{"id":85,"date":"2013-03-28T16:36:25","date_gmt":"2013-03-28T15:36:25","guid":{"rendered":"http:\/\/uilg.be\/blog\/?page_id=85"},"modified":"2016-12-10T23:07:20","modified_gmt":"2016-12-10T22:07:20","slug":"donnees-personnelles","status":"publish","type":"page","link":"https:\/\/uilg.be\/blog\/membres\/donnees-personnelles\/","title":{"rendered":"Donn\u00e9es personnelles"},"content":{"rendered":"<h1>Fiche individuelle<\/h1>\n<p>Merci de compl\u00e9ter ce formulaire en cas d&rsquo;affiliation \u00e0 l&rsquo;U.I.Lg ASBL ou pour signaler une modification de vos donn\u00e9es. Ces informations sont \u00e0 usage de l\u2019U.I.Lg. ASBL et de l\u2019UFIIB ASBL dont l\u2019UILg fait partie et sont r\u00e9gies par la loi de 1992 relative \u00e0 la protection de la vie priv\u00e9e. Nous vous enverrons les donn\u00e9es vous concernant en notre possession sur simple demande (<a href=\"mailto:info@uilg.be\">info@uilg.be<\/a>).<\/p>\n<div data-test='contact-form'\n\t\t\tid='contact-form-85'\n\t\t\tclass='jetpack-contact-form-container '\n\t\t\tdata-wp-interactive='jetpack\/form' data-wp-context='{\"formId\":\"85\",\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\",\"showErrors\":false,\"errors\":[],\"fields\":[],\"isMultiStep\":false,\"useAjax\":true,\"submissionData\":null,\"formattedSubmissionData\":[],\"submissionSuccess\":false,\"submissionError\":null,\"elementId\":\"jp-form-edf5672ca2adef9fdb755c45813bb261adf66bdd\",\"isSingleInputForm\":false,\"isForcedHorizontal\":false}'\n\t\t\tdata-wp-watch--scroll-to-wrapper=\"callbacks.scrollToWrapper\"\n\t\t>\n<div class=\"contact-form-submission contact-form-ajax-submission\" data-wp-bind--aria-hidden=\"state.isSuccessMessageAriaHidden\" data-wp-class--submission-success=\"context.submissionSuccess\" id=\"contact-form-success-edf5672ca2adef9fdb755c45813bb261adf66bdd\" tabindex=\"-1\" aria-labelledby=\"contact-form-success-header-edf5672ca2adef9fdb755c45813bb261adf66bdd\"><p class=\"go-back-message\"><a class=\"link\" role=\"button\" tabindex=\"0\" data-wp-on--click=\"actions.goBack\" href=\"\/blog\/wp-json\/wp\/v2\/pages\/85\">\u2190 Retour<\/a><\/p><h4 data-wp-bind--aria-hidden=\"state.isSuccessMessageAriaHidden\" id=\"contact-form-success-header-edf5672ca2adef9fdb755c45813bb261adf66bdd\">Merci pour votre r\u00e9ponse. \u2728<\/h4>\n\n<template data-wp-each--submission=\"context.formattedSubmissionData\">\n\t\t\t\t\t<div class=\"jetpack_forms_contact-form-success-summary\">\n\t\t\t\t\t\t<div class=\"field-name-wrapper\">\n\t\t\t\t\t\t\t<div class=\"field-type-icon\" data-wp-watch=\"callbacks.watchFieldTypeIcon\"><\/div>\n\t\t\t\t\t\t\t<div class=\"field-name\" data-wp-text=\"context.submission.label\" data-wp-bind--hidden=\"!context.submission.label\"><\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"field-value\" data-wp-text=\"context.submission.value\" data-wp-bind--hidden=\"!context.submission.showPlainValue\"><\/div>\n\t\t\t\t\t\t<a class=\"field-url\" data-wp-bind--href=\"context.submission.url\" data-wp-text=\"context.submission.value\" data-wp-bind--hidden=\"!context.submission.url\" target=\"_blank\" rel=\"noopener noreferrer\"><\/a>\n\t\t\t\t\t\t<div class=\"field-rating\" data-wp-bind--hidden=\"!context.submission.rating\" data-wp-watch=\"callbacks.watchRatingIcons\"><\/div>\n\t\t\t\t\t\t<div class=\"field-images\" data-wp-bind--hidden=\"!context.submission.images\">\n\t\t\t\t\t\t\t<template data-wp-each--image=\"context.submission.images\">\n\t\t\t\t\t\t\t\t<div class=\"field-image-option\" data-wp-class--is-empty=\"!context.image.src\">\n\t\t\t\t\t\t\t\t\t<figure class=\"field-image-option__image\" data-wp-class--is-empty=\"!context.image.src\">\n\t\t\t\t\t\t\t\t\t\t<img data-wp-bind--src=\"context.image.src\" data-wp-bind--hidden=\"!context.image.src\" \/>\n\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"data:image\/gif;base64,R0lGODlhAQABAAD\/ACwAAAAAAQABAAACADs=\" data-wp-bind--hidden=\"context.image.src\" \/>\n\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<div class=\"field-image-option__label-wrapper\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"field-image-option__label-code\" data-wp-text=\"context.image.letterCode\"><\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"field-image-option__label\" data-wp-text=\"context.image.label\" data-wp-bind--hidden=\"!context.image.label\"><\/span>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/template>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"field-files\" data-wp-bind--hidden=\"!context.submission.files\">\n\t\t\t\t\t\t\t<template data-wp-each--file=\"context.submission.files\">\n\t\t\t\t\t\t\t\t<div class=\"field-file\">\n\t\t\t\t\t\t\t\t\t<div class=\"field-file__thumbnail\" data-wp-style--background-image=\"context.file.previewUrl\" data-wp-style--mask-image=\"context.file.iconUrl\" data-wp-bind--hidden=\"!context.file.hasPreview\"><\/div>\n\t\t\t\t\t\t\t\t\t<svg class=\"field-file__icon\" data-wp-bind--hidden=\"context.file.hasPreview\" width=\"20\" height=\"20\" viewBox=\"0 0 24 24\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t<path d=\"M14 2H6C4.9 2 4 2.9 4 4V20C4 21.1 4.89 22 5.99 22H18C19.1 22 20 21.1 20 20V8L14 2ZM18 20H6V4H13V9H18V20Z\" fill=\"currentColor\"\/>\n\t\t\t\t\t\t\t\t\t<\/svg>\n\t\t\t\t\t\t\t\t\t<span class=\"field-file__name\" data-wp-text=\"context.file.name\"><\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"field-file__size\" data-wp-text=\"context.file.size\"><\/span>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/template>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/template><\/div><form action='https:\/\/uilg.be\/blog\/membres\/donnees-personnelles\/'\n\t\t\t\tid='jp-form-edf5672ca2adef9fdb755c45813bb261adf66bdd'\n\t\t\t\tmethod='post'\n\t\t\t\tclass='contact-form commentsblock jetpack-contact-form__form has-no-jetpack-form-layout' aria-label=\"Donn\u00e9es personnelles\"\n\t\t\t\tdata-wp-on--submit=\"actions.onFormSubmit\"\n\t\t\t\tdata-wp-on--reset=\"actions.onFormReset\"\n\t\t\t\tdata-wp-class--submission-success=\"context.submissionSuccess\"\n\t\t\t\tdata-wp-class--is-first-step=\"state.isFirstStep\"\n\t\t\t\tdata-wp-class--is-last-step=\"state.isLastStep\"\n\t\t\t\tdata-wp-class--is-ajax-form=\"context.useAjax\"\n\t\t\t\tnovalidate >\n<input type='hidden' name='jetpack_contact_form_jwt' 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\/>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-nom\",\"fieldType\":\"name\",\"fieldLabel\":\"Nom\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"1\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-name-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-nom' class=\"grunion-field-label name\" >Nom<span class=\"grunion-label-required\" aria-hidden=\"true\">(obligatoire)<\/span><\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-nom'\n\t\t\t\t\tid='g85-nom'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-nom-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='name  grunion-field' \n\t\t\t\t\trequired='true' aria-required='true'  \/>\n \n\t\t\t<div id=\"g85-nom-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-nom-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-prnom\",\"fieldType\":\"text\",\"fieldLabel\":\"Pr\\u00e9nom\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"1\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-prnom' class=\"grunion-field-label text\" >Pr\u00e9nom<span class=\"grunion-label-required\" aria-hidden=\"true\">(obligatoire)<\/span><\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-prnom'\n\t\t\t\t\tid='g85-prnom'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-prnom-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\trequired='true' aria-required='true'  \/>\n \n\t\t\t<div id=\"g85-prnom-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-prnom-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-email\",\"fieldType\":\"email\",\"fieldLabel\":\"Email\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"1\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-email-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-email' class=\"grunion-field-label email\" >Email<span class=\"grunion-label-required\" aria-hidden=\"true\">(obligatoire)<\/span><\/label>\n<input\n\t\t\t\t\ttype='email'\n\t\t\t\t\tname='g85-email'\n\t\t\t\t\tid='g85-email'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-email-email-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='email  grunion-field' \n\t\t\t\t\trequired='true' aria-required='true'  \/>\n \n\t\t\t<div id=\"g85-email-email-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-email-email-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-adresse\",\"fieldType\":\"textarea\",\"fieldLabel\":\"Adresse\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"1\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-textarea-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='contact-form-comment-g85-adresse' class=\"grunion-field-label textarea\" >Adresse<span class=\"grunion-label-required\" aria-hidden=\"true\">(obligatoire)<\/span><\/label>\n<textarea\n\t\t                style=''\n\t\t                name='g85-adresse'\n\t\t                id='contact-form-comment-g85-adresse'\n\t\t                rows='20'\n\t\t\t\t\t\tdata-wp-text='state.getFieldValue'\n\t\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\t\t\t\t\t\taria-describedby='g85-adresse-textarea-error-message'\n\t\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\t\tclass='textarea  grunion-field'  required aria-required='true'><\/textarea>\n \n\t\t\t<div id=\"g85-adresse-textarea-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-adresse-textarea-error-message\"><\/span>\n\t\t\t<\/div>\n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-pays\",\"fieldType\":\"text\",\"fieldLabel\":\"Pays\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-pays' class=\"grunion-field-label text\" >Pays<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-pays'\n\t\t\t\t\tid='g85-pays'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-pays-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-pays-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-pays-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-datedenaissance\",\"fieldType\":\"text\",\"fieldLabel\":\"Date de naissance\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-datedenaissance' class=\"grunion-field-label text\" >Date de naissance<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-datedenaissance'\n\t\t\t\t\tid='g85-datedenaissance'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-datedenaissance-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-datedenaissance-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-datedenaissance-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-sexe\",\"fieldType\":\"select\",\"fieldLabel\":\"Sexe\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-select-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-sexe' class=\"grunion-field-label select\" >Sexe<\/label>\n<div class=\"contact-form__select-wrapper select  grunion-field\"  style=''>\t<span class='contact-form__select-element-wrapper'><select name='g85-sexe' id='g85-sexe'  data-wp-on--change='actions.onFieldChange' data-wp-bind--aria-invalid='state.fieldAriaInvalid' >\n\t\t<option value=''>S\u00e9lectionner une option<\/option>\n\t\t<option value='Veuillez s\u00e9lectionner'>Veuillez s\u00e9lectionner<\/option>\n\t\t<option value='Homme'>Homme<\/option>\n\t\t<option value='Femme'>Femme<\/option>\n\t<\/select><span class='jetpack-field-dropdown__icon'><\/span><\/span>\n<\/div>\n\n\t\t\t<div id=\"g85-sexe-select-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-sexe-select-error-message\"><\/span>\n\t\t\t<\/div>\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-tatcivil\",\"fieldType\":\"text\",\"fieldLabel\":\"\\u00c9tat civil\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-tatcivil' class=\"grunion-field-label text\" >\u00c9tat civil<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-tatcivil'\n\t\t\t\t\tid='g85-tatcivil'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-tatcivil-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-tatcivil-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-tatcivil-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-telpriv\",\"fieldType\":\"text\",\"fieldLabel\":\"Tel priv\\u00e9\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-telpriv' class=\"grunion-field-label text\" >Tel priv\u00e9<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-telpriv'\n\t\t\t\t\tid='g85-telpriv'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-telpriv-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-telpriv-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-telpriv-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-faxpriv\",\"fieldType\":\"text\",\"fieldLabel\":\"Fax priv\\u00e9\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-faxpriv' class=\"grunion-field-label text\" >Fax priv\u00e9<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-faxpriv'\n\t\t\t\t\tid='g85-faxpriv'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-faxpriv-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-faxpriv-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-faxpriv-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-gsmpriv\",\"fieldType\":\"text\",\"fieldLabel\":\"GSM priv\\u00e9\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-gsmpriv' class=\"grunion-field-label text\" >GSM priv\u00e9<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-gsmpriv'\n\t\t\t\t\tid='g85-gsmpriv'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-gsmpriv-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-gsmpriv-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-gsmpriv-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-employeur\",\"fieldType\":\"text\",\"fieldLabel\":\"Employeur\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-employeur' class=\"grunion-field-label text\" >Employeur<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-employeur'\n\t\t\t\t\tid='g85-employeur'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-employeur-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-employeur-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-employeur-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-fonctions\",\"fieldType\":\"textarea\",\"fieldLabel\":\"Fonction(s)\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-textarea-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='contact-form-comment-g85-fonctions' class=\"grunion-field-label textarea\" >Fonction(s)<\/label>\n<textarea\n\t\t                style=''\n\t\t                name='g85-fonctions'\n\t\t                id='contact-form-comment-g85-fonctions'\n\t\t                rows='20'\n\t\t\t\t\t\tdata-wp-text='state.getFieldValue'\n\t\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\t\t\t\t\t\taria-describedby='g85-fonctions-textarea-error-message'\n\t\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\t\tclass='textarea  grunion-field'  ><\/textarea>\n \n\t\t\t<div id=\"g85-fonctions-textarea-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-fonctions-textarea-error-message\"><\/span>\n\t\t\t<\/div>\n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-service\",\"fieldType\":\"text\",\"fieldLabel\":\"Service\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-service' class=\"grunion-field-label text\" >Service<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-service'\n\t\t\t\t\tid='g85-service'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-service-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-service-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-service-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-secteurdactivit\",\"fieldType\":\"text\",\"fieldLabel\":\"Secteur d\\u0027activit\\u00e9\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-secteurdactivit' class=\"grunion-field-label text\" >Secteur d'activit\u00e9<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-secteurdactivit'\n\t\t\t\t\tid='g85-secteurdactivit'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-secteurdactivit-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-secteurdactivit-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-secteurdactivit-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-adresseprofessionnelle\",\"fieldType\":\"textarea\",\"fieldLabel\":\"Adresse Professionnelle\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-textarea-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='contact-form-comment-g85-adresseprofessionnelle' class=\"grunion-field-label textarea\" >Adresse Professionnelle<\/label>\n<textarea\n\t\t                style=''\n\t\t                name='g85-adresseprofessionnelle'\n\t\t                id='contact-form-comment-g85-adresseprofessionnelle'\n\t\t                rows='20'\n\t\t\t\t\t\tdata-wp-text='state.getFieldValue'\n\t\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\t\t\t\t\t\taria-describedby='g85-adresseprofessionnelle-textarea-error-message'\n\t\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\t\tclass='textarea  grunion-field'  ><\/textarea>\n \n\t\t\t<div id=\"g85-adresseprofessionnelle-textarea-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-adresseprofessionnelle-textarea-error-message\"><\/span>\n\t\t\t<\/div>\n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-pays-1\",\"fieldType\":\"text\",\"fieldLabel\":\"Pays\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-pays-1' class=\"grunion-field-label text\" >Pays<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-pays-1'\n\t\t\t\t\tid='g85-pays-1'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-pays-1-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-pays-1-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-pays-1-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-tlprofessionnel\",\"fieldType\":\"text\",\"fieldLabel\":\"T\\u00e9l professionnel\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-tlprofessionnel' class=\"grunion-field-label text\" >T\u00e9l professionnel<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-tlprofessionnel'\n\t\t\t\t\tid='g85-tlprofessionnel'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-tlprofessionnel-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-tlprofessionnel-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-tlprofessionnel-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-faxprofessionnel\",\"fieldType\":\"text\",\"fieldLabel\":\"Fax professionnel\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-faxprofessionnel' class=\"grunion-field-label text\" >Fax professionnel<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-faxprofessionnel'\n\t\t\t\t\tid='g85-faxprofessionnel'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-faxprofessionnel-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-faxprofessionnel-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-faxprofessionnel-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-gsmprofessionnel\",\"fieldType\":\"text\",\"fieldLabel\":\"GSM professionnel\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-gsmprofessionnel' class=\"grunion-field-label text\" >GSM professionnel<\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-gsmprofessionnel'\n\t\t\t\t\tid='g85-gsmprofessionnel'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-gsmprofessionnel-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-gsmprofessionnel-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-gsmprofessionnel-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-emailprofessionnel\",\"fieldType\":\"email\",\"fieldLabel\":\"Email professionnel\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-email-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-emailprofessionnel' class=\"grunion-field-label email\" >Email professionnel<\/label>\n<input\n\t\t\t\t\ttype='email'\n\t\t\t\t\tname='g85-emailprofessionnel'\n\t\t\t\t\tid='g85-emailprofessionnel'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-emailprofessionnel-email-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='email  grunion-field' \n\t\t\t\t\t \/>\n \n\t\t\t<div id=\"g85-emailprofessionnel-email-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-emailprofessionnel-email-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-titreprofessionnel\",\"fieldType\":\"select\",\"fieldLabel\":\"Titre professionnel\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"1\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-select-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-titreprofessionnel' class=\"grunion-field-label select\" >Titre professionnel<span class=\"grunion-label-required\" aria-hidden=\"true\">(obligatoire)<\/span><\/label>\n<div class=\"contact-form__select-wrapper select  grunion-field\"  style=''>\t<span class='contact-form__select-element-wrapper'><select name='g85-titreprofessionnel' id='g85-titreprofessionnel' required aria-required='true' data-wp-on--change='actions.onFieldChange' data-wp-bind--aria-invalid='state.fieldAriaInvalid' >\n\t\t<option value=''>S\u00e9lectionner une option<\/option>\n\t\t<option value='Veuillez s\u00e9lectionner'>Veuillez s\u00e9lectionner<\/option>\n\t\t<option value='It. (Ing\u00e9nieur technicien)'>It. (Ing\u00e9nieur technicien)<\/option>\n\t\t<option value='Ing. (Ing\u00e9nieur industriel)'>Ing. (Ing\u00e9nieur industriel)<\/option>\n\t<\/select><span class='jetpack-field-dropdown__icon'><\/span><\/span>\n<\/div>\n\n\t\t\t<div id=\"g85-titreprofessionnel-select-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-titreprofessionnel-select-error-message\"><\/span>\n\t\t\t<\/div>\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-reconnaissanceeuring\",\"fieldType\":\"checkbox\",\"fieldLabel\":\"Reconnaissance Eur-Ing ?\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-checkbox-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<div class='contact-form__checkbox-wrap' style='' ><input id='g85-reconnaissanceeuring' type='checkbox' data-wp-on--change='actions.onFieldChange' name='g85-reconnaissanceeuring' value='Oui' class='checkbox  grunion-field'  \/> \n<label for='g85-reconnaissanceeuring' class='grunion-field-label checkbox' style=''>Reconnaissance Eur-Ing ?<\/label>\n<div class='clear-form'><\/div>\n<\/div>\n\t\t\t<div id=\"g85-reconnaissanceeuring-checkbox-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-reconnaissanceeuring-checkbox-error-message\"><\/span>\n\t\t\t<\/div>\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-annedepromotion\",\"fieldType\":\"text\",\"fieldLabel\":\"Ann\\u00e9e de promotion\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"1\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-text-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='g85-annedepromotion' class=\"grunion-field-label text\" >Ann\u00e9e de promotion<span class=\"grunion-label-required\" aria-hidden=\"true\">(obligatoire)<\/span><\/label>\n<input\n\t\t\t\t\ttype='text'\n\t\t\t\t\tname='g85-annedepromotion'\n\t\t\t\t\tid='g85-annedepromotion'\n\t\t\t\t\tvalue=''\n\n\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\tdata-wp-bind--value='state.getFieldValue'\n\t\t\t\t\taria-describedby='g85-annedepromotion-text-error-message'\n\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\n\t\t\t\t\tclass='text  grunion-field' \n\t\t\t\t\trequired='true' aria-required='true'  \/>\n \n\t\t\t<div id=\"g85-annedepromotion-text-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-annedepromotion-text-error-message\"><\/span>\n\t\t\t<\/div> \n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-formationscomplmentaires\",\"fieldType\":\"textarea\",\"fieldLabel\":\"Formation(s) compl\\u00e9mentaire(s)\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-textarea-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='contact-form-comment-g85-formationscomplmentaires' class=\"grunion-field-label textarea\" >Formation(s) compl\u00e9mentaire(s)<\/label>\n<textarea\n\t\t                style=''\n\t\t                name='g85-formationscomplmentaires'\n\t\t                id='contact-form-comment-g85-formationscomplmentaires'\n\t\t                rows='20'\n\t\t\t\t\t\tdata-wp-text='state.getFieldValue'\n\t\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\t\t\t\t\t\taria-describedby='g85-formationscomplmentaires-textarea-error-message'\n\t\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\t\tclass='textarea  grunion-field'  ><\/textarea>\n \n\t\t\t<div id=\"g85-formationscomplmentaires-textarea-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-formationscomplmentaires-textarea-error-message\"><\/span>\n\t\t\t<\/div>\n\t<\/div>\n\n<div style=\"\"  data-wp-interactive=\"jetpack\/form\" data-wp-context='{\"fieldId\":\"g85-commentaires\",\"fieldType\":\"textarea\",\"fieldLabel\":\"Commentaires\",\"fieldValue\":\"\",\"fieldPlaceholder\":\"\",\"fieldIsRequired\":\"\",\"fieldErrorMessage\":\"\",\"fieldExtra\":[],\"formHash\":\"edf5672ca2adef9fdb755c45813bb261adf66bdd\"}'  class='grunion-field-textarea-wrap grunion-field-wrap'  data-wp-init='callbacks.initializeField' data-wp-on--jetpack-form-reset='callbacks.initializeField' >\n<label\n\t\t\t\tfor='contact-form-comment-g85-commentaires' class=\"grunion-field-label textarea\" >Commentaires<\/label>\n<textarea\n\t\t                style=''\n\t\t                name='g85-commentaires'\n\t\t                id='contact-form-comment-g85-commentaires'\n\t\t                rows='20'\n\t\t\t\t\t\tdata-wp-text='state.getFieldValue'\n\t\t\t\t\t\tdata-wp-on--input='actions.onFieldChange'\n\t\t\t\t\t\tdata-wp-on--blur='actions.onFieldBlur'\n\t\t\t\t\t\tdata-wp-class--has-value='state.hasFieldValue'\n\t\t\t\t\t\taria-describedby='g85-commentaires-textarea-error-message'\n\t\t\t\t\t\tdata-wp-bind--aria-invalid='state.fieldAriaInvalid'\n\t\t\t\t\t\tclass='textarea  grunion-field'  ><\/textarea>\n \n\t\t\t<div id=\"g85-commentaires-textarea-error\" class=\"contact-form__input-error\" data-wp-class--has-errors=\"state.fieldHasErrors\">\n\t\t\t\t<span class=\"contact-form__warning-icon\" aria-hidden=\"true\">\n\t\t\t\t\t<svg width=\"16\" height=\"16\" viewBox=\"0 0 16 16\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n\t\t\t\t\t\t<path d=\"M8.50015 11.6402H7.50015V10.6402H8.50015V11.6402Z\" \/>\n\t\t\t\t\t\t<path d=\"M7.50015 9.64018H8.50015V6.30684H7.50015V9.64018Z\" \/>\n\t\t\t\t\t\t<path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M6.98331 3.0947C7.42933 2.30177 8.57096 2.30177 9.01698 3.09469L13.8771 11.7349C14.3145 12.5126 13.7525 13.4735 12.8602 13.4735H3.14004C2.24774 13.4735 1.68575 12.5126 2.12321 11.7349L6.98331 3.0947ZM8.14541 3.58496C8.08169 3.47168 7.9186 3.47168 7.85488 3.58496L2.99478 12.2251C2.93229 12.3362 3.01257 12.4735 3.14004 12.4735H12.8602C12.9877 12.4735 13.068 12.3362 13.0055 12.2251L8.14541 3.58496Z\" \/>\n\t\t\t\t\t<\/svg>\n\t\t\t\t<\/span>\n\t\t\t\t<span data-wp-text=\"state.errorMessage\" id=\"g85-commentaires-textarea-error-message\"><\/span>\n\t\t\t<\/div>\n\t<\/div>\n\t<p class='contact-submit'>\n<div class=\"contact-form__error\" data-wp-class--show-errors=\"state.showFormErrors\"><span class=\"contact-form__warning-icon\" aria-hidden=\"true\"><i><\/i><\/span><span class=\"contact-form__error-message\" tabindex=\"-1\" data-wp-watch=\"callbacks.focusOnValidationError\" data-wp-text=\"state.getFormErrorMessage\"><\/span><ul aria-label=\"Erreurs de formulaire\">\n\t\t\t\t<template data-wp-each=\"state.getErrorList\" data-wp-key=\"context.item.id\">\n\t\t\t\t\t<li><a data-wp-bind--href=\"context.item.anchor\" data-wp-on--click=\"actions.scrollIntoView\" data-wp-text=\"context.item.label\"><\/a><\/li>\n\t\t\t\t<\/template>\n\t\t\t\t<\/ul><\/div><div class=\"contact-form__error\" data-wp-class--show-errors=\"state.showSubmissionError\" data-wp-text=\"context.submissionError\" tabindex=\"-1\" data-wp-watch=\"callbacks.focusOnSubmissionError\"><\/div>\t\t<button type='submit' class='pushbutton-wide'>Envoyer<\/button>\t\t<input type='hidden' name='contact-form-id' value='85' \/>\n\t\t<input type='hidden' name='action' value='grunion-contact-form' \/>\n\t\t<input type='hidden' name='contact-form-hash' value='edf5672ca2adef9fdb755c45813bb261adf66bdd' \/>\n\t<\/p>\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"134\"\/><script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n\/* ]]> *\/\n<\/script>\n<\/p><\/form>\n<\/div>\n<p>Conform\u00e9ment \u00e0 le loi du 8 d\u00e9cembre 1992 relative \u00e0 la protection de la vie priv\u00e9e \u00e0 l\u2019\u00e9gard des traitements de donn\u00e9es \u00e0 caract\u00e8re personnel, nous vous signalons que les donn\u00e9es que vous nous avez communiqu\u00e9es feront l\u2019objet d\u2019un traitement par l\u2019UILg et par l\u2019UFIIB. La finalit\u00e9 de ces traitements est l\u2019administration des membres de ces associations et l\u2019information des confr\u00e8res sur leurs situations professionnelles r\u00e9ciproques. A d\u00e9faut de refus \u00e9crit de votre part, devant nous parvenir au plus tard \u00e0 la date de cl\u00f4ture des modifications des donn\u00e9es, vous serez repris tel que mentionn\u00e9 au recto de la pr\u00e9sente dans l\u2019annuaire de l\u2019UILg et dans celui de l\u2019UFIIB.<br \/>\nPour l\u2019UILg, le responsable du traitement est l\u2019UILg, repr\u00e9sent\u00e9e par son pr\u00e9sident.<br \/>\nPour l\u2019UFIIB, le responsable du traitement est l\u2019UFIIB, repr\u00e9sent\u00e9e par son pr\u00e9sident.<br \/>\nLes destinataires des donn\u00e9es sont les membres de l\u2019UILg, et de l\u2019UFIIB (Union Francophone des Ing\u00e9nieurs Industriels de Belgique).<br \/>\nEn vertu de la loi du 8 d\u00e9cembre 1992, vous disposez \u00e0 tout moment du droit d\u2019obtenir communication des donn\u00e9es vous concernant et de demander leur rectification, s\u2019il y a lieu, en adressant une lettre dat\u00e9e, sign\u00e9e et accompagn\u00e9e d\u2019une photocopie recto verso de votre carte d\u2019identit\u00e9 au si\u00e8ge de l\u2019UILg : 6 quai Gloesner 4020 Li\u00e8ge et\/ou au si\u00e8ge de l\u2019UFIIB : 84 Avenue Moli\u00e8re 1190 Bruxelles.<br \/>\nVous avez \u00e9galement la possibilit\u00e9 d\u2019obtenir des renseignements compl\u00e9mentaires aupr\u00e8s du registre public de la Commission de la protection de la vie priv\u00e9e situ\u00e9e rue de la R\u00e9gence 61 \u00e0 1000 Bruxelles.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fiche individuelle Merci de compl\u00e9ter ce formulaire en cas d&rsquo;affiliation \u00e0 l&rsquo;U.I.Lg ASBL ou pour signaler une modification de vos donn\u00e9es. Ces informations sont \u00e0 usage de l\u2019U.I.Lg. ASBL et de l\u2019UFIIB ASBL dont l\u2019UILg fait partie et sont r\u00e9gies &hellip; <a href=\"https:\/\/uilg.be\/blog\/membres\/donnees-personnelles\/\">Continuer la lecture <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":78,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"sidebar-page.php","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-85","page","type-page","status-publish","hentry"],"jetpack_shortlink":"https:\/\/wp.me\/P3rzaT-1n","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/pages\/85","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/comments?post=85"}],"version-history":[{"count":7,"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/pages\/85\/revisions"}],"predecessor-version":[{"id":938,"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/pages\/85\/revisions\/938"}],"up":[{"embeddable":true,"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/pages\/78"}],"wp:attachment":[{"href":"https:\/\/uilg.be\/blog\/wp-json\/wp\/v2\/media?parent=85"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}