{"id":1109,"date":"2018-12-14T13:08:16","date_gmt":"2018-12-14T13:08:16","guid":{"rendered":"http:\/\/ccimm.com\/\/student-visa-federal\/"},"modified":"2018-12-20T16:31:13","modified_gmt":"2018-12-20T16:31:13","slug":"student-visa-federal","status":"publish","type":"page","link":"https:\/\/ccimm.com\/fr\/student-visa-federal\/","title":{"rendered":"Visa d&rsquo;\u00e9tudiant (f\u00e9d\u00e9ral)"},"content":{"rendered":"<div class=\"row\"  ><div class=\"container\"><div class=\"row \"  >\n<div class=\"col-xs-12 col-sm-12 col-md-12 col-lg-12\">\n<h3>Evaluation en ligne (Visa Etudiant) <\/h3>\n<p>Veuillez suivre les instructions attentivement afin que nous puissions vous fournir une \u00e9valuation ad\u00e9quate. <\/p>\n<p>Les champs marqu\u00e9s avec * sont obligatoires.<\/p>\n<\/div>\n<div class=\"col-xs-12 col-sm-12 col-md-12 col-lg-12\">\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1151-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1151\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/fr\/wp-json\/wp\/v2\/pages\/1109#wpcf7-f1151-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"1151\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.0.6\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1151-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/div>\n<div class=\"form-block\">\n\t<div class=\"form-block-title\">\n\t\t<h5>D\u00e9tails Personnels\n\t\t<\/h5>\n\t\t<p>Veuillez fournir votre nom et votre adresse.\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"block-field\">\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Salutation<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"salutation\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"salutation\"><option value=\"Mr.\">Mr.<\/option><option value=\"Ms.\">Ms.<\/option><option value=\"Mrs.\">Mrs.<\/option><option value=\"Dr.\">Dr.<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Pr\u00e9nom<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><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=\"first-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Deuxi\u00e8me pr\u00e9nom<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"middle-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"middle-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Nom<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><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=\"last-name\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Sexe<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"gender\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"gender\"><option value=\"Homme\">Homme<\/option><option value=\"Femme\">Femme<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Date de Naissance<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper date-field\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"birth-date\"><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=\"birth-date\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"birth-month\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"birth-month\"><option value=\"January\">January<\/option><option value=\"February\">February<\/option><option value=\"March\">March<\/option><option value=\"April\">April<\/option><option value=\"May\">May<\/option><option value=\"June\">June<\/option><option value=\"July\">July<\/option><option value=\"August\">August<\/option><option value=\"September\">September<\/option><option value=\"October\">October<\/option><option value=\"November\">November<\/option><option value=\"December\">December<\/option><\/select><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"birth-year\"><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=\"birth-year\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Etat Civil<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"martial-status\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"martial-status\"><option value=\"C\u00e9libataire\">C\u00e9libataire<\/option><option value=\"Mari\u00e9\">Mari\u00e9<\/option><option value=\"Veuf\">Veuf<\/option><option value=\"S\u00e9par\u00e9\">S\u00e9par\u00e9<\/option><option value=\"Mariage annul\u00e9\">Mariage annul\u00e9<\/option><option value=\"Divorc\u00e9\">Divorc\u00e9<\/option><option value=\"Conjoint de fait\">Conjoint de fait<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Pays de Citoyennet\u00e9<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"country-citizenship\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"country-citizenship\"><option value=\"Aruba\">Aruba<\/option><option value=\"Afghanistan\">Afghanistan<\/option><option value=\"Angola\">Angola<\/option><option value=\"Anguilla\">Anguilla<\/option><option value=\"\u00c5land Islands\">\u00c5land Islands<\/option><option value=\"Albania\">Albania<\/option><option value=\"Andorra\">Andorra<\/option><option value=\"United Arab Emirates\">United Arab Emirates<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"Armenia\">Armenia<\/option><option value=\"American Samoa\">American Samoa<\/option><option value=\"Antarctica\">Antarctica<\/option><option value=\"French Southern Territories\">French Southern Territories<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Australia\">Australia<\/option><option value=\"Austria\">Austria<\/option><option value=\"Azerbaijan\">Azerbaijan<\/option><option value=\"Burundi\">Burundi<\/option><option value=\"Belgium\">Belgium<\/option><option value=\"Benin\">Benin<\/option><option value=\"Bonaire, Sint Eustatius and Saba\">Bonaire, Sint Eustatius and Saba<\/option><option value=\"Burkina Faso\">Burkina Faso<\/option><option value=\"Bangladesh\">Bangladesh<\/option><option value=\"Bulgaria\">Bulgaria<\/option><option value=\"Bahrain\">Bahrain<\/option><option value=\"Bahamas\">Bahamas<\/option><option value=\"Bosnia and Herzegovina\">Bosnia and Herzegovina<\/option><option value=\"Saint Barth\u00e9lemy\">Saint Barth\u00e9lemy<\/option><option value=\"Belarus\">Belarus<\/option><option value=\"Belize\">Belize<\/option><option value=\"Bermuda\">Bermuda<\/option><option value=\"Bolivia, Plurinational State of\">Bolivia, Plurinational State of<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Brunei Darussalam\">Brunei Darussalam<\/option><option value=\"Bhutan\">Bhutan<\/option><option value=\"Bouvet Island\">Bouvet Island<\/option><option value=\"Botswana\">Botswana<\/option><option value=\"Central African Republic\">Central African Republic<\/option><option value=\"Canada\">Canada<\/option><option value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option value=\"Switzerland\">Switzerland<\/option><option value=\"Chile\">Chile<\/option><option value=\"China\">China<\/option><option value=\"C\u00f4te d&#039;Ivoire\">C\u00f4te d&#039;Ivoire<\/option><option value=\"Cameroon\">Cameroon<\/option><option value=\"Congo, the Democratic Republic of the\">Congo, the Democratic Republic of the<\/option><option value=\"Congo\">Congo<\/option><option value=\"Cook Islands\">Cook Islands<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Comoros\">Comoros<\/option><option value=\"Cape Verde\">Cape Verde<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Cura\u00e7ao\">Cura\u00e7ao<\/option><option value=\"Christmas Island\">Christmas Island<\/option><option value=\"Cayman Islands\">Cayman Islands<\/option><option value=\"Cyprus\">Cyprus<\/option><option value=\"Czech Republic\">Czech Republic<\/option><option value=\"Germany\">Germany<\/option><option value=\"Djibouti\">Djibouti<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Denmark\">Denmark<\/option><option value=\"Dominican Republic\">Dominican Republic<\/option><option value=\"Algeria\">Algeria<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"Egypt\">Egypt<\/option><option value=\"Eritrea\">Eritrea<\/option><option value=\"Western Sahara\">Western Sahara<\/option><option value=\"Spain\">Spain<\/option><option value=\"Estonia\">Estonia<\/option><option value=\"Ethiopia\">Ethiopia<\/option><option value=\"Finland\">Finland<\/option><option value=\"Fiji\">Fiji<\/option><option value=\"Falkland Islands (Malvinas)\">Falkland Islands (Malvinas)<\/option><option value=\"France\">France<\/option><option value=\"Faroe Islands\">Faroe Islands<\/option><option value=\"Micronesia, Federated States of\">Micronesia, Federated States of<\/option><option value=\"Gabon\">Gabon<\/option><option value=\"United Kingdom\">United Kingdom<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Guernsey\">Guernsey<\/option><option value=\"Ghana\">Ghana<\/option><option value=\"Gibraltar\">Gibraltar<\/option><option value=\"Guinea\">Guinea<\/option><option value=\"Guadeloupe\">Guadeloupe<\/option><option value=\"Gambia\">Gambia<\/option><option value=\"Guinea-Bissau\">Guinea-Bissau<\/option><option value=\"Equatorial Guinea\">Equatorial Guinea<\/option><option value=\"Greece\">Greece<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Greenland\">Greenland<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"French Guiana\">French Guiana<\/option><option value=\"Guam\">Guam<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Hong Kong\">Hong Kong<\/option><option value=\"Heard Island and McDonald Islands\">Heard Island and McDonald Islands<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Croatia\">Croatia<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Hungary\">Hungary<\/option><option value=\"Indonesia\">Indonesia<\/option><option value=\"Isle of Man\">Isle of Man<\/option><option value=\"India\">India<\/option><option value=\"British Indian Ocean Territory\">British Indian Ocean Territory<\/option><option value=\"Ireland\">Ireland<\/option><option value=\"Iran, Islamic Republic of\">Iran, Islamic Republic of<\/option><option value=\"Iraq\">Iraq<\/option><option value=\"Iceland\">Iceland<\/option><option value=\"Israel\">Israel<\/option><option value=\"Italy\">Italy<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Jersey\">Jersey<\/option><option value=\"Jordan\">Jordan<\/option><option value=\"Japan\">Japan<\/option><option value=\"Kazakhstan\">Kazakhstan<\/option><option value=\"Kenya\">Kenya<\/option><option value=\"Kyrgyzstan\">Kyrgyzstan<\/option><option value=\"Cambodia\">Cambodia<\/option><option value=\"Kiribati\">Kiribati<\/option><option value=\"Saint Kitts and Nevis\">Saint Kitts and Nevis<\/option><option value=\"Korea, Republic of\">Korea, Republic of<\/option><option value=\"Kuwait\">Kuwait<\/option><option value=\"Lao People&#039;s Democratic Republic\">Lao People&#039;s Democratic Republic<\/option><option value=\"Lebanon\">Lebanon<\/option><option value=\"Liberia\">Liberia<\/option><option value=\"Libya\">Libya<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Liechtenstein\">Liechtenstein<\/option><option value=\"Sri Lanka\">Sri Lanka<\/option><option value=\"Lesotho\">Lesotho<\/option><option value=\"Lithuania\">Lithuania<\/option><option value=\"Luxembourg\">Luxembourg<\/option><option value=\"Latvia\">Latvia<\/option><option value=\"Macao\">Macao<\/option><option value=\"Saint Martin (French part)\">Saint Martin (French part)<\/option><option value=\"Morocco\">Morocco<\/option><option value=\"Monaco\">Monaco<\/option><option value=\"Moldova, Republic of\">Moldova, Republic of<\/option><option value=\"Madagascar\">Madagascar<\/option><option value=\"Maldives\">Maldives<\/option><option value=\"Mexico\">Mexico<\/option><option value=\"Marshall Islands\">Marshall Islands<\/option><option value=\"Macedonia, the former Yugoslav Republic of\">Macedonia, the former Yugoslav Republic of<\/option><option value=\"Mali\">Mali<\/option><option value=\"Malta\">Malta<\/option><option value=\"Myanmar\">Myanmar<\/option><option value=\"Montenegro\">Montenegro<\/option><option value=\"Mongolia\">Mongolia<\/option><option value=\"Northern Mariana Islands\">Northern Mariana Islands<\/option><option value=\"Mozambique\">Mozambique<\/option><option value=\"Mauritania\">Mauritania<\/option><option value=\"Montserrat\">Montserrat<\/option><option value=\"Martinique\">Martinique<\/option><option value=\"Mauritius\">Mauritius<\/option><option value=\"Malawi\">Malawi<\/option><option value=\"Malaysia\">Malaysia<\/option><option value=\"Mayotte\">Mayotte<\/option><option value=\"Namibia\">Namibia<\/option><option value=\"New Caledonia\">New Caledonia<\/option><option value=\"Niger\">Niger<\/option><option value=\"Norfolk Island\">Norfolk Island<\/option><option value=\"Nigeria\">Nigeria<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Niue\">Niue<\/option><option value=\"Netherlands\">Netherlands<\/option><option value=\"Norway\">Norway<\/option><option value=\"Nepal\">Nepal<\/option><option value=\"Nauru\">Nauru<\/option><option value=\"New Zealand\">New Zealand<\/option><option value=\"Oman\">Oman<\/option><option value=\"Pakistan\">Pakistan<\/option><option value=\"Panama\">Panama<\/option><option value=\"Pitcairn\">Pitcairn<\/option><option value=\"Peru\">Peru<\/option><option value=\"Philippines\">Philippines<\/option><option value=\"Palau\">Palau<\/option><option value=\"Papua New Guinea\">Papua New Guinea<\/option><option value=\"Poland\">Poland<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Korea, Democratic People&#039;s Republic of\">Korea, Democratic People&#039;s Republic of<\/option><option value=\"Portugal\">Portugal<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Palestine, State of\">Palestine, State of<\/option><option value=\"French Polynesia\">French Polynesia<\/option><option value=\"Qatar\">Qatar<\/option><option value=\"R\u00e9union\">R\u00e9union<\/option><option value=\"Romania\">Romania<\/option><option value=\"Russian Federation\">Russian Federation<\/option><option value=\"Rwanda\">Rwanda<\/option><option value=\"Saudi Arabia\">Saudi Arabia<\/option><option value=\"Sudan\">Sudan<\/option><option value=\"Senegal\">Senegal<\/option><option value=\"Singapore\">Singapore<\/option><option value=\"South Georgia and the South Sandwich Islands\">South Georgia and the South Sandwich Islands<\/option><option value=\"Saint Helena, Ascension and Tristan da Cunha\">Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"Svalbard and Jan Mayen\">Svalbard and Jan Mayen<\/option><option value=\"Solomon Islands\">Solomon Islands<\/option><option value=\"Sierra Leone\">Sierra Leone<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"San Marino\">San Marino<\/option><option value=\"Somalia\">Somalia<\/option><option value=\"Saint Pierre and Miquelon\">Saint Pierre and Miquelon<\/option><option value=\"Serbia\">Serbia<\/option><option value=\"South Sudan\">South Sudan<\/option><option value=\"Sao Tome and Principe\">Sao Tome and Principe<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Slovakia\">Slovakia<\/option><option value=\"Slovenia\">Slovenia<\/option><option value=\"Sweden\">Sweden<\/option><option value=\"Swaziland\">Swaziland<\/option><option value=\"Sint Maarten (Dutch part)\">Sint Maarten (Dutch part)<\/option><option value=\"Seychelles\">Seychelles<\/option><option value=\"Syrian Arab Republic\">Syrian Arab Republic<\/option><option value=\"Turks and Caicos Islands\">Turks and Caicos Islands<\/option><option value=\"Chad\">Chad<\/option><option value=\"Togo\">Togo<\/option><option value=\"Thailand\">Thailand<\/option><option value=\"Tajikistan\">Tajikistan<\/option><option value=\"Tokelau\">Tokelau<\/option><option value=\"Turkmenistan\">Turkmenistan<\/option><option value=\"Timor-Leste\">Timor-Leste<\/option><option value=\"Tonga\">Tonga<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Tunisia\">Tunisia<\/option><option value=\"Turkey\">Turkey<\/option><option value=\"Tuvalu\">Tuvalu<\/option><option value=\"Taiwan, Province of China\">Taiwan, Province of China<\/option><option value=\"Tanzania, United Republic of\">Tanzania, United Republic of<\/option><option value=\"Uganda\">Uganda<\/option><option value=\"Ukraine\">Ukraine<\/option><option value=\"United States Minor Outlying Islands\">United States Minor Outlying Islands<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"United States\">United States<\/option><option value=\"Uzbekistan\">Uzbekistan<\/option><option value=\"Holy See (Vatican City State)\">Holy See (Vatican City State)<\/option><option value=\"Saint Vincent and the Grenadines\">Saint Vincent and the Grenadines<\/option><option value=\"Venezuela, Bolivarian Republic of\">Venezuela, Bolivarian Republic of<\/option><option value=\"Virgin Islands, British\">Virgin Islands, British<\/option><option value=\"Virgin Islands, U.S.\">Virgin Islands, U.S.<\/option><option value=\"Viet Nam\">Viet Nam<\/option><option value=\"Vanuatu\">Vanuatu<\/option><option value=\"Wallis and Futuna\">Wallis and Futuna<\/option><option value=\"Samoa\">Samoa<\/option><option value=\"Yemen\">Yemen<\/option><option value=\"South Africa\">South Africa<\/option><option value=\"Zambia\">Zambia<\/option><option value=\"Zimbabwe\">Zimbabwe<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"form-block-title\">\n\t\t<h5>D\u00e9tails de la Correspondance\n\t\t<\/h5>\n\t\t<!-- <p>Correspondence Details<\/p> -->\n\t<\/div>\n\t<div class=\"block-field\">\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label><strong>* Adresse Postale<\/strong><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mailing-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mailing-address\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Ville<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mailing-city\"><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=\"mailing-city\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>\u00c9tat\/Province<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mailing-state\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mailing-state\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Pays<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mailing-country\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"mailing-country\"><option value=\"Aruba\">Aruba<\/option><option value=\"Afghanistan\">Afghanistan<\/option><option value=\"Angola\">Angola<\/option><option value=\"Anguilla\">Anguilla<\/option><option value=\"\u00c5land Islands\">\u00c5land Islands<\/option><option value=\"Albania\">Albania<\/option><option value=\"Andorra\">Andorra<\/option><option value=\"United Arab Emirates\">United Arab Emirates<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"Armenia\">Armenia<\/option><option value=\"American Samoa\">American Samoa<\/option><option value=\"Antarctica\">Antarctica<\/option><option value=\"French Southern Territories\">French Southern Territories<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Australia\">Australia<\/option><option value=\"Austria\">Austria<\/option><option value=\"Azerbaijan\">Azerbaijan<\/option><option value=\"Burundi\">Burundi<\/option><option value=\"Belgium\">Belgium<\/option><option value=\"Benin\">Benin<\/option><option value=\"Bonaire, Sint Eustatius and Saba\">Bonaire, Sint Eustatius and Saba<\/option><option value=\"Burkina Faso\">Burkina Faso<\/option><option value=\"Bangladesh\">Bangladesh<\/option><option value=\"Bulgaria\">Bulgaria<\/option><option value=\"Bahrain\">Bahrain<\/option><option value=\"Bahamas\">Bahamas<\/option><option value=\"Bosnia and Herzegovina\">Bosnia and Herzegovina<\/option><option value=\"Saint Barth\u00e9lemy\">Saint Barth\u00e9lemy<\/option><option value=\"Belarus\">Belarus<\/option><option value=\"Belize\">Belize<\/option><option value=\"Bermuda\">Bermuda<\/option><option value=\"Bolivia, Plurinational State of\">Bolivia, Plurinational State of<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Brunei Darussalam\">Brunei Darussalam<\/option><option value=\"Bhutan\">Bhutan<\/option><option value=\"Bouvet Island\">Bouvet Island<\/option><option value=\"Botswana\">Botswana<\/option><option value=\"Central African Republic\">Central African Republic<\/option><option value=\"Canada\">Canada<\/option><option value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option value=\"Switzerland\">Switzerland<\/option><option value=\"Chile\">Chile<\/option><option value=\"China\">China<\/option><option value=\"C\u00f4te d&#039;Ivoire\">C\u00f4te d&#039;Ivoire<\/option><option value=\"Cameroon\">Cameroon<\/option><option value=\"Congo, the Democratic Republic of the\">Congo, the Democratic Republic of the<\/option><option value=\"Congo\">Congo<\/option><option value=\"Cook Islands\">Cook Islands<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Comoros\">Comoros<\/option><option value=\"Cape Verde\">Cape Verde<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Cura\u00e7ao\">Cura\u00e7ao<\/option><option value=\"Christmas Island\">Christmas Island<\/option><option value=\"Cayman Islands\">Cayman Islands<\/option><option value=\"Cyprus\">Cyprus<\/option><option value=\"Czech Republic\">Czech Republic<\/option><option value=\"Germany\">Germany<\/option><option value=\"Djibouti\">Djibouti<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Denmark\">Denmark<\/option><option value=\"Dominican Republic\">Dominican Republic<\/option><option value=\"Algeria\">Algeria<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"Egypt\">Egypt<\/option><option value=\"Eritrea\">Eritrea<\/option><option value=\"Western Sahara\">Western Sahara<\/option><option value=\"Spain\">Spain<\/option><option value=\"Estonia\">Estonia<\/option><option value=\"Ethiopia\">Ethiopia<\/option><option value=\"Finland\">Finland<\/option><option value=\"Fiji\">Fiji<\/option><option value=\"Falkland Islands (Malvinas)\">Falkland Islands (Malvinas)<\/option><option value=\"France\">France<\/option><option value=\"Faroe Islands\">Faroe Islands<\/option><option value=\"Micronesia, Federated States of\">Micronesia, Federated States of<\/option><option value=\"Gabon\">Gabon<\/option><option value=\"United Kingdom\">United Kingdom<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Guernsey\">Guernsey<\/option><option value=\"Ghana\">Ghana<\/option><option value=\"Gibraltar\">Gibraltar<\/option><option value=\"Guinea\">Guinea<\/option><option value=\"Guadeloupe\">Guadeloupe<\/option><option value=\"Gambia\">Gambia<\/option><option value=\"Guinea-Bissau\">Guinea-Bissau<\/option><option value=\"Equatorial Guinea\">Equatorial Guinea<\/option><option value=\"Greece\">Greece<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Greenland\">Greenland<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"French Guiana\">French Guiana<\/option><option value=\"Guam\">Guam<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Hong Kong\">Hong Kong<\/option><option value=\"Heard Island and McDonald Islands\">Heard Island and McDonald Islands<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Croatia\">Croatia<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Hungary\">Hungary<\/option><option value=\"Indonesia\">Indonesia<\/option><option value=\"Isle of Man\">Isle of Man<\/option><option value=\"India\">India<\/option><option value=\"British Indian Ocean Territory\">British Indian Ocean Territory<\/option><option value=\"Ireland\">Ireland<\/option><option value=\"Iran, Islamic Republic of\">Iran, Islamic Republic of<\/option><option value=\"Iraq\">Iraq<\/option><option value=\"Iceland\">Iceland<\/option><option value=\"Israel\">Israel<\/option><option value=\"Italy\">Italy<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Jersey\">Jersey<\/option><option value=\"Jordan\">Jordan<\/option><option value=\"Japan\">Japan<\/option><option value=\"Kazakhstan\">Kazakhstan<\/option><option value=\"Kenya\">Kenya<\/option><option value=\"Kyrgyzstan\">Kyrgyzstan<\/option><option value=\"Cambodia\">Cambodia<\/option><option value=\"Kiribati\">Kiribati<\/option><option value=\"Saint Kitts and Nevis\">Saint Kitts and Nevis<\/option><option value=\"Korea, Republic of\">Korea, Republic of<\/option><option value=\"Kuwait\">Kuwait<\/option><option value=\"Lao People&#039;s Democratic Republic\">Lao People&#039;s Democratic Republic<\/option><option value=\"Lebanon\">Lebanon<\/option><option value=\"Liberia\">Liberia<\/option><option value=\"Libya\">Libya<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Liechtenstein\">Liechtenstein<\/option><option value=\"Sri Lanka\">Sri Lanka<\/option><option value=\"Lesotho\">Lesotho<\/option><option value=\"Lithuania\">Lithuania<\/option><option value=\"Luxembourg\">Luxembourg<\/option><option value=\"Latvia\">Latvia<\/option><option value=\"Macao\">Macao<\/option><option value=\"Saint Martin (French part)\">Saint Martin (French part)<\/option><option value=\"Morocco\">Morocco<\/option><option value=\"Monaco\">Monaco<\/option><option value=\"Moldova, Republic of\">Moldova, Republic of<\/option><option value=\"Madagascar\">Madagascar<\/option><option value=\"Maldives\">Maldives<\/option><option value=\"Mexico\">Mexico<\/option><option value=\"Marshall Islands\">Marshall Islands<\/option><option value=\"Macedonia, the former Yugoslav Republic of\">Macedonia, the former Yugoslav Republic of<\/option><option value=\"Mali\">Mali<\/option><option value=\"Malta\">Malta<\/option><option value=\"Myanmar\">Myanmar<\/option><option value=\"Montenegro\">Montenegro<\/option><option value=\"Mongolia\">Mongolia<\/option><option value=\"Northern Mariana Islands\">Northern Mariana Islands<\/option><option value=\"Mozambique\">Mozambique<\/option><option value=\"Mauritania\">Mauritania<\/option><option value=\"Montserrat\">Montserrat<\/option><option value=\"Martinique\">Martinique<\/option><option value=\"Mauritius\">Mauritius<\/option><option value=\"Malawi\">Malawi<\/option><option value=\"Malaysia\">Malaysia<\/option><option value=\"Mayotte\">Mayotte<\/option><option value=\"Namibia\">Namibia<\/option><option value=\"New Caledonia\">New Caledonia<\/option><option value=\"Niger\">Niger<\/option><option value=\"Norfolk Island\">Norfolk Island<\/option><option value=\"Nigeria\">Nigeria<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Niue\">Niue<\/option><option value=\"Netherlands\">Netherlands<\/option><option value=\"Norway\">Norway<\/option><option value=\"Nepal\">Nepal<\/option><option value=\"Nauru\">Nauru<\/option><option value=\"New Zealand\">New Zealand<\/option><option value=\"Oman\">Oman<\/option><option value=\"Pakistan\">Pakistan<\/option><option value=\"Panama\">Panama<\/option><option value=\"Pitcairn\">Pitcairn<\/option><option value=\"Peru\">Peru<\/option><option value=\"Philippines\">Philippines<\/option><option value=\"Palau\">Palau<\/option><option value=\"Papua New Guinea\">Papua New Guinea<\/option><option value=\"Poland\">Poland<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Korea, Democratic People&#039;s Republic of\">Korea, Democratic People&#039;s Republic of<\/option><option value=\"Portugal\">Portugal<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Palestine, State of\">Palestine, State of<\/option><option value=\"French Polynesia\">French Polynesia<\/option><option value=\"Qatar\">Qatar<\/option><option value=\"R\u00e9union\">R\u00e9union<\/option><option value=\"Romania\">Romania<\/option><option value=\"Russian Federation\">Russian Federation<\/option><option value=\"Rwanda\">Rwanda<\/option><option value=\"Saudi Arabia\">Saudi Arabia<\/option><option value=\"Sudan\">Sudan<\/option><option value=\"Senegal\">Senegal<\/option><option value=\"Singapore\">Singapore<\/option><option value=\"South Georgia and the South Sandwich Islands\">South Georgia and the South Sandwich Islands<\/option><option value=\"Saint Helena, Ascension and Tristan da Cunha\">Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"Svalbard and Jan Mayen\">Svalbard and Jan Mayen<\/option><option value=\"Solomon Islands\">Solomon Islands<\/option><option value=\"Sierra Leone\">Sierra Leone<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"San Marino\">San Marino<\/option><option value=\"Somalia\">Somalia<\/option><option value=\"Saint Pierre and Miquelon\">Saint Pierre and Miquelon<\/option><option value=\"Serbia\">Serbia<\/option><option value=\"South Sudan\">South Sudan<\/option><option value=\"Sao Tome and Principe\">Sao Tome and Principe<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Slovakia\">Slovakia<\/option><option value=\"Slovenia\">Slovenia<\/option><option value=\"Sweden\">Sweden<\/option><option value=\"Swaziland\">Swaziland<\/option><option value=\"Sint Maarten (Dutch part)\">Sint Maarten (Dutch part)<\/option><option value=\"Seychelles\">Seychelles<\/option><option value=\"Syrian Arab Republic\">Syrian Arab Republic<\/option><option value=\"Turks and Caicos Islands\">Turks and Caicos Islands<\/option><option value=\"Chad\">Chad<\/option><option value=\"Togo\">Togo<\/option><option value=\"Thailand\">Thailand<\/option><option value=\"Tajikistan\">Tajikistan<\/option><option value=\"Tokelau\">Tokelau<\/option><option value=\"Turkmenistan\">Turkmenistan<\/option><option value=\"Timor-Leste\">Timor-Leste<\/option><option value=\"Tonga\">Tonga<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Tunisia\">Tunisia<\/option><option value=\"Turkey\">Turkey<\/option><option value=\"Tuvalu\">Tuvalu<\/option><option value=\"Taiwan, Province of China\">Taiwan, Province of China<\/option><option value=\"Tanzania, United Republic of\">Tanzania, United Republic of<\/option><option value=\"Uganda\">Uganda<\/option><option value=\"Ukraine\">Ukraine<\/option><option value=\"United States Minor Outlying Islands\">United States Minor Outlying Islands<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"United States\">United States<\/option><option value=\"Uzbekistan\">Uzbekistan<\/option><option value=\"Holy See (Vatican City State)\">Holy See (Vatican City State)<\/option><option value=\"Saint Vincent and the Grenadines\">Saint Vincent and the Grenadines<\/option><option value=\"Venezuela, Bolivarian Republic of\">Venezuela, Bolivarian Republic of<\/option><option value=\"Virgin Islands, British\">Virgin Islands, British<\/option><option value=\"Virgin Islands, U.S.\">Virgin Islands, U.S.<\/option><option value=\"Viet Nam\">Viet Nam<\/option><option value=\"Vanuatu\">Vanuatu<\/option><option value=\"Wallis and Futuna\">Wallis and Futuna<\/option><option value=\"Samoa\">Samoa<\/option><option value=\"Yemen\">Yemen<\/option><option value=\"South Africa\">South Africa<\/option><option value=\"Zambia\">Zambia<\/option><option value=\"Zimbabwe\">Zimbabwe<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Code postal<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mailing-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mailing-code\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label><strong>Adresse R\u00e9sidentielle <\/strong><small>Laissez vide si m\u00eame que ci-dessus<\/small><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"residential-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"residential-address\" \/><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"residential-address-2\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"residential-address-2\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Ville<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"residential-city\"><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=\"residential-city\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>\u00c9tat\/Province<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"residential-state\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"residential-state\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Pays<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"residential-country\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"residential-country\"><option value=\"Aruba\">Aruba<\/option><option value=\"Afghanistan\">Afghanistan<\/option><option value=\"Angola\">Angola<\/option><option value=\"Anguilla\">Anguilla<\/option><option value=\"\u00c5land Islands\">\u00c5land Islands<\/option><option value=\"Albania\">Albania<\/option><option value=\"Andorra\">Andorra<\/option><option value=\"United Arab Emirates\">United Arab Emirates<\/option><option value=\"Argentina\">Argentina<\/option><option value=\"Armenia\">Armenia<\/option><option value=\"American Samoa\">American Samoa<\/option><option value=\"Antarctica\">Antarctica<\/option><option value=\"French Southern Territories\">French Southern Territories<\/option><option value=\"Antigua and Barbuda\">Antigua and Barbuda<\/option><option value=\"Australia\">Australia<\/option><option value=\"Austria\">Austria<\/option><option value=\"Azerbaijan\">Azerbaijan<\/option><option value=\"Burundi\">Burundi<\/option><option value=\"Belgium\">Belgium<\/option><option value=\"Benin\">Benin<\/option><option value=\"Bonaire, Sint Eustatius and Saba\">Bonaire, Sint Eustatius and Saba<\/option><option value=\"Burkina Faso\">Burkina Faso<\/option><option value=\"Bangladesh\">Bangladesh<\/option><option value=\"Bulgaria\">Bulgaria<\/option><option value=\"Bahrain\">Bahrain<\/option><option value=\"Bahamas\">Bahamas<\/option><option value=\"Bosnia and Herzegovina\">Bosnia and Herzegovina<\/option><option value=\"Saint Barth\u00e9lemy\">Saint Barth\u00e9lemy<\/option><option value=\"Belarus\">Belarus<\/option><option value=\"Belize\">Belize<\/option><option value=\"Bermuda\">Bermuda<\/option><option value=\"Bolivia, Plurinational State of\">Bolivia, Plurinational State of<\/option><option value=\"Brazil\">Brazil<\/option><option value=\"Barbados\">Barbados<\/option><option value=\"Brunei Darussalam\">Brunei Darussalam<\/option><option value=\"Bhutan\">Bhutan<\/option><option value=\"Bouvet Island\">Bouvet Island<\/option><option value=\"Botswana\">Botswana<\/option><option value=\"Central African Republic\">Central African Republic<\/option><option value=\"Canada\">Canada<\/option><option value=\"Cocos (Keeling) Islands\">Cocos (Keeling) Islands<\/option><option value=\"Switzerland\">Switzerland<\/option><option value=\"Chile\">Chile<\/option><option value=\"China\">China<\/option><option value=\"C\u00f4te d&#039;Ivoire\">C\u00f4te d&#039;Ivoire<\/option><option value=\"Cameroon\">Cameroon<\/option><option value=\"Congo, the Democratic Republic of the\">Congo, the Democratic Republic of the<\/option><option value=\"Congo\">Congo<\/option><option value=\"Cook Islands\">Cook Islands<\/option><option value=\"Colombia\">Colombia<\/option><option value=\"Comoros\">Comoros<\/option><option value=\"Cape Verde\">Cape Verde<\/option><option value=\"Costa Rica\">Costa Rica<\/option><option value=\"Cuba\">Cuba<\/option><option value=\"Cura\u00e7ao\">Cura\u00e7ao<\/option><option value=\"Christmas Island\">Christmas Island<\/option><option value=\"Cayman Islands\">Cayman Islands<\/option><option value=\"Cyprus\">Cyprus<\/option><option value=\"Czech Republic\">Czech Republic<\/option><option value=\"Germany\">Germany<\/option><option value=\"Djibouti\">Djibouti<\/option><option value=\"Dominica\">Dominica<\/option><option value=\"Denmark\">Denmark<\/option><option value=\"Dominican Republic\">Dominican Republic<\/option><option value=\"Algeria\">Algeria<\/option><option value=\"Ecuador\">Ecuador<\/option><option value=\"Egypt\">Egypt<\/option><option value=\"Eritrea\">Eritrea<\/option><option value=\"Western Sahara\">Western Sahara<\/option><option value=\"Spain\">Spain<\/option><option value=\"Estonia\">Estonia<\/option><option value=\"Ethiopia\">Ethiopia<\/option><option value=\"Finland\">Finland<\/option><option value=\"Fiji\">Fiji<\/option><option value=\"Falkland Islands (Malvinas)\">Falkland Islands (Malvinas)<\/option><option value=\"France\">France<\/option><option value=\"Faroe Islands\">Faroe Islands<\/option><option value=\"Micronesia, Federated States of\">Micronesia, Federated States of<\/option><option value=\"Gabon\">Gabon<\/option><option value=\"United Kingdom\">United Kingdom<\/option><option value=\"Georgia\">Georgia<\/option><option value=\"Guernsey\">Guernsey<\/option><option value=\"Ghana\">Ghana<\/option><option value=\"Gibraltar\">Gibraltar<\/option><option value=\"Guinea\">Guinea<\/option><option value=\"Guadeloupe\">Guadeloupe<\/option><option value=\"Gambia\">Gambia<\/option><option value=\"Guinea-Bissau\">Guinea-Bissau<\/option><option value=\"Equatorial Guinea\">Equatorial Guinea<\/option><option value=\"Greece\">Greece<\/option><option value=\"Grenada\">Grenada<\/option><option value=\"Greenland\">Greenland<\/option><option value=\"Guatemala\">Guatemala<\/option><option value=\"French Guiana\">French Guiana<\/option><option value=\"Guam\">Guam<\/option><option value=\"Guyana\">Guyana<\/option><option value=\"Hong Kong\">Hong Kong<\/option><option value=\"Heard Island and McDonald Islands\">Heard Island and McDonald Islands<\/option><option value=\"Honduras\">Honduras<\/option><option value=\"Croatia\">Croatia<\/option><option value=\"Haiti\">Haiti<\/option><option value=\"Hungary\">Hungary<\/option><option value=\"Indonesia\">Indonesia<\/option><option value=\"Isle of Man\">Isle of Man<\/option><option value=\"India\">India<\/option><option value=\"British Indian Ocean Territory\">British Indian Ocean Territory<\/option><option value=\"Ireland\">Ireland<\/option><option value=\"Iran, Islamic Republic of\">Iran, Islamic Republic of<\/option><option value=\"Iraq\">Iraq<\/option><option value=\"Iceland\">Iceland<\/option><option value=\"Israel\">Israel<\/option><option value=\"Italy\">Italy<\/option><option value=\"Jamaica\">Jamaica<\/option><option value=\"Jersey\">Jersey<\/option><option value=\"Jordan\">Jordan<\/option><option value=\"Japan\">Japan<\/option><option value=\"Kazakhstan\">Kazakhstan<\/option><option value=\"Kenya\">Kenya<\/option><option value=\"Kyrgyzstan\">Kyrgyzstan<\/option><option value=\"Cambodia\">Cambodia<\/option><option value=\"Kiribati\">Kiribati<\/option><option value=\"Saint Kitts and Nevis\">Saint Kitts and Nevis<\/option><option value=\"Korea, Republic of\">Korea, Republic of<\/option><option value=\"Kuwait\">Kuwait<\/option><option value=\"Lao People&#039;s Democratic Republic\">Lao People&#039;s Democratic Republic<\/option><option value=\"Lebanon\">Lebanon<\/option><option value=\"Liberia\">Liberia<\/option><option value=\"Libya\">Libya<\/option><option value=\"Saint Lucia\">Saint Lucia<\/option><option value=\"Liechtenstein\">Liechtenstein<\/option><option value=\"Sri Lanka\">Sri Lanka<\/option><option value=\"Lesotho\">Lesotho<\/option><option value=\"Lithuania\">Lithuania<\/option><option value=\"Luxembourg\">Luxembourg<\/option><option value=\"Latvia\">Latvia<\/option><option value=\"Macao\">Macao<\/option><option value=\"Saint Martin (French part)\">Saint Martin (French part)<\/option><option value=\"Morocco\">Morocco<\/option><option value=\"Monaco\">Monaco<\/option><option value=\"Moldova, Republic of\">Moldova, Republic of<\/option><option value=\"Madagascar\">Madagascar<\/option><option value=\"Maldives\">Maldives<\/option><option value=\"Mexico\">Mexico<\/option><option value=\"Marshall Islands\">Marshall Islands<\/option><option value=\"Macedonia, the former Yugoslav Republic of\">Macedonia, the former Yugoslav Republic of<\/option><option value=\"Mali\">Mali<\/option><option value=\"Malta\">Malta<\/option><option value=\"Myanmar\">Myanmar<\/option><option value=\"Montenegro\">Montenegro<\/option><option value=\"Mongolia\">Mongolia<\/option><option value=\"Northern Mariana Islands\">Northern Mariana Islands<\/option><option value=\"Mozambique\">Mozambique<\/option><option value=\"Mauritania\">Mauritania<\/option><option value=\"Montserrat\">Montserrat<\/option><option value=\"Martinique\">Martinique<\/option><option value=\"Mauritius\">Mauritius<\/option><option value=\"Malawi\">Malawi<\/option><option value=\"Malaysia\">Malaysia<\/option><option value=\"Mayotte\">Mayotte<\/option><option value=\"Namibia\">Namibia<\/option><option value=\"New Caledonia\">New Caledonia<\/option><option value=\"Niger\">Niger<\/option><option value=\"Norfolk Island\">Norfolk Island<\/option><option value=\"Nigeria\">Nigeria<\/option><option value=\"Nicaragua\">Nicaragua<\/option><option value=\"Niue\">Niue<\/option><option value=\"Netherlands\">Netherlands<\/option><option value=\"Norway\">Norway<\/option><option value=\"Nepal\">Nepal<\/option><option value=\"Nauru\">Nauru<\/option><option value=\"New Zealand\">New Zealand<\/option><option value=\"Oman\">Oman<\/option><option value=\"Pakistan\">Pakistan<\/option><option value=\"Panama\">Panama<\/option><option value=\"Pitcairn\">Pitcairn<\/option><option value=\"Peru\">Peru<\/option><option value=\"Philippines\">Philippines<\/option><option value=\"Palau\">Palau<\/option><option value=\"Papua New Guinea\">Papua New Guinea<\/option><option value=\"Poland\">Poland<\/option><option value=\"Puerto Rico\">Puerto Rico<\/option><option value=\"Korea, Democratic People&#039;s Republic of\">Korea, Democratic People&#039;s Republic of<\/option><option value=\"Portugal\">Portugal<\/option><option value=\"Paraguay\">Paraguay<\/option><option value=\"Palestine, State of\">Palestine, State of<\/option><option value=\"French Polynesia\">French Polynesia<\/option><option value=\"Qatar\">Qatar<\/option><option value=\"R\u00e9union\">R\u00e9union<\/option><option value=\"Romania\">Romania<\/option><option value=\"Russian Federation\">Russian Federation<\/option><option value=\"Rwanda\">Rwanda<\/option><option value=\"Saudi Arabia\">Saudi Arabia<\/option><option value=\"Sudan\">Sudan<\/option><option value=\"Senegal\">Senegal<\/option><option value=\"Singapore\">Singapore<\/option><option value=\"South Georgia and the South Sandwich Islands\">South Georgia and the South Sandwich Islands<\/option><option value=\"Saint Helena, Ascension and Tristan da Cunha\">Saint Helena, Ascension and Tristan da Cunha<\/option><option value=\"Svalbard and Jan Mayen\">Svalbard and Jan Mayen<\/option><option value=\"Solomon Islands\">Solomon Islands<\/option><option value=\"Sierra Leone\">Sierra Leone<\/option><option value=\"El Salvador\">El Salvador<\/option><option value=\"San Marino\">San Marino<\/option><option value=\"Somalia\">Somalia<\/option><option value=\"Saint Pierre and Miquelon\">Saint Pierre and Miquelon<\/option><option value=\"Serbia\">Serbia<\/option><option value=\"South Sudan\">South Sudan<\/option><option value=\"Sao Tome and Principe\">Sao Tome and Principe<\/option><option value=\"Suriname\">Suriname<\/option><option value=\"Slovakia\">Slovakia<\/option><option value=\"Slovenia\">Slovenia<\/option><option value=\"Sweden\">Sweden<\/option><option value=\"Swaziland\">Swaziland<\/option><option value=\"Sint Maarten (Dutch part)\">Sint Maarten (Dutch part)<\/option><option value=\"Seychelles\">Seychelles<\/option><option value=\"Syrian Arab Republic\">Syrian Arab Republic<\/option><option value=\"Turks and Caicos Islands\">Turks and Caicos Islands<\/option><option value=\"Chad\">Chad<\/option><option value=\"Togo\">Togo<\/option><option value=\"Thailand\">Thailand<\/option><option value=\"Tajikistan\">Tajikistan<\/option><option value=\"Tokelau\">Tokelau<\/option><option value=\"Turkmenistan\">Turkmenistan<\/option><option value=\"Timor-Leste\">Timor-Leste<\/option><option value=\"Tonga\">Tonga<\/option><option value=\"Trinidad and Tobago\">Trinidad and Tobago<\/option><option value=\"Tunisia\">Tunisia<\/option><option value=\"Turkey\">Turkey<\/option><option value=\"Tuvalu\">Tuvalu<\/option><option value=\"Taiwan, Province of China\">Taiwan, Province of China<\/option><option value=\"Tanzania, United Republic of\">Tanzania, United Republic of<\/option><option value=\"Uganda\">Uganda<\/option><option value=\"Ukraine\">Ukraine<\/option><option value=\"United States Minor Outlying Islands\">United States Minor Outlying Islands<\/option><option value=\"Uruguay\">Uruguay<\/option><option value=\"United States\">United States<\/option><option value=\"Uzbekistan\">Uzbekistan<\/option><option value=\"Holy See (Vatican City State)\">Holy See (Vatican City State)<\/option><option value=\"Saint Vincent and the Grenadines\">Saint Vincent and the Grenadines<\/option><option value=\"Venezuela, Bolivarian Republic of\">Venezuela, Bolivarian Republic of<\/option><option value=\"Virgin Islands, British\">Virgin Islands, British<\/option><option value=\"Virgin Islands, U.S.\">Virgin Islands, U.S.<\/option><option value=\"Viet Nam\">Viet Nam<\/option><option value=\"Vanuatu\">Vanuatu<\/option><option value=\"Wallis and Futuna\">Wallis and Futuna<\/option><option value=\"Samoa\">Samoa<\/option><option value=\"Yemen\">Yemen<\/option><option value=\"South Africa\">South Africa<\/option><option value=\"Zambia\">Zambia<\/option><option value=\"Zimbabwe\">Zimbabwe<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Adresse Postale<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"residential-code\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"residential-code\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label><strong>* Statut juridique<\/strong><small>dans le pays de r\u00e9sidence<\/small><\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"legal-status\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"legal-status\"><option value=\"Citizen\">Citizen<\/option><option value=\"Permanent Resident\">Permanent Resident<\/option><option value=\"Temporary Worker\">Temporary Worker<\/option><option value=\"Student\">Student<\/option><option value=\"Other\">Other<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>T\u00e9l\u00e9phone \u00e0 domicile<\/label>\n\t\t\t\t<\/p>\n\t\t\t\t<p>Code du pays-Indicatif r\u00e9gional-Num\u00e9ro de t\u00e9l\u00e9phone\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"home-phone-city-code\"><input size=\"40\" maxlength=\"4\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"home-phone-city-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"home-phone-area-code\"><input size=\"40\" maxlength=\"5\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"home-phone-area-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"home-phone-number\"><input size=\"40\" maxlength=\"11\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"home-phone-number\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Autre t\u00e9l\u00e9phone<\/label>\n\t\t\t\t<\/p>\n\t\t\t\t<p>Code du pays-Indicatif r\u00e9gional-Num\u00e9ro de t\u00e9l\u00e9phone\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"other-phone-city-code\"><input size=\"40\" maxlength=\"4\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"other-phone-city-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"other-phone-area-code\"><input size=\"40\" maxlength=\"5\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"other-phone-area-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"other-phone-number\"><input size=\"40\" maxlength=\"11\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"other-phone-number\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>T\u00e9l\u00e9phone cellulaire<\/label>\n\t\t\t\t<\/p>\n\t\t\t\t<p>Code du pays-Indicatif r\u00e9gional-Num\u00e9ro de t\u00e9l\u00e9phone\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"cell-phone-city-code\"><input size=\"40\" maxlength=\"4\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"cell-phone-city-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"cell-phone-number\"><input size=\"40\" maxlength=\"11\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"cell-phone-number\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>T\u00e9l\u00e9copieur<\/label>\n\t\t\t\t<\/p>\n\t\t\t\t<p>Code du pays-Indicatif r\u00e9gional-Num\u00e9ro de t\u00e9l\u00e9phone\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fax-city-code\"><input size=\"40\" maxlength=\"4\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fax-city-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"fax-area-code\"><input size=\"40\" maxlength=\"5\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fax-area-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"fax-phone-number\"><input size=\"40\" maxlength=\"11\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"fax-phone-number\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>T\u00e9l\u00e9copieur<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"fax-city-code\"><input size=\"40\" maxlength=\"4\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fax-city-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"fax-area-code\"><input size=\"40\" maxlength=\"5\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"fax-area-code\" \/><\/span> - <span class=\"wpcf7-form-control-wrap\" data-name=\"fax-phone-number\"><input size=\"40\" maxlength=\"11\" class=\"wpcf7-form-control wpcf7-tel wpcf7-text wpcf7-validates-as-tel\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"fax-phone-number\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Courriel<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><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=\"your-email\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Entrer \u00e0 nouveau votre courriel<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"re-your-email\"><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=\"re-your-email\" \/><\/span><br \/>\n<small>Assurez-vous que ce courriel est actif et valide le r\u00e9sultat de votre \u00e9valuation sera envoy\u00e9e sur cette adresse.<\/small>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<p>[cf7mls_step step-1 \"Next\"]\n<\/p>\n<div class=\"form-block\">\n\t<div class=\"form-block-title\">\n\t\t<h5><strong>Etudes D\u00e9tails Sp\u00e9cifiques <\/strong>\n\t\t<\/h5>\n\t\t<p>Votre \u00e9valuation est bas\u00e9e aussi sur les d\u00e9tails suivants\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"block-field\">\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label><br \/>\n<span>* Years of Formal Education<\/span><br \/>\n<\/label>\n\t\t\t\t<\/p>\n\t\t\t\t<p class=\"color-red\">De l'enseignement primaire\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"years-of-formal-education\"><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=\"years-of-formal-education\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>* Niveau de scolarit\u00e9 compl\u00e9t\u00e9<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-980\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-980\" value=\"Master&#039;s or Ph.D.\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Master&#039;s or Ph.D.<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"2 or more Bachelor&#039;s degrees\" \/><span class=\"wpcf7-list-item-label\">2 or more Bachelor&#039;s degrees<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Bachelor&#039;s - 4 Years\" \/><span class=\"wpcf7-list-item-label\">Bachelor&#039;s - 4 Years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Bachelor&#039;s - 3 Years\" \/><span class=\"wpcf7-list-item-label\">Bachelor&#039;s - 3 Years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Bachelor&#039;s - 2 Years\" \/><span class=\"wpcf7-list-item-label\">Bachelor&#039;s - 2 Years<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Bachelor&#039;s - 1 Year\" \/><span class=\"wpcf7-list-item-label\">Bachelor&#039;s - 1 Year<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Diploma\/Trade Cert.\/Apprenticeship - 3 Yr\" \/><span class=\"wpcf7-list-item-label\">Diploma\/Trade Cert.\/Apprenticeship - 3 Yr<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Diploma\/Trade Cert.\/Apprenticeship - 2 Yr\" \/><span class=\"wpcf7-list-item-label\">Diploma\/Trade Cert.\/Apprenticeship - 2 Yr<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Diploma\/Trade Cert.\/Apprenticeship - 1 Yr\" \/><span class=\"wpcf7-list-item-label\">Diploma\/Trade Cert.\/Apprenticeship - 1 Yr<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-980\" value=\"Completed secondary school (high school)\" \/><span class=\"wpcf7-list-item-label\">Completed secondary school (high school)<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-980\" value=\"Did not complete secondary school (high school)\" \/><span class=\"wpcf7-list-item-label\">Did not complete secondary school (high school)<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>* Quand avez-vous re\u00e7u votre dipl\u00f4me le plus r\u00e9cent?\t<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"when-highest-education-completed-month\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"when-highest-education-completed-month\"><option value=\"January\">January<\/option><option value=\"February\">February<\/option><option value=\"March\">March<\/option><option value=\"April\">April<\/option><option value=\"May\">May<\/option><option value=\"June\">June<\/option><option value=\"July\">July<\/option><option value=\"August\">August<\/option><option value=\"September\">September<\/option><option value=\"October\">October<\/option><option value=\"November\">November<\/option><option value=\"December\">December<\/option><\/select><\/span><br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"when-highest-education-completed\"><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=\"when-highest-education-completed\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>*Stream (Arts, Commerce, Medical, Non Medical etc.)<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"stream\"><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=\"stream\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Pourcentage moyen \/ Grade<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"average-percentage\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"average-percentage\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Cours d\u00e9sir\u00e9 d'\u00e9tudes au Canada<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"desired-course-of-study\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"desired-course-of-study\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Zone Major \/ Stream d'\u00e9tudes au Canada<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"major-area-stream-of-study\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"major-area-stream-of-study\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Course Type Preference<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"course-type-preference\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"course-type-preference\"><option value=\"Diploma\">Diploma<\/option><option value=\"Bachelors\">Bachelors<\/option><option value=\"Masters\">Masters<\/option><option value=\"Doctorate\">Doctorate<\/option><option value=\"Any\">Any<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>P\u00e9riode d'\u00e9tudes vis\u00e9e<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper flex-wrap\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"intended-period\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"intended-period\" \/><\/span>[select \"Years\" \"Months\" \"Weeks\"]\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Quand pr\u00e9voyez-vous Pour d\u00e9marrer<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"when-do-you-plan-to-start\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"when-do-you-plan-to-start\"><option value=\"Immediately\">Immediately<\/option><option value=\"6 Months\">6 Months<\/option><option value=\"1 Year\">1 Year<\/option><option value=\"2 Years\">2 Years<\/option><option value=\"After 2 Years\">After 2 Years<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Source des fonds<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"source-of-funds\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"source-of-funds[]\" value=\"Own\/Parents Funds\" \/><span class=\"wpcf7-list-item-label\">Own\/Parents Funds<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"source-of-funds[]\" value=\"Bank Loan\" \/><span class=\"wpcf7-list-item-label\">Bank Loan<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"source-of-funds[]\" value=\"Scholarship\" \/><span class=\"wpcf7-list-item-label\">Scholarship<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"source-of-funds[]\" value=\"Sponsorship\" \/><span class=\"wpcf7-list-item-label\">Sponsorship<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"source-of-funds[]\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Si vous \u00eates d\u00e9j\u00e0 accept\u00e9 par un \u00e9tablissement au Canada, fournir le nom et la ville de l'institut<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"accepted-instituion-in-canada\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"accepted-instituion-in-canada\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Avez-vous de la parent\u00e9 au Canada?\t<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"blood-relative-canada\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"blood-relative-canada\"><option value=\"None\">None<\/option><option value=\"Parent\">Parent<\/option><option value=\"Brother\">Brother<\/option><option value=\"Sister\">Sister<\/option><option value=\"Grandparent\">Grandparent<\/option><option value=\"Child\">Child<\/option><option value=\"Uncle\">Uncle<\/option><option value=\"Aunt\">Aunt<\/option><option value=\"Niece\">Niece<\/option><option value=\"Nephew\">Nephew<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<p>[cf7mls_step step-2 \"Back\" \"Next\"]\n<\/p>\n<div class=\"form-block\">\n\t<div class=\"form-block-title\">\n\t\t<h5>D\u00e9tail d'admissibilit\u00e9\n\t\t<\/h5>\n\t\t<p>Ces questions se rapporte au requerant, la personne qui immigrera au Canada.\n\t\t<\/p>\n\t<\/div>\n\t<div class=\"block-field\">\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Aviez une maladie grave ou probl\u00e8me physique ou psychologique?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"psychological-disorder\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"psychological-disorder\"><option value=\"No\">No<\/option><option value=\"Yes\">Yes<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Avoir \u00e9t\u00e9 d\u00e9clar\u00e9 coupable ou \u00eates pr\u00e9sentement accus\u00e9 d'une infraction criminelle dans n'importe quel pays?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"criminal-offence-any-country\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"criminal-offence-any-country\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Avoir d\u00e9j\u00e0 appliqu\u00e9 pour une r\u00e9sidence temporaire au Canada?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"temporary-visa-to-canada\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"temporary-visa-to-canada\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Avoir d\u00e9j\u00e0 appliqu\u00e9 pour une r\u00e9sidence permanente au Canada?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"permanent-residence-in-canada\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"permanent-residence-in-canada\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Avoir \u00e9t\u00e9 refus\u00e9 d'un visa au Canada ou tout autre pays?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"refused-visa-in-canada-other-country\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"refused-visa-in-canada-other-country\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Vavoir vu se refuser l'admission ou l'ordre de renvoi du Canada ou tout autre pays?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"refused-admission-from-canada-or-other-country\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"refused-admission-from-canada-or-other-country\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Avoir \u00e9t\u00e9 impliqu\u00e9 \u00e0 la commission de violations des droits humains, actes de subversion, d'espionnage, de terrorisme ou de criminalit\u00e9 organis\u00e9e?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"been-inloved-commission\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"been-inloved-commission\"><option value=\"Non\">Non<\/option><option value=\"Oui\">Oui<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p>Si vous avez repondu par oui pour n'importe quelles questions si dessus, s'il vous plait ecrivez les details ci-apr\u00e8s\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper small-texarea\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"details\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"details\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"form-block-title\">\n\t\t<h5>Renseignements financiers (en dollars)\n\t\t<\/h5>\n\t<\/div>\n\t<div class=\"block-field\">\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Revenu mensuel familial total<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"monthly-income\"><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=\"monthly-income\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Valeur nette totale de vos actifs<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"total-net-worth-of-your-family\"><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=\"total-net-worth-of-your-family\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Total des \u00e9pargnes (dans les banques et autres placements)<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"total-savings\"><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=\"total-savings\" \/><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Br\u00e8ve description de la provenance des ressources financi\u00e8res pour couvrir les frais d'immigration<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper small-texarea\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"brief-description\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"brief-description\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<div class=\"form-block-title\">\n\t\t<h5>Information Finale\n\t\t<\/h5>\n\t<\/div>\n\t<div class=\"block-field\">\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Comment avez vous pris connaissance de notre compagnie?<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"how-did-you-come\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"how-did-you-come\"><option value=\"Online Advertisement\">Online Advertisement<\/option><option value=\"Referred By A Client\">Referred By A Client<\/option><option value=\"Search Engine (Google)\">Search Engine (Google)<\/option><\/select><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-wrapper-full\">\n\t\t\t\t<h5>Fournir toute information compl\u00e9mentaire que vous pensez pertinante pour \u00e9valuer votre demande et collez votre curriculum vitae ci-apr\u00e8s:\n\t\t\t\t<\/h5>\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"additional-information\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"additional-information\"><\/textarea><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t\t<div class=\"block-wrapper\">\n\t\t\t<div class=\"field-label\">\n\t\t\t\t<p><label>Declaration<\/label>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t\t<div class=\"field-wrapper\">\n\t\t\t\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"declaration\"><span class=\"wpcf7-form-control wpcf7-acceptance optional\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"declaration\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">e d\u00e9clare que les renseignements donn\u00e9s dans ce formulaire d'\u00e9valuation sont vraies, au meilleur de mes connaissances. Je comprends que votre entreprise pourrait utiliser ces informations pour me contacter par tous les moyens de communication disponibles et de m'envoyer des informations selon le besoin.<\/span><\/label><\/span><\/span><\/span>\n\t\t\t\t<\/p>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<div class=\"submit-wrapper\">\n\t<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n\t<\/p>\n<\/div><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<\/div>\n<\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1109","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/pages\/1109","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/comments?post=1109"}],"version-history":[{"count":4,"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/pages\/1109\/revisions"}],"predecessor-version":[{"id":1324,"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/pages\/1109\/revisions\/1324"}],"wp:attachment":[{"href":"https:\/\/ccimm.com\/fr\/wp-json\/wp\/v2\/media?parent=1109"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}