{"id":4490,"date":"2017-03-24T17:16:39","date_gmt":"2017-03-24T16:16:39","guid":{"rendered":"https:\/\/trivalis.fr\/?page_id=4490"},"modified":"2017-03-24T17:18:37","modified_gmt":"2017-03-24T16:18:37","slug":"inscription-annuaire-reemploi","status":"publish","type":"page","link":"https:\/\/trivalis.fr\/annuaire-acteurs-reemploi-2\/inscription-annuaire-reemploi\/","title":{"rendered":"Inscription annuaire du r\u00e9emploi"},"content":{"rendered":"<h2>D\u00e9poser votre candidature<\/h2>\n<h3>Int\u00e9grer l&rsquo;annuaire du r\u00e9emploi en compl\u00e9tant ce formulaire<\/h3>\n\n                <div class='gf_browser_unknown gform_wrapper' id='gform_wrapper_12' ><a id='gf_12' class='gform_anchor' ><\/a><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_12' id='gform_12'  action='\/wp-json\/wp\/v2\/pages\/4490\/#gf_12'> \r\n <input type='hidden' class='gforms-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/>\n                        <div class='gform_body'><ul id='gform_fields_12' class='gform_fields top_label form_sublabel_above description_above'><li id='field_12_2'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_2' >Nom de la structure<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_2' id='input_12_2' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_12_3'  class='gfield field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_3' >Nom du d\u00e9clarant<\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_12_3' type='text' value='' class='medium'      aria-invalid=\"false\" \/><\/div><\/li><li id='field_12_4'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_4' >Type d\u2019\u00e9tablissement<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='gfield_description'>association, artisan, etc.<\/div><div class='ginput_container ginput_container_text'><input name='input_4' id='input_12_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_12_5'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex' for='input_12_5_1' >Adresse<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_zip ginput_container_address gfield_trigger_change' id='input_12_5' >\n                         <span class='ginput_full address_line_1' id='input_12_5_1_container' >\n                                        <label for='input_12_5_1' id='input_12_5_1_label' >Adresse postale<\/label>\n                                        <input type='text' name='input_5.1' id='input_12_5_1' value=''   \/>\n                                    <\/span><span class='ginput_full address_line_2' id='input_12_5_2_container' >\n                                        <label for='input_12_5_2' id='input_12_5_2_label' >Adresse ligne 2<\/label>\n                                        <input type='text' name='input_5.2' id='input_12_5_2' value=''   \/>\n                                    <\/span><span class='ginput_left address_zip' id='input_12_5_5_container' >\n                                    <label for='input_12_5_5' id='input_12_5_5_label' >ZIP \/ Code postal<\/label>\n                                    <input type='text' name='input_5.5' id='input_12_5_5' value='85'   \/>\n                                <\/span><span class='ginput_right address_city' id='input_12_5_3_container' >\n                                    <label for='input_12_5_3' id='input_12_5_3_label' >Ville<\/label>\n                                    <input type='text' name='input_5.3' id='input_12_5_3' value=''   \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_5.4' id='input_12_5_4' value=''\/><input type='hidden' class='gform_hidden' name='input_5.6' id='input_12_5_6' value='France'\/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/li><li id='field_12_6'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_6' >T\u00e9l\u00e9phone<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_6' id='input_12_6' type='tel' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_12_7'  class='gfield field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex' for='input_12_7' >E-mail<\/label><div class='ginput_complex ginput_container ginput_container_email' id='input_12_7_container'>\n                                <span id='input_12_7_1_container' class='ginput_left'>\n                                    <label for='input_12_7'>Saisissez un e-mail<\/label>\n                                    <input class='' type='email' name='input_7' id='input_12_7' value=''      aria-invalid=\"false\"\/>\n                                <\/span>\n                                <span id='input_12_7_2_container' class='ginput_right'>\n                                    <label for='input_12_7_2' >Confirmez l\u2019e-mail<\/label>\n                                    <input class='' type='email' name='input_7_2' id='input_12_7_2' value=''     aria-invalid=\"false\"\/>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><\/li><li id='field_12_8'  class='gfield field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_8' >Site Web <span id='field_12_8_dmessage' class='sr-only'> - veuillez saisir une URL valide, comme par exemple https:\/\/www.google.com<\/span><\/label><div class='ginput_container ginput_container_website'>\n                    <input aria-describedby='field_12_8_dmessage' name='input_8' id='input_12_8' type='url' value='' class='medium'     placeholder='http:\/\/'  aria-invalid=\"false\"\/>\n                <\/div><\/li><li id='field_12_9'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_9' >Horaires d&#039;ouverture<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='gfield_description'>Sp\u00e9cifier les heures d'ouvertures (\u00e9t\u00e9, hiver si diff\u00e9rentes).\nFormat souhait\u00e9:\nLundi au Vendredi : 9h-12h \/ 14h-19h\nSamedi : 9h-13h<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_9' id='input_12_9' class='textarea medium'    aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_12_10'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >Cat\u00e9gories<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='gfield_description'>S\u00e9lectionner les cat\u00e9gories qui correspondent \u00e0 vos activit\u00e9s<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_12_10'><li class='gchoice_12_10_1'>\n\t\t\t\t\t\t\t\t<input name='input_10.1' type='checkbox'  value='Achat \/ Vente d\u2019occasion'  id='choice_12_10_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_10_1' id='label_12_10_1'>Achat \/ Vente d\u2019occasion<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_10_2'>\n\t\t\t\t\t\t\t\t<input name='input_10.2' type='checkbox'  value='Don'  id='choice_12_10_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_10_2' id='label_12_10_2'>Don<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_10_3'>\n\t\t\t\t\t\t\t\t<input name='input_10.3' type='checkbox'  value='\u00c9change \/ Troc'  id='choice_12_10_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_10_3' id='label_12_10_3'>\u00c9change \/ Troc<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_10_4'>\n\t\t\t\t\t\t\t\t<input name='input_10.4' type='checkbox'  value='Location \/ Emprunt'  id='choice_12_10_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_10_4' id='label_12_10_4'>Location \/ Emprunt<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_10_5'>\n\t\t\t\t\t\t\t\t<input name='input_10.5' type='checkbox'  value='R\u00e9paration \/ Relookage'  id='choice_12_10_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_10_5' id='label_12_10_5'>R\u00e9paration \/ Relookage<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_12_11'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label'  >Types de produits<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='gfield_description'>S\u00e9lectionner les produits qui correspondent \u00e0 vos activit\u00e9s<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_12_11'><li class='gchoice_12_11_1'>\n\t\t\t\t\t\t\t\t<input name='input_11.1' type='checkbox'  value='Ameublement'  id='choice_12_11_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_1' id='label_12_11_1'>Ameublement<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_2'>\n\t\t\t\t\t\t\t\t<input name='input_11.2' type='checkbox'  value='Arts de la table'  id='choice_12_11_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_2' id='label_12_11_2'>Arts de la table<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_3'>\n\t\t\t\t\t\t\t\t<input name='input_11.3' type='checkbox'  value='Automobile et moto'  id='choice_12_11_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_3' id='label_12_11_3'>Automobile et moto<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_4'>\n\t\t\t\t\t\t\t\t<input name='input_11.4' type='checkbox'  value='Bijoux et horlogerie'  id='choice_12_11_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_4' id='label_12_11_4'>Bijoux et horlogerie<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_5'>\n\t\t\t\t\t\t\t\t<input name='input_11.5' type='checkbox'  value='Bricolage et outillage'  id='choice_12_11_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_5' id='label_12_11_5'>Bricolage et outillage<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_6'>\n\t\t\t\t\t\t\t\t<input name='input_11.6' type='checkbox'  value='Chaussures et maroquinerie'  id='choice_12_11_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_6' id='label_12_11_6'>Chaussures et maroquinerie<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_7'>\n\t\t\t\t\t\t\t\t<input name='input_11.7' type='checkbox'  value='Consoles et jeux vid\u00e9o'  id='choice_12_11_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_7' id='label_12_11_7'>Consoles et jeux vid\u00e9o<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_8'>\n\t\t\t\t\t\t\t\t<input name='input_11.8' type='checkbox'  value='D\u00e9coration'  id='choice_12_11_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_8' id='label_12_11_8'>D\u00e9coration<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_9'>\n\t\t\t\t\t\t\t\t<input name='input_11.9' type='checkbox'  value='\u00c9lectrom\u00e9nager'  id='choice_12_11_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_9' id='label_12_11_9'>\u00c9lectrom\u00e9nager<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_11'>\n\t\t\t\t\t\t\t\t<input name='input_11.11' type='checkbox'  value='\u00c9quipement de jardin'  id='choice_12_11_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_11' id='label_12_11_11'>\u00c9quipement de jardin<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_12'>\n\t\t\t\t\t\t\t\t<input name='input_11.12' type='checkbox'  value='Informatique et t\u00e9l\u00e9phonie'  id='choice_12_11_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_12' id='label_12_11_12'>Informatique et t\u00e9l\u00e9phonie<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_13'>\n\t\t\t\t\t\t\t\t<input name='input_11.13' type='checkbox'  value='Instruments de musique'  id='choice_12_11_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_13' id='label_12_11_13'>Instruments de musique<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_14'>\n\t\t\t\t\t\t\t\t<input name='input_11.14' type='checkbox'  value='Jeux et jouets'  id='choice_12_11_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_14' id='label_12_11_14'>Jeux et jouets<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_15'>\n\t\t\t\t\t\t\t\t<input name='input_11.15' type='checkbox'  value='Linge de maison'  id='choice_12_11_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_15' id='label_12_11_15'>Linge de maison<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_16'>\n\t\t\t\t\t\t\t\t<input name='input_11.16' type='checkbox'  value='Livres et revues \/ CD et DVD'  id='choice_12_11_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_16' id='label_12_11_16'>Livres et revues \/ CD et DVD<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_17'>\n\t\t\t\t\t\t\t\t<input name='input_11.17' type='checkbox'  value='Mat\u00e9riel de jardinage \/ Bricolage et motoculture'  id='choice_12_11_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_17' id='label_12_11_17'>Mat\u00e9riel de jardinage \/ Bricolage et motoculture<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_18'>\n\t\t\t\t\t\t\t\t<input name='input_11.18' type='checkbox'  value='Mobilier \/ D\u00e9coration et vaisselle'  id='choice_12_11_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_18' id='label_12_11_18'>Mobilier \/ D\u00e9coration et vaisselle<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_19'>\n\t\t\t\t\t\t\t\t<input name='input_11.19' type='checkbox'  value='Pu\u00e9riculture'  id='choice_12_11_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_19' id='label_12_11_19'>Pu\u00e9riculture<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_21'>\n\t\t\t\t\t\t\t\t<input name='input_11.21' type='checkbox'  value='Sports et hobbies'  id='choice_12_11_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_21' id='label_12_11_21'>Sports et hobbies<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_22'>\n\t\t\t\t\t\t\t\t<input name='input_11.22' type='checkbox'  value='T\u00e9l\u00e9phones portables'  id='choice_12_11_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_22' id='label_12_11_22'>T\u00e9l\u00e9phones portables<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_23'>\n\t\t\t\t\t\t\t\t<input name='input_11.23' type='checkbox'  value='TV \/ Hi-fi \/ Photo \/ Vid\u00e9o \/ Son'  id='choice_12_11_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_23' id='label_12_11_23'>TV \/ Hi-fi \/ Photo \/ Vid\u00e9o \/ Son<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_24'>\n\t\t\t\t\t\t\t\t<input name='input_11.24' type='checkbox'  value='V\u00e9los'  id='choice_12_11_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_24' id='label_12_11_24'>V\u00e9los<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice_12_11_25'>\n\t\t\t\t\t\t\t\t<input name='input_11.25' type='checkbox'  value='V\u00eatements et textiles'  id='choice_12_11_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_11_25' id='label_12_11_25'>V\u00eatements et textiles<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id='field_12_12'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><label class='gfield_label' for='input_12_12' >Description de l\u2019activit\u00e9<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/label><div class='gfield_description'>En quelques mots\/lignes, d\u00e9crivez vos activit\u00e9s et sp\u00e9cificit\u00e9s<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_12_12' class='textarea medium'    aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_12_13'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><fieldset aria-required='true' class='gfieldset'><legend class='gfield_label'>Autorisation<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/legend><div class='gfield_description'>J\u2019autorise la diffusion des donn\u00e9es renseign\u00e9es ci-dessus par le syndicat Trivalis pour leur utilisation dans l\u2019annuaire du r\u00e9emploi, de la r\u00e9paration et de la location afin d\u2019assurer la promotion et le d\u00e9veloppement du secteur d\u2019activit\u00e9s de l\u2019entreprise et ceci dans le cadre du respect de la loi Informatique et Libert\u00e9s.<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_12_13'><li class='gchoice_12_13_1'>\n\t\t\t\t\t\t\t\t<input name='input_13.1' type='checkbox'  value='J&#039;ai lu et j&#039;accepte'  id='choice_12_13_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_13_1' id='label_12_13_1'>J'ai lu et j'accepte<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/fieldset><\/li><li id='field_12_14'  class='gfield gfield_contains_required field_sublabel_above field_description_above gfield_visibility_visible' ><fieldset aria-required='true' class='gfieldset'><legend class='gfield_label'>Attestation<span class='gfield_required'> * <span class='sr-only'> Obligatoire<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_12_14'><li class='gchoice_12_14_1'>\n\t\t\t\t\t\t\t\t<input name='input_14.1' type='checkbox'  value='Je certifie que toutes les informations fournies dans le pr\u00e9sent formulaire sont exactes.'  id='choice_12_14_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_12_14_1' id='label_12_14_1'>Je certifie que toutes les informations fournies dans le pr\u00e9sent formulaire sont 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