{"id":2047,"date":"2015-01-26T16:07:28","date_gmt":"2015-01-26T15:07:28","guid":{"rendered":"http:\/\/www.planete-sciences.org\/mediterranee\/?page_id=2047"},"modified":"2015-01-26T16:07:28","modified_gmt":"2015-01-26T15:07:28","slug":"inscription-agrement-microfusee","status":"publish","type":"page","link":"https:\/\/www.planete-sciences.org\/mediterranee\/thematiques\/espace\/agrement-microfusee\/inscription-agrement-microfusee\/","title":{"rendered":"Inscription Agr\u00e9ment microfus\u00e9e"},"content":{"rendered":"<div id=\"vfb-form-4\" class=\"visual-form-builder-container\"><form id=\"inscription-agrement-microfusee-4\" class=\"visual-form-builder vfb-form-4 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t  \t<input type=\"hidden\" name=\"form_id\" value=\"4\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 86 \" id=\"item-vfb-86\">&nbsp;<ul class=\"vfb-section vfb-section-1\"><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-90\"><label for=\"vfb-90\" class=\"vfb-desc\">Nom  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-90\" id=\"vfb-90\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-91\"><label for=\"vfb-91\" class=\"vfb-desc\">Pr\u00e9nom  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-91\" id=\"vfb-91\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-92\"><label for=\"vfb-92\" class=\"vfb-desc\">Date de naissance  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-92\" id=\"vfb-92\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-93\"><label for=\"vfb-93\" class=\"vfb-desc\">Adresse compl\u00e8te <\/label><input type=\"text\" name=\"vfb-93\" id=\"vfb-93\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-94\"><label for=\"vfb-94\" class=\"vfb-desc\">Code postal <\/label><input type=\"text\" name=\"vfb-94\" id=\"vfb-94\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-95\"><label for=\"vfb-95\" class=\"vfb-desc\">Ville <\/label><input type=\"text\" name=\"vfb-95\" id=\"vfb-95\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-96\"><label for=\"vfb-96\" class=\"vfb-desc\">T\u00e9l\u00e9phone  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-96\" id=\"vfb-96\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-97\"><label for=\"vfb-97\" class=\"vfb-desc\">Email  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-97\" id=\"vfb-97\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-instructions  \" id=\"item-vfb-98\"><label class=\"vfb-desc\">Inscription <\/label><\/li><li class=\"vfb-item vfb-item-checkbox  \" id=\"item-vfb-101\"><label class=\"vfb-desc\">Stage agr\u00e9ment microfus\u00e9e <\/label><div><span><label>(cocher la case correspondant \u00e0 votre choix)<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-101[]\" id=\"vfb-101-0\" value=\"du 9 au 11 mars 2023 \u00e0 Grasse (06) en externat\" class=\"vfb-checkbox  \" \/><label for=\"vfb-101-0\" class=\"vfb-choice\">du 9 au 11 mars 2023 \u00e0 Grasse (06) en externat<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><li class=\"vfb-item vfb-item-instructions  \" id=\"item-vfb-103\"><label class=\"vfb-desc\"> <\/label>Paiement\r\n\r\nAfin de confirmer votre place, merci de r\u00e9gler 100\u20ac \u00e0 titre d\u2019arrhes \r\n-soit directement par Paypal (\u00e0 mediterranee@planete-sciences.org)\r\n-soit par ch\u00e8que \u00e0 l\u2019ordre de Plan\u00e8te Sciences M\u00e9diterran\u00e9e et \u00e0 renvoyer \u00e0 l\u2019adresse : Plan\u00e8te Sciences M\u00e9diterran\u00e9e, 11 rue Sans Peur, 06130 Grasse<\/li><li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-112\"><label class=\"vfb-desc\">Paiement des arrhes  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span><label>Choisissez la m\u00e9thode de paiement pour les arrhes<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-112\" id=\"vfb-112-1\" value=\"Paypal\" class=\"vfb-radio  required \" \/><label for=\"vfb-112-1\" class=\"vfb-choice\">Paypal<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-112\" id=\"vfb-112-2\" value=\"Ch\u00e8que\" class=\"vfb-radio  required \" \/><label for=\"vfb-112-2\" class=\"vfb-choice\">Ch\u00e8que<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-112\" id=\"vfb-112-3\" value=\"Virement\" class=\"vfb-radio  required \" \/><label for=\"vfb-112-3\" class=\"vfb-choice\">Virement<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><li class=\"vfb-item vfb-item-checkbox  \" id=\"item-vfb-117\"><label class=\"vfb-desc\">Vous souhaitez payer le solde (\u00e0 verser au plus tard le premier jour de la formation)  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-117[]\" id=\"vfb-117-0\" value=\"Par ch\u00e8que (\u00e0 l&#039;ordre de Plan\u00e8te Sciences M\u00e9diterran\u00e9e)\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-117-0\" class=\"vfb-choice\">Par ch\u00e8que (\u00e0 l'ordre de Plan\u00e8te Sciences M\u00e9diterran\u00e9e)<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-117[]\" id=\"vfb-117-1\" value=\"Par virement bancaire\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-117-1\" class=\"vfb-choice\">Par virement bancaire<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-117[]\" id=\"vfb-117-2\" value=\"Par Paypal\" class=\"vfb-checkbox  required \" \/><label for=\"vfb-117-2\" class=\"vfb-choice\">Par Paypal<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><li class=\"vfb-item vfb-item-instructions  \" id=\"item-vfb-118\"><label class=\"vfb-desc\"> <\/label>*pour les paiements par virement bancaire ou par Paypal, l\u2019association prendra contact d\u00e8s r\u00e9ception de votre inscription pour vous communiquer les modalit\u00e9s de r\u00e8glement.\r\n\r\nEn cas d\u2019un nombre insuffisant de stagiaires, Plan\u00e8te Sciences M\u00e9diterran\u00e9e se r\u00e9serve le droit d\u2019annuler le stage. Vous serez inform\u00e9 au plus tard 10 jours avant le d\u00e9but du stage. Dans ce cas, les arrhes vous seront rembours\u00e9es sans autre indemnit\u00e9.<\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 verification \" id=\"item-vfb-87\" style=\"display:block\"><div class=\"vfb-legend\"><h3>Verification<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-88\" class=\"vfb-desc\">Merci d&#039;entrer deux chiffres <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-88\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-88\" id=\"vfb-88\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" style=\"display:block\" \/><label>Exemple: 12<\/label><\/span><li style=\"display:none;\"><label>This box is for spam protection - &lt;strong&gt;please leave it blank&lt;\/strong&gt;:<\/label><div><input name=\"vfb-spam\" \/><\/div><\/li>\n\t\t\t<li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-89\">\n\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-89\" value=\"Envoyer\" class=\"vfb-submit \" \/>\n\t\t\t\t<\/li><\/ul>\n\t\t\t<\/fieldset><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/mediterranee\/wp-json\/wp\/v2\/pages\/2047\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":2039,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"_acf_changed":false,"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-2047","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2047","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/comments?post=2047"}],"version-history":[{"count":1,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2047\/revisions"}],"predecessor-version":[{"id":2048,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2047\/revisions\/2048"}],"up":[{"embeddable":true,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2039"}],"wp:attachment":[{"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/media?parent=2047"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}