Membership Application

Username:

E-Mail:

Full Name:

Birthday:

Street:

{{ form.street.data if form.street.data else "Not specified"|safe }}

ZIP-Code:

City:

{{ form.city.data if form.city.data else "Not specified"|safe }}

State/County/Province:

{{ form.state.data if form.state.data else "Not specified"|safe }}

Country:

{{ form.country.data if form.country.data else "Not specified"|safe }}

Membership Plan:

Student:

Starving:

Payment:

Agreed to Terms & Conditions:

Minor Member:

Username:

E-Mail:

Full Name:

Birthday:

Street:

{{ form.street.data if form.street.data else "Not specified"|safe }}

ZIP-Code:

City:

{{ form.city.data if form.city.data else "Not specified"|safe }}

State/County/Province:

{{ form.state.data if form.state.data else "Not specified"|safe }}

Country:

{{ form.country.data if form.country.data else "Not specified"|safe }}

Membership Plan:

Student:

Starving:

Payment:

Agreed to Terms & Conditions:

Minor Member:

Send this document to the Chaos Computer Club Lëtzebuerg!

@@ -51,34 +88,40 @@ {% elif form.payment.data == 'cash' %}

Please bring {{ price }}€ with you the next time you meet us!

{% elif form.payment.data == 'bitcoin' %} -

Address: 3BV5UPToMUmXJiqUVndHjSSq2HqDW8npRd
Label: Membership Fee
Message: {{ year }} {{ form.username.data }}
Amount: {{ price }} BTC

- {% set bitcoin_url= 'bitcoin:3BV5UPToMUmXJiqUVndHjSSq2HqDW8npRd?amount={amount}&label=Membership Fee {year} {username}&message=Membership Fee {year} {username}'.format(amount=price, year=year, username=form.username.data) %} -

+ {% set bitcoin_url="bitcoin:3BV5UPToMUmXJiqUVndHjSSq2HqDW8npRd?amount={amount}&label=Membership Fee {year} {username}&message=Membership Fee {year} {username}".format(amount=price, year=year, username=form.username.data) %} +

{% elif form.payment.data == 'ethereum' %} -

Address: 0x1C05b4C236914B218B57e0E25948d416B4885655
Label: Membership Fee
Message: {{ year }} {{ form.username.data }}
Amount: {{ price }} ETH

- {% set ethereum_url= '0x1C05b4C236914B218B57e0E25948d416B4885655' %} -

Address: 0x1C05b4C236914B218B57e0E25948d416B4885655
Label: Membership Fee
Message: {{ year }} {{ form.username.data }}
Amount: {{ price }} ETH

+ {% set ethereum_url="0x1C05b4C236914B218B57e0E25948d416B4885655" %} +

{% elif form.payment.data == 'digicash' %} -

{% set digicash_url='https://pos.digica.sh/qrcode/generator?merchantId=CHAOSPC1&amount={amount}&transactionReference=Membership_{username}'.format(amount=price, username=form.username.data) %} -

Pay with digicash!

{% endif %} -

Luxembourg, the