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wmdeit_kaform/ka.php

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<!doctype html>
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<?php
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$lang=$_GET['lang'];
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if ( in_array ($lang, array('en_US'))){
$loc = "$lang".".utf8";
$loc1 = $lang;
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}
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else
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$loc = "de_DE";
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$domain = "messages";
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setlocale(LC_MESSAGES, $loc);
setlocale(LC_ALL, $loc);
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$results = putenv("LC_ALL=$loc");
$results = putenv("LC_MESSAGES=$loc");
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$results = bindtextdomain($domain,"./locale");
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?>
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<html >
<head>
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<title>Kostenerstattungsformular</title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
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<!-- Kube CSS -->
<link rel="stylesheet" href="css/kube.min.css">
<link rel="stylesheet" href="addons/kube-addons.min.css" />
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<link rel="stylesheet" href="master.css" />
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</head>
<body>
<div class="page is-container">
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<div class="main-sidebar">
<img alt="wikimedia logo" src="Wikimedia_Deutschland-Logo.svg"/>
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</div>
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<div class="main-content">
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<h1>
<?php echo _( "Antrag auf Kostenerstattung")?>
</h1>
<p>
<?php echo _("Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines Projektes entstanden sind?")?><BR>
<?php echo _("Bitte fülle dieses Formular aus. Pflichtfelder sind mit einem * gekennzeichnet.")?>
</p>
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<form data-kube="kaform" name="theform" id="theform" action="submit.php" method="POST">
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<div class="is-row">
<div class="is-col is-70">
<fieldset>
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<legend><?php echo _("1. Erfasse deine Stammdaten")?></legend>
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<div class="is-row">
<div class="is-col">
<input required type="input"
size="32" id="projectid" name="project"
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placeholder="<?php echo _("Projekt/Zweck der Reise*")?>" />
</div>
</div>
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<br>
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<div class="is-row">
<div class="is-col">
<input required type="input" size="32"
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` id="realname" name="realname" placeholder="<?php echo _("Dein Realname (Vorname Nachname)*")?>" />
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</div>
<div class="is-col">
<input type="input" size="32"
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` id="wmdecontact" name="wmdecontact"
placeholder="<?= _("Deine Ansprechperson bei Wikimedia")?>" />
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</div>
</div>
<br>
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<div class="is-row">
<div class="is-col">
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<input type="tel" size="32"
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id="phone" name="phone"
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placeholder="<?= _("Deine Telefonnummer")?>" />
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</div>
<div class="is-col">
</div>
</div>
<br>
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<div class="is-row">
<div class="is-col">
<input required type="email" size="32" id="email"
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name="email" placeholder="<?= _("Deine E-Mail-Adresse*")?>" />
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</div>
<div class="is-col">
</div>
</div>
<br>
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<div class="is-row">
<div class="is-col">
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<nav class="tabs" data-kube="tabs" data-equal="false">
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<a href="#bank-eu" class="is-active"><?=_("Banküberweisung")?></a>
<a href="#bank-noneu"><?=_("Banküberweisung (Non-EU)")?></a>
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<!-- <a href="#bank-paypal">PayPal</a>
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<a href="#bank-bar">Barauszahlung</a>
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--> </nav>
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<section id="bank-eu">
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<div class="is-row">
<div class="is-col">
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<input type="input" size="32" name="Owner" placeholder="<?=_("Kontoinhabende Person")?>" />
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</div>
<div class="is-col">
</div>
</div>
<br>
<div class="is-row">
<div class="is-col">
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<input type="input" size="32" id="iban" name="iban" placeholder="<?=_("IBAN*")?>" />
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</div>
<div class="is-col">
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<input type="input" size="32" id="bic" name="bic" placeholder="<?=_("BIC (wenn ausländische Bank)")?>" />
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</div>
</div>
<br>
<!-- <input type="input" size="32" id="purpose" name="purpose" placeholder="Verwendungszweck" /> -->
<textarea id="comments" name="comments"
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style="resize:both;" cols="32" rows="4"
placeholder="<?=_("Weitere Anmerkungen z.B. intermediäre Bank, Grund für abweichende Kontoinhbende Person")?>">
</textarea >
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</section>
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<section id="bank-noneu">
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<div class="is-row">
<div class="is-col">
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<input type="input" size="32" name="Owner" placeholder="<?=_("Kontoinhabende Person")?>" />
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</div>
<div class="is-col">
</div>
</div>
<br>
<div class="is-row">
<div class="is-col">
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<input type="input" size="32" id="n_iban" name="n_iban" placeholder="<?=_("Kontonummer*")?>" />
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</div>
<div class="is-col">
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<input type="input" size="32" id="n_bic" name="n_bic" placeholder="<?=_("BIC/SWIFT*")?>" />
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</div>
</div>
<br>
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<input class="EU nonEU" type="input" size="32" id="n_bank" name="n_bankname" placeholder="<?="Name der Bank*"?>" />
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<br>
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<textarea class="nonEU" name="n_bankaddress" id="n_bankaddress" style="resize:both;" cols="32" rows="4"
placeholder="<?=_("Adresse der Bank (Stra&szlig;e und Hausnummer/Postleitzahl/Land)")?>"></textarea>
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<br>
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<textarea name="n_address" lang="de" class="nonEU" id="n_address" style="resize:both;" cols="32" rows="4"
placeholder="<?=_("Deine Anschrift (Srta&szlig;e und Hausnummer/Postleitzahl/Land)")?>">
</textarea>
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<br>
<!-- <input type="input" size="32" id="n_purpose" name="n_purpose" placeholder="Verwendungszweck" /> -->
<textarea id="n_comments" name="n_comments"
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style="resize:both;" cols="32" rows="4"
placeholder="<?=_("Weitere Anmerkungen z.B. intermediäre Bank,Grund für abweichende kontoinhabende Person")?>">
</textarea>
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</section>
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<!-- <section id="bank-paypal">
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<input name="paypal" type="input" size="32"
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id="paypal" placeholder="Dein PayPal Account (paypal@example.com)" />
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</section> -->
<!-- <section id="bank-bar">
</section> -->
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</div> <!-- i-col -->
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</div> <!-- is-row -->
</fieldset>
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</div>
<div class="is-col ">
<?php
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$ct = @file_get_contents( "./locale/$loc1/h1.php");
if ($ct==false)
$ct = file_get_contents( "h1.php");
echo $ct;
?>
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</div>
</div> <!-- is row -->
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<br>
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<div class="is-row">
<div class="is-col is-70">
<fieldset id="fieldset2">
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<legend><?=_("2. Erfasse deine Ausgaben")?></legend>
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<div class="is-col is-70">
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<?=_("Währung:")?>
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</div>
<div class="is-col is-20">
<select onchange="renumberTableRows()" id="currency" >
<option value="EUR">EUR</option>
<option value="CHF">CHF</option>
<option value="GBP">GBP</option>
<option value="USD">USD</option>
<option value="AUD">AUD</option>
<option value="BGN">BGN</option>
<option value="BRL">BRL</option>
<option value="CAD">CAD</option>
<option value="CNY">CNY</option>
<option value="CZK">CZK</option>
<option value="DKK">DKK</option>
<option value="HKD">HKD</option>
<option value="HUF">HUF</option>
<option value="IDR">IDR</option>
<option value="ILS">ILS</option>
<option value="INR">INR</option>
<option value="ISK">ISK</option>
<option value="JPY">JPY</option>
<option value="KRW">KRW</option>
<option value="MXN">MXN</option>
<option value="MYR">MYR</option>
<option value="NOK">NOK</option>
<option value="NZD">NZD</option>
<option value="PHP">PHP</option>
<option value="PLN">PLN</option>
<option value="RON">RON</option>
<option value="SEK">SEK</option>
<option value="SGD">SGD</option>
<option value="THB">THB</option>
<option value="TRY">TRY</option>
<option value="ZAR">ZAR</option>
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</select>
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</div>
<table id="tabtab" class="is-bordered is-striped">
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<thead>
<tr>
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<th><?=_("Pos.")?></th>
<th><?=_("Datum")?></th>
<th><?=_("Beschreibung")?></th>
<th><?=_("Betrag")?></th>
<th><?=_("Währung")?></th>
<th><?=_("Belege")?></th>
<th><?=_("L&ouml;schen")?></th>
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</tr>
</thead>
<tbody id="tabbody">
</tbody>
</table>
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<div class="is-col">
<button id="add_issue" type="button" onclick="addRow();"
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class="button is-green"><?=_("Ausgabe hinzuf&uuml;gen")?></button>
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</div>
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</fieldset>
<br>
<fieldset>
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<legend><?=_("3. Vorschuss und Sonstiges")?></legend>
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<div class="is-row">
<div class="is-col valign="center"">
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<?=_("Ich habe bereits einen Vorschuss erhalten in H&ouml;he von:")?>
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</div>
<div class="is-col">
<input input name="advance" id="advance" type="text" placeholder="0,00 EUR"/>
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</div>
</div>
<br>
<div class="is-row">
<div class="is-col valign="center"">
<?=_("Hiermit bestätige ich die Vollständig- und Richtigkeit meiner Angaben:")?>*
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</div>
<div class="is-col">
<input id="agree" type="checkbox" />
</div>
</div>
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</fieldset>
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<button type="button" onclick="downloadDocument(true);"
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class="button is-green"><?=_("Antrag elektronisch direkt an WMDE schicken")?></button>
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<button type="button" onclick="downloadDocument(false);"
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class="button is-orange"><?=_("Antrag herunterladen und später einreichen")?></button>
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</div>
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<div class="is-col">
<?php
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$ct = @file_get_contents( "./locale/$loc1/h2.php");
if ($ct==false)
$ct = file_get_contents( "h2.php");
echo $ct;
?>
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</div>
</div>
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</div>
</div>
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<input type="hidden" id="banktype" name="banktype"/>
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<input type="hidden" id="sendmail" name="sendmail"/>
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<!-- <input type="submit" style="display:none" name="submitButton" /> -->
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</form>
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<!-- Kube JS (optional if you are using Kube CSS only) -->
<script src="js/kube.min.js"></script>
<script src="addons/upload/kube.upload.min.js"></script>
<script src="addons/kube-addons.min.js"></script>
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<script src="iban.js/iban.js"></script>
<script src="js/kaform.js"></script>
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</div>
</div>
</body>
</html>