{"id":817,"date":"2021-06-20T12:46:16","date_gmt":"2021-06-20T10:46:16","guid":{"rendered":"https:\/\/tatoulu.org\/?page_id=817"},"modified":"2026-08-27T19:55:30","modified_gmt":"2026-08-27T17:55:30","slug":"formulaire-dadhesion","status":"publish","type":"page","link":"https:\/\/tatoulu.org\/index.php\/formulaire-dadhesion\/","title":{"rendered":"Formulaire d&rsquo;inscription au prix Tatoulu"},"content":{"rendered":"\n<p class=\"has-medium-font-size wp-block-paragraph\"><em>Ce formulaire est r\u00e9serv\u00e9 aux <strong>m\u00e9diateurs <\/strong>(adultes souhaitant accompagner un groupe de jeunes pour participer au prix Tatoulu)<\/em><\/p>\n\n\n\n<p class=\"has-medium-font-size wp-block-paragraph\"><em>L&rsquo;inscription au prix tient lieu d&rsquo;adh\u00e9sion \u00e0 l&rsquo;association Tatoulu (pour une inscription sans participer au prix, <a href=\"mailto:tatoulu@tatoulu.org\">contacter directement l&rsquo;association<\/a>)<\/em><\/p>\n\n\n\n<p class=\"has-medium-font-size wp-block-paragraph\"><em>Des questions sur les modalit\u00e9s d&rsquo;inscription ? <a rel=\"noreferrer noopener\" href=\"https:\/\/tatoulu.org\/index.php\/modalites-dadhesion-a-tatoulu\/\" target=\"_blank\">Consultez le mode op\u00e9ratoire<\/a><\/em><\/p>\n\n\n\n<div class='fluentform ff-default fluentform_wrapper_17 ffs_default_wrap'><form data-form_id=\"17\" id=\"fluentform_17\" class=\"frm-fluent-form fluent_form_17 ff-el-form-top ff_form_instance_17_1 ff-form-loading ff_calc_form ff_calc_form ffs_default\" data-form_instance=\"ff_form_instance_17_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Inscriptions<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='817' \/><input type=\"hidden\" id=\"_fluentform_17_fluentformnonce\" name=\"_fluentform_17_fluentformnonce\" value=\"1e583cadb1\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/817\" \/><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_1\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p>La saisie des champs suivis de * est obligatoire<\/p><\/div><hr \/><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_2\" ><h3 class='ff-el-section-title'>INFORMATIONS PERSONNELLES<\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_names_first_name_' id='label_ff_17_names_first_name_' >Pr\u00e9nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_17_names_first_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group  ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_names_last_name_' id='label_ff_17_names_last_name_' >Nom<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_17_names_last_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_email' id='label_ff_17_email' aria-label=\"E-mail\">E-mail<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_17_email\" class=\"ff-el-form-control\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_phone' id='label_ff_17_phone' aria-label=\"T\u00e9l\u00e9phone\">T\u00e9l\u00e9phone<\/label><\/div><div class='ff-el-input--content'><input name=\"phone\" class=\"ff-el-form-control ff-el-phone\" type=\"tel\" placeholder=\"Portable ou fixe\" data-name=\"phone\" id=\"ff_17_phone\" inputmode=\"tel\"  aria-invalid='false' aria-required=true><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_3\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_4\" ><h3 class='ff-el-section-title'>PARTICIPATION AU PRIX TATOULU<\/h3><div class='ff-section_break_desk'><p><strong>Montant : 110 \u20ac<\/strong> (25 \u20ac d'adh\u00e9sion \u00e0 l'association + 85 \u20ac de livres)<\/p><\/div><hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_numeric-field_11' id='label_ff_17_numeric-field_11' aria-label=\"Combien de participants au prix allez-vous accompagner ?\">Combien de participants au prix allez-vous accompagner ?<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_11\" id=\"ff_17_numeric-field_11\" class=\"ff-el-form-control\" placeholder=\"nombre estim\u00e9\" data-name=\"numeric-field_11\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Choisissez la s\u00e9lection correspondant au groupe que vous allez accompagner :\">Choisissez la s\u00e9lection correspondant au groupe que vous allez accompagner :<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_b77163e110e04caa0ce26497bb46ae11'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou rose (petite \/ moyenne section)\"  id='input_radio_4_b77163e110e04caa0ce26497bb46ae11' aria-label='Tatou rose (petite \/ moyenne section)' aria-invalid='false' aria-required=true> <span>Tatou rose (petite \/ moyenne section)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_2d59c53f325c6490da3e248dd59616e2'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou jaune (grande section \/ pr\u00e9paratoire)\"  id='input_radio_4_2d59c53f325c6490da3e248dd59616e2' aria-label='Tatou jaune (grande section \/ pr\u00e9paratoire)' aria-invalid='false' aria-required=true> <span>Tatou jaune (grande section \/ pr\u00e9paratoire)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_95256698c2c108e8a7fa2d0cad438303'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou vert (cours \u00e9l\u00e9mentaire)\"  id='input_radio_4_95256698c2c108e8a7fa2d0cad438303' aria-label='Tatou vert (cours \u00e9l\u00e9mentaire)' aria-invalid='false' aria-required=true> <span>Tatou vert (cours \u00e9l\u00e9mentaire)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_4c9465615ff13d1b3a54708e5039ef4d'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou bleu (cours moyen)\"  id='input_radio_4_4c9465615ff13d1b3a54708e5039ef4d' aria-label='Tatou bleu (cours moyen)' aria-invalid='false' aria-required=true> <span>Tatou bleu (cours moyen)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_d021be4648381b470c9d7669c59f0bd6'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou violet (6\u00e8me)\"  id='input_radio_4_d021be4648381b470c9d7669c59f0bd6' aria-label='Tatou violet (6\u00e8me)' aria-invalid='false' aria-required=true> <span>Tatou violet (6\u00e8me)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_5d5a8970b33bdd62c6cf160d7aa61a82'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou rouge (5\u00e8me)\"  id='input_radio_4_5d5a8970b33bdd62c6cf160d7aa61a82' aria-label='Tatou rouge (5\u00e8me)' aria-invalid='false' aria-required=true> <span>Tatou rouge (5\u00e8me)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_21ef71cd0cc2605155db6c6fc14800db'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou blanc (4\u00e8me \/ 3\u00e8me)\"  id='input_radio_4_21ef71cd0cc2605155db6c6fc14800db' aria-label='Tatou blanc (4\u00e8me \/ 3\u00e8me)' aria-invalid='false' aria-required=true> <span>Tatou blanc (4\u00e8me \/ 3\u00e8me)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_4_be0a24df976952fb16e649efd0e428f2'><input  type=\"radio\" name=\"input_radio_4\" data-name=\"input_radio_4\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Tatou noir (lyc\u00e9e)\"  id='input_radio_4_be0a24df976952fb16e649efd0e428f2' aria-label='Tatou noir (lyc\u00e9e)' aria-invalid='false' aria-required=true> <span>Tatou noir (lyc\u00e9e)<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Voulez vous commander les livres de la s\u00e9lection choisie ?\">Voulez vous commander les livres de la s\u00e9lection choisie ?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6f90d3084ffdbc8e566ed2a18c6f9aaf'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_6f90d3084ffdbc8e566ed2a18c6f9aaf' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_297c592157b312100af8b83810df9d3a'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_297c592157b312100af8b83810df9d3a' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group  has-conditions ff-el-section-break  ff_left\" data-name=\"section_break-17_5\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Livres suppl\u00e9mentaires<\/strong><\/p>\n<p>Vous pouvez commander des s\u00e9ries de livres suppl\u00e9mentaires \u00e0 prix co\u00fbtant (une s\u00e9rie correspond aux 6 livres d'une s\u00e9lection)<em>.<\/em><\/p>\n<p>Indiquez le nombre de s\u00e9ries souhait\u00e9es :<\/p><\/div><hr \/><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_2' id='label_ff_17_numeric-field_2' aria-label=\"Tatou rose (85 \u20ac)\">Tatou rose (85 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_2\" id=\"ff_17_numeric-field_2\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_2\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_3' id='label_ff_17_numeric-field_3' aria-label=\"Tatou jaune (96\u20ac)\">Tatou jaune (96\u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_3\" id=\"ff_17_numeric-field_3\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_3\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_9' id='label_ff_17_numeric-field_9' aria-label=\"Tatou vert (87 \u20ac)\">Tatou vert (87 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_9\" id=\"ff_17_numeric-field_9\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_9\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_8' id='label_ff_17_numeric-field_8' aria-label=\"Tatou bleu (70 \u20ac)\">Tatou bleu (70 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_8\" id=\"ff_17_numeric-field_8\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_8\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_7' id='label_ff_17_numeric-field_7' aria-label=\"Tatou violet (70 \u20ac)\">Tatou violet (70 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_7\" id=\"ff_17_numeric-field_7\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_7\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_6' id='label_ff_17_numeric-field_6' aria-label=\"Tatou rouge (65 \u20ac)\">Tatou rouge (65 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_6\" id=\"ff_17_numeric-field_6\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_6\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_5' id='label_ff_17_numeric-field_5' aria-label=\"Tatou blanc (75 \u20ac)\">Tatou blanc (75 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_5\" id=\"ff_17_numeric-field_5\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_5\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_4' id='label_ff_17_numeric-field_4' aria-label=\"Tatou noir (92 \u20ac)\">Tatou noir (92 \u20ac)<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric-field_4\" id=\"ff_17_numeric-field_4\" class=\"ff-el-form-control\" placeholder=\"nombre de s\u00e9ries demand\u00e9es\" data-name=\"numeric-field_4\" inputmode=\"numeric\" step=\"any\" min=\"0\" aria-valuemin=\"0\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_6\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_7\" ><h3 class='ff-el-section-title'>ETABLISSEMENT CONCERNE<\/h3><div class='ff-section_break_desk'><p><strong>\u00a0<\/strong><strong>Coordonn\u00e9es de l'\u00e9tablissement dans lequel vous effecturez la m\u00e9diation.<\/strong><\/p><\/div><hr \/><\/div><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_input_text_4' id='label_ff_17_input_text_4' aria-label=\"Nom de l&#039;\u00e9tablissement\">Nom de l'\u00e9tablissement<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_4\" class=\"ff-el-form-control\" placeholder=\"nom de l&#039;\u00e9tablissement ou de l&#039;organisme payeur\" data-name=\"input_text_4\" id=\"ff_17_input_text_4\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_dropdown' id='label_ff_17_dropdown' aria-label=\"Type de l&#039;\u00e9tablissement\">Type de l'\u00e9tablissement<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown\" id=\"ff_17_dropdown\" class=\"ff-el-form-control\" data-name=\"dropdown\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_17_dropdown\"><option value=\"\">- choisissez dans la liste -<\/option><option value=\"Ecole\"  >Ecole<\/option><option value=\"Coll\u00e8ge ou lyc\u00e9e\"  >Coll\u00e8ge ou lyc\u00e9e<\/option><option value=\"Autre \u00e9tablissement\"  >Autre \u00e9tablissement<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_email_1' id='label_ff_17_email_1' aria-label=\"E-mail officiel de l&#039;\u00e9tablissement\">E-mail officiel de l'\u00e9tablissement<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email_1\" id=\"ff_17_email_1\" class=\"ff-el-form-control\" data-name=\"email_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_kwpx9f\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_address_kwpx9f_address_line_1_' id='label_ff_17_address_kwpx9f_address_line_1_' aria-label=\"Rue\">Rue<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_kwpx9f[address_line_1]\" id=\"ff_17_address_kwpx9f_address_line_1_\" class=\"ff-el-form-control\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_kwpx10f\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_address_kwpx10f_zip_' id='label_ff_17_address_kwpx10f_zip_' aria-label=\"Code postal\">Code postal<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_kwpx10f[zip]\" id=\"ff_17_address_kwpx10f_zip_\" class=\"ff-el-form-control\" data-key_name=\"zip\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_kwpx11f\" ><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_address_kwpx11f_city_' id='label_ff_17_address_kwpx11f_city_' aria-label=\"Ville\">Ville<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_kwpx11f[city]\" id=\"ff_17_address_kwpx11f_city_\" class=\"ff-el-form-control\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_dropdown_1' id='label_ff_17_dropdown_1' aria-label=\"R\u00e9gion\">R\u00e9gion<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_1\" id=\"ff_17_dropdown_1\" class=\"ff-el-form-control\" data-name=\"dropdown_1\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_17_dropdown_1\"><option value=\"\">- Choisissez dans la liste -<\/option><option value=\"Ile de France\"  >Ile de France<\/option><option value=\"Occitanie\"  >Occitanie<\/option><option value=\"Autre r\u00e9gion\"  >Autre r\u00e9gion<\/option><\/select><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_8\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_9\" ><h3 class='ff-el-section-title'>COMITE DE LECTURE<\/h3><div class='ff-section_break_desk'><p>Les r\u00e9unions du Comit\u00e9 de Lecture ont lieu \u00e0 Paris ou en r\u00e9gion Occitanie (Haute-Garonne ou Gers).<\/p><\/div><hr \/><\/div><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Voulez-vous participer au Comit\u00e9 de Lecture ?\">Voulez-vous participer au Comit\u00e9 de Lecture ?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_0669e8507470e4de05f0e1953e22fa4c'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Oui\"  id='input_radio_1_0669e8507470e4de05f0e1953e22fa4c' aria-label='Oui' aria-invalid='false' aria-required=true> <span>Oui<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_a63692ade15b6c34539f4bc296bc9b3b'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Non\"  id='input_radio_1_a63692ade15b6c34539f4bc296bc9b3b' aria-label='Non' aria-invalid='false' aria-required=true> <span>Non<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_10\" ><h3 class='ff-el-section-title'>PAIEMENT<\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field' id='label_ff_17_numeric-field' aria-label=\"Montant inscription :\">Montant inscription :<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"numeric-field\" id=\"ff_17_numeric-field\" class=\"ff-el-form-control  ff_has_formula\" data-name=\"numeric-field\" data-calculation_formula=\"25+{input.numeric-field_10}\" readonly=\"1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-el-form-left has-conditions'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric-field_10' id='label_ff_17_numeric-field_10' aria-label=\"Montant inscription :\">Montant inscription :<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"numeric-field_10\" id=\"ff_17_numeric-field_10\" class=\"ff-el-form-control  ff_has_formula\" data-name=\"numeric-field_10\" data-calculation_formula=\"110+{input.numeric-field_2}*85+{input.numeric-field_3}*96+{input.numeric-field_9}*87+{input.numeric-field_8}*70+{input.numeric-field_7}*70+{input.numeric-field_6}*65+{input.numeric-field_5}*75+{input.numeric-field_4}*92\" readonly=\"1\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Prise en charge des frais d&#039;inscription :\">Prise en charge des frais d'inscription :<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6_fd3f7904434e2cf9b50f62fb8c927757'><input  type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Par vous-m\u00eame\"  id='input_radio_6_fd3f7904434e2cf9b50f62fb8c927757' aria-label='Par vous-m\u00eame' aria-invalid='false' aria-required=true> <span>Par vous-m\u00eame<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_6_4cd8aa3ade96c295769d88cd35cb09d8'><input  type=\"radio\" name=\"input_radio_6\" data-name=\"input_radio_6\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Par votre \u00e9tablissement\"  id='input_radio_6_4cd8aa3ade96c295769d88cd35cb09d8' aria-label='Par votre \u00e9tablissement' aria-invalid='false' aria-required=true> <span>Par votre \u00e9tablissement<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group  has-conditions ff-el-section-break  ff_left\" data-name=\"section_break-17_11\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Le montant de votre adh\u00e9sion est pris en charge par votre \u00e9tablissement : Tatoulu\u00a0 adressera une facture par mail \u00e0 votre \u00e9tablissement \u00e0 la fin de la p\u00e9riode d'inscription.<\/strong><em><br \/><\/em><\/p>\n<p><strong>S'il y a plusieurs m\u00e9diateurs dans l' \u00e9tablissement, Tatoulu proc\u00e8dera \u00e0 une facturation group\u00e9e.<\/strong><\/p><\/div><hr \/><\/div><div class='ff-el-group ff-el-form-top has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Mode de r\u00e8glement choisi :\">Mode de r\u00e8glement choisi :<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_180b60a8785350671eaa68d7f31829d5'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ch\u00e8que\"  id='input_radio_2_180b60a8785350671eaa68d7f31829d5' aria-label='Ch\u00e8que' aria-invalid='false' aria-required=true> <span>Ch\u00e8que<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_3384e8d72a5963ef427940156f5e00d2'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Mandat administratif\"  id='input_radio_2_3384e8d72a5963ef427940156f5e00d2' aria-label='Mandat administratif' aria-invalid='false' aria-required=true> <span>Mandat administratif<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_d9de3ba8e177cd897f9afc465924371e'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Virement bancaire\"  id='input_radio_2_d9de3ba8e177cd897f9afc465924371e' aria-label='Virement bancaire' aria-invalid='false' aria-required=true> <span>Virement bancaire<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group  has-conditions ff-el-section-break  ff_left\" data-name=\"section_break-17_12\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Vous prenez en charge le montant de votre adh\u00e9sion : Tatoulu vous enverra une facture par mail \u00e0 la r\u00e9ception de l'inscription.<\/strong><\/p><\/div><hr \/><\/div><div class='ff-el-group ff-el-form-top has-conditions'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Mode de r\u00e8glement choisi :\">Mode de r\u00e8glement choisi :<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9_c369dd372b770d045279febc08f70efc'><input  type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Ch\u00e8que\"  id='input_radio_9_c369dd372b770d045279febc08f70efc' aria-label='Ch\u00e8que' aria-invalid='false' aria-required=true> <span>Ch\u00e8que<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_9_8beac75896deb3dbc3d09c3abcdb1691'><input  type=\"radio\" name=\"input_radio_9\" data-name=\"input_radio_9\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Virement bancaire\"  id='input_radio_9_8beac75896deb3dbc3d09c3abcdb1691' aria-label='Virement bancaire' aria-invalid='false' aria-required=true> <span>Virement bancaire<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_13\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p>o R\u00e8glement par ch\u00e8que : les ch\u00e8ques doivent \u00eatre envoy\u00e9s par courrier \u00e0 l'adresse suivante : Dominique PIVETEAUD, 3 rue B\u00e9ziat, 31400 Toulouse (\u00e0 l'ordre de TATOULU). Afin de faciliter la gestion, merci de noter au dos du ch\u00e8que le nom et le pr\u00e9nom de l'adh\u00e9rent.<\/p>\n<p>o R\u00e8glement par mandat administratif ou virement bancaire : un RIB de Tatoulu sera joint \u00e0 la facture.<\/p><\/div><hr \/><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_14\" ><h3 class='ff-el-section-title'>AIDEZ NOUS A AMELIORER NOTRE COMMUNICATION<\/h3><div class='ff-section_break_desk'><\/div><hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Comment avez-vous connu Tatoulu ?\">Comment avez-vous connu Tatoulu ?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_7e1743cfe4ba0eba721686397d653171'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Gr\u00e2ce \u00e0 des proches (famille, amis, coll\u00e8gues ...)\"  id='input_radio_3_7e1743cfe4ba0eba721686397d653171' aria-label='Gr\u00e2ce \u00e0 des proches (famille, amis, coll\u00e8gues ...)' aria-invalid='false' aria-required=true> <span>Gr\u00e2ce \u00e0 des proches (famille, amis, coll\u00e8gues ...)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_44e778e0f209138895c1c09eafd79744'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Gr\u00e2ce \u00e0 des informations trouv\u00e9es sur internet (r\u00e9seaux sociaux, site tatoulu.org ...)\"  id='input_radio_3_44e778e0f209138895c1c09eafd79744' aria-label='Gr\u00e2ce \u00e0 des informations trouv\u00e9es sur internet (r\u00e9seaux sociaux, site tatoulu.org ...)' aria-invalid='false' aria-required=true> <span>Gr\u00e2ce \u00e0 des informations trouv\u00e9es sur internet (r\u00e9seaux sociaux, site tatoulu.org ...)<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_990cb1ed17e3587dad55dce64c9ecd59'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Vous \u00eates un ancien adh\u00e9rent de Tatoulu\"  id='input_radio_3_990cb1ed17e3587dad55dce64c9ecd59' aria-label='Vous \u00eates un ancien adh\u00e9rent de Tatoulu' aria-invalid='false' aria-required=true> <span>Vous \u00eates un ancien adh\u00e9rent de Tatoulu<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_3_01156ec67260c6c4c946eec6de1d6bff'><input  type=\"radio\" name=\"input_radio_3\" data-name=\"input_radio_3\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Autre\"  id='input_radio_3_01156ec67260c6c4c946eec6de1d6bff' aria-label='Autre' aria-invalid='false' aria-required=true> <span>Autre<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-17_15\" ><h3 class='ff-el-section-title'>Besoin d'aide ?<\/h3><div class='ff-section_break_desk'><p>Adressez votre question par e-mail \u00e0 tatoulu@tatoulu.org<\/p><\/div><hr \/><\/div><div class='ff-el-group ff-text-right ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-md ff_btn_style\"  aria-label=\"VALIDER\">VALIDER<\/button><\/div><\/fieldset><\/form><div id='fluentform_17_errors' class='ff-errors-in-stack ff_form_instance_17_1 ff-form-loading_errors ff_form_instance_17_1_errors'><\/div><\/div>            <script type=\"text\/javascript\">\n                window.fluent_form_ff_form_instance_17_1 = {\"id\":\"17\",\"ajaxUrl\":\"https:\\\/\\\/tatoulu.org\\\/wp-admin\\\/admin-ajax.php\",\"settings\":{\"layout\":{\"labelPlacement\":\"top\",\"helpMessagePlacement\":\"with_label\",\"errorMessagePlacement\":\"inline\",\"asteriskPlacement\":\"asterisk-right\"},\"restrictions\":{\"denyEmptySubmission\":{\"enabled\":false}}},\"form_instance\":\"ff_form_instance_17_1\",\"form_id_selector\":\"fluentform_17\",\"rules\":{\"names[first_name]\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"}},\"names[middle_name]\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"}},\"names[last_name]\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"}},\"email\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"},\"email\":{\"value\":true,\"message\":\"Ce champ doit contenir un e-mail valide\",\"global\":false,\"global_message\":\"Ce champ doit contenir un e-mail valide\"}},\"phone\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"},\"valid_phone_number\":{\"value\":false,\"message\":\"Le num\\u00e9ro de t\\u00e9l\\u00e9phone n'est pas valide\",\"global\":false,\"global_message\":\"Le num\\u00e9ro de t\\u00e9l\\u00e9phone est invalide\"}},\"numeric-field_11\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"},\"numeric\":{\"value\":true,\"message\":\"Ce champ doit contenir de la valeur num\\u00e9rique\",\"global\":false,\"global_message\":\"Ce champ doit contenir une valeur num\\u00e9rique\"},\"min\":{\"value\":\"0\",\"message\":\"saisie incorrecte\",\"global\":false,\"global_message\":\"\\u00c9chec de la validation pour la valeur minimale\"},\"max\":{\"value\":\"\",\"message\":\"La valeur maximale est\",\"global\":false,\"global_message\":\"\\u00c9chec de la validation pour la valeur maximale\"}},\"input_radio_4\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"}},\"input_radio\":{\"required\":{\"value\":true,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"}},\"numeric-field_2\":{\"required\":{\"value\":false,\"message\":\"Ce champ est requis\",\"global\":false,\"global_message\":\"Ce champ est obligatoire\"},\"numeric\":{\"value\":true,\"message\":\"Ce champ doit contenir de la valeur num\\u00e9rique\",\"global\":false,\"global_message\":\"Ce champ doit contenir une valeur num\\u00e9rique\"},\"min\":{\"value\":\"0\",\"message\":\"Mauvaise valeur saisie\",\"global\":false,\"global_message\":\"\\u00c9chec de la validation pour la valeur 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sur les modalit\u00e9s d&rsquo;inscription ? Consultez le mode op\u00e9ratoire<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-817","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/pages\/817","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/comments?post=817"}],"version-history":[{"count":16,"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/pages\/817\/revisions"}],"predecessor-version":[{"id":1802,"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/pages\/817\/revisions\/1802"}],"wp:attachment":[{"href":"https:\/\/tatoulu.org\/index.php\/wp-json\/wp\/v2\/media?parent=817"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}