<html>
<!--
Complain about how broken everything is plz:
https://github.com/HerrSpace/CCC-Membership-Form/issues
-->
<head>
	<meta name="viewport" content="width=device-width">
	<style type="text/css">
		html, body {
			sacrifice: goat;
			font-family: -apple-system, BlinkMacSystemFont, Roboto, Oxygen, Ubuntu, Cantarell, "Fira Sans", "Droid Sans", "Helvetica Neue", Arial, sans-serif;
			font-size: 15px;
			line-height: 1.3;
			background-color: #ccc;
			margin: 0 !important;
			padding: 0 !important;
		}
		page[size="A4"] {
			position: relative;
			background-color: #fff;
			width: 21cm;
			height: 29.7cm;
			display: block;
			margin: 1cm auto;
			padding: 1cm 2cm;
			box-sizing: border-box;
			margin-bottom: 0.5cm;
			box-shadow: 0 0 0.5cm rgba(0,0,0,0.5);
		}

		@media print {
			@page {
				margin: 0mm;
				size: auto;
			}
			body, page[size="A4"] {
				margin: 0;
				box-shadow: 0;
				/* Thanks obama. */
				-webkit-print-color-adjust: exact;
				width: 100%;
				height: 100%;
			}
			#formpage {
				display: block !important;
			}
			#sc-container {
				display: none !important;
			}
		}

		@media screen and (max-device-width: 640px) {
			#sc-form {
				max-width: 95% !important;
			}
		}

		.falzt, .falzb, .hole {
			position: absolute;
			left: 0;
			width: 7mm;
			border-bottom: 1px black solid;
		}
		.falzt {
			top: 87mm;
		}
		.falzb {
			top: 192mm;
		}
		.hole {
			top: 148.5mm;
			width: 10mm;
		}


		.dinHead,
		.dinAddrRet,
		.dinAddrFwd,
		.dinInfo,
		.dinCont,
		.dinFoot {
			position: absolute;
			/*border: 1px solid black;*/
		}

		.dinHead {
			top: 10mm;
			left: 25mm;
			width: 165mm;
			height: 15mm;
		}

		.dinHead h1 {
			margin: 0;
		}
		.dinHead ul {
			display: inline;
		}

		.dinAddrRet {
			font-size: 10px;
			padding: 3px 0 0 0;
			left: 25mm;
			top: 27mm;
			width: 85mm;
			height: 5mm;
		}

		.dinAddrFwd {
			left: 25mm;
			top: 37mm;
			width: 85mm;
			height: 35mm;
		}

		.dinInfo {
			right: 20mm;
			top: 32mm;
			width: 65mm;
			height: 40mm;
		}

		.dinCont {
			left: 25mm;
			top: 80.46mm;
			width: 165mm;
			height: 175mm;
		}

		.dinCont h3 {
			margin-top: 0;
		}

		.dinFoot {
			left: 25mm;
			bottom: 10mm;
			width: 165mm;
			height: 18mm;
		}

		.dinFoot span {
			position: absolute;
			top: 0;
		}

		.dinFoot #uno {
			left: 0%;
			width: 33%;
		}

		.dinFoot #dos {
			left: 34%;
			width: 38%;

		}

		.dinFoot #tres {
			left: 73%;
		}


		.bold { font-weight: bold; }

		.underline {
			border: 0 !important;
			border-bottom: 1px solid black !important;
			background-color: #fff;
		}

		input[type=text],
		select,
		.underline {
			width: 100%;
			height: 22px;
			display: inline;
		}

		input[type="text"],
		select {
			/* All browsers round select, iOS browsers round.. a lot?  */
			border-radius: 0;

			padding: 1px 0px;
			border: solid 1px #dcdcdc;
			border-collapse: collapse;
			transition: box-shadow 0.3s, border 0.3s;
		}
		input[type="text"]:focus,
		input[type="text"].focus {
			border: solid 1px #707070;
			box-shadow: 0 0 5px 1px #969696;
		}

		.comment {
			display: block;
			width: 100%;
			resize: none;
			overflow: hidden;
			border: none;
			font-size: 14px;
			line-height: 18px;
		}

		#comment {
			background-size: 100% 18px;

			background-image: -moz-repeating-linear-gradient(180deg, transparent, transparent 17px, black);
			background-image: -webkit-repeating-linear-gradient(180deg, transparent, transparent 17px, black);
			background-image: -o-repeating-linear-gradient(180deg, transparent, transparent 17px, black);
			background-image: repeating-linear-gradient(180deg, transparent, transparent 17px, black);
		}
		#sc-comment {
			margin-top: 10px;
			height: auto !important;

			background-image: -moz-repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
			background-image: -webkit-repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
			background-image: -o-repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
			background-image: repeating-linear-gradient(180deg, transparent, transparent 17px, #dcdcdc);
			background-size: 100% 18px;
		}

		#qrCode {
			position: absolute;
			width: 200;
			height: 200;
			right: 0;
			bottom: 0;
		}

		#letterHead ul {
			list-style-type: none;
		}
		#letterHead ul li {
			display: inline;
		}
		#personalInfo div div,
		.signfield {
			float: left;
			box-sizing: border-box;
			padding: 2px 2px;
		}
		.signfield span {
			text-align: center;
			font-size: 10px;
		}
		#personalInfo div div span {
			font-size: 10px;
			padding: 2px 0;
			/*margin-top: 10px;*/
		}

		.dinCont li {
			margin-bottom: 7px;
		}

		#sc-container {
			/* The sanity checker is enabled via JS.
			   This way the form can also work in tinfoil hat browsers.*/
			display: none;

			position: absolute;
			z-index: 10;
			transition: 0.5s;

			top: 0;
			left: 0;
			height: 100%;
			width: 100%;
			overflow-y: scroll;
			background-color: #3D3D3D;
		}
		#sc-form {
			margin: 0 auto;
			padding: 1.5em 0;
			max-width: 30em;
			font-weight: 50;
			color: #fff;
		}
		#sc-form input[type=text],
		#sc-form select,
		#sc-form button,
		#sc-form textarea	{
			-webkit-appearance: none;
			-moz-appearance : none;
			height: 44px;
			padding: 0 8px;
			margin-top: -1px;
			background-color: #3D3D3D;
			color: white;
		}
		#sc-form select option {
			background-color: #3D3D3D;
		}
		#sc-form label, .sc-payment-title  {
			margin-top: 9px;
			margin-bottom: 2px;
			display: block;
		}
		#show-form {
			font-size: 14px;
			color: rgba(0, 0, 0, 0.6) !important;
			background-color: #3edd55 !important;
			width: 100%;
			border: none;
			border-radius: 0;
			text-align: center;
			text-decoration: none;
		}

		#sc-form a:link,
		#sc-form a:visited { color: #3eccdd; }
		#sc-form a:hover   { color: #7FDBFF; }
		#sc-form a         { color: #3eccdd;
					transition: color .1s;}


		.sc-payment-switch {
			overflow: hidden;
			width: 100%;
		}

		.sc-payment-switch input {
			position: absolute !important;
			clip: rect(0, 0, 0, 0);
			height: 1px;
			width: 1px;
			border: 0;
			overflow: hidden;
		}

		.sc-payment-switch label {
			padding-top: 12px;
			float: left;
			box-sizing: border-box;
			width: 50%;
			height: 44px;
			margin-bottom: 0;
			background-color: #e4e4e4;
			color: rgba(0, 0, 0, 0.6);
			font-size: 14px;
			text-align: center;
			border: 1px solid rgba(220, 220, 220, 0.2);*/
			transition: all 0.1s ease-in-out;
		}

		.sc-payment-switch label:hover {
			cursor: pointer;
		}

		.sc-payment-switch input:checked + label {
			background-color: #3edd55;
			-webkit-box-shadow: none;
			box-shadow: none;
		}
	</style>
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		https://github.com/dankogai/js-base64
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		/*! QRious v4.0.2 | (C) 2017 Alasdair Mercer | GPL v3 License
		Based on jsqrencode | (C) 2010 tz@execpc.com | GPL v3 License
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e,i,n,s,r,o=t.value.length;for(this._badness=[],this._level=l.LEVELS[t.level],this._polynomial=[],this._value=t.value,this._version=0,this._stringBuffer=[];this._version<40&&(this._version++,n=4*(this._level-1)+16*(this._version-1),s=l.BLOCKS[n++],r=l.BLOCKS[n++],e=l.BLOCKS[n++],i=l.BLOCKS[n],n=e*(s+r)+r-3+(this._version<=9),!(o<=n)););this._dataBlock=e,this._eccBlock=i,this._neccBlock1=s,this._neccBlock2=r;var a=this.width=17+4*this._version;this.buffer=v._createArray(a*a),this._ecc=v._createArray(e+(e+i)*(s+r)+r),this._mask=v._createArray((a*(a+1)+1)/2),this._insertFinders(),this._insertAlignments(),this.buffer[8+a*(a-8)]=1,this._insertTimingGap(),this._reverseMask(),this._insertTimingRowAndColumn(),this._insertVersion(),this._syncMask(),this._convertBitStream(o),this._calculatePolynomial(),this._appendEccToData(),this._interleaveBlocks(),this._pack(),this._finish()},{_addAlignment:function(t,e){var i,n=this.buffer,s=this.width;for(n[t+s*e]=1,i=-2;i<2;i++)n[t+i+s*(e-2)]=1,n[t-2+s*(e+i+1)]=1,n[t+2+s*(e+i)]=1,n[t+i+1+s*(e+2)]=1;for(i=0;i<2;i++)this._setMask(t-1,e+i),this._setMask(t+1,e-i),this._setMask(t-i,e-1),this._setMask(t+i,e+1)},_appendData:function(t,e,i,n){var s,r,o,a=this._polynomial,h=this._stringBuffer;for(r=0;r<n;r++)h[i+r]=0;for(r=0;r<e;r++){if(255!==(s=_.LOG[h[t+r]^h[i]]))for(o=1;o<n;o++)h[i+o-1]=h[i+o]^_.EXPONENT[v._modN(s+a[n-o])];else for(o=i;o<i+n;o++)h[o]=h[o+1];h[i+n-1]=255===s?0:_.EXPONENT[v._modN(s+a[0])]}},_appendEccToData:function(){var t,e=0,i=this._dataBlock,n=this._calculateMaxLength(),s=this._eccBlock;for(t=0;t<this._neccBlock1;t++)this._appendData(e,i,n,s),e+=i,n+=s;for(t=0;t<this._neccBlock2;t++)this._appendData(e,i+1,n,s),e+=i+1,n+=s},_applyMask:function(t){var e,i,n,s,r=this.buffer,o=this.width;switch(t){case 0:for(s=0;s<o;s++)for(n=0;n<o;n++)n+s&1||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 1:for(s=0;s<o;s++)for(n=0;n<o;n++)1&s||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 2:for(s=0;s<o;s++)for(e=0,n=0;n<o;n++,e++)3===e&&(e=0),e||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 3:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=i,n=0;n<o;n++,e++)3===e&&(e=0),e||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 4:for(s=0;s<o;s++)for(e=0,i=s>>1&1,n=0;n<o;n++,e++)3===e&&(e=0,i=!i),i||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 5:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=0,n=0;n<o;n++,e++)3===e&&(e=0),(n&s&1)+!(!e|!i)||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 6:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=0,n=0;n<o;n++,e++)3===e&&(e=0),(n&s&1)+(e&&e===i)&1||this._isMasked(n,s)||(r[n+s*o]^=1);break;case 7:for(i=0,s=0;s<o;s++,i++)for(3===i&&(i=0),e=0,n=0;n<o;n++,e++)3===e&&(e=0),(e&&e===i)+(n+s&1)&1||this._isMasked(n,s)||(r[n+s*o]^=1)}},_calculateMaxLength:function(){return this._dataBlock*(this._neccBlock1+this._neccBlock2)+this._neccBlock2},_calculatePolynomial:function(){var t,e,i=this._eccBlock,n=this._polynomial;for(n[0]=1,t=0;t<i;t++){for(n[t+1]=1,e=t;e>0;e--)n[e]=n[e]?n[e-1]^_.EXPONENT[v._modN(_.LOG[n[e]]+t)]:n[e-1];n[0]=_.EXPONENT[v._modN(_.LOG[n[0]]+t)]}for(t=0;t<=i;t++)n[t]=_.LOG[n[t]]},_checkBadness:function(){var t,e,i,n,s,r=0,o=this._badness,a=this.buffer,h=this.width;for(s=0;s<h-1;s++)for(n=0;n<h-1;n++)(a[n+h*s]&&a[n+1+h*s]&&a[n+h*(s+1)]&&a[n+1+h*(s+1)]||!(a[n+h*s]||a[n+1+h*s]||a[n+h*(s+1)]||a[n+1+h*(s+1)]))&&(r+=v.N2);var f=0;for(s=0;s<h;s++){for(i=0,o[0]=0,t=0,n=0;n<h;n++)t===(e=a[n+h*s])?o[i]++:o[++i]=1,f+=(t=e)?1:-1;r+=this._getBadness(i)}f<0&&(f=-f);var c=0,u=f;for(u+=u<<2,u<<=1;u>h*h;)u-=h*h,c++;for(r+=c*v.N4,n=0;n<h;n++){for(i=0,o[0]=0,t=0,s=0;s<h;s++)t===(e=a[n+h*s])?o[i]++:o[++i]=1,t=e;r+=this._getBadness(i)}return r},_convertBitStream:function(t){var e,i,n=this._ecc,s=this._version;for(i=0;i<t;i++)n[i]=this._value.charCodeAt(i);var r=this._stringBuffer=n.slice(),o=this._calculateMaxLength();t>=o-2&&(t=o-2,s>9&&t--);var a=t;if(s>9){for(r[a+2]=0,r[a+3]=0;a--;)e=r[a],r[a+3]|=255&e<<4,r[a+2]=e>>4;r[2]|=255&t<<4,r[1]=t>>4,r[0]=64|t>>12}else{for(r[a+1]=0,r[a+2]=0;a--;)e=r[a],r[a+2]|=255&e<<4,r[a+1]=e>>4;r[1]|=255&t<<4,r[0]=64|t>>4}for(a=t+3-(s<10);a<o;)r[a++]=236,r[a++]=17},_getBadness:function(t){var e,i=0,n=this._badness;for(e=0;e<=t;e++)n[e]>=5&&(i+=v.N1+n[e]-5);for(e=3;e<t-1;e+=2)n[e-2]===n[e+2]&&n[e+2]===n[e-1]&&n[e-1]===n[e+1]&&3*n[e-1]===n[e]&&(0===n[e-3]||e+3>t||3*n[e-3]>=4*n[e]||3*n[e+3]>=4*n[e])&&(i+=v.N3);return i},_finish:function(){this._stringBuffer=this.buffer.slice();var t,e,i=0,n=3e4;for(e=0;e<8&&(this._applyMask(e),(t=this._checkBadness())<n&&(n=t,i=e),7!==i);e++)this.buffer=this._stringBuffer.slice();i!==e&&this._applyMask(i),n=l.FINAL_FORMAT[i+(this._level-1<<3)];var s=this.buffer,r=this.width;for(e=0;e<8;e++,n>>=1)1&n&&(s[r-1-e+8*r]=1,e<6?s[8+r*e]=1:s[8+r*(e+1)]=1);for(e=0;e<7;e++,n>>=1)1&n&&(s[8+r*(r-7+e)]=1,e?s[6-e+8*r]=1:s[7+8*r]=1)},_interleaveBlocks:function(){var t,e,i=this._dataBlock,n=this._ecc,s=this._eccBlock,r=0,o=this._calculateMaxLength(),a=this._neccBlock1,h=this._neccBlock2,f=this._stringBuffer;for(t=0;t<i;t++){for(e=0;e<a;e++)n[r++]=f[t+e*i];for(e=0;e<h;e++)n[r++]=f[a*i+t+e*(i+1)]}for(e=0;e<h;e++)n[r++]=f[a*i+t+e*(i+1)];for(t=0;t<s;t++)for(e=0;e<a+h;e++)n[r++]=f[o+t+e*s];this._stringBuffer=n},_insertAlignments:function(){var t,e,i,n=this._version,s=this.width;if(n>1)for(t=u.BLOCK[n],i=s-7;;){for(e=s-7;e>t-3&&(this._addAlignment(e,i),!(e<t));)e-=t;if(i<=t+9)break;i-=t,this._addAlignment(6,i),this._addAlignment(i,6)}},_insertFinders:function(){var t,e,i,n,s=this.buffer,r=this.width;for(t=0;t<3;t++){for(e=0,n=0,1===t&&(e=r-7),2===t&&(n=r-7),s[n+3+r*(e+3)]=1,i=0;i<6;i++)s[n+i+r*e]=1,s[n+r*(e+i+1)]=1,s[n+6+r*(e+i)]=1,s[n+i+1+r*(e+6)]=1;for(i=1;i<5;i++)this._setMask(n+i,e+1),this._setMask(n+1,e+i+1),this._setMask(n+5,e+i),this._setMask(n+i+1,e+5);for(i=2;i<4;i++)s[n+i+r*(e+2)]=1,s[n+2+r*(e+i+1)]=1,s[n+4+r*(e+i)]=1,s[n+i+1+r*(e+4)]=1}},_insertTimingGap:function(){var t,e,i=this.width;for(e=0;e<7;e++)this._setMask(7,e),this._setMask(i-8,e),this._setMask(7,e+i-7);for(t=0;t<8;t++)this._setMask(t,7),this._setMask(t+i-8,7),this._setMask(t,i-8)},_insertTimingRowAndColumn:function(){var t,e=this.buffer,i=this.width;for(t=0;t<i-14;t++)1&t?(this._setMask(8+t,6),this._setMask(6,8+t)):(e[8+t+6*i]=1,e[6+i*(8+t)]=1)},_insertVersion:function(){var 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			<p>
				Daten, die in dieses Antragsformular eingetragen werden, gehen <span class="bold">nicht</span> über das Internet. Die Daten werden ausschließlich im Web-Browser verarbeitet und im fertigen Formular maschinenlesbar dargestellt. Dies hilft uns Anträge schneller zu berarbeiten.
			</p>

			<p>
				Ich möchte <span class="bold">Fördermitglied im Chaos Computer Club e. V.</span> werden (unregelmäßig und <span class="bold">selten</span> erscheinende Datenschleuder inklusive) und habe <a href="https://www.ccc.de/de/satzung">die Satzung</a> und <a href="https://www.ccc.de/de/faq">FAQ</a> gelesen.
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				<label for="sc-regular">Normal (72€)</label>
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				<label for="sc-reduced">Ermäßigt (36€ mit Nachweis)</label>
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				<option value="CM">Kamerun</option>
				<option value="CA">Kanada</option>
				<option value="CV">Kap Verde</option>
				<option value="KY">Kaimaninseln</option>
				<option value="CF">Zentralafrikanische Republik</option>
				<option value="TD">Tschad</option>
				<option value="CL">Chile</option>
				<option value="CN">China</option>
				<option value="CX">Weihnachtsinsel</option>
				<option value="CC">Kokosinseln</option>
				<option value="CO">Kolumbien</option>
				<option value="KM">Komoren</option>
				<option value="CK">Cookinseln</option>
				<option value="CR">Costa Rica</option>
				<option value="HR">Kroatien</option>
				<option value="CU">Kuba</option>
				<option value="CW">Curacao</option>
				<option value="CY">Zypern</option>
				<option value="CZ">Tschechische Republik</option>
				<option value="CD">Demokratische Republik Kongo</option>
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				<option value="DJ">Dschibuti</option>
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				<option value="TL">Osttimor</option>
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				<option value="FK">Falkland-Inseln</option>
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				<option value="GA">Gabun</option>
				<option value="GM">Gambia</option>
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				<option value="GR">Griechenland</option>
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				<option value="GD">Grenada</option>
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				<option value="GW">Guinea-Bissau</option>
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				<option value="MY">Malaysia</option>
				<option value="MV">Malediven</option>
				<option value="ML">Mali</option>
				<option value="MT">Malta</option>
				<option value="MH">Marshallinseln</option>
				<option value="MQ">Martinique</option>
				<option value="MR">Mauretanien</option>
				<option value="MU">Mauritius</option>
				<option value="YT">Mayotte</option>
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				<option value="FM">Mikronesien</option>
				<option value="MD">Moldawien</option>
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				<option value="ME">Montenegro</option>
				<option value="MS">Montserrat</option>
				<option value="MA">Marokko</option>
				<option value="MZ">Mosambik</option>
				<option value="MM">Myanmar</option>
				<option value="NA">Namibia</option>
				<option value="NR">Nauru</option>
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				<option value="RO">Rumänien</option>
				<option value="RU">Russland</option>
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				<option value="SH">St. Helena</option>
				<option value="KN">St. Kitts und Nevis</option>
				<option value="LC">St. Lucia</option>
				<option value="MF">St. Martin</option>
				<option value="PM">Saint-Pierre und Miquelon</option>
				<option value="VC">St. Vincent und die Grenadinen</option>
				<option value="WS">Samoa</option>
				<option value="SM">San Marino</option>
				<option value="ST">São Tomé und Príncipe</option>
				<option value="SA">Saudi-Arabien</option>
				<option value="SN">Senegal</option>
				<option value="RS">Serbien</option>
				<option value="CS">Serbien und Montenegro</option>
				<option value="SC">Seychellen</option>
				<option value="SL">Sierra Leone</option>
				<option value="SG">Singapur</option>
				<option value="SX">Sint Maarten</option>
				<option value="SK">Slowakei</option>
				<option value="SI">Slowenien</option>
				<option value="SB">Salomon-Inseln</option>
				<option value="SO">Somalia</option>
				<option value="ZA">Südafrika</option>
				<option value="GS">Südgeorgien und die Südlichen Sandwichinseln</option>
				<option value="KR">Südkorea</option>
				<option value="SS">Südsudan</option>
				<option value="ES">Spanien</option>
				<option value="LK">Sri Lanka</option>
				<option value="SD">Sudan</option>
				<option value="SR">Suriname</option>
				<option value="SJ">Svalbard und Jan Mayen</option>
				<option value="SZ">Swasiland</option>
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				<option value="SY">Syrien</option>
				<option value="TW">Taiwan</option>
				<option value="TJ">Tadschikistan</option>
				<option value="TZ">Tansania</option>
				<option value="TH">Thailand</option>
				<option value="TG">Togo</option>
				<option value="TK">Tokelau</option>
				<option value="TO">Tonga</option>
				<option value="TT">Trinidad und Tobago</option>
				<option value="TN">Tunesien</option>
				<option value="TR">Türkei</option>
				<option value="TM">Turkmenistan</option>
				<option value="TC">Turks- und Caicosinseln</option>
				<option value="TV">Tuvalu</option>
				<option value="VI">Amerikanische Jungferninseln</option>
				<option value="UG">Uganda</option>
				<option value="UA">Ukraine</option>
				<option value="AE">Vereinte Arabische Emirate</option>
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				<option value="UZ">Usbekistan</option>
				<option value="VU">Vanuatu</option>
				<option value="VA">Vatikanstadt</option>
				<option value="VE">Venezuela</option>
				<option value="VN">Vietnam</option>
				<option value="WF">Wallis und Futuna</option>
				<option value="EH">Westsahara</option>
				<option value="YE">Jemen</option>
				<option value="ZM">Sambia</option>
				<option value="ZW">Simbabwe</option>
			</select>

			<label for="sc-email">E-Mail-Adresse</label>
			<input type="text" name="sc-email" pattern=".+@.+\..+" maxlength="50" placeholder="h.acker@example.com" required>

			<label for="sc-pgp">Optional: PGP-Key ID (Key muss auf den Key-Servern sein)</label>
			<input type="text" name="sc-pgp" pattern="(0x)?[0-9a-fA-F]{16}([0-9a-fA-F]{24})?" maxlength="50" placeholder="0x1337cafe2342feed" onblur="this.value = this.value.replace(/\s/g, '');">

			<label><input type="checkbox" name="sc-consent">Über wichtige Vereinsangelegenheiten möchte ich per Mail oder ersatzweise brieflich informiert werden.</label>

			<button id="show-form" type="submit">Drucken</button>

			<label for="sc-comment">Bemerkungen</label>
			<textarea class="comment" id="sc-comment" name="sc-comment" rows="3" maxlength="144"></textarea>

			<br>
			<p>
				Solltest du Probleme mit diesem Formular haben, möchten wir <a href="https://github.com/HerrSpace/CCC-Membership-Form/issues">diese gerne erfahren</a>. Alternativ kannst du <a href="https://www.ccc.de/system/uploads/269/original/Supporterform-de-v5.pdf">diesen PDF Antrag</a> ausfüllen.
			</p>
		</form>
	</div>
	<page size="A4" id="formpage">
		<span class="falzt"></span>
		<span class="falzb"></span>
		<span class="hole"></span>

		<div class="dinHead">
			<h1>Chaos Computer Club e. V.</h1>
			<span><a href="mailto:office@ccc.de">office@ccc.de</a> • <a href="https://www.ccc.de/de/membership">https://www.ccc.de/de/membership</a></span>
		</div>

		<div class="dinAddrRet"></div>
		<div class="dinAddrFwd">
			Chaos Computer Club e. V.<br/>Zeiseweg 9<br/>22765 Hamburg<br/>Germany
		</div>

		<div class="dinInfo">
			<canvas id="qrCode"></canvas>
		</div>

		<div class="dinCont">

			<h3>Antrag auf Fördermitgliedschaft im Chaos Computer Club e. V.</h3>

			<form id="application" action="#">
				<input type="hidden" name="version" value="1"/>
				<p>
					Ich möchte <span class="bold">Fördermitglied im Chaos Computer Club e. V.</span> werden (unregelmäßig und <span class="bold">selten</span> erscheinende Datenschleuder inklusive) und habe die Satzung (<a href="https://www.ccc.de/de/satzung">https://www.ccc.de/de/satzung</a>) und FAQ (<a href="https://www.ccc.de/de/faq">https://www.ccc.de/de/faq</a>) gelesen.
				</p>
				<p>
					<input type="radio" name="payment" value="regular" id="regular" onclick="return false;">
					<label for="regular"><span class="bold">Normale</span> Fördermitgliedschaft für <span class="bold">72€</span> pro Jahr oder</label><br/>
					<input type="radio" name="payment" value="reduced" id="reduced" onclick="return false;">
					<label for="reduced"><span class="bold">Ermäßigte</span> Fördermitgliedschaft für <span class="bold">36€</span> pro Jahr. Einen <span class="bold">Nachweis</span>, aus dem einer der folgenden Ermäßigungsgründe hervorgeht, lege ich in Kopie bei: Studium, Schule, Arbeitslosigkeit, Umschulung, Rente oder Behinderung.</label>
				</p>
				<p>
					<div id="personalInfo">
						<div>
							<div style="width: 33%;">
								<input type="text" name="firstname">
								<span>Vorname</span>
							</div>
							<div style="width: 33%;">
								<input type="text" name="lastname">
								<span>Nachname</span>
							</div>
							<div style="width: 34%;">
								<input type="text" name="addr3">
								<span>Optional: Adresszusatz, Organisation oder c/o</span>
							</div>
						</div>
						<div>
							<div style="width: 50%;">
								<input type="text" name="addr1">
								<span>Straße und Hausnummer</span>
							</div>
							<div style="width: 30%;">
								<input type="text" name="addr2">
								<span>Postleitzahl und Stadt</span>
							</div>
							<div style="width: 20%;">
								<input type="text" name="country">
								<span>Land</span>
							</div>
						</div>
						<div>
							<div style="width: 50%;">
								<input type="text" name="email">
								<span class="bold">E-Mail-Adresse – (Bitte unbedingt angeben!)</span>
							</div>
							<div style="width: 50%;">
								<input type="text" name="pgp">
								<span>Optional: PGP-Key ID (Key muss auf den <span class="bold">Key-Servern</span> sein)</span>
							</div>
						</div>
					</div>
					<div>
						<div style="width: 100%;">
							<input type="checkbox" name="consent">
							<span>Über wichtige Vereinsangelegenheiten möchte ich per Mail oder ersatzweise brieflich informiert werden.</span>
						</div>
					</div>
				</p>
				<p>
					<span>Dieses Formular ausdrucken und <span class="bold">handschriftlich</span> unterzeichnen</span>
				</p>
				<p style="height: 5px">
					<div class="signfield" style="width: 20%">
						<span class="underline"></span>
						<input type="text" name="date" class="underline">
						<span>Datum</span>
					</div>
					<div class="signfield" style="width: 80%">
						<span class="underline"></span>
						<input type="text" name="signature" class="underline" readonly>
						<span>Unterschrift (bei Minderjährigen Unterschrift der Erziehungsberechtigten)</span>
					</div>
				</p>
			</form>
			<p>
				<span>Diesen Antrag <span class="bold">vorzugsweise</span> einscannen und <span class="bold">per E-Mail an <a href="mailto:office@ccc.de">office@ccc.de</a></span> senden oder ausreichend frankiert per Post senden. <span class="bold">Einschreiben oder nicht ausreichend frankierte Briefe werden nicht angenommen!</span> Es ist einfach tagsüber niemand da um die Post anzunehmen.
			</p>
			<p>
				<span>Die E-Mail von <a href="mailto:office@ccc.de">office@ccc.de</a> (PGP-Key zu finden auf <a href="https://www.ccc.de/de/office">https://www.ccc.de/de/office</a>) mit Bestätigung und weiteren Anweisungen sollte <span class="bold">binnen drei Wochen</span> eintreffen. Zum Jahresende kann dies noch länger dauern.</span>
			</p>
			<span class="underline">Bemerkungen:</span>
			<textarea class="comment" id="comment" name="comment" rows="3"></textarea>
		</div>

		<div class="dinFoot">
			<span id="uno"><span class="bold">Verein:</span><br/>Eingetragen beim Vereinsgericht Hamburg unter der Vereinsregister-<br/>nummer: 10940</span>
			<span id="dos"><span class="bold">Internet:</span><br/>Webseite: <a href="https://www.ccc.de/">https://www.ccc.de/</a> Regionale Erfakreise und Chaostreffs: <a href="https://www.ccc.de/regional">https://www.ccc.de/regional</a></span>
			<span id="tres"><span class="bold">Kontakt:</span><br/>Allgemeine Anfragen: <a href="mailto:mail@ccc.de">mail@ccc.de</a><br/>Mitgliederverwaltung: <a href="mailto:office@ccc.de">office@ccc.de</a></span>
		</div>
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