{"id":102145,"date":"2026-10-11T15:05:13","date_gmt":"2026-10-11T13:05:13","guid":{"rendered":"https:\/\/welem.com\/enr\/?page_id=102145"},"modified":"2026-10-11T15:19:30","modified_gmt":"2026-10-11T13:19:30","slug":"demande-installation-devis-installation-borne-de-recharge-vehicule-electrique","status":"publish","type":"page","link":"https:\/\/welem.com\/enr\/demande-installation-devis-installation-borne-de-recharge-vehicule-electrique\/","title":{"rendered":"Demande devis pour installation borne de recharge v\u00e9hicule \u00e9lectrique"},"content":{"rendered":"<style type=\"text\/css\"> \n#cmsms_row_6acbcb5e51799 .cmsms_row_outer_parent { \n\tpadding-top: 30px; \n} \n\n#cmsms_row_6acbcb5e51799 .cmsms_row_outer_parent { \n\tpadding-bottom: 0px; \n} \n\n \n#cmsms_notice_6acbcb5e5186e { \n\tbackground-color:#4f3d3c; \n\tborder-color:#bfd029; \n\tcolor:#cccccc; \n} \n.cmsms_notice:before {\n\n\tcolor:#bfd029; \n}\n \n#cmsms_notice_6acbcb5e51957 { \n\tbackground-color:#4f3d3c; \n\tborder-color:#fcbd16; \n\tcolor:#fcbd16; \n} \n.cmsms_notice:before {\n\n\tcolor:#fcbd16; \n}\n \n#cmsms_row_6acbcb5e51de0 .cmsms_row_outer_parent { \n\tpadding-top: 0px; \n} \n\n#cmsms_row_6acbcb5e51de0 .cmsms_row_outer_parent { \n\tpadding-bottom: 50px; \n} \n\n<\/style><div id=\"cmsms_row_6acbcb5e51799\" class=\"cmsms_row cmsms_color_scheme_default\">\n<div class=\"cmsms_row_outer_parent\">\n<div class=\"cmsms_row_outer\">\n<div class=\"cmsms_row_inner\">\n<div class=\"cmsms_row_margin\">\n<div class=\"cmsms_column two_third\">\n<div id=\"cmsms_notice_6acbcb5e5186e\" class=\"cmsms_notice cmsms_notice_custom\">\n<div class=\"notice_icon\"><\/div>\n<div class=\"notice_content\">\n<p>Pour votre projet pompe \u00e0 chaleur, faites appel \u00e0 WELEM, soci\u00e9t\u00e9 exp\u00e9riment\u00e9e et reconnue localement. Comme de nombreux clients qui nous ont fait confiance, vous appr\u00e9cierez le conseil, la qualit\u00e9 de pose et le service apr\u00e8s-vente de notre soci\u00e9t\u00e9.<\/p>\n<\/div>\n<\/div>\n<div id=\"cmsms_notice_6acbcb5e51957\" class=\"cmsms_notice cmsms_notice_custom cmsms-icon-warning-empty\" data-animation=\"rollIn\" data-delay=\"0\">\n<div class=\"notice_icon\"><\/div>\n<div class=\"notice_content\">\n<p>Ne pas d\u00e9passer 4 Mb pour la taille de vos fichiers image<\/p>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"cmsms_column one_third\">\n<div class=\"cmsms_img  cmsms_image_n\" data-animation=\"flipInX\" data-delay=\"0\">\n<img decoding=\"async\" src=\"https:\/\/welem.com\/enr\/wp-content\/uploads\/WlmZAPPI-300x227.jpg\" \/>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div id=\"cmsms_row_6acbcb5e51de0\" class=\"cmsms_row cmsms_color_scheme_default\">\n<div class=\"cmsms_row_outer_parent\">\n<div class=\"cmsms_row_outer\">\n<div class=\"cmsms_row_inner\">\n<div class=\"cmsms_row_margin\">\n<div class=\"cmsms_column one_first\">\n<div class=\"cmsms_text\">\n<p><script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_12' style='display:none'>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_12'  action='\/enr\/wp-json\/wp\/v2\/pages\/102145' data-formid='12' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_12' class='gform_fields top_label form_sublabel_above description_below validation_below'><div id=\"field_12_13\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations de contact<\/h3><\/div><fieldset id=\"field_12_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Demandeur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_12_1'>\n                            \n                            <span id='input_12_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_12_1_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_1.3' id='input_12_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" \/>\n                                                <\/span>\n                            \n                            <span id='input_12_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_12_1_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_1.6' id='input_12_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_12_16\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adresse<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_12_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_12_16_1_container' >\n                                        <label for='input_12_16_1' id='input_12_16_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                        <input type='text' name='input_16.1' id='input_12_16_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_12_16_3_container' >\n                                    <label for='input_12_16_3' id='input_12_16_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                    <input type='text' name='input_16.3' id='input_12_16_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_16.4' id='input_12_16_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_12_16_5_container' >\n                                    <label for='input_12_16_5' id='input_12_16_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                    <input type='text' name='input_16.5' id='input_12_16_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_12_16_6' value='FR' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><div class='gfield_description' id='gfield_description_12_16'>ATTENTION, nous r\u00e9pondons aux  demandes de devis uniquement pour une installation dans le Finist\u00e8re. <\/div><\/fieldset><div id=\"field_12_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_2'><span class='gform-field-label__text'>Email<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_12_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_12_14\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-international gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_14'><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_14' id='input_12_14' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/div><div id=\"field_12_77\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Localisation chantier<\/h3><\/div><fieldset id=\"field_12_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Localisation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_69'>\n\t\t\t<div class='gchoice gchoice_12_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Idem adresse du demandeur' checked='checked' id='choice_12_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_69_0' id='label_12_69_0' class='gform-field-label gform-field-label--type-inline'>Idem adresse du demandeur<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Adresse diff\u00e9rente'  id='choice_12_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_69_1' id='label_12_69_1' class='gform-field-label gform-field-label--type-inline'>Adresse diff\u00e9rente<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_72\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adresse chantier<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip ginput_container_address gform-grid-row' id='input_12_72' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_12_72_1_container' >\n                                        <label for='input_12_72_1' id='input_12_72_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                        <input type='text' name='input_72.1' id='input_12_72_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_12_72_3_container' >\n                                    <label for='input_12_72_3' id='input_12_72_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                    <input type='text' name='input_72.3' id='input_12_72_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_72.4' id='input_12_72_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_12_72_5_container' >\n                                    <label for='input_12_72_5' id='input_12_72_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                    <input type='text' name='input_72.5' id='input_12_72_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_72.6' id='input_12_72_6' value='' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_12_23\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Caract\u00e9ristiques du b\u00e2timent<\/h3><\/div><fieldset id=\"field_12_63\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Type de b\u00e2timent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_63'>\n\t\t\t<div class='gchoice gchoice_12_63_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Maison d&#039;habitation'  id='choice_12_63_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_63_0' id='label_12_63_0' class='gform-field-label gform-field-label--type-inline'>Maison d'habitation<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_63_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Appartement'  id='choice_12_63_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_63_1' id='label_12_63_1' class='gform-field-label gform-field-label--type-inline'>Appartement<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_63_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='B\u00e2timent tertiaire'  id='choice_12_63_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_63_2' id='label_12_63_2' class='gform-field-label gform-field-label--type-inline'>B\u00e2timent tertiaire<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_63_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='Entrep\u00f4t'  id='choice_12_63_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_63_3' id='label_12_63_3' class='gform-field-label gform-field-label--type-inline'>Entrep\u00f4t<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_63_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_63' type='radio' value='gf_other_choice'  id='choice_12_63_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_63_4' id='label_12_63_4' class='gform-field-label gform-field-label--type-inline'>Autre<\/label><br \/><input id='input_12_63_other' class='gchoice_other_control' name='input_63_other' type='text' value='Autre' aria-label='Autre choix, veuillez sp\u00e9cifier'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_38\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_38'><span class='gform-field-label__text'>Photo d&#039;ensemble du b\u00e2timent<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='4194304' \/><input name='input_38' id='input_12_38' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_38\" onchange='javascript:gformValidateFileSize( this, 4194304 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_38'>Types de fichiers accept\u00e9s\u00a0: jpg, gif, png, pdf, Taille max. des fichiers\u00a0: 4 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_38'><\/div> <\/div><\/div><div id=\"field_12_18\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Caract\u00e9ristiques \u00e9lectriques<\/h3><\/div><fieldset id=\"field_12_6\" class=\"gfield gfield--type-survey gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Puissance Abonnement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_6'>\n\t\t\t<div class='gchoice gchoice_12_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='3 kVA'  id='choice_12_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_6_0' id='label_12_6_0' class='gform-field-label gform-field-label--type-inline'>3 kVA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='6 kVA'  id='choice_12_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_6_1' id='label_12_6_1' class='gform-field-label gform-field-label--type-inline'>6 kVA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_6_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='9 kVA'  id='choice_12_6_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_6_2' id='label_12_6_2' class='gform-field-label gform-field-label--type-inline'>9 kVA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_6_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='12 kVA'  id='choice_12_6_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_6_3' id='label_12_6_3' class='gform-field-label gform-field-label--type-inline'>12 kVA<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_6_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='gf_other_choice'  id='choice_12_6_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_6_4' id='label_12_6_4' class='gform-field-label gform-field-label--type-inline'>Autre<\/label><br \/><input id='input_12_6_other' class='gchoice_other_control' name='input_6_other' type='text' value='Autre' aria-label='Autre choix, veuillez sp\u00e9cifier'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Type de raccordement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_19'>\n\t\t\t<div class='gchoice gchoice_12_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Monophas\u00e9'  id='choice_12_19_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_19_0' id='label_12_19_0' class='gform-field-label gform-field-label--type-inline'>Monophas\u00e9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Triphas\u00e9'  id='choice_12_19_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_19_1' id='label_12_19_1' class='gform-field-label gform-field-label--type-inline'>Triphas\u00e9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_3\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_3'><span class='gform-field-label__text'>Localisation du compteur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_12_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_44\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_44'><span class='gform-field-label__text'>Photo du compteur<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='4194304' \/><input name='input_44' id='input_12_44' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_44\" onchange='javascript:gformValidateFileSize( this, 4194304 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_44'>Types de fichiers accept\u00e9s\u00a0: jpg, gif, png, pdf, Taille max. des fichiers\u00a0: 4 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_44'><\/div> <\/div><\/div><div id=\"field_12_43\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_43'><span class='gform-field-label__text'>Localisation du tableau \u00e9lectrique<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_43' id='input_12_43' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_12_45\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_45'><span class='gform-field-label__text'>Photo du tableau \u00e9lectrique<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='4194304' \/><input name='input_45' id='input_12_45' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_45\" onchange='javascript:gformValidateFileSize( this, 4194304 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_45'>Types de fichiers accept\u00e9s\u00a0: jpg, gif, png, pdf, Taille max. des fichiers\u00a0: 4 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_45'><\/div> <\/div><\/div><div id=\"field_12_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Votre projet<\/h3><\/div><fieldset id=\"field_12_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Pose de la borne<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_52'>\n\t\t\t<div class='gchoice gchoice_12_52_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Contre un mur'  id='choice_12_52_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_52_0' id='label_12_52_0' class='gform-field-label gform-field-label--type-inline'>Contre un mur<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_52_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_52' type='radio' value='Sur pi\u00e9destal'  id='choice_12_52_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_52_1' id='label_12_52_1' class='gform-field-label gform-field-label--type-inline'>Sur pi\u00e9destal<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_12_58\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Environnement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_58'>\n\t\t\t<div class='gchoice gchoice_12_58_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Int\u00e9rieur'  id='choice_12_58_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_58_0' id='label_12_58_0' class='gform-field-label gform-field-label--type-inline'>Int\u00e9rieur<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_58_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Ext\u00e9rieur sous abris'  id='choice_12_58_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_58_1' id='label_12_58_1' class='gform-field-label gform-field-label--type-inline'>Ext\u00e9rieur sous abris<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_58_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_58' type='radio' value='Ext\u00e9rieur sans abris'  id='choice_12_58_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_58_2' id='label_12_58_2' class='gform-field-label gform-field-label--type-inline'>Ext\u00e9rieur sans abris<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_61\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_61'><span class='gform-field-label__text'>Largeur emplacement souhait\u00e9 de la borne<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_61' id='input_12_61' type='number' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_12_61\" \/><\/div><div class='gfield_description' id='gfield_description_12_61'>Largeur disponible en centim\u00e8tre<\/div><\/div><div id=\"field_12_62\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_62'><span class='gform-field-label__text'>Hauteur emplacement souhait\u00e9 de la borne<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_62' id='input_12_62' type='number' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_12_62\" \/><\/div><div class='gfield_description' id='gfield_description_12_62'>Hauteur disponible en centim\u00e8tre<\/div><\/div><div id=\"field_12_37\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_37'><span class='gform-field-label__text'>Photo de l&#039;emplacement souhait\u00e9 pour la pose de la borne<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='4194304' \/><input name='input_37' id='input_12_37' type='file' class='large' aria-describedby=\"gfield_upload_rules_12_37\" onchange='javascript:gformValidateFileSize( this, 4194304 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_37'>Types de fichiers accept\u00e9s\u00a0: jpg, gif, png, pdf, Taille max. des fichiers\u00a0: 4 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_12_37'><\/div> <\/div><\/div><div id=\"field_12_39\" class=\"gfield gfield--type-number gfield--input-type-number gfield--width-half gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_39'><span class='gform-field-label__text'>Distance de raccordement en m<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_39' id='input_12_39' type='number' step='any'   value='' class='small'     aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_12_39\" \/><\/div><div class='gfield_description' id='gfield_description_12_39'>Longueur de c\u00e2ble estim\u00e9e entre la borne et le tableau \u00e9lectrique<\/div><\/div><fieldset id=\"field_12_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Difficult\u00e9 de passage des c\u00e2bles<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_40'>\n\t\t\t<div class='gchoice gchoice_12_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Facile (passage facile, totalement accessible, pas de percement \u00e0 pr\u00e9voir)'  id='choice_12_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_40_0' id='label_12_40_0' class='gform-field-label gform-field-label--type-inline'>Facile (passage facile, totalement accessible, pas de percement \u00e0 pr\u00e9voir)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Normale (passage facile, majoritairement accessible, 2 ou 3 percements)'  id='choice_12_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_40_1' id='label_12_40_1' class='gform-field-label gform-field-label--type-inline'>Normale (passage facile, majoritairement accessible, 2 ou 3 percements)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_40_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='Difficile (Passage difficile, faiblement accessible)'  id='choice_12_40_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_40_2' id='label_12_40_2' class='gform-field-label gform-field-label--type-inline'>Difficile (Passage difficile, faiblement accessible)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_12_59\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_12_59'><span class='gform-field-label__text'>Photos du parcours possible du c\u00e2ble de raccordement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_12_59' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_12_59&quot;,&quot;container&quot;:&quot;gform_multifile_upload_12_59&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_12_59&quot;,&quot;filelist&quot;:&quot;gform_preview_12_59&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/welem.com\\\/enr\\\/?gf_page=65153d9d48d6147&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/welem.com\\\/enr\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/welem.com\\\/enr\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Fichiers autoris\\u00e9s&quot;,&quot;extensions&quot;:&quot;jpg,gif,png,pdf&quot;}],&quot;max_file_size&quot;:&quot;4194304b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:12,&quot;field_id&quot;:59,&quot;_gform_file_upload_nonce_12_59&quot;:&quot;fe4f9c334a&quot;},&quot;gf_vars&quot;:{&quot;max_files&quot;:&quot;3&quot;,&quot;message_id&quot;:&quot;gform_multifile_messages_12_59&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phar&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_12_59' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>D\u00e9posez les fichiers ici ou <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_12_59' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_12_59\"  >S\u00e9lectionnez des fichiers<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_12_59'>Types de fichiers accept\u00e9s\u00a0: jpg, gif, png, pdf, Taille max. des fichiers\u00a0: 4 MB, Max. des fichiers\u00a0: 3.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_12_59'><\/ul> <div id='gform_preview_12_59' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_12_29\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Puissance de borne monophas\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_29'>\n\t\t\t<div class='gchoice gchoice_12_29_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='3,7 kW'  id='choice_12_29_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_12_29\"   \/>\n\t\t\t\t\t<label for='choice_12_29_0' id='label_12_29_0' class='gform-field-label gform-field-label--type-inline'>3,7 kW<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_29_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_29' type='radio' value='7 kW'  id='choice_12_29_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_29_1' id='label_12_29_1' class='gform-field-label gform-field-label--type-inline'>7 kW<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_12_29'>Puissance maximum de recharge souhait\u00e9e<\/div><\/fieldset><fieldset id=\"field_12_78\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Puissance de borne triphas\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_78'>\n\t\t\t<div class='gchoice gchoice_12_78_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='3,7 kW'  id='choice_12_78_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_12_78\"   \/>\n\t\t\t\t\t<label for='choice_12_78_0' id='label_12_78_0' class='gform-field-label gform-field-label--type-inline'>3,7 kW<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_78_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='11 kW'  id='choice_12_78_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_78_1' id='label_12_78_1' class='gform-field-label gform-field-label--type-inline'>11 kW<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_78_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='22 kW'  id='choice_12_78_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_78_2' id='label_12_78_2' class='gform-field-label gform-field-label--type-inline'>22 kW<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_12_78'>Puissance maximum de recharge souhait\u00e9e<\/div><\/fieldset><fieldset id=\"field_12_66\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Type de borne<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_66'>\n\t\t\t<div class='gchoice gchoice_12_66_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Basique'  id='choice_12_66_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_12_66\"   \/>\n\t\t\t\t\t<label for='choice_12_66_0' id='label_12_66_0' class='gform-field-label gform-field-label--type-inline'>Basique<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_66_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Pilotable HC\/HP'  id='choice_12_66_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_66_1' id='label_12_66_1' class='gform-field-label gform-field-label--type-inline'>Pilotable HC\/HP<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_66_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_66' type='radio' value='Intelligente'  id='choice_12_66_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_66_2' id='label_12_66_2' class='gform-field-label gform-field-label--type-inline'>Intelligente<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_12_66'>HC\/HP:Heures creuse\/Heures pleines. \nInteligente: Recharge avec surplus production photovolta\u00efque<\/div><\/fieldset><div id=\"field_12_12\" class=\"gfield gfield--type-survey gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_12_12'><span class='gform-field-label__text'>Information compl\u00e9mentaire que vous jugez utile<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_12' id='input_12_12' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_12_65\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Comment nous avez-vous connu ?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_12_65'>\n\t\t\t<div class='gchoice gchoice_12_65_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Recherche sur internet'  id='choice_12_65_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_65_0' id='label_12_65_0' class='gform-field-label gform-field-label--type-inline'>Recherche sur internet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_65_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Bouche \u00e0 oreille'  id='choice_12_65_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_65_1' id='label_12_65_1' class='gform-field-label gform-field-label--type-inline'>Bouche \u00e0 oreille<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_65_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Foire, salon'  id='choice_12_65_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_65_2' id='label_12_65_2' class='gform-field-label gform-field-label--type-inline'>Foire, salon<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_12_65_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_65' type='radio' value='Publicit\u00e9'  id='choice_12_65_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_12_65_3' id='label_12_65_3' 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