{% trans %}Membership Application{% endtrans %}

{% trans %}Username:{% endtrans %}
{{ form.username.data }}
{% trans %}E-Mail:{% endtrans %}
{{ form.email.data }}
{% trans %}Full Name:{% endtrans %}
{{ form.fullname.data }}
{% trans %}Birthday:{% endtrans %}
{{ form.birthday.data }}
{% trans %}Street:{% endtrans %}
{{ form.street.data if form.street.data else "".join(["",_("Not specified"),""])|safe }}
{% trans %}ZIP-Code:{% endtrans %}
{{ form.zip.data if form.zip.data else "".join(["",_("Not specified"),""])|safe }}
{% trans %}City:{% endtrans %}
{{ form.city.data if form.city.data else "".join(["",_("Not specified"),""])|safe }}
{% trans %}State/County/Province:{% endtrans %}
{{ form.state.data if form.state.data else "".join(["",_("Not specified"),""])|safe }}
{% trans %}Country:{% endtrans %}
{{ form.country.data if form.country.data else "".join(["",_("Not specified"),""])|safe }}
{% trans %}Membership Plan:{% endtrans%}
{{ form.membership.data }}
{% trans %}Voting rights:{% endtrans%}
{{ _("Yes") if voting else _("No") }}
{% trans %}Student:{% endtrans %}
{{ _("Yes") if form.student.data else _("No") }}
{% trans %}Starving:{% endtrans %}
{{ _("Yes") if form.starving.data else _("No") }}
{% trans %}Payment:{% endtrans %}
{{ form.payment.data.lower() }}
{% trans %}Agreed to Terms & Conditions:{% endtrans %}
{{ _("Yes") if form.terms.data else _("No") }}
{% trans %}Minor Member:{% endtrans %}
{{ _("Yes") if minor_member else _("No") }}

{% trans %}Send this document to the Chaos Computer Club Lëtzebuerg!{% endtrans %}

{% if form.payment.data == 'wire transfer' %} {% elif form.payment.data == 'cash' %}

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

{% elif form.payment.data in config["CRYPTOCURRENCIES"] %}
{% set address = config["CRYPTOCURRENCIES"][form.payment.data]["ADDRESS"] %} {% set crypto_url=config["CRYPTOCURRENCIES"][form.payment.data]["URL"].format(address=address, amount=price, year=year, username=form.username.data) %}
{% elif form.payment.data == 'digicash' %}
{% set payconiq_url='https://payconiq.com/t/1/62068d4d71445b0006dfbd5d?A={amount}&R=Membership&D={username}'.format(amount=price, username=form.username.data) %}

{% trans %}Pay with DigiCash/Payconiq!{% endtrans %}

{% elif form.payment.data == 'satispay' %}
{% set satispay_url='https://www.satispay.com/app/pay/shops/e5ca1df1-1f72-457e-88a2-7691ab630947?amount={amount}'.format(amount=price) %}

{% trans %}Pay with Satispay!{% endtrans %}

{% endif %}

{% trans %}Luxembourg, the{% endtrans %}

{{ _("Signature of your legal representative") if minor_member else _("Your signature") }}