Offre Bastogne | Soirmag

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id="edit-submitted-vos-coordonnees-user-profil-civilite" class="form-radios"><div class="form-item form-item-submitted-vos-coordonnees-user-profil-civilite form-type-radio radio"> <label class="control-label" for="edit-submitted-vos-coordonnees-user-profil-civilite-1"><input required="required" type="radio" id="edit-submitted-vos-coordonnees-user-profil-civilite-1" name="submitted[vos_coordonnees][user_profil_civilite]" value="Mme" class="form-radio" />Madame</label> </div><div class="form-item form-item-submitted-vos-coordonnees-user-profil-civilite form-type-radio radio"> <label class="control-label" for="edit-submitted-vos-coordonnees-user-profil-civilite-2"><input required="required" type="radio" id="edit-submitted-vos-coordonnees-user-profil-civilite-2" name="submitted[vos_coordonnees][user_profil_civilite]" value="M." class="form-radio" />Monsieur</label> </div></div></div><div class="label-floating form-item webform-component webform-component-textfield webform-component--vos-coordonnees--user-profil-nom form-group form-item form-item-submitted-vos-coordonnees-user-profil-nom form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-user-profil-nom">Nom <span class="form-required" title="Ce champ est requis.">*</span></label> <input required="required" class="form-control form-text required" type="text" id="edit-submitted-vos-coordonnees-user-profil-nom" name="submitted[vos_coordonnees][user_profil_nom]" value="" size="60" maxlength="128" /></div><div class="label-floating form-item webform-component webform-component-textfield webform-component--vos-coordonnees--user-profil-prenom form-group form-item form-item-submitted-vos-coordonnees-user-profil-prenom form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-user-profil-prenom">Prénom <span class="form-required" title="Ce champ est requis.">*</span></label> <input required="required" class="form-control form-text required" type="text" id="edit-submitted-vos-coordonnees-user-profil-prenom" name="submitted[vos_coordonnees][user_profil_prenom]" value="" size="60" maxlength="128" /></div><fieldset class="cm-adresse-belge belgian-address-fieldset webform-component--adresse-livraison panel panel-default form-wrapper" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge"> <legend class="panel-heading"> <span class="panel-title fieldset-legend">Adresse de livraison</span> </legend> <div class="panel-body" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-body"> <div class="label-floating col-md-4 form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--code-postal form-group form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-code-postal form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-code-postal">Code postal <span class="form-required" title="Ce champ est requis.">*</span></label> <input autocomplete="postal-code" class="adresse_belge_code_postal form-control form-text required" pattern="^\d{1,5}$" required="required" type="text" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-code-postal" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][code_postal]" value="" size="5" maxlength="5" /></div><div class="label-floating col-md-8 form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--ville form-group form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-ville form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-ville">Ville <span class="form-required" title="Ce champ est requis.">*</span></label> <input autocomplete="locality" class="adresse_belge_ville form-control form-text required" required="required" type="text" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-ville" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][ville]" value="" size="60" maxlength="128" /></div><div class="label-floating col-md-5 form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--numero-rue form-group form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-numero-rue form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-numero-rue">Numéro <span class="form-required" title="Ce champ est requis.">*</span></label> <input class="adresse_belge_numero_rue form-control form-text required" required="required" type="text" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-numero-rue" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][numero_rue]" value="" size="10" maxlength="10" /></div><div class="label-floating col-md-7 form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--nom-rue form-group form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-nom-rue form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-nom-rue">Nom de rue <span class="form-required" title="Ce champ est requis.">*</span></label> <input class="adresse_belge_nom_rue form-control form-text required" required="required" type="text" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-nom-rue" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][nom_rue]" value="" size="60" maxlength="128" /></div><div class="label-floating col-md-4 form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--boite form-group form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-boite form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-boite">Boîte</label> <input class="form-control form-text" type="text" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-boite" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][boite]" value="" size="10" maxlength="10" /></div><div class="label-floating col-md-8 form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--complement-adresse form-group form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-complement-adresse form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-complement-adresse">Complément d'adresse</label> <input class="form-control form-text" type="text" id="edit-submitted-vos-coordonnees-adresse-livraison-adresse-belge-complement-adresse" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][complement_adresse]" value="" size="60" maxlength="128" /></div><div class="form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--adresse-normalisee form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-adresse-normalisee form-type-hidden"><input id="edit-submitted-adresse-livraison-adresse-belge-adresse-normalisee" class="adresse_belge_adresse_normalisee" type="hidden" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][adresse_normalisee]" value="0" /> </div><div class="form-item webform-component webform-component-belgian-address webform-component--vos-coordonnees--adresse-livraison--adresse-belge--modele-base-adresses form-item form-item-submitted-vos-coordonnees-adresse-livraison-adresse-belge-modele-base-adresses form-type-hidden"><input type="hidden" name="submitted[vos_coordonnees][adresse_livraison][adresse_belge][modele_base_adresses]" value="ROAD65" /> </div> </div> </fieldset> <div class="cm-date form-item webform-component webform-component-date webform-component--vos-coordonnees--user-profil-naissance webform-container-inline form-group form-inline form-item form-item-submitted-vos-coordonnees-user-profil-naissance form-type-date form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-user-profil-naissance">Date</label> <div class="form-item form-item-submitted-vos-coordonnees-user-profil-naissance-day form-type-select form-group"><select class="day form-control form-select" id="edit-submitted-vos-coordonnees-user-profil-naissance-day" name="submitted[vos_coordonnees][user_profil_naissance][day]"><option value="" selected="selected">Jour</option><option value="1">1</option><option value="2">2</option><option value="3">3</option><option value="4">4</option><option value="5">5</option><option value="6">6</option><option value="7">7</option><option value="8">8</option><option value="9">9</option><option value="10">10</option><option value="11">11</option><option value="12">12</option><option value="13">13</option><option value="14">14</option><option value="15">15</option><option value="16">16</option><option value="17">17</option><option value="18">18</option><option value="19">19</option><option value="20">20</option><option value="21">21</option><option value="22">22</option><option value="23">23</option><option value="24">24</option><option value="25">25</option><option value="26">26</option><option value="27">27</option><option value="28">28</option><option value="29">29</option><option value="30">30</option><option value="31">31</option></select> <label class="control-label element-invisible" for="edit-submitted-vos-coordonnees-user-profil-naissance-day">Jour</label> </div><div class="form-item form-item-submitted-vos-coordonnees-user-profil-naissance-month form-type-select form-group"><select class="month form-control form-select" id="edit-submitted-vos-coordonnees-user-profil-naissance-month" name="submitted[vos_coordonnees][user_profil_naissance][month]"><option value="" selected="selected">Mois</option><option value="1">jan</option><option value="2">fév</option><option value="3">Mar</option><option value="4">avr</option><option value="5">mai</option><option value="6">juin</option><option value="7">juil</option><option value="8">aoû</option><option value="9">sep</option><option value="10">oct</option><option value="11">nov</option><option value="12">déc</option></select> <label class="control-label element-invisible" for="edit-submitted-vos-coordonnees-user-profil-naissance-month">Mois</label> </div><div class="form-item form-item-submitted-vos-coordonnees-user-profil-naissance-year form-type-select form-group"><select class="year form-control form-select" id="edit-submitted-vos-coordonnees-user-profil-naissance-year" name="submitted[vos_coordonnees][user_profil_naissance][year]"><option value="" selected="selected">Année</option><option value="1920">1920</option><option value="1921">1921</option><option value="1922">1922</option><option value="1923">1923</option><option value="1924">1924</option><option value="1925">1925</option><option value="1926">1926</option><option value="1927">1927</option><option value="1928">1928</option><option value="1929">1929</option><option value="1930">1930</option><option value="1931">1931</option><option value="1932">1932</option><option value="1933">1933</option><option value="1934">1934</option><option value="1935">1935</option><option value="1936">1936</option><option value="1937">1937</option><option value="1938">1938</option><option value="1939">1939</option><option value="1940">1940</option><option value="1941">1941</option><option value="1942">1942</option><option value="1943">1943</option><option value="1944">1944</option><option value="1945">1945</option><option value="1946">1946</option><option value="1947">1947</option><option value="1948">1948</option><option value="1949">1949</option><option value="1950">1950</option><option value="1951">1951</option><option value="1952">1952</option><option value="1953">1953</option><option value="1954">1954</option><option value="1955">1955</option><option value="1956">1956</option><option value="1957">1957</option><option value="1958">1958</option><option value="1959">1959</option><option value="1960">1960</option><option value="1961">1961</option><option value="1962">1962</option><option value="1963">1963</option><option value="1964">1964</option><option value="1965">1965</option><option value="1966">1966</option><option value="1967">1967</option><option value="1968">1968</option><option value="1969">1969</option><option value="1970">1970</option><option value="1971">1971</option><option value="1972">1972</option><option value="1973">1973</option><option value="1974">1974</option><option value="1975">1975</option><option value="1976">1976</option><option value="1977">1977</option><option value="1978">1978</option><option value="1979">1979</option><option value="1980">1980</option><option value="1981">1981</option><option value="1982">1982</option><option value="1983">1983</option><option value="1984">1984</option><option value="1985">1985</option><option value="1986">1986</option><option value="1987">1987</option><option value="1988">1988</option><option value="1989">1989</option><option value="1990">1990</option><option value="1991">1991</option><option value="1992">1992</option><option value="1993">1993</option><option value="1994">1994</option><option value="1995">1995</option><option value="1996">1996</option><option value="1997">1997</option><option value="1998">1998</option><option value="1999">1999</option><option value="2000">2000</option><option value="2001">2001</option><option value="2002">2002</option><option value="2003">2003</option><option value="2004">2004</option><option value="2005">2005</option><option value="2006">2006</option></select> <label class="control-label element-invisible" for="edit-submitted-vos-coordonnees-user-profil-naissance-year">Année</label> </div></div><div class="form-item webform-component webform-component-markup webform-component--vos-coordonnees--separationa2 form-group form-item form-type-markup form-group"><hr /></div><div class="label-floating form-item webform-component webform-component-phone webform-component--vos-coordonnees--numero-de-telephone form-group form-item form-item-submitted-vos-coordonnees-numero-de-telephone form-type-textfield form-group"> <label class="control-label" for="edit-submitted-vos-coordonnees-numero-de-telephone">Numéro de téléphone <span class="form-required" title="Ce champ est requis.">*</span></label> <input required="required" pattern="^[\d\.\+\s-]+\d$" class="form-control form-text required" title="Le numéro doit comporter des chiffres, et peut contenir des espaces, points, tirets, parenthèses et le signe plus (+)" data-toggle="tooltip" type="text" id="edit-submitted-vos-coordonnees-numero-de-telephone" name="submitted[vos_coordonnees][numero_de_telephone]" value="" size="60" maxlength="128" /></div><div class="form-item webform-component webform-component-markup webform-component--vos-coordonnees--separationa form-group form-item form-type-markup form-group"><hr /></div> </div> </fieldset> <div class="small form-item webform-component webform-component-checkboxes webform-component--optin-soirmag-offres form-group form-item form-item-submitted-optin-soirmag-offres form-type-checkboxes form-group"><div id="edit-submitted-optin-soirmag-offres" class="form-checkboxes"><div class="form-item form-item-submitted-optin-soirmag-offres-1 form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-optin-soirmag-offres-1"><input type="checkbox" id="edit-submitted-optin-soirmag-offres-1" name="submitted[optin_soirmag_offres][1]" value="1" class="form-checkbox" />J'accepte de recevoir des offres, des informations du <strong>Soirmag</strong></label> </div></div> <label class="control-label element-invisible" for="edit-submitted-optin-soirmag-offres">optin offre Soirmag</label> </div><div class="small form-item webform-component webform-component-checkboxes webform-component--optin-soirmag-partenaires form-group form-item form-item-submitted-optin-soirmag-partenaires form-type-checkboxes form-group"><div id="edit-submitted-optin-soirmag-partenaires" class="form-checkboxes"><div class="form-item form-item-submitted-optin-soirmag-partenaires-1 form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-optin-soirmag-partenaires-1"><input type="checkbox" id="edit-submitted-optin-soirmag-partenaires-1" name="submitted[optin_soirmag_partenaires][1]" value="1" class="form-checkbox" />J'accepte de recevoir des offres, des informations des partenaires du <strong>Soirmag</strong></label> </div></div> <label class="control-label element-invisible" for="edit-submitted-optin-soirmag-partenaires">optin offre partenaire Soirmag</label> </div><div class="form-item webform-component webform-component-markup webform-component--separation form-group form-item form-type-markup form-group"><hr /></div><div class="form-item webform-component webform-component-consentement webform-component--conditions-generales form-group form-item form-item-submitted-conditions-generales form-type-checkboxes form-group"><div id="edit-submitted-conditions-generales" class="form-checkboxes checkbox-consentement"><div class="form-item form-item-submitted-conditions-generales-1 form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-conditions-generales-1"><input required="required" class="checkbox-consentement form-checkbox" type="checkbox" id="edit-submitted-conditions-generales-1" name="submitted[conditions_generales][1]" value="1" />J'accepte les <a href="/cgv">conditions générales de vente</a>.</label> </div></div> <label class="control-label element-invisible" for="edit-submitted-conditions-generales">Conditions Générales <span class="form-required" title="Ce champ est requis.">*</span></label> </div><div class="form-item webform-component webform-component-markup webform-component--champs-obligatoires form-group form-item form-type-markup form-group"><p>* ce champ doit être rempli</p> </div><div class="form-actions"><button class="webform-next button-primary btn btn-default form-submit" type="submit" name="op" value="Suivant">Suivant</button> <p>Vous pouvez consulter notre <a href="https://www.rossel.be/wp-content/uploads/politique-de-protection-de-la-vie-privee-belgique.pdf">politique de protection de la vie privée</a> qui vous informe des modalités de traitement de vos données personnelles ainsi que de vos droits sur ces données. </p> </div></div><div class="cm-progressbar"> <div class="cm-progressbar-outer"> <span class="cm-progressbar-page current"> <span class="cm-progressbar-page-number">1</span> <span class="cm-progressbar-page-label"> Abonnement </span> </span> <span class="cm-progressbar-page"> <span class="cm-progressbar-page-number">2</span> <span class="cm-progressbar-page-label"> Paiement </span> </span> <span class="cm-progressbar-page"> <span class="cm-progressbar-page-number">3</span> <span class="cm-progressbar-page-label"> Terminé </span> </span> </div> </div> <input type="hidden" name="details[sid]" /> <input type="hidden" name="details[page_num]" value="1" /> <input type="hidden" name="details[page_count]" value="2" /> <input type="hidden" name="details[finished]" value="0" /> <input type="hidden" name="form_build_id" value="form-OTpfTsqjq7gPQg4y06sJashTkoykogojPMuN9xBB8sY" /> <input type="hidden" name="form_id" value="webform_client_form_2253" /> <script> // GTM pour le formulaire en cours if( typeof(registerToCmp) !== 'undefined' && registerToCmp != 'undefind') { registerToCmp('ecommerce', 'ECommerce', function() { dataLayer.push({ 'event': 'checkout', 'ecommerce': { 'checkout': { 'actionField': { 'step': 1}, 'products': [ { "webform_step_number": 1, "webform_submission_id": null, "form_progress": 50, "form_erpcode": "C5156_10", "name": "", "id": "C5156_10", "category": "", "price": "81", "step": 1, "variant": "", "quantity": 1, "brand": "Offre Bastogne" } ] } } }); if(typeof(Drupal.settings.datalayer) !== 'undefined' && typeof(Drupal.settings.datalayer.debugMode) !== 'undefined' && Drupal.settings.datalayer.debugMode){ console.debug('Mise à jour du datalayer effectuée :'); 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