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  1. <!doctype html>
  2. <?php
  3. $lang=$_GET['lang'];
  4. if ( !in_array ($lang, array('en'))){
  5. $lang="";
  6. }
  7. ?>
  8. <html >
  9. <head>
  10. <title>Kostenerstattungsforumlar</title>
  11. <meta charset="utf-8">
  12. <meta name="viewport" content="width=device-width, initial-scale=1">
  13. <!-- Kube CSS -->
  14. <link rel="stylesheet" href="css/kube.min.css">
  15. <link rel="stylesheet" href="addons/kube-addons.min.css" />
  16. <link rel="stylesheet" href="master.css" />
  17. </head>
  18. <body>
  19. <div class="page is-container">
  20. <div class="main-sidebar">
  21. <img alt="wikimedia logo" src="Wikimedia_Deutschland-Logo.svg"/>
  22. </div>
  23. <div class="main-content">
  24. <?php echo _( "
  25. <h1>Antrag auf Kostenerstattung</h1>
  26. <p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines
  27. Projektes entstanden sind?<BR>
  28. Bitte fülle dieses Formular aus.
  29. Pflichtfelder sind mit einem * gekennzeichnet.
  30. </p>") ?>
  31. <form data-kube="kaform" name="theform" id="theform" action="submit.php" method="POST">
  32. <div class="is-row">
  33. <div class="is-col is-70">
  34. <fieldset>
  35. <legend><?php echo _("1. Erfasse deine Stammdaten</legend>")?>
  36. <div class="is-row">
  37. <div class="is-col">
  38. <input required type="input"
  39. size="32" id="projectid" name="project"
  40. placeholder="Projekt/Zweck der Reise*" />
  41. </div>
  42. </div>
  43. <br>
  44. <div class="is-row">
  45. <div class="is-col">
  46. <input required type="input" size="32"
  47. ` id="realname" name="realname" placeholder="Dein Realname (Vorname Nachname)*" />
  48. </div>
  49. <div class="is-col">
  50. <input type="input" size="32"
  51. ` id="wmdecontact" name="wmdecontact" placeholder="Deine Ansprechperson bei Wikimedia" />
  52. </div>
  53. </div>
  54. <br>
  55. <div class="is-row">
  56. <div class="is-col">
  57. <input type="tel" size="32"
  58. id="phone" name="phone"
  59. placeholder="Deine Telefonnummer" />
  60. </div>
  61. <div class="is-col">
  62. </div>
  63. </div>
  64. <br>
  65. <div class="is-row">
  66. <div class="is-col">
  67. <input required type="email" size="32" id="email"
  68. name="email" placeholder="Deine E-Mail-Adresse*" />
  69. </div>
  70. <div class="is-col">
  71. </div>
  72. </div>
  73. <br>
  74. <div class="is-row">
  75. <div class="is-col">
  76. <nav class="tabs" data-kube="tabs" data-equal="false">
  77. <a href="#bank-eu" class="is-active">Banküberweisung</a>
  78. <a href="#bank-noneu">Banküberweisung (Non-EU)</a>
  79. <!-- <a href="#bank-paypal">PayPal</a>
  80. <a href="#bank-bar">Barauszahlung</a>
  81. --> </nav>
  82. <section id="bank-eu">
  83. <div class="is-row">
  84. <div class="is-col">
  85. <input type="input" size="32" name="Owner" placeholder="Kontoinhabende Person" />
  86. </div>
  87. <div class="is-col">
  88. </div>
  89. </div>
  90. <br>
  91. <div class="is-row">
  92. <div class="is-col">
  93. <input type="input" size="32" id="iban" name="iban" placeholder="IBAN*" />
  94. </div>
  95. <div class="is-col">
  96. <input type="input" size="32" id="bic" name="bic" placeholder="BIC (wenn ausländische Bank)" />
  97. </div>
  98. </div>
  99. <br>
  100. <!-- <input type="input" size="32" id="purpose" name="purpose" placeholder="Verwendungszweck" /> -->
  101. <textarea id="comments" name="comments"
  102. style="resize:both;" cols="32" rows="4" placeholder="Weitere Anmerkungen
  103. z.B. intermediäre Bank,
  104. Grund für abweichende Kontoinhbende Person"></textarea>
  105. </section>
  106. <section id="bank-noneu">
  107. <div class="is-row">
  108. <div class="is-col">
  109. <input type="input" size="32" name="Owner" placeholder="Kontoinhabende Person" />
  110. </div>
  111. <div class="is-col">
  112. </div>
  113. </div>
  114. <br>
  115. <div class="is-row">
  116. <div class="is-col">
  117. <input type="input" size="32" id="n_iban" name="n_iban" placeholder="Kontonummer*" />
  118. </div>
  119. <div class="is-col">
  120. <input type="input" size="32" id="n_bic" name="n_bic" placeholder="BIC/SWIFT*" />
  121. </div>
  122. </div>
  123. <br>
  124. <input class="EU nonEU" type="input" size="32" id="n_bank" name="n_bankname" placeholder="Name der Bank*" />
  125. <br>
  126. <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>
  127. <br>
  128. <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)
  129. "></textarea>
  130. <br>
  131. <!-- <input type="input" size="32" id="n_purpose" name="n_purpose" placeholder="Verwendungszweck" /> -->
  132. <textarea id="n_comments" name="n_comments"
  133. style="resize:both;" cols="32" rows="4" placeholder="Weitere Anmerkungen
  134. z.B. intermediäre Bank,
  135. Grund für abweichende kontoinhabende Person"></textarea>
  136. </section>
  137. <!-- <section id="bank-paypal">
  138. <input name="paypal" type="input" size="32"
  139. id="paypal" placeholder="Dein PayPal Account (paypal@example.com)" />
  140. </section> -->
  141. <!-- <section id="bank-bar">
  142. </section> -->
  143. </div> <!-- i-col -->
  144. </div> <!-- is-row -->
  145. </fieldset>
  146. </div>
  147. <div class="is-col ">
  148. <?php include "h1.php"; ?>
  149. </div>
  150. </div> <!-- is row -->
  151. <br>
  152. <div class="is-row">
  153. <div class="is-col is-70">
  154. <fieldset id="fieldset2">
  155. <legend>2. Erfasse deine Ausgaben</legend>
  156. <div class="is-col is-70">
  157. Währung:
  158. </div>
  159. <div class="is-col is-20">
  160. <select onchange="renumberTableRows()" id="currency" >
  161. <option value="EUR">EUR</option>
  162. <option value="USD">USD</option>
  163. <option value="CHF">CHF</option>
  164. <option value="XBT">XBT</option>
  165. </select>`
  166. </div>
  167. <table id="tabtab" class="is-bordered is-striped">
  168. <thead>
  169. <tr>
  170. <th>Pos.</th>
  171. <th>Datum</th>
  172. <th>Beschreibung</th>
  173. <th>Betrag</th>
  174. <th>Währung</th>
  175. <th>Belege</th>
  176. <th>L&ouml;schen</th>
  177. </tr>
  178. </thead>
  179. <tbody id="tabbody">
  180. </tbody>
  181. </table>
  182. <div class="is-col">
  183. <button id="add_issue" type="button" onclick="addRow();"
  184. class="button is-green">Ausgabe hinzuf&uuml;gen</button>
  185. </div>
  186. </fieldset>
  187. <br>
  188. <fieldset>
  189. <legend>3. Vorschuss und Sonstiges</legend>
  190. <div class="is-row">
  191. <div class="is-col valign="center"">
  192. Ich habe bereits einen Vorschuss erhalten in
  193. H&ouml;he von:
  194. </div>
  195. <div class="is-col">
  196. <input input name="advance" id="advance" type="text" placeholder="0,00 EUR"/>
  197. </div>
  198. </div>
  199. <br>
  200. <div class="is-row">
  201. <div class="is-col valign="center"">
  202. Ich versichere, dass ich alle Angaben
  203. nach bestem Wissen und Gewissen gemacht habe:
  204. </div>
  205. <div class="is-col">
  206. <input id="agree" type="checkbox" />
  207. </div>
  208. </div>
  209. </fieldset>
  210. </div>
  211. <div class="is-col">
  212. <?php include "h2.php"; ?>
  213. </div>
  214. </div>
  215. <button type="button" onclick="downloadDocument(true);"
  216. class="button is-green">Antrag elektronisch direkt an WMDE schicken</button>
  217. <button type="button" onclick="downloadDocument(false);"
  218. class="button is-orange">Antrag herunterladen und später einreichen</button>
  219. </div>
  220. </div>
  221. <input type="hidden" id="banktype" name="banktype"/>
  222. <input type="hidden" id="sendmail" name="sendmail"/>
  223. <!-- <input type="submit" style="display:none" name="submitButton" /> -->
  224. </form>
  225. <!-- Kube JS (optional if you are using Kube CSS only) -->
  226. <script src="js/kube.min.js"></script>
  227. <script src="addons/upload/kube.upload.min.js"></script>
  228. <script src="addons/kube-addons.min.js"></script>
  229. <script src="kaform.js"></script>
  230. <script src="iban.js/iban.js"></script>
  231. </div>
  232. </div>
  233. </body>
  234. </html>