left' colspan='2' class='fond_question_sondage'><b>Quel age avez vous?</b></td></tr><tr><td align='center' width='30'><input type='radio' name='reponse_sondage' value='198138' checked  style='width: 18px; background-color: none; background: none; border: none' id='chval_sond198138'></td><td align='left' width='470'><label for='chval_sond198138'>Moin de 10 ans</label></td></tr><tr><td align='center' width='30'><input type='radio' name='reponse_sondage' value='198139' style='width: 18px; background-color: none; background: none; border: none' id='chval_sond198139'></td><td align='left' width='470'><label for='chval_sond198139'>10 ans</label></td></tr><tr><td align='center' width='30'><input type='radio' name='reponse_sondage' value='198140' style='width: 18px; background-color: none; background: none; border: none' id='chval_sond198140'></td><td align='left' width='470'><label for='chval_sond198140'>Entre 11 et 16</label></td></tr><tr><td align='center' width='30'><input type='radio' name='reponse_sondage' value='198141' style='width: 18px; background-color: none; background: none; border: none' id='chval_sond198141'></td><td align='left' width='470'><label for='chval_sond198141'>Entre 16 et 20 ans</label></td></tr><tr><td align='center' width='30'><input type='radio' name='reponse_sondage' value='198142' style='width: 18px; background-color: none; background: none; border: none' id='chval_sond198142'></td><td align='left' width='470'><label for='chval_sond198142'>Plus de 20 ans</label></td></tr><tr><td align='left' colspan='2' class='fond_question_sondage' height='10'></td></tr><tr><td align='center' colspan='2'><input type='submit' name='voter_sondage' value='Valider' class='bouton_normal' onmouseover='this.className='bouton_enfonce';' onmouseout='this.className='bouton_normal';' /> &nbsp; &nbsp; &nbsp; <input type='button' name='histo_sond' value='Historique' onclick=JavaScript:window.open('./designs/design2/include/historique_sondages.php?lnb_hist=85699&co=10','','width=550,height=400,left=0,top=0,scrollbars=yes,resizable=yes');></td></tr></table></form><br />");