{{ define "main" }} <section class="section" data-pagefind-body> <div class="container"> <div class="row"> <div class="col-lg-8 mb-4 mb-lg-0"> <form action="https://forms.cantorgymnasium.de/form/gcg-aufnahmeformular" method="post" enctype="multipart/form-data"> <div hidden> <input type="text" id="bad_email" name="bad_email" value="" /> </div> <div class="input-group"> <input type="text" class="form-control mb-3" id="student_surname" name="student_surname" placeholder="Name (Schüler/in)" required> <input type="text" class="form-control mb-3" id="student_name" name="student_name" placeholder="Vorname" required> </div> <div class="input-group mb-3"> <input type="text" class="form-control" id="student_sex" name="student_sex" placeholder="Geschlecht" required> <span class="input-group-text">Geburtsdatum</span> <input type="date" class="form-control" id="student_birthday" name="student_birthday" min="2005-01-01" required> </div> <input type="text" class="form-control mb-3" id="street" name="street" placeholder="Straße" required> <div class="input-group"> <input type="text" class="form-control mb-3" id="house" name="house" placeholder="Hausnummer" required> <input type="text" class="form-control mb-3" id="adresszusatz" name="adresszusatz" placeholder="Adresszusatz"> </div> <div class="input-group"> <input type="text" inputmode="numeric" class="form-control mb-3" id="zipcode" name="zipcode" placeholder="PLZ" pattern="[0-9]{5}" title="Postleitzahlen bestehen aus exakt 5 Ziffern" required> <input type="text" class="form-control mb-3" id="city" name="city" placeholder="Stadt" required> </div> <input type="text" class="form-control mb-3" id="landkreis" name="landkreis" placeholder="Landkreis"> <div class="input-group"> <input type="tel" class="form-control mb-3" id="tpriv" name="tpriv" placeholder="Telefon privat"> <input type="tel" class="form-control mb-3" id="tdienstl" name="tdienstl" placeholder="Telefon dienstl."> </div> <div class="input-group"> <select class="form-control" name="anrede_1" id="anrede_1" required> <option value="keine Angabe">keine Angabe</option> <option value="Herr">Herr</option> <option value="Frau">Frau</option> </select> <input type="text" class="form-control" id="parent_name_1" name="parent_name_1" placeholder="Nachname (Erziehungsberechtigter 1)" required> </div> <div class="input-group mb-3"> <select class="form-control" name="anrede_2" id="anrede_2"> <option value="keine Angabe">keine Angabe</option> <option value="Herr">Herr</option> <option value="Frau">Frau</option> </select> <input type="text" class="form-control" id="parent_name_2" name="parent_name_2" placeholder="Nachname (Erziehungsberechtigter 2)"> </div> <input type="text" class="form-control mb-3" id="grundschule" name="grundschule" placeholder="Grundschule" required> <input type="email" class="form-control mb-3" id="parent_email" name="parent_email" placeholder="Ihre E-Mail-Adresse" required> <textarea id="message" name="message" class="form-control mb-3" placeholder="Bemerkungen"></textarea> <div class="input-group mb-3"> <input type="file" class="form-control" id="zeugnis_1" name="zeugnis_1" accept="image/*,.pdf"> <span class="input-group-text">Zeugnis (Vorderseite)</span> </div> <div class="input-group mb-3"> <input type="file" class="form-control" id="zeugnis_2" name="zeugnis_2" accept="image/*,.pdf"> <span class="input-group-text">Zeugnis (Rückseite)</span> </div> <div class="input-group mb-3"> <input type="file" class="form-control" id="slbe" name="slbe" accept="image/*,.pdf"> <span class="input-group-text">Schullaufbahnempfehlung</span> </div> <div class="input-group mb-3"> <div class="input-group-text"> <input type="checkbox" class="form-check-input" id="accept" name="accept" required> </div> <p class="form-control mb-0">Hiermit melden wir unser Kind verbindlich zur Aufnahmeprüfung an.</p> </div> <button type="submit" value="send" class="btn btn-primary">Senden</button> </form> </div> <div class="col-lg-4"> {{ .Content }} </div> </div> </div> </section> {{ end }}