{"id":2,"date":"2019-07-25T11:39:43","date_gmt":"2019-07-25T09:39:43","guid":{"rendered":"https:\/\/wp.dev80.fr\/?page_id=2"},"modified":"2025-01-23T11:22:32","modified_gmt":"2025-01-23T10:22:32","slug":"page-d-exemple","status":"publish","type":"page","link":"https:\/\/adhesion.parti-radical.fr\/","title":{"rendered":"Adh\u00e9sion \/ Don en ligne"},"content":{"rendered":"\n                <div class='gf_browser_gecko gform_wrapper' id='gform_wrapper_9' style='display:none'><a id='gf_9' class='gform_anchor' ><\/a><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_9' id='gform_9'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F2#gf_9'><div id='gf_page_steps_9' class='gf_page_steps'><div id='gf_step_9_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span>&nbsp;<span class='gf_step_label'>Votre<br\/>don\/adh\u00e9sion<\/span><\/div><div id='gf_step_9_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span>&nbsp;<span class='gf_step_label'>Votre<br\/>identit\u00e9<\/span><\/div><div id='gf_step_9_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span>&nbsp;<span class='gf_step_label'>Vos<br\/>coordonn\u00e9es<\/span><\/div><div id='gf_step_9_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span>&nbsp;<span class='gf_step_label'>Mandats<\/span><\/div><div id='gf_step_9_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span>&nbsp;<span class='gf_step_label'>Votre<br\/>conjoint<\/span><\/div><div id='gf_step_9_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span>&nbsp;<span class='gf_step_label'>Mandats<br\/>de votre conjoint<\/span><\/div><div id='gf_step_9_7' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>7<\/span>&nbsp;<span class='gf_step_label'>Confirmation<\/span><\/div><div class='gf_step_clear'><\/div><\/div>\n                        <div class='gform_body'><div id='gform_page_9_1' class='gform_page' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_9' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_6' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label'  >Votre contribution 2026 au Parti Radical<span class='gfield_required'>*<\/span><\/label><div class='gfield_description'>Toute adh\u00e9sion et\/ou don donne droit \u00e0 une r\u00e9duction\nfiscale de 66%, voir mentions l\u00e9gales.<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_6'><li class='gchoice_9_6_0'><input name='input_6' type='radio' value='Je souhaite adh\u00e9rer : 30\u20ac' checked='checked' id='choice_9_6_0' tabindex='1'  onclick='gf_apply_rules(9,[7,8,4]);' onkeypress='gf_apply_rules(9,[7,8,4]);'  \/><label for='choice_9_6_0' id='label_9_6_0'>Je souhaite adh\u00e9rer : 30\u20ac<\/label><\/li><li class='gchoice_9_6_1'><input name='input_6' type='radio' value='Adh\u00e9sion en couple : 40\u20ac'  id='choice_9_6_1' tabindex='2'  onclick='gf_apply_rules(9,[7,8,4]);' onkeypress='gf_apply_rules(9,[7,8,4]);'  \/><label for='choice_9_6_1' id='label_9_6_1'>Adh\u00e9sion en couple : 40\u20ac<\/label><\/li><li class='gchoice_9_6_2'><input name='input_6' type='radio' value='Je b\u00e9n\u00e9ficie d&#039;une adh\u00e9sion \u00e0 tarif r\u00e9duit  : 10\u20ac&lt;br&gt;&lt;i&gt; (- de 30 ans et demandeurs d&#039;emploi)&lt;\/i&gt;'  id='choice_9_6_2' tabindex='3'  onclick='gf_apply_rules(9,[7,8,4]);' onkeypress='gf_apply_rules(9,[7,8,4]);'  \/><label for='choice_9_6_2' id='label_9_6_2'>Je b\u00e9n\u00e9ficie d'une adh\u00e9sion \u00e0 tarif r\u00e9duit  : 10\u20ac<br><i> (- de 30 ans et demandeurs d'emploi)<\/i><\/label><\/li><li class='gchoice_9_6_3'><input name='input_6' type='radio' value='Je propose une coop\u00e9ration (gratuit)'  id='choice_9_6_3' tabindex='4'  onclick='gf_apply_rules(9,[7,8,4]);' onkeypress='gf_apply_rules(9,[7,8,4]);'  \/><label for='choice_9_6_3' id='label_9_6_3'>Je propose une coop\u00e9ration (gratuit)<\/label><\/li><li class='gchoice_9_6_4'><input name='input_6' type='radio' value='J&#039;effectue un don libre'  id='choice_9_6_4' tabindex='5'  onclick='gf_apply_rules(9,[7,8,4]);' onkeypress='gf_apply_rules(9,[7,8,4]);'  \/><label for='choice_9_6_4' id='label_9_6_4'>J'effectue un don libre<\/label><\/li><\/ul><\/div><\/li><li id='field_9_7' class='gfield field_sublabel_above field_description_above' ><label class='gfield_label'  >Souhaitez-vous \u00e9galement faire un don ?<\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_9_7'><li class='gchoice_9_7_1'>\n\t\t\t\t\t\t\t\t<input name='input_7.1' type='checkbox' onclick='gf_apply_rules(9,[8,4]);' onkeypress='gf_apply_rules(9,[8,4]);' value='Souhaitez-vous \u00e9galement faire un don ?'  id='choice_9_7_1' tabindex='6'  \/>\n\t\t\t\t\t\t\t\t<label for='choice_9_7_1' id='label_9_7_1'>Souhaitez-vous \u00e9galement faire un don ?<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_9_8' class='gfield gf_list_2col field_sublabel_above field_description_above' ><label class='gfield_label'  >Destinataire du don<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_8'><li class='gchoice_9_8_0'><input name='input_8' type='radio' value='Don pour le national' checked='checked' id='choice_9_8_0' tabindex='7'    \/><label for='choice_9_8_0' id='label_9_8_0'>Don pour le national<\/label><\/li><li class='gchoice_9_8_1'><input name='input_8' type='radio' value='Don pour ma f\u00e9d\u00e9ration'  id='choice_9_8_1' tabindex='8'    \/><label for='choice_9_8_1' id='label_9_8_1'>Don pour ma f\u00e9d\u00e9ration<\/label><\/li><\/ul><\/div><\/li><li id='field_9_4' class='gfield gfield_price gfield_price_9_4 gfield_product_9_4 gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_4' >Montant de votre don<span class='gfield_required'>*<\/span><\/label><div class='gfield_description'>Les dons (y compris les adh\u00e9sions) ne peuvent exce\u0301der 7500\u20ac par personne physique et par an : voir les mentions l\u00e9gales ci-dessous. Un don ne peut \u00eatre attribu\u00e9 fiscalement qu'au payeur.<\/div><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_4' id='input_9_4' type='text' value='' class='small ginput_amount' tabindex='9'   aria-required=\"true\" aria-invalid=\"false\" \/>\n\t\t\t\t<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                         <input type='button' id='gform_next_button_9_21' class='gform_next_button button' value='Etape suivante : Votre identit\u00e9' tabindex='10' onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_2' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_9' class='gfield gf_list_2col gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label'  >Civilit\u00e9<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_9'><li class='gchoice_9_9_0'><input name='input_9' type='radio' value='Madame' checked='checked' id='choice_9_9_0' tabindex='11'    \/><label for='choice_9_9_0' id='label_9_9_0'>Madame<\/label><\/li><li class='gchoice_9_9_1'><input name='input_9' type='radio' value='Monsieur'  id='choice_9_9_1' tabindex='12'    \/><label for='choice_9_9_1' id='label_9_9_1'>Monsieur<\/label><\/li><\/ul><\/div><\/li><li id='field_9_1' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label gfield_label_before_complex' for='input_9_1_3' >Votre identit\u00e9<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gfield_trigger_change' id='input_9_1'>\n                            \n                            <span id='input_9_1_3_container' class='name_first' >\n                                                    <label for='input_9_1_3' >Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_1.3' id='input_9_1_3' value='' aria-label='Pr\u00e9nom' tabindex='14'  aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                <\/span>\n                            \n                            <span id='input_9_1_6_container' class='name_last' >\n                                                            <label for='input_9_1_6' >Nom<\/label>\n                                                            <input type='text' name='input_1.6' id='input_9_1_6' value='' aria-label='Nom' tabindex='16'  aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id='field_9_10' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_10' >Votre date de naissance<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_10' id='input_9_10' type='text' value='' class='datepicker medium dmy datepicker_no_icon' tabindex='18'  \/>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_10' class='gform_hidden' value='https:\/\/adhesion.parti-radical.fr\/wp-content\/plugins\/gravityforms\/images\/calendar.png'\/><\/li><li id='field_9_47' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_47' >Nationalit\u00e9<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_9_47' type='text' value='' class='medium'  tabindex='19'   aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_12' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_12' >Votre profession<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_9_12' type='text' value='' class='medium'  tabindex='20'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_25' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_25' >Responsabilit\u00e9 associative<\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_9_25' type='text' value='' class='medium'  tabindex='21'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_45' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_45' >Domaines d&#039;expertise<\/label><div class='gfield_description'>Si vous avez une expertise particuli\u00e8re sur un sujet (sant\u00e9, droit, ...) vous pouvez nous le signaler ici. Vous pourrez alors \u00eatre contact\u00e9 par le Parti Radical lorsque cette expertise sera recherch\u00e9e.<\/div><div class='ginput_container ginput_container_text'><input name='input_45' id='input_9_45' type='text' value='' class='medium'  tabindex='22'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_13' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_13' >Votre f\u00e9d\u00e9ration<span class='gfield_required'>*<\/span><\/label><div class='gfield_description'>Votre f\u00e9d\u00e9ration de rattachement est par d\u00e9faut celle de votre d\u00e9partement\/collectivit\u00e9 de r\u00e9sidence. Le si\u00e8ge ou la f\u00e9d\u00e9ration peut vous demander de justifier votre choix.<\/div><div class='ginput_container ginput_container_select'><select name='input_13' id='input_9_13'  class='medium gfield_select' tabindex='23'  aria-required=\"true\" aria-invalid=\"false\"><option value='01 - AIN' >01 - AIN<\/option><option value='02 - AISNE' >02 - AISNE<\/option><option value='03 - ALLIER' >03 - ALLIER<\/option><option value='04 - ALPES-DE-HAUTE-PROVENCE' >04 - ALPES-DE-HAUTE-PROVENCE<\/option><option value='05 - HAUTES-ALPES' >05 - HAUTES-ALPES<\/option><option value='06 - ALPES-MARITIMES' >06 - ALPES-MARITIMES<\/option><option value='07 - ARDECHE' >07 - ARDECHE<\/option><option value='08 - ARDENNES' >08 - ARDENNES<\/option><option value='09 - ARIEGE' >09 - ARIEGE<\/option><option value='10 - AUBE' >10 - AUBE<\/option><option value='11 - AUDE' >11 - AUDE<\/option><option value='12 - AVEYRON' >12 - AVEYRON<\/option><option value='13 - BOUCHES-DU-RHONE' >13 - BOUCHES-DU-RHONE<\/option><option value='14 - CALVADOS' >14 - CALVADOS<\/option><option value='15 - CANTAL' >15 - CANTAL<\/option><option value='16 - CHARENTE' >16 - CHARENTE<\/option><option value='17 - CHARENTE-MARITIME' >17 - CHARENTE-MARITIME<\/option><option value='18 - CHER' >18 - CHER<\/option><option value='19 - CORREZE' >19 - CORREZE<\/option><option value='20 - CORSE' >20 - CORSE<\/option><option value='21 - COTE-D&#039;OR' >21 - COTE-D&#039;OR<\/option><option value='22 - COTES-D&#039;ARMOR' >22 - COTES-D&#039;ARMOR<\/option><option value='23 - CREUSE' >23 - CREUSE<\/option><option value='24 - DORDOGNE' >24 - DORDOGNE<\/option><option value='25 - DOUBS' >25 - DOUBS<\/option><option value='26 - DROME' >26 - DROME<\/option><option value='27 - EURE' >27 - EURE<\/option><option value='28 - EURE-ET-LOIR' >28 - EURE-ET-LOIR<\/option><option value='29 - FINISTERE' >29 - FINISTERE<\/option><option value='30 - GARD' >30 - GARD<\/option><option value='31 - HAUTE-GARONNE' >31 - HAUTE-GARONNE<\/option><option value='32 - GERS' >32 - GERS<\/option><option value='33 - GIRONDE' >33 - GIRONDE<\/option><option value='34 - HERAULT' >34 - HERAULT<\/option><option value='35 - ILLE-ET-VILAINE' >35 - ILLE-ET-VILAINE<\/option><option value='36 - INDRE' >36 - INDRE<\/option><option value='37 - INDRE-ET-LOIRE' >37 - INDRE-ET-LOIRE<\/option><option value='38 - ISERE' >38 - ISERE<\/option><option value='39 - JURA' >39 - JURA<\/option><option value='40 - LANDES' >40 - LANDES<\/option><option value='41 - LOIR-ET-CHER' >41 - LOIR-ET-CHER<\/option><option value='42 - LOIRE' >42 - LOIRE<\/option><option value='43 - HAUTE-LOIRE' >43 - HAUTE-LOIRE<\/option><option value='44 - LOIRE-ATLANTIQUE' >44 - LOIRE-ATLANTIQUE<\/option><option value='45 - LOIRET' >45 - LOIRET<\/option><option value='46 - LOT' >46 - LOT<\/option><option value='47 - LOT-ET-GARONNE' >47 - LOT-ET-GARONNE<\/option><option value='48 - LOZERE' >48 - LOZERE<\/option><option value='49 - MAINE-ET-LOIRE' >49 - MAINE-ET-LOIRE<\/option><option value='50 - MANCHE' >50 - MANCHE<\/option><option value='51 - MARNE' >51 - MARNE<\/option><option value='52 - HAUTE-MARNE' >52 - HAUTE-MARNE<\/option><option value='53 - MAYENNE' >53 - MAYENNE<\/option><option value='54 - MEURTHE-ET-MOSELLE' >54 - MEURTHE-ET-MOSELLE<\/option><option value='55 - MEUSE' >55 - MEUSE<\/option><option value='56 - MORBIHAN' >56 - MORBIHAN<\/option><option value='57 - MOSELLE' >57 - MOSELLE<\/option><option value='58 - NIEVRE' >58 - NIEVRE<\/option><option value='59 - NORD' >59 - NORD<\/option><option value='60 - OISE' >60 - OISE<\/option><option value='61 - ORNE' >61 - ORNE<\/option><option value='62 - PAS-DE-CALAIS' >62 - PAS-DE-CALAIS<\/option><option value='63 - PUY-DE-DOME' >63 - PUY-DE-DOME<\/option><option value='64 - PYR\u00c9N\u00c9ES-ATLANTIQUES' >64 - PYR\u00c9N\u00c9ES-ATLANTIQUES<\/option><option value='65 - HAUTES-PYRENEES' >65 - HAUTES-PYRENEES<\/option><option value='66 - PYRENEES-ORIENTALES' >66 - PYRENEES-ORIENTALES<\/option><option value='67 - BAS-RHIN' >67 - BAS-RHIN<\/option><option value='68 - HAUT-RHIN' >68 - HAUT-RHIN<\/option><option value='69-D - NOUVEAU RH\u00d4NE' >69-D - NOUVEAU RH\u00d4NE<\/option><option value='69-M - LYON M\u00c9TROPOLE' >69-M - LYON M\u00c9TROPOLE<\/option><option value='70 - HAUTE-SAONE' >70 - HAUTE-SAONE<\/option><option value='71 - SAONE-ET-LOIRE' >71 - SAONE-ET-LOIRE<\/option><option value='72 - SARTHE' >72 - SARTHE<\/option><option value='73 - SAVOIE' >73 - SAVOIE<\/option><option value='74 - HAUTE-SAVOIE' >74 - HAUTE-SAVOIE<\/option><option value='75 - PARIS' >75 - PARIS<\/option><option value='76 - SEINE-MARITIME' >76 - SEINE-MARITIME<\/option><option value='77 - SEINE-ET-MARNE' >77 - SEINE-ET-MARNE<\/option><option value='78 - YVELINES' >78 - YVELINES<\/option><option value='79 - DEUX-SEVRES' >79 - DEUX-SEVRES<\/option><option value='80 - SOMME' >80 - SOMME<\/option><option value='81 - TARN' >81 - TARN<\/option><option value='82 - TARN-ET-GARONNE' >82 - TARN-ET-GARONNE<\/option><option value='83 - VAR' >83 - VAR<\/option><option value='84 - VAUCLUSE' >84 - VAUCLUSE<\/option><option value='85 - VENDEE' >85 - VENDEE<\/option><option value='86 - VIENNE' >86 - VIENNE<\/option><option value='87 - HAUTE-VIENNE' >87 - HAUTE-VIENNE<\/option><option value='88 - VOSGES' >88 - VOSGES<\/option><option value='89 - YONNE' >89 - YONNE<\/option><option value='90 - TERRITOIRE DE BELFORT' >90 - TERRITOIRE DE BELFORT<\/option><option value='91 - ESSONNE' >91 - ESSONNE<\/option><option value='92 - HAUTS-DE-SEINE' >92 - HAUTS-DE-SEINE<\/option><option value='93 - SEINE-SAINT-DENIS' >93 - SEINE-SAINT-DENIS<\/option><option value='94 - VAL-DE-MARNE' >94 - VAL-DE-MARNE<\/option><option value='95 - VAL-D&#039;OISE' >95 - VAL-D&#039;OISE<\/option><option value='971 - GUADELOUPE' >971 - GUADELOUPE<\/option><option value='972 - MARTINIQUE' >972 - MARTINIQUE<\/option><option value='973 - GUYANNE' >973 - GUYANNE<\/option><option value='974 - LA R\u00c9UNION' >974 - LA R\u00c9UNION<\/option><option value='975 - SAINT-PIERRE-ET-MIQUELON' >975 - SAINT-PIERRE-ET-MIQUELON<\/option><option value='976 - MAYOTTE' >976 - MAYOTTE<\/option><option value='986 - WALLIS-ET-FUTUNA' >986 - WALLIS-ET-FUTUNA<\/option><option value='987 - POLYNESIE FRANCAISE' >987 - POLYNESIE FRANCAISE<\/option><option value='988 - NOUVELLE-CALEDONIE' >988 - NOUVELLE-CALEDONIE<\/option><option value='99 - \u00c9TRANGER' >99 - \u00c9TRANGER<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_9_22' class='gform_previous_button button' value='Etape pr\u00e9c\u00e9dente : Votre don\/adh\u00e9sion' tabindex='25' onclick='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"1\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> <input type='button' id='gform_next_button_9_22' class='gform_next_button button' value='Etape suivante : Vos coordonn\u00e9es' tabindex='24' onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_3' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_3' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label gfield_label_before_complex' for='input_9_3' >Votre adresse e-mail<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container ginput_container_email' id='input_9_3_container'>\n                                <span id='input_9_3_1_container' class='ginput_left'>\n                                    <label for='input_9_3'>Saisissez votre e-mail<\/label>\n                                    <input class='' type='text' name='input_3' id='input_9_3' value='' tabindex='26'    aria-required=\"true\" aria-invalid=\"false\"\/>\n                                <\/span>\n                                <span id='input_9_3_2_container' class='ginput_right'>\n                                    <label for='input_9_3_2' >Confirmez votre e-mail<\/label>\n                                    <input class='' type='text' name='input_3_2' id='input_9_3_2' value='' tabindex='27'   aria-required=\"true\" aria-invalid=\"false\"\/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id='field_9_11' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_11' >T\u00e9l\u00e9phone<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_11' id='input_9_11' type='text' value='' class='medium' tabindex='28'   aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_2' class='gfield ggf-cf-country gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label gfield_label_before_complex' for='input_9_2_1' >Vos coordonn\u00e9es<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gfield_trigger_change' id='input_9_2' >\n                         <span class='ginput_full address_line_1' id='input_9_2_1_container' >\n                                        <label for='input_9_2_1' id='input_9_2_1_label' >Adresse<\/label>\n                                        <input type='text' name='input_2.1' id='input_9_2_1' value='' tabindex='29'  \/>\n                                    <\/span><span class='ginput_full address_line_2' id='input_9_2_2_container' >\n                                        <label for='input_9_2_2' id='input_9_2_2_label' >Compl\u00e9ment d&#039;adresse<\/label>\n                                        <input type='text' name='input_2.2' id='input_9_2_2' value='' tabindex='30'  \/>\n                                    <\/span><span class='ginput_left address_zip' id='input_9_2_5_container' >\n                                    <label for='input_9_2_5' id='input_9_2_5_label' >Code Postal<\/label>\n                                    <input type='text' name='input_2.5' id='input_9_2_5' value='' tabindex='31'  \/>\n                                <\/span><span class='ginput_right address_city' id='input_9_2_3_container' >\n                                    <label for='input_9_2_3' id='input_9_2_3_label' >Ville<\/label>\n                                    <input type='text' name='input_2.3' id='input_9_2_3' value='' tabindex='32'  \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_2.4' id='input_9_2_4' value=''\/><span class='ginput_left address_country' id='input_9_2_6_container' >\n                                        <label for='input_9_2_6' id='input_9_2_6_label' >Pays<\/label>\n                                        <select name='input_2.6' id='input_9_2_6' tabindex='33' ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='La Barbade' >La Barbade<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Brunei' >Brunei<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='\u00celes Cayman ' >\u00celes Cayman <\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='Tchad' >Tchad<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique du Congo' >R\u00e9publique du Congo<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Chypre' >Chypre<\/option><option value='R\u00e9publique tch\u00e8que' >R\u00e9publique tch\u00e8que<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='Salvador' >Salvador<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='Estonie' >Estonie<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Ghana' >Ghana<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Groenland' >Groenland<\/option><option value='Grenade' >Grenade<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Islande' >Islande<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Iran' >Iran<\/option><option value='Irak' >Irak<\/option><option value='Irlande' >Irlande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Cor\u00e9e du Nord' >Cor\u00e9e du Nord<\/option><option value='Cor\u00e9e du Sud' >Cor\u00e9e du Sud<\/option><option value='Kosovo' >Kosovo<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Laos' >Laos<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Mac\u00e9doine' >Mac\u00e9doine<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaisie' >Malaisie<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Maroc' >Maroc<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Portugal' >Portugal<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Russie' >Russie<\/option><option value='Rwanda' >Rwanda<\/option><option value='Saint-Kitts-et-Nevis' >Saint-Kitts-et-Nevis<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Saint-Martin' >Saint-Martin<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Iles Salomon' >Iles Salomon<\/option><option value='Somalie' >Somalie<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Espagne' >Espagne<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan Sud' >Soudan Sud<\/option><option value='Suriname' >Suriname<\/option><option value='Swaziland' >Swaziland<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='Suisse' >Suisse<\/option><option value='Syrie' >Syrie<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie' >Tanzanie<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Togo' >Togo<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad et Tobago' >Trinidad et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turquie' >Turquie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='Uruguay' >Uruguay<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Cit\u00e9 du Vatican' >Cit\u00e9 du Vatican<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_9_24' class='gform_previous_button button' value='Etape pr\u00e9c\u00e9dente : Votre identit\u00e9' tabindex='35' onclick='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"2\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> <input type='button' id='gform_next_button_9_24' class='gform_next_button button' value='Etape suivante : Mandats' tabindex='34' onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_4' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_14' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_14' >Mandat \u00e9lectif 1<\/label><div class='ginput_container ginput_container_select'><select name='input_14' id='input_9_14'  class='medium gfield_select' tabindex='36'   aria-invalid=\"false\"><option value='--' >--<\/option><option value='Conseiller(e) d&#039;arrondissement' >Conseiller(e) d&#039;arrondissement<\/option><option value='Conseiller(e) municipal(e)' >Conseiller(e) municipal(e)<\/option><option value='Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)' >Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)<\/option><option value='Adjoint(e) au Maire' >Adjoint(e) au Maire<\/option><option value='Maire' >Maire<\/option><option value='Conseiller(e) communautaire' >Conseiller(e) communautaire<\/option><option value='Vice-Pr\u00e9sident(e) d&#039;EPCI' >Vice-Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Pr\u00e9sident(e) d&#039;EPCI' >Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Conseiller(e) d\u00e9partemental(e)' >Conseiller(e) d\u00e9partemental(e)<\/option><option value='Vice-Pr\u00e9sident(e) de D\u00e9partement' >Vice-Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Pr\u00e9sident(e) de D\u00e9partement' >Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Conseiller(e) r\u00e9gional(e)' >Conseiller(e) r\u00e9gional(e)<\/option><option value='Vice-Pr\u00e9sident(e) de R\u00e9gion' >Vice-Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Pr\u00e9sident(e) de R\u00e9gion' >Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer' >Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Conseiller(e) CESE' >Conseiller(e) CESE<\/option><option value='Pr\u00e9sident(e) de section du CESE' >Pr\u00e9sident(e) de section du CESE<\/option><option value='Pr\u00e9sident(e) de groupe du CESE' >Pr\u00e9sident(e) de groupe du CESE<\/option><option value='D\u00e9put\u00e9(e)' >D\u00e9put\u00e9(e)<\/option><option value='S\u00e9nateur(trice)' >S\u00e9nateur(trice)<\/option><option value='Conseiller(e) consulaire' >Conseiller(e) consulaire<\/option><option value='Conseiller(e) AFE' >Conseiller(e) AFE<\/option><option value='Membre du Comit\u00e9 des R\u00e9gions' >Membre du Comit\u00e9 des R\u00e9gions<\/option><option value='D\u00e9put\u00e9(e) europ\u00e9en(ne)' >D\u00e9put\u00e9(e) europ\u00e9en(ne)<\/option><\/select><\/div><\/li><li id='field_9_17' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_17' >Collectivit\u00e9 1<\/label><div class='ginput_container ginput_container_text'><input name='input_17' id='input_9_17' type='text' value='' class='medium'  tabindex='37'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_15' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_15' >Mandat \u00e9lectif 2<\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_9_15'  class='medium gfield_select' tabindex='38'   aria-invalid=\"false\"><option value='--' >--<\/option><option value='Conseiller(e) d&#039;arrondissement' >Conseiller(e) d&#039;arrondissement<\/option><option value='Conseiller(e) municipal(e)' >Conseiller(e) municipal(e)<\/option><option value='Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)' >Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)<\/option><option value='Adjoint(e) au Maire' >Adjoint(e) au Maire<\/option><option value='Maire' >Maire<\/option><option value='Conseiller(e) communautaire' >Conseiller(e) communautaire<\/option><option value='Vice-Pr\u00e9sident(e) d&#039;EPCI' >Vice-Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Pr\u00e9sident(e) d&#039;EPCI' >Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Conseiller(e) d\u00e9partemental(e)' >Conseiller(e) d\u00e9partemental(e)<\/option><option value='Vice-Pr\u00e9sident(e) de D\u00e9partement' >Vice-Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Pr\u00e9sident(e) de D\u00e9partement' >Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Conseiller(e) r\u00e9gional(e)' >Conseiller(e) r\u00e9gional(e)<\/option><option value='Vice-Pr\u00e9sident(e) de R\u00e9gion' >Vice-Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Pr\u00e9sident(e) de R\u00e9gion' >Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer' >Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Conseiller(e) CESE' >Conseiller(e) CESE<\/option><option value='Pr\u00e9sident(e) de section du CESE' >Pr\u00e9sident(e) de section du CESE<\/option><option value='Pr\u00e9sident(e) de groupe du CESE' >Pr\u00e9sident(e) de groupe du CESE<\/option><option value='D\u00e9put\u00e9(e)' >D\u00e9put\u00e9(e)<\/option><option value='S\u00e9nateur(trice)' >S\u00e9nateur(trice)<\/option><option value='Conseiller(e) consulaire' >Conseiller(e) consulaire<\/option><option value='Conseiller(e) AFE' >Conseiller(e) AFE<\/option><option value='Membre du Comit\u00e9 des R\u00e9gions' >Membre du Comit\u00e9 des R\u00e9gions<\/option><option value='D\u00e9put\u00e9(e) europ\u00e9en(ne)' >D\u00e9put\u00e9(e) europ\u00e9en(ne)<\/option><\/select><\/div><\/li><li id='field_9_18' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_18' >Collectivit\u00e9 2<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_9_18' type='text' value='' class='medium'  tabindex='39'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_16' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_16' >Mandat \u00e9lectif 3<\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_9_16'  class='medium gfield_select' tabindex='40'   aria-invalid=\"false\"><option value='--' >--<\/option><option value='Conseiller(e) d&#039;arrondissement' >Conseiller(e) d&#039;arrondissement<\/option><option value='Conseiller(e) municipal(e)' >Conseiller(e) municipal(e)<\/option><option value='Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)' >Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)<\/option><option value='Adjoint(e) au Maire' >Adjoint(e) au Maire<\/option><option value='Maire' >Maire<\/option><option value='Conseiller(e) communautaire' >Conseiller(e) communautaire<\/option><option value='Vice-Pr\u00e9sident(e) d&#039;EPCI' >Vice-Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Pr\u00e9sident(e) d&#039;EPCI' >Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Conseiller(e) d\u00e9partemental(e)' >Conseiller(e) d\u00e9partemental(e)<\/option><option value='Vice-Pr\u00e9sident(e) de D\u00e9partement' >Vice-Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Pr\u00e9sident(e) de D\u00e9partement' >Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Conseiller(e) r\u00e9gional(e)' >Conseiller(e) r\u00e9gional(e)<\/option><option value='Vice-Pr\u00e9sident(e) de R\u00e9gion' >Vice-Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Pr\u00e9sident(e) de R\u00e9gion' >Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer' >Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Conseiller(e) CESE' >Conseiller(e) CESE<\/option><option value='Pr\u00e9sident(e) de section du CESE' >Pr\u00e9sident(e) de section du CESE<\/option><option value='Pr\u00e9sident(e) de groupe du CESE' >Pr\u00e9sident(e) de groupe du CESE<\/option><option value='D\u00e9put\u00e9(e)' >D\u00e9put\u00e9(e)<\/option><option value='S\u00e9nateur(trice)' >S\u00e9nateur(trice)<\/option><option value='Conseiller(e) consulaire' >Conseiller(e) consulaire<\/option><option value='Conseiller(e) AFE' >Conseiller(e) AFE<\/option><option value='Membre du Comit\u00e9 des R\u00e9gions' >Membre du Comit\u00e9 des R\u00e9gions<\/option><option value='D\u00e9put\u00e9(e) europ\u00e9en(ne)' >D\u00e9put\u00e9(e) europ\u00e9en(ne)<\/option><\/select><\/div><\/li><li id='field_9_19' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_19' >Collectivit\u00e9 3<\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_9_19' type='text' value='' class='medium'  tabindex='41'    aria-invalid=\"false\" \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_9_28' class='gform_previous_button button' value='Etape pr\u00e9c\u00e9dente : Vos coordonn\u00e9es' tabindex='43' onclick='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"3\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> <input type='button' id='gform_next_button_9_28' class='gform_next_button button' value='Etape suivante' tabindex='42' onclick='jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_5' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_5' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_33' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_33' >Date de naissance de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_33' id='input_9_33' type='text' value='' class='datepicker medium dmy datepicker_no_icon' tabindex='44'  \/>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_9_33' class='gform_hidden' value='https:\/\/adhesion.parti-radical.fr\/wp-content\/plugins\/gravityforms\/images\/calendar.png'\/><\/li><li id='field_9_31' class='gfield gf_list_2col gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label'  >Civilit\u00e9 de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_31'><li class='gchoice_9_31_0'><input name='input_31' type='radio' value='Madame' checked='checked' id='choice_9_31_0' tabindex='45'    \/><label for='choice_9_31_0' id='label_9_31_0'>Madame<\/label><\/li><li class='gchoice_9_31_1'><input name='input_31' type='radio' value='Monsieur'  id='choice_9_31_1' tabindex='46'    \/><label for='choice_9_31_1' id='label_9_31_1'>Monsieur<\/label><\/li><\/ul><\/div><\/li><li id='field_9_32' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label gfield_label_before_complex' for='input_9_32_3' >Identit\u00e9 de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gfield_trigger_change' id='input_9_32'>\n                            \n                            <span id='input_9_32_3_container' class='name_first' >\n                                                    <label for='input_9_32_3' >Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_32.3' id='input_9_32_3' value='' aria-label='Pr\u00e9nom' tabindex='48'  aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                <\/span>\n                            \n                            <span id='input_9_32_6_container' class='name_last' >\n                                                            <label for='input_9_32_6' >Nom<\/label>\n                                                            <input type='text' name='input_32.6' id='input_9_32_6' value='' aria-label='Nom' tabindex='50'  aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id='field_9_48' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_48' >Nationalit\u00e9 de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_48' id='input_9_48' type='text' value='' class='medium'  tabindex='52'   aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_34' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_34' >Profession de votre conjoint<\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_9_34' type='text' value='' class='medium'  tabindex='53'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_35' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_35' >Responsabilit\u00e9 associative de votre conjoint<\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_9_35' type='text' value='' class='medium'  tabindex='54'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_36' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_36' >F\u00e9d\u00e9ration de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='gfield_description'>Votre f\u00e9d\u00e9ration de rattachement est par d\u00e9faut celle de votre d\u00e9partement\/collectivit\u00e9 de r\u00e9sidence. Le si\u00e8ge ou la f\u00e9d\u00e9ration peut vous demander de justifier votre choix.<\/div><div class='ginput_container ginput_container_select'><select name='input_36' id='input_9_36'  class='medium gfield_select' tabindex='55'  aria-required=\"true\" aria-invalid=\"false\"><option value='01 - AIN' >01 - AIN<\/option><option value='02 - AISNE' >02 - AISNE<\/option><option value='03 - ALLIER' >03 - ALLIER<\/option><option value='04 - ALPES-DE-HAUTE-PROVENCE' >04 - ALPES-DE-HAUTE-PROVENCE<\/option><option value='05 - HAUTES-ALPES' >05 - HAUTES-ALPES<\/option><option value='06 - ALPES-MARITIMES' >06 - ALPES-MARITIMES<\/option><option value='07 - ARDECHE' >07 - ARDECHE<\/option><option value='08 - ARDENNES' >08 - ARDENNES<\/option><option value='09 - ARIEGE' >09 - ARIEGE<\/option><option value='10 - AUBE' >10 - AUBE<\/option><option value='11 - AUDE' >11 - AUDE<\/option><option value='12 - AVEYRON' >12 - AVEYRON<\/option><option value='13 - BOUCHES-DU-RHONE' >13 - BOUCHES-DU-RHONE<\/option><option value='14 - CALVADOS' >14 - CALVADOS<\/option><option value='15 - CANTAL' >15 - CANTAL<\/option><option value='16 - CHARENTE' >16 - CHARENTE<\/option><option value='17 - CHARENTE-MARITIME' >17 - CHARENTE-MARITIME<\/option><option value='18 - CHER' >18 - CHER<\/option><option value='19 - CORREZE' >19 - CORREZE<\/option><option value='20 - CORSE' >20 - CORSE<\/option><option value='21 - COTE-D&#039;OR' >21 - COTE-D&#039;OR<\/option><option value='22 - COTES-D&#039;ARMOR' >22 - COTES-D&#039;ARMOR<\/option><option value='23 - CREUSE' >23 - CREUSE<\/option><option value='24 - DORDOGNE' >24 - DORDOGNE<\/option><option value='25 - DOUBS' >25 - DOUBS<\/option><option value='26 - DROME' >26 - DROME<\/option><option value='27 - EURE' >27 - EURE<\/option><option value='28 - EURE-ET-LOIR' >28 - EURE-ET-LOIR<\/option><option value='29 - FINISTERE' >29 - FINISTERE<\/option><option value='30 - GARD' >30 - GARD<\/option><option value='31 - HAUTE-GARONNE' >31 - HAUTE-GARONNE<\/option><option value='32 - GERS' >32 - GERS<\/option><option value='33 - GIRONDE' >33 - GIRONDE<\/option><option value='34 - HERAULT' >34 - HERAULT<\/option><option value='35 - ILLE-ET-VILAINE' >35 - ILLE-ET-VILAINE<\/option><option value='36 - INDRE' >36 - INDRE<\/option><option value='37 - INDRE-ET-LOIRE' >37 - INDRE-ET-LOIRE<\/option><option value='38 - ISERE' >38 - ISERE<\/option><option value='39 - JURA' >39 - JURA<\/option><option value='40 - LANDES' >40 - LANDES<\/option><option value='41 - LOIR-ET-CHER' >41 - LOIR-ET-CHER<\/option><option value='42 - LOIRE' >42 - LOIRE<\/option><option value='43 - HAUTE-LOIRE' >43 - HAUTE-LOIRE<\/option><option value='44 - LOIRE-ATLANTIQUE' >44 - LOIRE-ATLANTIQUE<\/option><option value='45 - LOIRET' >45 - LOIRET<\/option><option value='46 - LOT' >46 - LOT<\/option><option value='47 - LOT-ET-GARONNE' >47 - LOT-ET-GARONNE<\/option><option value='48 - LOZERE' >48 - LOZERE<\/option><option value='49 - MAINE-ET-LOIRE' >49 - MAINE-ET-LOIRE<\/option><option value='50 - MANCHE' >50 - MANCHE<\/option><option value='51 - MARNE' >51 - MARNE<\/option><option value='52 - HAUTE-MARNE' >52 - HAUTE-MARNE<\/option><option value='53 - MAYENNE' >53 - MAYENNE<\/option><option value='54 - MEURTHE-ET-MOSELLE' >54 - MEURTHE-ET-MOSELLE<\/option><option value='55 - MEUSE' >55 - MEUSE<\/option><option value='56 - MORBIHAN' >56 - MORBIHAN<\/option><option value='57 - MOSELLE' >57 - MOSELLE<\/option><option value='58 - NIEVRE' >58 - NIEVRE<\/option><option value='59 - NORD' >59 - NORD<\/option><option value='60 - OISE' >60 - OISE<\/option><option value='61 - ORNE' >61 - ORNE<\/option><option value='62 - PAS-DE-CALAIS' >62 - PAS-DE-CALAIS<\/option><option value='63 - PUY-DE-DOME' >63 - PUY-DE-DOME<\/option><option value='64 - PYR\u00c9N\u00c9ES-ATLANTIQUES' >64 - PYR\u00c9N\u00c9ES-ATLANTIQUES<\/option><option value='65 - HAUTES-PYRENEES' >65 - HAUTES-PYRENEES<\/option><option value='66 - PYRENEES-ORIENTALES' >66 - PYRENEES-ORIENTALES<\/option><option value='67 - BAS-RHIN' >67 - BAS-RHIN<\/option><option value='68 - HAUT-RHIN' >68 - HAUT-RHIN<\/option><option value='69-D - NOUVEAU RH\u00d4NE' >69-D - NOUVEAU RH\u00d4NE<\/option><option value='69-M - LYON M\u00c9TROPOLE' >69-M - LYON M\u00c9TROPOLE<\/option><option value='70 - HAUTE-SAONE' >70 - HAUTE-SAONE<\/option><option value='71 - SAONE-ET-LOIRE' >71 - SAONE-ET-LOIRE<\/option><option value='72 - SARTHE' >72 - SARTHE<\/option><option value='73 - SAVOIE' >73 - SAVOIE<\/option><option value='74 - HAUTE-SAVOIE' >74 - HAUTE-SAVOIE<\/option><option value='75 - PARIS' >75 - PARIS<\/option><option value='76 - SEINE-MARITIME' >76 - SEINE-MARITIME<\/option><option value='77 - SEINE-ET-MARNE' >77 - SEINE-ET-MARNE<\/option><option value='78 - YVELINES' >78 - YVELINES<\/option><option value='79 - DEUX-SEVRES' >79 - DEUX-SEVRES<\/option><option value='80 - SOMME' >80 - SOMME<\/option><option value='81 - TARN' >81 - TARN<\/option><option value='82 - TARN-ET-GARONNE' >82 - TARN-ET-GARONNE<\/option><option value='83 - VAR' >83 - VAR<\/option><option value='84 - VAUCLUSE' >84 - VAUCLUSE<\/option><option value='85 - VENDEE' >85 - VENDEE<\/option><option value='86 - VIENNE' >86 - VIENNE<\/option><option value='87 - HAUTE-VIENNE' >87 - HAUTE-VIENNE<\/option><option value='88 - VOSGES' >88 - VOSGES<\/option><option value='89 - YONNE' >89 - YONNE<\/option><option value='90 - TERRITOIRE DE BELFORT' >90 - TERRITOIRE DE BELFORT<\/option><option value='91 - ESSONNE' >91 - ESSONNE<\/option><option value='92 - HAUTS-DE-SEINE' >92 - HAUTS-DE-SEINE<\/option><option value='93 - SEINE-SAINT-DENIS' >93 - SEINE-SAINT-DENIS<\/option><option value='94 - VAL-DE-MARNE' >94 - VAL-DE-MARNE<\/option><option value='95 - VAL-D&#039;OISE' >95 - VAL-D&#039;OISE<\/option><option value='971 - GUADELOUPE' >971 - GUADELOUPE<\/option><option value='972 - MARTINIQUE' >972 - MARTINIQUE<\/option><option value='973 - GUYANNE' >973 - GUYANNE<\/option><option value='974 - LA R\u00c9UNION' >974 - LA R\u00c9UNION<\/option><option value='975 - SAINT-PIERRE-ET-MIQUELON' >975 - SAINT-PIERRE-ET-MIQUELON<\/option><option value='976 - MAYOTTE' >976 - MAYOTTE<\/option><option value='986 - WALLIS-ET-FUTUNA' >986 - WALLIS-ET-FUTUNA<\/option><option value='987 - POLYNESIE FRANCAISE' >987 - POLYNESIE FRANCAISE<\/option><option value='988 - NOUVELLE-CALEDONIE' >988 - NOUVELLE-CALEDONIE<\/option><option value='99 - \u00c9TRANGER' >99 - \u00c9TRANGER<\/option><\/select><\/div><\/li><li id='field_9_29' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label gfield_label_before_complex' for='input_9_3' >Adresse e-mail de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container ginput_container_email' id='input_9_29_container'>\n                                <span id='input_9_29_1_container' class='ginput_left'>\n                                    <label for='input_9_29'>Saisissez un e-mail<\/label>\n                                    <input class='' type='text' name='input_29' id='input_9_29' value='' tabindex='56'    aria-required=\"true\" aria-invalid=\"false\"\/>\n                                <\/span>\n                                <span id='input_9_29_2_container' class='ginput_right'>\n                                    <label for='input_9_29_2' >Confirmez votre e-mail<\/label>\n                                    <input class='' type='text' name='input_29_2' id='input_9_29_2' value='' tabindex='57'   aria-required=\"true\" aria-invalid=\"false\"\/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id='field_9_30' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_30' >T\u00e9l\u00e9phone de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_30' id='input_9_30' type='text' value='' class='medium' tabindex='58'   aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_37' class='gfield gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label'  >Adresse de votre conjoint<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_9_37'><li class='gchoice_9_37_0'><input name='input_37' type='radio' value='Utiliser la m\u00eame adresse' checked='checked' id='choice_9_37_0' tabindex='59'  onclick='gf_apply_rules(9,[27]);' onkeypress='gf_apply_rules(9,[27]);'  \/><label for='choice_9_37_0' id='label_9_37_0'>Utiliser la m\u00eame adresse<\/label><\/li><li class='gchoice_9_37_1'><input name='input_37' type='radio' value='Sp\u00e9cifier une adresse diff\u00e9rente'  id='choice_9_37_1' tabindex='60'  onclick='gf_apply_rules(9,[27]);' onkeypress='gf_apply_rules(9,[27]);'  \/><label for='choice_9_37_1' id='label_9_37_1'>Sp\u00e9cifier une adresse diff\u00e9rente<\/label><\/li><\/ul><\/div><\/li><li id='field_9_27' class='gfield ggf-cf-country gfield_contains_required field_sublabel_above field_description_above' ><label class='gfield_label gfield_label_before_complex' for='input_9_27_1' >Coordonn\u00e9es de votre conjoint<span class='gfield_required'>*<\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip has_country ginput_container_address gfield_trigger_change' id='input_9_27' >\n                         <span class='ginput_full address_line_1' id='input_9_27_1_container' >\n                                        <label for='input_9_27_1' id='input_9_27_1_label' >Adresse<\/label>\n                                        <input type='text' name='input_27.1' id='input_9_27_1' value='' tabindex='61'  \/>\n                                    <\/span><span class='ginput_full address_line_2' id='input_9_27_2_container' >\n                                        <label for='input_9_27_2' id='input_9_27_2_label' >Compl\u00e9ment d&#039;adresse<\/label>\n                                        <input type='text' name='input_27.2' id='input_9_27_2' value='' tabindex='62'  \/>\n                                    <\/span><span class='ginput_left address_zip' id='input_9_27_5_container' >\n                                    <label for='input_9_27_5' id='input_9_27_5_label' >Code Postal<\/label>\n                                    <input type='text' name='input_27.5' id='input_9_27_5' value='' tabindex='63'  \/>\n                                <\/span><span class='ginput_right address_city' id='input_9_27_3_container' >\n                                    <label for='input_9_27_3' id='input_9_27_3_label' >Ville<\/label>\n                                    <input type='text' name='input_27.3' id='input_9_27_3' value='' tabindex='64'  \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_27.4' id='input_9_27_4' value=''\/><span class='ginput_left address_country' id='input_9_27_6_container' >\n                                        <label for='input_9_27_6' id='input_9_27_6_label' >Pays<\/label>\n                                        <select name='input_27.6' id='input_9_27_6' tabindex='65' ><option value='' selected='selected'><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='La Barbade' >La Barbade<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Brunei' >Brunei<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' >Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='\u00celes Cayman ' >\u00celes Cayman <\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='Tchad' >Tchad<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique du Congo' >R\u00e9publique du Congo<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Chypre' >Chypre<\/option><option value='R\u00e9publique tch\u00e8que' >R\u00e9publique tch\u00e8que<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='Salvador' >Salvador<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='Estonie' >Estonie<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Ghana' >Ghana<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Groenland' >Groenland<\/option><option value='Grenade' >Grenade<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Islande' >Islande<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Iran' >Iran<\/option><option value='Irak' >Irak<\/option><option value='Irlande' >Irlande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kiribati' >Kiribati<\/option><option value='Cor\u00e9e du Nord' >Cor\u00e9e du Nord<\/option><option value='Cor\u00e9e du Sud' >Cor\u00e9e du Sud<\/option><option value='Kosovo' >Kosovo<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Laos' >Laos<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Lesotho' >Lesotho<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Mac\u00e9doine' >Mac\u00e9doine<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malawi' >Malawi<\/option><option value='Malaisie' >Malaisie<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Maroc' >Maroc<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Oman' >Oman<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Portugal' >Portugal<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Russie' >Russie<\/option><option value='Rwanda' >Rwanda<\/option><option value='Saint-Kitts-et-Nevis' >Saint-Kitts-et-Nevis<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Samoa' >Samoa<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Saint-Martin' >Saint-Martin<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Iles Salomon' >Iles Salomon<\/option><option value='Somalie' >Somalie<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Espagne' >Espagne<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan Sud' >Soudan Sud<\/option><option value='Suriname' >Suriname<\/option><option value='Swaziland' >Swaziland<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='Suisse' >Suisse<\/option><option value='Syrie' >Syrie<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie' >Tanzanie<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Togo' >Togo<\/option><option value='Tonga' >Tonga<\/option><option value='Trinidad et Tobago' >Trinidad et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turquie' >Turquie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ukraine' >Ukraine<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='Uruguay' >Uruguay<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Cit\u00e9 du Vatican' >Cit\u00e9 du Vatican<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_9_38' class='gform_previous_button button' value='Etape pr\u00e9c\u00e9dente : Mandats' tabindex='67' onclick='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"4\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> <input type='button' id='gform_next_button_9_38' class='gform_next_button button' value='Etape suivante : Mandat de votre conjoint' tabindex='66' onclick='jQuery(\"#gform_target_page_number_9\").val(\"6\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"6\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_6' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_6' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_39' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_39' >Mandat \u00e9lectif 1<\/label><div class='ginput_container ginput_container_select'><select name='input_39' id='input_9_39'  class='medium gfield_select' tabindex='68'   aria-invalid=\"false\"><option value='--' >--<\/option><option value='Conseiller(e) d&#039;arrondissement' >Conseiller(e) d&#039;arrondissement<\/option><option value='Conseiller(e) municipal(e)' >Conseiller(e) municipal(e)<\/option><option value='Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)' >Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)<\/option><option value='Adjoint(e) au Maire' >Adjoint(e) au Maire<\/option><option value='Maire' >Maire<\/option><option value='Conseiller(e) communautaire' >Conseiller(e) communautaire<\/option><option value='Vice-Pr\u00e9sident(e) d&#039;EPCI' >Vice-Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Pr\u00e9sident(e) d&#039;EPCI' >Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Conseiller(e) d\u00e9partemental(e)' >Conseiller(e) d\u00e9partemental(e)<\/option><option value='Vice-Pr\u00e9sident(e) de D\u00e9partement' >Vice-Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Pr\u00e9sident(e) de D\u00e9partement' >Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Conseiller(e) r\u00e9gional(e)' >Conseiller(e) r\u00e9gional(e)<\/option><option value='Vice-Pr\u00e9sident(e) de R\u00e9gion' >Vice-Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Pr\u00e9sident(e) de R\u00e9gion' >Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer' >Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Conseiller(e) CESE' >Conseiller(e) CESE<\/option><option value='Pr\u00e9sident(e) de section du CESE' >Pr\u00e9sident(e) de section du CESE<\/option><option value='Pr\u00e9sident(e) de groupe du CESE' >Pr\u00e9sident(e) de groupe du CESE<\/option><option value='D\u00e9put\u00e9(e)' >D\u00e9put\u00e9(e)<\/option><option value='S\u00e9nateur(trice)' >S\u00e9nateur(trice)<\/option><option value='Conseiller(e) consulaire' >Conseiller(e) consulaire<\/option><option value='Conseiller(e) AFE' >Conseiller(e) AFE<\/option><option value='Membre du Comit\u00e9 des R\u00e9gions' >Membre du Comit\u00e9 des R\u00e9gions<\/option><option value='D\u00e9put\u00e9(e) europ\u00e9en(ne)' >D\u00e9put\u00e9(e) europ\u00e9en(ne)<\/option><\/select><\/div><\/li><li id='field_9_40' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_40' >Collectivit\u00e9 1<\/label><div class='ginput_container ginput_container_text'><input name='input_40' id='input_9_40' type='text' value='' class='medium'  tabindex='69'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_41' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_41' >Mandat \u00e9lectif 2<\/label><div class='ginput_container ginput_container_select'><select name='input_41' id='input_9_41'  class='medium gfield_select' tabindex='70'   aria-invalid=\"false\"><option value='--' >--<\/option><option value='Conseiller(e) d&#039;arrondissement' >Conseiller(e) d&#039;arrondissement<\/option><option value='Conseiller(e) municipal(e)' >Conseiller(e) municipal(e)<\/option><option value='Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)' >Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)<\/option><option value='Adjoint(e) au Maire' >Adjoint(e) au Maire<\/option><option value='Maire' >Maire<\/option><option value='Conseiller(e) communautaire' >Conseiller(e) communautaire<\/option><option value='Vice-Pr\u00e9sident(e) d&#039;EPCI' >Vice-Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Pr\u00e9sident(e) d&#039;EPCI' >Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Conseiller(e) d\u00e9partemental(e)' >Conseiller(e) d\u00e9partemental(e)<\/option><option value='Vice-Pr\u00e9sident(e) de D\u00e9partement' >Vice-Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Pr\u00e9sident(e) de D\u00e9partement' >Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Conseiller(e) r\u00e9gional(e)' >Conseiller(e) r\u00e9gional(e)<\/option><option value='Vice-Pr\u00e9sident(e) de R\u00e9gion' >Vice-Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Pr\u00e9sident(e) de R\u00e9gion' >Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer' >Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Conseiller(e) CESE' >Conseiller(e) CESE<\/option><option value='Pr\u00e9sident(e) de section du CESE' >Pr\u00e9sident(e) de section du CESE<\/option><option value='Pr\u00e9sident(e) de groupe du CESE' >Pr\u00e9sident(e) de groupe du CESE<\/option><option value='D\u00e9put\u00e9(e)' >D\u00e9put\u00e9(e)<\/option><option value='S\u00e9nateur(trice)' >S\u00e9nateur(trice)<\/option><option value='Conseiller(e) consulaire' >Conseiller(e) consulaire<\/option><option value='Conseiller(e) AFE' >Conseiller(e) AFE<\/option><option value='Membre du Comit\u00e9 des R\u00e9gions' >Membre du Comit\u00e9 des R\u00e9gions<\/option><option value='D\u00e9put\u00e9(e) europ\u00e9en(ne)' >D\u00e9put\u00e9(e) europ\u00e9en(ne)<\/option><\/select><\/div><\/li><li id='field_9_42' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_42' >Collectivit\u00e9 2<\/label><div class='ginput_container ginput_container_text'><input name='input_42' id='input_9_42' type='text' value='' class='medium'  tabindex='71'    aria-invalid=\"false\" \/><\/div><\/li><li id='field_9_43' class='gfield gf_left_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_43' >Mandat \u00e9lectif 3<\/label><div class='ginput_container ginput_container_select'><select name='input_43' id='input_9_43'  class='medium gfield_select' tabindex='72'   aria-invalid=\"false\"><option value='--' >--<\/option><option value='Conseiller(e) d&#039;arrondissement' >Conseiller(e) d&#039;arrondissement<\/option><option value='Conseiller(e) municipal(e)' >Conseiller(e) municipal(e)<\/option><option value='Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)' >Conseiller(e) municipal d\u00e9l\u00e9gu\u00e9(e)<\/option><option value='Adjoint(e) au Maire' >Adjoint(e) au Maire<\/option><option value='Maire' >Maire<\/option><option value='Conseiller(e) communautaire' >Conseiller(e) communautaire<\/option><option value='Vice-Pr\u00e9sident(e) d&#039;EPCI' >Vice-Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Pr\u00e9sident(e) d&#039;EPCI' >Pr\u00e9sident(e) d&#039;EPCI<\/option><option value='Conseiller(e) d\u00e9partemental(e)' >Conseiller(e) d\u00e9partemental(e)<\/option><option value='Vice-Pr\u00e9sident(e) de D\u00e9partement' >Vice-Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Pr\u00e9sident(e) de D\u00e9partement' >Pr\u00e9sident(e) de D\u00e9partement<\/option><option value='Conseiller(e) r\u00e9gional(e)' >Conseiller(e) r\u00e9gional(e)<\/option><option value='Vice-Pr\u00e9sident(e) de R\u00e9gion' >Vice-Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Pr\u00e9sident(e) de R\u00e9gion' >Pr\u00e9sident(e) de R\u00e9gion<\/option><option value='Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer' >Conseiller(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Vice-Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer' >Pr\u00e9sident(e) de Collectivit\u00e9 d&#039;outre-mer<\/option><option value='Conseiller(e) CESE' >Conseiller(e) CESE<\/option><option value='Pr\u00e9sident(e) de section du CESE' >Pr\u00e9sident(e) de section du CESE<\/option><option value='Pr\u00e9sident(e) de groupe du CESE' >Pr\u00e9sident(e) de groupe du CESE<\/option><option value='D\u00e9put\u00e9(e)' >D\u00e9put\u00e9(e)<\/option><option value='S\u00e9nateur(trice)' >S\u00e9nateur(trice)<\/option><option value='Conseiller(e) consulaire' >Conseiller(e) consulaire<\/option><option value='Conseiller(e) AFE' >Conseiller(e) AFE<\/option><option value='Membre du Comit\u00e9 des R\u00e9gions' >Membre du Comit\u00e9 des R\u00e9gions<\/option><option value='D\u00e9put\u00e9(e) europ\u00e9en(ne)' >D\u00e9put\u00e9(e) europ\u00e9en(ne)<\/option><\/select><\/div><\/li><li id='field_9_44' class='gfield gf_right_half field_sublabel_above field_description_above' ><label class='gfield_label' for='input_9_44' >Collectivit\u00e9 3<\/label><div class='ginput_container ginput_container_text'><input name='input_44' id='input_9_44' type='text' value='' class='medium'  tabindex='73'    aria-invalid=\"false\" \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_9_23' class='gform_previous_button button' value='Etape pr\u00e9c\u00e9dente : Votre conjoint' tabindex='75' onclick='jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"5\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> <input type='button' id='gform_next_button_9_23' class='gform_next_button button' value='Etape suivante : Confirmation' tabindex='74' onclick='jQuery(\"#gform_target_page_number_9\").val(\"7\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' onkeypress='jQuery(\"#gform_target_page_number_9\").val(\"7\");  jQuery(\"#gform_9\").trigger(\"submit\",[true]); ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_9_7' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_9_7' class='gform_fields top_label form_sublabel_above description_above'><li id='field_9_26' class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above field_description_above' ><div style=\"overflow: auto; width: 100%; border: 1px solid black; padding: 8px; height: 250px; text-align: justify;\"><strong>Traitement des donn&eacute;es :<\/strong> <br \/>Seul le Parti Radical est destinataire des informations que vous lui communiquez ainsi que les organismes associ&eacute;s. Conform&eacute;ment &agrave; la loi &laquo; Informatique et Libert&eacute;s &raquo; du 6 janvier 1978, vous disposez d&rsquo;un droit d&rsquo;acc&egrave;s et de rectification aux donn&eacute;es personnelles qui vous concernent. Vous pouvez exercer ces droits en nous &eacute;crivant &agrave; communication@parti-radical.fr.\n<p><strong>Dispositions statutaires et r&egrave;glementaires :<\/strong><br \/>La demande d&rsquo;adh&eacute;sion est soumise au traitement mentionn&eacute; dans le R&egrave;glement Int&eacute;rieur. Les remboursements ne peuvent se faire qu&rsquo;&agrave; la suite d&rsquo;un refus de l&rsquo;adh&eacute;sion. La perte de la qualit&eacute; de membre dans un autre cas ne peut faire l&rsquo;objet d&rsquo;un remboursement.<\/p>\n<strong>Mentions L&eacute;gales :<\/strong><br \/>Les dons et les cotisations sont vers&eacute;s &agrave; l&rsquo;AFPPR (agr&eacute;ment du 11 d&eacute;cembre 1991) au b&eacute;n&eacute;fice du Parti Radical et donnent droit &agrave; une r&eacute;duction d&rsquo;imp&ocirc;t de 66% des sommes vers&eacute;es dans la limite de 20% du revenu imposable, et de 15000 &euro; par an et par foyer fiscal. Un re&ccedil;u fiscal &agrave; joindre &agrave; votre d&eacute;claration de revenus vous sera adress&eacute; en d&eacute;but d&rsquo;ann&eacute;e suivante. Aux termes de l&rsquo;article 11-4 de la loi n&deg;88-227 du 11 mars 1988 relative &agrave; la transparence financi&egrave;re de la vie politique modifi&eacute;e par la loi 2017-286 du 6 mars 2017 &laquo; Une personne physique peut verser un don &agrave; un parti ou groupement politique si elle est de nationalit&eacute; fran&ccedil;aise ou si elle r&eacute;side en France. Les dons consentis et les cotisations vers&eacute;es en qualit&eacute; d&rsquo;adh&eacute;rent d&rsquo;un ou de plusieurs partis ou groupements politiques par une personne physique d&ucirc;ment identifi&eacute;e &agrave; une ou plusieurs associations agr&eacute;&eacute;es en qualit&eacute; d&rsquo;association de financement ou &agrave; un ou plusieurs mandataires financiers d&rsquo;un ou de plusieurs partis ou groupements politiques ne peuvent annuellement exc&eacute;der 7500 euros. [...] &raquo; &laquo;\u202fLes personnes morales &agrave; l&rsquo;exception des partis ou groupements politiques ne peuvent contribuer au financement des partis ou groupements politiques, ni en consentant des dons, sous quelque forme que ce soit, &agrave; leurs associations de financement ou &agrave; leurs mandataires financiers, ni en leur fournissant des biens, services ou autres avantages directs ou indirects &agrave; des prix inf&eacute;rieurs &agrave; ceux qui sont habituellement pratiqu&eacute;s. &raquo; &laquo;\u202fAucune association de financement ou aucun mandataire financier d&rsquo;un parti ou groupement politique ne peut recevoir, directement ou indirectement, des contributions ou aides mat&eacute;rielles d&rsquo;un Etat &eacute;tranger ou d&rsquo;une personne morale de droit &eacute;tranger. 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