Anmeldung

Ich bestätige meine Anmeldung als Teilnehmer der Aktivierungskampagne der Bäcker- und Konditormeister 2018. Als Teilnehmer erhalte ich gratis mein Aktionspaket bis spätestens 30.09.2018. Dieses Paket enthält:

  • 1 Poster im A3-Format
  • 1 Schaufensterkleber
  • 1 Glasdekorfolie im A4-Format
  • 1000 Brottüten (2 verschiedene Formate)
  • 250 Kalender für 2019

Damit Sie von diesem Angebot profitieren können, müssen Ihre Mitgliedsbeiträge bezahlt sein und Ihr Teilnahmeantrag muss spätestens am 31 mai 2018 um Mitternacht bei uns eingegangen sein.

{!! Form::open(array('url' => 'anmeldung', 'method' => 'POST', 'class' => 'form2check')) !!}

DIE ANGABEN Ihres Ladenlokals
(nicht zu verwechseln mit dem Firmensitz Ihrer Gesellschaft):

{{ Form::hidden('lang', 'de') }}
{!! Form::label('name', 'Name des Ladenlokals') !!} {!! Form::text('name', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('name', ':message') !!}
{!! Form::label('lastname', 'Name des Verantwortlichen:') !!} {!! Form::text('lastname', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('lastname', ':message') !!}
{!! Form::label('firstname', 'Vorname:') !!} {!! Form::text('firstname', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('firstname', ':message') !!}
{!! Form::label('street', 'Straße und Hausnummer:') !!} {!! Form::text('street', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('street', ':message') !!}
{!! Form::label('zip', 'Postleitzahl:') !!} {!! Form::text('zip', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('zip', ':message') !!}
{!! Form::label('city', 'Ort:') !!} {!! Form::text('city', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('city', ':message') !!}
{!! Form::label('phone', 'Telefon:') !!} {!! Form::text('phone', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('phone', ':message') !!}
{!! Form::label('mobile', 'Mobiltelefon:') !!} {!! Form::text('mobile', '', array('class' => 'form-control')) !!} {!! $errors->first('mobile', ':message') !!}
{!! Form::label('website', 'Webseite:') !!} {!! Form::text('website', '', array('class' => 'form-control')) !!} {!! $errors->first('website', ':message') !!}
{!! Form::label('email', 'E-Mailadresse:') !!} {!! Form::text('email', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('email', ':message') !!}
{!! Form::label('email_confirmation', 'E-Mailadresse (confirmation) : ') !!} {!! Form::text('email_confirmation', '', array('class' => 'form-control', 'required')) !!} {!! $errors->first('email_confirmation', ':message') !!}
{!! Form::label('tva', 'MwSt.-Nr.:') !!} {!! Form::text('tva', '', array('class' => 'form-control', 'placeholder' => 'BE0XXX XXX XXX', 'required')) !!} {!! $errors->first('tva', ':message') !!}

Bitte geben Sie die Öffnungszeiten und die Tage an, an denen Ihr Geschäft geschlossen ist:

{!! Form::select("mon_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('mon_morning_in', ':message') !!}
{!! Form::select("mon_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('mon_morning_out', ':message') !!}
{!! Form::select("mon_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('mon_afternoon_in', ':message') !!}
{!! Form::select("mon_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('mon_afternoon_out', ':message') !!}
{!! Form::select("tue_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('tue_morning_in', ':message') !!}
{!! Form::select("tue_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('tue_morning_out', ':message') !!}
{!! Form::select("tue_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('tue_afternoon_in', ':message') !!}
{!! Form::select("tue_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('tue_afternoon_out', ':message') !!}
{!! Form::select("wed_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('wed_morning_in', ':message') !!}
{!! Form::select("wed_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('wed_morning_out', ':message') !!}
{!! Form::select("wed_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('wed_afternoon_in', ':message') !!}
{!! Form::select("wed_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('wed_afternoon_out', ':message') !!}
{!! Form::select("thu_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('thu_morning_in', ':message') !!}
{!! Form::select("thu_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('thu_morning_out', ':message') !!}
{!! Form::select("thu_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('thu_afternoon_in', ':message') !!}
{!! Form::select("thu_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('thu_afternoon_out', ':message') !!}
{!! Form::select("fri_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('fri_morning_in', ':message') !!}
{!! Form::select("fri_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('fri_morning_out', ':message') !!}
{!! Form::select("fri_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('fri_afternoon_in', ':message') !!}
{!! Form::select("fri_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('fri_afternoon_out', ':message') !!}
{!! Form::select("sat_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('sat_morning_in', ':message') !!}
{!! Form::select("sat_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('sat_morning_out', ':message') !!}
{!! Form::select("sat_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('sat_afternoon_in', ':message') !!}
{!! Form::select("sat_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('sat_afternoon_out', ':message') !!}
{!! Form::select("sun_morning_in", $select_hours_am, '7:00', ['class'=>'form-control required']) !!} {!! $errors->first('sun_morning_in', ':message') !!}
{!! Form::select("sun_morning_out", $select_hours_am, '12:00', ['class'=>'form-control required']) !!} {!! $errors->first('sun_morning_out', ':message') !!}
{!! Form::select("sun_afternoon_in", $select_hours_pm, '13:00', ['class'=>'form-control required']) !!} {!! $errors->first('sun_afternoon_in', ':message') !!}
{!! Form::select("sun_afternoon_out", $select_hours_pm, '18:00', ['class'=>'form-control required']) !!} {!! $errors->first('sun_afternoon_out', ':message') !!}


Hiermit bestätige ich das Folgende:






Optional:

 
Soll nicht der Verantwortliche auf der Plakette genannt werden, sondern eine andere Person, dann geben Sie bitte den zu nennenden Namen und Vornamen hier an:

{!! Form::label('mbp_lastname', 'Name:') !!} {!! Form::text('mbp_lastname', '', array('class' => 'form-control')) !!} {!! $errors->first('mbp_lastname', ':message') !!}
{!! Form::label('mbp_firstname', 'Vorname:') !!} {!! Form::text('mbp_firstname', '', array('class' => 'form-control')) !!} {!! $errors->first('mbp_firstname', ':message') !!}


{!! Form::submit("Ich bestätige meine anmeldung", array('class' => 'btn btn-baker')) !!}
{!! Form::close() !!}