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id="geschlecht_1" /> <label style="display: inline; font-weight: normal;" for="geschlecht_1">m盲nnlich</label> </div> <div style="width: 240px; float: left;"> <input value="W" type="radio" class="" name="geschlecht" id="geschlecht_2" /> <label style="display: inline; font-weight: normal;" for="geschlecht_2">weiblich</label> </div> <div style="width: 240px; float: left;"> <input value="D" type="radio" class="" name="geschlecht" id="geschlecht_3" /> <label style="display: inline; font-weight: normal;" for="geschlecht_3">divers</label> </div> <div class="clearfix" aria-hidden="true"></div> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <span><b>Titel</b></span> <div class=""> <div style="width: 240px; float: left;"> <input value="Dr." type="radio" class="" name="titel" id="titel_1" /> <label style="display: inline; font-weight: normal;" for="titel_1">Dr.</label> </div> <div style="width: 240px; float: left;"> <input value="Prof. Dr." type="radio" class="" name="titel" id="titel_2" /> <label style="display: inline; font-weight: normal;" for="titel_2">Prof. Dr.</label> </div> </div> <div class="clearfix" aria-hidden="true"></div> <div class=""> <div style="width: 240px; float: left;"> <input value="Mag. pharm." type="radio" class="" name="titel" id="titel_3" /> <label style="display: inline; font-weight: normal;" for="titel_3">Mag. pharm.</label> </div> </div> <div class="clearfix" aria-hidden="true"></div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-users" title="Vorname*"></i></span> <input value="" type="text" class="form-control textfeld" name="vorname" id="vorname" placeholder="Vorname*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-users" title="Name*"></i></span> <input value="" type="text" class="form-control textfeld" name="name" id="name" placeholder="Name*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-users" title="Geburtstag*"></i></span> <input value="" type="text" class="form-control textfeld" name="gebdatum" id="gebdatum" placeholder="Geburtstag*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <span><b>Qualifikation*</b></span> <div class=""> <div style="width: 240px; float: left;"> <input value="11" type="radio" class="" name="kennzeichen" id="kennzeichen_1" /> <label style="display: inline; font-weight: normal;" for="kennzeichen_1">ApothekerIn</label> </div> <div style="width: 240px; float: left;"> <input value="12" type="radio" class="" name="kennzeichen" id="kennzeichen_2" /> <label style="display: inline; font-weight: normal;" for="kennzeichen_2">PTA / PTA in Ausbildung</label> </div> </div> <div class="clearfix" aria-hidden="true"></div> <div class=""> <div style="width: 240px; float: left;"> <input value="14" type="radio" class="" name="kennzeichen" id="kennzeichen_3" /> <label style="display: inline; font-weight: normal;" for="kennzeichen_3">PharmazeutIn im Praktikum / StudentIn</label> </div> <div style="width: 240px; float: left;"> <input value="13" type="radio" class="" name="kennzeichen" id="kennzeichen_4" /> <label style="display: inline; font-weight: normal;" for="kennzeichen_4">PKA / PKA-Auszubildende</label> </div> </div> <div class="clearfix" aria-hidden="true"></div> <div class=""> <div style="width: 240px; float: left;"> <input value="17" type="radio" class="" name="kennzeichen" id="kennzeichen_5" /> <label style="display: inline; font-weight: normal;" for="kennzeichen_5">PharmazieingenieurIn / ApothekerassistentIn</label> </div> </div> <div class="clearfix" aria-hidden="true"></div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-home" title="Stra脽e und Hausnummer*"></i></span> <input value="" type="text" class="form-control textfeld" name="strasse" id="strasse" placeholder="Stra脽e und Hausnummer*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-map-marker" title="PLZ*"></i></span> <input value="" type="text" class="form-control textfeld" name="plz" id="plz" placeholder="PLZ*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-map-signs" title="Ort*"></i></span> <input value="" type="text" class="form-control textfeld" name="ort" id="ort" placeholder="Ort*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-phone" title="Telefonnummer*"></i></span> <input value="" type="text" class="form-control textfeld" name="telefonnummer" id="telefonnummer" placeholder="Telefonnummer*" autocomplete="off"/> </div> </div> </div> <div class="form-group"> <div class="cols-sm-10"> <div class="input-group"> <span class="input-group-addon"><i class="fa fa-envelope fa" title="E-Mail*"></i></span> <input value="" type="text" class="form-control textfeld" name="email" id="email" placeholder="E-Mail*" autocomplete="off"/> </div> </div> </div> <div class="datenschutz"> <!-- Link zum Datenschutz muss f眉r die neue Webseite noch ge盲ndert werden! --> <label style="font-weight: normal;"><input type="checkbox" name="datenschutz" id="datenschutz" > Ich habe die <a href="https://blak.de/service/datenschutz" target="_blank">Datenschutzerkl盲rung</a> gelesen und erkl盲re mich damit einverstanden.*</label> </div> <br /> <p class="hinweis_zeichenfolge">Bitte schreiben Sie die Zeichenfolge in das darunter liegende Eingabefeld:</p> <div class="captcha"> <div class="captcha_img_refresh"> <img class="img_captcha" alt="Sicherheitscode" src="../webtools/captcha.php?=1733252575"> <span class="reload_captcha"><i class="reload_captcha_icon fa fa-refresh fa-2x" title="Captcha neu laden"></i></span> </div> <input type="text" class="tedit_captcha form-control form_mandatory notooltip" name="tedit_captcha" autocomplete="off" placeholder="Zeichenfolge"> <div style="clear: both"></div> </div> <br /> <div class="agb"> <!-- Link zu den AGBs muss f眉r die neue Webseite noch ge盲ndert werden! --> <p>Mit Absenden dieses Formulars erkl盲ren Sie sich mit unseren <a href="https://blak.de/fort-und-weiterbildung/agb" target="_blank">Allgemeinen Gesch盲ftsbedingungen</a> <b>ein颅ver颅standen</b>.</p> </div> <div class="buttonleiste"> <button type="submit" style="width: 16em;" class="btn btn-success" title="Online-Konto Beantragen"><i class="fa fa-check"></i> Online-Konto Beantragen</button> </div> </div> </form> </div> </main> <!-- </div> --> </section> <footer> <div class="footer_table"> <div class="accordion_button"> <button class="ansprechpartner_ausklappen">↑   Liste an Ansprechpartnerinnen ausklappen   ↑</button> </div> <div class="ansprechpartner_table" style="overflow-x: auto"> <table class="Ansprechpartner"> <tr> <th aria-label="Nummer" class="number"></th> <th>Aufgabenbereich</th> <th>Name</th> <th>E-Mail-Adresse/Telefon</th> </tr> <tr> <td class="number">1</td> <td>PTA-Zusatzqualifikation,<br>Wiedereinsteigerkurs f眉r Apotheker</td> <td>Petra Sinner</td> <td><a href="mailto:petra.sinner@blak.de">petra.sinner@blak.de</a> <br>Telefon: 089 92 62 - 69</td> </tr> <tr> <td class="number">2</td> <td>ATHINA</td> <td>Barbara Moosbauer</td> <td><a href="mailto:barbara.moosbauer@blak.de">barbara.moosbauer@blak.de</a> <br>Telefon: 089 92 62 - 67</td> </tr> <tr> <td class="number">3</td> <td>Fortbildung</td> <td>Martina Katholnig</td> <td><a href="mailto:martina.katholnig@blak.de">martina.katholnig@blak.de</a> <br>Telefon: 089 92 62 - 64</td> </tr> <tr> <td class="number">4</td> <td>Fortbildung</td> <td>Michaela Klink</td> <td><a href="mailto:michaela.klink@blak.de">michaela.klink@blak.de</a> <br>Telefon: 089 92 62 - 81</td> </tr> <tr> <td class="number">5</td> <td>Fortbildung</td> <td>Valentina Kress</td> <td><a href="mailto:valentina.kress@blak.de">valentina.kress@blak.de</a> <br>Telefon: 089 92 62 - 63</td> </tr> <tr> <td class="number">6</td> <td>Fortbildung</td> <td>Birgit R枚ller</td> <td><a href="mailto:birgit.roeller@blak.de">birgit.roeller@blak.de</a> <br>Telefon: 089 92 62 - 65</td> </tr> </table> </div> </div> </div> <div class="footer_bar"> <div class="footer_bar_container"> <div class="copyright col-sm-6"> 漏 Bayerische Landesapothekerkammer </div> <div class="links col-sm-6"> <ul class="level_1"> <li class="neutral first"><a href="https://www.blak.de/service/impressum" title="Impressum" class="neutral first">Impressum</a> </li> <li class="neutral last"><a 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registerNamespace("KuferTools.Utils"); KuferTools.Spracheinstellungen = {"Dozent":{"Singular":{"Nominativ":"DozentIn","Genitiv":"Dozenten\/in","Dativ":"Dozenten\/in","Akkusativ":"Dozenten\/in"},"Singular_mit_Artikel":{"Nominativ":"der\/die DozentIn","Genitiv":"des\/der Dozenten\/in","Dativ":"dem\/der Dozenten\/in","Akkusativ":"den\/die Dozenten\/in"},"Plural":{"Nominativ":"DozentInnen","Genitiv":"DozentInnen","Dativ":"DozentInnen","Akkusativ":"DozentInnen"},"Plural_mit_Artikel":{"Nominativ":"die DozentInnen","Genitiv":"der DozentInnen","Dativ":"den DozentInnen","Akkusativ":"die DozentInnen"}},"Teilnehmer":{"Singular":{"Nominativ":"TeilnehmerIn","Genitiv":"Teilnehmers\/in","Dativ":"TeilnehmerIn","Akkusativ":"TeilnehmerIn"},"Singular_mit_Artikel":{"Nominativ":"der\/die TeilnehmerIn","Genitiv":"des\/der Teilnehmers\/in","Dativ":"dem\/der TeilnehmerIn","Akkusativ":"den\/die 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