{"id":14450,"date":"2017-04-19T11:29:04","date_gmt":"2017-04-19T09:29:04","guid":{"rendered":"https:\/\/www.chu-poitiers.fr\/?page_id=14450"},"modified":"2021-04-20T18:05:13","modified_gmt":"2021-04-20T16:05:13","slug":"demande-de-disponibilite","status":"publish","type":"page","link":"https:\/\/www.chu-poitiers.fr\/en\/demande-de-disponibilite\/","title":{"rendered":"Demande de disponibilit\u00e9"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f14449-o1\" lang=\"fr-FR\" dir=\"ltr\" data-wpcf7-id=\"14449\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/en\/wp-json\/wp\/v2\/pages\/14450#wpcf7-f14449-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Formulaire de contact\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"14449\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.2\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"fr_FR\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f14449-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<table width=\"100%\" border=\"0\" cellpadding=\"0\" class=\"form\">\n\t<tr valign=\"middle\">\n\t\t<td colspan=\"2\">\n\t\t\t<p align=\"center\"><b>ETAT CIVIL<\/b>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Nom*\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Pr\u00e9nom* :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-surname\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-surname\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" scope=\"col\" width=\"25%\">\n\t\t\t<p>Date de naissance* :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td scope=\"col\">\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"text-327\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-327\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Adresse :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-adress\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-adress\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Code postal :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-postal\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-postal\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Ville :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-city\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-city\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>T\u00e9l\u00e9phone :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-phone-redac\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"your-phone-redac\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Courriel* :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email-673\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-673\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t<\/td>\n\t<\/tr>\n\t<tr valign=\"middle\">\n\t\t<td colspan=\"2\">\n\t\t\t<p align=\"center\"><b>FORMATION<\/b>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>M\u00e9tier pr\u00e9par\u00e9* :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-metier\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-metier\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Etablissement\/\u00e9cole* :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-ecole\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-ecole\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Adresse :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"adress\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adress\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Code postal :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"postal\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"postal\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Ville :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"city\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"city\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>T\u00e9l\u00e9phone :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"30\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p>Courriel* :\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email-66\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email-66\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\">\n\t\t\t<p><b>Objectifs du stage* :<\/b>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-objectifs\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"your-objectifs\"><\/textarea><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p><b>P\u00e9riode de stage* : <\/b>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-periode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-periode\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td colspan=\"2\">\n\t\t<\/td>\n\t<\/tr>\n\t<tr>\n\t\t<td align=\"right\" valign=\"top\" width=\"25%\">\n\t\t\t<p><b>Service demand\u00e9* (une seule possibilit\u00e9) : <\/b>\n\t\t\t<\/p>\n\t\t<\/td>\n\t\t<td>\n\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-service\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-service\" \/><\/span>\n\t\t\t<\/p>\n\t\t<\/td>\n\t<\/tr>\n<\/table>\n<p><b>Ajouter un CV :<\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"file-625\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\"audio\/*,video\/*,image\/*\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"file-625\" \/><\/span><br \/>\n<b>Ajouter une lettre de motivation :<\/b><span class=\"wpcf7-form-control-wrap\" data-name=\"file-626\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file wpcf7-validates-as-required\" accept=\"audio\/*,video\/*,image\/*\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" name=\"file-626\" \/><\/span>\n<\/p>\n<p style=\"text-align: left;\"><span>* champs obligatoires<\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Valider\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"31\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"ETAT CIVIL Nom* Pr\u00e9nom* : Date de naissance* : Adresse : Code postal : Ville : T\u00e9l\u00e9phone : Courriel* : FORMATION M\u00e9tier pr\u00e9par\u00e9* : Etablissement\/\u00e9cole* : Adresse : Code postal : Ville : T\u00e9l\u00e9phone : Courriel* : Objectifs du stage* : P\u00e9riode de stage* : Service demand\u00e9* (une seule possibilit\u00e9) : Ajouter un CV : [...]","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-14450","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ 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