<!DOCTYPE html>
<html>
<head>
<title>Membership Application - {{ form.username.data }}</title>
<link rel="stylesheet" href="{{ url_for('static', filename='pdf.css') }}" />
</head>
<body>
<img src="{{ url_for('static', filename='images/logo.png') }}"></img>
<h1>Membership Application</h1>
<dl>
<dt>Username:</dt>
<dd>{{ form.username.data }}</dd>
<dt>E-Mail:</dt>
<dd>{{ form.email.data }}</dd>
<dt>Full Name:</dt>
<dd>{{ form.fullname.data }}</dd>
<dt>Street:</dt>
<dd>{{ form.street.data if form.street.data else "<i>Not specified</i>"|safe }}</dd>
<dt>ZIP-Code:</dt>
<dd>{{ form.zip.data if form.zip.data else "<i>Not specified</i>"|safe }}</dd>
<dt>City:</dt>
<dd>{{ form.city.data if form.city.data else "<i>Not specified</i>"|safe }}</dd>
<dt>State/County/Province:</dt>
<dd>{{ form.state.data if form.state.data else "<i>Not specified</i>"|safe }}</dd>
<dt>Country:</dt>
<dd>{{ form.country.data if form.country.data else "<i>Not specified</i>"|safe }}</dd>
<dt>Membership Plan:</dt>
<dd>{{ membership }}</dd>
<dt>Payment:</dt>
<dd>{{ form.payment.data }}</dd>
<dt>Agreed to Terms & Conditions:</dt>
<dd>{{ "Yes" if form.terms.data else "No" }}</dd>
<dt>Minor Member:</dt>
<dd>{{ "Yes" if form.minor_member.data else "No" }}</dd>
<dt>GPG-ID:</dt>
<dd>{{ form.gpg.data or "<i>Not specified</i>"|safe }}</dd>
<dt>Jabber Handle:</dt>
<dd>{{ form.jabber.data or "<i>Not specified</i>"|safe }}</dd>
<dt>Twitter Handle:</dt>
<dd>{{ form.twitter.data or "<i>Not specified</i>"|safe }}</dd>
</dl>
<p>Send this document to the Chaos Computer Club Lëtzebuerg!</p>
{% if form.payment.data == 'wire transfer' %}
<ul class="bank">
<li>Account Holder: Chaos Computer Club Lëtzebuerg</li>
<li>BIC/Swift: BCEELULLXXX</li>
<li>IBAN: LU29 0019 2855 3890 4000</li>
<li>Message: Membership fee {{ year }} {{ form.username.data }}</li>
<li>Amount: {{ price }}€</li>
</ul>
{% elif form.payment.data == 'cash' %}
<p>Please bring {{ price }}€ with you the next time you meet us!</p>
{% elif form.payment.data == 'bitcoin' %}
<div>
<ul class='btctext'>
<li><b>Address:</b> 3BV5UPToMUmXJiqUVndHjSSq2HqDW8npRd</li>
<li><b>Label:</b> Membership Fee</li>
<li><b>Message:</b> {{ year }} {{ form.username.data }}</li>
<li><b>Amount:</b> {{ price }} BTC</li>
</ul>
{% 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) %}
<img class='btcqrcode' src="{{ qrcode(bitcoin_url) }}"></img>
</div>
{% elif form.payment.data == 'ethereum' %}
<div>
<ul class='btctext'>
<li><b>Address:</b> 0x1C05b4C236914B218B57e0E25948d416B4885655</li>
<li><b>Label:</b> Membership Fee</li>
<li><b>Message:</b> {{ year }} {{ form.username.data }}</li>
<li><b>Amount:</b> {{ price }} ETH</li>
</ul>
{% set ethereum_url= '0x1C05b4C236914B218B57e0E25948d416B4885655' %}
<img class="btcqrcode" src="{{ qrcode(ethereum_url) }}"></img>
</div>
{% elif form.payment.data == 'digicash' %}
<div>
{% set digicash_url='https://pos.digica.sh/qrcode/generator?merchantId=CHAOSPC1&amount={amount}&transactionReference=Membership_{username}'.format(amount=price, username=form.username.data) %}
<img class="btqrcode" src="{{ digicash_url }}"></img>
</div>
{% endif %}
<div>
<p class="membersignature">
Luxembourg, the
</p>
<p class="adminsignature">
{{ "Signature of your legal representative" if form.minor_member.data else "Your signature" }}
</p>
</div>
<footer>
<hr>
<b>C</b>haos <b>C</b>omputer <b>C</b>lub <b>L</b>ëtzebuerg A.S.B.L.<br>
Halle Victor Hugo - 60 Avenue Victor Hugo L-1750 Luxembourg (Europe)<br>
info@c3l.lu - <a href="https://c3l.lu">http://c3l.lu</a>
<!--<i>Registered as an NPO with the “Registre de Commerce et des Sociétés Luxembourg” with the registration number: <a href="http://www.legilux.public.lu/entr/search/index.php?ss_soc=chaos&sc_soc=&sr_soc=name&sr_fj=all&sr_tp=all&sr_date=all&sl_d=1&sl_m=1&sl_y=2014&sl_d1=1&sl_m1=1&sl_y1=2014&sl_d2=1&sl_m2=2&sl_y2=2014&page_len=100&page_no=1&idm=20086101433&page=result&select_soc=true&submit=Choisir">F0007653</a></i>-->
</footer>
</body>
</html>