{"id":2654,"date":"2021-04-19T17:13:30","date_gmt":"2021-04-19T17:13:30","guid":{"rendered":"https:\/\/pf-poirie.fr\/?page_id=2654"},"modified":"2021-04-19T17:13:30","modified_gmt":"2021-04-19T17:13:30","slug":"demande-de-devis-prevoyance","status":"publish","type":"page","link":"https:\/\/pf-poirie.fr\/index.php\/demande-de-devis-prevoyance\/","title":{"rendered":"Demande de devis Pr\u00e9voyance"},"content":{"rendered":"<p>[vc_row row_type=\u00a0\u00bbrow\u00a0\u00bb use_row_as_full_screen_section=\u00a0\u00bbno\u00a0\u00bb type=\u00a0\u00bbgrid\u00a0\u00bb angled_section=\u00a0\u00bbno\u00a0\u00bb text_align=\u00a0\u00bbleft\u00a0\u00bb background_image_as_pattern=\u00a0\u00bbwithout_pattern\u00a0\u00bb css=\u00a0\u00bb.vc_custom_1469441071554{padding-top: 3.2% !important;padding-bottom: 4% !important;}\u00a0\u00bb][vc_column][vc_empty_space height=\u00a0\u00bb30px\u00a0\u00bb][vc_column_text]<\/p>\n<div class=\"caldera-grid\" id=\"caldera_form_1\" data-cf-ver=\"1.9.7\" data-cf-form-id=\"CF605e06cf094d3\"><div id=\"caldera_notices_1\" data-spinner=\"https:\/\/pf-poirie.fr\/wp-admin\/images\/spinner.gif\"><\/div><form data-instance=\"1\" class=\"CF605e06cf094d3 caldera_forms_form cfajax-trigger\" method=\"POST\" enctype=\"multipart\/form-data\" id=\"CF605e06cf094d3_1\" data-form-id=\"CF605e06cf094d3\" aria-label=\"Devis Pr&eacute;voyance\" data-target=\"#caldera_notices_1\" data-template=\"#cfajax_CF605e06cf094d3-tmpl\" data-cfajax=\"CF605e06cf094d3\" data-load-element=\"_parent\" data-load-class=\"cf_processing\" data-post-disable=\"0\" data-action=\"cf_process_ajax_submit\" data-request=\"https:\/\/pf-poirie.fr\/cf-api\/CF605e06cf094d3\" data-hiderows=\"true\">\r\n<input type=\"hidden\" id=\"_cf_verify_CF605e06cf094d3\" name=\"_cf_verify\" value=\"e5e069a591\"  data-nonce-time=\"1775619503\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php\/wp-json\/wp\/v2\/pages\/2654\" \/><div id=\"cf2-CF605e06cf094d3_1\"><\/div><input type=\"hidden\" name=\"_cf_frm_id\" value=\"CF605e06cf094d3\">\r\n<input type=\"hidden\" name=\"_cf_frm_ct\" value=\"1\">\r\n<input type=\"hidden\" name=\"cfajax\" value=\"CF605e06cf094d3\">\r\n<input type=\"hidden\" name=\"_cf_cr_pst\" value=\"2654\">\r\n<div class=\"hide\" style=\"display:none; overflow:hidden;height:0;width:0;\">\r\n<label>Company<\/label><input type=\"text\" name=\"company\" value=\"\" autocomplete=\"off\">\r\n<\/div><div id=\"CF605e06cf094d3_1-row-1\"  class=\"row  first_row\"><div  class=\"col-sm-9  first_col\"><div class=\"\"><h2>Demandez votre devis de Pr\u00e9voyance fun\u00e9raire<br \/>\n(gratuit et sans engagement)<\/p>\n<h2\/>\n<\/div><\/div><div  class=\"col-sm-3  last_col\"><\/div><\/div><div id=\"CF605e06cf094d3_1-row-2\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div class=\"\"><h3>Type de demande<\/p>\n<h3\/>\n<\/div><div data-field-wrapper=\"fld_1345180\" class=\"form-group\" id=\"fld_1345180_1-wrap\">\r\n\t<label id=\"fld_1345180Label\" for=\"fld_1345180_1\" class=\"control-label\">Vous souhaitez<\/label>\r\n\t<div class=\"\">\r\n\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_1345180_1_opt1310928\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Financer vos obs\u00e8ques \u00e0 l&#039;avance\"\n                                data-field=\"fld_1345180\"\n                                id=\"fld_1345180_1_opt1310928\"\n                                class=\"fld_1345180_1\"\n                                name=\"fld_1345180[opt1310928]\"\n                                value=\"Financer vos obs\u00e8ques \u00e0 l&#039;avance\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_1345180_1\"\n                                                                data-calc-value=\"Financer vos obs\u00e8ques \u00e0 l&#039;avance\"\n                            >\n                    Financer vos obs\u00e8ques \u00e0 l'avance                <\/label>\n\n                \t\t\t\t\t\t\t\t\n                <label  class=\"checkbox-inline\"                        for=\"fld_1345180_1_opt1536386\"\n                >\n                            <input\n                                                                type=\"checkbox\"\n                                data-label=\"Financer et pr\u00e9voir l&#039;organisation de vos obs\u00e8ques \u00e0 l&#039;avance\"\n                                data-field=\"fld_1345180\"\n                                id=\"fld_1345180_1_opt1536386\"\n                                class=\"fld_1345180_1\"\n                                name=\"fld_1345180[opt1536386]\"\n                                value=\"Financer et pr\u00e9voir l&#039;organisation de vos obs\u00e8ques \u00e0 l&#039;avance\"\n                                                                data-type=\"checkbox\"\n                                data-checkbox-field=\"fld_1345180_1\"\n                                                                data-calc-value=\"Financer et pr\u00e9voir l&#039;organisation de vos obs\u00e8ques \u00e0 l&#039;avance\"\n                            >\n                    Financer et pr\u00e9voir l'organisation de vos obs\u00e8ques \u00e0 l'avance                <\/label>\n\n                \t\t\t\t\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><\/div><\/div><div id=\"CF605e06cf094d3_1-row-3\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_1142139_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF605e06cf094d3_1-row-4\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div class=\"\"><h3>Demandeur<\/p>\n<h3\/>\n<\/div><div data-field-wrapper=\"fld_9870429\" class=\"form-group\" id=\"fld_9870429_1-wrap\">\r\n\t<label id=\"fld_9870429Label\" for=\"fld_9870429_1\" class=\"control-label\">Les personnes \u00e0 assurer :<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_9870429\" value=\"opt1490067\" data-field=\"fld_9870429\" class=\"form-control\" id=\"fld_9870429_1\"    aria-labelledby=\"fld_9870429Label\" >\n\t\t\t\t\t\t\t<option value=\"S\u00e9lectionnez\" selected=\"selected\" data-calc-value=\"S\u00e9lectionnez\" >\n\t\t\t\t\t\tS\u00e9lectionnez\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Vous\"  data-calc-value=\"Vous\" >\n\t\t\t\t\t\tVous\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Vous et votre conjoint\"  data-calc-value=\"Vous et votre conjoint\" >\n\t\t\t\t\t\tVous et votre conjoint\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Vous, votre conjoint et une personne \u00e0 votre charge\"  data-calc-value=\"Vous, votre conjoint et une personne \u00e0 votre charge\" >\n\t\t\t\t\t\tVous, votre conjoint et une personne \u00e0 votre charge\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_490907\" class=\"form-group\" id=\"fld_490907_1-wrap\">\r\n\t<label id=\"fld_490907Label\" for=\"fld_490907_1\" class=\"control-label\">Votre date de naissance :<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"date\" data-field=\"fld_490907\" class=\" form-control\" id=\"fld_490907_1\" name=\"fld_490907\" value=\"\" data-type=\"date\"   aria-labelledby=\"fld_490907Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_2699154\" class=\"form-group\" id=\"fld_2699154_1-wrap\">\r\n\t<label id=\"fld_2699154Label\" for=\"fld_2699154_1\" class=\"control-label\">Votre situation familiale :<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_2699154\" value=\"opt1254638\" data-field=\"fld_2699154\" class=\"form-control\" id=\"fld_2699154_1\"    aria-labelledby=\"fld_2699154Label\" >\n\t\t\t\t\t\t\t<option value=\"S\u00e9lectionnez\" selected=\"selected\" data-calc-value=\"S\u00e9lectionnez\" >\n\t\t\t\t\t\tS\u00e9lectionnez\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"C\u00e9libataire\"  data-calc-value=\"C\u00e9libataire\" >\n\t\t\t\t\t\tC\u00e9libataire\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mari\u00e9(e)\/Pacs\u00e9(e)\"  data-calc-value=\"Mari\u00e9(e)\/Pacs\u00e9(e)\" >\n\t\t\t\t\t\tMari\u00e9(e)\/Pacs\u00e9(e)\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Concubin\"  data-calc-value=\"Concubin\" >\n\t\t\t\t\t\tConcubin\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"S\u00e9par\u00e9(e)\"  data-calc-value=\"S\u00e9par\u00e9(e)\" >\n\t\t\t\t\t\tS\u00e9par\u00e9(e)\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Divorc\u00e9(e)\"  data-calc-value=\"Divorc\u00e9(e)\" >\n\t\t\t\t\t\tDivorc\u00e9(e)\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Veuf(ve)\"  data-calc-value=\"Veuf(ve)\" >\n\t\t\t\t\t\tVeuf(ve)\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4939789\" class=\"form-group\" id=\"fld_4939789_1-wrap\">\r\n\t<label id=\"fld_4939789Label\" for=\"fld_4939789_1\" class=\"control-label\">Montant du capital \u00e0 souscrire :<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_4939789\" value=\"opt1846472\" data-field=\"fld_4939789\" class=\"form-control\" id=\"fld_4939789_1\"    aria-labelledby=\"fld_4939789Label\" >\n\t\t\t\t\t\t\t<option value=\"S\u00e9lectionnez\" selected=\"selected\" data-calc-value=\"S\u00e9lectionnez\" >\n\t\t\t\t\t\tS\u00e9lectionnez\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"2000\u20ac\"  data-calc-value=\"2000\u20ac\" >\n\t\t\t\t\t\t2000\u20ac\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"3000\u20ac\"  data-calc-value=\"3000\u20ac\" >\n\t\t\t\t\t\t3000\u20ac\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"4000\u20ac\"  data-calc-value=\"4000\u20ac\" >\n\t\t\t\t\t\t4000\u20ac\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"5000\u20ac\"  data-calc-value=\"5000\u20ac\" >\n\t\t\t\t\t\t5000\u20ac\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"6000\u20ac\"  data-calc-value=\"6000\u20ac\" >\n\t\t\t\t\t\t6000\u20ac\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"7000\u20ac\"  data-calc-value=\"7000\u20ac\" >\n\t\t\t\t\t\t7000\u20ac\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"8000\u20ac ou plus\"  data-calc-value=\"8000\u20ac ou plus\" >\n\t\t\t\t\t\t8000\u20ac ou plus\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8150399\" class=\"form-group\" id=\"fld_8150399_1-wrap\">\r\n\t<label id=\"fld_8150399Label\" for=\"fld_8150399_1\" class=\"control-label\">Modalit\u00e9s de paiements :<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_8150399\" value=\"opt1750665\" data-field=\"fld_8150399\" class=\"form-control\" id=\"fld_8150399_1\"    aria-labelledby=\"fld_8150399Label\" >\n\t\t\t\t\t\t\t<option value=\"S\u00e9lectionnez\" selected=\"selected\" data-calc-value=\"S\u00e9lectionnez\" >\n\t\t\t\t\t\tS\u00e9lectionnez\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"En une seule fois\"  data-calc-value=\"En une seule fois\" >\n\t\t\t\t\t\tEn une seule fois\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Sur 1 an\"  data-calc-value=\"Sur 1 an\" >\n\t\t\t\t\t\tSur 1 an\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Sur 5 ans\"  data-calc-value=\"Sur 5 ans\" >\n\t\t\t\t\t\tSur 5 ans\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Sur 10 ans\"  data-calc-value=\"Sur 10 ans\" >\n\t\t\t\t\t\tSur 10 ans\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Sur 15 ans\"  data-calc-value=\"Sur 15 ans\" >\n\t\t\t\t\t\tSur 15 ans\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Sur 20 ans\"  data-calc-value=\"Sur 20 ans\" >\n\t\t\t\t\t\tSur 20 ans\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Viager\"  data-calc-value=\"Viager\" >\n\t\t\t\t\t\tViager\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-6  last_col\"><\/div><\/div><div id=\"CF605e06cf094d3_1-row-5\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_4760796_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF605e06cf094d3_1-row-6\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_6447776\" class=\"form-group\" id=\"fld_6447776_1-wrap\">\r\n\t<label id=\"fld_6447776Label\" for=\"fld_6447776_1\" class=\"control-label\">Commentaires\/informations compl\u00e9mentaires<\/label>\r\n\t<div class=\"\">\r\n\t\t<textarea name=\"fld_6447776\" value=\"\" data-field=\"fld_6447776\" class=\"form-control\" id=\"fld_6447776_1\" rows=\"4\"    aria-labelledby=\"fld_6447776Label\" ><\/textarea>\n\t\t\t<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF605e06cf094d3_1-row-7\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_2678282_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF605e06cf094d3_1-row-8\"  class=\"row \"><div  class=\"col-sm-6  first_col\"><div class=\"\"><h3>Coordonn\u00e9es du demandeur<\/p>\n<h3\/>\n<\/div><\/div><div  class=\"col-sm-6  last_col\"><\/div><\/div><div id=\"CF605e06cf094d3_1-row-9\"  class=\"row \"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_9399077\" class=\"form-group\" id=\"fld_9399077_1-wrap\">\r\n\t<label id=\"fld_9399077Label\" for=\"fld_9399077_1\" class=\"control-label\">Civilit\u00e9<\/label>\r\n\t<div class=\"\">\r\n\t\t<select name=\"fld_9399077\" value=\"\" data-field=\"fld_9399077\" class=\"form-control\" id=\"fld_9399077_1\"    aria-labelledby=\"fld_9399077Label\" >\n\t\t<option value=\"\"><\/option>\r\n\t\t\t\t\t<option value=\"S\u00e9lectionnez\"  data-calc-value=\"S\u00e9lectionnez\" >\n\t\t\t\t\t\tS\u00e9lectionnez\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mlle\"  data-calc-value=\"Mlle\" >\n\t\t\t\t\t\tMlle\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"Mme\"  data-calc-value=\"Mme\" >\n\t\t\t\t\t\tMme\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t\t\t<option value=\"M\"  data-calc-value=\"M\" >\n\t\t\t\t\t\tM\t\t\t\t\t<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_2023738\" class=\"form-group\" id=\"fld_2023738_1-wrap\">\r\n\t<label id=\"fld_2023738Label\" for=\"fld_2023738_1\" class=\"control-label\">Adresse<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_2023738\" class=\" form-control\" id=\"fld_2023738_1\" name=\"fld_2023738\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_2023738Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7181960\" class=\"form-group\" id=\"fld_7181960_1-wrap\">\r\n\t<label id=\"fld_7181960Label\" for=\"fld_7181960_1\" class=\"control-label\">T\u00e9l\u00e9phone <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '9999999999'\"  required type=\"phone\" data-field=\"fld_7181960\" class=\" form-control\" id=\"fld_7181960_1\" name=\"fld_7181960\" value=\"\" data-type=\"phone\" aria-required=\"true\"   aria-labelledby=\"fld_7181960Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_76797\" class=\"form-group\" id=\"fld_76797_1-wrap\">\r\n\t<label id=\"fld_76797Label\" for=\"fld_76797_1\" class=\"control-label\">Nom <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_76797\" class=\" form-control\" id=\"fld_76797_1\" name=\"fld_76797\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_76797Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_8329528\" class=\"form-group\" id=\"fld_8329528_1-wrap\">\r\n\t<label id=\"fld_8329528Label\" for=\"fld_8329528_1\" class=\"control-label\">Code postal<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"number\" data-field=\"fld_8329528\" class=\" form-control\" id=\"fld_8329528_1\" name=\"fld_8329528\" value=\"\" data-type=\"number\" data-parsley-type=\"number\"   aria-labelledby=\"fld_8329528Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_4670395\" class=\"form-group\" id=\"fld_4670395_1-wrap\">\r\n\t<label id=\"fld_4670395Label\" for=\"fld_4670395_1\" class=\"control-label\">Portable <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input  data-inputmask=\"'mask': '9999999999'\"  required type=\"phone\" data-field=\"fld_4670395\" class=\" form-control\" id=\"fld_4670395_1\" name=\"fld_4670395\" value=\"\" data-type=\"phone\" aria-required=\"true\"   aria-labelledby=\"fld_4670395Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3 \"><div data-field-wrapper=\"fld_791463\" class=\"form-group\" id=\"fld_791463_1-wrap\">\r\n\t<label id=\"fld_791463Label\" for=\"fld_791463_1\" class=\"control-label\">Pr\u00e9nom <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"text\" data-field=\"fld_791463\" class=\" form-control\" id=\"fld_791463_1\" name=\"fld_791463\" value=\"\" data-type=\"text\" aria-required=\"true\"   aria-labelledby=\"fld_791463Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_5490137\" class=\"form-group\" id=\"fld_5490137_1-wrap\">\r\n\t<label id=\"fld_5490137Label\" for=\"fld_5490137_1\" class=\"control-label\">Ville<\/label>\r\n\t<div class=\"\">\r\n\t\t<input    type=\"text\" data-field=\"fld_5490137\" class=\" form-control\" id=\"fld_5490137_1\" name=\"fld_5490137\" value=\"\" data-type=\"text\"   aria-labelledby=\"fld_5490137Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<div data-field-wrapper=\"fld_7362733\" class=\"form-group\" id=\"fld_7362733_1-wrap\">\r\n\t<label id=\"fld_7362733Label\" for=\"fld_7362733_1\" class=\"control-label\">Email <span aria-hidden=\"true\" role=\"presentation\" class=\"field_required\" style=\"color:#ee0000;\">*<\/span><\/label>\r\n\t<div class=\"\">\r\n\t\t<input   required type=\"email\" data-field=\"fld_7362733\" class=\" form-control\" id=\"fld_7362733_1\" name=\"fld_7362733\" value=\"\" data-type=\"email\" aria-required=\"true\"   aria-labelledby=\"fld_7362733Label\" >\t\t\t<\/div>\r\n<\/div>\r\n<\/div><div  class=\"col-sm-3  last_col\"><\/div><\/div><div id=\"CF605e06cf094d3_1-row-10\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_7621837_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF605e06cf094d3_1-row-11\"  class=\"row \"><div  class=\"col-sm-12  single\"><div class=\"\"><p>Les informations vous concernant sont n\u00e9cessaires aux fins d'ex\u00e9cution du service. Elles sont destin\u00e9es aux pompes fun\u00e8bres ANDRE POIRIE et ses Partenaires exclusivement. Conform\u00e9ment \u00e0 la loi \"Informatique & Libert\u00e9s\" du 6 janvier 1978, vous disposez d'un droit d'acc\u00e8s et de rectification sur ces donn\u00e9es, que vous pouvez exercer \u00e0 l'adresse suivante : andrepoirie@orange.fr ou en adressant un courrier \u00e0 Pompes Fun\u00e9raire ANDRE POIRIE, rue Roger Couderc, Zone Pin\u00e7onlieu, 60000 BEAUVAIS.<br \/>\nNous vous informons de l'existence de la liste d'opposition au d\u00e9marchage t\u00e9l\u00e9phonique \u00ab Bloctel \u00bb, sur laquelle vous pouvez vous inscrire sur le site https:\/\/conso.bloctel.fr\/<\/p>\n<p\/>\n<\/div><\/div><\/div><div id=\"CF605e06cf094d3_1-row-12\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_7144383_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF605e06cf094d3_1-row-13\"  class=\"row \"><div  class=\"col-sm-12  single\"><div data-field-wrapper=\"fld_5793707\" class=\"form-group\" id=\"fld_5793707_1-wrap\">\r\n<div class=\"\">\r\n\n<div class=\"checkbox-inline caldera-forms-consent-field\">\n    <input data-parsley-required=\"true\" data-parsley-group=\"fld_5793707_1\" data-parsley-multiple=\"fld_5793707_1\"        type=\"checkbox\" data-label=\"Acceptation\"\n        data-field=\"fld_5793707\"\n        id=\"fld_5793707_1\"\n        class=\"fld_5793707_1 option-required\"\n        name=\"fld_5793707\"\n        value=\"1\"\n        data-type=\"checkbox\"\n        data-checkbox-field=\"fld_5793707_1\"\n    >\n    <label for=\"fld_5793707_1\"\n           class=\"caldera-forms-gdpr-field-label\"\n           style=\"display:inline; margin-left: 0.5rem;\"\n    >\n        Acceptation        <p\n            class=\"caldera-forms-consent-field-agreement\"\n        >\n            En soumettant ce formulaire, j\u2019accepte que les informations saisies soient exploit\u00e9es dans le cadre de la demande de devis et de la relation commerciale qui en d\u00e9coulent.\n\u00ab Vous devez cliquer sur la case de consentement ci-dessus avant de pouvoir envoyer votre demande \u00bb        <\/p>\n        <a href=\"\"\n           target=\"_blank\"\n                title=\"Page de politique de confidentialit\u00e9\"\n            class=\"caldera-forms-consent-field-linked_text\"\n            >\n            https:\/\/pf-poirie.fr\/index.php\/mentions-legales\/        <\/a>\n    <\/label>\n    <span style=\"color:#ff0000;\">*<\/span>\n<\/div>\n\n<\/div>\r\n<\/div>\r\n<\/div><\/div><div id=\"CF605e06cf094d3_1-row-14\"  class=\"row \"><div  class=\"col-sm-12  single\"><hr id=\"fld_3171866_1\" class=\"\" style=\"width: 100%\" \/><\/div><\/div><div id=\"CF605e06cf094d3_1-row-15\"  class=\"row  last_row\"><div  class=\"col-sm-3  first_col\"><div data-field-wrapper=\"fld_5111128\" class=\"form-group\" id=\"fld_5111128_1-wrap\">\r\n<div class=\"\">\r\n\t<input  class=\"btn btn-default\" type=\"submit\" name=\"fld_5111128\" id=\"fld_5111128_1\" value=\"Envoyer\" data-field=\"fld_5111128\"  >\n<\/div>\r\n<\/div>\r\n\t<input class=\"button_trigger_1\" type=\"hidden\" name=\"fld_5111128\" id=\"fld_5111128_1_btn\" value=\"\" data-field=\"fld_5111128\"  \/>\n<\/div><div  class=\"col-sm-3 \"><\/div><div  class=\"col-sm-6  last_col\"><\/div><\/div><\/form>\r\n<\/div>\r\n\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][vc_separator color=\u00a0\u00bbpeacoc\u00a0\u00bb][vc_empty_space][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_row row_type=\u00a0\u00bbrow\u00a0\u00bb use_row_as_full_screen_section=\u00a0\u00bbno\u00a0\u00bb type=\u00a0\u00bbgrid\u00a0\u00bb angled_section=\u00a0\u00bbno\u00a0\u00bb text_align=\u00a0\u00bbleft\u00a0\u00bb background_image_as_pattern=\u00a0\u00bbwithout_pattern\u00a0\u00bb css=\u00a0\u00bb.vc_custom_1469441071554{padding-top: 3.2% !important;padding-bottom: 4% !important;}\u00a0\u00bb][vc_column][vc_empty_space height=\u00a0\u00bb30px\u00a0\u00bb][vc_column_text] [\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space][vc_separator color=\u00a0\u00bbpeacoc\u00a0\u00bb][vc_empty_space][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"class_list":["post-2654","page","type-page","status-publish","hentry","description-off"],"_links":{"self":[{"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/pages\/2654","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/comments?post=2654"}],"version-history":[{"count":1,"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/pages\/2654\/revisions"}],"predecessor-version":[{"id":2655,"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/pages\/2654\/revisions\/2655"}],"wp:attachment":[{"href":"https:\/\/pf-poirie.fr\/index.php\/wp-json\/wp\/v2\/media?parent=2654"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}