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<!doctype html>
<?php
$lang=$_GET['lang'];
if ( !in_array ($lang, array('en'))){
$lang="";
}
?>
<html >
<head>
<title>Kostenerstattungsforumlar</title>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<!-- Kube CSS -->
<link rel="stylesheet" href="css/kube.min.css">
<link rel="stylesheet" href="addons/kube-addons.min.css" />
<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">
<?php echo _( "
<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><?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="Projekt/Zweck der Reise*" />
</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-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>
<table id="tabtab" class="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 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>
<!-- 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>
<script src="iban.js/iban.js"></script>
</div>
</div>
</body>
</html>