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@ -15,27 +15,123 @@ |
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</head> |
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</head> |
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<body> |
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<body> |
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<div class="page is-container"> |
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<div class="page is-container"> |
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<div class="main-sidebar">Sidebar</div> |
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<div class="main-sidebar">Wikimedia Logo</div> |
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<div class="main-content"> |
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<div class="main-content"> |
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<h1>Antrag auf Kostenerstattung</h1> |
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<p>Bitte beachte beim Ausfüllen die |
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<a target="_blank" href="https://www.wikimedia.de/wiki/ |
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Gesch%C3%A4ftsordnung#Reisekostenordnung"> |
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Reisekostenordnung |
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</a>. |
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<h1>Auslagenersatz</h1> |
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<p>Du möchtest dir Kosten erstatten lassen, welche im Rahmen deines |
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Projektes entstanden sind?<BR> |
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Bitte fülle dieses Formular aus ... |
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</p> |
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</p> |
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<h3>Bitte fülle die allgemeinen Daten für die Erstattung aus.</h3> |
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<form name="theform" id="theform" action="submit.php" method="POST"> |
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<form name="theform" id="theform" action="submit.php" method="POST"> |
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<fieldset> |
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<div class="is-row"> |
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<div class="is-col is-70"> |
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<fieldset> |
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<div class="is-row"> |
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<div class="is-col"> |
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<input required type="input" |
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size="32" id="nickname" name="nickname" |
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placeholder="Nickname*" /> |
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</div> |
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<div class="is-col"> |
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<input required type="input" |
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size="32" id="projekt" name="project" |
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placeholder="Projekt-ID*" /> |
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</div> |
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</div> |
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<br> |
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<div class="is-row"> |
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<div class="is-col"> |
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<input required type="input" size="32" |
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` name="realname" placeholder="Realname*" /> |
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</div> |
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<div class="is-col"> |
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</div> |
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</div> |
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<br> |
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<div class="is-row"> |
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<div class="is-col"> |
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<input required type="email" size="32" id="email" |
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name="email" placeholder="E-Mail-Adresse*" /> |
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</div> |
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<div class="is-col"> |
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</div> |
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</div> |
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<br> |
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<legend>Dein Projekt / Zweck der Reise</legend> |
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<input required type="input" |
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size="32" id="projekt" name="project" |
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placeholder="Projekt xy" /> |
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</fieldset> |
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<div class="is-row"> |
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<div class="is-col"> |
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<input class="screen" type="radio" id="eu" |
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name="bank" value="EU" checked> |
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<label class="screen radio" for="eu">EU-Banküberweisung</label> |
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<br> |
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<input class="screen" type="radio" |
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id="noneu" name="bank" value="Non-EU"> |
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<label class="screen radio" for="noneu"> |
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Non-EU-Banküberweisung</label> |
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<br> |
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<input class="screen" type="radio" id="paypal" |
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name="bank" value="PayPal"> |
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<label class="screen radio" for="paypal">PayPal</label> |
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<br> |
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<input class="screen" type="radio" id="bar" |
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name="bank" value="Bar"> |
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<label class="screen radio" for="bar" lang="de"> |
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Bargeld</label> |
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<br><br> |
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<label class="EU nonEU" for="owner" >Kontoinhaber</label> |
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<input class="EU nonEU" type="input" size="32" id="ownerDe" name="Owner" placeholder="wenn abweichend vom Realnamen" /> |
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<label class="EU nonEU" for="iban" >IBAN</label> |
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<input class="EU nonEU" type="input" size="32" id="iban" name="IBAN" placeholder="DE0123…" /> |
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<label class="EU nonEU" for="bic">BIC / SWIFT</label> |
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<input class="EU nonEU" type="input" size="32" id="bic" name="BIC" placeholder="LBMU…" /> |
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<label class="EU nonEU" for="bank" >Name der Bank</label> |
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<input class="EU nonEU" type="input" size="32" id="bank" name="Bankname" placeholder="Banky McBankface" /> |
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<label class="nonEU" for="bankaddress" >Bankanschrift</label> |
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<textarea class="nonEU" name="bankaddress" id="bankaddress" style="resize:both;" cols="32" rows="4" placeholder="Straße und Hausnummer |
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Postleitzahl und Ort |
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Land"></textarea> |
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<label class="nonEU" for="address" >Deine Anschrift</label> |
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<textarea name="address" lang="de" class="nonEU" id="address" style="resize:both;" cols="32" rows="4" placeholder="Straße und Hausnummer |
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Postleitzahl und Ort |
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Land"></textarea> |
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<label class="EU nonEU" for="comments" lang="de">Weitere Anmerkungen</label> |
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<textarea class="EU nonEU" id="comments" name="comments" |
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style="resize:both;" cols="32" rows="4" placeholder="z.B. intermdiäre Bank, |
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Grund für abweichende Kontoinhaberin"></textarea> |
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<label class="paypal" for="accountnumber"> |
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PayPal account</label> |
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<input class="paypal" type="input" size="32" |
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id="paypal" placeholder="paypal@example.com" /> |
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</div> <!-- i-col --> |
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</div> <!-- is-row --> |
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</fieldset> |
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</div> |
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<div class="is-col "> |
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Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext Hilfetext |
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</div> |
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</div> <!-- is row --> |
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Hallo |
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</div> |
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</div> |
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<fieldset> |
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<fieldset> |
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<legend>Deine Ansprechperson bei Wikimedia</legend> |
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<legend>Deine Ansprechperson bei Wikimedia</legend> |
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7u83
4 years ago