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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' ))){
$locale = $lang ;
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}
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else
$locale = " de_DE " ;
$locale = " en_US " ;
$domain = " messages " ;
setlocale ( LC_MESSAGES , $locale );
setlocale ( LC_ALL , $locale );
$results = putenv ( " LC_ALL= $locale " );
$results = bindtextdomain ( $domain , " ./locale " );
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?>
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< html >
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< head >
< title > Kostenerstattungsforumlar </ 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 " >
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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 >
< ? 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 " >
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< 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 * " )?> " />
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</ 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 " >
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< 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 >
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<!-- < 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 (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 " /> -->
< textarea id = " n_comments " name = " n_comments "
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 > -->
<!-- < 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 >
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< div class = " is-col " >
< ? php
$ct = @ file_get_contents ( " ./locale/ $locale /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 " >
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< fieldset id = " fieldset2 " >
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< legend > 2. Erfasse deine Ausgaben </ legend >
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< div class = " is-col is-70 " >
Währung :
</ div >
< div class = " is-col is-20 " >
< select onchange = " renumberTableRows() " id = " currency " >
< option value = " EUR " > EUR </ option >
< option value = " USD " > USD </ option >
< option value = " CHF " > CHF </ option >
< option value = " XBT " > XBT </ option >
</ select > `
</ div >
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< table id = " tabtab " class = " is-bordered is-striped " >
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< thead >
< tr >
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< th > Pos .</ th >
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< th > Datum </ th >
< th > Beschreibung </ th >
< th > Betrag </ th >
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< th > Währung </ th >
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< th > Belege </ th >
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< th > L & ouml ; schen </ th >
</ tr >
</ thead >
< tbody id = " tabbody " >
</ tbody >
</ table >
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< div class = " is-col " >
< button id = " add_issue " type = " button " onclick = " addRow(); "
class = " button is-green " > Ausgabe hinzuf & uuml ; gen </ button >
</ div >
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</ 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 " >
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< 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 " " >
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 >
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</ fieldset >
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< 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 >
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< div class = " is-col " >
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< ? php
$ct = @ file_get_contents ( " ./locale/ $locale /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 >
< script src = " kaform.js " ></ script >
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< script src = " iban.js/iban.js " ></ script >
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</ div >
</ div >
</ body >
</ html >