1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
<form id="coop_validation_form" lang="fr" autocomplete="off">
<div class="data">
{% if ask_for_sex %}
<p>
{% include "members/sex_input.html" %}
</p>
{% endif %}
<p>
<input name="lastname" required class="b_yellow" placeholder="Nom" autocomplete="address-level4"/> <!--different autocomplete value to disable chrome-->
<input name="firstname" required class="b_yellow" placeholder="Prénom" autocomplete="address-level4" />
<input name="birthdate" placeholder="jj/mm/aaaa (naissance)" class="b_green" autocomplete="address-level4"/>
</p>
<p>
<input name="address" placeholder="Adresse" class="b_green" type="text" autocomplete="address-level4" />
{% if ask_for_street2 %}
<input name="street2" placeholder="Complément d'adresse" class="b_green" type="text" autocomplete="address-level4" />
{% endif %}
</p>
<p>
<input name="zip" placeholder="Code postal" class="b_green" autocomplete="address-level4"/>
<input name="city" placeholder="Ville" class="b_green" autocomplete="address-level4"/>
<input name="country" placeholder="Pays" class="b_yellow" autocomplete="address-level4"/>
<span class="phone-wrapper{% if ask_for_second_phone %}-2{% endif %}">
<input type="tel" name="mobile" placeholder="Tél. mobile" class="b_green" pattern="{{input_phone_pattern}}" autocomplete="address-level4"/>
{% if ask_for_second_phone %}
<input type="tel" name="phone" placeholder="Tél. fixe" class="b_green" pattern="{{input_phone_pattern}}" autocomplete="address-level4"/>
{% endif %}
</span>
</p>
<p>
<input name="email" size="49" required class="b_yellow" pattern="(?:[a-z0-9!#$%&'*+/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&'*+/=?^_`{|}~-]+)*|(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21\x23-\x5b\x5d-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])*)@(?:(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?|\[(?:(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?)\.){3}(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?|[a-z0-9-]*[a-z0-9]:(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21-\x5a\x53-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])+)\])" placeholder="email" autocomplete="address-level4"/>
<span id="choosen_shift"> Créneau : <input name="week" disabled="disabled" autocomplete="address-level4"/> <input name="day" disabled="disabled" autocomplete="address-level4"/> <input name="hour" disabled="disabled" autocomplete="address-level4"/> <input name="place" disabled="disabled" autocomplete="address-level4"/> <input name="ftop" disabled="disabled" value="Volant" autocomplete="address-level4"/>
<a id="change_shift_template" class="btn--primary">Changer</a>
</span>
</p>
<p>
<input type="number" step="1" min="1" placeholder="Nombre de parts" name="shares_nb" id="shares_nb" class="b_yellow" required disabled/>
<label for="shares_nb">Parts sociales</label>
<input type="number" step="10" min="10" placeholder="Montant souscription" name="shares_euros" id="shares_euros" class="b_yellow" required disabled/>
<label for="shares_euros">Euros</label>
</p>
<p>
<label for="payment_meaning">Payé en </label>
<select name="payment_meaning" id="payment_meaning" required disabled>
<option value="">Moyen de paiement</option>
{% for pm in payment_meanings %}
<option value="{{pm.code}}">{{pm.title}}</option>
{% endfor %}
</select>
<label for="checks_nb" id="checks_nb_label" style="display:none;">Nombre de chèque(s)</label>
<input type="number" min="0" name="checks_nb" id="checks_nb" class="b_yellow" style="display:none;" disabled/>
</p>
<div id="checks" class="main" style="display:none;">
<p>Saisie des chèques</p>
<div class="check_details">
</div>
</div>
{% if input_barcode %}
<p>
<input type="text" name="m_barcode" id="m_barcode" disabled/>
</p>
{% endif %}
<div id="associated_member">
En binôme avec : <span id ="associated_member_name"></span>
</div>
</div>
<p class="buttons">
<button class="btn--success" name="valider">Tout est bon</button>
-- OU --
<a class="btn--danger" name="signaler">Signaler un problème</a>
</p>
</form>