{"id":24595,"date":"2025-07-23T15:17:48","date_gmt":"2025-07-23T13:17:48","guid":{"rendered":"https:\/\/payconiq.lu\/?page_id=24595"},"modified":"2025-07-24T16:28:04","modified_gmt":"2025-07-24T14:28:04","slug":"test-form","status":"publish","type":"page","link":"https:\/\/payconiq.lu\/fr\/test-form\/","title":{"rendered":"test form"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\"  style='background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;padding-top:70px;padding-right:30px;padding-bottom:85px;padding-left:30px;'><div class=\"fusion-builder-row fusion-row \"><div  class=\"fusion-layout-column fusion_builder_column fusion_builder_column_1_1 fusion-builder-column-1 fusion-one-full fusion-column-first fusion-column-last 1_1\"  style='margin-top:0px;margin-bottom:0px;'>\n\t\t\t\t\t<div class=\"fusion-column-wrapper\" style=\"padding: 0px 0px 0px 0px;background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;\"   data-bg-url=\"\">\n\t\t\t\t\t\t\n    <form action=\"\/fr\/wp-json\/wp\/v2\/pages\/24595#form_merchants\" method=\"post\" class=\"form_facture\" id=\"form_merchants\" enctype=\"multipart\/form-data\">\n        <p>\n            <label>Pr\u00e9nom*<br>\n                <input type=\"text\" name=\"your-firstname\" required>\n            <\/label><br>\n\n            <label>Nom*<br>\n                <input type=\"text\" name=\"your-lastname\" required>\n            <\/label><br>\n\n            <label>Email*<br>\n                <input type=\"email\" name=\"your-email\" required>\n            <\/label><br>\n\n            <label>Num\u00e9ro de t\u00e9l\u00e9phone<br>\n                <input type=\"tel\" name=\"your-phone\">\n            <\/label><br>\n\n            <label>Nom du fournisseur \/ commer\u00e7ant*<br>\n                <input type=\"text\" name=\"your-supplier\" required>\n            <\/label><br>\n\n            <label>Ins\u00e9rer une facture SANS le QR code Payconiq*<br>\n                <input type=\"file\" name=\"file-907\" accept=\".pdf,.jpg,.jpeg,.png\" required>\n            <\/label>\n        <\/p>\n\n        <p>\n            <label>En cliquant sur \u00ab Envoyer \u00bb, vous reconnaissez avoir lu et vous consentez :<br>\n                - <a href=\"\/fr\/reglement-general-des-offres-et-jeux-concours-de-payconiq\/\">aux Conditions g\u00e9n\u00e9rales<\/a><br>\n                - <a href=\"\/fr\/confidentialite\/\">\u00e0 la Politique de confidentialit\u00e9<\/a>\n            <\/label>\n        <\/p>\n\n        <input type=\"hidden\" id=\"ff_nonce\" name=\"ff_nonce\" value=\"8f7e6d311e\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/24595\" \/>        <p>\n            <input type=\"submit\" name=\"ff_submitted\" class=\"wpcf7-form-control wpcf7-submit has-spinner btnSubmit\" value=\"Envoyer\">\n        <\/p>\n    <\/form>\n\n\t<div id=\"form-modal-message\" class=\"form-modal hidden\">\n\t\t<div class=\"form-modal-content\">\n\t\t\t<a href=\"#\" class=\"form-modal-close\" onclick=\"closeModal(); return false;\">&times;<\/a>\n\t\t\t<div class=\"form-modal-text\"><\/div>\n\t\t<\/div>\n\t<\/div>\n\n\t<script>\n\t\tfunction closeModal() {\n\t\t\tconst modal = document.getElementById('form-modal-message');\n\t\t\tif (modal) {\n\t\t\t\tmodal.classList.remove('active');\n\t\t\t}\n\t\t}\n\t<\/script>\n\n\n    \n\n<div class=\"fusion-clearfix\"><\/div>\n\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":9,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"tags":[],"class_list":["post-24595","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.7 - 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