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aem_monespace/monaem/templates/inscriptions/passr_cde.pt
2023-06-22 10:26:17 +02:00

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<metal:block use-macro="main_template">
<div metal:fill-slot="content">
<div class="alert alert-danger" tal:condition="message" tal:content="message" />
<div class="row">
<br />
<p>Je minscris au <b>PASS ROUSSEAU</b> pour un montant de <b>${layout.to_euro(montant)}</b>.</p>
<br />
<form id="sinscrire-form" action="${url}" role="form" method="post" class="form-horizontal"
data-fv-framework="bootstrap"
data-fv-icon-valid="glyphicon glyphicon-ok"
data-fv-icon-invalid="glyphicon glyphicon-remove"
data-fv-icon-validating="glyphicon glyphicon-refresh">
<div class="form-group">
<label class="col-xs-4 control-label" for="civilite">Civilité</label>
<div class="col-xs-8">
<select class="form-control" id="civilite" name="civilite">
<tal:block tal:repeat="item civilites">
<option value="${item}" tal:attributes="selected item == civilite and 'selected' or None">${item}</option>
</tal:block>
</select>
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="nom">Nom</label>
<div class="col-xs-8">
<input class="form-control" type="text" id="nom" name="nom" value="${nom}" placeholder="Votre nom"
data-fv-notempty="true"
data-fv-notempty-message="Le nom est obligatoire"
data-fv-stringlength="true"
data-fv-stringlength-max="30"
data-fv-stringlength-message="34 caractères maximum" />
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="prenom">Prénom(s)</label>
<div class="col-xs-8">
<input class="form-control" type="text" id="prenom" name="prenom" value="${prenom}"
placeholder="tel(s) quindiqué(s) sur votre pièce didentité"
data-fv-notempty="true"
data-fv-notempty-message="Le prénom est obligatoire"
data-fv-stringlength="true"
data-fv-stringlength-max="37"
data-fv-stringlength-message="37 caractères maximum" />
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="date_nais">Date de naissance</label>
<div class="col-xs-8">
<input class="form-control" type="text" id="date_nais" name="date_nais" value="${date_nais}" placeholder="JJ/MM/AAAA"
data-fv-notempty="true"
data-fv-notempty-message="La date de naissance est obligatoire"
data-fv-date="true"
data-fv-date-format="DD/MM/YYYY"
data-fv-date-message="La date de naissance n'est pas valide (JJ/MM/AAAA)" />
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="codpost">Code postal</label>
<div class="col-xs-8">
<input class="form-control" type="text" id="codpost" name="codpost" value="${codpost}"
data-fv-notempty="true"
data-fv-notempty-message="Le code postal est obligatoire"
data-fv-stringlength="true"
data-fv-stringlength-max="5"
data-fv-stringlength-message="5 caractères maximum" />
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="no_tel_dom">Téléphone</label>
<div class="col-xs-8">
<input class="form-control phoneNumber" type="text" id="no_tel_dom" name="no_tel_dom" value="${no_tel_dom}"
data-fv-notempty="true"
data-fv-notempty-message="Le numéro de téléphone est obligatoire"
data-fv-phone="true"
data-fv-phone-country="FR"
data-fv-phone-message="Ce numéro de téléphone n'est pas vailde" />
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="mail">Email</label>
<div class="col-xs-8">
<input class="form-control" type="text" id="mail" name="mail" value="${mail}"
data-fv-notempty="true"
data-fv-notempty-message="L'adresse email est obligatoire"
data-fv-emailaddress="true"
data-fv-emailaddress-message="L'adresse email n'est pas valide" />
</div>
</div>
<div class="form-group">
<label class="col-xs-4 control-label" for="permis_demande">Permis souhaité</label>
<div class="col-xs-8">
<select class="form-control" id="permis_demande" name="permis_demande">
<tal:block tal:repeat="item permis">
<option value="${item.CAT}" tal:attributes="selected item.CAT == permis_demande and 'selected' or None">${item.CAT} | ${item.LIB}</option>
</tal:block>
</select>
</div>
</div>
<!-- case a cocher "Acceptation des infos" -->
<div class="form-group">
<div class="col-xs-offset-1 col-xs-7">
<div class="checkbox">
<input type="checkbox" name="cb_spam" value="cb_spam" id="cb_spam"
tal:attributes="checked cb_spam == 'oui' and 'checked' or None">
J'accepte de recevoir des informations et offres commerciales éventuelles liées à la sécurité routière.</input>
</div>
</div>
</div>
<!-- case a cocher "Acceptation des CGI" -->
<div class="form-group">
<div class="col-xs-offset-1 col-xs-11">
<div class="checkbox">
<input type="checkbox" name="cb_cgv" id="cb_cgv" class="styled">
En cochant cette case, je reconnais avoir lu et accepté les <a href="/faq_view/2765" target="_blank">Conditions Générales de Vente ci-après</a>
et je valide mon inscription par mon règlement.
</input>
</div>
</div>
</div>
<div class="form-group">
<div class="col-xs-offset-4 col-xs-8">
<button class="btn btn-primary" type="submit" name="form.submitted">
<span class="glyphicon glyphicon-ok"></span>&nbsp;Enregistrer et régler l'inscription</button>
</div>
</div>
</form>
<br />
</div>
<script>
$(document).ready(function() {
// validate the form
$('#sinscrire-form').formValidation({
framework: 'bootstrap',
fields: {
cb_cgv: {
validators: {
notEmpty: {
message: 'Veuillez accepter les Conditions Générales de Vente pour continuer.'
}
}
},
}
})
.find('[name="date_nais"]').mask('00/00/0000');
});
</script>
</div>
</metal:block>