{"id":80,"date":"2023-10-17T10:50:23","date_gmt":"2023-10-17T08:50:23","guid":{"rendered":"https:\/\/cassar.ch\/?page_id=80"},"modified":"2024-01-31T12:30:19","modified_gmt":"2024-01-31T11:30:19","slug":"last-will-and-testament","status":"publish","type":"page","link":"https:\/\/cassar.ch\/en\/dernieres-volontes\/","title":{"rendered":"Last will and testament"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"80\" class=\"elementor elementor-80\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-af4bb01 e-flex e-con-boxed e-con e-parent\" data-id=\"af4bb01\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f858dce elementor-widget elementor-widget-heading\" data-id=\"f858dce\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Publications<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-77c4994 elementor-widget elementor-widget-heading\" data-id=\"77c4994\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Derni\u00e8res volont\u00e9s<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c9558aa e-flex e-con-boxed e-con e-parent\" data-id=\"c9558aa\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c425df5 elementor-widget elementor-widget-heading\" data-id=\"c425df5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h5 class=\"elementor-heading-title elementor-size-default\"><b>Pr\u00e9voyance fun\u00e9raire : <\/b>votre avenir en toute confiance avec nos pr\u00e9voyances fun\u00e9raires. D\u00e9placement \u00e0 votre domicile et proposition sans engagement<\/h5>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2665620 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"2665620\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/cassar.ch\/contrat-de-prevoyance-funeraire\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">EN SAVOIR PLUS<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-59c9791 e-flex e-con-boxed e-con e-parent\" data-id=\"59c9791\" 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                         <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/en\/wp-json\/wp\/v2\/pages\/80#gf_2' data-formid='2' novalidate>\n        <div id='gf_progressbar_wrapper_2' class='gf_progressbar_wrapper' data-start-at-zero='1'>\n        \t<h3 class=\"gf_progressbar_title\">Step <span class='gf_step_current_page'>1<\/span> of <span class='gf_step_page_count'>7<\/span><span class='gf_step_page_name'><\/span>\n        \t<\/h3>\n            <div class='gf_progressbar gf_progressbar_gray' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_gray percentbar_0' style='width:0%;'><span>0%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_2_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_98\" class=\"gfield gfield--type-html form_page_info gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4 class=\"form-section-title\">Apr\u00e8s mon d\u00e9c\u00e8s<\/h4><\/li><li id=\"field_2_133\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Autopsie<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_133'>\n\t\t\t<li class='gchoice gchoice_2_133_0'>\n\t\t\t\t<input name='input_133' type='radio' value='je donne l&#039;autorisation pour qu&#039;une \u00e9ventuelle autopsie soit 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class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Pr\u00e9l\u00e8vement d&#039;organes<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_38'>\n\t\t\t<li class='gchoice gchoice_2_38_0'>\n\t\t\t\t<input name='input_38' type='radio' value='je ne permets aucun pr\u00e9l\u00e8vement d&#039;organes'  id='choice_2_38_0'    \/>\n\t\t\t\t<label for='choice_2_38_0' id='label_2_38_0' class='gform-field-label gform-field-label--type-inline'>je ne permets aucun pr\u00e9l\u00e8vement d'organes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_38_1'>\n\t\t\t\t<input name='input_38' type='radio' value='dans la mesure du possible, j&#039;autorise le pr\u00e9l\u00e8vement d&#039;organes'  id='choice_2_38_1'    \/>\n\t\t\t\t<label for='choice_2_38_1' id='label_2_38_1' class='gform-field-label gform-field-label--type-inline'>dans la mesure du possible, j'autorise le pr\u00e9l\u00e8vement d'organes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_38_2'>\n\t\t\t\t<input name='input_38' type='radio' value='au choix de la famille'  id='choice_2_38_2'    \/>\n\t\t\t\t<label for='choice_2_38_2' id='label_2_38_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_2_10' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_2' class='gform_page' data-js='page-field-id-10' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_2_2' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_100\" class=\"gfield gfield--type-html form_page_info gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4 class=\"form-section-title\">Indications pour mes obs\u00e8ques<\/h4><\/li><li id=\"field_2_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Habillement<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_37'>\n\t\t\t<li class='gchoice gchoice_2_37_0'>\n\t\t\t\t<input name='input_37' type='radio' value='personnel'  id='choice_2_37_0'    \/>\n\t\t\t\t<label for='choice_2_37_0' id='label_2_37_0' class='gform-field-label gform-field-label--type-inline'>personnel<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_37_1'>\n\t\t\t\t<input name='input_37' type='radio' value='chemise mortuaire (fournie par les pompes fun\u00e8bres)'  id='choice_2_37_1'    \/>\n\t\t\t\t<label for='choice_2_37_1' id='label_2_37_1' class='gform-field-label gform-field-label--type-inline'>chemise mortuaire (fournie par les pompes fun\u00e8bres)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_37_2'>\n\t\t\t\t<input name='input_37' type='radio' value='au choix de la famille'  id='choice_2_37_2'    \/>\n\t\t\t\t<label for='choice_2_37_2' id='label_2_37_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_37_3'>\n\t\t\t\t<input name='input_37' type='radio' value='gf_other_choice'  id='choice_2_37_3'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_2_37_other' name='input_37_other' type='text' value='Other' aria-label='Other' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Other\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Other\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_127\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_127'><span class='gform-field-label__text'>V\u00eatements si possible souhait\u00e9s<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_127' id='input_2_127' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_101\" class=\"gfield gfield--type-html form_seperator gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><hr><\/li><li id=\"field_2_143\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_143'><span class='gform-field-label__text'>Domicile mortuaire<\/span><\/label><div class='gfield_description' id='gfield_description_2_143'>Je d\u00e9sire reposer, si possible, \u00e0:<\/div><div class='ginput_container ginput_container_text'><input name='input_143' id='input_2_143' type='text' value='' class='medium'  aria-describedby=\"gfield_description_2_143\"    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_49\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Je souhaite que le cercueil soit:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_49'>\n\t\t\t<li class='gchoice gchoice_2_49_0'>\n\t\t\t\t<input name='input_49' type='radio' value='ouvert'  id='choice_2_49_0'    \/>\n\t\t\t\t<label for='choice_2_49_0' id='label_2_49_0' class='gform-field-label gform-field-label--type-inline'>ouvert<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_49_1'>\n\t\t\t\t<input name='input_49' type='radio' value='ferm\u00e9'  id='choice_2_49_1'    \/>\n\t\t\t\t<label for='choice_2_49_1' id='label_2_49_1' class='gform-field-label gform-field-label--type-inline'>ferm\u00e9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_49_2'>\n\t\t\t\t<input name='input_49' type='radio' value='au choix de la famille'  id='choice_2_49_2'    \/>\n\t\t\t\t<label for='choice_2_49_2' id='label_2_49_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_103\" class=\"gfield gfield--type-html form_seperator gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><hr><\/li><li id=\"field_2_55\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Qui informer lors de mon d\u00e9c\u00e8s ?<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_55'>\n\t\t\t<li class='gchoice gchoice_2_55_0'>\n\t\t\t\t<input name='input_55' type='radio' value='liste d&#039;adresses ci-dessous'  id='choice_2_55_0'    \/>\n\t\t\t\t<label for='choice_2_55_0' id='label_2_55_0' class='gform-field-label gform-field-label--type-inline'>liste d'adresses ci-dessous<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_55_1'>\n\t\t\t\t<input name='input_55' type='radio' value='au choix de la famille'  id='choice_2_55_1'    \/>\n\t\t\t\t<label for='choice_2_55_1' id='label_2_55_1' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_104\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_104'><span class='gform-field-label__text'>Liste de contacts et leur adresses<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_104' id='input_2_104' class='textarea medium'  aria-describedby=\"gfield_description_2_104\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_2_104'>Saisir vos contacts souhaitez ainsi que leurs adresses<\/div><\/li><li id=\"field_2_105\" class=\"gfield gfield--type-html form_seperator gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><hr><\/li><li id=\"field_2_60\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Je d\u00e9sire une c\u00e9r\u00e9monie fun\u00e8bre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_60'>\n\t\t\t<li class='gchoice gchoice_2_60_0'>\n\t\t\t\t<input name='input_60' type='radio' value='catholique'  id='choice_2_60_0'    \/>\n\t\t\t\t<label for='choice_2_60_0' id='label_2_60_0' class='gform-field-label gform-field-label--type-inline'>catholique<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_1'>\n\t\t\t\t<input name='input_60' type='radio' value='protestante'  id='choice_2_60_1'    \/>\n\t\t\t\t<label for='choice_2_60_1' id='label_2_60_1' class='gform-field-label gform-field-label--type-inline'>protestante<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_2'>\n\t\t\t\t<input name='input_60' type='radio' value='la\u00efque'  id='choice_2_60_2'    \/>\n\t\t\t\t<label for='choice_2_60_2' id='label_2_60_2' class='gform-field-label gform-field-label--type-inline'>la\u00efque<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_3'>\n\t\t\t\t<input name='input_60' type='radio' value='juda\u00efque'  id='choice_2_60_3'    \/>\n\t\t\t\t<label for='choice_2_60_3' id='label_2_60_3' class='gform-field-label gform-field-label--type-inline'>juda\u00efque<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_4'>\n\t\t\t\t<input name='input_60' type='radio' value='musulmane'  id='choice_2_60_4'    \/>\n\t\t\t\t<label for='choice_2_60_4' id='label_2_60_4' class='gform-field-label gform-field-label--type-inline'>musulmane<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_5'>\n\t\t\t\t<input name='input_60' type='radio' value='recueillement musical'  id='choice_2_60_5'    \/>\n\t\t\t\t<label for='choice_2_60_5' id='label_2_60_5' class='gform-field-label gform-field-label--type-inline'>recueillement musical<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_6'>\n\t\t\t\t<input name='input_60' type='radio' value='je n&#039;ai pas d&#039;appartenance \u00e0 un ordre religieux'  id='choice_2_60_6'    \/>\n\t\t\t\t<label for='choice_2_60_6' id='label_2_60_6' class='gform-field-label gform-field-label--type-inline'>je n'ai pas d'appartenance \u00e0 un ordre religieux<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_7'>\n\t\t\t\t<input name='input_60' type='radio' value='au choix de la famille'  id='choice_2_60_7'    \/>\n\t\t\t\t<label for='choice_2_60_7' id='label_2_60_7' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_8'>\n\t\t\t\t<input name='input_60' type='radio' value='sans aucune c\u00e9r\u00e9monie'  id='choice_2_60_8'    \/>\n\t\t\t\t<label for='choice_2_60_8' id='label_2_60_8' class='gform-field-label gform-field-label--type-inline'>sans aucune c\u00e9r\u00e9monie<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_60_9'>\n\t\t\t\t<input name='input_60' type='radio' value='autre (indiquez dans le champs ci-dessous)'  id='choice_2_60_9'    \/>\n\t\t\t\t<label for='choice_2_60_9' id='label_2_60_9' class='gform-field-label gform-field-label--type-inline'>autre (indiquez dans le champs ci-dessous)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_144\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_144'><span class='gform-field-label__text'>Autre type de c\u00e9r\u00e9monie<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_144' id='input_2_144' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_62\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_62'><span class='gform-field-label__text'>Et pour r\u00e9pondre \u00e0 ce voeu, je souhaite, comme officiant, si possible:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_62' id='input_2_62' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_66\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>S&#039;il y a une c\u00e9r\u00e9monie fun\u00e8bre, elle doit \u00eatre:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_66'>\n\t\t\t<li class='gchoice gchoice_2_66_0'>\n\t\t\t\t<input name='input_66' type='radio' value='publique'  id='choice_2_66_0'    \/>\n\t\t\t\t<label for='choice_2_66_0' id='label_2_66_0' class='gform-field-label gform-field-label--type-inline'>publique<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_66_1'>\n\t\t\t\t<input name='input_66' type='radio' value='dans l&#039;intimit\u00e9'  id='choice_2_66_1'    \/>\n\t\t\t\t<label for='choice_2_66_1' id='label_2_66_1' class='gform-field-label gform-field-label--type-inline'>dans l'intimit\u00e9<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_66_2'>\n\t\t\t\t<input name='input_66' type='radio' value='au choix de la famille'  id='choice_2_66_2'    \/>\n\t\t\t\t<label for='choice_2_66_2' id='label_2_66_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_114\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_114'><span class='gform-field-label__text'>Lieu de la c\u00e9r\u00e9monie<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_114' id='input_2_114' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_135\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br>\n<B>Nous attirons votre attention:<\/B><br>\nSuivant certains de vos choix, cela peut \u00eatre soumis \u00e0 une taxe communale suppl\u00e9mentaire.<br>\nToutes les possibilit\u00e9s mentionn\u00e9es ci-dessus, ne sont pas forc\u00e9ment propos\u00e9es dans toutes les communes.<\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_9' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_2_9' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_3' class='gform_page' data-js='page-field-id-9' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_2_3' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_68\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Je d\u00e9sire:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_68'>\n\t\t\t<li class='gchoice gchoice_2_68_0'>\n\t\t\t\t<input name='input_68' type='radio' value='\u00eatre inhum\u00e9(e)'  id='choice_2_68_0'    \/>\n\t\t\t\t<label for='choice_2_68_0' id='label_2_68_0' class='gform-field-label gform-field-label--type-inline'>\u00eatre inhum\u00e9(e)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_68_1'>\n\t\t\t\t<input name='input_68' type='radio' value='\u00eatre incin\u00e9r\u00e9(e)'  id='choice_2_68_1'    \/>\n\t\t\t\t<label for='choice_2_68_1' id='label_2_68_1' class='gform-field-label gform-field-label--type-inline'>\u00eatre incin\u00e9r\u00e9(e)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_68_2'>\n\t\t\t\t<input name='input_68' type='radio' value='au choix de la famille'  id='choice_2_68_2'    \/>\n\t\t\t\t<label for='choice_2_68_2' id='label_2_68_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_70\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Cercueil<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_70'>\n\t\t\t<li class='gchoice gchoice_2_70_0'>\n\t\t\t\t<input name='input_70' type='radio' value='cercueil standard'  id='choice_2_70_0'    \/>\n\t\t\t\t<label for='choice_2_70_0' id='label_2_70_0' class='gform-field-label gform-field-label--type-inline'>cercueil standard<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_70_1'>\n\t\t\t\t<input name='input_70' type='radio' value='cercueil \u00e9cologique'  id='choice_2_70_1'    \/>\n\t\t\t\t<label for='choice_2_70_1' id='label_2_70_1' class='gform-field-label gform-field-label--type-inline'>cercueil \u00e9cologique<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_70_2'>\n\t\t\t\t<input name='input_70' type='radio' value='cercueil en bois noble'  id='choice_2_70_2'    \/>\n\t\t\t\t<label for='choice_2_70_2' id='label_2_70_2' class='gform-field-label gform-field-label--type-inline'>cercueil en bois noble<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_111\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Destination des cendres<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_111'>\n\t\t\t<li class='gchoice gchoice_2_111_0'>\n\t\t\t\t<input name='input_111' type='radio' value='au jardin du souvenir'  id='choice_2_111_0'    \/>\n\t\t\t\t<label for='choice_2_111_0' id='label_2_111_0' class='gform-field-label gform-field-label--type-inline'>au jardin du souvenir<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_1'>\n\t\t\t\t<input name='input_111' type='radio' value='au columbarium'  id='choice_2_111_1'    \/>\n\t\t\t\t<label for='choice_2_111_1' id='label_2_111_1' class='gform-field-label gform-field-label--type-inline'>au columbarium<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_2'>\n\t\t\t\t<input name='input_111' type='radio' value='dans une tombe de corps existante'  id='choice_2_111_2'    \/>\n\t\t\t\t<label for='choice_2_111_2' id='label_2_111_2' class='gform-field-label gform-field-label--type-inline'>dans une tombe de corps existante<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_3'>\n\t\t\t\t<input name='input_111' type='radio' value='dans une nouvelle tombe cin\u00e9raire'  id='choice_2_111_3'    \/>\n\t\t\t\t<label for='choice_2_111_3' id='label_2_111_3' class='gform-field-label gform-field-label--type-inline'>dans une nouvelle tombe cin\u00e9raire<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_4'>\n\t\t\t\t<input name='input_111' type='radio' value='dans une tombe cin\u00e9raire existante'  id='choice_2_111_4'    \/>\n\t\t\t\t<label for='choice_2_111_4' id='label_2_111_4' class='gform-field-label gform-field-label--type-inline'>dans une tombe cin\u00e9raire existante<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_5'>\n\t\t\t\t<input name='input_111' type='radio' value='concession une nouvelle tombe cin\u00e9raire (payant)'  id='choice_2_111_5'    \/>\n\t\t\t\t<label for='choice_2_111_5' id='label_2_111_5' class='gform-field-label gform-field-label--type-inline'>concession une nouvelle tombe cin\u00e9raire (payant)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_6'>\n\t\t\t\t<input name='input_111' type='radio' value='dispers\u00e9es'  id='choice_2_111_6'    \/>\n\t\t\t\t<label for='choice_2_111_6' id='label_2_111_6' class='gform-field-label gform-field-label--type-inline'>dispers\u00e9es<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_7'>\n\t\t\t\t<input name='input_111' type='radio' value='Au choix de me proches'  id='choice_2_111_7'    \/>\n\t\t\t\t<label for='choice_2_111_7' id='label_2_111_7' class='gform-field-label gform-field-label--type-inline'>Au choix de me proches<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_111_8'>\n\t\t\t\t<input name='input_111' type='radio' value='Autre'  id='choice_2_111_8'    \/>\n\t\t\t\t<label for='choice_2_111_8' id='label_2_111_8' class='gform-field-label gform-field-label--type-inline'>Autre<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_117\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_117'><span class='gform-field-label__text'>Lieu de dispersion<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_2_117' type='text' value='' class='medium'  aria-describedby=\"gfield_description_2_117\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_2_117'>ex : nature, lac, etc.<\/div><\/li><li id=\"field_2_150\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_150'><span class='gform-field-label__text'>Choix de la destination<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_150' id='input_2_150' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_84\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_2_84'><span class='gform-field-label__text'>Nom du cimeti\u00e8re<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_2_84' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_129\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_129'><span class='gform-field-label__text'>Nom et pr\u00e9nom de la personne pr\u00e9d\u00e9c\u00e9d\u00e9e<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_129' id='input_2_129' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_149\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_149'><span class='gform-field-label__text'>Choix du cimeti\u00e8re<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_149' id='input_2_149' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_69' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_2_69' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_4' class='gform_page' data-js='page-field-id-69' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_2_4' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>R\u00e9ception \/ collation<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_87'>\n\t\t\t<li class='gchoice gchoice_2_87_0'>\n\t\t\t\t<input name='input_87' type='radio' value='pour tous'  id='choice_2_87_0'    \/>\n\t\t\t\t<label for='choice_2_87_0' id='label_2_87_0' class='gform-field-label gform-field-label--type-inline'>pour tous<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_87_1'>\n\t\t\t\t<input name='input_87' type='radio' value='en famille'  id='choice_2_87_1'    \/>\n\t\t\t\t<label for='choice_2_87_1' id='label_2_87_1' class='gform-field-label gform-field-label--type-inline'>en famille<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_87_2'>\n\t\t\t\t<input name='input_87' type='radio' value='au choix de la famille'  id='choice_2_87_2'    \/>\n\t\t\t\t<label for='choice_2_87_2' id='label_2_87_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_87_3'>\n\t\t\t\t<input name='input_87' type='radio' value='pas de collation'  id='choice_2_87_3'    \/>\n\t\t\t\t<label for='choice_2_87_3' id='label_2_87_3' class='gform-field-label gform-field-label--type-inline'>pas de collation<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_130\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_130'><span class='gform-field-label__text'>Je d\u00e9sire que l&#039;on organise une collation \u00e0:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_130' id='input_2_130' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_115' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_2_115' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_5' class='gform_page' data-js='page-field-id-115' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_2_5' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_131\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_131'><span class='gform-field-label__text'>Coordonn\u00e9es de la personne \u00e0 contacter dans votre famille:<\/span><\/label><div class='gfield_description' id='gfield_description_2_131'>Nom, Pr\u00e9nom, t\u00e9l\u00e9phone, e-mail<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_131' id='input_2_131' class='textarea medium'  aria-describedby=\"gfield_description_2_131\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_2_132\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_132'><span class='gform-field-label__text'>Dispositions particuli\u00e8res<\/span><\/label><div class='gfield_description' id='gfield_description_2_132'>Indications<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_132' id='input_2_132' class='textarea medium'  aria-describedby=\"gfield_description_2_132\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_142' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_2_142' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_6' class='gform_page' data-js='page-field-id-142' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_2_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_116\" class=\"gfield gfield--type-html form_page_info gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h4 class=\"form-section-title\">Avis mortuaire<\/h4><\/li><li id=\"field_2_52\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Avis mortuaire<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_52'>\n\t\t\t<li class='gchoice gchoice_2_52_0'>\n\t\t\t\t<input name='input_52' type='radio' value='avis'  id='choice_2_52_0'    \/>\n\t\t\t\t<label for='choice_2_52_0' id='label_2_52_0' class='gform-field-label gform-field-label--type-inline'>avis<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_52_1'>\n\t\t\t\t<input name='input_52' type='radio' value='pas d&#039;avis'  id='choice_2_52_1'    \/>\n\t\t\t\t<label for='choice_2_52_1' id='label_2_52_1' class='gform-field-label gform-field-label--type-inline'>pas d'avis<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_52_2'>\n\t\t\t\t<input name='input_52' type='radio' value='au choix de la famille'  id='choice_2_52_2'    \/>\n\t\t\t\t<label for='choice_2_52_2' id='label_2_52_2' class='gform-field-label gform-field-label--type-inline'>au choix de la famille<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_139\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Journal(aux)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_139'>\n\t\t\t<li class='gchoice gchoice_2_139_0'>\n\t\t\t\t<input name='input_139' type='radio' value='dans le(s) journal(aux) suivant(s):'  id='choice_2_139_0'    \/>\n\t\t\t\t<label for='choice_2_139_0' id='label_2_139_0' class='gform-field-label gform-field-label--type-inline'>dans le(s) journal(aux) suivant(s):<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_139_1'>\n\t\t\t\t<input name='input_139' type='radio' value='autre'  id='choice_2_139_1'    \/>\n\t\t\t\t<label for='choice_2_139_1' id='label_2_139_1' class='gform-field-label gform-field-label--type-inline'>autre<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_152\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_152'><span class='gform-field-label__text'>Nom du (des) journal(aux)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_152' id='input_2_152' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_151\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Choix des journaux<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_151'><li class='gchoice gchoice_2_151_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.1' type='checkbox'  value='24 Heures'  id='choice_2_151_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_1' id='label_2_151_1' class='gform-field-label gform-field-label--type-inline'>24 Heures<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.2' type='checkbox'  value='Anzeiger von Saanen'  id='choice_2_151_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_2' id='label_2_151_2' class='gform-field-label gform-field-label--type-inline'>Anzeiger von Saanen<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.3' type='checkbox'  value='Arcinfo'  id='choice_2_151_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_3' id='label_2_151_3' class='gform-field-label gform-field-label--type-inline'>Arcinfo<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.4' type='checkbox'  value='BASLER ZEITUNG'  id='choice_2_151_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_4' id='label_2_151_4' class='gform-field-label gform-field-label--type-inline'>BASLER ZEITUNG<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.5' type='checkbox'  value='Berner Oberland Anzeiger'  id='choice_2_151_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_5' id='label_2_151_5' class='gform-field-label gform-field-label--type-inline'>Berner Oberland Anzeiger<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.6' type='checkbox'  value='BERNER ZEITUNG'  id='choice_2_151_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_6' id='label_2_151_6' class='gform-field-label gform-field-label--type-inline'>BERNER ZEITUNG<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.7' type='checkbox'  value='DER BUND'  id='choice_2_151_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_7' id='label_2_151_7' class='gform-field-label gform-field-label--type-inline'>DER BUND<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.8' type='checkbox'  value='DIE S\u00dcDOSTSCHWEIZ (Glarus)'  id='choice_2_151_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_8' id='label_2_151_8' class='gform-field-label gform-field-label--type-inline'>DIE S\u00dcDOSTSCHWEIZ (Glarus)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.9' type='checkbox'  value='Feuille d&#039;avis et Journal de Vallorbe et environs'  id='choice_2_151_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_9' id='label_2_151_9' class='gform-field-label gform-field-label--type-inline'>Feuille d'avis et Journal de Vallorbe et environs<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.11' type='checkbox'  value='Feuille d&#039;avis de la Vall\u00e9e'  id='choice_2_151_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_11' id='label_2_151_11' class='gform-field-label gform-field-label--type-inline'>Feuille d'avis de la Vall\u00e9e<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.12' type='checkbox'  value='FREIBURGER NACHRICHTEN'  id='choice_2_151_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_12' id='label_2_151_12' class='gform-field-label gform-field-label--type-inline'>FREIBURGER NACHRICHTEN<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_13'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.13' type='checkbox'  value='Journal de Cossonay'  id='choice_2_151_13'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_13' id='label_2_151_13' class='gform-field-label gform-field-label--type-inline'>Journal de Cossonay<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_14'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.14' type='checkbox'  value='Journal de Morges'  id='choice_2_151_14'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_14' id='label_2_151_14' class='gform-field-label gform-field-label--type-inline'>Journal de Morges<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_15'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.15' type='checkbox'  value='Journal du Pays-d&#039;Enhaut'  id='choice_2_151_15'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_15' id='label_2_151_15' class='gform-field-label gform-field-label--type-inline'>Journal du Pays-d'Enhaut<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_16'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.16' type='checkbox'  value='L&#039;Echo du Gros-de-Vaud'  id='choice_2_151_16'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_16' id='label_2_151_16' class='gform-field-label gform-field-label--type-inline'>L'Echo du Gros-de-Vaud<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_17'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.17' type='checkbox'  value='L&#039;Omnibus'  id='choice_2_151_17'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_17' id='label_2_151_17' class='gform-field-label gform-field-label--type-inline'>L'Omnibus<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_18'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.18' type='checkbox'  value='La C\u00f4te'  id='choice_2_151_18'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_18' id='label_2_151_18' class='gform-field-label gform-field-label--type-inline'>La C\u00f4te<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_19'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.19' type='checkbox'  value='La Broye'  id='choice_2_151_19'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_19' id='label_2_151_19' class='gform-field-label gform-field-label--type-inline'>La Broye<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_21'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.21' type='checkbox'  value='La Gruy\u00e8re'  id='choice_2_151_21'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_21' id='label_2_151_21' class='gform-field-label gform-field-label--type-inline'>La Gruy\u00e8re<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_22'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.22' type='checkbox'  value='La Libert\u00e9'  id='choice_2_151_22'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_22' id='label_2_151_22' class='gform-field-label gform-field-label--type-inline'>La Libert\u00e9<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_23'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.23' type='checkbox'  value='La R\u00e9gion nord vaudois'  id='choice_2_151_23'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_23' id='label_2_151_23' class='gform-field-label gform-field-label--type-inline'>La R\u00e9gion nord vaudois<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_24'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.24' type='checkbox'  value='Le Courrier'  id='choice_2_151_24'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_24' id='label_2_151_24' class='gform-field-label gform-field-label--type-inline'>Le Courrier<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_25'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.25' type='checkbox'  value='Le Courrier (Gen\u00e8ve)'  id='choice_2_151_25'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_25' id='label_2_151_25' class='gform-field-label gform-field-label--type-inline'>Le Courrier (Gen\u00e8ve)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_26'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.26' type='checkbox'  value='Le Journal de Sainte-Croix et environs'  id='choice_2_151_26'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_26' id='label_2_151_26' class='gform-field-label gform-field-label--type-inline'>Le Journal de Sainte-Croix et environs<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_27'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.27' type='checkbox'  value='Le Journal du Jura'  id='choice_2_151_27'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_27' id='label_2_151_27' class='gform-field-label gform-field-label--type-inline'>Le Journal du Jura<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_28'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.28' type='checkbox'  value='Le Matin'  id='choice_2_151_28'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_28' id='label_2_151_28' class='gform-field-label gform-field-label--type-inline'>Le Matin<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_29'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.29' type='checkbox'  value='Le Messager'  id='choice_2_151_29'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_29' id='label_2_151_29' class='gform-field-label gform-field-label--type-inline'>Le Messager<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_31'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.31' type='checkbox'  value='Le Nouvelliste'  id='choice_2_151_31'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_31' id='label_2_151_31' class='gform-field-label gform-field-label--type-inline'>Le Nouvelliste<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_32'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.32' type='checkbox'  value='Le Quotidien Jurassien'  id='choice_2_151_32'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_32' id='label_2_151_32' class='gform-field-label gform-field-label--type-inline'>Le Quotidien Jurassien<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_33'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.33' type='checkbox'  value='le R\u00e9publician'  id='choice_2_151_33'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_33' id='label_2_151_33' class='gform-field-label gform-field-label--type-inline'>le R\u00e9publician<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_34'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.34' type='checkbox'  value='Le Temps'  id='choice_2_151_34'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_34' id='label_2_151_34' class='gform-field-label gform-field-label--type-inline'>Le Temps<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_35'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.35' type='checkbox'  value='Neue Luzerner Zeitung'  id='choice_2_151_35'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_35' id='label_2_151_35' class='gform-field-label gform-field-label--type-inline'>Neue Luzerner Zeitung<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_36'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.36' type='checkbox'  value='Neue Z\u00fcrcher Zeitung'  id='choice_2_151_36'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_36' id='label_2_151_36' class='gform-field-label gform-field-label--type-inline'>Neue Z\u00fcrcher Zeitung<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_37'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.37' type='checkbox'  value='Riviera Chablais'  id='choice_2_151_37'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_37' id='label_2_151_37' class='gform-field-label gform-field-label--type-inline'>Riviera Chablais<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_38'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.38' type='checkbox'  value='SKT. GALLER TAGBLATT'  id='choice_2_151_38'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_38' id='label_2_151_38' class='gform-field-label gform-field-label--type-inline'>SKT. GALLER TAGBLATT<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_39'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.39' type='checkbox'  value='TAGES-ANZEIGER'  id='choice_2_151_39'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_39' id='label_2_151_39' class='gform-field-label gform-field-label--type-inline'>TAGES-ANZEIGER<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_41'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.41' type='checkbox'  value='Tribune de Gen\u00e8ve'  id='choice_2_151_41'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_41' id='label_2_151_41' class='gform-field-label gform-field-label--type-inline'>Tribune de Gen\u00e8ve<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_151_42'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_151.42' type='checkbox'  value='Walliser Bote'  id='choice_2_151_42'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_151_42' id='label_2_151_42' class='gform-field-label gform-field-label--type-inline'>Walliser Bote<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_108\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_108'><span class='gform-field-label__text'>Contenu avis mortuaire<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_108' id='input_2_108' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_2_8' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='button' id='gform_next_button_2_8' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Suivant<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_2_7' class='gform_page' data-js='page-field-id-8' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_2_7' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_2_7\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"form-section-title\">Donn\u00e9es personnelles<\/h3><\/li><li id=\"field_2_120\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Civilit\u00e9<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_2_120'>\n\t\t\t<li class='gchoice gchoice_2_120_0'>\n\t\t\t\t<input name='input_120' type='radio' value='Monsieur'  id='choice_2_120_0'    \/>\n\t\t\t\t<label for='choice_2_120_0' id='label_2_120_0' class='gform-field-label gform-field-label--type-inline'>Monsieur<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_2_120_1'>\n\t\t\t\t<input name='input_120' type='radio' value='Madame'  id='choice_2_120_1'    \/>\n\t\t\t\t<label for='choice_2_120_1' id='label_2_120_1' class='gform-field-label gform-field-label--type-inline'>Madame<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_42\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Patronyme<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_2_42'>\n                            \n                            <span id='input_2_42_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_2_42_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                    <input type='text' name='input_42.3' id='input_2_42_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_2_42_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_2_42_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                            <input type='text' name='input_42.6' id='input_2_42_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_2_44\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adresse<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_2_44' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_2_44_1_container' >\n                                        <label for='input_2_44_1' id='input_2_44_1_label' class='gform-field-label gform-field-label--type-sub '>Rue<\/label>\n                                        <input type='text' name='input_44.1' id='input_2_44_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_2_44_3_container' >\n                                    <label for='input_2_44_3' id='input_2_44_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                    <input type='text' name='input_44.3' id='input_2_44_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_44.4' id='input_2_44_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_2_44_5_container' >\n                                    <label for='input_2_44_5' id='input_2_44_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                    <input type='text' name='input_44.5' id='input_2_44_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_2_44_6_container' >\n                                        <label for='input_2_44_6' id='input_2_44_6_label' class='gform-field-label gform-field-label--type-sub '>Country<\/label>\n                                        <select name='input_44.6' id='input_2_44_6'   aria-required='true'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AX' >\u00c5land Islands<\/option><option value='AL' >Albania<\/option><option value='DZ' >Algeria<\/option><option value='AS' >American Samoa<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctica<\/option><option value='AG' >Antigua and Barbuda<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BY' >Belarus<\/option><option value='BE' >Belgium<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhutan<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, Sint Eustatius and Saba<\/option><option value='BA' >Bosnia and Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet Island<\/option><option value='BR' >Brazil<\/option><option value='IO' >British Indian Ocean Territory<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='KH' >Cambodia<\/option><option value='CM' >Cameroon<\/option><option value='CA' >Canada<\/option><option value='CV' >Cape Verde<\/option><option value='KY' >Cayman Islands<\/option><option value='CF' >Central African Republic<\/option><option value='TD' >Chad<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CX' >Christmas Island<\/option><option value='CC' >Cocos Islands<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoros<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratic Republic of the<\/option><option value='CK' >Cook Islands<\/option><option value='CR' >Costa Rica<\/option><option value='CI' >C\u00f4te d&#039;Ivoire<\/option><option value='HR' >Croatia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='CZ' >Czechia<\/option><option value='DK' >Denmark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominican Republic<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypt<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatorial Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopia<\/option><option value='FK' >Falkland Islands<\/option><option value='FO' >Faroe Islands<\/option><option value='FJ' >Fiji<\/option><option value='FI' >Finland<\/option><option value='FR' >France<\/option><option value='GF' >French Guiana<\/option><option value='PF' >French Polynesia<\/option><option value='TF' >French Southern Territories<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='DE' >Germany<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Greece<\/option><option value='GL' >Greenland<\/option><option value='GD' >Grenada<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GW' >Guinea-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Haiti<\/option><option value='HM' >Heard Island and McDonald Islands<\/option><option value='VA' >Holy See<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungary<\/option><option value='IS' >Iceland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IR' >Iran<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Ireland<\/option><option value='IM' >Isle of Man<\/option><option value='IL' >Israel<\/option><option value='IT' >Italy<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordan<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KI' >Kiribati<\/option><option value='KP' >Korea, Democratic People&#039;s Republic of<\/option><option value='KR' >Korea, Republic of<\/option><option value='KW' >Kuwait<\/option><option value='KG' >Kyrgyzstan<\/option><option value='LA' >Lao People&#039;s Democratic Republic<\/option><option value='LV' >Latvia<\/option><option value='LB' >Lebanon<\/option><option value='LS' >Lesotho<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libya<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lithuania<\/option><option value='LU' >Luxembourg<\/option><option value='MO' >Macao<\/option><option value='MG' >Madagascar<\/option><option value='MW' >Malawi<\/option><option value='MY' >Malaysia<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='MH' >Marshall Islands<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritania<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldova<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MA' >Morocco<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NL' >Netherlands<\/option><option value='NC' >New Caledonia<\/option><option value='NZ' >New Zealand<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NF' >Norfolk Island<\/option><option value='MK' >North Macedonia<\/option><option value='MP' >Northern Mariana Islands<\/option><option value='NO' >Norway<\/option><option value='OM' >Oman<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestine, State of<\/option><option value='PA' >Panama<\/option><option value='PG' >Papua New Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PH' >Philippines<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Poland<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='RE' >R\u00e9union<\/option><option value='RO' >Romania<\/option><option value='RU' >Russian Federation<\/option><option value='RW' >Rwanda<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='SH' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='KN' >Saint Kitts and Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre and Miquelon<\/option><option value='VC' >Saint Vincent and the Grenadines<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tome and Principe<\/option><option value='SA' >Saudi Arabia<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovakia<\/option><option value='SI' >Slovenia<\/option><option value='SB' >Solomon Islands<\/option><option value='SO' >Somalia<\/option><option value='ZA' >South Africa<\/option><option value='GS' >South Georgia and the South Sandwich Islands<\/option><option value='SS' >South Sudan<\/option><option value='ES' >Spain<\/option><option value='LK' >Sri Lanka<\/option><option value='SD' >Sudan<\/option><option value='SR' >Suriname<\/option><option value='SJ' >Svalbard and Jan Mayen<\/option><option value='SE' >Sweden<\/option><option value='CH' >Switzerland<\/option><option value='SY' >Syria Arab Republic<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzania, the United Republic of<\/option><option value='TH' >Thailand<\/option><option value='TL' >Timor-Leste<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad and Tobago<\/option><option value='TN' >Tunisia<\/option><option value='TR' >T\u00fcrkiye<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks and Caicos Islands<\/option><option value='TV' >Tuvalu<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='AE' >United Arab Emirates<\/option><option value='GB' >United Kingdom<\/option><option value='US' >United States<\/option><option value='UY' >Uruguay<\/option><option value='UM' >US Minor Outlying Islands<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Viet Nam<\/option><option value='VG' >Virgin Islands, British<\/option><option value='VI' >Virgin Islands, U.S.<\/option><option value='WF' >Wallis and Futuna<\/option><option value='EH' >Western Sahara<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_2_43\" class=\"gfield gfield--type-phone gfield--phone-format-international gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_43'><span class='gform-field-label__text'>T\u00e9l\u00e9phone<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_43' id='input_2_43' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"    \/><\/div><\/li><li id=\"field_2_141\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_141'><li class='gchoice gchoice_2_141_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_141.1' type='checkbox'  value='Je d\u00e9sire \u00eatre contact\u00e9 par t\u00e9l\u00e9phone'  id='choice_2_141_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_141_1' id='label_2_141_1' class='gform-field-label gform-field-label--type-inline'>Je d\u00e9sire \u00eatre contact\u00e9 par t\u00e9l\u00e9phone<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_45\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_45'><span class='gform-field-label__text'>E-mail<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_45' id='input_2_45' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_2_89\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br>\n<B>Ces derni\u00e8res volont\u00e9s sont r\u00e9dig\u00e9es en pleine conscience et en toute ind\u00e9pendance.<\/B><\/li><li id=\"field_2_136\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_136'><span class='gform-field-label__text'>T\u00e9moin \u00e9ventuel:<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_136' id='input_2_136' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_155\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>curatelle<\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_155'><li class='gchoice gchoice_2_155_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_155.1' type='checkbox'  value='&lt;b&gt;Je confirme que je ne suis pas sous curatelle&lt;\/b&gt;'  id='choice_2_155_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_155_1' id='label_2_155_1' class='gform-field-label gform-field-label--type-inline'><b>Je confirme que je ne suis pas sous curatelle<\/b><\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_148\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_2_148'><span class='gform-field-label__text'>Contact de votre curateur<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_148' id='input_2_148' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_2_145\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' ><span class='gform-field-label__text'><\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_145'><li class='gchoice gchoice_2_145_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_145.1' type='checkbox'  value='En cochant cette case, vous acceptez notre &lt;a href=&quot;\/politique-de-protection-des-donnees&quot;&gt;politique de protection des donn\u00e9es&lt;\/a&gt;.'  id='choice_2_145_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_145_1' id='label_2_145_1' class='gform-field-label gform-field-label--type-inline'>En cochant cette case, vous acceptez notre <a href=\"\/politique-de-protection-des-donnees\">politique de protection des donn\u00e9es<\/a>.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_2' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Pr\u00e9c\u00e9dent<\/button> <button type='submit' id='gform_submit_button_2' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Envoyer et t\u00e9l\u00e9charger le PDF<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_2' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_2' id='gform_theme_2' value='legacy' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_2' id='gform_style_settings_2' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_2' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='2' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_currency' data-currency='CHF' 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class=\"elementor-element elementor-element-0b7d0c3 elementor-widget elementor-widget-image\" data-id=\"0b7d0c3\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"591\" height=\"547\" src=\"https:\/\/cassar.ch\/wp-content\/uploads\/2023\/10\/shutterstock_532234567.jpg\" class=\"attachment-large size-large wp-image-725\" alt=\"\" srcset=\"https:\/\/cassar.ch\/wp-content\/uploads\/2023\/10\/shutterstock_532234567.jpg 591w, https:\/\/cassar.ch\/wp-content\/uploads\/2023\/10\/shutterstock_532234567-300x278.jpg 300w\" sizes=\"(max-width: 591px) 100vw, 591px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8330271 e-con-full e-flex e-con e-child\" data-id=\"8330271\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-cc828e8 elementor-widget elementor-widget-heading\" data-id=\"cc828e8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Derni\u00e8res volont\u00e9s<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2f7c44c elementor-widget elementor-widget-heading\" data-id=\"2f7c44c\" data-element_type=\"widget\" data-e-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\">Vous pouvez r\u00e9diger ici et gratuitement vos derni\u00e8res volont\u00e9s.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6903f71 elementor-widget 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D\u00e9placement \u00e0 votre domicile et proposition sans engagement EN SAVOIR PLUS Derni\u00e8res volont\u00e9s Vous pouvez r\u00e9diger ici et gratuitement vos derni\u00e8res volont\u00e9s. Une fois le formulaire rempli, vous pourrez le t\u00e9l\u00e9charger en format PDF, sans engagement et ainsi le destiner [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-80","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Vos derni\u00e8res volont\u00e9s - Pompes Fun\u00e8bres Cassar<\/title>\n<meta name=\"description\" content=\"Vous pouvez r\u00e9diger ici et gratuitement vos derni\u00e8res volont\u00e9s, gr\u00e2ce \u00e0 notre formulaire qui facilite la d\u00e9marche\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cassar.ch\/en\/last-will-and-testament\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vos derni\u00e8res volont\u00e9s - 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