CINXE.COM
Demande d'inscription
<!DOCTYPE html> <html class="no-js " lang="fr"> <head> <meta charset="UTF-8"> <meta name="msapplication-config" content="none"/> <title>Demande d'inscription</title> <meta name="viewport" content="width=device-width, initial-scale=1.0 user-scalable=0"> <link href="/upload/favicon.png?ver=fc53b045a" type="image/x-icon" rel="icon"/><link href="/upload/favicon.png?ver=fc53b045a" type="image/x-icon" rel="shortcut icon"/> <link rel="stylesheet" type="text/css" href="/font/Poppins/poppins.css?ver=fc53b045a" /> <link rel="stylesheet" type="text/css" href="//maxcdn.bootstrapcdn.com/font-awesome/4.5.0/css/font-awesome.min.css" /> <link rel="stylesheet" type="text/css" href="/theme/GreenTech/plugins/ubistop/css/fontello.css?ver=fc53b045a" /> <link rel="stylesheet" type="text/css" href="/theme/GreenTech/css/front.min.css?ver=fc53b045a" /> <link rel="stylesheet" type="text/css" href="/theme/GreenTech/css/store.min.css?ver=fc53b045a" /> <script src="/theme/GreenTech/js/vendor/modernizr-2.6.2.min.js?ver=fc53b045a"></script> <!--[if lt IE 9]> <script src="/theme/GreenTech/js/vendor/html5shiv.min.js?ver=fc53b045a"></script> <script src="/theme/GreenTech/js/vendor/respond.min.js?ver=fc53b045a"></script> <![endif]--> <script src="/plugins/vue/vue%402.6.11/vue.min.js?ver=fc53b045a"></script> <script src="/js/vuejs-components/collection/app.js?fver=1733158271&ver=fc53b045a"></script> </head> <body class="theme_toplace passenger_registrations add"> <!--[if lt IE 8]> <p class="browserupgrade"> Vous utilisez un navigateur <strong>d茅pr茅ci茅</strong>. Merci de <a href="http://browsehappy.com/">mettre 脿 jour votre navigateur</a>.</p> <![endif]--> <header class="header-area"> <div class="header-top hidden-xs hidden-sm"> <div class="container"> <div class="row"> <div class="col-sm-6 welcome-mes"> </div> <div class="col-sm-6 header-right-menu"> <nav> <ul> <li role="none"> <a href="/centre-aide" role="menuitem">Centre d'aide</a> </li> <li role="none"> <a href="/moncompte/connexion" role="menuitem">Connexion</a> </li> <li role="none"> <a href="javascript:void(0);" aria-label="Langue actuelle : Fran莽ais (FR)"> <img src="/theme/GreenTech/img/flags/fr-fr.png?ver=fc53b045a" alt="fr-fr" title="Fran莽ais (FR)"/> <i class="fa fa-angle-down"></i> </a> <ul class="language-select"> <li role="none"> <a href="/to_cloud/change_language/en-us"><img src="/theme/GreenTech/img/flags/en-us.png?ver=fc53b045a" alt="en-us"/> English (US)</a> </li> <li role="none"> <a href="/to_cloud/change_language/fr-ca"><img src="/theme/GreenTech/img/flags/fr-ca.png?ver=fc53b045a" alt="fr-ca"/> Fran莽ais (CA)</a> </li> <li role="none"> <a href="/to_cloud/change_language/fr-fr"><img src="/theme/GreenTech/img/flags/fr-fr.png?ver=fc53b045a" alt="fr-fr"/> Fran莽ais (FR)</a> </li> <li role="none"> <a href="/to_cloud/change_language/es-es"><img src="/img/flags/es-es.png?ver=fc53b045a" alt="es-es"/> Espa帽ol (ES)</a> </li> </ul> </li> </ul> </nav> </div> </div> </div> </div> <div class="header-middle hidden-xs hidden-sm"> <div class="container sm-wide"> <div class="row"> <div class="col-md-2 col-lg-3"> <div class="logo"> <a href="https://sam.monbus.mobi//front" title="" target="_self"><img src="/upload/logo_client.png?ver=fc53b045a" alt=""/></a> </div> </div> <div class="col-md-10 col-lg-9"> <div class="mainmenu"> <nav> <ul role="menu"> <li class="" role="none"> <a href="/mondossier" role="menuitem">Mon dossier</a> </li> <li class="" role="none"> <a href="/boutique" role="menuitem">Boutique</a> </li> <li class="active" role="none"> <a href="/inscription/2place" role="menuitem">Demande d'inscription</a> </li> <li class="" role="none"> <a href="/2clock" role="menuitem">Informations Voyageur</a> </li> <li class="" role="none"> <a href="/2sms/abonnement" role="menuitem">Alertes SMS</a> </li> </ul> </nav> </div> </div> </div> </div> </div> <div class="nav-mobile hidden-md hidden-lg" id="navMobileApp"> <div class="nav-mobile__bar"> <a href="/front" title="" class="nav-mobile__bar__logo"><img src="/upload/logo_client.png?ver=fc53b045a" alt="" class="nav-mobile__bar__logo__inner"/></a> <button id="nav-mobile-btn" class="nav-mobile__bar__btn" aria-haspopup="true" aria-controls="nav-mobile-nav" :aria-expanded="[isMenuOpen ? 'true' : 'false']" :title="[isMenuOpen ? 'Fermer le menu' : 'Ouvrir le menu']" @click="toggle('isMenuOpen')"> <i class="fa" aria-hidden="true" :class="[isMenuOpen ? 'fa-times' : 'fa-bars']"></i> </button> </div> <transition name="nav-mobile"> <nav id="nav-mobile-nav" class="nav-mobile__nav" aria-labelledby="nav-mobile-btn" v-show="isMenuOpen" v-cloak> <ul class="nav-mobile__nav__list" role="menu"> <li class="nav-mobile__nav__item " role="none"> <a href="/front" class="nav-mobile__nav__link" role="menuitem">Accueil</a> </li> <li class="nav-mobile__nav__item " role="none"> <a href="/mondossier" class="nav-mobile__nav__link" role="menuitem">Mon dossier</a> </li> <li class="nav-mobile__nav__item " role="none"> <a href="/boutique" class="nav-mobile__nav__link" role="menuitem">Boutique</a> </li> <li class="nav-mobile__nav__item active" role="none"> <a href="/inscription/2place" class="nav-mobile__nav__link" role="menuitem">Demande d'inscription</a> </li> <li class="nav-mobile__nav__item " role="none"> <a href="/to_clock/to_clock/network_selection" class="nav-mobile__nav__link" role="menuitem">Informations Voyageur</a> </li> <li class="nav-mobile__nav__item " role="none"> <a href="/2sms/abonnement" class="nav-mobile__nav__link" role="menuitem">Alertes SMS</a> </li> <li class="nav-mobile__nav__item" role="none"> <a href="/centre-aide" class="nav-mobile__nav__link" role="menuitem">Centre d'aide</a> </li> <li class="nav-mobile__nav__item" role="none"> <a href="/moncompte/connexion" class="nav-mobile__nav__link" role="menuitem">Connexion</a> </li> <li class="nav-mobile__nav__item" role="none"> <span class="nav-mobile__nav__link" aria-label="Langue actuelle : Fran莽ais (FR)"> <img src="/theme/GreenTech/img/flags/fr-fr.png?ver=fc53b045a" alt="fr-fr" aria-hidden="true"/> Fran莽ais (FR) </span> <button id="nav-mobile-language-btn" class="nav-mobile__nav__collapse-btn" aria-haspopup="true" aria-controls="nav-mobile-language" aria-expanded="false" :aria-expanded="[isLanguageOpen ? 'true' : 'false']" :title="[isLanguageOpen ? 'Fermer le sous menu de s茅lection de langues' : 'Ouvrir le sous menu de s茅lection de langues']" @click="toggle('isLanguageOpen')"> <i class="fa" aria-hidden="true" :class="[isLanguageOpen ? 'fa-minus' : 'fa-plus']"></i> </button> <ul id="nav-mobile-language" class="nav-mobile__nav__sublist" aria-labelledby="nav-mobile-language-btn" v-show="isLanguageOpen"> <li class="nav-mobile__nav__item" role="none"> <a href="/to_cloud/change_language/en-us" class="nav-mobile__nav__link"><img src="/theme/GreenTech/img/flags/en-us.png?ver=fc53b045a" alt="en-us" aria-hidden="true"/> English (US)</a> </li> <li class="nav-mobile__nav__item" role="none"> <a href="/to_cloud/change_language/fr-ca" class="nav-mobile__nav__link"><img src="/theme/GreenTech/img/flags/fr-ca.png?ver=fc53b045a" alt="fr-ca" aria-hidden="true"/> Fran莽ais (CA)</a> </li> <li class="nav-mobile__nav__item" role="none"> <a href="/to_cloud/change_language/es-es" class="nav-mobile__nav__link"><img src="/img/flags/es-es.png?ver=fc53b045a" alt="es-es" aria-hidden="true"/> Espa帽ol (ES)</a> </li> </ul> </li> </ul> </nav> </transition> </div> </header> <section class="main-content-area mg-top-10"> <div class="container"> <div class="greentect_bradcame"> <ul><li class="first">Mon compte</li><li class="last">Demande d'inscription</li></ul></div> <div class="row"> <div class="col-lg-6 col-lg-offset-3 col-md-8 col-md-offset-2"> <div class="about-greentech-text text-center"> <h1>Demande d'inscription</h1> <p>Votre demande d'inscription sera trait茅e dans les meilleurs d茅lais</p> </div> <h3 class="form-legend">Informations</h3> <p><fieldset style="margin-bottom: 15px; color:#000000"><p>Bienvenue sur la page d鈥檌nscription du r茅seau de transport S猫te Agglop么le Mobilit茅.</p><p>Le r茅seau SAMobilit茅 s鈥檈ngage au quotidien pour faciliter votre mobilit茅. Cette page vous permet de vous pr茅-inscrire sur le r茅seau de bus SAMobilit茅 afin d鈥檃cheter votre abonnement ou titre de transport.</p></fieldset><fieldset style="margin-bottom: 30px; color:#000000"><p>L鈥檌nscription 脿 ce service n茅cessite l鈥檌mpression d鈥檜ne carte de transport et son envoi 脿 votre domicile. Cette proc茅dure implique donc un d茅lai de fabrication et d鈥檃cheminement. </p><p> Vous avez d茅j脿 une carte de transport de S猫te Agllop么le Mobilit茅 : <a href="https://sam.plateforme-2cloud.com/boutique" target="_blank">rendez-vous ici</a> </p></fieldset><fieldset style="margin-bottom: 15px; color:#000000"><p> Vous n鈥檃vez pas de carte de transport :</p><ul style="margin-left:25px; margin-bottom: 20px;"><li><i style="margin-right: 10px" class="fa fa-check"></i>Vous devez cr茅er votre compte en compl茅tant le formulaire qui suit</li><li><i style="margin-right: 10px" class="fa fa-check"></i>Vous devez fournir les documents suivants : photo d鈥檌dentit茅 et pi猫ce d鈥檌dentit茅 (CNI, passeport)</li></ul></fieldset><fieldset style="margin-bottom: 15px; color:#000000"><p>D猫s que votre compte est valid茅, nos agents associent une carte de transport 脿 votre compte et vous l鈥檈nvoient par courrier 脿 votre domicile. Vous pourrez ensuite vous connecter 脿 votre compte sur cette page et acheter votre abonnement ou titre de transport.</p><p>Assurez-vous de saisir votre domiciliation exacte afin de faciliter l鈥檃cheminement de votre carte. En cas de perte, un duplicata pourrait vous 锚tre factur茅.</p></fieldset></p> <form action="/inscription/2place" class="jsFormDelayOnSubmit" data-submit-label="Envoi en cours <i class="fa fa-spin fa-spinner"></i>" id="PassengerRegistrationAddForm" enctype="multipart/form-data" method="post" accept-charset="utf-8"><div style="display:none;"><input type="hidden" name="_method" value="POST"/><input type="hidden" name="data[_Token][key]" value="36c7bb86a2074bdb5ed842b11e9d59fcb7364b418d59215d5a2dfef3817b65a102d8da09ef3eb81725c9a2de81331eb340e69f6f5faea8e9601627e47eadcadd" id="Token608135360" autocomplete="off"/></div> <h3 class="form-legend">Informations g茅n茅rales</h3> <div class="checkbox"><input type="hidden" name="data[PassengerRegistration][is_tutor]" id="PassengerRegistrationIsTutor_" value="0"/><div class="controls"><label for="PassengerRegistrationIsTutor" class="checkbox"><input type="checkbox" name="data[PassengerRegistration][is_tutor]" value="1" id="PassengerRegistrationIsTutor"/>Je suis responsable l茅gal, j'inscris un proche</label></div></div> <div class="row"> <div class="col-sm-6"> <div class="input-outline disabled"><label for="PassengerRegistrationTutorLastname" class="control-label">Nom du responsable l茅gal *</label><div class="controls"><input name="data[PassengerRegistration][tutor_lastname]" placeholder="Baudry" disabled="disabled" class="input-outline__field disabled" autocomplete="family-name" type="text" id="PassengerRegistrationTutorLastname"/></div></div> </div> <div class="col-sm-6"> <div class="input-outline disabled"><label for="PassengerRegistrationTutorFirstname" class="control-label">Pr茅nom du responsable l茅gal *</label><div class="controls"><input name="data[PassengerRegistration][tutor_firstname]" placeholder="Stanislas" disabled="disabled" class="input-outline__field disabled" autocomplete="given-name" type="text" id="PassengerRegistrationTutorFirstname"/></div></div> </div> </div> <hr class="mg-top-5 mg-bottom-10"> <div class="input-outline"><label for="PassengerRegistrationEmail" class="control-label">E-mail *</label><div class="controls"><input name="data[PassengerRegistration][email]" placeholder="baudry.stanislas@mail.com" required="required" class="input-outline__field" autocomplete="email" maxlength="255" type="email" id="PassengerRegistrationEmail"/><p class="help-block">L'adresse e-mail renseign茅e vous servira d'identifiant lors de vos prochaines connexions</p></div></div> <b>Les informations suivantes sont celles de la personne qui voyagera : </b> <div class="flex align-items-baseline mg-top-10"> <label for="PassengerRegistrationGender">Civilit茅 :</label><input type="hidden" name="data[PassengerRegistration][gender]" id="PassengerRegistrationGender_" value=""/><label class="radio"><input type="radio" name="data[PassengerRegistration][gender]" id="PassengerRegistrationGender1" value="1" />M.</label> <label class="radio"><input type="radio" name="data[PassengerRegistration][gender]" id="PassengerRegistrationGender2" value="2" />Mme.</label> <label class="radio"><input type="radio" name="data[PassengerRegistration][gender]" id="PassengerRegistrationGender0" value="0" />Autre</label></div> <div class="row"> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationLastname" class="control-label">Nom *</label><div class="controls"><input name="data[PassengerRegistration][lastname]" placeholder="Baudry" required="required" class="input-outline__field" autocomplete="family-name" maxlength="255" type="text" id="PassengerRegistrationLastname"/></div></div> </div> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationFirstname" class="control-label">Pr茅nom *</label><div class="controls"><input name="data[PassengerRegistration][firstname]" placeholder="Stanislas" required="required" class="input-outline__field" autocomplete="given-name" maxlength="255" type="text" id="PassengerRegistrationFirstname"/></div></div> </div> </div> <div class="input-outline"><label for="PassengerRegistrationDateofbirth" class="control-label">Date de naissance *</label><div class="controls"><input name="data[PassengerRegistration][dateofbirth]" placeholder="JJ/MM/AAAA" required="required" class="input-outline__field" minlength="10" maxlength="10" autocomplete="bday" type="text" id="PassengerRegistrationDateofbirth"/></div></div> <h3 class="form-legend">Coordonn茅es</h3> <div id="contactFormAddressApp"> <div class="alert alert-danger" role="alert" data-invalid-message="L'adresse que vous avez saisie n'est pas compl猫te. Veuillez renseigner les champs suivants." data-unconfirmed-message="L'adresse que vous avez saisie n'a pas 茅t茅 valid茅e. Veuillez s茅lectionner une adresse." ref="alertMessage" v-show="alertMessage" v-cloak> <span v-html="alertMessage"></span> </div> <div v-show="!requestsInProgress && !displayedSuggestions"> <div class="row"> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationAddressCountry" class="control-label">Pays</label><div class="controls"><select name="data[PassengerRegistration][address_country]" class="input-outline__field select state-code-builder jsCountrySelect" data-state-codes="{"Canada":{"AB":"Alberta","BC":"Colombie-Britannique","PE":"\u00cele-du-Prince-\u00c9douard","MB":"Manitoba","NB":"Nouveau-Brunswick","NS":"Nouvelle-\u00c9cosse","ON":"Ontario","QC":"Qu\u00e9bec","SK":"Saskatchewan","NL":"Terre-Neuve-et-Labrador","NU":"Nunavut","NT":"Territoires du Nord-Ouest","YT":"Yukon"},"\u00c9tats-Unis":{"AL":"Alabama","AK":"Alaska","AZ":"Arizona","AR":"Arkansas","CA":"Californie","CO":"Colorado","CT":"Connecticut","DE":"Delaware","FL":"Florida","GA":"Georgie","HI":"Hawaii","ID":"Idaho","IL":"Illinois","IN":"Indiana","IA":"Iowa","KS":"Kansas","KY":"Kentucky","LA":"Lousiane","ME":"Maine","MD":"Maryland","MA":"Massachusetts","MI":"Michigan","MN":"Minnesota","MS":"Mississippi","MO":"Missouri","MT":"Montana","NE":"Nebraska","NV":"Nevada","NH":"New Hampshire","NJ":"New Jersey","NM":"Nouveau Mexique","NY":"New York","NC":"Caroline du Nord","ND":"Dakota du Nord","OH":"Ohio","OK":"Oklahoma","OR":"Oregon","PA":"Pennsylvanie","RI":"Rhode Island","SC":"Caroline du Sud","SD":"Dakota du Sud","TN":"Tennessee","TX":"Texas","UT":"Utah","VT":"Vermont","VA":"Virginie","WA":"Washington","WV":"Virginie-Occidentale","WI":"Wisconsin","WY":"Wyoming"}}" data-state-code-placeholder="S茅lectionner" autocomplete="country-name" v-model="inputs.country" @blur="checkAddress" @focus="focusField" ref="inputCountry" :readonly="readOnly" :class="{'no-pointer-event' : readOnly}" id="PassengerRegistrationAddressCountry"> <option value="">S茅lectionner</option> <option value="Afghanistan" data-country="AFGHANISTAN">Afghanistan</option> <option value="Afrique du Sud" data-country="AFRIQUE DU SUD">Afrique du Sud</option> <option value="Albanie" data-country="ALBANIE">Albanie</option> <option value="Alg茅rie" data-country="ALG茅RIE">Alg茅rie</option> <option value="Allemagne" data-country="ALLEMAGNE">Allemagne</option> <option value="Andorre" data-country="ANDORRE">Andorre</option> <option value="Angola" data-country="ANGOLA">Angola</option> <option value="Anguilla" data-country="ANGUILLA">Anguilla</option> <option value="Antarctique" data-country="ANTARCTIQUE">Antarctique</option> <option value="Antigua-et-Barbuda" data-country="ANTIGUA-ET-BARBUDA">Antigua-et-Barbuda</option> <option value="Antilles n茅erlandaises" data-country="ANTILLES N茅ERLANDAISES">Antilles n茅erlandaises</option> <option value="Arabie saoudite" data-country="ARABIE SAOUDITE">Arabie saoudite</option> <option value="Argentine" data-country="ARGENTINE">Argentine</option> <option value="Arm茅nie" data-country="ARM茅NIE">Arm茅nie</option> <option value="Aruba" data-country="ARUBA">Aruba</option> <option value="Australie" data-country="AUSTRALIE">Australie</option> <option value="Autriche" data-country="AUTRICHE">Autriche</option> <option value="Azerba茂djan" data-country="AZERBA茂DJAN">Azerba茂djan</option> <option value="Bahamas" data-country="BAHAMAS">Bahamas</option> <option value="Bahre茂n" data-country="BAHRE茂N">Bahre茂n</option> <option value="Bangladesh" data-country="BANGLADESH">Bangladesh</option> <option value="Barbade" data-country="BARBADE">Barbade</option> <option value="B茅larus" data-country="B茅LARUS">B茅larus</option> <option value="Belgique" data-country="BELGIQUE">Belgique</option> <option value="Belize" data-country="BELIZE">Belize</option> <option value="B茅nin" data-country="B茅NIN">B茅nin</option> <option value="Bermudes" data-country="BERMUDES">Bermudes</option> <option value="Bhoutan" data-country="BHOUTAN">Bhoutan</option> <option value="Bolivie" data-country="BOLIVIE">Bolivie</option> <option value="Bosnie-Herz茅govine" data-country="BOSNIE-HERZ茅GOVINE">Bosnie-Herz茅govine</option> <option value="Botswana" data-country="BOTSWANA">Botswana</option> <option value="Br茅sil" data-country="BR茅SIL">Br茅sil</option> <option value="Brun茅i Darussalam" data-country="BRUN茅I DARUSSALAM">Brun茅i Darussalam</option> <option value="Bulgarie" data-country="BULGARIE">Bulgarie</option> <option value="Burkina Faso" data-country="BURKINA FASO">Burkina Faso</option> <option value="Burundi" data-country="BURUNDI">Burundi</option> <option value="Cambodge" data-country="CAMBODGE">Cambodge</option> <option value="Cameroun" data-country="CAMEROUN">Cameroun</option> <option value="Canada" data-country="CANADA">Canada</option> <option value="Cap-Vert" data-country="CAP-VERT">Cap-Vert</option> <option value="Chili" data-country="CHILI">Chili</option> <option value="Chine" data-country="CHINE">Chine</option> <option value="Chypre" data-country="CHYPRE">Chypre</option> <option value="Colombie" data-country="COLOMBIE">Colombie</option> <option value="Comores" data-country="COMORES">Comores</option> <option value="Congo" data-country="CONGO">Congo</option> <option value="Cor茅e du Nord" data-country="COR茅E DU NORD">Cor茅e du Nord</option> <option value="Cor茅e du Sud" data-country="COR茅E DU SUD">Cor茅e du Sud</option> <option value="Costa Rica" data-country="COSTA RICA">Costa Rica</option> <option value="C么te d鈥橧voire" data-country="C么TE D鈥橧VOIRE">C么te d鈥橧voire</option> <option value="Croatie" data-country="CROATIE">Croatie</option> <option value="Cuba" data-country="CUBA">Cuba</option> <option value="Danemark" data-country="DANEMARK">Danemark</option> <option value="Djibouti" data-country="DJIBOUTI">Djibouti</option> <option value="Dominique" data-country="DOMINIQUE">Dominique</option> <option value="脡gypte" data-country="脡GYPTE">脡gypte</option> <option value="El Salvador" data-country="EL SALVADOR">El Salvador</option> <option value="脡mirats arabes unis" data-country="脡MIRATS ARABES UNIS">脡mirats arabes unis</option> <option value="脡quateur" data-country="脡QUATEUR">脡quateur</option> <option value="脡rythr茅e" data-country="脡RYTHR茅E">脡rythr茅e</option> <option value="Espagne" data-country="ESPAGNE">Espagne</option> <option value="Estonie" data-country="ESTONIE">Estonie</option> <option value="脡tat de la Cit茅 du Vatican" data-country="脡TAT DE LA CIT茅 DU VATICAN">脡tat de la Cit茅 du Vatican</option> <option value="脡tats f茅d茅r茅s de Micron茅sie" data-country="脡TATS F茅D茅R茅S DE MICRON茅SIE">脡tats f茅d茅r茅s de Micron茅sie</option> <option value="脡tats-Unis" data-country="脡TATS-UNIS">脡tats-Unis</option> <option value="脡thiopie" data-country="脡THIOPIE">脡thiopie</option> <option value="Fidji" data-country="FIDJI">Fidji</option> <option value="Finlande" data-country="FINLANDE">Finlande</option> <option value="France" data-country="FRANCE" selected="selected">France</option> <option value="Gabon" data-country="GABON">Gabon</option> <option value="Gambie" data-country="GAMBIE">Gambie</option> <option value="G茅orgie" data-country="G茅ORGIE">G茅orgie</option> <option value="G茅orgie du Sud et les 卯les Sandwich du Sud" data-country="G茅ORGIE DU SUD ET LES 卯LES SANDWICH DU SUD">G茅orgie du Sud et les 卯les Sandwich du Sud</option> <option value="Ghana" data-country="GHANA">Ghana</option> <option value="Gibraltar" data-country="GIBRALTAR">Gibraltar</option> <option value="Gr猫ce" data-country="GR猫CE">Gr猫ce</option> <option value="Grenade" data-country="GRENADE">Grenade</option> <option value="Groenland" data-country="GROENLAND">Groenland</option> <option value="Guadeloupe" data-country="GUADELOUPE">Guadeloupe</option> <option value="Guam" data-country="GUAM">Guam</option> <option value="Guatemala" data-country="GUATEMALA">Guatemala</option> <option value="Guernesey" data-country="GUERNESEY">Guernesey</option> <option value="Guin茅e" data-country="GUIN茅E">Guin茅e</option> <option value="Guin茅e 茅quatoriale" data-country="GUIN茅E 茅QUATORIALE">Guin茅e 茅quatoriale</option> <option value="Guin茅e-Bissau" data-country="GUIN茅E-BISSAU">Guin茅e-Bissau</option> <option value="Guyana" data-country="GUYANA">Guyana</option> <option value="Guyane fran莽aise" data-country="GUYANE FRAN莽AISE">Guyane fran莽aise</option> <option value="Ha茂ti" data-country="HA茂TI">Ha茂ti</option> <option value="Honduras" data-country="HONDURAS">Honduras</option> <option value="Hongrie" data-country="HONGRIE">Hongrie</option> <option value="脦le Bouvet" data-country="脦LE BOUVET">脦le Bouvet</option> <option value="脦le Christmas" data-country="脦LE CHRISTMAS">脦le Christmas</option> <option value="脦le de Man" data-country="脦LE DE MAN">脦le de Man</option> <option value="脦le Norfolk" data-country="脦LE NORFOLK">脦le Norfolk</option> <option value="脦les 脜land" data-country="脦LES 脜LAND">脦les 脜land</option> <option value="脦les Ca茂mans" data-country="脦LES CA茂MANS">脦les Ca茂mans</option> <option value="脦les Cocos - Keeling" data-country="脦LES COCOS - KEELING">脦les Cocos - Keeling</option> <option value="脦les Cook" data-country="脦LES COOK">脦les Cook</option> <option value="脦les F茅ro茅" data-country="脦LES F茅RO茅">脦les F茅ro茅</option> <option value="脦les Heard et MacDonald" data-country="脦LES HEARD ET MACDONALD">脦les Heard et MacDonald</option> <option value="脦les Malouines" data-country="脦LES MALOUINES">脦les Malouines</option> <option value="脦les Mariannes du Nord" data-country="脦LES MARIANNES DU NORD">脦les Mariannes du Nord</option> <option value="脦les Marshall" data-country="脦LES MARSHALL">脦les Marshall</option> <option value="脦les Mineures 脡loign茅es des 脡tats-Unis" data-country="脦LES MINEURES 脡LOIGN茅ES DES 脡TATS-UNIS">脦les Mineures 脡loign茅es des 脡tats-Unis</option> <option value="脦les Salomon" data-country="脦LES SALOMON">脦les Salomon</option> <option value="脦les Turks et Ca茂ques" data-country="脦LES TURKS ET CA茂QUES">脦les Turks et Ca茂ques</option> <option value="脦les Vierges britanniques" data-country="脦LES VIERGES BRITANNIQUES">脦les Vierges britanniques</option> <option value="脦les Vierges des 脡tats-Unis" data-country="脦LES VIERGES DES 脡TATS-UNIS">脦les Vierges des 脡tats-Unis</option> <option value="Inde" data-country="INDE">Inde</option> <option value="Indon茅sie" data-country="INDON茅SIE">Indon茅sie</option> <option value="Irak" data-country="IRAK">Irak</option> <option value="Iran" data-country="IRAN">Iran</option> <option value="Irlande" data-country="IRLANDE">Irlande</option> <option value="Islande" data-country="ISLANDE">Islande</option> <option value="Isra毛l" data-country="ISRA毛L">Isra毛l</option> <option value="Italie" data-country="ITALIE">Italie</option> <option value="Jama茂que" data-country="JAMA茂QUE">Jama茂que</option> <option value="Japon" data-country="JAPON">Japon</option> <option value="Jersey" data-country="JERSEY">Jersey</option> <option value="Jordanie" data-country="JORDANIE">Jordanie</option> <option value="Kazakhstan" data-country="KAZAKHSTAN">Kazakhstan</option> <option value="Kenya" data-country="KENYA">Kenya</option> <option value="Kirghizistan" data-country="KIRGHIZISTAN">Kirghizistan</option> <option value="Kiribati" data-country="KIRIBATI">Kiribati</option> <option value="Kowe茂t" data-country="KOWE茂T">Kowe茂t</option> <option value="Laos" data-country="LAOS">Laos</option> <option value="Lesotho" data-country="LESOTHO">Lesotho</option> <option value="Lettonie" data-country="LETTONIE">Lettonie</option> <option value="Liban" data-country="LIBAN">Liban</option> <option value="Lib茅ria" data-country="LIB茅RIA">Lib茅ria</option> <option value="Libye" data-country="LIBYE">Libye</option> <option value="Liechtenstein" data-country="LIECHTENSTEIN">Liechtenstein</option> <option value="Lituanie" data-country="LITUANIE">Lituanie</option> <option value="Luxembourg" data-country="LUXEMBOURG">Luxembourg</option> <option value="Mac茅doine" data-country="MAC茅DOINE">Mac茅doine</option> <option value="Madagascar" data-country="MADAGASCAR">Madagascar</option> <option value="Malaisie" data-country="MALAISIE">Malaisie</option> <option value="Malawi" data-country="MALAWI">Malawi</option> <option value="Maldives" data-country="MALDIVES">Maldives</option> <option value="Mali" data-country="MALI">Mali</option> <option value="Malte" data-country="MALTE">Malte</option> <option value="Maroc" data-country="MAROC">Maroc</option> <option value="Martinique" data-country="MARTINIQUE">Martinique</option> <option value="Maurice" data-country="MAURICE">Maurice</option> <option value="Mauritanie" data-country="MAURITANIE">Mauritanie</option> <option value="Mayotte" data-country="MAYOTTE">Mayotte</option> <option value="Mexique" data-country="MEXIQUE">Mexique</option> <option value="Moldavie" data-country="MOLDAVIE">Moldavie</option> <option value="Monaco" data-country="MONACO">Monaco</option> <option value="Mongolie" data-country="MONGOLIE">Mongolie</option> <option value="Mont茅n茅gro" data-country="MONT茅N茅GRO">Mont茅n茅gro</option> <option value="Montserrat" data-country="MONTSERRAT">Montserrat</option> <option value="Mozambique" data-country="MOZAMBIQUE">Mozambique</option> <option value="Myanmar" data-country="MYANMAR">Myanmar</option> <option value="Namibie" data-country="NAMIBIE">Namibie</option> <option value="Nauru" data-country="NAURU">Nauru</option> <option value="N茅pal" data-country="N茅PAL">N茅pal</option> <option value="Nicaragua" data-country="NICARAGUA">Nicaragua</option> <option value="Niger" data-country="NIGER">Niger</option> <option value="Nig茅ria" data-country="NIG茅RIA">Nig茅ria</option> <option value="Niue" data-country="NIUE">Niue</option> <option value="Norv猫ge" data-country="NORV猫GE">Norv猫ge</option> <option value="Nouvelle-Cal茅donie" data-country="NOUVELLE-CAL茅DONIE">Nouvelle-Cal茅donie</option> <option value="Nouvelle-Z茅lande" data-country="NOUVELLE-Z茅LANDE">Nouvelle-Z茅lande</option> <option value="Oman" data-country="OMAN">Oman</option> <option value="Ouganda" data-country="OUGANDA">Ouganda</option> <option value="Ouzb茅kistan" data-country="OUZB茅KISTAN">Ouzb茅kistan</option> <option value="Pakistan" data-country="PAKISTAN">Pakistan</option> <option value="Palaos" data-country="PALAOS">Palaos</option> <option value="Panama" data-country="PANAMA">Panama</option> <option value="Papouasie-Nouvelle-Guin茅e" data-country="PAPOUASIE-NOUVELLE-GUIN茅E">Papouasie-Nouvelle-Guin茅e</option> <option value="Paraguay" data-country="PARAGUAY">Paraguay</option> <option value="Pays-Bas" data-country="PAYS-BAS">Pays-Bas</option> <option value="P茅rou" data-country="P茅ROU">P茅rou</option> <option value="Philippines" data-country="PHILIPPINES">Philippines</option> <option value="Pitcairn" data-country="PITCAIRN">Pitcairn</option> <option value="Pologne" data-country="POLOGNE">Pologne</option> <option value="Polyn茅sie fran莽aise" data-country="POLYN茅SIE FRAN莽AISE">Polyn茅sie fran莽aise</option> <option value="Porto Rico" data-country="PORTO RICO">Porto Rico</option> <option value="Portugal" data-country="PORTUGAL">Portugal</option> <option value="Qatar" data-country="QATAR">Qatar</option> <option value="R.A.S. chinoise de Hong Kong" data-country="R.A.S. CHINOISE DE HONG KONG">R.A.S. chinoise de Hong Kong</option> <option value="R.A.S. chinoise de Macao" data-country="R.A.S. CHINOISE DE MACAO">R.A.S. chinoise de Macao</option> <option value="r茅gion ind茅termin茅e" data-country="R茅GION IND茅TERMIN茅E">r茅gion ind茅termin茅e</option> <option value="R茅publique centrafricaine" data-country="R茅PUBLIQUE CENTRAFRICAINE">R茅publique centrafricaine</option> <option value="R茅publique d茅mocratique du Congo" data-country="R茅PUBLIQUE D茅MOCRATIQUE DU CONGO">R茅publique d茅mocratique du Congo</option> <option value="R茅publique dominicaine" data-country="R茅PUBLIQUE DOMINICAINE">R茅publique dominicaine</option> <option value="R茅publique tch猫que" data-country="R茅PUBLIQUE TCH猫QUE">R茅publique tch猫que</option> <option value="R茅union" data-country="R茅UNION">R茅union</option> <option value="Roumanie" data-country="ROUMANIE">Roumanie</option> <option value="Royaume-Uni" data-country="ROYAUME-UNI">Royaume-Uni</option> <option value="Russie" data-country="RUSSIE">Russie</option> <option value="Rwanda" data-country="RWANDA">Rwanda</option> <option value="Sahara occidental" data-country="SAHARA OCCIDENTAL">Sahara occidental</option> <option value="Saint-Barth茅l茅my" data-country="SAINT-BARTH茅L茅MY">Saint-Barth茅l茅my</option> <option value="Saint-Kitts-et-Nevis" data-country="SAINT-KITTS-ET-NEVIS">Saint-Kitts-et-Nevis</option> <option value="Saint-Marin" data-country="SAINT-MARIN">Saint-Marin</option> <option value="Saint-Martin" data-country="SAINT-MARTIN">Saint-Martin</option> <option value="Saint-Pierre-et-Miquelon" data-country="SAINT-PIERRE-ET-MIQUELON">Saint-Pierre-et-Miquelon</option> <option value="Saint-Vincent-et-les Grenadines" data-country="SAINT-VINCENT-ET-LES GRENADINES">Saint-Vincent-et-les Grenadines</option> <option value="Sainte-H茅l猫ne" data-country="SAINTE-H茅L猫NE">Sainte-H茅l猫ne</option> <option value="Sainte-Lucie" data-country="SAINTE-LUCIE">Sainte-Lucie</option> <option value="Samoa" data-country="SAMOA">Samoa</option> <option value="Samoa am茅ricaines" data-country="SAMOA AM茅RICAINES">Samoa am茅ricaines</option> <option value="Sao Tom茅-et-Principe" data-country="SAO TOM茅-ET-PRINCIPE">Sao Tom茅-et-Principe</option> <option value="S茅n茅gal" data-country="S茅N茅GAL">S茅n茅gal</option> <option value="Serbie" data-country="SERBIE">Serbie</option> <option value="Serbie-et-Mont茅n茅gro" data-country="SERBIE-ET-MONT茅N茅GRO">Serbie-et-Mont茅n茅gro</option> <option value="Seychelles" data-country="SEYCHELLES">Seychelles</option> <option value="Sierra Leone" data-country="SIERRA LEONE">Sierra Leone</option> <option value="Singapour" data-country="SINGAPOUR">Singapour</option> <option value="Slovaquie" data-country="SLOVAQUIE">Slovaquie</option> <option value="Slov茅nie" data-country="SLOV茅NIE">Slov茅nie</option> <option value="Somalie" data-country="SOMALIE">Somalie</option> <option value="Soudan" data-country="SOUDAN">Soudan</option> <option value="Sri Lanka" data-country="SRI LANKA">Sri Lanka</option> <option value="Su猫de" data-country="SU猫DE">Su猫de</option> <option value="Suisse" data-country="SUISSE">Suisse</option> <option value="Suriname" data-country="SURINAME">Suriname</option> <option value="Svalbard et 脦le Jan Mayen" data-country="SVALBARD ET 脦LE JAN MAYEN">Svalbard et 脦le Jan Mayen</option> <option value="Swaziland" data-country="SWAZILAND">Swaziland</option> <option value="Syrie" data-country="SYRIE">Syrie</option> <option value="Tadjikistan" data-country="TADJIKISTAN">Tadjikistan</option> <option value="Tanzanie" data-country="TANZANIE">Tanzanie</option> <option value="Tchad" data-country="TCHAD">Tchad</option> <option value="Terres australes fran莽aises" data-country="TERRES AUSTRALES FRAN莽AISES">Terres australes fran莽aises</option> <option value="Territoire britannique de l'oc茅an Indien" data-country="TERRITOIRE BRITANNIQUE DE L'OC茅AN INDIEN">Territoire britannique de l'oc茅an Indien</option> <option value="Territoire palestinien" data-country="TERRITOIRE PALESTINIEN">Territoire palestinien</option> <option value="Tha茂lande" data-country="THA茂LANDE">Tha茂lande</option> <option value="Timor oriental" data-country="TIMOR ORIENTAL">Timor oriental</option> <option value="Togo" data-country="TOGO">Togo</option> <option value="Tokelau" data-country="TOKELAU">Tokelau</option> <option value="Tonga" data-country="TONGA">Tonga</option> <option value="Trinit茅-et-Tobago" data-country="TRINIT茅-ET-TOBAGO">Trinit茅-et-Tobago</option> <option value="Tunisie" data-country="TUNISIE">Tunisie</option> <option value="Turkm茅nistan" data-country="TURKM茅NISTAN">Turkm茅nistan</option> <option value="Turquie" data-country="TURQUIE">Turquie</option> <option value="Tuvalu" data-country="TUVALU">Tuvalu</option> <option value="Ukraine" data-country="UKRAINE">Ukraine</option> <option value="Uruguay" data-country="URUGUAY">Uruguay</option> <option value="Vanuatu" data-country="VANUATU">Vanuatu</option> <option value="Venezuela" data-country="VENEZUELA">Venezuela</option> <option value="Vi锚t Nam" data-country="VI锚T NAM">Vi锚t Nam</option> <option value="Wallis-et-Futuna" data-country="WALLIS-ET-FUTUNA">Wallis-et-Futuna</option> <option value="Y茅men" data-country="Y茅MEN">Y茅men</option> <option value="Zambie" data-country="ZAMBIE">Zambie</option> <option value="Zimbabwe" data-country="ZIMBABWE">Zimbabwe</option> </select></div></div> </div> <div class="col-sm-6 hidden" ref="stateCodeParent"> <div class="input-outline"><label for="PassengerRegistrationAddressStateCode" class="control-label">Code 脡tat</label><div class="controls"><select name="data[PassengerRegistration][address_state_code]" id="stateCodeSelect" data-required="false" class="input-outline__field select" v-model="inputs.stateCode" @focus="focusField" ref="selectStateCode" :readonly="readOnly" > <option value="">S茅lectionner</option> </select></div></div> </div> </div> <div class="input-outline"><label for="PassengerRegistrationAddress1" class="control-label">Adresse</label><div class="controls"><input name="data[PassengerRegistration][address_1]" placeholder="3 rue Emile Zola" class="input-outline__field" v-model="inputs.address" @blur="checkAddress" @focus="focusField" ref="inputAddress" :readonly="readOnly" autocomplete="address-line1" maxlength="255" type="text" id="PassengerRegistrationAddress1"/></div></div><div class="input-outline"><label for="PassengerRegistrationAddress2" class="control-label">Compl茅ment d'adresse</label><div class="controls"><input name="data[PassengerRegistration][address_2]" placeholder="R茅sidence Les Tilleuls" class="input-outline__field" v-model="inputs.address2" @focus="focusField" @blur="blurSecondaryField" :readonly="readOnly" autocomplete="address-line2" maxlength="255" type="text" id="PassengerRegistrationAddress2"/></div></div> <div class="row"> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationAddressZipcode" class="control-label">Code postal</label><div class="controls"><input name="data[PassengerRegistration][address_zipcode]" placeholder="75000" class="input-outline__field" maxlength="10" autocomplete="postal-code" v-model="inputs.zipCode" @blur="checkAddress" @focus="focusField" ref="inputZipCode" :readonly="readOnly" type="text" id="PassengerRegistrationAddressZipcode"/></div></div> </div> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationAddressCity" class="control-label">Ville</label><div class="controls"><input name="data[PassengerRegistration][address_city]" placeholder="Paris" class="input-outline__field" autocomplete="address-level2" v-model="inputs.city" @blur="checkAddress" @focus="focusField" ref="inputCity" :readonly="readOnly" maxlength="255" type="text" id="PassengerRegistrationAddressCity"/></div></div> </div> </div> <div class="text-right"> <button class="gt-button gt-button--outline gt-button--round mg-bottom-15" type="button" v-show="readOnly" @click="unlockFields" v-cloak> Modifier mon adresse </button> </div> </div> <div class="addresses-list-ctn addresses-list-ctn--highlight-style" v-show="requestsInProgress || displayedSuggestions" v-cloak> <div class="text-center pd-top-50 pd-bottom-50" aria-hidden="true" v-show="requestsInProgress"> <p>Recherche de l'adresse en cours...</p> <i class="fa fa-spinner fa-2x fa-spin" aria-hidden="true"></i> </div> <div v-show="displayedSuggestions"> <p v-show="suggestions.length === 1"> Nous avons trouv茅 une adresse qui pourrait correspondre 脿 votre saisie.<br /> </p> <p v-show="suggestions.length > 1"> Nous avons trouv茅 plusieurs adresses qui pourraient correspondre 脿 votre saisie.<br /> Veuillez s茅lectionner votre adresse parmi ces suggestions : </p> <ul class="addresses-list" v-show="suggestions.length > 0"> <li v-for="(suggestion, index) in suggestions"> <div class="addresses-list__label radio"> <label :for="'suggestion-' + index"> <input type="radio" name="suggestion" :id="'suggestion-' + index" :value="suggestion" v-model="selectedSuggestion"> {{ formatePlace(suggestion) }} </label> </div> </li> </ul> <p v-show="suggestions.length === 1"> Il ne s'agit pas de votre adresse ? Vous pouvez confirmer l'adresse que vous avez saisie. </p> <p v-show="1 || inputMatchSuggestion"> Aucune suggestion ne correspond 脿 votre adresse ? Vous pouvez confirmer l'adresse que vous avez saisie. </p> <p v-show="suggestions.length === 0"> Nous n'avons pas trouv茅 d'adresse correspondant 脿 votre saisie. <br/> Nous vous invitons 脿 v茅rifier ou confirmer votre saisie. </p> <ul v-show="1 || inputMatchSuggestion" class="addresses-list"> <li> <div class="addresses-list__label radio" v-if="!readOnly"> <label for="suggestion-user"> <input type="radio" name="suggestion" id="suggestion-user" :value="inputs" v-model="selectedSuggestion"> {{ filled }} </label> </div> </li> </ul> <div> <button type="button" class="gt-button gt-button--small gt-button--outline gt-button--round mg-right-10 mg-top-10" @click="ignore"> Modifier mon adresse </button> <button type="button" class="gt-button gt-button--small gt-button--round mg-top-10" @click="addressChoice(selectedSuggestion)"> Valider l'adresse </button> </div> </div> </div> </div> <input type="hidden" value="France" id="defaultCountry"><div class="row"> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationMobilePhone" class="control-label">T茅l茅phone portable</label><div class="controls"><input name="data[PassengerRegistration][mobile_phone]" placeholder="0000000000" class="input-outline__field" autocomplete="tel" maxlength="255" type="text" id="PassengerRegistrationMobilePhone"/></div></div> </div> <div class="col-sm-6"> <div class="input-outline"><label for="PassengerRegistrationHomePhone" class="control-label">T茅l茅phone fixe</label><div class="controls"><input name="data[PassengerRegistration][home_phone]" placeholder="0000000000" class="input-outline__field" autocomplete="tel" maxlength="255" type="text" id="PassengerRegistrationHomePhone"/></div></div> </div> </div> <h3 class="form-legend">Compl茅ment d'information</h3> <p class="small justify-center"> * Vous ne devez faire mention dans le champ ci-dessous d'aucune donn茅e 脿 caract猫re personnel. La soci茅t茅 collectant les donn茅es ne peut en aucun cas 锚tre responsable du non respect de cette consigne. </p> <div class="input-outline"><label for="PassengerRegistrationComment" class="control-label">Commentaire</label><div class="controls"><textarea name="data[PassengerRegistration][comment]" class="input-outline__field" style="max-width: 100%" placeholder="" rows="3" id="PassengerRegistrationComment"></textarea></div></div> <h3 class="form-legend">Documents 脿 fournir</h3> <div class="row"> <div class="col-sm-6"> <label for="PassengerRegistrationPhotoId">Photo d'identit茅<span style="font-size: 10px; color: #f71701;">(obligatoire)</span></label><div class="input-file-outline"><label for="PassengerRegistrationPhotoId" title="Formats accept茅s : .jpg / .jpeg / .png" aria-label="Photo d'identit茅. obligatoire. Le poids maximum du fichier autoris茅 est de 4 M茅ga octet" class="control-label"><i class="fa fa-download fa-lg fa-fw"></i> Choisir un fichier</label><span class="ok-icon " hidden> <i class="fa fa-check-circle fa-lg fa-fw text-success"></i> </span> <span class="error-icon " hidden> <i class="fa fa-times-circle fa-lg fa-fw text-danger"></i> </span><div class="controls"><input type="file" name="data[PassengerRegistration][photoId]" data-title="Choisir un fichier" required="required" accept=".jpg,.jpeg,.png" onchange="validateFile(this, 4194304)" class="" id="PassengerRegistrationPhotoId"/><p class="help-block">Formats accept茅s : .jpg / .jpeg / .png<br>Poids max : 4M</p></div></div> </div> <div class="col-sm-6"> <label for="PassengerRegistrationProofId">Pi猫ce d'identit茅<span style="font-size: 10px; color: #f71701;">(obligatoire)</span></label><div class="input-file-outline"><label for="PassengerRegistrationProofId" title="Formats accept茅s : .jpg / .jpeg / .png / .pdf" aria-label="Pi猫ce d'identit茅. obligatoire. Le poids maximum du fichier autoris茅 est de 4 M茅ga octet" class="control-label"><i class="fa fa-download fa-lg fa-fw"></i> Choisir un fichier</label><span class="ok-icon " hidden> <i class="fa fa-check-circle fa-lg fa-fw text-success"></i> </span> <span class="error-icon " hidden> <i class="fa fa-times-circle fa-lg fa-fw text-danger"></i> </span><div class="controls"><input type="file" name="data[PassengerRegistration][proofId]" data-title="Choisir un fichier" required="required" accept=".jpg,.jpeg,.png,.pdf" onchange="validateFile(this, 4194304)" class="" id="PassengerRegistrationProofId"/><p class="help-block">Formats accept茅s : .jpg / .jpeg / .png / .pdf<br>Poids max : 4M</p></div></div> </div> </div> <div class="checkbox"><input type="hidden" name="data[PassengerRegistration][privacy_policy]" id="PassengerRegistrationPrivacyPolicy_" value="0"/><div class="controls"><label for="PassengerRegistrationPrivacyPolicy" class="checkbox"><input type="checkbox" name="data[PassengerRegistration][privacy_policy]" required="required" value="1" id="PassengerRegistrationPrivacyPolicy"/>J'ai lu et j'accepte <a href="/upload/privacy_security/legal_documents/privacy_policy.pdf?1733188932" title="Voir le document l茅gal Politique de confidentialit茅" target="_blank">la politique de confidentialit茅</a>.*</label></div></div><div class="hidden"> <div class="control-group"><label for="PassengerRegistrationCommentSecond" class="control-label">second commentaire</label><div class="controls"><input name="data[PassengerRegistration][commentSecond]" required="required" class="honeypot" type="text" id="PassengerRegistrationCommentSecond"/></div></div></div> <p class="mg-bottom-30 small"> * Champs obligatoires<br> Vos donn茅es personnelles sont par ailleurs trait茅es pour cr茅er un Compte Mobilit茅, garantissant ainsi l'interop茅rabilit茅 de votre compte sur tous les r茅seaux de transport 茅quip茅s par Matawan. Vos donn茅es sont stock茅es dans les syst猫mes de Matawan pendant la dur茅e d'activit茅 de votre compte. Au moment d'acc茅der 脿 un r茅seau distinct, vos donn茅es personnelles seront partag茅es avec ce dernier lorsque vous renseignerez votre adresse email.</p> <div data-sitekey="6a2bd788-453c-4ff0-90c1-7bcf53e048ea" class="h-captcha"> </div> <div class="row"> <div class="col-md-6 col-md-offset-3"> <button type="submit" class="gt-button gt-button--md gt-button--round gt-button--block" id="submit_register_form">Envoyer ma demande</button> </div> </div> <div style="display:none;"><input type="hidden" name="data[_Token][fields]" value="e7526c4ca88f5b19e058bc4f640beaaccd1f3090%3A" id="TokenFields1467941638" autocomplete="off"/><input type="hidden" name="data[_Token][unlocked]" value="PassengerRegistration.gender%7CPassengerRegistration.is_tutor%7CPassengerRegistration.privacy_policy%7Cg-recaptcha-response%7Ch-captcha-response" id="TokenUnlocked1837291894" autocomplete="off"/></div></form> </div> </div> </div> </section> <footer class="footer"> <div class="footer__top"> <div class="container"> <div> <ul class="footer__links"> <li class="footer__links__item"> <a href="/upload/mentionslegales.pdf" target="_blank">Mentions l茅gales</a> </li> <li class="footer__links__item"> <a href="/upload/privacy_security/legal_documents/privacy_policy.pdf?1733188932" title="Voir la politique de confidentialit茅" target="_blank">La politique de confidentialit茅</a> </li> <li class="footer__links__item"> <a href="#" id="show-cookie-popup">Gestion des cookies</a> </li> </ul> </div> <ul class="footer__address"> <li class="footer__address__item">15 Rue de Copenhague, 34200 S猫te</li> <li class="footer__address__item"><a href="mailto:contact.sam@keolis.com">contact.sam@keolis.com</a></li> </ul> </div> </div> <div class="container"> <div class="copy-right-area"> <p class="copy-right">Services propuls茅s par <a href="https://matawan-mobility.com" target="_blank" alt="Matawan"><img src="https://sam.plateforme-2cloud.com/img/logos/logo_matawan_long.svg?ver=fc53b045a" style="line-height: 2em;vertical-align: middle;max-width: 9rem;display: inline-block;margin: 0 5 0 5;" alt=""/></a></p> <p class="copy-right small">© Copyright 2024 - Tous droits r茅serv茅s</p> </div> <div class="scroll-to-top"> <a href="#" class="greentech-scrollertop" style="display:none;">retour en haut</a> </div> </div> <div id="cookie-popup"> <h3 role="doc-subtitle">Gestion des cookies</h3> <hr> <div> <form class="summary"> <div class="summary-text"> <div> <p>Nous utilisons les cookies afin de fournir les services et fonctionnalit茅s propos茅s sur notre site et afin d鈥檃m茅liorer l鈥檈xp茅rience de nos utilisateurs.</p> <p>En cliquant sur "<b>J'accepte tout</b>", vous acceptez l鈥檜tilisation de tous nos cookies. Vous pourrez toujours les d茅sactiver ult茅rieurement.</p> <p>En cliquant sur "<b>Je refuse</b>" ou en poursuivant la navigation sur ce site, vous acceptez uniquement l鈥檜tilisation des cookies n茅cessaires au fonctionnement du site.</p> <div class="links-container"> <a href="/upload/privacy_security/legal_documents/privacy_policy.pdf" title="Voir la politique de confidentialit茅" target="_blank">Notre politique de confidentialit茅</a> <a href="#" class="show-detail-link toggle-detail">Plus de d茅tails</a> </div> <div class="links-container"> <a href="/files/privacy_security/legal_documents/default_legal_document.pdf" title="Voir la politique de cookies" target="_blank">Notre politique de cookies</a> </div> </div> </div> <div class="actions-container"> <button type="button" class="btn btn-primary accept-all">J'accepte tout</button> <button type="button" class="btn btn-secondary reject-all">Je refuse</button> <a href="#" class="show-detail-link toggle-detail">Plus de d茅tails</a> </div> </form> <form class="details"> <div class="text-container"> <a href="#" class="toggle-detail">< Retour</a> <p>Nous utilisons les cookies afin de fournir les services et fonctionnalit茅s propos茅s sur notre site et afin d鈥檃m茅liorer l鈥檈xp茅rience de nos utilisateurs.</p> <p>En s茅lectionnant "<b>Autoriser tous les cookies</b>", vous acceptez l鈥檜tilisation de <b>tous les cookies</b> (fonctionnels et autres).</p> <p>Vous pouvez activer ou d茅sactiver des cookies non fonctionnels 脿 tout moment en acc茅dant 脿 la fen锚tre de gestion des cookies depuis le lien disponible dans le footer de notre site.</p> <p class="switches-legend-portrait">Pour configurer vos cookies, nous vous invitons 脿 utiliser les boutons ci-dessous :</p> </div> <div class="switches-container"> <p class="switches-legend-landscape">Pour configurer vos cookies, nous vous invitons 脿 utiliser les boutons ci-dessous :</p> <h2>Fonctionnalit茅s</h2> <h3>Ubitransport</h3> <div class="switch-container" title="Ne peuvent 锚tre d茅sactiv茅s"> <div class="switch-label"> Utilis茅s par 2Cloud pour son fonctionnement technique. </div> <div class="form__switch"> <input id="functional_cookies_disabled" class="form__switch__input" value="0" type="radio" disabled required name="functional_cookies_enabled"> <input id="functional_cookies_enabled" class="form__switch__input" value="1" type="radio" disabled checked required name="functional_cookies_enabled"> <label for="functional_cookies_enabled" class="form__switch__label"> Activer </label> <span class="form__switch__toggle-outside"> <span class="form__switch__toggle-inside"></span> </span> </div> </div> <h3>New Relic</h3> <div class="switch-container"> <div class="switch-label"> Monitore les performances des solutions logicielles Ubitransport et ne contient aucune donn茅e personnelle. </div> <div class="form__switch"> <input id="new_relic_cookies_disabled" class="form__switch__input" value="0" type="radio" name="new_relic_cookies_enabled"> <input id="new_relic_cookies_enabled" class="form__switch__input" value="1" type="radio" checked name="new_relic_cookies_enabled"> <label for="new_relic_cookies_enabled" class="form__switch__label"> Activer </label> <span class="form__switch__toggle-outside"> <span class="form__switch__toggle-inside"></span> </span> </div> </div> <div class="switch-container"> <div class="switch-label"> <a href="/upload/privacy_security/legal_documents/privacy_policy.pdf" title="Voir la politique de confidentialit茅" target="_blank">Notre politique de confidentialit茅</a> </div> <div class="switch-label"> <a href="/files/privacy_security/legal_documents/default_legal_document.pdf" title="Voir la politique de cookies" target="_blank">Notre politique de cookies</a> </div> </div> </div> <div class="actions-container"> <div> <button type="button" class="btn btn-secondary accept-all">Accepter tous les cookies</button> </div> <div> <button type="button" class="btn btn-primary accept-selected">Accepter les cookies s茅lectionn茅s</button> </div> </div> </form> </div> </div> </footer> <script src="/theme/GreenTech/js/front.min.js?ver=fc53b045a"></script> <script> //<![CDATA[ $(document).ready(function () { function activateOrNotTutorPart() { var $isTutorChecked = $('#PassengerRegistrationIsTutor').prop('checked'); var $lastName = $('#PassengerRegistrationTutorLastname'); var $lastNameDiv = $lastName.parents('.input-outline'); var $firstName = $('#PassengerRegistrationTutorFirstname'); var $firstNameDiv = $firstName.parents('.input-outline'); $lastName.prop('disabled', !$isTutorChecked); $firstName.prop('disabled', !$isTutorChecked); $lastName.prop('required', $isTutorChecked); $firstName.prop('required', $isTutorChecked); $lastNameDiv.toggleClass('disabled', !$isTutorChecked); $firstNameDiv.toggleClass('disabled', !$isTutorChecked); } activateOrNotTutorPart(); $('#PassengerRegistrationIsTutor').click(activateOrNotTutorPart); }); //]]> </script><script> //<![CDATA[ if (window.history.replaceState) { window.history.replaceState(null, null, window.location.href); } //]]> </script><script> //<![CDATA[ // For Safari browser only if (window.navigator.userAgent.indexOf('Safari') != -1 && window.navigator.userAgent.indexOf('Chrome') == -1) { csrfExpiration(); } function csrfExpiration() { var now = Date.now() / 1000; var tokenTtl = 1733190732; var formReloadInProgress = false; window.onfocus = function () { if (formReloadInProgress || now < tokenTtl) { return false; } formReloadInProgress = true; window.scroll(0,0); window.alert("Nous avons d茅t茅ct茅 une inactivit茅 prolong茅e sur cette page. La page va 锚tre actualis茅e."); window.location.reload(); }; } //]]> </script><script> //<![CDATA[ var geocodeUrl = "/api/api_location_v1/geocode"; var authToken = "UBI-60141483532"; var contactFormAddressApp = null; $(document).ready(function () { contactFormAddressApp = initAddressForm( "contactFormAddress", { country: "France", address: "", address2: "", address3: "", zipCode: "", city: "", stateCode: "", }, false, ); }); //]]> </script><script src="/js/vuejs-components/location/formAddresses.js?ver=fc53b045a"></script><script> //<![CDATA[ function validateFile(target, maxSize) { var file = target.files[0]; var $target = $(target); var $parent = $(target).parents('.input-file-outline'); var $okIcon = $parent.children('.ok-icon'); var $errorIcon = $parent.children('.error-icon'); var error = false; target.setCustomValidity(''); $okIcon.hide(); $errorIcon.hide(); if (!$target.val()) { target.setCustomValidity("Veuillez choisir un fichier"); error = true; } else if (file.size > maxSize) { target.setCustomValidity("La taille du fichier est trop importante"); error = true; } if (error) { $errorIcon.show(); } else { $okIcon.show(); } target.reportValidity(); } //]]> </script><script> //<![CDATA[ $(document).ready(function () { var $honeypot = $('.honeypot'); $('#submit_register_form').click(function(event) { $honeypot.prop("required", false); }); }); //]]> </script><script src="//js.hcaptcha.com/1/api.js" async="async" defer="defer"></script><script> //<![CDATA[ var optionalCookies = '' //]]> </script> </body> </html>