{"id":20006,"date":"2025-11-04T14:14:18","date_gmt":"2025-11-04T13:14:18","guid":{"rendered":"https:\/\/bc.academy\/formulaire-dinscription-e-learnings-pecb-iso-27001\/"},"modified":"2026-01-08T12:48:33","modified_gmt":"2026-01-08T11:48:33","slug":"formulaire-dinscription-e-learnings-pecb-iso-27001","status":"publish","type":"page","link":"https:\/\/bc.academy\/fr\/formulaire-dinscription-e-learnings-pecb-iso-27001\/","title":{"rendered":"Formulaire d\u2019inscription \u2013 e-Learnings PECB ISO 27001"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><form method='post' enctype='multipart\/form-data'  id='gform_26'  action='\/fr\/wp-json\/wp\/v2\/pages\/20006' data-formid='26' novalidate>\t\t\t\t\t<div style=\"display: none !important;\" class=\"akismet-fields-container gf_invisible\" data-prefix=\"ak_\">\n\t\t\t\t\t\t<label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label>\n\t\t\t\t\t\t<input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"16\" \/>\n\t\t\t\t\t\t<script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n\n\t\t\t\t\t<\/div>\n                        <div class='gform-body gform_body'><div id='gform_fields_26' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_26_3\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"26eb2de6\" data-field-span=\"12\"><h3 class=\"gsection_title\">Coordonn\u00e9es<\/h3><\/div><fieldset id=\"field_26_5\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"f31b1bbe\" data-field-span=\"12\"><legend id='gfield_label_26_5' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nom<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_26_5'>\n                            \n                            <span id='input_26_5_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.3' id='input_26_5_3' value=''   aria-required='true'     aria-labelledby=\"input_26_5_3_label gfield_label_26_5\"\/>\n                                                    <label for='input_26_5_3' id='input_26_5_3_label' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_26_5_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_5.6' id='input_26_5_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_26_5_6' id='input_26_5_6_label' class='gform-field-label gform-field-label--type-sub '>Nom de famille<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_26_7\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"fbd70569\" data-field-span=\"12\"><label id='gfield_label_26_7' class='gfield_label gform-field-label' for='input_26_7'><span class='gform-field-label__text'>Adresse e-mail<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_7' id='input_26_7' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_26_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"f40e80c2\" data-field-span=\"12\"><label id='gfield_label_26_8' class='gfield_label gform-field-label' for='input_26_8'><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_26_8' type='tel' value='' class='large'    aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_26_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"38f44134\" data-field-span=\"12\"><h3 class=\"gsection_title\">Informations sur l\u2019organisation<\/h3><\/div><div id=\"field_26_10\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"43869b92\" data-field-span=\"12\"><label id='gfield_label_26_10' class='gfield_label gform-field-label' for='input_26_10'><span class='gform-field-label__text'>Nom de l\u2019entreprise<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_26_10' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_26_12\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"03d651c6\" data-field-span=\"12\"><legend id='gfield_label_26_12' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adresse<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_26_12' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_26_12_1_container' >\n                                        <input type='text' name='input_12.1' id='input_26_12_1' value=''    aria-required='true'    aria-labelledby=\"input_26_12_1_label gfield_label_26_12\"\/>\n                                        <label for='input_26_12_1' id='input_26_12_1_label' class='gform-field-label gform-field-label--type-sub '>Rue + num\u00e9ro<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_26_12_3_container' >\n                                    <input type='text' name='input_12.3' id='input_26_12_3' value=''    aria-required='true'    \/>\n                                    <label for='input_26_12_3' id='input_26_12_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_12.4' id='input_26_12_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_26_12_5_container' >\n                                    <input type='text' name='input_12.5' id='input_26_12_5' value=''    aria-required='true'    \/>\n                                    <label for='input_26_12_5' id='input_26_12_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_12.6' id='input_26_12_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_26_36\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"589d85c5\" data-field-span=\"12\"><label id='gfield_label_26_36' class='gfield_label gform-field-label' for='input_26_36'><span class='gform-field-label__text'>Pays de l&#039;entreprise<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_36' id='input_26_36' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Belgique' >Belgique<\/option><option value='France' >France<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Suisse' >Suisse<\/option><\/select><\/div><\/div><div id=\"field_26_37\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"df76c78f\" data-field-span=\"12\"><h3 class=\"gsection_title\">Conditions de paiement pour les entreprises \u00e9tablies en Suisse<\/h3><div class='gsection_description' id='gfield_description_26_37'>Les demandes de paiement sur facture des entreprises \u00e9tablies en Suisse font l&#8217;objet d&#8217;une v\u00e9rification compl\u00e9mentaire.\n\nSelon le r\u00e9sultat de cette v\u00e9rification, un paiement anticip\u00e9 peut \u00eatre exig\u00e9 avant l&#8217;activation de la formation.<\/div><\/div><div id=\"field_26_13\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"0ea27c8f\" data-field-span=\"12\"><label id='gfield_label_26_13' class='gfield_label gform-field-label' for='input_26_13'><span class='gform-field-label__text'>Num\u00e9ro de TVA<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_26_13' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_26_9\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"bf71fc9c\" data-field-span=\"12\"><h3 class=\"gsection_title\">Donn\u00e9es de facturation<\/h3><\/div><div id=\"field_26_26\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7fa4db29\" data-field-span=\"12\"><h3 class=\"gsection_title\">Informations de facturation<\/h3><\/div><div id=\"field_26_30\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"db6ebb50\" data-field-span=\"12\"><label id='gfield_label_26_30' class='gfield_label gform-field-label' for='input_26_30'><span class='gform-field-label__text'>Adresse e-mail de facturation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_30' id='input_26_30' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_26_31\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"47f90584\" data-field-span=\"12\"><legend id='gfield_label_26_31' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Afwijkend factuuradres<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_26_31'><div class='gchoice gchoice_26_31_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_31.1' type='checkbox'  value='L\u2019adresse de facturation diff\u00e8re de l\u2019adresse de l\u2019organisation'  id='choice_26_31_1'    aria-labelledby=\"label_26_31_1 gfield_label_26_31\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_26_31_1' id='label_26_31_1' class='gform-field-label gform-field-label--type-inline'>L\u2019adresse de facturation diff\u00e8re de l\u2019adresse de l\u2019organisation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_26_28\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"70592aba\" data-field-span=\"12\"><legend id='gfield_label_26_28' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adresse de facturation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_26_28' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_26_28_1_container' >\n                                        <input type='text' name='input_28.1' id='input_26_28_1' value=''    aria-required='true'    aria-labelledby=\"input_26_28_1_label gfield_label_26_28\"\/>\n                                        <label for='input_26_28_1' id='input_26_28_1_label' class='gform-field-label gform-field-label--type-sub '>Rue + num\u00e9ro<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_26_28_3_container' >\n                                    <input type='text' name='input_28.3' id='input_26_28_3' value=''    aria-required='true'    \/>\n                                    <label for='input_26_28_3' id='input_26_28_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_28.4' id='input_26_28_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_26_28_5_container' >\n                                    <input type='text' name='input_28.5' id='input_26_28_5' value=''    aria-required='true'    \/>\n                                    <label for='input_26_28_5' id='input_26_28_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_28.6' id='input_26_28_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_26_38\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"ba977fbb\" data-field-span=\"12\"><label id='gfield_label_26_38' class='gfield_label gform-field-label' for='input_26_38'><span class='gform-field-label__text'>Pays de facturation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_38' id='input_26_38' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Belgique' >Belgique<\/option><option value='France' >France<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Suisse' >Suisse<\/option><\/select><\/div><\/div><div id=\"field_26_23\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"2d1fd633\" data-field-span=\"12\"><label id='gfield_label_26_23' class='gfield_label gform-field-label' for='input_26_23'><span class='gform-field-label__text'>R\u00e9f\u00e9rence \/ num\u00e9ro de commande (PO)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_26_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_26_32\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"b1809ec5\" data-field-span=\"12\"><legend id='gfield_label_26_32' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Mode de facturation<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_26_32'><div class='gchoice gchoice_26_32_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_32.1' type='checkbox'  value='Je souhaite recevoir la facture via Peppol'  id='choice_26_32_1'    aria-labelledby=\"label_26_32_1 gfield_label_26_32\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_26_32_1' id='label_26_32_1' class='gform-field-label gform-field-label--type-inline'>Je souhaite recevoir la facture via Peppol<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_26_33\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"58dc31e3\" data-field-span=\"12\"><label id='gfield_label_26_33' class='gfield_label gform-field-label' for='input_26_33'><span class='gform-field-label__text'>Identifiant Peppol \/ Num\u00e9ro d\u2019organisation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_26_33' type='text' value='' class='large'  aria-describedby=\"gfield_description_26_33\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_26_33'>Si votre organisation est connect\u00e9e \u00e0 Peppol, veuillez indiquer votre identifiant Peppol ou votre num\u00e9ro d\u2019organisation enregistr\u00e9.<\/div><\/div><div id=\"field_26_29\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"9d94cff9\" data-field-span=\"12\"><h3 class=\"gsection_title\">Details e-learning<\/h3><\/div><fieldset id=\"field_26_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"666142fa\" data-field-span=\"12\"><legend id='gfield_label_26_19' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Formation souhait\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_26_19'>\n\t\t\t<div class='gchoice gchoice_26_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='PECB ISO\/IEC 27001 Lead Implementer'  id='choice_26_19_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_26_19_0 gfield_label_26_19\"   \/>\n\t\t\t\t\t<label for='choice_26_19_0' id='label_26_19_0' class='gform-field-label gform-field-label--type-inline'>PECB ISO\/IEC 27001 Lead Implementer<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_26_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='PECB ISO\/IEC 27001 Lead Auditor'  id='choice_26_19_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_26_19_1' id='label_26_19_1' class='gform-field-label gform-field-label--type-inline'>PECB ISO\/IEC 27001 Lead Auditor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_26_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='PECB ISO\/IEC 27001 Foundation'  id='choice_26_19_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_26_19_2' id='label_26_19_2' class='gform-field-label gform-field-label--type-inline'>PECB ISO\/IEC 27001 Foundation<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_26_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"02526617\" data-field-span=\"12\"><legend id='gfield_label_26_24' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Langue de formation souhait\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_26_24'>\n\t\t\t<div class='gchoice gchoice_26_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Anglais'  id='choice_26_24_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_26_24_0 gfield_label_26_24\"   \/>\n\t\t\t\t\t<label for='choice_26_24_0' id='label_26_24_0' class='gform-field-label gform-field-label--type-inline'>Anglais<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_26_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Fran\u00e7ais'  id='choice_26_24_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_26_24_1' id='label_26_24_1' class='gform-field-label gform-field-label--type-inline'>Fran\u00e7ais<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_26_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Espagnol'  id='choice_26_24_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_26_24_2' id='label_26_24_2' class='gform-field-label gform-field-label--type-inline'>Espagnol<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_26_34\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"a023b69c\" data-field-span=\"12\"><legend id='gfield_label_26_34' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Langue de formation souhait\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_26_34'>\n\t\t\t<div class='gchoice gchoice_26_34_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Anglais'  id='choice_26_34_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_26_34_0 gfield_label_26_34\"   \/>\n\t\t\t\t\t<label for='choice_26_34_0' id='label_26_34_0' class='gform-field-label gform-field-label--type-inline'>Anglais<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_26_34_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_34' type='radio' value='Fran\u00e7ais'  id='choice_26_34_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_26_34_1' id='label_26_34_1' class='gform-field-label gform-field-label--type-inline'>Fran\u00e7ais<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_26_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"79506199\" data-field-span=\"12\"><label id='gfield_label_26_35' class='gfield_label gform-field-label' for='input_26_35'><span class='gform-field-label__text'>Code de r\u00e9duction<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_26_35' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_26_22\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"baec8458\" data-field-span=\"12\"><label id='gfield_label_26_22' class='gfield_label gform-field-label' for='input_26_22'><span class='gform-field-label__text'>Remarques<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_26_22' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_26_27\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"65fd7952\" data-field-span=\"12\"><legend id='gfield_label_26_27' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Payment obligation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(N\u00e9cessaire)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_26_27'><div class='gchoice gchoice_26_27_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.1' type='checkbox'  value='En soumettant cette demande, vous acceptez les frais associ\u00e9s et vous engagez \u00e0 une obligation de paiement conform\u00e9ment \u00e0 nos conditions de paiement.'  id='choice_26_27_1'    aria-labelledby=\"label_26_27_1 gfield_label_26_27\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_26_27_1' id='label_26_27_1' class='gform-field-label gform-field-label--type-inline'>En soumettant cette demande, vous acceptez les frais associ\u00e9s et vous engagez \u00e0 une obligation de paiement conform\u00e9ment \u00e0 nos conditions de paiement.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_26' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Soumettre<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_26' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_26' id='gform_theme_26' value='orbital' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_26' id='gform_style_settings_26' 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