forked from tohe/wmdeit_kaform
323 lines
8.6 KiB
PHP
323 lines
8.6 KiB
PHP
<!doctype html>
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<html >
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<head>
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<title>Kostenerstattungsforumlar</title>
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<meta charset="utf-8">
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<meta name="viewport" content="width=device-width, initial-scale=1">
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<!-- Kube CSS -->
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<link rel="stylesheet" href="css/kube.min.css">
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<link rel="stylesheet" href="addons/kube-addons.min.css" />
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<link rel="stylesheet" href="master.css" />
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</head>
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<body>
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<div class="page is-container">
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<div class="main-sidebar">
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<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>Antrag auf Kostenerstattung</h1>
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<p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines
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Projektes entstanden sind?<BR>
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Bitte fülle dieses Formular aus.
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Pflichtfelder sind mit einem * gekennzeichnet.
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</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">
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<div class="is-col is-70">
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<fieldset>
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<legend>1. Erfasse deine Stammdaten</legend>
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<div class="is-row">
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<div class="is-col">
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<input required type="input"
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size="32" id="projectid" name="project"
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placeholder="Projekt/Zweck der Reise*" />
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</div>
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</div>
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<!-- <div class="is-row">
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<div class="is-col">
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<input required type="input"
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size="32" id="nickname" name="nickname"
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placeholder="Nickname*" />
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</div>
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<div class="is-col">
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<input required type="input"
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size="32" id="projectid" name="project"
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placeholder="Projekt-ID*" />
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</div>
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</div>
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--> <br>
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<div class="is-row">
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<div class="is-col">
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<input required type="input" size="32"
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` id="realname" name="realname" placeholder="Dein Realname (Vorname Nachname)*" />
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</div>
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<div class="is-col">
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<input required type="input" size="32"
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` id="wmdecontact" name="wmdecontact" placeholder="Deine Ansprechperson bei Wikimedia*" />
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</div>
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</div>
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<br>
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<div class="is-row">
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<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>
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<div class="is-col">
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</div>
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</div>
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<br>
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<div class="is-row">
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<div class="is-col">
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<input required type="email" size="32" id="email"
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name="email" placeholder="Deine E-Mail-Adresse*" />
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</div>
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<div class="is-col">
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</div>
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</div>
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<br>
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<div class="is-row">
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<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>
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<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">
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<div class="is-col">
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<input type="input" size="32" name="Owner" placeholder="Kontoinhabende Person" />
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</div>
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<div class="is-col">
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</div>
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</div>
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<br>
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<div class="is-row">
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<div class="is-col">
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<input type="input" size="32" id="iban" name="iban" placeholder="IBAN*" />
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</div>
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<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>
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</div>
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<br>
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<!-- <input type="input" size="32" id="purpose" name="purpose" placeholder="Verwendungszweck" /> -->
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<textarea id="comments" name="comments"
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style="resize:both;" cols="32" rows="4" placeholder="Weitere Anmerkungen
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z.B. intermediäre Bank,
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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">
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<div class="is-col">
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<input type="input" size="32" name="Owner" placeholder="Kontoinhabende Person" />
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</div>
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<div class="is-col">
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</div>
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</div>
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<br>
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<div class="is-row">
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<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>
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<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>
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</div>
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<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 (Straße 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 (Srtaße und Hausnummer/Postleitzahl/Land)
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"></textarea>
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<br>
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<!-- <input type="input" size="32" id="n_purpose" name="n_purpose" placeholder="Verwendungszweck" /> -->
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<textarea id="n_comments" name="n_comments"
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style="resize:both;" cols="32" rows="4" placeholder="Weitere Anmerkungen
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z.B. intermediäre Bank,
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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> -->
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<!-- <section id="bank-bar">
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</section> -->
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</div> <!-- i-col -->
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</div> <!-- is-row -->
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</fieldset>
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</div>
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<div class="is-col ">
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<?php include "h1.php"; ?>
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</div>
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</div> <!-- is row -->
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<br>
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<div class="is-row">
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<div class="is-col is-70">
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<fieldset id="fieldset2">
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<legend>2. Erfasse deine Ausgaben</legend>
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<div class="is-row">
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<div class="is-col is-70">
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<div class="is-row">
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<div class="is-col is-60">
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<input id="a_date" type="date" name="a_date" placeholder="Datum*"/>
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<!-- <input id="a_type" type="text" name="type" placeholder="Auslagenart*"/> -->
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</div>
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<div class="is-col is-40">
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</div>
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</div>
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<br>
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<input id="a_description" type="text" name="description" placeholder="Beschreibung*"/>
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<br>
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<div class="is-row">
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<div class="is-col">
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<input id="a_amount" type="text" name="amount" placeholder="Betrag*"/>
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</div>
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<div class="is-col">
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<select disabled id="a_currency" name="currency" >
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<option value="EUR">EUR</option>
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<option value="USD">USD</option>
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<option value="CHF">CHF</option>
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<option value="BTC">BTC</option>
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</select>
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<!-- <input id="a_currency" type="text" name="curreny" placeholder="Waehrung*"/> -->
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</div>
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<div class="is-col">
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<button type="button" onclick="addTableRow();"
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class="button is-green">Ausgabe hinzufügen</button>
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</div>
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</div>
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</div>
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<div class="is-col is-30">
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<div id="uploadfield" class="form-item">
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</div>
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</div>
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</div>
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<br>
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<table id="tabtab" class="is-bordered is-striped">
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<thead>
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<tr>
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<!-- <th>Auslagenart</th>-->
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<th>Datum</th>
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<th>Beschreibung</th>
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<th>Betrag</th>
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<th>Währung</th>
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<th>Löschen</th>
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</tr>
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</thead>
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<tbody id="tabbody">
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</tbody>
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</table>
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</fieldset>
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<br>
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<fieldset>
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<legend>3. Vorschuss und Sonstiges</legend>
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<div class="is-row">
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<div class="is-col valign="center"">
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Ich habe bereits einen Vorschuss erhalten in
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Höhe von:
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</div>
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<div class="is-col">
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<input input name="advance" id="advance" type="text" placeholder="0,00 EUR"/>
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</div>
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</div>
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<br>
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<div class="is-row">
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<div class="is-col valign="center"">
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Ich versichere, dass ich alle Angaben
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nach bestem Wissen und Gewissen gemacht habe:
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</div>
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<div class="is-col">
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<input id="agree" type="checkbox" />
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</div>
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</div>
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</fieldset>
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</div>
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<div class="is-col">
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<?php include "h2.php"; ?>
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</div>
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</div>
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<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>
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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) -->
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<script src="js/kube.min.js"></script>
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<script src="addons/upload/kube.upload.min.js"></script>
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<script src="addons/kube-addons.min.js"></script>
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<script src="kaform.js"></script>
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<script src="iban.js/iban.js"></script>
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</div>
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</div>
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</body>
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</html>
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