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  1. <!-- Begin MailChimp Signup Form -->
  2. <link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css">
  3. <style type="text/css">
  4. #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }
  5. /* Add your own MailChimp form style overrides in your site stylesheet or in this style block.
  6. We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */
  7. </style>
  8. <style type="text/css">
  9. #mc-embedded-subscribe-form input[type=checkbox]{display: inline; width: auto;margin-right: 10px;}
  10. #mergeRow-gdpr {margin-top: 20px;}
  11. #mergeRow-gdpr fieldset label {font-weight: normal;}
  12. #mc-embedded-subscribe-form .mc_fieldset{border:none;min-height: 0px;padding-bottom:0px;}
  13. </style>
  14. <div id="mc_embed_signup">
  15. <form action="https://groupe-quinze-gp.us18.list-manage.com/subscribe/post?u=7395c62e6ce541c5c49eec39b&id=ec522592a9" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
  16. <div id="mc_embed_signup_scroll">
  17. <h2>Subscribe to our mailing list</h2>
  18. <div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
  19. <div class="mc-field-group">
  20. <label for="mce-FNAME">Prenom <span class="asterisk">*</span>
  21. </label>
  22. <input type="text" value="" name="FNAME" class="required" id="mce-FNAME">
  23. </div>
  24. <div class="mc-field-group">
  25. <label for="mce-LNAME">Nom <span class="asterisk">*</span>
  26. </label>
  27. <input type="text" value="" name="LNAME" class="required" id="mce-LNAME">
  28. </div>
  29. <div class="mc-field-group">
  30. <label for="mce-EMAIL">Email <span class="asterisk">*</span>
  31. </label>
  32. <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
  33. </div>
  34. <div class="mc-field-group size1of2">
  35. <label for="mce-PHONE">Telephone </label>
  36. <input type="text" name="PHONE" class="" value="" id="mce-PHONE">
  37. </div>
  38. <div class="mc-address-group">
  39. <div class="mc-field-group">
  40. <label for="mce-ADDRESS-addr1">Address </label>
  41. <input type="text" value="" maxlength="70" name="ADDRESS[addr1]" id="mce-ADDRESS-addr1" class="">
  42. </div>
  43. <div class="mc-field-group">
  44. <label for="mce-ADDRESS-addr2">Address Line 2</label>
  45. <input type="text" value="" maxlength="70" name="ADDRESS[addr2]" id="mce-ADDRESS-addr2">
  46. </div>
  47. <div class="mc-field-group size1of2">
  48. <label for="mce-ADDRESS-city">City</label>
  49. <input type="text" value="" maxlength="40" name="ADDRESS[city]" id="mce-ADDRESS-city" class="">
  50. </div>
  51. <div class="mc-field-group size1of2">
  52. <label for="mce-ADDRESS-state">State/Province/Region</label>
  53. <input type="text" value="" maxlength="20" name="ADDRESS[state]" id="mce-ADDRESS-state" class="">
  54. </div>
  55. <div class="mc-field-group size1of2">
  56. <label for="mce-ADDRESS-zip">Postal / Zip Code</label>
  57. <input type="text" value="" maxlength="10" name="ADDRESS[zip]" id="mce-ADDRESS-zip" class="">
  58. </div>
  59. <div class="mc-field-group size1of2">
  60. <label for="mce-ADDRESS-country">Country</label>
  61. <select name="ADDRESS[country]" id="mce-ADDRESS-country" class=""><option value="164">USA</option><option value="286">Aaland Islands</option><option value="274">Afghanistan</option><option value="2">Albania</option><option value="3">Algeria</option><option value="178">American Samoa</option><option value="4">Andorra</option><option value="5">Angola</option><option value="176">Anguilla</option><option value="175">Antigua And Barbuda</option><option value="6">Argentina</option><option value="7">Armenia</option><option value="179">Aruba</option><option value="8">Australia</option><option value="9">Austria</option><option value="10">Azerbaijan</option><option value="11">Bahamas</option><option value="12">Bahrain</option><option value="13">Bangladesh</option><option value="14">Barbados</option><option value="15">Belarus</option><option value="16">Belgium</option><option value="17">Belize</option><option value="18">Benin</option><option value="19">Bermuda</option><option value="20">Bhutan</option><option value="21">Bolivia</option><option value="325">Bonaire, Saint Eustatius and Saba</option><option value="22">Bosnia and Herzegovina</option><option value="23">Botswana</option><option value="181">Bouvet Island</option><option value="24">Brazil</option><option value="180">Brunei Darussalam</option><option value="25">Bulgaria</option><option value="26">Burkina Faso</option><option value="27">Burundi</option><option value="28">Cambodia</option><option value="29">Cameroon</option><option value="30">Canada</option><option value="31">Cape Verde</option><option value="32">Cayman Islands</option><option value="33">Central African Republic</option><option value="34">Chad</option><option value="35">Chile</option><option value="36">China</option><option value="185">Christmas Island</option><option value="37">Colombia</option><option value="204">Comoros</option><option value="38">Congo</option><option value="183">Cook Islands</option><option value="268">Costa Rica</option><option value="275">Cote D'Ivoire</option><option value="40">Croatia</option><option value="276">Cuba</option><option value="298">Curacao</option><option value="41">Cyprus</option><option value="42">Czech Republic</option><option value="318">Democratic Republic of the Congo</option><option value="43">Denmark</option><option value="44">Djibouti</option><option value="289">Dominica</option><option value="187">Dominican Republic</option><option value="45">Ecuador</option><option value="46">Egypt</option><option value="47">El Salvador</option><option value="48">Equatorial Guinea</option><option value="49">Eritrea</option><option value="50">Estonia</option><option value="51">Ethiopia</option><option value="189">Falkland Islands</option><option value="191">Faroe Islands</option><option value="52">Fiji</option><option value="53">Finland</option><option value="54" selected>France</option><option value="193">French Guiana</option><option value="277">French Polynesia</option><option value="56">Gabon</option><option value="57">Gambia</option><option value="58">Georgia</option><option value="59">Germany</option><option value="60">Ghana</option><option value="194">Gibraltar</option><option value="61">Greece</option><option value="195">Greenland</option><option value="192">Grenada</option><option value="196">Guadeloupe</option><option value="62">Guam</option><option value="198">Guatemala</option><option value="270">Guernsey</option><option value="63">Guinea</option><option value="65">Guyana</option><option value="200">Haiti</option><option value="66">Honduras</option><option value="67">Hong Kong</option><option value="68">Hungary</option><option value="69">Iceland</option><option value="70">India</option><option value="71">Indonesia</option><option value="278">Iran</option><option value="279">Iraq</option><option value="74">Ireland</option><option value="323">Isle of Man</option><option value="75">Israel</option><option value="76">Italy</option><option value="202">Jamaica</option><option value="78">Japan</option><option value="288">Jersey (Channel Islands)</option><option value="79">Jordan</option><option value="80">Kazakhstan</option><option value="81">Kenya</option><option value="203">Kiribati</option><option value="82">Kuwait</option><option value="83">Kyrgyzstan</option><option value="84">Lao People's Democratic Republic</option><option value="85">Latvia</option><option value="86">Lebanon</option><option value="87">Lesotho</option><option value="88">Liberia</option><option value="281">Libya</option><option value="90">Liechtenstein</option><option value="91">Lithuania</option><option value="92">Luxembourg</option><option value="208">Macau</option><option value="93">Macedonia</option><option value="94">Madagascar</option><option value="95">Malawi</option><option value="96">Malaysia</option><option value="97">Maldives</option><option value="98">Mali</option><option value="99">Malta</option><option value="207">Marshall Islands</option><option value="210">Martinique</option><option value="100">Mauritania</option><option value="212">Mauritius</option><option value="241">Mayotte</option><option value="101">Mexico</option><option value="102">Moldova, Republic of</option><option value="103">Monaco</option><option value="104">Mongolia</option><option value="290">Montenegro</option><option value="294">Montserrat</option><option value="105">Morocco</option><option value="106">Mozambique</option><option value="242">Myanmar</option><option value="107">Namibia</option><option value="108">Nepal</option><option value="109">Netherlands</option><option value="110">Netherlands Antilles</option><option value="213">New Caledonia</option><option value="111">New Zealand</option><option value="112">Nicaragua</option><option value="113">Niger</option><option value="114">Nigeria</option><option value="217">Niue</option><option value="214">Norfolk Island</option><option value="272">North Korea</option><option value="116">Norway</option><option value="117">Oman</option><option value="118">Pakistan</option><option value="222">Palau</option><option value="282">Palestine</option><option value="119">Panama</option><option value="219">Papua New Guinea</option><option value="120">Paraguay</option><option value="121">Peru</option><option value="122">Philippines</option><option value="221">Pitcairn</option><option value="123">Poland</option><option value="124">Portugal</option><option value="126">Qatar</option><option value="315">Republic of Kosovo</option><option value="127">Reunion</option><option value="128">Romania</option><option value="129">Russia</option><option value="130">Rwanda</option><option value="205">Saint Kitts and Nevis</option><option value="206">Saint Lucia</option><option value="324">Saint Martin</option><option value="237">Saint Vincent and the Grenadines</option><option value="132">Samoa (Independent)</option><option value="227">San Marino</option><option value="255">Sao Tome and Principe</option><option value="133">Saudi Arabia</option><option value="134">Senegal</option><option value="326">Serbia</option><option value="135">Seychelles</option><option value="136">Sierra Leone</option><option value="137">Singapore</option><option value="302">Sint Maarten</option><option value="138">Slovakia</option><option value="139">Slovenia</option><option value="223">Solomon Islands</option><option value="140">Somalia</option><option value="141">South Africa</option><option value="257">South Georgia and the South Sandwich Islands</option><option value="142">South Korea</option><option value="311">South Sudan</option><option value="143">Spain</option><option value="144">Sri Lanka</option><option value="293">Sudan</option><option value="146">Suriname</option><option value="225">Svalbard and Jan Mayen Islands</option><option value="147">Swaziland</option><option value="148">Sweden</option><option value="149">Switzerland</option><option value="285">Syria</option><option value="152">Taiwan</option><option value="260">Tajikistan</option><option value="153">Tanzania</option><option value="154">Thailand</option><option value="233">Timor-Leste</option><option value="155">Togo</option><option value="232">Tonga</option><option value="234">Trinidad and Tobago</option><option value="156">Tunisia</option><option value="157">Turkey</option><option value="158">Turkmenistan</option><option value="287">Turks & Caicos Islands</option><option value="159">Uganda</option><option value="161">Ukraine</option><option value="162">United Arab Emirates</option><option value="262">United Kingdom</option><option value="163">Uruguay</option><option value="165">Uzbekistan</option><option value="239">Vanuatu</option><option value="166">Vatican City State (Holy See)</option><option value="167">Venezuela</option><option value="168">Vietnam</option><option value="169">Virgin Islands (British)</option><option value="238">Virgin Islands (U.S.)</option><option value="188">Western Sahara</option><option value="170">Yemen</option><option value="173">Zambia</option><option value="174">Zimbabwe</option></select>
  62. </div>
  63. </div>
  64. <div id="mergeRow-gdpr" class="mergeRow gdpr-mergeRow content__gdprBlock mc-field-group">
  65. <div class="content__gdpr">
  66. <label>Autorisations de marketing</label>
  67. <p>Groupe Quinze utilisera les informations fournies sur ce formulaire pour vous contacter et vous transmettre des mises à jour ainsi qu'à des fins commerciales. Merci de nous préciser comment vous souhaitez être contacté:</p>
  68. <fieldset class="mc_fieldset gdprRequired mc-field-group" name="interestgroup_field">
  69. <label class="checkbox subfield" for="gdpr_30639"><input type="checkbox" id="gdpr_30639" name="gdpr[30639]" value="Y" class="av-checkbox "><span>E-mail</span> </label><label class="checkbox subfield" for="gdpr_30647"><input type="checkbox" id="gdpr_30647" name="gdpr[30647]" value="Y" class="av-checkbox "><span>Publicité en ligne personnalisée</span> </label>
  70. </fieldset>
  71. <p>Vous pouvez changer d'avis à tout moment en cliquant sur le lien Se désinscrire situé le pied de page de tout e-mail que vous recevez de notre part, ou en nous contactant à office@groupe-quinze-gp.com. Nous traiterons vos informations avec respect. Pour plus d'informations sur nos pratiques de confidentialité, veuillez visiter notre site Web. En cliquant ci-dessous, vous acceptez que nous puissions traiter vos informations conformément à ces termes.</p>
  72. </div>
  73. <div class="content__gdprLegal">
  74. <p>Nous utilisons MailChimp comme plateforme marketing. En cliquant ci-dessous pour vous abonner, vous reconnaissez que vos informations seront transférées et traitées par MailChimp. Pour en savoir plus sur les pratiques de confidentialité de MailChimp, rendez-vous <a href="https://mailchimp.com/legal/" target="_blank">ici</a>.</p>
  75. </div>
  76. </div>
  77. <div id="mce-responses" class="clear">
  78. <div class="response" id="mce-error-response" style="display:none"></div>
  79. <div class="response" id="mce-success-response" style="display:none"></div>
  80. </div> <!-- real people should not fill this in and expect good things - do not remove this or risk form bot signups-->
  81. <div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_7395c62e6ce541c5c49eec39b_ec522592a9" tabindex="-1" value=""></div>
  82. <div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
  83. </div>
  84. </form>
  85. </div>
  86. <script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[0]='EMAIL';ftypes[0]='email';fnames[4]='PHONE';ftypes[4]='phone';fnames[3]='ADDRESS';ftypes[3]='address';fnames[5]='ZIPCODE';ftypes[5]='text';fnames[6]='CITY';ftypes[6]='text';fnames[7]='COUNTRY';ftypes[7]='text';fnames[8]='GENDER';ftypes[8]='dropdown';fnames[9]='SALUTATION';ftypes[9]='text'; /*
  87. * Translated default messages for the $ validation plugin.
  88. * Locale: FR
  89. */
  90. $.extend($.validator.messages, {
  91. required: "Ce champ est requis.",
  92. remote: "Veuillez remplir ce champ pour continuer.",
  93. email: "Veuillez entrer une adresse email valide.",
  94. url: "Veuillez entrer une URL valide.",
  95. date: "Veuillez entrer une date valide.",
  96. dateISO: "Veuillez entrer une date valide (ISO).",
  97. number: "Veuillez entrer un nombre valide.",
  98. digits: "Veuillez entrer (seulement) une valeur numérique.",
  99. creditcard: "Veuillez entrer un numéro de carte de crédit valide.",
  100. equalTo: "Veuillez entrer une nouvelle fois la même valeur.",
  101. accept: "Veuillez entrer une valeur avec une extension valide.",
  102. maxlength: $.validator.format("Veuillez ne pas entrer plus de {0} caractères."),
  103. minlength: $.validator.format("Veuillez entrer au moins {0} caractères."),
  104. rangelength: $.validator.format("Veuillez entrer entre {0} et {1} caractères."),
  105. range: $.validator.format("Veuillez entrer une valeur entre {0} et {1}."),
  106. max: $.validator.format("Veuillez entrer une valeur inférieure ou égale à {0}."),
  107. min: $.validator.format("Veuillez entrer une valeur supérieure ou égale à {0}.")
  108. });}(jQuery));var $mcj = jQuery.noConflict(true);</script>
  109. <!--End mc_embed_signup-->
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