<\/p>

<\/ul><\/div>\n
\n

\n\n\n\n\n\n\n\n\n\n\n\n\n<\/div>\n

Je suis\n<\/h3>\n

—Veuillez choisir une option—<\/option>Une mairie<\/option>Un adh\u00e9rent<\/option>Un particulier<\/option><\/select><\/span>\n<\/p>\n

\n\t

<\/span>\n\t<\/p>\n<\/div>\n

\n\t

<\/span>
\nVisible sur la carte de tiers payant<\/em>\n\t<\/p>\n<\/div>\n

---

\n

<\/span>\n<\/p>\n

<\/span>\n<\/p>\n

<\/span>\n<\/p>\n

<\/span>\n<\/p>\n

<\/span>\n<\/p>\n

---

\n

Ma demande concerne\n<\/h3>\n

\n\t

La mise en place du partenariat<\/option>Information sur les diff\u00e9rents services<\/option>Autres demandes<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n

\n\t

Une information sur mon contrat<\/option>Informations sur nos services<\/option>\u00catre recontact\u00e9<\/option>Autre demande<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n

\n\t

Demande de devis \/ souscription<\/option>Informations sur les diff\u00e9rents services<\/option>\u00catre recontact\u00e9<\/option>Autre demande<\/option><\/select><\/span>\n\t<\/p>\n<\/div>\n


\n<\/textarea><\/span> <\/label>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"acceptance-320\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-320\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">En envoyant ce formulaire, vous acceptez les conditions d'utilisations. **<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap kc_captcha\" data-name=\"kc_captcha\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"captcha-image\" ><span class=\"cf7ic_instructions\">Svp prouvez que vous \u00eates un humain en s\u00e9lectionnant<span> La Voiture<\/span>.<\/span><label><input type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg width=\"50\" height=\"50\" aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 576 512\"><path fill=\"currentColor\" d=\"M488 313v143c0 13-11 24-24 24H348c-7 0-12-5-12-12V356c0-7-5-12-12-12h-72c-7 0-12 5-12 12v112c0 7-5 12-12 12H112c-13 0-24-11-24-24V313c0-4 2-7 4-10l188-154c5-4 11-4 16 0l188 154c2 3 4 6 4 10zm84-61l-84-69V44c0-6-5-12-12-12h-56c-7 0-12 6-12 12v73l-89-74a48 48 0 00-61 0L4 252c-5 4-5 12-1 17l25 31c5 5 12 5 17 1l235-193c5-4 11-4 16 0l235 193c5 5 13 4 17-1l25-31c4-6 4-13-1-17z\"\/><\/svg><\/label><label><input type=\"radio\" name=\"kc_captcha\" value=\"kc_human\" \/><svg width=\"50\" height=\"50\" aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M500 168h-55l-8-21a127 127 0 00-120-83H195a127 127 0 00-120 83l-8 21H12c-8 0-14 8-11 16l8 24a12 12 0 0011 8h29a64 64 0 00-33 56v48c0 16 6 31 16 42v62c0 13 11 24 24 24h48c13 0 24-11 24-24v-40h256v40c0 13 11 24 24 24h48c13 0 24-11 24-24v-62c10-11 16-26 16-42v-48c0-24-13-45-33-56h29a12 12 0 0011-8l8-24c3-8-3-16-11-16zm-365 2c9-25 33-42 60-42h122c27 0 51 17 60 42l15 38H120l15-38zM88 328a32 32 0 010-64c18 0 48 30 48 48s-30 16-48 16zm336 0c-18 0-48 2-48-16s30-48 48-48 32 14 32 32-14 32-32 32z\"\/><\/svg><\/label><label><input type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg width=\"50\" height=\"50\" aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 640 512\"><path fill=\"currentColor\" d=\"M624 352h-16V244c0-13-5-25-14-34L494 110c-9-9-21-14-34-14h-44V48c0-26-21-48-48-48H48C22 0 0 22 0 48v320c0 27 22 48 48 48h16a96 96 0 00192 0h128a96 96 0 00192 0h48c9 0 16-7 16-16v-32c0-9-7-16-16-16zM160 464a48 48 0 110-96 48 48 0 010 96zm320 0a48 48 0 110-96 48 48 0 010 96zm80-208H416V144h44l100 100v12z\"\/><\/svg><\/label>\r\n <\/span>\r\n <span style=\"display:none\">\r\n <input type=\"text\" name=\"kc_honeypot\">\r\n <\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Envoyer\" \/>\n<\/p>\n<hr \/>\n<p><em>* Les champs sont obligatoires<\/em><br \/>\n<em>** les donn\u00e9es personnelles recueillies sur ce formulaire sont trait\u00e9es afin de vous contacter, suite \u00e0 votre demande, pour r\u00e9pondre \u00e0 vos demandes d\u2019information. les donn\u00e9es de ce formulaire seront conserv\u00e9es pendant 1 ans \u00e0 partir du dernier contact de votre part, sauf si vous vous y opposez. la base l\u00e9gale du traitement de vos donn\u00e9es est l\u2019int\u00e9r\u00eat l\u00e9gitime. vous pouvez acc\u00e9der aux donn\u00e9es vous concernant, demander leur rectification ou leur effacement. vous pouvez aussi vous opposer au traitement de vos donn\u00e9es ou en demander la limitation. pour en savoir plus sur le traitement de vos donn\u00e9es personnelles et comment exercer ces droits vous pouvez consulter <a href=\"\/rgpd\/\" target=\"_blank\">notre politique de confidentialit\u00e9<\/a><\/em>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":29800,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":""},"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/pages\/29782"}],"collection":[{"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/comments?post=29782"}],"version-history":[{"count":3,"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/pages\/29782\/revisions"}],"predecessor-version":[{"id":29968,"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/pages\/29782\/revisions\/29968"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/media\/29800"}],"wp:attachment":[{"href":"https:\/\/associationactiom.neomind.dev\/wp-json\/wp\/v2\/media?parent=29782"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}