www.votreopinion.be
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Submitted URL: https://echo7.bluehornet.com/ct/59658552:JOGCneE1N:m:1:3171583689:D6289FF1D1FD734B95A667E42A7B7D87:r
Effective URL: https://www.votreopinion.be/fr/signup?id=grjen1kgjyunzio&offer_id=8986&aff_id=1412&aff_sub=467865&transaction_id=102f302e179...
Submission: On February 27 via api from BE — Scanned from DE
Effective URL: https://www.votreopinion.be/fr/signup?id=grjen1kgjyunzio&offer_id=8986&aff_id=1412&aff_sub=467865&transaction_id=102f302e179...
Submission: On February 27 via api from BE — Scanned from DE
Form analysis 1 forms found in the DOM
Name: ff.form —
<form name="ff.form" ng-submit="ff.submit()" novalidate="" autocomplete="off" class="ng-pristine ng-valid-pattern ng-invalid ng-invalid-required ng-valid-email ng-valid-match">
<!-- Prevent autocompletes -->
<input type="password" style="display: none">
<ng-transclude>
<div class="twoColumns ng-scope">
<div class="col-1">
<div class="form-description ng-scope" form-group-desc="">
<div ng-bind-html="$root.unsafeHTML(ff.getActiveGroup().description)" class="ng-binding">
<style>
.imageContainer a:nth-child(1) {
display: none !important;
}
.securityLogos {
display: none !important;
}
h2 {
padding-bottom: 8px;
}
.btn,
.button {
font-weight: 600;
}
</style>
<h2>Plus que deux petites étapes vous séparent de votre premier sondage !</h2>
<p>Nous avons besoin de certaines informations de base pour que vous puissiez commencer.</p>
</div>
</div>
<div style="margin-bottom: 30px; margin-top: 30px; text-align: center">
<div prefix="Adhérer avec"></div>
</div>
<div class="form-description" ng-bind-html-recompile="vm.campaignTranslations.offer"></div>
<!-- ngIf: vm.campaignTranslations -->
<div ng-if="vm.campaignTranslations" class="terms-link ng-scope">
<a href="" ng-click="vm.createTermsModal()" class="ng-binding"></a>
</div><!-- end ngIf: vm.campaignTranslations -->
</div>
<div class="col-2">
<div form-steps="" class="ng-scope">
<div class="reg-steps">
<ul class="steps">
<!-- ngRepeat: group in ff.groups -->
<li ng-repeat="group in ff.groups" ng-class="{ active: ff.activeGroupIndex === $index }" class="ng-scope active">
<span class="step-label"><b class="ng-binding">1</b></span>
<span class="step-text ng-binding">Vos informations</span>
</li><!-- end ngRepeat: group in ff.groups -->
<li ng-repeat="group in ff.groups" ng-class="{ active: ff.activeGroupIndex === $index }" class="ng-scope">
<span class="step-label"><b class="ng-binding">2</b></span>
<span class="step-text ng-binding">Terminé</span>
</li><!-- end ngRepeat: group in ff.groups -->
</ul>
</div>
</div>
<div form-elements="" class="ng-scope"><!-- ngIf: ff.formCannotLoad -->
<!-- ngIf: !ff.formCannotLoad -->
<div cg-busy="ff.isLoadingPromise" ng-if="!ff.formCannotLoad" class="ng-scope" style="position: relative;">
<!-- Global Errors -->
<div class="form-type1-row field-global-errors ng-hide ng-inactive" ng-show="ff.hasGlobalErrors()" ng-messages="" for="ff.globalErrors">
<span class="fa fa-exclamation-circle field-global-error-icon" aria-hidden="true"></span>
<!-- ngMessagesInclude: v-error-messages --><!-- ngMessage: birthDate -->
<!-- ngMessage: required -->
<!-- ngMessage: number -->
<!-- ngMessage: date -->
<!-- ngMessage: email -->
<!-- ngMessage: pattern -->
<!-- ngMessage: emailMatch -->
<!-- ngMessage: existingPostalCode -->
<!-- ngMessage: passwordMatch -->
<!-- ngMessage: uniqueEmail -->
<!-- ngMessage: alternateEmailNotMatchPrimary -->
<!-- ngMessage: error_ageMin -->
<!-- ngMessage: error_requiredDataMissing -->
<!-- ngMessage: error_brandNotExist -->
<!-- ngMessage: error_consentNotGiven -->
<!-- ngMessage: error_captcha -->
<!-- ngMessage: error_emailExist -->
<!-- ngMessage: error_enrollmentSuspended -->
<!-- ngMessage: error_generalError -->
<!-- ngMessage: error_invalidCaptcha -->
<!-- ngMessage: error_invalidCredentials -->
<!-- ngMessage: error_invalidToken -->
<!-- ngMessage: error_mobileNotVerified -->
<!-- ngMessage: error_panelNotExist -->
<!-- ngMessage: error_passwordNotMatch -->
<!-- ngMessage: error_invalidValue -->
<!-- ngMessage: error_passwordRequirementFail -->
<!-- ngMessage: error_postalCode -->
<!-- ngMessage: error_unexpectedError -->
<!-- ngMessage: error_userDeleted -->
<!-- ngMessage: error_userLocked -->
<!-- ngMessage: error_userNotFound -->
<!-- ngMessage: error_resourceNotFound -->
<!-- ngMessage: error_taxFormRequired -->
<!-- ngMessage: error_resourceDoesNotExist -->
<!-- ngMessage: error_wrongAnswer -->
<!-- ngMessage: error_wrongPassword -->
<!-- ngMessage: error_matchCurrentPassword -->
<!-- ngMessage: error_noVouchersAvailable -->
<!-- ngMessage: error_exceeded_points_per_time -->
<!-- ngMessage: error_exceeded_awards_at_once -->
<!-- ngMessage: error_exceeded_redemptions_per_time -->
<!-- ngMessage: error_exceeded_redemptions_per_time_per_reward -->
<!-- ngMessage: minlength -->
</div>
<!-- Formly Form Elements -->
<ng-form class="form-type1 formly ng-pristine ng-valid ng-isolate-scope" name="formly_1" role="form" form="ff.form" ng-show="ff.formReady" model="ff.model" fields="ff.formFields">
<!-- ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-name" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index">
<div class="form-type1-row ng-scope">
<!-- Error Handling for First Name -->
<label class="form-type1-title" for="firstName">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model.firstName.label)" class="ng-binding">Prénom</span>
<!-- ngIf: form.$submitted || !form.firstName.$pristine -->
<!-- ngIf: form.firstName.$valid && form.firstName.$dirty && !form.firstName.$pristine -->
<!-- ngIf: form.firstName.$pending && form.firstName.$dirty -->
</label>
<input pattern=".*" autocomplete="off" class="form-type1-text ng-pristine ng-untouched ng-empty ng-valid-pattern ng-invalid ng-invalid-required" type="text" name="firstName" id="firstName"
ng-required="options.templateOptions.model.firstName.required" ng-model="options.model.firstName" ng-model-options="{debounce: 700}" placeholder="" formly-custom-validation="" required="required">
<!-- ngIf: options.templateOptions.model.firstName.supportingText -->
</div>
<div class="form-type1-row ng-scope">
<!-- Error Handling for Last Name -->
<label class="form-type1-title" for="lastName">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model.lastName.label)" class="ng-binding">Nom</span>
<!-- ngIf: form.$submitted || !form.lastName.$pristine -->
<!-- ngIf: form.lastName.$valid && form.lastName.$dirty && !form.lastName.$pristine -->
<!-- ngIf: form.lastName.$pending && form.lastName.$dirty -->
</label>
<input pattern=".*" autocomplete="off" class="form-type1-text ng-pristine ng-untouched ng-empty ng-valid-pattern ng-invalid ng-invalid-required" type="text" name="lastName" id="lastName"
ng-required="options.templateOptions.model.lastName.required" ng-model="options.model.lastName" ng-model-options="{debounce: 700}" placeholder="" formly-custom-validation="" required="required">
<!-- ngIf: options.templateOptions.model.lastName.supportingText -->
</div>
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-select" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index"><!-- ngRepeat: def in options.templateOptions.model | customSortObjectByKey: 'displayOrder' -->
<div class="form-type1-row ng-scope" ng-repeat="def in options.templateOptions.model | customSortObjectByKey: 'displayOrder'" ng-init="field = def.__key">
<!-- Error Handling -->
<label class="form-type1-title" for="gender">
<span ng-bind-html="$root.unsafeHTML(def.label)" class="ng-binding">Sexe</span>
<!-- ngIf: form.$submitted || !form[field].$pristine -->
<!-- ngIf: form[field].$valid && form[field].$dirty && !form[field].$pristine -->
<!-- ngIf: form[field].$pending && form[field].$dirty -->
</label>
<select class="form-type1-select ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" name="gender" id="gender" ng-model="options.model[field]" ng-required="true" formly-custom-validation="" required="required">
<option value="" selected="" disabled="" style="display:none" class="ng-binding">Sélectionnez :</option>
<!-- ngRepeat: option in def.values track by $index -->
<option value="M" ng-repeat="option in def.values track by $index" class="ng-binding ng-scope">Homme</option><!-- end ngRepeat: option in def.values track by $index -->
<option value="F" ng-repeat="option in def.values track by $index" class="ng-binding ng-scope">Femme</option><!-- end ngRepeat: option in def.values track by $index -->
</select>
<!-- ngIf: def.supportingText -->
</div><!-- end ngRepeat: def in options.templateOptions.model | customSortObjectByKey: 'displayOrder' -->
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-birthDate" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index">
<div class="form-type1-row ng-scope">
<!-- Error Handling -->
<label class="form-type1-title">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.label)" class="ng-binding">Date de naissance</span>
<span class="field-errors">
<!-- ngIf: form.$submitted || (!form.month.$pristine && !form.day.$pristine && !form.year.$pristine) -->
<!-- ngIf: birthDateField.complete && birthDateField.validDob && birthDateField.minAge -->
</span>
</label>
<div class="form-type1-inline-date">
<!-- ngRepeat: key in ['day', 'month', 'year'] --><select ng-repeat="key in ['day', 'month', 'year']" class="form-type1-select day ng-empty ng-invalid ng-invalid-required" name="day" id="day" ng-change="validateBirthDate()"
ng-model="birthDateField[key]" ng-required="true" formly-custom-validation="" required="required">
<option value="" selected="" disabled="" style="display:none" class="ng-binding">jour</option>
<!-- ngRepeat: option in dateOptions[key] track by $index -->
<option value="01" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">01</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="02" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">02</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="03" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">03</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="04" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">04</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="05" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">05</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="06" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">06</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="07" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">07</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="08" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">08</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="09" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">09</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="10" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">10</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="11" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">11</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="12" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">12</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="13" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">13</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="14" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">14</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="15" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">15</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="16" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">16</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="17" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">17</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="18" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">18</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="19" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">19</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="20" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">20</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="21" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">21</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="22" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">22</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="23" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">23</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="24" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">24</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="25" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">25</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="26" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">26</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="27" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">27</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="28" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">28</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="29" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">29</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="30" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">30</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="31" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">31</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
</select><!-- end ngRepeat: key in ['day', 'month', 'year'] --><select ng-repeat="key in ['day', 'month', 'year']" class="form-type1-select month ng-empty ng-invalid ng-invalid-required" name="month" id="month"
ng-change="validateBirthDate()" ng-model="birthDateField[key]" ng-required="true" formly-custom-validation="" required="required">
<option value="" selected="" disabled="" style="display:none" class="ng-binding">mois</option>
<!-- ngRepeat: option in dateOptions[key] track by $index -->
<option value="01" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">01</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="02" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">02</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="03" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">03</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="04" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">04</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="05" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">05</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="06" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">06</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="07" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">07</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="08" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">08</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="09" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">09</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="10" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">10</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="11" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">11</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="12" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">12</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
</select><!-- end ngRepeat: key in ['day', 'month', 'year'] --><select ng-repeat="key in ['day', 'month', 'year']" class="form-type1-select year ng-empty ng-invalid ng-invalid-required" name="year" id="year"
ng-change="validateBirthDate()" ng-model="birthDateField[key]" ng-required="true" formly-custom-validation="" required="required">
<option value="" selected="" disabled="" style="display:none" class="ng-binding">année</option>
<!-- ngRepeat: option in dateOptions[key] track by $index -->
<option value="2022" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2022</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2021" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2021</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2020" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2020</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2019" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2019</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2018" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2018</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2017" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2017</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2016" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2016</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2015" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2015</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2014" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2014</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2013" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2013</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2012" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2012</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2011" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2011</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2010" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2010</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2009" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2009</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2008" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2008</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2007" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2007</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2006" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2006</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2005" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2005</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2004" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2004</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2003" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2003</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2002" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2002</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2001" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2001</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="2000" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">2000</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1999" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1999</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1998" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1998</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1997" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1997</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1996" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1996</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1995" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1995</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1994" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1994</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1993" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1993</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1992" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1992</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1991" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1991</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1990" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1990</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1989" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1989</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1988" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1988</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1987" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1987</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1986" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1986</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1985" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1985</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1984" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1984</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1983" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1983</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1982" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1982</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1981" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1981</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1980" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1980</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1979" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1979</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1978" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1978</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1977" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1977</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1976" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1976</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1975" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1975</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1974" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1974</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1973" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1973</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1972" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1972</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1971" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1971</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1970" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1970</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1969" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1969</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1968" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1968</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1967" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1967</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1966" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1966</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1965" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1965</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1964" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1964</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1963" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1963</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1962" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1962</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1961" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1961</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1960" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1960</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1959" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1959</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1958" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1958</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1957" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1957</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1956" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1956</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1955" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1955</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1954" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1954</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1953" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1953</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1952" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1952</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1951" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1951</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1950" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1950</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1949" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1949</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1948" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1948</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1947" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1947</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1946" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1946</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1945" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1945</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1944" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1944</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1943" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1943</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1942" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1942</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1941" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1941</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1940" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1940</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1939" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1939</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1938" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1938</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1937" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1937</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1936" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1936</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1935" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1935</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1934" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1934</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1933" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1933</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1932" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1932</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1931" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1931</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1930" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1930</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1929" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1929</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1928" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1928</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1927" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1927</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1926" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1926</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1925" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1925</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1924" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1924</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1923" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1923</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
<option value="1922" ng-repeat="option in dateOptions[key] track by $index" class="ng-binding ng-scope">1922</option><!-- end ngRepeat: option in dateOptions[key] track by $index -->
</select><!-- end ngRepeat: key in ['day', 'month', 'year'] -->
</div>
<!-- ngIf: options.templateOptions.model.birthDate.supportingText -->
</div>
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-postal" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index"><!-- ngRepeat: def in options.templateOptions.model | customSortObjectByKey: 'displayOrder' -->
<div ng-repeat="def in options.templateOptions.model | customSortObjectByKey: 'displayOrder'" class="ng-scope">
<!-- ngIf: (def.inputType === 'select' && def.values.length > 0) || def.inputType === 'postal' || def.inputType === 'text' -->
<div class="form-type1-row ng-scope" ng-init="field = def.__key" ng-if="(def.inputType === 'select' && def.values.length > 0) || def.inputType === 'postal' || def.inputType === 'text'">
<!-- Error Handling -->
<label class="form-type1-title" for="200">
<span ng-bind-html="$root.unsafeHTML(def.label)" class="ng-binding">Quel est votre code postal ?</span>
<!-- ngIf: form.$submitted || !form[field].$pristine -->
<!-- ngIf: form[field].$valid && form[field].$dirty && !form[field].$pristine -->
<!-- ngIf: form[field].$pending && form[field].$dirty -->
</label>
<!-- ngIf: def.inputType === 'postal' --><input ng-if="def.inputType === 'postal'" data-postalcode-check="1" autocomplete="off"
class="form-type1-text one-third ng-pristine ng-untouched ng-scope ng-isolate-scope ng-empty ng-invalid ng-invalid-required ng-valid-pattern" type="text" name="200" id="200" custom-validation="customValidation"
ng-disabled="def.readOnly" ng-required="def.required" ng-pattern="^([0-9]{4})$" ng-model="postalTemp" ng-model-options="{debounce: 700}" placeholder="" formly-custom-validation=""
required="required"><!-- end ngIf: def.inputType === 'postal' -->
<!-- ngIf: def.inputType === 'text' -->
<!-- ngIf: def.inputType === 'select' && def.values.length > 0 -->
<!-- ngIf: def.supportingText -->
</div><!-- end ngIf: (def.inputType === 'select' && def.values.length > 0) || def.inputType === 'postal' || def.inputType === 'text' -->
</div><!-- end ngRepeat: def in options.templateOptions.model | customSortObjectByKey: 'displayOrder' -->
<div ng-repeat="def in options.templateOptions.model | customSortObjectByKey: 'displayOrder'" class="ng-scope">
<!-- ngIf: (def.inputType === 'select' && def.values.length > 0) || def.inputType === 'postal' || def.inputType === 'text' -->
</div><!-- end ngRepeat: def in options.templateOptions.model | customSortObjectByKey: 'displayOrder' -->
<div ng-repeat="def in options.templateOptions.model | customSortObjectByKey: 'displayOrder'" class="ng-scope">
<!-- ngIf: (def.inputType === 'select' && def.values.length > 0) || def.inputType === 'postal' || def.inputType === 'text' -->
</div><!-- end ngRepeat: def in options.templateOptions.model | customSortObjectByKey: 'displayOrder' -->
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-confirmEmail" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index">
<div class="form-type1-row ng-scope">
<!-- Error Handling for Email -->
<label class="form-type1-title" for="email">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model.email.label)" class="ng-binding">Adresse e-mail</span>
<!-- ngIf: form.$submitted || !form.email.$pristine -->
<!-- ngIf: form.email.$valid && form.email.$dirty && !form.email.$pristine -->
<!-- ngIf: form.email.$pending && form.email.$dirty -->
</label>
<input pattern="^\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*$" autocomplete="off" class="form-type1-text ng-pristine ng-untouched ng-isolate-scope ng-empty ng-valid-email ng-valid-pattern ng-invalid ng-invalid-required"
type="email" name="email" id="email" ng-disabled="options.templateOptions.model.email.readOnly" ng-required="options.templateOptions.model.email.required" ng-model="options.model.email" ng-model-options="{debounce: 700}"
placeholder="" custom-email="^\w+([-+.']\w+)*@\w+([-.]\w+)*\.\w+([-.]\w+)*$" formly-custom-validation="" required="required">
<!-- ngIf: options.templateOptions.model.email.supportingText -->
</div>
<div class="form-type1-row ng-scope">
<!-- Error Handling for Confirm Email -->
<label class="form-type1-title" for="confirmEmail">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model.confirmEmail.label)" class="ng-binding">Confirmer l'adresse e-mail</span>
<!-- ngIf: form.$submitted || !form.confirmEmail.$pristine -->
<!-- ngIf: form.confirmEmail.$valid && form.confirmEmail.$dirty && !form.confirmEmail.$pristine -->
<span ng-show="form.confirmEmail.$pending && form.confirmEmail.$dirty" class="ng-hide">
<i class="fa fa-spin fa-circle-o-notch" aria-hidden="true"></i>
</span>
</label>
<input pattern="" autocomplete="off" class="form-type1-text ng-pristine ng-untouched ng-isolate-scope ng-empty ng-valid-pattern ng-invalid ng-invalid-required ng-valid-match" type="text" name="confirmEmail" id="confirmEmail"
ng-disabled="options.templateOptions.model.confirmEmail.readOnly" ng-required="options.templateOptions.model.confirmEmail.required" ng-model="options.model.confirmEmail" ng-model-options="{debounce: 700}" placeholder=""
field-match="options.model.email" field-message-name="match" formly-custom-validation="" required="required" data-exclude="1">
<!-- ngIf: options.templateOptions.model.emailConfirm.supportingText -->
</div>
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-passwordConfirm" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index">
<div class="form-type1-row ng-scope">
<!-- Error Handling for Password -->
<label class="form-type1-title" for="password">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model.password.label)" class="ng-binding">Mot de passe</span>
<!-- ngIf: form.$submitted || !form.password.$pristine -->
<!-- ngIf: form.password.$valid && form.password.$dirty && !form.password.$pristine -->
<!-- ngIf: form.password.$pending && form.password.$dirty -->
</label>
<input pattern="^(?=.*\d)(?=.*[^\d]).{8,100}$" autocomplete="off" class="form-type1-text ng-pristine ng-untouched ng-empty ng-valid-pattern ng-invalid ng-invalid-required" type="password" name="password" id="password"
ng-disabled="options.templateOptions.model.password.readOnly" ng-required="options.templateOptions.model.password.required" ng-model="options.model.password" ng-model-options="{debounce: 700}" placeholder=""
custom-password="^(?=.*\d)(?=.*[^\d]).{8,100}$" formly-custom-validation="" required="required">
<!-- ngIf: options.templateOptions.model.password.supportingText -->
<div class="form-help-text ng-binding ng-scope" ng-if="options.templateOptions.model.password.supportingText" ng-bind-html="$root.unsafeHTML(options.templateOptions.model.password.supportingText)">Vous devez saisir un minimum de 8
caractères, avec au moins une (1) lettre et un (1) chiffre.</div><!-- end ngIf: options.templateOptions.model.password.supportingText -->
</div>
<div class="form-type1-row ng-scope">
<!-- Error Handling for Confirm Password -->
<label class="form-type1-title" for="confirmPassword">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model.confirmPassword.label)" class="ng-binding">Confirmer le mot de passe</span>
<!-- ngIf: form.$submitted || !form.confirmPassword.$pristine -->
<!-- ngIf: form.confirmPassword.$valid && form.confirmPassword.$dirty && !form.confirmPassword.$pristine -->
<!-- ngIf: form.confirmPassword.$pending && form.confirmPassword.$dirty -->
</label>
<input pattern="" autocomplete="off" class="form-type1-text ng-pristine ng-untouched ng-isolate-scope ng-empty ng-valid-pattern ng-invalid ng-invalid-required ng-valid-match" type="password" name="confirmPassword"
id="confirmPassword" ng-disabled="options.templateOptions.model.confirmPassword.readOnly" ng-required="options.templateOptions.model.confirmPassword.required" ng-model="options.model.confirmPassword"
ng-model-options="{debounce: 700}" placeholder="" field-match="options.model.password" field-message-name="match" formly-custom-validation="" required="required">
<!-- ngIf: options.templateOptions.model.confirmPassword.supportingText -->
</div>
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-recaptcha" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index">
<div class="form-type1-row ng-scope">
<!-- Error Handling -->
<label class="form-type1-title" for="recaptcha">
<span ng-bind-html="$root.unsafeHTML(options.templateOptions.model[options.key].label)" class="ng-binding">Veuillez saisir le CAPTCHA ci-dessous :</span>
<!-- ngIf: form.$submitted || !form[options.key].$pristine -->
<!-- ngIf: form[options.key].$valid && form[options.key].$dirty && !form[options.key].$pristine -->
<!-- ngIf: form[options.key].$pending && form[options.key].$dirty -->
</label>
<input type="hidden" name="recaptcha" ng-model="options.model[options.key]" id="ff.form_recaptcha_recaptcha_6" formly-custom-validation="" class="ng-pristine ng-untouched ng-valid ng-empty">
<div class="form-type1-row">
<div class="g-recaptcha" id="recaptcha_1645994315985">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcLxwMTAAAAAC7dz-plX055g19vhvY6J7Pvy1qs&co=aHR0cHM6Ly93d3cudm90cmVvcGluaW9uLmJlOjQ0Mw..&hl=fr&v=PdoyIVkd8v16xl_NMp3H0N1Y&size=normal&cb=vfyf3dfiqp7q"
width="304" height="78" role="presentation" name="a-f3cwmf49meam" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
<!-- ngIf: options.templateOptions.model[options.key].supportingText -->
</div>
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields --><!-- ngIf: !field.hide -->
<div formly-field="" ng-repeat="field in fields " ng-if="!field.hide" class="formly-field ng-scope ng-isolate-scope formly-field-consent" options="field" model="field.model || model" original-model="model" fields="fields"
form="theFormlyForm" form-id="formly_1" form-state="options.formState" form-options="options" index="$index"><!-- Consent -->
<!-- ngRepeat: (parameterId, parameter) in parameters[0] -->
<div class="parameter-rendered ng-scope checkbox_grid" ng-repeat="(parameterId, parameter) in parameters[0]" ng-class="getParameterClass(parameter)">
<div class="field-errors ng-hide" ng-show="!isValidAnswerValue(parameter, options.model[parameterId]) && !isValidForm">
<span class="ng-binding">* Veuillez choisir une des réponses suivantes.</span>
</div>
<!-- ngIf: parameter.values.length > 0 -->
<div class="questionAndAnswerWrap ng-scope" ng-if="parameter.values.length > 0">
<div class="answers">
<!-- ngIf: hasParameterClass('checkbox_grid', parameter) -->
<div ng-if="hasParameterClass('checkbox_grid', parameter)" class="ng-scope">
<div class="answer first" ng-class="{'first':$index === 0}">
<div class="answer-wrapper">
<label for="sstb_85_">
<input autocomplete="off" id="sstb_85_" class="multi_select ng-pristine ng-untouched ng-valid ng-empty ng-valid-required" type="checkbox" ng-disabled="isAnswerDisabled(parameter, answer)"
ng-model="options.model[parameter.parameterId]" ng-required="false" ng-true-value="'296151'" ng-false-value="'296153'" name="ff.form_consent_85_7" formly-custom-validation="">
<span ng-bind-html="sanitizeHtml(parameter.label)" class="ng-binding">J'autorise la collecte, l'usage et le partage des données de profil que j'ai fournies à des fins de participation à des études de marché</span>
</label>
</div>
</div>
</div><!-- end ngIf: hasParameterClass('checkbox_grid', parameter) -->
</div>
</div><!-- end ngIf: parameter.values.length > 0 -->
</div><!-- end ngRepeat: (parameterId, parameter) in parameters[0] -->
<div class="parameter-rendered ng-scope checkbox_grid" ng-repeat="(parameterId, parameter) in parameters[0]" ng-class="getParameterClass(parameter)">
<div class="field-errors ng-hide" ng-show="!isValidAnswerValue(parameter, options.model[parameterId]) && !isValidForm">
<span class="ng-binding">* Veuillez choisir une des réponses suivantes.</span>
</div>
<!-- ngIf: parameter.values.length > 0 -->
<div class="questionAndAnswerWrap ng-scope" ng-if="parameter.values.length > 0">
<div class="answers">
<!-- ngIf: hasParameterClass('checkbox_grid', parameter) -->
<div ng-if="hasParameterClass('checkbox_grid', parameter)" class="ng-scope">
<div class="answer" ng-class="{'first':$index === 0}">
<div class="answer-wrapper">
<label for="sstb_86_">
<input autocomplete="off" id="sstb_86_" class="multi_select ng-pristine ng-untouched ng-valid ng-empty ng-valid-required" type="checkbox" ng-disabled="isAnswerDisabled(parameter, answer)"
ng-model="options.model[parameter.parameterId]" ng-required="false" ng-true-value="'296151'" ng-false-value="'296153'" name="ff.form_consent_85_7" formly-custom-validation="">
<span ng-bind-html="sanitizeHtml(parameter.label)" class="ng-binding">J’ai lu, compris et accepté la <a href="https://www.votreopinion.be/privacy" target="_blank">
Politique de confidentialité
</a> .</span>
</label>
</div>
</div>
</div><!-- end ngIf: hasParameterClass('checkbox_grid', parameter) -->
</div>
</div><!-- end ngIf: parameter.values.length > 0 -->
</div><!-- end ngRepeat: (parameterId, parameter) in parameters[0] -->
<div class="parameter-rendered ng-scope checkbox_grid" ng-repeat="(parameterId, parameter) in parameters[0]" ng-class="getParameterClass(parameter)">
<div class="field-errors ng-hide" ng-show="!isValidAnswerValue(parameter, options.model[parameterId]) && !isValidForm">
<span class="ng-binding">* Veuillez choisir une des réponses suivantes.</span>
</div>
<!-- ngIf: parameter.values.length > 0 -->
<div class="questionAndAnswerWrap ng-scope" ng-if="parameter.values.length > 0">
<div class="answers">
<!-- ngIf: hasParameterClass('checkbox_grid', parameter) -->
<div ng-if="hasParameterClass('checkbox_grid', parameter)" class="ng-scope">
<div class="answer" ng-class="{'first':$index === 0}">
<div class="answer-wrapper">
<label for="sstb_87_">
<input autocomplete="off" id="sstb_87_" class="multi_select ng-pristine ng-untouched ng-valid ng-empty ng-valid-required" type="checkbox" ng-disabled="isAnswerDisabled(parameter, answer)"
ng-model="options.model[parameter.parameterId]" ng-required="false" ng-true-value="'296151'" ng-false-value="'296153'" name="ff.form_consent_85_7" formly-custom-validation="">
<span ng-bind-html="sanitizeHtml(parameter.label)" class="ng-binding">J’ai lu, compris et accepté les <a href="https://www.votreopinion.be/terms" target="_blank">Conditions générales</a>. Je comprends que, pour
bénéficier du service, je recevrai des e-mails concernant les enquêtes pertinentes et les mises à jour de l’abonnement.</span>
</label>
</div>
</div>
</div><!-- end ngIf: hasParameterClass('checkbox_grid', parameter) -->
</div>
</div><!-- end ngIf: parameter.values.length > 0 -->
</div><!-- end ngRepeat: (parameterId, parameter) in parameters[0] -->
</div><!-- end ngIf: !field.hide --><!-- end ngRepeat: field in fields -->
<div ng-transclude="" class=""></div>
</ng-form>
<!-- Submit Actions -->
<!-- ngIf: ff.formReady && ff.flareFormsShowSubmit -->
<div class="form-type1-row form-type1-actions ng-scope" ng-if="ff.formReady && ff.flareFormsShowSubmit">
<button type="submit" ng-class="{ valid: ff.form.$valid }" class="button button-yellow buttonSecondary button-medium submit">
<span class="ng-binding">Étape suivante</span>
</button>
<span ng-show="vm.submitStatus === 'pending'" class="ng-hide">
<i class="fa fa-spin fa-circle-o-notch" aria-hidden="true"></i>
</span>
<span class="field-errors ng-binding ng-hide" ng-show="ff.form.$invalid && ff.form.$submitted"> Le formulaire contient des erreurs </span>
</div><!-- end ngIf: ff.formReady && ff.flareFormsShowSubmit -->
<div class="cg-busy cg-busy-backdrop cg-busy-backdrop-animation ng-scope ng-hide" ng-show="$cgBusyIsActive()"></div>
<div class="cg-busy cg-busy-animation ng-scope ng-hide" ng-show="$cgBusyIsActive()">
<div class="cg-busy-default-wrapper" style="position: absolute; inset: 0px;">
<div class="cg-busy-default-sign">
<div class="cg-busy-default-spinner">
<div class="bar1"></div>
<div class="bar2"></div>
<div class="bar3"></div>
<div class="bar4"></div>
<div class="bar5"></div>
<div class="bar6"></div>
<div class="bar7"></div>
<div class="bar8"></div>
<div class="bar9"></div>
<div class="bar10"></div>
<div class="bar11"></div>
<div class="bar12"></div>
</div>
<div class="cg-busy-default-text ng-binding">Chargement en cours...</div>
</div>
</div>
</div>
</div><!-- end ngIf: !ff.formCannotLoad -->
</div>
</div>
</div>
</ng-transclude>
<input type="hidden" name="ra_1" id="ra_1" style="width:1200px" value="370e8800-2eff-48ef-ab6f-f73a9e27ea90"><input type="hidden" name="ra_2" id="ra_2" style="width:1200px" value="4101bf0a-31d9-4605-a29d-ae242e891cc5"><input type="hidden"
name="ra_3" id="ra_3" style="width:1200px" value="8c6c290e-87c6-7e5b-94f4-06b46c537174"><input type="text" id="ra__71621" data-exclude="1" tabindex="-1" style="width: 0px; height: 0px; border: none;">
</form>Text Content
VOUS ÊTES DÉJÀ INSCRIT(E) L’adresse email est déjà enregistrée et prête à être utilisée. Si vous souhaitez réinitialiser votre mot de passe et de nouveau prendre part à nos sondages, cliquez ici pour le faire. Merci, L’Equipe Votre Opinion Nous vous remercions de l'intérêt que vous nous portez ! Nous ne sommes actuellement pas en mesure d'accepter votre inscription. Conditions générales PLUS QUE DEUX PETITES ÉTAPES VOUS SÉPARENT DE VOTRE PREMIER SONDAGE ! Nous avons besoin de certaines informations de base pour que vous puissiez commencer. * 1 Vos informations * 2 Terminé Prénom Nom Sexe Sélectionnez : HommeFemme Date de naissance jour 01020304050607080910111213141516171819202122232425262728293031 mois 010203040506070809101112 année 20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922 Quel est votre code postal ? Adresse e-mail Confirmer l'adresse e-mail Mot de passe Vous devez saisir un minimum de 8 caractères, avec au moins une (1) lettre et un (1) chiffre. Confirmer le mot de passe Veuillez saisir le CAPTCHA ci-dessous : * Veuillez choisir une des réponses suivantes. J'autorise la collecte, l'usage et le partage des données de profil que j'ai fournies à des fins de participation à des études de marché * Veuillez choisir une des réponses suivantes. J’ai lu, compris et accepté la Politique de confidentialité . * Veuillez choisir une des réponses suivantes. J’ai lu, compris et accepté les Conditions générales. Je comprends que, pour bénéficier du service, je recevrai des e-mails concernant les enquêtes pertinentes et les mises à jour de l’abonnement. Étape suivante Le formulaire contient des erreurs Chargement en cours... Aide À notre propos Affiliés Conditions générales Informations légales Vie privée ©2022 Votre Opinion. Votre Opinion est une marque déposée de Dynata Global UK Limited (f/k/a Research Now Limited). Français * Français * Nederlands Il semble que Javascript soit désactivé. Pour que cette page fonctionne, vous devez activer Javascript. Veuillez consulter le site http://enable-javascript.com/ pour plus d'informations x Nous avons besoin de votre autorisation pour continuer Notre site utilise des cookies locaux et de tierce partie, ainsi que d’autres technologies, qui nous permettent de nous souvenir de vous, de comprendre comment vous utilisez notre site et nos enquêtes, et enfin de prévenir les fraudes. De plus, nos partenaires tiers utilisent ou lisent des cookies ou d’autres technologies apparentées par le biais de notre site, afin de mieux comprendre vos activités en ligne dans le cadre d’un programme de suivi de l’efficacité des publicités. En tant que participants à ce programme, nos partenaires tiers déposent ou lisent un cookie ou une technologie apparentée dans votre navigateur pour nous permettre de vous envoyer des enquêtes concernant les publicités affichées durant vos activités de consultation de sites Internet. Avis concernant les cookiesPour consulter une liste des sociétés qui utilisent ces technologies et pour choisir si elles peuvent être utilisées sur votre appareil ou non, ouvrez notre Avis concernant les cookies. Ce message n’apparaîtra qu’une seule fois, mais vous aurez la possibilité de configurer vos préférences à tout moment dans l’Outil Accepter les cookies. Lorsque vous accédez à notre site, les sociétés figurant sur la liste dans l’Outil Accepter les cookies utilisent des cookies ainsi que d’autres technologies. Accepter et accéder au site Contrôles de la vie privée par Evidon, Inc.