Vous souhaitez adhérer à l'ADAGGE, renseignez le bordereau suivant. Les rubriques avec * sont obligatoires.
Email*
Valid email
Image title
*
Image title
*
Hover text
Loading image…
Loading...
Loading…
Prénom NOM
*
Question
Prénom NOM
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Adresse mail
*
Question
Adresse mail
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Contains
Doesn't contain
Email
URL
Text
and
Text
Custom error text
Answer key
(0 points)
Loading...
Loading…
Adresse postale
*
Question
Adresse postale
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Téléphone
*
Question
Téléphone
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Short answer text
Response validation has been added.
Remove
Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
Equal to
Not equal to
Between
Not between
Is number
Whole number
Number
and
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Je fais parvenir mon adhésion de 5€
*
Question
Je fais parvenir mon adhésion de 5€
*
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Description
Loading image…
Caption
Chèque bancaire à l'ordre de l'ADAGGE 7 impasse des douaires 27600 GAILLON
Virement bancaire sur le compte de l'ADAGGE (voir RIB)
Je m'en acquitterai à l'A.G.
Other…
Add option
or
add "Other"
…
Select at least
Select at most
Select exactly
Number
Custom error text
Answer key
(0 points)
Loading...
Loading…
Link to Sheets
The number of responses collected by this form may exceed the limit supported by Sheets. If you're having trouble viewing your responses in Sheets, try downloading a .CSV instead.
Message for respondents
This form is no longer accepting responses
Summary
Question
Individual
Insights
Total points distribution
Loading...
Loading responses…
Prénom NOM
Copy
No responses yet for this question.
Adresse mail
Copy
No responses yet for this question.
Adresse postale
Copy
No responses yet for this question.
Téléphone
Copy
No responses yet for this question.
Je fais parvenir mon adhésion de 5€
Copy
No responses yet for this question.
Waiting for responses
of
6
of
1
Loading...
Loading response…
Grades from previous versions of this form are hidden. Learn more
Settings
Release grades
Respondent settings
Global quiz defaults
Default question point value
Point values for every new question
points
Responses
Manage how responses are collected and protected
Collect email addresses
Required by Locked mode
Do not collect
Verified
Responder input
Send responders a copy of their response
Disabled by Locked mode
Requires Collect email addresses
Off
When requested
Always
Requires sign in
File upload
Total size limit for all uploaded files
This limit is smaller than the max size of a single response.
Responses will not be accepted after the limit is reached. Learn more
1 GB
10 GB
100 GB
1 TB
Presentation
Manage how the form and responses are presented
Form presentation
After submission
Confirmation message
Nous avons bien reçu votre Bordereau d'adhésion. Celle-ci deviendra effective à réception de votre cotisation.