{"id":15962,"date":"2026-07-23T17:38:00","date_gmt":"2026-07-23T15:38:00","guid":{"rendered":"https:\/\/reseauentreprendre-preprod.sugarpepperandsalt.com\/cote-d-opale\/formulaire-partenaire\/"},"modified":"2026-07-24T12:24:45","modified_gmt":"2026-07-24T10:24:45","slug":"formulaire-partenaire","status":"publish","type":"page","link":"https:\/\/reseauentreprendre-preprod.sugarpepperandsalt.com\/cote-d-opale\/formulaire-partenaire\/","title":{"rendered":"Formulaire partenaire"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"15962\" class=\"elementor elementor-15962\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cf24c75 e-con-full e-flex e-con e-parent\" data-id=\"cf24c75\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7c1af34 elementor-widget elementor-widget-header_editopage\" data-id=\"7c1af34\" data-element_type=\"widget\" data-widget_type=\"header_editopage.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t    <div class=\"edito_header_widget-wrapper\">\r\n        <div class=\"edito_header_widget-gradient\">\r\n    \r\n            <div class=\"edito_header_widget-left\">\r\n                                <img decoding=\"async\" src=\"https:\/\/reseauentreprendre-preprod.sugarpepperandsalt.com\/cote-d-opale\/wp-content\/themes\/hello-elementor\/assets\/images\/illlus-header.png\" alt=\"\">\r\n            <\/div>\r\n    \r\n            <div class=\"edito_header_widget-right\">\r\n                <h1 class=\"edito_header_widget-title\">Soutenir<\/h1>\r\n                                                <div class=\"edito_header_widget-desc\"><span>Vous souhaitez soutenir une association de chefs d\u2019entreprise solidaires\u202f? Les valeurs v\u00e9hicul\u00e9es par R\u00e9seau Entreprendre\u00ae vous parle\u202f? Rejoignez-nous\u202f!<\/span><\/div>\r\n    \r\n\r\n            <\/div>\r\n    \r\n        <\/div>\r\n    <\/div>\r\n<style>\r\n    .edito_header_widget-wrapper .edito_header_widget-left {\r\n        flex: 0 0 49%;\r\n    }\r\n    .edito_header_widget-wrapper .edito_header_widget-right {\r\n        flex: 0 0 51%;\r\n    }\r\n<\/style>\r\n    \r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-466e90de-df4e-4b5f-b9c7-f17eeed1cfd8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"466e90de-df4e-4b5f-b9c7-f17eeed1cfd8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c0a73c54-c29d-4015-af72-fecf89db0ba9\" data-id=\"c0a73c54-c29d-4015-af72-fecf89db0ba9\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5fcc2562-c93b-4985-b3da-af34929e3375 elementor-widget elementor-widget-heading\" data-id=\"5fcc2562-c93b-4985-b3da-af34929e3375\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Rejoignez-nous...<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e50ea2cc-7aa3-422d-b541-fa9e800e3cb1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e50ea2cc-7aa3-422d-b541-fa9e800e3cb1\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fac2f0db-bbc4-46b2-be9e-e303e51ffd8b\" data-id=\"fac2f0db-bbc4-46b2-be9e-e303e51ffd8b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-dd48aa1f-87ca-41f5-a2e8-1b6dc9cf9973 elementor-widget elementor-widget-wpforms\" data-id=\"dd48aa1f-87ca-41f5-a2e8-1b6dc9cf9973\" data-element_type=\"widget\" data-widget_type=\"wpforms.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-15999\"><form id=\"wpforms-form-15999\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"15999\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/cote-d-opale\/wp-json\/wp\/v2\/pages\/15962\" data-token=\"1a6183c8f1e86ddd082deeaafc58ad2b\" data-token-time=\"1790049508\"><noscript class=\"wpforms-error-noscript\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-15999-field_44-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"44\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-15999-field_60-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"60\"><label class=\"wpforms-field-label\" for=\"wpforms-15999-field_60\">Nom de votre entreprise <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-15999-field_60\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][60]\" aria-errormessage=\"wpforms-15999-field_60-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-15999-field_62-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"62\"><label class=\"wpforms-field-label\" for=\"wpforms-15999-field_62\">Poste occup\u00e9:<\/label><input type=\"text\" id=\"wpforms-15999-field_62\" class=\"wpforms-field-medium\" name=\"wpforms[fields][62]\" aria-errormessage=\"wpforms-15999-field_62-error\" ><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-15999-field_67-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-id=\"67\"><label class=\"wpforms-field-label\" for=\"wpforms-15999-field_67\">Formulez votre demande: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-15999-field_67\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][67]\" aria-errormessage=\"wpforms-15999-field_67-error\" required><\/textarea><\/div><div id=\"wpforms-15999-field_72-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"72\"><div id=\"wpforms-15999-field_72\" aria-errormessage=\"wpforms-15999-field_72-error\"><hr \/><\/div><\/div><div id=\"wpforms-15999-field_68-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-inline\" data-field-id=\"68\"><fieldset><legend class=\"wpforms-field-label\">Civilit\u00e9 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-15999-field_68\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-15999-field_68_1\" name=\"wpforms[fields][68][]\" value=\"Monsieur\" aria-errormessage=\"wpforms-15999-field_68_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_68_1\">Monsieur<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-15999-field_68_2\" name=\"wpforms[fields][68][]\" value=\"Madame\" aria-errormessage=\"wpforms-15999-field_68_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_68_2\">Madame<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-15999-field_69-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"69\"><fieldset><legend class=\"wpforms-field-label\">Pr\u00e9nom NOM <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-15999-field_69\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][69][first]\" aria-errormessage=\"wpforms-15999-field_69-error\" required><label for=\"wpforms-15999-field_69\" class=\"wpforms-field-sublabel after\">Pr\u00e9nom<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-15999-field_69-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][69][last]\" aria-errormessage=\"wpforms-15999-field_69-last-error\" required><label for=\"wpforms-15999-field_69-last\" class=\"wpforms-field-sublabel after\">Nom<\/label><\/div><\/div><\/fieldset><\/div><div id=\"wpforms-15999-field_64-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"64\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-15999-field_71-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"71\"><label class=\"wpforms-field-label\" for=\"wpforms-15999-field_71\">E-mail <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-15999-field_71\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][71]\" spellcheck=\"false\" aria-errormessage=\"wpforms-15999-field_71-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-15999-field_70-container\" class=\"wpforms-field wpforms-field-phone\" data-field-id=\"70\"><label class=\"wpforms-field-label\" for=\"wpforms-15999-field_70\">T\u00e9l\u00e9phone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-15999-field_70\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][70]\" aria-label=\"T\u00e9l\u00e9phone\" aria-errormessage=\"wpforms-15999-field_70-error\" required><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-15999-field_73-container\" class=\"wpforms-field wpforms-field-html\" data-field-id=\"73\"><div id=\"wpforms-15999-field_73\" aria-errormessage=\"wpforms-15999-field_73-error\"><hr \/><\/div><\/div><div id=\"wpforms-15999-field_27-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-3-columns\" data-field-id=\"27\"><fieldset><legend class=\"wpforms-field-label\">Comment avez-vous entendu parler de nous ?<\/legend><ul id=\"wpforms-15999-field_27\"><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_4\" name=\"wpforms[fields][27]\" value=\"Acteurs de la cr\u00e9ation\" aria-errormessage=\"wpforms-15999-field_27_4-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_4\">Acteurs de la cr\u00e9ation<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_5\" name=\"wpforms[fields][27]\" value=\"APM\" aria-errormessage=\"wpforms-15999-field_27_5-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_5\">APM<\/label><\/li><li class=\"choice-6 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_6\" name=\"wpforms[fields][27]\" value=\"Association R\u00e9seau Entreprendre\u00a9\" aria-errormessage=\"wpforms-15999-field_27_6-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_6\">Association R\u00e9seau Entreprendre\u00ae\u00a9<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_7\" name=\"wpforms[fields][27]\" value=\"Autre candidat\" aria-errormessage=\"wpforms-15999-field_27_7-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_7\">Autre candidat<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_8\" name=\"wpforms[fields][27]\" value=\"Autre Partenaire\" aria-errormessage=\"wpforms-15999-field_27_8-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_8\">Autre Partenaire<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_9\" name=\"wpforms[fields][27]\" value=\"Banque\" aria-errormessage=\"wpforms-15999-field_27_9-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_9\">Banque<\/label><\/li><li class=\"choice-10 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_10\" name=\"wpforms[fields][27]\" value=\"CCI\" aria-errormessage=\"wpforms-15999-field_27_10-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_10\">CCI<\/label><\/li><li class=\"choice-11 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_11\" name=\"wpforms[fields][27]\" value=\"CJD\" aria-errormessage=\"wpforms-15999-field_27_11-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_11\">CJD<\/label><\/li><li class=\"choice-12 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_12\" name=\"wpforms[fields][27]\" value=\"CRA\" aria-errormessage=\"wpforms-15999-field_27_12-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_12\">CRA<\/label><\/li><li class=\"choice-13 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_13\" name=\"wpforms[fields][27]\" value=\"\u00c9quipe association\" aria-errormessage=\"wpforms-15999-field_27_13-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_13\">\u00c9quipe association<\/label><\/li><li class=\"choice-14 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_14\" name=\"wpforms[fields][27]\" value=\"\u00c9quipe comptable\" aria-errormessage=\"wpforms-15999-field_27_14-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_14\">\u00c9quipe comptable<\/label><\/li><li class=\"choice-15 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_15\" name=\"wpforms[fields][27]\" value=\"Internet\" aria-errormessage=\"wpforms-15999-field_27_15-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_15\">Internet<\/label><\/li><li class=\"choice-16 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_16\" name=\"wpforms[fields][27]\" value=\"Laur\u00e9at\" aria-errormessage=\"wpforms-15999-field_27_16-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_16\">Laur\u00e9at<\/label><\/li><li class=\"choice-17 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_17\" name=\"wpforms[fields][27]\" value=\"MEDEF\" aria-errormessage=\"wpforms-15999-field_27_17-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_17\">MEDEF<\/label><\/li><li class=\"choice-18 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_18\" name=\"wpforms[fields][27]\" value=\"Membre\" aria-errormessage=\"wpforms-15999-field_27_18-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_18\">Membre<\/label><\/li><li class=\"choice-19 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_19\" name=\"wpforms[fields][27]\" value=\"Presse\" aria-errormessage=\"wpforms-15999-field_27_19-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_19\">Presse<\/label><\/li><li class=\"choice-20 depth-1\"><input type=\"radio\" id=\"wpforms-15999-field_27_20\" name=\"wpforms[fields][27]\" value=\"Universit\u00e9 \/ \u00c9cole\" aria-errormessage=\"wpforms-15999-field_27_20-error\"  ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_27_20\">Universit\u00e9 \/ \u00c9cole<\/label><\/li><\/ul><\/fieldset><\/div><div id=\"wpforms-15999-field_40-container\" class=\"wpforms-field wpforms-field-gdpr-checkbox\" data-field-id=\"40\"><label class=\"wpforms-field-label wpforms-label-hide\" aria-hidden=\"false\">Accord RGPD <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><ul id=\"wpforms-15999-field_40\" class=\"wpforms-field-required\"><li class=\"choice-1\"><input type=\"checkbox\" id=\"wpforms-15999-field_40_1\" name=\"wpforms[fields][40][]\" value=\"En cochant cette case, j\u2019accepte le traitement de mes donn\u00e9es par ce site, et autorise R\u00e9seau Entreprendre \u00e0 me contacter.\" aria-errormessage=\"wpforms-15999-field_40_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-15999-field_40_1\">En cochant cette case, j\u2019accepte le traitement de mes donn\u00e9es par ce site, et autorise R\u00e9seau Entreprendre\u00ae \u00e0 me contacter. <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><\/li><\/ul><\/div><div id=\"wpforms-15999-field_43-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"43\"><div id=\"wpforms-15999-field_43\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-15999-field_43-error\"><p style=\"font-size: 11px\">Les informations recueillies sur ce formulaire sont enregistr\u00e9es dans un fichier informatis\u00e9 par R\u00e9seau Entreprendre\u00ae pour la gestion de notre prospection de laur\u00e9ats potentiels, et qui peuvent \u00eatre accompagn\u00e9s par l\u2019association R\u00e9seau Entreprendre\u00ae de leur r\u00e9gion. Elles sont conserv\u00e9es pendant 6 mois et sont destin\u00e9es \u00e0 l\u2019association R\u00e9seau Entreprendre\u00ae de votre r\u00e9gion, qui peut-\u00eatre install\u00e9e dans l\u2019union europ\u00e9enne ou dans les 10 pays dans lesquels R\u00e9seau Entreprendre\u00ae est implant\u00e9. Conform\u00e9ment \u00e0 la loi \u00ab Informatique et libert\u00e9s \u00bb puis \u00ab RGPD \u00bb au 25 mai 2018, vous pouvez exercer votre droit d\u2019acc\u00e8s aux donn\u00e9es vous concernant et les faire rectifier ou supprimer ou porter en contactant : rgpd@reseau-entreprendre.org.<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-15999-field_76-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"76\"><div id=\"wpforms-15999-field_76\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-15999-field_76-error\"><h1 style=\"font-size: 18px\"><span style=\"color: #f34f63\"><strong>Information de s\u00e9curit\u00e9 et probl\u00e8me d'envoi :<\/strong><\/span><\/h1>\n<p style=\"font-size: 13px\">Si vous rencontrez des difficult\u00e9s pour envoyer le formulaire, vous devez vous rendre dans les Cookies et accepter le Cookie antispam ReCaptcha. Une fois le formulaire envoy\u00e9, vous pouvez le d\u00e9cocher et continuer votre visite. Merci de votre visite. 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