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1<html>
2<!--
3Complain about how broken everything is plz:
4https://github.com/HerrSpace/CCC-Membership-Form/issues
5-->
6<head>
7 <meta name="viewport" content="width=device-width">
8 <style type="text/css">
9 html, body {
10 sacrifice: goat;
11 font-family: -apple-system, BlinkMacSystemFont, Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", Arial, sans-serif;
12 font-size: 15px;
13 line-height: 1.3;
14 background-color: #ccc;
15 margin: 0 !important;
16 padding: 0 !important;
17 }
18 page[size="A4"] {
19 position: relative;
20 background-color: #fff;
21 width: 21cm;
22 height: 29.7cm;
23 display: block;
24 margin: 1cm auto;
25 padding: 1cm 2cm;
26 box-sizing: border-box;
27 margin-bottom: 0.5cm;
28 box-shadow: 0 0 0.5cm rgba(0,0,0,0.5);
29 }
30
31 @media print {
32 @page {
33 margin: 0mm;
34 size: auto;
35 }
36 body, page[size="A4"] {
37 margin: 0;
38 box-shadow: 0;
39 /* Thanks obama. */
40 -webkit-print-color-adjust: exact;
41 width: 100%;
42 height: 100%;
43 }
44 #formpage {
45 display: block !important;
46 }
47 #sc-container {
48 display: none !important;
49 }
50 }
51
52 @media screen and (max-device-width: 640px) {
53 #sc-form {
54 max-width: 95% !important;
55 }
56 }
57
58 .falzt, .falzb, .hole {
59 position: absolute;
60 left: 0;
61 width: 7mm;
62 border-bottom: 1px black solid;
63 }
64 .falzt {
65 top: 87mm;
66 }
67 .falzb {
68 top: 192mm;
69 }
70 .hole {
71 top: 148.5mm;
72 width: 10mm;
73 }
74
75
76 .dinHead,
77 .dinAddrRet,
78 .dinAddrFwd,
79 .dinInfo,
80 .dinCont,
81 .dinFoot {
82 position: absolute;
83 /*border: 1px solid black;*/
84 }
85
86 .dinHead {
87 top: 10mm;
88 left: 25mm;
89 width: 165mm;
90 height: 15mm;
91 }
92
93 .dinHead h1 {
94 margin: 0;
95 }
96 .dinHead ul {
97 display: inline;
98 }
99
100 .dinAddrRet {
101 font-size: 10px;
102 padding: 3px 0 0 0;
103 left: 25mm;
104 top: 27mm;
105 width: 85mm;
106 height: 5mm;
107 }
108
109 .dinAddrFwd {
110 left: 25mm;
111 top: 37mm;
112 width: 85mm;
113 height: 35mm;
114 }
115
116 .dinInfo {
117 right: 20mm;
118 top: 32mm;
119 width: 65mm;
120 height: 40mm;
121 }
122
123 .dinCont {
124 left: 25mm;
125 top: 80.46mm;
126 width: 165mm;
127 height: 175mm;
128 }
129
130 .dinCont h3 {
131 margin-top: 0;
132 }
133
134 .dinFoot {
135 left: 25mm;
136 bottom: 10mm;
137 width: 165mm;
138 height: 18mm;
139 }
140
141 .dinFoot span {
142 position: absolute;
143 top: 0;
144 }
145
146 .dinFoot #uno {
147 left: 0%;
148 width: 33%;
149 }
150
151 .dinFoot #dos {
152 left: 34%;
153 width: 38%;
154
155 }
156
157 .dinFoot #tres {
158 left: 73%;
159 }
160
161
162 .bold { font-weight: bold; }
163
164 .underline {
165 border: 0 !important;
166 border-bottom: 1px solid black !important;
167 background-color: #fff;
168 }
169
170 input[type=text],
171 select,
172 .underline {
173 width: 100%;
174 height: 22px;
175 display: inline;
176 }
177
178 input[type="text"],
179 select {
180 /* All browsers round select, iOS browsers round.. a lot? */
181 border-radius: 0;
182
183 padding: 1px 0px;
184 border: solid 1px #dcdcdc;
185 border-collapse: collapse;
186 transition: box-shadow 0.3s, border 0.3s;
187 }
188 input[type="text"]:focus,
189 input[type="text"].focus {
190 border: solid 1px #707070;
191 box-shadow: 0 0 5px 1px #969696;
192 }
193
194 .comment {
195 display: block;
196 width: 100%;
197 resize: none;
198 overflow: hidden;
199 border: none;
200 font-size: 14px;
201 line-height: 18px;
202 }
203
204 #comment {
205 background-size: 100% 18px;
206
207 background-image: -moz-repeating-linear-gradient(180deg, transparent, transparent 17px, black);
208 background-image: -webkit-repeating-linear-gradient(180deg, transparent, transparent 17px, black);
209 background-image: -o-repeating-linear-gradient(180deg, transparent, transparent 17px, black);
210 background-image: repeating-linear-gradient(180deg, transparent, transparent 17px, black);
211 }
212 #sc-comment {
213 margin-top: 10px;
214 height: auto !important;
215
216 background-image: -moz-repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
217 background-image: -webkit-repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
218 background-image: -o-repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
219 background-image: repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
220 background-size: 100% 18px;
221 }
222
223 #qrCode {
224 position: absolute;
225 width: 200;
226 height: 200;
227 right: 0;
228 bottom: 0;
229 }
230
231 #letterHead ul {
232 list-style-type: none;
233 }
234 #letterHead ul li {
235 display: inline;
236 }
237 #personalInfo div div,
238 .signfield {
239 float: left;
240 box-sizing: border-box;
241 padding: 2px 2px;
242 }
243 .signfield span {
244 text-align: center;
245 font-size: 10px;
246 }
247 #personalInfo div div span {
248 font-size: 10px;
249 padding: 2px 0;
250 /*margin-top: 10px;*/
251 }
252
253 .dinCont li {
254 margin-bottom: 7px;
255 }
256
257 #sc-container {
258 /* The sanity checker is enabled via JS.
259 This way the form can also work in tinfoil hat browsers.*/
260 display: none;
261
262 position: absolute;
263 z-index: 10;
264 transition: 0.5s;
265
266 top: 0;
267 left: 0;
268 height: 100%;
269 width: 100%;
270 overflow-y: scroll;
271 background-color: #3D3D3D;
272 }
273 #sc-form {
274 margin: 0 auto;
275 padding: 1.5em 0;
276 max-width: 30em;
277 font-weight: 50;
278 color: #fff;
279 }
280 #sc-form input[type=text],
281 #sc-form select,
282 #sc-form button,
283 #sc-form textarea {
284 -webkit-appearance: none;
285 -moz-appearance : none;
286 height: 44px;
287 padding: 0 8px;
288 margin-top: -1px;
289 background-color: #3D3D3D;
290 color: white;
291 }
292 #sc-form select option {
293 background-color: #3D3D3D;
294 }
295 #sc-form label, .sc-payment-title {
296 margin-top: 9px;
297 margin-bottom: 2px;
298 display: block;
299 }
300 #show-form {
301 font-size: 14px;
302 color: rgba(0, 0, 0, 0.6) !important;
303 background-color: #3edd55 !important;
304 width: 100%;
305 border: none;
306 border-radius: 0;
307 text-align: center;
308 text-decoration: none;
309 }
310
311 #sc-form a:link,
312 #sc-form a:visited { color: #3eccdd; }
313 #sc-form a:hover { color: #7FDBFF; }
314 #sc-form a { color: #3eccdd;
315 transition: color .1s;}
316
317
318 .sc-payment-switch {
319 overflow: hidden;
320 width: 100%;
321 }
322
323 .sc-payment-switch input {
324 position: absolute !important;
325 clip: rect(0, 0, 0, 0);
326 height: 1px;
327 width: 1px;
328 border: 0;
329 overflow: hidden;
330 }
331
332 .sc-payment-switch label {
333 padding-top: 12px;
334 float: left;
335 box-sizing: border-box;
336 width: 50%;
337 height: 44px;
338 margin-bottom: 0;
339 background-color: #e4e4e4;
340 color: rgba(0, 0, 0, 0.6);
341 font-size: 14px;
342 text-align: center;
343 border: 1px solid rgba(220, 220, 220, 0.2);*/
344 transition: all 0.1s ease-in-out;
345 }
346
347 .sc-payment-switch label:hover {
348 cursor: pointer;
349 }
350
351 .sc-payment-switch input:checked + label {
352 background-color: #3edd55;
353 -webkit-box-shadow: none;
354 box-shadow: none;
355 }
356 </style>
357 <script type="text/javascript">
358 /*! js-base64
359 https://github.com/dankogai/js-base64
360 */
361 (function(global,factory){typeof exports==="object"&&typeof module!=="undefined"?module.exports=factory(global):typeof define==="function"&&define.amd?define(factory):factory(global)})(typeof self!=="undefined"?self:typeof window!=="undefined"?window:typeof global!=="undefined"?global:this,function(global){"use strict";var _Base64=global.Base64;var version="2.4.3";var buffer;if(typeof module!=="undefined"&&module.exports){try{buffer=require("buffer").Buffer}catch(err){}}var b64chars="ABCDEFGHIJKLMNOPQRSTUVWXYZabcdefghijklmnopqrstuvwxyz0123456789+/";var b64tab=function(bin){var t={};for(var i=0,l=bin.length;i<l;i++)t[bin.charAt(i)]=i;return t}(b64chars);var fromCharCode=String.fromCharCode;var cb_utob=function(c){if(c.length<2){var cc=c.charCodeAt(0);return cc<128?c:cc<2048?fromCharCode(192|cc>>>6)+fromCharCode(128|cc&63):fromCharCode(224|cc>>>12&15)+fromCharCode(128|cc>>>6&63)+fromCharCode(128|cc&63)}else{var cc=65536+(c.charCodeAt(0)-55296)*1024+(c.charCodeAt(1)-56320);return fromCharCode(240|cc>>>18&7)+fromCharCode(128|cc>>>12&63)+fromCharCode(128|cc>>>6&63)+fromCharCode(128|cc&63)}};var re_utob=/[\uD800-\uDBFF][\uDC00-\uDFFFF]|[^\x00-\x7F]/g;var utob=function(u){return u.replace(re_utob,cb_utob)};var cb_encode=function(ccc){var padlen=[0,2,1][ccc.length%3],ord=ccc.charCodeAt(0)<<16|(ccc.length>1?ccc.charCodeAt(1):0)<<8|(ccc.length>2?ccc.charCodeAt(2):0),chars=[b64chars.charAt(ord>>>18),b64chars.charAt(ord>>>12&63),padlen>=2?"=":b64chars.charAt(ord>>>6&63),padlen>=1?"=":b64chars.charAt(ord&63)];return chars.join("")};var btoa=global.btoa?function(b){return global.btoa(b)}:function(b){return b.replace(/[\s\S]{1,3}/g,cb_encode)};var _encode=buffer?buffer.from&&buffer.from!==Uint8Array.from?function(u){return(u.constructor===buffer.constructor?u:buffer.from(u)).toString("base64")}:function(u){return(u.constructor===buffer.constructor?u:new buffer(u)).toString("base64")}:function(u){return btoa(utob(u))};var encode=function(u,urisafe){return!urisafe?_encode(String(u)):_encode(String(u)).replace(/[+\/]/g,function(m0){return m0=="+"?"-":"_"}).replace(/=/g,"")};var encodeURI=function(u){return encode(u,true)};var re_btou=new RegExp(["[À-ß][€-¿]","[à-ï][€-¿]{2}","[ð-÷][€-¿]{3}"].join("|"),"g");var cb_btou=function(cccc){switch(cccc.length){case 4:var cp=(7&cccc.charCodeAt(0))<<18|(63&cccc.charCodeAt(1))<<12|(63&cccc.charCodeAt(2))<<6|63&cccc.charCodeAt(3),offset=cp-65536;return fromCharCode((offset>>>10)+55296)+fromCharCode((offset&1023)+56320);case 3:return fromCharCode((15&cccc.charCodeAt(0))<<12|(63&cccc.charCodeAt(1))<<6|63&cccc.charCodeAt(2));default:return fromCharCode((31&cccc.charCodeAt(0))<<6|63&cccc.charCodeAt(1))}};var btou=function(b){return b.replace(re_btou,cb_btou)};var cb_decode=function(cccc){var len=cccc.length,padlen=len%4,n=(len>0?b64tab[cccc.charAt(0)]<<18:0)|(len>1?b64tab[cccc.charAt(1)]<<12:0)|(len>2?b64tab[cccc.charAt(2)]<<6:0)|(len>3?b64tab[cccc.charAt(3)]:0),chars=[fromCharCode(n>>>16),fromCharCode(n>>>8&255),fromCharCode(n&255)];chars.length-=[0,0,2,1][padlen];return chars.join("")};var atob=global.atob?function(a){return global.atob(a)}:function(a){return a.replace(/[\s\S]{1,4}/g,cb_decode)};var _decode=buffer?buffer.from&&buffer.from!==Uint8Array.from?function(a){return(a.constructor===buffer.constructor?a:buffer.from(a,"base64")).toString()}:function(a){return(a.constructor===buffer.constructor?a:new buffer(a,"base64")).toString()}:function(a){return btou(atob(a))};var decode=function(a){return _decode(String(a).replace(/[-_]/g,function(m0){return m0=="-"?"+":"/"}).replace(/[^A-Za-z0-9\+\/]/g,""))};var noConflict=function(){var Base64=global.Base64;global.Base64=_Base64;return Base64};global.Base64={VERSION:version,atob:atob,btoa:btoa,fromBase64:decode,toBase64:encode,utob:utob,encode:encode,encodeURI:encodeURI,btou:btou,decode:decode,noConflict:noConflict};if(typeof Object.defineProperty==="function"){var noEnum=function(v){return{value:v,enumerable:false,writable:true,configurable:true}};global.Base64.extendString=function(){Object.defineProperty(String.prototype,"fromBase64",noEnum(function(){return decode(this)}));Object.defineProperty(String.prototype,"toBase64",noEnum(function(urisafe){return encode(this,urisafe)}));Object.defineProperty(String.prototype,"toBase64URI",noEnum(function(){return encode(this,true)}))}}if(global["Meteor"]){Base64=global.Base64}if(typeof module!=="undefined"&&module.exports){module.exports.Base64=global.Base64}else if(typeof define==="function"&&define.amd){define([],function(){return global.Base64})}return{Base64:global.Base64}});
362 </script>
363 <script type="text/javascript">
364 /*! QRious v4.0.2 | (C) 2017 Alasdair Mercer | GPL v3 License
365 Based on jsqrencode | (C) 2010 tz@execpc.com | GPL v3 License
366 */
367 !function(t,e){"object"==typeof exports&&"undefined"!=typeof module?module.exports=e():"function"==typeof define&&define.amd?define(e):t.QRious=e()}(this,function(){"use strict";function t(t,e){var n;return"function"==typeof Object.create?n=Object.create(t):(s.prototype=t,n=new s,s.prototype=null),e&&i(!0,n,e),n}function e(e,n,s,r){var o=this;return"string"!=typeof e&&(r=s,s=n,n=e,e=null),"function"!=typeof n&&(r=s,s=n,n=function(){return o.apply(this,arguments)}),i(!1,n,o,r),n.prototype=t(o.prototype,s),n.prototype.constructor=n,n.class_=e||o.class_,n.super_=o,n}function i(t,e,i){for(var n,s,a=0,h=(i=o.call(arguments,2)).length;a<h;a++){s=i[a];for(n in s)t&&!r.call(s,n)||(e[n]=s[n])}}function n(){}var s=function(){},r=Object.prototype.hasOwnProperty,o=Array.prototype.slice,a=e;n.class_="Nevis",n.super_=Object,n.extend=a;var h=n,f=h.extend(function(t,e,i){this.qrious=t,this.element=e,this.element.qrious=t,this.enabled=Boolean(i)},{draw:function(t){},getElement:function(){return 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e,i,n,s,r,o=t.value.length;for(this._badness=[],this._level=l.LEVELS[t.level],this._polynomial=[],this._value=t.value,this._version=0,this._stringBuffer=[];this._version<40&&(this._version++,n=4*(this._level-1)+16*(this._version-1),s=l.BLOCKS[n++],r=l.BLOCKS[n++],e=l.BLOCKS[n++],i=l.BLOCKS[n],n=e*(s+r)+r-3+(this._version<=9),!(o<=n)););this._dataBlock=e,this._eccBlock=i,this._neccBlock1=s,this._neccBlock2=r;var a=this.width=17+4*this._version;this.buffer=v._createArray(a*a),this._ecc=v._createArray(e+(e+i)*(s+r)+r),this._mask=v._createArray((a*(a+1)+1)/2),this._insertFinders(),this._insertAlignments(),this.buffer[8+a*(a-8)]=1,this._insertTimingGap(),this._reverseMask(),this._insertTimingRowAndColumn(),this._insertVersion(),this._syncMask(),this._convertBitStream(o),this._calculatePolynomial(),this._appendEccToData(),this._interleaveBlocks(),this._pack(),this._finish()},{_addAlignment:function(t,e){var i,n=this.buffer,s=this.width;for(n[t+s*e]=1,i=-2;i<2;i++)n[t+i+s*(e-2)]=1,n[t-2+s*(e+i+1)]=1,n[t+2+s*(e+i)]=1,n[t+i+1+s*(e+2)]=1;for(i=0;i<2;i++)this._setMask(t-1,e+i),this._setMask(t+1,e-i),this._setMask(t-i,e-1),this._setMask(t+i,e+1)},_appendData:function(t,e,i,n){var s,r,o,a=this._polynomial,h=this._stringBuffer;for(r=0;r<n;r++)h[i+r]=0;for(r=0;r<e;r++){if(255!==(s=_.LOG[h[t+r]^h[i]]))for(o=1;o<n;o++)h[i+o-1]=h[i+o]^_.EXPONENT[v._modN(s+a[n-o])];else for(o=i;o<i+n;o++)h[o]=h[o+1];h[i+n-1]=255===s?0:_.EXPONENT[v._modN(s+a[0])]}},_appendEccToData:function(){var t,e=0,i=this._dataBlock,n=this._calculateMaxLength(),s=this._eccBlock;for(t=0;t<this._neccBlock1;t++)this._appendData(e,i,n,s),e+=i,n+=s;for(t=0;t<this._neccBlock2;t++)this._appendData(e,i+1,n,s),e+=i+1,n+=s},_applyMask:function(t){var e,i,n,s,r=this.buffer,o=this.width;switch(t){case 0:for(s=0;s<o;s++)for(n=0;n<o;n++)n+s&1||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 1:for(s=0;s<o;s++)for(n=0;n<o;n++)1&s||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 2:for(s=0;s<o;s++)for(e=0,n=0;n<o;n++,e++)3===e&&(e=0),e||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 3:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=i,n=0;n<o;n++,e++)3===e&&(e=0),e||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 4:for(s=0;s<o;s++)for(e=0,i=s>>1&1,n=0;n<o;n++,e++)3===e&&(e=0,i=!i),i||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 5:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=0,n=0;n<o;n++,e++)3===e&&(e=0),(n&s&1)+!(!e|!i)||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 6:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=0,n=0;n<o;n++,e++)3===e&&(e=0),(n&s&1)+(e&&e===i)&1||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 7:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=0,n=0;n<o;n++,e++)3===e&&(e=0),(e&&e===i)+(n+s&1)&1||this._isMasked(n,s)||(r[n+s*o]^=1)}},_calculateMaxLength:function(){return this._dataBlock*(this._neccBlock1+this._neccBlock2)+this._neccBlock2},_calculatePolynomial:function(){var t,e,i=this._eccBlock,n=this._polynomial;for(n[0]=1,t=0;t<i;t++){for(n[t+1]=1,e=t;e>0;e--)n[e]=n[e]?n[e-1]^_.EXPONENT[v._modN(_.LOG[n[e]]+t)]:n[e-1];n[0]=_.EXPONENT[v._modN(_.LOG[n[0]]+t)]}for(t=0;t<=i;t++)n[t]=_.LOG[n[t]]},_checkBadness:function(){var t,e,i,n,s,r=0,o=this._badness,a=this.buffer,h=this.width;for(s=0;s<h-1;s++)for(n=0;n<h-1;n++)(a[n+h*s]&&a[n+1+h*s]&&a[n+h*(s+1)]&&a[n+1+h*(s+1)]||!(a[n+h*s]||a[n+1+h*s]||a[n+h*(s+1)]||a[n+1+h*(s+1)]))&&(r+=v.N2);var f=0;for(s=0;s<h;s++){for(i=0,o[0]=0,t=0,n=0;n<h;n++)t===(e=a[n+h*s])?o[i]++:o[++i]=1,f+=(t=e)?1:-1;r+=this._getBadness(i)}f<0&&(f=-f);var c=0,u=f;for(u+=u<<2,u<<=1;u>h*h;)u-=h*h,c++;for(r+=c*v.N4,n=0;n<h;n++){for(i=0,o[0]=0,t=0,s=0;s<h;s++)t===(e=a[n+h*s])?o[i]++:o[++i]=1,t=e;r+=this._getBadness(i)}return r},_convertBitStream:function(t){var e,i,n=this._ecc,s=this._version;for(i=0;i<t;i++)n[i]=this._value.charCodeAt(i);var r=this._stringBuffer=n.slice(),o=this._calculateMaxLength();t>=o-2&&(t=o-2,s>9&&t--);var a=t;if(s>9){for(r[a+2]=0,r[a+3]=0;a--;)e=r[a],r[a+3]|=255&e<<4,r[a+2]=e>>4;r[2]|=255&t<<4,r[1]=t>>4,r[0]=64|t>>12}else{for(r[a+1]=0,r[a+2]=0;a--;)e=r[a],r[a+2]|=255&e<<4,r[a+1]=e>>4;r[1]|=255&t<<4,r[0]=64|t>>4}for(a=t+3-(s<10);a<o;)r[a++]=236,r[a++]=17},_getBadness:function(t){var e,i=0,n=this._badness;for(e=0;e<=t;e++)n[e]>=5&&(i+=v.N1+n[e]-5);for(e=3;e<t-1;e+=2)n[e-2]===n[e+2]&&n[e+2]===n[e-1]&&n[e-1]===n[e+1]&&3*n[e-1]===n[e]&&(0===n[e-3]||e+3>t||3*n[e-3]>=4*n[e]||3*n[e+3]>=4*n[e])&&(i+=v.N3);return i},_finish:function(){this._stringBuffer=this.buffer.slice();var t,e,i=0,n=3e4;for(e=0;e<8&&(this._applyMask(e),(t=this._checkBadness())<n&&(n=t,i=e),7!==i);e++)this.buffer=this._stringBuffer.slice();i!==e&&this._applyMask(i),n=l.FINAL_FORMAT[i+(this._level-1<<3)];var s=this.buffer,r=this.width;for(e=0;e<8;e++,n>>=1)1&n&&(s[r-1-e+8*r]=1,e<6?s[8+r*e]=1:s[8+r*(e+1)]=1);for(e=0;e<7;e++,n>>=1)1&n&&(s[8+r*(r-7+e)]=1,e?s[6-e+8*r]=1:s[7+8*r]=1)},_interleaveBlocks:function(){var t,e,i=this._dataBlock,n=this._ecc,s=this._eccBlock,r=0,o=this._calculateMaxLength(),a=this._neccBlock1,h=this._neccBlock2,f=this._stringBuffer;for(t=0;t<i;t++){for(e=0;e<a;e++)n[r++]=f[t+e*i];for(e=0;e<h;e++)n[r++]=f[a*i+t+e*(i+1)]}for(e=0;e<h;e++)n[r++]=f[a*i+t+e*(i+1)];for(t=0;t<s;t++)for(e=0;e<a+h;e++)n[r++]=f[o+t+e*s];this._stringBuffer=n},_insertAlignments:function(){var t,e,i,n=this._version,s=this.width;if(n>1)for(t=u.BLOCK[n],i=s-7;;){for(e=s-7;e>t-3&&(this._addAlignment(e,i),!(e<t));)e-=t;if(i<=t+9)break;i-=t,this._addAlignment(6,i),this._addAlignment(i,6)}},_insertFinders:function(){var t,e,i,n,s=this.buffer,r=this.width;for(t=0;t<3;t++){for(e=0,n=0,1===t&&(e=r-7),2===t&&(n=r-7),s[n+3+r*(e+3)]=1,i=0;i<6;i++)s[n+i+r*e]=1,s[n+r*(e+i+1)]=1,s[n+6+r*(e+i)]=1,s[n+i+1+r*(e+6)]=1;for(i=1;i<5;i++)this._setMask(n+i,e+1),this._setMask(n+1,e+i+1),this._setMask(n+5,e+i),this._setMask(n+i+1,e+5);for(i=2;i<4;i++)s[n+i+r*(e+2)]=1,s[n+2+r*(e+i+1)]=1,s[n+4+r*(e+i)]=1,s[n+i+1+r*(e+4)]=1}},_insertTimingGap:function(){var t,e,i=this.width;for(e=0;e<7;e++)this._setMask(7,e),this._setMask(i-8,e),this._setMask(7,e+i-7);for(t=0;t<8;t++)this._setMask(t,7),this._setMask(t+i-8,7),this._setMask(t,i-8)},_insertTimingRowAndColumn:function(){var t,e=this.buffer,i=this.width;for(t=0;t<i-14;t++)1&t?(this._setMask(8+t,6),this._setMask(6,8+t)):(e[8+t+6*i]=1,e[6+i*(8+t)]=1)},_insertVersion:function(){var 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368 </script>
369 <script type="text/javascript">
370 function generateQR() {
371 var form = document.getElementById('application');
372
373 var formDict = {};
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382 formDict["consent"] = document.getElementsByName('consent')[0].checked;
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396 document.getElementsByName("addr1")[0].value,
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419 var today = new Date();
420 document.getElementsByName('date')[0].value = today.toISOString().substring(0,10);
421
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445</head>
446<body>
447 <div id="sc-container">
448 <form id="sc-form">
449 <input type="hidden" name="version" value="alpha"/>
450
451 <p>
452 Daten, die in dieses Antragsformular eingetragen werden, gehen <span class="bold">nicht</span> über das Internet. Die Daten werden ausschließlich im Web-Browser verarbeitet und im fertigen Formular maschinenlesbar dargestellt. Dies hilft uns Anträge schneller zu berarbeiten.
453 </p>
454
455 <p>
456 Ich möchte <span class="bold">Fördermitglied im Chaos Computer Club e. V.</span> werden (unregelmäßig und <span class="bold">selten</span> erscheinende Datenschleuder inklusive) und habe <a href="https://www.ccc.de/de/satzung">die Satzung</a> und <a href="https://www.ccc.de/de/faq">FAQ</a> gelesen.
457 </p>
458
459 <div class="sc-payment-switch">
460 <div class="sc-payment-title">Normaler oder ermäßigter Beitrag?</div>
461 <input type="radio" id="sc-regular" name="sc-payment" value="regular" checked/>
462 <label for="sc-regular">Normal (72€)</label>
463 <input type="radio" id="sc-reduced" name="sc-payment" value="reduced" />
464 <label for="sc-reduced">Ermäßigt (36€ mit Nachweis)</label>
465 </div>
466
467 <label for="sc-firstname">Vorname</label>
468 <input type="text" name="sc-firstname" maxlength="40" placeholder="Hannah" required autofocus>
469
470 <label for="sc-lastname">Nachname</label>
471 <input type="text" name="sc-lastname" maxlength="40" placeholder="Acker" required>
472
473 <label for="sc-addr1">Adresse</label>
474 <input type="text" name="sc-addr1" maxlength="60" placeholder="Hauptstraße 1" required>
475 <input type="text" name="sc-addr2" maxlength="60" placeholder="12345 Entenhausen" required>
476 <input type="text" name="sc-addr3" maxlength="60" placeholder="c/o Frank Nord">
477 <select name="sc-country" selected="Deutschland">
478 <option value="DE">Deutschland</option>
479 <option value="CH">Schweiz</option>
480 <option value="AT">Österreich</option>
481 <option value="AF">Afghanistan</option>
482 <option value="AX">Åland</option>
483 <option value="AL">Albanien</option>
484 <option value="DZ">Algerien</option>
485 <option value="AS">Amerikanisch-Samoa</option>
486 <option value="AD">Andorra</option>
487 <option value="AO">Angola</option>
488 <option value="AI">Anguilla</option>
489 <option value="AQ">Antarktis</option>
490 <option value="AG">Antigua und Barbuda</option>
491 <option value="AR">Argentinien</option>
492 <option value="AM">Armenien</option>
493 <option value="AW">Aruba</option>
494 <option value="AU">Australien</option>
495 <option value="AZ">Aserbaidschan</option>
496 <option value="BS">Bahamas</option>
497 <option value="BH">Bahrain</option>
498 <option value="BD">Bangladesch</option>
499 <option value="BB">Barbados</option>
500 <option value="BY">Weißrussland</option>
501 <option value="BE">Belgien</option>
502 <option value="BZ">Belize</option>
503 <option value="BJ">Benin</option>
504 <option value="BM">Bermuda</option>
505 <option value="BT">Bhutan</option>
506 <option value="BO">Bolivien</option>
507 <option value="BQ">Bonaire, Sint Eustatius und Saba</option>
508 <option value="BA">Bosnien und Herzegowina</option>
509 <option value="BW">Botswana</option>
510 <option value="BV">Bouvetinsel</option>
511 <option value="BR">Brasilien</option>
512 <option value="IO">Britisches Territorium im Indischen Ozean</option>
513 <option value="VG">Britische Jungferninseln</option>
514 <option value="BN">Brunei</option>
515 <option value="BG">Bulgarien</option>
516 <option value="BF">Burkina Faso</option>
517 <option value="BI">Burundi</option>
518 <option value="KH">Kambodscha</option>
519 <option value="CM">Kamerun</option>
520 <option value="CA">Kanada</option>
521 <option value="CV">Kap Verde</option>
522 <option value="KY">Kaimaninseln</option>
523 <option value="CF">Zentralafrikanische Republik</option>
524 <option value="TD">Tschad</option>
525 <option value="CL">Chile</option>
526 <option value="CN">China</option>
527 <option value="CX">Weihnachtsinsel</option>
528 <option value="CC">Kokosinseln</option>
529 <option value="CO">Kolumbien</option>
530 <option value="KM">Komoren</option>
531 <option value="CK">Cookinseln</option>
532 <option value="CR">Costa Rica</option>
533 <option value="HR">Kroatien</option>
534 <option value="CU">Kuba</option>
535 <option value="CW">Curacao</option>
536 <option value="CY">Zypern</option>
537 <option value="CZ">Tschechische Republik</option>
538 <option value="CD">Demokratische Republik Kongo</option>
539 <option value="DK">Dänemark</option>
540 <option value="DJ">Dschibuti</option>
541 <option value="DM">Dominica</option>
542 <option value="DO">Dominikanische Republik</option>
543 <option value="TL">Osttimor</option>
544 <option value="EC">Ecuador</option>
545 <option value="EG">Ägypten</option>
546 <option value="SV">El Salvador</option>
547 <option value="GQ">Äquatorialguinea</option>
548 <option value="ER">Eritrea</option>
549 <option value="EE">Estland</option>
550 <option value="ET">Äthiopien</option>
551 <option value="FK">Falkland-Inseln</option>
552 <option value="FO">Färöer-Inseln</option>
553 <option value="FJ">Fidschi</option>
554 <option value="FI">Finnland</option>
555 <option value="FR">Frankreich</option>
556 <option value="GF">Französisch-Guayana</option>
557 <option value="PF">Französisch-Polynesien</option>
558 <option value="TF">Französische Süd- und Antarktisgebiete</option>
559 <option value="GA">Gabun</option>
560 <option value="GM">Gambia</option>
561 <option value="GE">Georgien</option>
562 <option value="GH">Ghana</option>
563 <option value="GI">Gibraltar</option>
564 <option value="GR">Griechenland</option>
565 <option value="GL">Grönland</option>
566 <option value="GD">Grenada</option>
567 <option value="GP">Guadeloupe</option>
568 <option value="GU">Guam</option>
569 <option value="GT">Guatemala</option>
570 <option value="GG">Guernsey</option>
571 <option value="GN">Guinea</option>
572 <option value="GW">Guinea-Bissau</option>
573 <option value="GY">Guyana</option>
574 <option value="HT">Haiti</option>
575 <option value="HM">Heard und McDonaldinseln</option>
576 <option value="HN">Honduras</option>
577 <option value="HK">Hongkong</option>
578 <option value="HU">Ungarn</option>
579 <option value="IS">Island</option>
580 <option value="IN">Indien</option>
581 <option value="ID">Indonesien</option>
582 <option value="IR">Iran</option>
583 <option value="IQ">Irak</option>
584 <option value="IE">Irland</option>
585 <option value="IM">Isle of Man</option>
586 <option value="IL">Israel</option>
587 <option value="IT">Italien</option>
588 <option value="CI">Elfenbeinküste</option>
589 <option value="JM">Jamaika</option>
590 <option value="JP">Japan</option>
591 <option value="JE">Jersey</option>
592 <option value="JO">Jordanien</option>
593 <option value="KZ">Kasachstan</option>
594 <option value="KE">Kenia</option>
595 <option value="KI">Kiribati</option>
596 <option value="XK">Kosovo</option>
597 <option value="KW">Kuwait</option>
598 <option value="KG">Kirgisistan</option>
599 <option value="LA">Laos</option>
600 <option value="LV">Lettland</option>
601 <option value="LB">Libanon</option>
602 <option value="LS">Lesotho</option>
603 <option value="LR">Liberia</option>
604 <option value="LY">Libyen</option>
605 <option value="LI">Liechtenstein</option>
606 <option value="LT">Litauen</option>
607 <option value="LU">Luxemburg</option>
608 <option value="MO">Macao</option>
609 <option value="MK">Mazedonien</option>
610 <option value="MG">Madagaskar</option>
611 <option value="MW">Malawi</option>
612 <option value="MY">Malaysia</option>
613 <option value="MV">Malediven</option>
614 <option value="ML">Mali</option>
615 <option value="MT">Malta</option>
616 <option value="MH">Marshallinseln</option>
617 <option value="MQ">Martinique</option>
618 <option value="MR">Mauretanien</option>
619 <option value="MU">Mauritius</option>
620 <option value="YT">Mayotte</option>
621 <option value="MX">Mexiko</option>
622 <option value="FM">Mikronesien</option>
623 <option value="MD">Moldawien</option>
624 <option value="MC">Monaco</option>
625 <option value="MN">Mongolei</option>
626 <option value="ME">Montenegro</option>
627 <option value="MS">Montserrat</option>
628 <option value="MA">Marokko</option>
629 <option value="MZ">Mosambik</option>
630 <option value="MM">Myanmar</option>
631 <option value="NA">Namibia</option>
632 <option value="NR">Nauru</option>
633 <option value="NP">Nepal</option>
634 <option value="NL">Niederlande</option>
635 <option value="AN">Niederländische Antillen</option>
636 <option value="NC">Neukaledonien</option>
637 <option value="NZ">Neuseeland</option>
638 <option value="NI">Nicaragua</option>
639 <option value="NE">Niger</option>
640 <option value="NG">Nigeria</option>
641 <option value="NU">Niue</option>
642 <option value="NF">Norfolkinsel</option>
643 <option value="KP">Nordkorea</option>
644 <option value="MP">Nördliche Marianen</option>
645 <option value="NO">Norwegen</option>
646 <option value="OM">Oman</option>
647 <option value="PK">Pakistan</option>
648 <option value="PW">Palau</option>
649 <option value="PS">Palästinensische Autonomiegebiete</option>
650 <option value="PA">Panama</option>
651 <option value="PG">Papua-Neuguinea</option>
652 <option value="PY">Paraguay</option>
653 <option value="PE">Peru</option>
654 <option value="PH">Philippinen</option>
655 <option value="PN">Pitcairninseln</option>
656 <option value="PL">Polen</option>
657 <option value="PT">Portugal</option>
658 <option value="PR">Puerto Rico</option>
659 <option value="QA">Katar</option>
660 <option value="CG">Republik Kongo</option>
661 <option value="RE">Réunion</option>
662 <option value="RO">Rumänien</option>
663 <option value="RU">Russland</option>
664 <option value="RW">Ruanda</option>
665 <option value="BL">Saint-Barthélemy</option>
666 <option value="SH">St. Helena</option>
667 <option value="KN">St. Kitts und Nevis</option>
668 <option value="LC">St. Lucia</option>
669 <option value="MF">St. Martin</option>
670 <option value="PM">Saint-Pierre und Miquelon</option>
671 <option value="VC">St. Vincent und die Grenadinen</option>
672 <option value="WS">Samoa</option>
673 <option value="SM">San Marino</option>
674 <option value="ST">São Tomé und Príncipe</option>
675 <option value="SA">Saudi-Arabien</option>
676 <option value="SN">Senegal</option>
677 <option value="RS">Serbien</option>
678 <option value="CS">Serbien und Montenegro</option>
679 <option value="SC">Seychellen</option>
680 <option value="SL">Sierra Leone</option>
681 <option value="SG">Singapur</option>
682 <option value="SX">Sint Maarten</option>
683 <option value="SK">Slowakei</option>
684 <option value="SI">Slowenien</option>
685 <option value="SB">Salomon-Inseln</option>
686 <option value="SO">Somalia</option>
687 <option value="ZA">Südafrika</option>
688 <option value="GS">Südgeorgien und die Südlichen Sandwichinseln</option>
689 <option value="KR">Südkorea</option>
690 <option value="SS">Südsudan</option>
691 <option value="ES">Spanien</option>
692 <option value="LK">Sri Lanka</option>
693 <option value="SD">Sudan</option>
694 <option value="SR">Suriname</option>
695 <option value="SJ">Svalbard und Jan Mayen</option>
696 <option value="SZ">Swasiland</option>
697 <option value="SE">Schweden</option>
698 <option value="SY">Syrien</option>
699 <option value="TW">Taiwan</option>
700 <option value="TJ">Tadschikistan</option>
701 <option value="TZ">Tansania</option>
702 <option value="TH">Thailand</option>
703 <option value="TG">Togo</option>
704 <option value="TK">Tokelau</option>
705 <option value="TO">Tonga</option>
706 <option value="TT">Trinidad und Tobago</option>
707 <option value="TN">Tunesien</option>
708 <option value="TR">Türkei</option>
709 <option value="TM">Turkmenistan</option>
710 <option value="TC">Turks- und Caicosinseln</option>
711 <option value="TV">Tuvalu</option>
712 <option value="VI">Amerikanische Jungferninseln</option>
713 <option value="UG">Uganda</option>
714 <option value="UA">Ukraine</option>
715 <option value="AE">Vereinte Arabische Emirate</option>
716 <option value="GB">Großbritannien</option>
717 <option value="US">Vereinigte Staaten von Amerika (USA)</option>
718 <option value="UM">United States Minor Outlying Islands</option>
719 <option value="UY">Uruguay</option>
720 <option value="UZ">Usbekistan</option>
721 <option value="VU">Vanuatu</option>
722 <option value="VA">Vatikanstadt</option>
723 <option value="VE">Venezuela</option>
724 <option value="VN">Vietnam</option>
725 <option value="WF">Wallis und Futuna</option>
726 <option value="EH">Westsahara</option>
727 <option value="YE">Jemen</option>
728 <option value="ZM">Sambia</option>
729 <option value="ZW">Simbabwe</option>
730 </select>
731
732 <label for="sc-email">E-Mail-Adresse</label>
733 <input type="text" name="sc-email" pattern=".+@.+\..+" maxlength="50" placeholder="h.acker@example.com" required>
734
735 <label for="sc-pgp">Optional: PGP-Key ID (Key muss auf den Key-Servern sein)</label>
736 <input type="text" name="sc-pgp" pattern="(0x)?[0-9a-fA-F]{16}([0-9a-fA-F]{24})?" maxlength="50" placeholder="0x1337cafe2342feed" onblur="this.value = this.value.replace(/\s/g, '');">
737
738 <label><input type="checkbox" name="sc-consent">Über wichtige Vereinsangelegenheiten möchte ich per Mail oder ersatzweise brieflich informiert werden.</label>
739
740 <button id="show-form" type="submit">Drucken</button>
741
742 <label for="sc-comment">Bemerkungen</label>
743 <textarea class="comment" id="sc-comment" name="sc-comment" rows="3" maxlength="144"></textarea>
744
745 <br>
746 <p>
747 Solltest du Probleme mit diesem Formular haben, möchten wir <a href="https://github.com/HerrSpace/CCC-Membership-Form/issues">diese gerne erfahren</a>. Alternativ kannst du <a href="https://www.ccc.de/system/uploads/269/original/Supporterform-de-v5.pdf">diesen PDF Antrag</a> ausfüllen.
748 </p>
749 </form>
750 </div>
751 <page size="A4" id="formpage">
752 <span class="falzt"></span>
753 <span class="falzb"></span>
754 <span class="hole"></span>
755
756 <div class="dinHead">
757 <h1>Chaos Computer Club e. V.</h1>
758 <span><a href="mailto:office@ccc.de">office@ccc.de</a> • <a href="https://www.ccc.de/de/membership">https://www.ccc.de/de/membership</a></span>
759 </div>
760
761 <div class="dinAddrRet"></div>
762 <div class="dinAddrFwd">
763 Chaos Computer Club e. V.<br/>Zeiseweg 9<br/>22765 Hamburg<br/>Germany
764 </div>
765
766 <div class="dinInfo">
767 <canvas id="qrCode"></canvas>
768 </div>
769
770 <div class="dinCont">
771
772 <h3>Antrag auf Fördermitgliedschaft im Chaos Computer Club e. V.</h3>
773
774 <form id="application" action="#">
775 <input type="hidden" name="version" value="1"/>
776 <p>
777 Ich möchte <span class="bold">Fördermitglied im Chaos Computer Club e. V.</span> werden (unregelmäßig und <span class="bold">selten</span> erscheinende Datenschleuder inklusive) und habe die Satzung (<a href="https://www.ccc.de/de/satzung">https://www.ccc.de/de/satzung</a>) und FAQ (<a href="https://www.ccc.de/de/faq">https://www.ccc.de/de/faq</a>) gelesen.
778 </p>
779 <p>
780 <input type="radio" name="payment" value="regular" id="regular" onclick="return false;">
781 <label for="regular"><span class="bold">Normale</span> Fördermitgliedschaft für <span class="bold">72€</span> pro Jahr oder</label><br/>
782 <input type="radio" name="payment" value="reduced" id="reduced" onclick="return false;">
783 <label for="reduced"><span class="bold">Ermäßigte</span> Fördermitgliedschaft für <span class="bold">36€</span> pro Jahr. Einen <span class="bold">Nachweis</span>, aus dem einer der folgenden Ermäßigungsgründe hervorgeht, lege ich in Kopie bei: Studium, Schule, Arbeitslosigkeit, Umschulung, Rente oder Behinderung.</label>
784 </p>
785 <p>
786 <div id="personalInfo">
787 <div>
788 <div style="width: 33%;">
789 <input type="text" name="firstname">
790 <span>Vorname</span>
791 </div>
792 <div style="width: 33%;">
793 <input type="text" name="lastname">
794 <span>Nachname</span>
795 </div>
796 <div style="width: 34%;">
797 <input type="text" name="addr3">
798 <span>Optional: Adresszusatz, Organisation oder c/o</span>
799 </div>
800 </div>
801 <div>
802 <div style="width: 50%;">
803 <input type="text" name="addr1">
804 <span>Straße und Hausnummer</span>
805 </div>
806 <div style="width: 30%;">
807 <input type="text" name="addr2">
808 <span>Postleitzahl und Stadt</span>
809 </div>
810 <div style="width: 20%;">
811 <input type="text" name="country">
812 <span>Land</span>
813 </div>
814 </div>
815 <div>
816 <div style="width: 50%;">
817 <input type="text" name="email">
818 <span class="bold">E-Mail-Adresse – (Bitte unbedingt angeben!)</span>
819 </div>
820 <div style="width: 50%;">
821 <input type="text" name="pgp">
822 <span>Optional: PGP-Key ID (Key muss auf den <span class="bold">Key-Servern</span> sein)</span>
823 </div>
824 </div>
825 </div>
826 <div>
827 <div style="width: 100%;">
828 <input type="checkbox" name="consent">
829 <span>Über wichtige Vereinsangelegenheiten möchte ich per Mail oder ersatzweise brieflich informiert werden.</span>
830 </div>
831 </div>
832 </p>
833 <p>
834 <span>Dieses Formular ausdrucken und <span class="bold">handschriftlich</span> unterzeichnen</span>
835 </p>
836 <p style="height: 5px">
837 <div class="signfield" style="width: 20%">
838 <span class="underline"></span>
839 <input type="text" name="date" class="underline">
840 <span>Datum</span>
841 </div>
842 <div class="signfield" style="width: 80%">
843 <span class="underline"></span>
844 <input type="text" name="signature" class="underline" readonly>
845 <span>Unterschrift (bei Minderjährigen Unterschrift der Erziehungsberechtigten)</span>
846 </div>
847 </p>
848 </form>
849 <p>
850 <span>Diesen Antrag <span class="bold">vorzugsweise</span> einscannen und <span class="bold">per E-Mail an <a href="mailto:office@ccc.de">office@ccc.de</a></span> senden oder ausreichend frankiert per Post senden. <span class="bold">Einschreiben oder nicht ausreichend frankierte Briefe werden nicht angenommen!</span> Es ist einfach tagsüber niemand da um die Post anzunehmen.
851 </p>
852 <p>
853 <span>Die E-Mail von <a href="mailto:office@ccc.de">office@ccc.de</a> (PGP-Key zu finden auf <a href="https://www.ccc.de/de/office">https://www.ccc.de/de/office</a>) mit Bestätigung und weiteren Anweisungen sollte <span class="bold">binnen drei Wochen</span> eintreffen. Zum Jahresende kann dies noch länger dauern.</span>
854 </p>
855 <span class="underline">Bemerkungen:</span>
856 <textarea class="comment" id="comment" name="comment" rows="3"></textarea>
857 </div>
858
859 <div class="dinFoot">
860 <span id="uno"><span class="bold">Verein:</span><br/>Eingetragen beim Vereinsgericht Hamburg unter der Vereinsregister-<br/>nummer: 10940</span>
861 <span id="dos"><span class="bold">Internet:</span><br/>Webseite: <a href="https://www.ccc.de/">https://www.ccc.de/</a> Regionale Erfakreise und Chaostreffs: <a href="https://www.ccc.de/regional">https://www.ccc.de/regional</a></span>
862 <span id="tres"><span class="bold">Kontakt:</span><br/>Allgemeine Anfragen: <a href="mailto:mail@ccc.de">mail@ccc.de</a><br/>Mitgliederverwaltung: <a href="mailto:office@ccc.de">office@ccc.de</a></span>
863 </div>
864 </page>
865</body>
866</html>
generated by cgit v1.2.3 (git 2.25.1) at 2024-11-22 13:18:53 +0000