document.write('<form action="annuaire_recherche.php" method="get" name="RechercheAdresse" id="RechercheAdresse">');
document.write('Mot cl&eacute;s : ');
document.write('<input name="q" type="text" id="q" size="22">'); 
document.write('dans'); 
document.write('<select name="w" id="w">');
document.write('<option value="keyword">Mots cl&eacute;s</option>');
document.write('<option value="rue">Adresse</option>');
document.write('<option value="ville">Localit&eacute;</option>');
document.write('<option value="nom">Nom de la soci&eacute;t&eacute;</option>');
document.write('<option value="nom_prenom">Propri&eacute;taire</option>');
document.write('</select>');
document.write('<input type="button" name="Submit" value="Recherche" onClick="document.RechercheAdresse.submit();">');
document.write('</form>');