{"id":44,"date":"2023-07-04T22:38:13","date_gmt":"2023-07-04T22:38:13","guid":{"rendered":"http:\/\/nouveauge-ci.net\/?page_id=44"},"modified":"2025-02-05T17:36:51","modified_gmt":"2025-02-05T17:36:51","slug":"regions","status":"publish","type":"page","link":"https:\/\/www.pnv-gn.org\/?page_id=44","title":{"rendered":"Adherer"},"content":{"rendered":"<style class=\"wpcode-css-snippet\"><meta name=\"viewport\" content=\"width=device-width, initial-scale=1\" \/>\r\n\r\n\r\n<style type=\"text\/css\">\r\n.TITRE {\r\ntext-align: center;\r\nfont-weight: bold;\r\ncolor: #090;\r\nfont-size: 24px;\r\n}\r\n\r\n.dou2{\r\ntext-align: center;\r\nfont-weight: bold;\r\ncolor: red;\r\nfont-size: 9px;\r\n}\r\n\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.asterisk {\r\nfont-size: 12px;\r\n}\r\n.insc {\r\nfont-weight: bold;\r\n}\r\n.bol {\r\nfont-weight: bold;\r\n}\r\n.dou {\r\nfont-weight: normal;\r\ntext-align: left;\r\n}\r\n\r\n \r\n\r\n\r\n\/\/DEBUT DU SCRIPT POUR L'AFFICHAGE DU FORMULAIRE SUR PHONE\r\n\/* Smartphones (portrait and landscape) ----------- *\/\r\n@media only screen\r\nand (min-device-width : 320px)\r\nand (max-device-width : 480px) {\r\n\r\n}\r\n\/* Smartphones (landscape) ----------- *\/\r\n@media only screen\r\nand (min-width : 321px) {\r\n\r\n \r\n\r\n\r\n}\r\n\/* Smartphones (portrait) ----------- *\/\r\n@media only screen\r\nand (max-width : 320px) {\r\n\/* Styles *\/\r\n}\r\n\/* iPads (portrait and landscape) ----------- *\/\r\n@media only screen\r\nand (min-device-width : 768px)\r\nand (max-device-width : 1024px) {\r\n\/* Styles *\/\r\n}\r\n\/* iPads (landscape) ----------- *\/\r\n@media only screen\r\nand (min-device-width : 768px)\r\nand (max-device-width : 1024px)\r\nand (orientation : landscape) {\r\n\/* Styles *\/\r\n}\r\n\/* iPads (portrait) ----------- *\/\r\n@media only screen\r\nand (min-device-width : 768px)\r\nand (max-device-width : 1024px)\r\nand (orientation : portrait) {\r\n\/* Styles *\/\r\n}\r\n\/* Desktops and laptops ----------- *\/\r\n@media only screen\r\nand (min-width : 1224px) {\r\n\r\n \r\n\r\n\r\n}\r\n\/* Large screens ----------- *\/\r\n@media only screen\r\nand (min-width : 1824px) {\r\n\/* Styles *\/\r\n}\r\n\/* iPhone 4 ----------- *\/\r\n@media\r\nonly screen and (-webkit-min-device-pixel-ratio : 1.5),\r\nonly screen and (min-device-pixel-ratio : 1.5) {\r\n\r\n \r\n\r\n\r\n}\r\n\/\/FIN SCRIPT D'AFFICHAGE\r\n\r\n<\/style>\r\n\r\n<link rel=\"stylesheet\" href=\"\/\/code.jquery.com\/ui\/1.12.1\/themes\/base\/jquery-ui.css\">\r\n<link rel=\"stylesheet\" href=\"\/resources\/demos\/style.css\">\r\n<script src=\"https:\/\/code.jquery.com\/jquery-1.12.4.js\"><\/script>\r\n<script src=\"https:\/\/code.jquery.com\/ui\/1.12.1\/jquery-ui.js\"><\/script>\r\n<script>\r\n$(function() {\r\n$( \"#dnaissance\" ).datepicker();\r\n});\r\n<\/script><\/style>\n\n\n\r\n\r\n<div style=\"overflow-y:auto;\">\r\n<form id=\"form1\" name=\"form1\" method=\"post\" action=\"#\">\r\n<table style=\"width:100px;\" border=\"0\" align=\"center\" cellspacing=\"10\" id=\"table_form\" name=\"table_form\">\r\n<tr>\r\n<td height=\"65\" colspan=\"2\" align=\"center\"><b style=\"text-align: center; color: #090; font-size: 24px;\">ADHERER AU PARTI NOUVELLE VISION<\/b>\r\n<br><b style=\"text-align: center; color: red; font-size: 9px;\" >-: Appellez imp\u00e9rativement au 624 30 88 54 (directement ou sur Whatsapp) pour les derni\u00e8re informations:-<b>\r\n<\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Nom*<\/td>\r\n<td> <span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"nom\" type=\"text\" id=\"nom\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Pr\u00e9noms*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"prenom\" type=\"text\" id=\"prenom\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Sexe*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n\r\n<select name=\"sexe\" id=\"sexe\" style=\"border-radius:25px;;background:white;border:solid 1px green;\">\r\n<option selected=\"selected\">Choisir<\/option>\r\n<option value=\"Masculin\">Masculin<\/option>\r\n<option value=\"Feminin\">Feminin<\/option>\r\n<\/select>\r\n\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">E-mail*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"email\" type=\"text\" id=\"email\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">N\u00b0 T\u00e9l\u00e9phone*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"tel\" type=\"text\" id=\"tel\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Date de Naissance*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"dnaissance\" type=\"text\" id=\"dnaissance\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Lieu de Naissance*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"lnaissance\" type=\"text\" id=\"lnaissance\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Niveau d'Etude*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"netude\" type=\"text\" id=\"netude\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Profession*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"profession\" type=\"text\" id=\"profession\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Fonction*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"fonction\" type=\"text\" id=\"fonction\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Adresse*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"adresse\" type=\"text\" id=\"adresse\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td width=\"207\" class=\"dou\" style=\"width:100px;\">Comit\u00e9 de base (Village\/quartier)*<\/td>\r\n<td width=\"300\" class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"cdbase\" type=\"text\" id=\"cdbase\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Coordination (Pr\u00e9fecture\/commune)*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px\" name=\"coordination\" type=\"text\" id=\"coordination\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">F\u00e9d\u00e9ration (R\u00e9gion Administrative)*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"federation\" type=\"text\" id=\"federation\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Pays*<\/td>\r\n<td class=\"bol\"><span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"pays\" type=\"text\" id=\"pays\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Quel statut voulez vous avoir*<\/td>\r\n<td class=\"bol\"><label for=\"statut\"><\/label>\r\n<select name=\"statut\" id=\"statut\" style=\"border-radius:25px;;background:white;border:solid 1px green;\">\r\n<option selected=\"selected\">Choisir<\/option>\r\n<option value=\"Simple membre\">Simple membre<\/option>\r\n<option value=\"Membre d'un bureau\">Membre d'un bureau<\/option>\r\n<option value=\"Membre Comit\u00e9 d'implantation\">Membre du comit\u00e9 en charge de l'implantation<\/option>\r\n<option value=\"Membre Cellule de Communication\">Membre de la cellule de Commmunication<\/option>\r\n<option value=\"Membre du cabinet pr\u00e9sidentielle\">Membre du Cabinet du Pr\u00e9sident<\/option>\r\n<\/select>\r\n<\/td>\r\n<\/tr>\r\n\r\n<tr>\r\n<td class=\"dou\" style=\"width:100px;\">Ville\/Village de Residence*<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"lieu_residence\" type=\"text\" id=\"lieu_residence\" size=\"50\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr>\r\n\r\n<tr>\r\n<td class=\"dou\">Qui vous a envoy\u00e9 dans le parti? *<\/td>\r\n<td class=\"bol\">\r\n<span class=\"dou\">\r\n<input style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"parain\" type=\"text\" id=\"parain\" size=\"50\" value=\"\" \/>\r\n<\/span><\/td>\r\n<\/tr>\r\n\r\n<tr>\r\n<td colspan=\"2\" class=\"dou\">Que Souhaitez-vous apporter au parti*<\/td>\r\n<\/tr>\r\n<tr>\r\n<td colspan=\"2\"><span class=\"dou\">\r\n<textarea style=\"border-radius:5px;background:white;border:solid 1px green;\" name=\"contribution\" id=\"contribution\" cols=\"90\" rows=\"10\"><\/textarea>\r\n<\/span><\/td>\r\n<\/tr>\r\n<tr align=\"center\">\r\n<td colspan=\"2\"><input style=\"border-radius:8px\" type=\"submit\" name=\"valider\" id=\"valider\" value=\"Envoyer\" \/><input name=\"verif\" type=\"hidden\" id=\"verif\" value=\"soumission\" \/><\/td>\r\n<\/tr>\r\n<tr>\r\n<td colspan=\"2\" class=\"dou\">NB: LES CHAMPS MARQUES PAR (*) SONT OBLIGATOIRES<\/td>\r\n<\/tr>\r\n<\/table><\/form>\r\n\r\n<\/div>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_regular_price":[],"currency_symbol":[],"footnotes":""},"class_list":["post-44","page","type-page","status-publish","hentry"],"post_slider_layout_featured_media_urls":{"thumbnail":"","post_slider_layout_landscape_large":"","post_slider_layout_portrait_large":"","post_slider_layout_square_large":"","post_slider_layout_landscape":"","post_slider_layout_portrait":"","post_slider_layout_square":"","full":""},"_links":{"self":[{"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=\/wp\/v2\/pages\/44","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=44"}],"version-history":[{"count":3,"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=\/wp\/v2\/pages\/44\/revisions"}],"predecessor-version":[{"id":799,"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=\/wp\/v2\/pages\/44\/revisions\/799"}],"wp:attachment":[{"href":"https:\/\/www.pnv-gn.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=44"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}