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  1. <!doctype html>
  2. <html >
  3. <head>
  4. <title>Kostenerstattungsforumlar</title>
  5. <meta charset="utf-8">
  6. <meta name="viewport" content="width=device-width, initial-scale=1">
  7. <!-- Kube CSS -->
  8. <link rel="stylesheet" href="css/kube.min.css">
  9. <link rel="stylesheet" href="addons/kube-addons.min.css" />
  10. <link rel="stylesheet" href="master.css" />
  11. </head>
  12. <body>
  13. <div class="page is-container">
  14. <div class="main-sidebar">Wikimedia Logo</div>
  15. <div class="main-content">
  16. <h1>Auslagenersatz</h1>
  17. <p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines
  18. Projektes entstanden sind?<BR>
  19. Bitte fülle dieses Formular aus ...
  20. </p>
  21. <form data-kube="kaform" name="theform" id="theform" action="submit.php" method="POST">
  22. <div class="is-row">
  23. <div class="is-col is-70">
  24. <fieldset>
  25. <legend>1. Erfasse deine Stammdaten</legend>
  26. <div class="is-row">
  27. <div class="is-col">
  28. <input required type="input"
  29. size="32" id="nickname" name="nickname"
  30. placeholder="Nickname*" />
  31. </div>
  32. <div class="is-col">
  33. <input required type="input"
  34. size="32" id="projekt" name="project"
  35. placeholder="Projekt-ID*" />
  36. </div>
  37. </div>
  38. <br>
  39. <div class="is-row">
  40. <div class="is-col">
  41. <input required type="input" size="32"
  42. ` name="realname" placeholder="Realname*" />
  43. </div>
  44. <div class="is-col">
  45. </div>
  46. </div>
  47. <br>
  48. <div class="is-row">
  49. <div class="is-col">
  50. <input required type="email" size="32" id="email"
  51. name="email" placeholder="E-Mail-Adresse*" />
  52. </div>
  53. <div class="is-col">
  54. </div>
  55. </div>
  56. <br>
  57. <div class="is-row">
  58. <div class="is-col">
  59. <nav class="tabs" data-kube="tabs" data-equal="false">
  60. <a href="#tab1" class="is-active">Banküberweisung</a>
  61. <a href="#tab2">Banküberweisung(Non-EU)</a>
  62. <a href="#tab3">PayPal</a>
  63. <a href="#tab4">Barauszahlung</a>
  64. </nav>
  65. <section id="tab1">
  66. <div class="is-row">
  67. <div class="is-col">
  68. <input type="input" size="32" name="Owner" placeholder="Kontoinhaber" />
  69. </div>
  70. <div class="is-col">
  71. </div>
  72. </div>
  73. <br>
  74. <div class="is-row">
  75. <div class="is-col">
  76. <input type="input" size="32" id="iban" name="IBAN" placeholder="IBAN*" />
  77. </div>
  78. <div class="is-col">
  79. <input type="input" size="32" id="bic" name="BIC" placeholder="BIC*" />
  80. </div>
  81. </div>
  82. <br>
  83. <input type="input" size="32" id="bic" name="purpose" placeholder="Verwendungszweck" />
  84. </section>
  85. <section id="tab2">
  86. <div class="is-row">
  87. <div class="is-col">
  88. <input type="input" size="32" name="Owner" placeholder="Kontoinhaber" />
  89. </div>
  90. <div class="is-col">
  91. </div>
  92. </div>
  93. <br>
  94. <div class="is-row">
  95. <div class="is-col">
  96. <input type="input" size="32" id="iban" name="IBAN" placeholder="Kontonummer*" />
  97. </div>
  98. <div class="is-col">
  99. <input type="input" size="32" id="bic" name="BIC" placeholder="BIC/SWIFT*" />
  100. </div>
  101. </div>
  102. <br>
  103. <input class="EU nonEU" type="input" size="32" id="bank" name="Bankname" placeholder="Name der Bank*" />
  104. <br>
  105. <textarea class="nonEU" name="bankaddress" id="bankaddress" style="resize:both;" cols="32" rows="4" placeholder="Adresse der Bank (Strasse und Hausnummer/Postleitzahl/Land)"></textarea>
  106. <br>
  107. <textarea name="address" lang="de" class="nonEU" id="address" style="resize:both;" cols="32" rows="4" placeholder="Deine Anschrift (Srtasse und Hausnummer/Postleitzahl/Land)
  108. "></textarea>
  109. <br>
  110. <input type="input" size="32" id="bic" name="purpose" placeholder="Verwendungszweck" />
  111. </section>
  112. <section id="tab3">
  113. <input class="paypal" type="input" size="32"
  114. id="paypal" placeholder="Dein PayPal Account (paypal@example.com)" />
  115. </section>
  116. <section id="tab4">
  117. </section>
  118. </div> <!-- i-col -->
  119. </div> <!-- is-row -->
  120. </fieldset>
  121. </div>
  122. <div class="is-col ">
  123. Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext
  124. </div>
  125. </div> <!-- is row -->
  126. <br>
  127. <div class="is-row">
  128. <div class="is-col is-70">
  129. <fieldset>
  130. <legend>2. Erfasse deine Ausgaben</legend>
  131. <div class="is-row">
  132. <div class="is-col is-70">
  133. <div class="is-row">
  134. <div class="is-col is-60">
  135. <input type="text" name="type" placeholder="Auslagenart*"/>
  136. </div>
  137. <div class="is-col is-40">
  138. <input type="date" name="type" placeholder="Dateum*"/>
  139. </div>
  140. </div>
  141. <br>
  142. <input type="text" name="description" placeholder="Beschreibung*"/>
  143. <br>
  144. <div class="is-row">
  145. <div class="is-col">
  146. <input type="text" name="amount" placeholder="Betrag*"/>
  147. </div>
  148. <div class="is-col">
  149. <input type="text" name="curreny" placeholder="Waehrung*"/>
  150. </div>
  151. <div class="is-col">
  152. <button onclick="addTableRow();" class="button is-green">Ausgabe hinzuf&uuml;gen</button>
  153. </div>
  154. </div>
  155. </div>
  156. <div class="is-col is-30">
  157. <div class="form-item">
  158. <div class="upload"
  159. data-kube="upload"
  160. data-type="file" data-multiple="true"
  161. data-target="#upload-target"
  162. data-url="upload.php" data-url-remove="delete.php"
  163. data-progress="true">
  164. </div>
  165. </div>
  166. </div>
  167. </div>
  168. <br>
  169. <table id="tabtab" class="is-bordered">
  170. <thead>
  171. <tr>
  172. <th>Auslagenart</th>
  173. <th>Datum</th>
  174. <th>Beschreibung</th>
  175. <th>Betrag</th>
  176. <th>W&auml;hrung</th>
  177. <th>L&ouml;schen</th>
  178. </tr>
  179. </thead>
  180. <tbody id="tabbody">
  181. </tbody>
  182. </table>
  183. </fieldset>
  184. </div>
  185. <div class="is-col">
  186. hilfe 2
  187. </div>
  188. </div>
  189. <button onclick="addTableRow();"
  190. class="button is-green">Antrag elektronisch versenden</button>
  191. <button onclick="document.theform.submitButton.click();"
  192. class="button is-orange">Herunterladen</button>
  193. </div>
  194. </div>
  195. <input type="submit" style="display:none" name="submitButton" />
  196. </form>
  197. <!-- Kube JS (optional if you are using Kube CSS only) -->
  198. <script src="js/kube.min.js"></script>
  199. <script src="addons/upload/kube.upload.min.js"></script>
  200. <script src="addons/kube-addons.min.js"></script>
  201. <script src="kaform.js"></script>
  202. </div>
  203. </div>
  204. </body>
  205. </html>