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<head>
	<title>Kostenerstattungsforumlar</title>
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	<link rel="stylesheet" href="master.css" />

</head>
<body>
	<div class="page is-container">
	<div class="main-sidebar">
		<img alt="wikimedia logo" src="Wikimedia_Deutschland-Logo.svg"/>
	</div>      
	<div class="main-content">
    
		<h1>Antrag auf Kostenerstattung</h1>
		<p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines
		Projektes entstanden sind?<BR>
		Bitte fülle dieses Formular aus.
		Pflichtfelder sind mit einem * gekennzeichnet.
		</p>

		<form data-kube="kaform" name="theform" id="theform" action="submit.php" method="POST">

		<div class="is-row">
		<div class="is-col is-70">
			<fieldset>
				<legend>1. Erfasse deine Stammdaten</legend>
				<div class="is-row">
					<div class="is-col"> 
						<input required type="input"
						   size="32" id="projectid" name="project"
						   placeholder="Projekt/Zweck der Reise*" />
					</div>
				</div>
<!--				<div class="is-row">
					<div class="is-col"> 
						<input required type="input"
						size="32" id="nickname" name="nickname"
						placeholder="Nickname*" />
					</div>
					<div class="is-col"> 
						<input required type="input"
						   size="32" id="projectid" name="project"
						   placeholder="Projekt-ID*" />
					</div>
				</div>
-->				<br>
				<div class="is-row">
					<div class="is-col"> 
						<input required type="input" size="32"
				`		id="realname"	name="realname" placeholder="Dein Realname (Vorname Nachname)*" />
					</div>
					<div class="is-col"> 
						<input type="input" size="32"
				`		id="wmdecontact"	name="wmdecontact" placeholder="Deine Ansprechperson bei Wikimedia" />
					</div>
				</div>
				<br>


				<div class="is-row">
					<div class="is-col"> 
							<input type="tel" size="32" 
							id="phone" name="phone"
							placeholder="Deine Telefonnummer" />
					</div>
					<div class="is-col"> 
					</div>
				</div>
				<br>


				<div class="is-row">
					<div class="is-col"> 
						<input required type="email" size="32" id="email"
							name="email" placeholder="Deine E-Mail-Adresse*" />
					</div>
					<div class="is-col"> 
					</div>
				</div>
				<br>

				<div class="is-row">
					<div class="is-col"> 

					<nav class="tabs" data-kube="tabs" data-equal="false">
					<a href="#bank-eu" class="is-active">Banküberweisung</a>
					<a href="#bank-noneu">Banküberweisung (Non-EU)</a>
<!--					<a href="#bank-paypal">PayPal</a>
					<a href="#bank-bar">Barauszahlung</a>
-->					</nav>

					<section id="bank-eu">
						<div class="is-row">
						<div class="is-col">
						<input type="input" size="32" name="Owner" placeholder="Kontoinhabende Person" />
						</div>
						<div class="is-col">
						</div>
						</div>
						<br>

						<div class="is-row">
						<div class="is-col">
			<input type="input" size="32" id="iban" name="iban" placeholder="IBAN*" />


						</div>
						<div class="is-col">
			<input type="input" size="32" id="bic" name="bic" placeholder="BIC (wenn ausländische Bank)" />
						</div>
						</div>
						<br>
<!--			<input type="input" size="32" id="purpose" name="purpose" placeholder="Verwendungszweck" /> -->
			<textarea  id="comments" name="comments"
					style="resize:both;" cols="32" rows="4" placeholder="Weitere Anmerkungen
z.B. intermediäre Bank,
Grund für abweichende Kontoinhbende Person"></textarea>




					</section>


					<section id="bank-noneu">
						<div class="is-row">
						<div class="is-col">
						<input type="input" size="32" name="Owner" placeholder="Kontoinhabende Person" />
						</div>
						<div class="is-col">
						</div>
						</div>
						<br>

						<div class="is-row">
						<div class="is-col">
			<input type="input" size="32" id="n_iban" name="n_iban" placeholder="Kontonummer*" />


						</div>
						<div class="is-col">
			<input type="input" size="32" id="n_bic" name="n_bic" placeholder="BIC/SWIFT*" />
						</div>
						</div>
						<br>
			<input class="EU nonEU" type="input" size="32" id="n_bank" name="n_bankname" placeholder="Name der Bank*" />
						<br>

			<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>
			<br>
			<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>
			<br>



<!--			<input type="input" size="32" id="n_purpose" name="n_purpose" placeholder="Verwendungszweck" /> -->
			<textarea  id="n_comments" name="n_comments"
					style="resize:both;" cols="32" rows="4" placeholder="Weitere Anmerkungen
z.B. intermediäre Bank,
Grund für abweichende kontoinhabende Person"></textarea>



					</section>
<!--					<section id="bank-paypal">
						<input name="paypal" type="input" size="32"
						       id="paypal" placeholder="Dein PayPal Account (paypal@example.com)" />
	

					</section> -->
<!--					<section id="bank-bar">
					</section> -->



					</div> <!-- i-col -->
				</div> <!-- is-row -->

			</fieldset>

		</div>
		<div class="is-col ">
			<?php include "h1.php"; ?>
		</div>
		</div> <!-- is row -->

		<br>

		<div class="is-row">
		<div class="is-col is-70">
			<fieldset id="fieldset2">
				<legend>2. Erfasse deine Ausgaben</legend>


				<div class="is-row">
					<div class="is-col is-70">
						<div class="is-row">
							<div class="is-col is-60">
								<input id="a_date" type="date" name="a_date" placeholder="Datum*"/> 

<!--								<input id="a_type" type="text" name="type" placeholder="Auslagenart*"/> -->
							</div>
							<div class="is-col is-40">
							</div>
						</div>
						<br>
						<input id="a_description" type="text" name="description" placeholder="Beschreibung*"/> 
						<br>

						<div class="is-row">
							<div class="is-col">
								<input id="a_amount" type="text" name="amount" placeholder="Betrag*"/> 
							</div>
							<div class="is-col">
<select id="a_currency" name="currency" >
  <option value="EUR">EUR</option>
  <option value="USD">USD</option>
  <option value="CHF">CHF</option>
  <option value="XBT">XBT</option>
</select>
<!--	<input id="a_currency" type="text" name="curreny" placeholder="Waehrung*"/> -->
							</div>
							<div class="is-col">
								<button type="button" onclick="addTableRow();" 
									class="button is-green">Ausgabe hinzuf&uuml;gen</button>
							</div>
						</div>							

					</div>
					<div  class="is-col is-30">
						<div id="uploadfield" class="form-item">
						</div>
					</div>
				</div>	
				<br>
				<table id="tabtab" class="is-bordered is-striped">
				<thead>
				<tr>
<!--					<th>Auslagenart</th>-->
					<th>Pos.</th>
					<th>Datum</th>
					<th>Beschreibung</th>
					<th>Betrag</th>
					<th>Belege</th>
					<th>L&ouml;schen</th>
				</tr>
				</thead>
				<tbody id="tabbody">
				</tbody>
	    
				</table>
			</fieldset>
			<br>
			<fieldset>
				<legend>3. Vorschuss und Sonstiges</legend>
				<div class="is-row">
				<div class="is-col valign="center"">
						Ich habe bereits einen Vorschuss erhalten in 
						H&ouml;he von:
				</div>
				<div class="is-col">
					<input input name="advance" id="advance" type="text" placeholder="0,00 EUR"/>
				</div>
				</div>	
				<br>

				<div class="is-row">
				<div class="is-col valign="center"">
						Ich versichere, dass ich alle Angaben 
						nach bestem Wissen und Gewissen gemacht habe:
				</div>
				<div class="is-col">
					<input id="agree" type="checkbox" />
				</div>
				</div>	



			</fieldset>
		</div>
		<div class="is-col">
			<?php include "h2.php"; ?>
		</div>
			
		</div>
		<button type="button" onclick="downloadDocument(true);"
			class="button is-green">Antrag elektronisch direkt an WMDE schicken</button>

		<button type="button" onclick="downloadDocument(false);"
			class="button is-orange">Antrag herunterladen und später einreichen</button>
	
		</div>
	</div>
	<input type="hidden" id="banktype" name="banktype"/>  
	<input type="hidden" id="sendmail" name="sendmail"/>  
  
	<!--		<input type="submit" style="display:none" name="submitButton" />  -->
	</form>
	

	
	
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	<script src="iban.js/iban.js"></script>

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