{"id":2133,"date":"2015-02-19T17:21:07","date_gmt":"2015-02-19T16:21:07","guid":{"rendered":"http:\/\/www.planete-sciences.org\/mediterranee\/?page_id=2133"},"modified":"2024-05-18T21:02:04","modified_gmt":"2024-05-18T19:02:04","slug":"formulaire-dadhesion","status":"publish","type":"page","link":"https:\/\/www.planete-sciences.org\/mediterranee\/devenir-membre\/formulaire-dadhesion\/","title":{"rendered":"Formulaire d&rsquo;adh\u00e9sion"},"content":{"rendered":"<div id=\"vfb-form-8\" class=\"visual-form-builder-container\"><form id=\"adhesion-planete-sciences-mediterranee-8\" class=\"visual-form-builder vfb-form-8 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t  \t<input type=\"hidden\" name=\"form_id\" value=\"8\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 montant-des-cotisations \" id=\"item-vfb-246\"><div class=\"vfb-legend\"><h3>Montant des cotisations<\/h3><\/div><ul class=\"vfb-section vfb-section-1\"><li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-250\"><label class=\"vfb-desc\">Type d&#039;adh\u00e9sion souhait\u00e9e :  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-250\" id=\"vfb-250-1\" value=\"Membre individuel - 20\u20ac\" class=\"vfb-radio  required \" \/><label for=\"vfb-250-1\" class=\"vfb-choice\">Membre individuel - 20\u20ac<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-250\" id=\"vfb-250-2\" value=\"Membre individuel \u00e9tudiant ou ch\u00f4meurs - 10\u20ac\" class=\"vfb-radio  required \" \/><label for=\"vfb-250-2\" class=\"vfb-choice\">Membre individuel \u00e9tudiant ou ch\u00f4meurs - 10\u20ac<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-250\" id=\"vfb-250-3\" value=\"Famille - 35\u20ac\" class=\"vfb-radio  required \" \/><label for=\"vfb-250-3\" class=\"vfb-choice\">Famille - 35\u20ac<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-250\" id=\"vfb-250-4\" value=\"Groupe\/collectif - 50\u20ac\" class=\"vfb-radio  required \" \/><label for=\"vfb-250-4\" class=\"vfb-choice\">Groupe\/collectif - 50\u20ac<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 informations-personnelles \" id=\"item-vfb-251\"><div class=\"vfb-legend\"><h3>Informations personnelles<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-252\"><label for=\"vfb-252\" class=\"vfb-desc\">Nom de famille, du groupe ou de la structure  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-252\" id=\"vfb-252\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-253\"><label for=\"vfb-253\" class=\"vfb-desc\">Pr\u00e9nom <\/label><input type=\"text\" name=\"vfb-253\" id=\"vfb-253\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-date  \" id=\"item-vfb-256\"><label for=\"vfb-256\" class=\"vfb-desc\">Date de naissance <\/label><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-256\" id=\"vfb-256\" value=\"\" class=\"vfb-text vfb-date-picker  vfb-medium  \" data-dp-dateFormat=\"jj\/mm\/aaaa\" \/><label>jj\/mm\/aaaa (uniquement pour les adh\u00e9rents individuels)<\/label><\/span><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-257\"><label for=\"vfb-257\" class=\"vfb-desc\">Nom et qualit\u00e9 du responsable <\/label><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-257\" id=\"vfb-257\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><label>(uniquement pour les adh\u00e9sions groupe\/collectif)<\/label><\/span><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-258\"><label for=\"vfb-258\" class=\"vfb-desc\">Nombre de personnes concern\u00e9es par l&#039;adh\u00e9sion collective <\/label><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-258\" id=\"vfb-258\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><label>(uniquement pour les adh\u00e9sions de groupe\/collectif)<\/label><\/span><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-254\"><label for=\"vfb-254\" class=\"vfb-desc\">Adresse postale compl\u00e8te  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-254\" id=\"vfb-254\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-255\"><label for=\"vfb-255\" class=\"vfb-desc\">T\u00e9l\u00e9phone (fixe ou mobile)  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-255\" id=\"vfb-255\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-259\"><label for=\"vfb-259\" class=\"vfb-desc\">Adresse email  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-259\" id=\"vfb-259\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-3 reglement \" id=\"item-vfb-262\"><div class=\"vfb-legend\"><h3>R\u00e9glement<\/h3><\/div><ul class=\"vfb-section vfb-section-3\"><li class=\"vfb-item vfb-item-radio  \" id=\"item-vfb-261\"><label class=\"vfb-desc\">Vous souhaitez r\u00e9gler votre cotisation :  <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-261\" id=\"vfb-261-1\" value=\"Par virement bancaire (un RIB vous sera envoy\u00e9)\" class=\"vfb-radio  required \" \/><label for=\"vfb-261-1\" class=\"vfb-choice\">Par virement bancaire (un RIB vous sera envoy\u00e9)<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-261\" id=\"vfb-261-2\" value=\"Par ch\u00e8que (\u00e0 l&#039;ordre de Plan\u00e8te Sciences M\u00e9diterran\u00e9e, 11 rue Sans Peur 06130 Grasse)\" class=\"vfb-radio  required \" \/><label for=\"vfb-261-2\" class=\"vfb-choice\">Par ch\u00e8que (\u00e0 l'ordre de Plan\u00e8te Sciences M\u00e9diterran\u00e9e, 11 rue Sans Peur 06130 Grasse)<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-261\" id=\"vfb-261-3\" value=\"Par esp\u00e8ce sur place\" class=\"vfb-radio  required \" \/><label for=\"vfb-261-3\" class=\"vfb-choice\">Par esp\u00e8ce sur place<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-261\" id=\"vfb-261-4\" value=\"Par Paypal (bouton de paiement sous ce formulaire))\" class=\"vfb-radio  required \" \/><label for=\"vfb-261-4\" class=\"vfb-choice\">Par Paypal (bouton de paiement sous ce formulaire))<\/label><\/span><span class=\"vfb-span\"><input type=\"radio\" name=\"vfb-261\" id=\"vfb-261-5\" value=\"Par Carte Bancaire (bouton de paiement sous ce formulaire))\" class=\"vfb-radio  required \" \/><label for=\"vfb-261-5\" class=\"vfb-choice\">Par Carte Bancaire (bouton de paiement sous ce formulaire))<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-4 verification \" id=\"item-vfb-247\" style=\"display:block\"><div class=\"vfb-legend\"><h3>Verification<\/h3><\/div><ul class=\"vfb-section vfb-section-4\"><li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-248\" class=\"vfb-desc\">Merci d&#039;entrer deux chiffres <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-248\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-248\" id=\"vfb-248\" 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-249\">\n\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-249\" 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\/2133\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n\n\n<p>Vous pouvez payer votre adh\u00e9sion soit :<\/p>\n<ul>\n<li>en envoyant de l&rsquo;argent via Paypal \u00e0 : mediterranee@planete-sciences.org<\/li>\n<li>en envoyant un ch\u00e8que \u00e0 : Plan\u00e8te Sciences M\u00e9diterran\u00e9e&nbsp; 11 rue Sans Peur&nbsp; 06130 GRASSE<\/li>\n<li>en effectuant un virement bancaire : demandez notre RIB par <a href=\"mailto:mediterranee@planete-sciences.org\">email<\/a><\/li>\n<li>en cliquant sur le bouton ci-dessous apr\u00e8s avoir s\u00e9lectionn\u00e9 le montant de l&rsquo;adh\u00e9sion (paiement via Paypal ou par Carte Bancaire possible)<\/li>\n<\/ul>\n\n\n\n<div id=\"smart-button-container\">\n      <div style=\"text-align: center;\">\n        <div style=\"margin-bottom: 1.25rem;\">\n          <p>Adh\u00e9sion PSM<\/p>\n          <select id=\"item-options\"><option value=\"Individuelle\" price=\"20\">Individuelle &#8211; 20 EUR<\/option><option value=\"Famille\" price=\"35\">Famille &#8211; 35 EUR<\/option><option value=\"Ch\u00f4meur, Etudiant, Retrait\u00e9\" price=\"10\">Ch\u00f4meur, Etudiant, Retrait\u00e9 &#8211; 10 EUR<\/option><option value=\"Structure publique ou priv\u00e9e\" price=\"50\">Structure publique ou priv\u00e9e &#8211; 50 EUR<\/option><\/select>\n          <select style=\"visibility: hidden\" id=\"quantitySelect\"><\/select>\n        <\/div>\n      <div id=\"paypal-button-container\" style=\"width: 300px; margin: auto\"><\/div>\n      <\/div>\n    <\/div>\n    <script src=\"https:\/\/www.paypal.com\/sdk\/js?client-id=AY8OaZsn-ANnTt-Q6U3o9crSPZivfxoz0J0hX0PCQ0Le1C8Gsba5M9YTGObHLeQg1REKhRtKEB8DuwjC&amp;enable-funding=venmo&amp;currency=EUR\" data-sdk-integration-source=\"button-factory\"><\/script>\n    <script>\n      function initPayPalButton() {\n        var shipping = 0;\n        var itemOptions = document.querySelector(\"#smart-button-container #item-options\");\n    var quantity = parseInt();\n    var quantitySelect = document.querySelector(\"#smart-button-container #quantitySelect\");\n    if (!isNaN(quantity)) {\n      quantitySelect.style.visibility = \"visible\";\n    }\n    var orderDescription = 'Adh\u00e9sion PSM';\n    if(orderDescription === '') {\n      orderDescription = 'Item';\n    }\n    paypal.Buttons({\n      style: {\n        shape: 'pill',\n        color: 'blue',\n        layout: 'vertical',\n        label: 'paypal',\n        \n      },\n      createOrder: function(data, actions) {\n        var selectedItemDescription = itemOptions.options[itemOptions.selectedIndex].value;\n        var selectedItemPrice = parseFloat(itemOptions.options[itemOptions.selectedIndex].getAttribute(\"price\"));\n        var tax = (0 === 0 || false) ? 0 : (selectedItemPrice * (parseFloat(0)\/100));\n        if(quantitySelect.options.length > 0) {\n          quantity = parseInt(quantitySelect.options[quantitySelect.selectedIndex].value);\n        } else {\n          quantity = 1;\n        }\n\n        tax *= quantity;\n        tax = Math.round(tax * 100) \/ 100;\n        var priceTotal = quantity * selectedItemPrice + parseFloat(shipping) + tax;\n        priceTotal = Math.round(priceTotal * 100) \/ 100;\n        var itemTotalValue = Math.round((selectedItemPrice * quantity) * 100) \/ 100;\n\n        return actions.order.create({\n          purchase_units: [{\n            description: orderDescription,\n            amount: {\n              currency_code: 'EUR',\n              value: priceTotal,\n              breakdown: {\n                item_total: {\n                  currency_code: 'EUR',\n                  value: itemTotalValue,\n                },\n                shipping: {\n                  currency_code: 'EUR',\n                  value: shipping,\n                },\n                tax_total: {\n                  currency_code: 'EUR',\n                  value: tax,\n                }\n              }\n            },\n            items: [{\n              name: selectedItemDescription,\n              unit_amount: {\n                currency_code: 'EUR',\n                value: selectedItemPrice,\n              },\n              quantity: quantity\n            }]\n          }]\n        });\n      },\n      onApprove: function(data, actions) {\n        return actions.order.capture().then(function(orderData) {\n          \n          \/\/ Full available details\n          console.log('Capture result', orderData, JSON.stringify(orderData, null, 2));\n\n          \/\/ Show a success message within this page, e.g.\n          const element = document.getElementById('paypal-button-container');\n          element.innerHTML = '';\n          element.innerHTML = '<h3>Merci pour votre paiement !<\/h3>';\n\n          \/\/ Or go to another URL:  actions.redirect('thank_you.html');\n\n        });\n      },\n      onError: function(err) {\n        console.log(err);\n      },\n    }).render('#paypal-button-container');\n  }\n  initPayPalButton();\n    <\/script>\n","protected":false},"excerpt":{"rendered":"<p>Vous pouvez payer votre adh\u00e9sion soit : en envoyant de l&rsquo;argent via Paypal \u00e0 : mediterranee@planete-sciences.org en envoyant un ch\u00e8que \u00e0 : Plan\u00e8te Sciences M\u00e9diterran\u00e9e&nbsp; 11 rue Sans Peur&nbsp; 06130 GRASSE en effectuant un virement bancaire : demandez notre RIB par email en cliquant sur le bouton ci-dessous apr\u00e8s avoir s\u00e9lectionn\u00e9 le montant de l&rsquo;adh\u00e9sion [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":48,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"_acf_changed":false,"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-2133","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2133","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=2133"}],"version-history":[{"count":15,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2133\/revisions"}],"predecessor-version":[{"id":5570,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/2133\/revisions\/5570"}],"up":[{"embeddable":true,"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/pages\/48"}],"wp:attachment":[{"href":"https:\/\/www.planete-sciences.org\/mediterranee\/wp-json\/wp\/v2\/media?parent=2133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}