alpcentaur
/
wmdeit_kaform

<!doctype html><html lang="de">  <head>        <title>Kostenerstattungsforumlar</title>
    <meta charset="utf-8">    <meta name="viewport" content="width=device-width, initial-scale=1">
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    <link rel="stylesheet" href="master.css" />
  </head>  <body>    <div class="page is-container">      <div class="main-sidebar">Sidebar</div>            <div class="main-content">    	<h1>Antrag auf Kostenerstattung</h1>	<p>Bitte beachte beim Ausfüllen die	  <a href="https://www.wikimedia.de/wiki/		   Gesch%C3%A4ftsordnung#Reisekostenordnung">	    Reisekostenordnung</a>.	</p>	<h3>Bitte fülle die allgemeinen Daten für die Erstattung aus.</h3>
	<form action="submit.php" method="POST">
	  <fieldset>	    <legend>Dein Projekt / Zweck der Reise</legend>	    <input required type="input"		   size="32" id="projekt" name="project"		   placeholder="Projekt xy" />	  </fieldset>	  	  <fieldset>	    <legend>Deine Ansprechperson bei Wikimedia</legend>	    <input required type="input" size="32" id="wmdecontact"		   name="wmdecontact" placeholder="John Doe" />	  </fieldset>
	  <fieldset>	    <legend>Deine Kontaktdaten</legend>	    <label for="realname" >Dein Realname</label>	    <input required type="input" size="32"		   name="realname" placeholder="Corinna Commonsuser" />	    <label for="email">E-Mail-Adresse</label>	    <input required type="email" size="32" id="email"		   name="email" placeholder="name@example.org" />	    	    <label for="phone" >Telefonnummer</label>	    <input required type="tel" size="32" "phone" name="phone"		   placeholder="0123-456789" />	  </fieldset>
	  <fieldset class="iblock" id="bankdetails">	    <legend lang="de">Auszahlungsweg</legend>	    <legend lang="en">Payout method</legend>	    <input class="screen" type="radio"   id="eu" name="bank" value="EU" checked>	    <label class="screen radio" for="eu"		   lang="de">EU-Banküberweisung</label>	    <label class="screen radio" for="eu"		   lang="en">EU bank transfer</label>			<input class="screen" type="radio" id="noneu" name="bank" value="Non-EU"><label class="screen radio" for="noneu" lang="de">Non-EU-Banküberweisung</label><label class="screen radio" for="noneu" lang="en">Non EU bank transfer</label>			<input class="screen" type="radio" id="paypal" name="bank" value="PayPal"><label class="screen radio" for="paypal">PayPal</label>			<input class="screen" type="radio" id="bar" name="bank" value="Bar"><label class="screen radio" for="bar" lang="de">Bargeld</label><label class="screen radio" for="bar" lang="en">Cash</label>			<label class="EU nonEU" for="owner" lang="de">Kontoinhaber</label><label class="EU nonEU" for="owner" lang="en">Bank account owner</label><input class="EU nonEU" type="input" size="32" id="ownerDe" name="Owner" placeholder="wenn abweichend vom Realnamen" lang="de" /><input class="EU nonEU" type="input" size="32" id="ownerEn" name="Owner" placeholder="if different from full legal name" lang="en" />			<label class="EU nonEU" for="iban" lang="de">IBAN</label><label class="EU nonEU" for="iban" lang="en">Bank account number</label><input class="EU nonEU" type="input" size="32" id="iban" name="IBAN" placeholder="DE0123…" />			<label class="EU nonEU" for="bic">BIC / SWIFT</label><input class="EU nonEU" type="input" size="32" id="bic" name="BIC" placeholder="LBMU…" />			<label class="EU nonEU" for="bank" lang="de">Name der Bank</label><label class="EU nonEU" for="bank" lang="en">Name of bank</label><input class="EU nonEU" type="input" size="32" id="bank" name="Bankname" placeholder="Banky McBankface" />			<label class="nonEU" for="bankaddress" lang="en">Bank address</label><textarea lang="en" class="nonEU" id="bankaddress" style="resize:both;" cols="32" rows="4" placeholder="Street and house numberPostal code and cityCountry"></textarea>			<label class="nonEU" for="address" lang="en">Your address</label><textarea lang="en" class="nonEU" id="address" style="resize:both;" cols="32" rows="4" placeholder="Street and house numberPostal code and cityCountry"></textarea>			<label class="EU nonEU" for="comments" lang="en">Further comments</label><textarea lang="en" class="EU nonEU" id="comments" style="resize:both;" cols="32" rows="4" placeholder="e.g. intermediary bank,reasons for differing account owner"></textarea>
			<label class="nonEU" for="bankaddress" lang="de">Bankanschrift</label><textarea lang="de" class="nonEU" id="bankaddress" style="resize:both;" cols="32" rows="4" placeholder="Straße und HausnummerPostleitzahl und OrtLand"></textarea>			<label class="nonEU" for="address" lang="de">Deine Anschrift</label><textarea lang="de" class="nonEU" id="address" style="resize:both;" cols="32" rows="4" placeholder="Straße und HausnummerPostleitzahl und OrtLand"></textarea>			<label class="EU nonEU" for="comments" lang="de">Weitere Anmerkungen</label><textarea lang="de" class="EU nonEU" id="comments" style="resize:both;" cols="32" rows="4" placeholder="z.B. intermdiäre Bank,Grund für abweichende Kontoinhaberin"></textarea>
			<label class="paypal" for="accountnumber">PayPal account</label><input class="paypal" type="input" size="32" id="paypal" placeholder="paypal@example.com" />		</fieldset>	  	  	  <label>Dein Projekt / Zweck der Reise</label>	  <input type="text" name="projekt"/> 	  <h2>Bitte trage deine einzelnen Kostenpositionen ein.</h2>	  <p>	    Bitte trage nur eine Ausgabe pro Zeile ein, lege den	    Originalbeleg dem Antrag bei und kennzeichne den Beleg	    mit der entsprechenden Zeilennummer. Aus der Beschreibung	    soll zu ersehen sein, ob es sich um Transport, Dienstleistung,	    Materialien, Verpflegung oder ähnliches handelt.	  </p>	  	  	  <table id="tabtab" class="is-bordered">	    <thead>	      <tr>		<th>Pos.</th>		<th>Beschreibung</th>		<th>Belegdatum</th>		<th>Betrag</th>		<th>Beleg</th>	      </tr>	    </thead>	    <tbody id="tabbody">	    </tbody>	    	  </table>	  <input type="submit"/>    	</form>	<button onclick="addTableRow();"		class="button">Position hinzuf&uuml;gen</button>	<button onclick="submitTable();"		class="button">Absenden</button>					<!-- 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>      </div>    </div>      </body></html>