alpcentaur
/
wmdeit_kaform

<!doctype html><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="wmde.png"/>	</div>      	<div class="main-content">    		<h1>Auslagenersatz</h1>		<p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines		Projektes entstanden sind?<BR>		Bitte fülle dieses Formular aus ...		</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>1. Erfasse deine Stammdaten</legend>				<div class="is-row">					<div class="is-col"> 						<input required type="input"						size="32" id="nickname" name="nickname"						placeholder="Nickname*" />					</div>					<div class="is-col"> 						<input required type="input"						   size="32" id="projectid" name="project"						   placeholder="Projekt-ID*" />					</div>				</div>				<br>				<div class="is-row">					<div class="is-col"> 						<input required type="input" size="32"				`		id="realname"	name="realname" placeholder="Realname*" />					</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="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="#tab1" class="is-active">Banküberweisung</a>					<a href="#tab2">Banküberweisung(Non-EU)</a>					<a href="#tab3">PayPal</a>					<a href="#tab4">Barauszahlung</a>					</nav>
					<section id="tab1">						<div class="is-row">						<div class="is-col">						<input type="input" size="32" name="Owner" placeholder="Kontoinhaber" />						</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*" />						</div>						</div>						<br>			<input type="input" size="32" id="bic" name="purpose" placeholder="Verwendungszweck" />
					</section>

					<section id="tab2">						<div class="is-row">						<div class="is-col">						<input type="input" size="32" name="Owner" placeholder="Kontoinhaber" />						</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="Kontonummer*" />

						</div>						<div class="is-col">			<input type="input" size="32" id="bic" name="BIC" placeholder="BIC/SWIFT*" />						</div>						</div>						<br>			<input class="EU nonEU" type="input" size="32" id="bank" name="Bankname" placeholder="Name der Bank*" />						<br>
			<textarea  class="nonEU" name="bankaddress" id="bankaddress" style="resize:both;" cols="32" rows="4" placeholder="Adresse der Bank (Strasse und Hausnummer/Postleitzahl/Land)"></textarea>			<br>			<textarea name="address" lang="de" class="nonEU" id="address" style="resize:both;" cols="32" rows="4" placeholder="Deine Anschrift (Srtasse und Hausnummer/Postleitzahl/Land)
"></textarea>
			<br>


			<input type="input" size="32" id="bic" name="purpose" placeholder="Verwendungszweck" />

					</section>					<section id="tab3">						<input class="paypal" type="input" size="32"						       id="paypal" placeholder="Dein PayPal Account (paypal@example.com)" />	
					</section>					<section id="tab4">					</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-row">					<div class="is-col is-70">						<div class="is-row">							<div class="is-col is-60">								<input id="a_type" type="text" name="type" placeholder="Auslagenart*"/> 							</div>							<div class="is-col is-40">								<input id="a_date" type="date" name="type" placeholder="Datum*"/> 							</div>						</div>						<br>						<input id="a_description" type="text" name="description" placeholder="Beschreibung*"/> 						<br>
						<div class="is-row">							<div class="is-col">								<input id="a_amount" type="text" name="amount" placeholder="Betrag*"/> 							</div>							<div class="is-col">								<input id="a_currency" type="text" name="curreny" placeholder="Waehrung*"/> 							</div>							<div class="is-col">								<button type="button" onclick="addTableRow();" 									class="button is-green">Ausgabe hinzuf&uuml;gen</button>							</div>						</div>							
					</div>					<div  class="is-col is-30">						<div id="uploadfield" class="form-item">						</div>					</div>				</div>					<br>				<table id="tabtab" class="is-bordered is-striped">				<thead>				<tr>					<th>Auslagenart</th>					<th>Datum</th>					<th>Beschreibung</th>					<th>Betrag</th>					<th>W&auml;hrung</th>					<th>L&ouml;schen</th>				</tr>				</thead>				<tbody id="tabbody">				</tbody>	    				</table>			</fieldset>		</div>		<div class="is-col">			hilfe 2		</div>					</div>		<button onclick="addTableRow();"			class="button is-green">Antrag elektronisch versenden</button>
		<button type="button" onclick="downloadDocument();"			class="button is-orange">Herunterladen</button>			</div>	</div>	    	<!--		<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>      </div>    </div>      </body></html>