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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.")?><BR><BR>
<?php
$ct = @file_get_contents( "./locale/$loc1/h1.php");
if ($ct==false)
$ct = file_get_contents( "h1.php");
echo $ct;
?>
</p>
<form data-kube="kaform" name="theform" id="theform" action="submit.php" method="POST">
<fieldset> <legend><?php echo _("1. Erfasse deine Stammdaten")?></legend>
<div class="is-row">
<div class="is-col">
<input required type="input"
size="32" id="projectid" name="project"
placeholder="<?php echo _("Projekt/Zweck der Reise*")?>" />
</div>
</div>
<div class="is-row">
<div class="is-col">
<input required type="input" size="32"
` id="realname" name="realname" placeholder="<?php echo _("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>
<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>
<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>
<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 (SEPA)")?></a>
<a href="#bank-noneu"><?=_("Banküberweisung (nicht SEPA)")?></a>
</nav>
<section id="bank-eu">
<div class="is-row">
<div class="is-col">
<input type="input" size="32" name="sepa_owner" placeholder="<?=_("Kontoinhabende Person")?>" />
</div>
<div class="is-col">
</div>
</div>
<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>
<textarea id="comments" name="comments" style="resize:none;" cols="32" rows="4"
placeholder="<?=_("weitere Anmerkungen z.B. intermediäre Bank, Grund für abweichende kontoinhabende Person")?>"></textarea >
</section>
<section id="bank-noneu">
<div class="is-row">
<div class="is-col">
<input type="input" size="32" name="non_sepa_owner" placeholder="<?=_("Kontoinhabende Person")?>" />
</div>
<div class="is-col">
<input type="input" size="32" id="n_bic" name="n_bic" placeholder="<?=_("BIC/SWIFT*")?>" />
</div>
</div>
<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_routing" name="n_routing" placeholder="<?=_("Routing Number")?>" />
</div>
</div>
<input class="EU nonEU" type="input" size="32" id="n_bank" name="n_bankname" placeholder="<?="Name der Bank*"?>" />
<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, Ort, Land)")?>"></textarea>
<br>
<textarea name="n_address" lang="de" class="nonEU" id="n_address" style="resize:both;" cols="32" rows="4"
placeholder="<?=_("Deine Anschrift (Stra&szlig;e und Hausnummer, Postleitzahl, Ort, Land)*")?>"></textarea>
<br>
<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>
</div> <!-- i-col -->
</div> <!-- is-row -->
</fieldset>
<fieldset id="fieldset2"> <legend><?=_("2. Erfasse deine Ausgaben")?></legend>
<div class="is-row">
<div class="is-col">
<?=_("Währung:")?>
</div>
<div class="is-col">
<select onchange="renumberTableRows()" name='currency' id="currency" >
<option value="EUR">EUR</option>
<option value="USD">USD</option>
<option value="CHF">CHF</option>
<option value="XBT">XBT</option>
</select>
</div>
<div class="is-col">
</div>
</div>
<table id="tabtab" class="is-responsive is-bordered is-striped">
<thead>
<tr>
<th><?=_("Pos.")?></th>
<th><?=_("Datum")?></th>
<th><?=_("Beschreibung")?></th>
<th><?=_("Betrag")?></th>
<th><?=_("Währung")?></th>
<th><?=_("Belege")?></th>
<th><?=_("L&ouml;schen")?></th>
</tr>
</thead>
<tbody id="tabbody">
</tbody>
</table>
<div class="is-col">
<button id="add_issue" type="button" onclick="addRow();"
class="button is-green"><?=_("Ausgabe hinzuf&uuml;gen")?></button>
</div>
</fieldset>
<br>
<fieldset> <legend><?=_("3. Vorschuss und Sonstiges")?></legend>
<div class="is-row">
<div class="is-col valign="center"">
<?=_("Ich habe bereits einen Vorschuss in folgender H&ouml;he erhalten:")?>
</div>
<div class="is-col">
<input input name="advance" id="advance" type="text" placeholder="0,00 EUR"/>
</div>
</div>
<div class="is-row">
<div class="is-col valign="center"">
<?=_("Hiermit bestätige ich die Vollständig- und Richtigkeit meiner Angaben:")?>*
</div>
<div class="is-col">
<input id="agree" type="checkbox" />
</div>
</div>
<div class="is-row">
<div class="is-col">
<button type="button" onclick="downloadDocument(false);"
class="button is-orange"><?=_("Antrag herunterladen und später einreichen")?></button>
</div>
<div class="is-col">
<button type="button" onclick="downloadDocument(true);"
class="button is-green"><?=_("Antrag elektronisch direkt an WMDE schicken")?></button>
</div>
</div>
</fieldset>
<input type="hidden" id="banktype" name="banktype"/>
<input type="hidden" id="sendmail" name="sendmail"/>
</form>
<?php