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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>
-
- <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")?></a>
- <a href="#bank-noneu"><?=_("Banküberweisung (Non-EU)")?></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>
-
- <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 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>
-
- <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>
- <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 (Straße 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 (Srtaße und Hausnummer/Postleitzahl/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()" 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><?=_("Löschen")?></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 hinzufügen")?></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 Höhe von:")?>
- </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(true);"
- class="button is-green"><?=_("Antrag elektronisch direkt an WMDE schicken")?></button>
- </div>
-
- <div class="is-col">
- <button type="button" onclick="downloadDocument(false);"
- class="button is-orange"><?=_("Antrag herunterladen und später einreichen")?></button>
- </div>
- </div>
- </fieldset>
-
-
-
- <input type="hidden" id="banktype" name="banktype"/>
- <input type="hidden" id="sendmail" name="sendmail"/>
-
-
-
- </form>
- <?php
-
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