{"id":26364,"date":"2017-08-21T20:58:25","date_gmt":"2017-08-22T02:58:25","guid":{"rendered":"https:\/\/www.nfu.ca\/membre-associe\/"},"modified":"2025-11-06T11:50:53","modified_gmt":"2025-11-06T17:50:53","slug":"membre-associe","status":"publish","type":"page","link":"https:\/\/www.nfu.ca\/fr\/adherez\/membre-associe\/","title":{"rendered":"Devenez membre associ\u00e9"},"content":{"rendered":"\n<header class=\"wp-block-cover alignfull is-light has-custom-content-position is-position-bottom-center banner-top\" id=\"banner-top\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim has-background-gradient\" style=\"background-color:#a18c7f;background:linear-gradient(180deg,rgba(0,0,0,0.97) 0%,rgba(0,0,0,0.05) 69%)\"><\/span><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"600\" src=\"https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/associate-member-johann-siemens-thumb.jpg\" class=\"wp-block-cover__image-background wp-post-image\" alt=\"membre-associ\u00e9-johann-siemens-pouce\" data-object-fit=\"cover\" srcset=\"https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/associate-member-johann-siemens-thumb.jpg 1200w, https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/associate-member-johann-siemens-thumb-300x150.jpg 300w, https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/associate-member-johann-siemens-thumb-768x384.jpg 768w, https:\/\/www.nfu.ca\/wp-content\/uploads\/2018\/07\/associate-member-johann-siemens-thumb-1024x512.jpg 1024w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<p class=\"has-text-align-left has-large-font-size\"><\/p>\n<\/div><\/header>\n\n<div class=\"wp-block-stackable-hero alignwide stk-block-hero stk-block stk-08fda9e is-style-default mb\" data-v=\"2\" id=\"content-first\" data-block-id=\"08fda9e\"><style>.stk-08fda9e .stk-block-hero__content{min-height:500px !important;align-items:center !important;display:flex !important;}<\/style><div class=\"stk-block-hero__content stk-content-align stk-08fda9e-column alignwide stk-container stk-08fda9e-container stk--no-background stk--no-padding\"><div class=\"stk-block-content stk-inner-blocks has-text-align-left stk-08fda9e-inner-blocks\"><ol class=\"breadcrumb\"><li><a href=\"https:\/\/www.nfu.ca\/fr\/\">National Farmers Union<\/a><\/li><\/ol>\n\n\n\n<div class=\"wp-block-stackable-heading stk-block-heading stk-block-heading--v2 stk-block stk-6c2c9d1 page-title\" id=\"become-an-associate-member\" data-block-id=\"6c2c9d1\"><h1 class=\"stk-block-heading__text\">Devenez membre associ\u00e9<\/h1><\/div>\n\n\n\n<div class=\"wp-block-stackable-columns stk-block-columns stk-block stk-54b76e7 content-upper\" id=\"content-upper\" data-block-id=\"54b76e7\"><div class=\"stk-row stk-inner-blocks has-text-align-left stk-block-content stk-content-align stk-54b76e7-column\">\n<div class=\"wp-block-stackable-column stk-block-column stk-column stk-block stk-ef63229 about-membership\" data-v=\"4\" id=\"about-membership\" data-block-id=\"ef63229\"><div class=\"stk-column-wrapper stk-block-column__content stk-container stk-ef63229-container stk--no-background stk--no-padding\"><div class=\"has-text-align-left stk-block-content stk-inner-blocks stk-ef63229-inner-blocks\">\n<p class=\"has-medium-font-size\">Le statut de membre associ\u00e9 permet aux personnes qui n&rsquo;exploitent pas d&rsquo;entreprise agricole de s&rsquo;impliquer dans l&rsquo;UNF.<\/p>\n\n\n\n<div class=\"wp-block-stackable-text stk-block-text stk--hide-desktop stk--hide-tablet stk-block stk-76cdc18\" data-block-id=\"76cdc18\"><p class=\"stk-block-text__text\"><a href=\"#yearly\">Aller au formulaire<\/a><\/p><\/div>\n\n\n\n<h3 class=\"wp-block-heading\">Pourquoi devenir membre associ\u00e9 ?<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">Qualit\u00e9 des aliments<\/h4>\n\n\n\n<p>La qualit\u00e9 des aliments qui se trouvent sur votre table d\u00e9pend en grande partie des conditions dans lesquelles ils sont cultiv\u00e9s. Pour produire des aliments sains et de qualit\u00e9, les fermi\u00e8res doivent pouvoir travailler dans des conditions \u00e9quitables sans avoir \u00e0 sacrifier la qualit\u00e9 et la s\u00e9curit\u00e9 des aliments pour maximiser la production. Les prix bas nous obligent \u00e0 choisir entre des raccourcis dangereux et la perte de notre gagne-pain.<\/p>\n\n\n\n<p>Les politiques gouvernementales qui favorisent l&rsquo;accroissement du commerce mondial des denr\u00e9es alimentaires et le nivellement par le bas des normes de s\u00e9curit\u00e9 compromettent notre capacit\u00e9 \u00e0 garantir des aliments s\u00fbrs aux consommateurs canadiens.<\/p>\n\n\n\n<p>Nous respectons le scepticisme du public \u00e0 l&rsquo;\u00e9gard des aliments g\u00e9n\u00e9tiquement modifi\u00e9s et nous nous joignons aux consommateurs pour exiger des tests, une r\u00e9glementation et une inspection approfondis.<\/p>\n\n\n\n<p>La Nationale des Fermiers continue d&rsquo;\u0153uvrer en faveur de politiques commerciales \u00e9quitables, d&rsquo;une plus grande autosuffisance alimentaire nationale, de normes de s\u00e9curit\u00e9 \u00e9lev\u00e9es et d&rsquo;une pleine responsabilit\u00e9 r\u00e9glementaire vis-\u00e0-vis du public.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">L&rsquo;environnement<\/h4>\n\n\n\n<p>Les communaut\u00e9s urbaines et rurales d\u00e9pendent toutes deux de l&rsquo;environnement et doivent assumer une responsabilit\u00e9 commune quant \u00e0 la mani\u00e8re dont il est trait\u00e9. Par exemple, l&rsquo;utilisation de pesticides peut affecter la qualit\u00e9 de l&rsquo;eau \u00e0 la ville comme \u00e0 la campagne. La d\u00e9gradation continue des sols contribue \u00e0 la pollution atmosph\u00e9rique urbaine.<\/p>\n\n\n\n<p>Les agriculteurs progressistes et soucieux de l&rsquo;environnement sont pr\u00e9occup\u00e9s par ces probl\u00e8mes environnementaux. Mais la politique agricole actuelle et le type d&rsquo;\u00e9conomie qu&rsquo;elle promeut font qu&rsquo;il est tr\u00e8s difficile pour beaucoup d&rsquo;entre nous de changer nos pratiques agricoles.<\/p>\n\n\n\n<p>Les fermi\u00e8res ont besoin de prix \u00e9quitables pour les aliments qu&rsquo;elles produisent afin de ne pas \u00eatre oblig\u00e9es de \u00ab\u00a0miner notre sol\u00a0\u00bb pour rester viables.<\/p>\n\n\n\n<p>Nous devons disposer d&rsquo;une politique publique qui encourage les pratiques agricoles conduisant \u00e0 une durabilit\u00e9 environnementale et financi\u00e8re \u00e0 long terme.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Communaut\u00e9s rurales<\/h4>\n\n\n\n<p>La soci\u00e9t\u00e9 est renforc\u00e9e par un \u00e9quilibre entre des centres urbains plus grands et plus industrialis\u00e9s et des communaut\u00e9s rurales stables et dynamiques. Pour enrayer l&rsquo;exode rural actuel et la d\u00e9possession des familles d&rsquo;agriculteurs (qui contribue au ch\u00f4mage urbain), il faut renouveler l&rsquo;engagement et les investissements en faveur des communaut\u00e9s rurales. La fuite acc\u00e9l\u00e9r\u00e9e des richesses et des populations des campagnes n&rsquo;est ni juste ni durable. Tous les Canadiens doivent travailler ensemble sur des strat\u00e9gies sociales et \u00e9conomiques afin de parvenir \u00e0 un \u00e9quilibre juste et sain entre les communaut\u00e9s rurales et urbaines.<\/p>\n\n\n\n<p><strong>L&rsquo;adh\u00e9sion en tant que membre associ\u00e9 vous permet<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>une voix dans l&rsquo;\u00e9laboration de la politique agricole et sociale (les membres associ\u00e9s peuvent participer pleinement \u00e0 toutes les activit\u00e9s de l&rsquo;UNF, \u00e0 l&rsquo;exception des d\u00e9l\u00e9gu\u00e9s votants et\/ou des repr\u00e9sentants \u00e9lus) ;<\/li>\n\n\n\n<li>des invitations aux activit\u00e9s et r\u00e9unions de l&rsquo;UNF, y compris la convention nationale annuelle ;<\/li>\n\n\n\n<li>un abonnement \u00e0 la lettre d&rsquo;information mensuelle de l&rsquo;Union Fermi\u00e8re &#8211; une source importante d&rsquo;informations et d&rsquo;analyses sur les questions relatives \u00e0 l&rsquo;alimentation et \u00e0 l&rsquo;agriculture ;<\/li>\n\n\n\n<li>un abonnement au magazine Union Fermi\u00e8re Trimestrial &#8211; une publication approfondie qui examine des sujets d&rsquo;actualit\u00e9 li\u00e9s \u00e0 l&rsquo;alimentation et \u00e0 l&rsquo;agriculture ;<\/li>\n\n\n\n<li>un moyen efficace et concret de manifester sa solidarit\u00e9 avec les fermi\u00e8res progressistes du Canada.<\/li>\n<\/ul>\n\n\n\n<p><strong>Qui est l&rsquo;UNF ?<\/strong><\/p>\n\n\n\n<p>La Nationale des Fermiers est la seule organisation agricole nationale volontaire au Canada qui s&rsquo;engage \u00e0.. :<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>en veillant \u00e0 ce que les exploitations familiales constituent la principale unit\u00e9 de production alimentaire ;<\/li>\n\n\n\n<li>promouvoir des pratiques agricoles respectueuses de l&rsquo;environnement ;<\/li>\n\n\n\n<li>donner aux agricultrices une voix \u00e9gale dans l&rsquo;\u00e9laboration de la politique agricole ;<\/li>\n\n\n\n<li>\u0153uvrer en faveur de prix alimentaires \u00e9quitables pour les fermi\u00e8res et les consommateurs ;<\/li>\n\n\n\n<li>impliquer, \u00e9duquer et responsabiliser les jeunes ruraux pour un avenir meilleur ;<\/li>\n\n\n\n<li>construire des communaut\u00e9s rurales saines et dynamiques ;<\/li>\n\n\n\n<li>garantir un approvisionnement suffisant en denr\u00e9es alimentaires s\u00fbres et nutritives pour les Canadiens.<\/li>\n<\/ul>\n\n\n\n<p>L&rsquo;exploitation agricole familiale est la pierre angulaire du syst\u00e8me qui fournit des aliments sains et nutritifs aux Canadiens. Les citadins, tout comme les fermiers, ont un int\u00e9r\u00eat dans ce projet. La Nationale des Fermiers est la seule organisation agricole \u00e0 d\u00e9fendre les int\u00e9r\u00eats des citoyens contre la mainmise des entreprises sur notre syst\u00e8me alimentaire.<\/p>\n\n\n\n<p><strong>L&rsquo;Union Nationale des Fermiers :<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>promeut des politiques de commerce \u00e9quitable au profit des fermiers et des consommateurs, plut\u00f4t que des multinationales de l&rsquo;agroalimentaire ;<\/li>\n\n\n\n<li>\u0153uvre pour des politiques fiscales \u00e9quitables ;<\/li>\n\n\n\n<li>soutient l&rsquo;investissement public dans la recherche sur les transports et l&rsquo;agriculture, ainsi que le contr\u00f4le de cette recherche, au b\u00e9n\u00e9fice de tous ;<\/li>\n\n\n\n<li>soutient la commercialisation ordonn\u00e9e des denr\u00e9es alimentaires pour le bien-\u00eatre mutuel des producteurs et des consommateurs.<\/li>\n\n\n\n<li>a jou\u00e9 un r\u00f4le de premier plan dans l&rsquo;interdiction de l&rsquo;hormone de croissance bovine au Canada.<\/li>\n<\/ul>\n\n\n\n<p>Les mouvements agricoles progressistes ont \u00e9t\u00e9 \u00e0 l&rsquo;avant-garde des luttes pour la justice sociale et politique dans le pass\u00e9, y compris la lutte pour l&rsquo;assurance-maladie en Saskatchewan (et finalement dans tout le Canada), une meilleure \u00e9ducation et des services sociaux financ\u00e9s par l&rsquo;\u00c9tat, et l&rsquo;\u00e9galit\u00e9 pour les femmes (par exemple, les femmes des syndicats agricoles ont men\u00e9 la campagne pour le vote et plus tard pour les lois sur les biens matrimoniaux).<\/p>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-stackable-column stk-block-column stk-column stk-block stk-30bd8ff yearly-form\" data-v=\"4\" id=\"yearly\" data-block-id=\"30bd8ff\"><div class=\"stk-column-wrapper stk-block-column__content stk-container stk-30bd8ff-container stk--no-background stk--no-padding\"><div class=\"stk-block-content stk-inner-blocks stk-30bd8ff-inner-blocks\">\n<div 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0.292893C10.0976 0.683417 10.0976 1.31658 9.70711 1.70711L5.70711 5.70711C5.31658 6.09763 4.68342 6.09763 4.29289 5.70711L0.292893 1.70711C-0.0976311 1.31658 -0.0976311 0.683418 0.292893 0.292893Z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-icon-ctrl-search: url(\"data:image\/svg+xml,%3Csvg width='640' height='640' xmlns='http:\/\/www.w3.org\/2000\/svg'%3E%3Cpath d='M256 128c-70.692 0-128 57.308-128 128 0 70.691 57.308 128 128 128 70.691 0 128-57.309 128-128 0-70.692-57.309-128-128-128zM64 256c0-106.039 85.961-192 192-192s192 85.961 192 192c0 41.466-13.146 79.863-35.498 111.248l154.125 154.125c12.496 12.496 12.496 32.758 0 45.254s-32.758 12.496-45.254 0L367.248 412.502C335.862 434.854 297.467 448 256 448c-106.039 0-192-85.962-192-192z' fill='rgba(17, 35, 55, 0.65)'\/%3E%3C\/svg%3E\");--gf-label-space-y-secondary: var(--gf-label-space-y-md-secondary);--gf-ctrl-border-color: #686e77;--gf-ctrl-size: var(--gf-ctrl-size-md);--gf-ctrl-label-color-primary: #112337;--gf-ctrl-label-color-secondary: #112337;--gf-ctrl-choice-size: var(--gf-ctrl-choice-size-md);--gf-ctrl-checkbox-check-size: var(--gf-ctrl-checkbox-check-size-md);--gf-ctrl-radio-check-size: var(--gf-ctrl-radio-check-size-md);--gf-ctrl-btn-font-size: var(--gf-ctrl-btn-font-size-md);--gf-ctrl-btn-padding-x: var(--gf-ctrl-btn-padding-x-md);--gf-ctrl-btn-size: var(--gf-ctrl-btn-size-md);--gf-ctrl-btn-border-color-secondary: #686e77;--gf-ctrl-file-btn-bg-color-hover: #EBEBEB;--gf-field-img-choice-size: var(--gf-field-img-choice-size-md);--gf-field-img-choice-card-space: var(--gf-field-img-choice-card-space-md);--gf-field-img-choice-check-ind-size: var(--gf-field-img-choice-check-ind-size-md);--gf-field-img-choice-check-ind-icon-size: var(--gf-field-img-choice-check-ind-icon-size-md);--gf-field-pg-steps-number-color: rgba(17, 35, 55, 0.8);}<\/style><div id='gf_20' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>\u00ab\u00a0<span class=\"gfield_required gfield_required_asterisk\">*<\/span>\u00a0\u00bb indique les champs n\u00e9cessaires<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_20' id='gform_20'  action='\/fr\/wp-json\/wp\/v2\/pages\/26364#gf_20' data-formid='20' novalidate><div class='gf_invisible ginput_recaptchav3' data-sitekey='6Lc38X4sAAAAAO6byCBm-Nw4Tv1RgJWQ4cskx_t7' data-tabindex='0'><input id=\"input_9fb3d1a6fe327e59fcf094ec03a5ee2a\" class=\"gfield_recaptcha_response\" type=\"hidden\" name=\"input_9fb3d1a6fe327e59fcf094ec03a5ee2a\" value=\"\"\/><\/div><input type='hidden' class='gform_hidden' name='gnd_token' id='gnd_token' autocomplete='off' value='20260408083543-2c027c3102385d02c505269a73f31c31cae019d2' \/>\n                        <div class='gform-body gform_body'><div id='gform_fields_20' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_20_64\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_64'>Comments<\/label><div class='ginput_container'><input name='input_64' id='input_20_64' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_20_64'>Ce champ n\u2019est utilis\u00e9 qu\u2019\u00e0 des fins de validation et devrait rester inchang\u00e9.<\/div><\/div><div id=\"field_20_50\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_50' id='input_20_50' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='Membre associ\u00e9 de l&#039;UNF' \/><\/div><\/div><div id=\"field_20_49\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_49' id='input_20_49' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='https:\/\/www.nfu.ca\/fr\/wp-json\/wp\/v2\/pages\/26364' \/><\/div><\/div><div id=\"field_20_60\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_60' id='input_20_60' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_20_55\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class=\"gfield_label gform-field-label\">Achetez une adh\u00e9sion d&rsquo;un an en tant que membre associ\u00e9 de l&rsquo;UNF<\/legend>\n<div class=\"h4 price-display\">$100.00<\/div><\/div><div id=\"field_20_54\" class=\"gfield gfield--type-product gfield--input-type-hiddenproduct gfield--width-full gform_hidden gfield_price gfield_price_20_54 gfield_product_20_54 gfield_hidden_product field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' for='input_20_54_1'>Acheter une adh\u00e9sion d&#039;un an en tant que membre associ\u00e9 de l&#039;UNF (produit r\u00e9el)<\/label><div class='ginput_container ginput_container_product_price_hidden'><input type='hidden' name='input_54.3' value='1' id='ginput_quantity_20_54' class='gform_hidden' \/><input type='hidden' name='input_54.1' value='Acheter une adh\u00e9sion d&#039;un an en tant que membre associ\u00e9 de l&#039;UNF (produit r\u00e9el)' class='gform_hidden' \/><input name='input_54.2' id='ginput_base_price_20_54' type='hidden' value='$ 100.00 CAD' class='gform_hidden ginput_amount' \/><\/div><\/div><fieldset id=\"field_20_61\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Vous \u00eates membre de l&#039;UNF pour la premi\u00e8re fois ?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_20_61'><div class='gchoice gchoice_20_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='oui'  id='choice_20_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_20_61_1' id='label_20_61_1' class='gform-field-label gform-field-label--type-inline'>oui, je suis membre de l&rsquo;UNF pour la premi\u00e8re fois<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_20_62\" class=\"gfield gfield--type-coupon gfield--input-type-coupon 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=\"Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.\"><\/i><span>Ce champ est masqu\u00e9 lorsque l\u2018on voit le formulaire.<\/span><\/div><label class='gfield_label gform-field-label' for='gf_coupon_code_20'>Code<\/label><div class='ginput_container' id='gf_coupons_container_20'><div class='ginput_container_coupon'><input id='gf_coupon_code_20' class='gf_coupon_code' onkeyup='DisableApplyButton(20);' onchange='DisableApplyButton(20);' onpaste='setTimeout(function(){DisableApplyButton(20);}, 50);' type='text'    \/><input type='button' disabled='disabled' onclick='ApplyCouponCode(20);' value='Appliquer' id='gf_coupon_button' class='button'  \/> <img style='display:none;' id='gf_coupon_spinner' src='https:\/\/www.nfu.ca\/wp-content\/plugins\/gravityformscoupons\/images\/spinner.gif' alt='veuillez patienter&hellip;'\/><\/div><div id='gf_coupon_info'><\/div><input type='hidden' id='gf_coupon_codes_20' name='input_62' value=''  \/><input type='hidden' id='gf_total_no_discount_20'\/><input type='hidden' id='gf_coupons_20' name='gf_coupons_20' value='' \/><\/div><\/div><fieldset id=\"field_20_56\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Don suppl\u00e9mentaire<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_20_56'><div class='gchoice gchoice_20_56_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.1' type='checkbox'  value='oui'  id='choice_20_56_1'   aria-describedby=\"gfield_description_20_56\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_20_56_1' id='label_20_56_1' class='gform-field-label gform-field-label--type-inline'>Oui, ajoutez un don \u00e0 ma cotisation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_20_56'>Lorsque vous achetez votre adh\u00e9sion, vous pouvez choisir de faire un don unique \u00e0 l&rsquo;UNF en m\u00eame temps que vous payez votre cotisation. Votre carte de cr\u00e9dit ne sera d\u00e9bit\u00e9e qu&rsquo;une seule fois.<\/div><\/fieldset><div id=\"field_20_57\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full gfield_price gfield_price_20_57 gfield_product_20_57 field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_57'>Montant du don<\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_57' id='input_20_57' type='text' value='' class='small ginput_amount'    aria-invalid=\"false\" aria-describedby=\"gfield_description_20_57\" \/>\n\t\t\t\t<\/div><div class='gfield_description' id='gfield_description_20_57'>Merci de votre attention ! Veuillez saisir le montant de votre don suppl\u00e9mentaire.<\/div><\/div><div id=\"field_20_32\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full donation_total gfield_price gfield_price_20_ gfield_total gfield_total_20_ field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  aria-atomic=\"true\" aria-live=\"polite\" ><label class='gfield_label gform-field-label' for='input_20_32'>D\u00e9biter votre carte de cr\u00e9dit au moment du paiement<\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_32' id='input_20_32' value='$ 0.00 CAD' class='gform-text-input-reset ginput_total ginput_total_20' \/>\n\t\t\t\t\t\t<\/div><\/div><fieldset id=\"field_20_37\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Pouvons-nous renouveler automatiquement votre adh\u00e9sion ?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_20_37'>\n\t\t\t<div class='gchoice gchoice_20_37_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='expirer' checked='checked' id='choice_20_37_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_37_0' id='label_20_37_0' class='gform-field-label gform-field-label--type-inline'>laisser mon adh\u00e9sion expirer et me contacter<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_20_37_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_37' type='radio' value='renouveler'  id='choice_20_37_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_37_1' id='label_20_37_1' class='gform-field-label gform-field-label--type-inline'>renouveler automatiquement mon adh\u00e9sion, veuillez<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_20_3\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations personnelles<\/h3><\/div><fieldset id=\"field_20_4\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Nom<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><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_20_4'>\n                            \n                            <span id='input_20_4_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.3' id='input_20_4_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_20_4_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_20_4_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_4.6' id='input_20_4_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_20_4_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_20_5\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half 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_20_5'>Courriel<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_5' id='input_20_5' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_20_10\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half 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_20_10'>Num\u00e9ro de t\u00e9l\u00e9phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_10' id='input_20_10' type='tel' value='' class='large'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_59\" class=\"gfield gfield--type-text gfield--input-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_20_59'>Num\u00e9ro de membre de l&#039;UNF<\/label><div class='ginput_container ginput_container_text'><input name='input_59' id='input_20_59' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_20_21\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Adresse postale<\/h3><\/div><fieldset id=\"field_20_15\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Votre adresse postale<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_20_15' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_20_15_1_container' >\n                                        <input type='text' name='input_15.1' id='input_20_15_1' value=''    aria-required='true'    \/>\n                                        <label for='input_20_15_1' id='input_20_15_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_20_15_2_container' >\n                                        <input type='text' name='input_15.2' id='input_20_15_2' value=''     aria-required='false'   \/>\n                                        <label for='input_20_15_2' id='input_20_15_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_20_15_3_container' >\n                                    <input type='text' name='input_15.3' id='input_20_15_3' value=''    aria-required='true'    \/>\n                                    <label for='input_20_15_3' id='input_20_15_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_20_15_4_container' >\n                                        <input type='text' name='input_15.4' id='input_20_15_4' value=''      aria-required='true'    \/>\n                                        <label for='input_20_15_4' id='input_20_15_4_label' class='gform-field-label gform-field-label--type-sub '>\u00c9tat\/Province\/R\u00e9gion<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_20_15_5_container' >\n                                    <input type='text' name='input_15.5' id='input_20_15_5' value=''    aria-required='true'    \/>\n                                    <label for='input_20_15_5' id='input_20_15_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_20_15_6_container' >\n                                        <select name='input_15.6' id='input_20_15_6'   aria-required='true'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba' >Bonaire, Saint-Eustache et Saba<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' selected='selected'>Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Chypre' >Chypre<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Cor\u00e9e (R\u00e9publique de)' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='Espagne' >Espagne<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini' >Eswatini<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='F\u00e9d\u00e9ration Russe' >F\u00e9d\u00e9ration Russe<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenade' >Grenade<\/option><option value='Groenland' >Groenland<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Guyane' >Guyane<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='G\u00e9orgie du Sud et \u00celes Sandwich du Sud' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Irlande<\/option><option value='Islande' >Islande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='La Barbade' >La Barbade<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Mac\u00e9doine du Nord' >Mac\u00e9doine du Nord<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaisie<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='Maroc' >Maroc<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='R\u00e9publique Tch\u00e8que' >R\u00e9publique Tch\u00e8que<\/option><option value='R\u00e9publique arabe syrienne' >R\u00e9publique arabe syrienne<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Salvador' >Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Somalie' >Somalie<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Suisse<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie (R\u00e9publique-Unie de)' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tchad' >Tchad<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Turquie' >Turquie<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' >Zimbabwe<\/option><option value='\u00c9gypte' >\u00c9gypte<\/option><option value='\u00c9mirats arabes unis' >\u00c9mirats arabes unis<\/option><option value='\u00c9quateur' >\u00c9quateur<\/option><option value='\u00c9rythr\u00e9e' >\u00c9rythr\u00e9e<\/option><option value='\u00c9tat palestinien' >\u00c9tat palestinien<\/option><option value='\u00c9tats-Unis' >\u00c9tats-Unis<\/option><option value='\u00c9thiopie' >\u00c9thiopie<\/option><option value='\u00cele Bouvet' >\u00cele Bouvet<\/option><option value='\u00cele Christmas' >\u00cele Christmas<\/option><option value='\u00cele Maurice' >\u00cele Maurice<\/option><option value='\u00cele Norfolk' >\u00cele Norfolk<\/option><option value='\u00cele de Man' >\u00cele de Man<\/option><option value='\u00celes Cayman' >\u00celes Cayman<\/option><option value='\u00celes Cocos' >\u00celes Cocos<\/option><option value='\u00celes Cook' >\u00celes Cook<\/option><option value='\u00celes Falkland' >\u00celes Falkland<\/option><option value='\u00celes F\u00e9ro\u00e9' >\u00celes F\u00e9ro\u00e9<\/option><option value='\u00celes Heard et McDonald' >\u00celes Heard et McDonald<\/option><option value='\u00celes Mariannes du Nord' >\u00celes Mariannes du Nord<\/option><option value='\u00celes Marshall' >\u00celes Marshall<\/option><option value='\u00celes Pitcairn' >\u00celes Pitcairn<\/option><option value='\u00celes Salomon' >\u00celes Salomon<\/option><option value='\u00celes Turques et Ca\u00efques' >\u00celes Turques et Ca\u00efques<\/option><option value='\u00celes Vierges am\u00e9ricaines' >\u00celes Vierges am\u00e9ricaines<\/option><option value='\u00celes Vierges britanniques' >\u00celes Vierges britanniques<\/option><option value='\u00celes de Svalbard et Jan Mayen' >\u00celes de Svalbard et Jan Mayen<\/option><option value='\u00celes mineures am\u00e9ricaines' >\u00celes mineures am\u00e9ricaines<\/option><option value='\u00celes \u00c5land' >\u00celes \u00c5land<\/option><\/select>\n                                        <label for='input_20_15_6' id='input_20_15_6_label' class='gform-field-label gform-field-label--type-sub '>Pays<\/label>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_20_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Options d&#039;achat<\/h3><\/div><fieldset id=\"field_20_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Options d&#039;achat<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_20_12'>\n\t\t\t<div class='gchoice gchoice_20_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='m\u00eame adresse physique' checked='checked' id='choice_20_12_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_12_0' id='label_20_12_0' class='gform-field-label gform-field-label--type-inline'>J&rsquo;ach\u00e8te cette adh\u00e9sion pour moi-m\u00eame.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_20_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='\u00e0 l&#039;abri des regards'  id='choice_20_12_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_20_12_1' id='label_20_12_1' class='gform-field-label gform-field-label--type-inline'>J&rsquo;ach\u00e8te une adh\u00e9sion au nom de quelqu&rsquo;un d&rsquo;autre.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_20_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Informations sur le b\u00e9n\u00e9ficiaire<\/h3><\/div><fieldset id=\"field_20_16\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Nom du b\u00e9n\u00e9ficiaire<\/legend><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_20_16'>\n                            \n                            <span id='input_20_16_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.3' id='input_20_16_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_20_16_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                <\/span>\n                            \n                            <span id='input_20_16_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_16.6' id='input_20_16_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_20_16_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_20_18\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_18'>Courriel du destinataire<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_18' id='input_20_18' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_20_19\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_20_19'>Num\u00e9ro de t\u00e9l\u00e9phone du destinataire<\/label><div class='ginput_container ginput_container_phone'><input name='input_19' id='input_20_19' type='tel' value='' class='large'    aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_20_20\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Adresse du destinataire<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row' id='input_20_20' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_20_20_1_container' >\n                                        <input type='text' name='input_20.1' id='input_20_20_1' value=''    aria-required='false'    \/>\n                                        <label for='input_20_20_1' id='input_20_20_1_label' class='gform-field-label gform-field-label--type-sub '>Adresse postale<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_20_20_2_container' >\n                                        <input type='text' name='input_20.2' id='input_20_20_2' value=''     aria-required='false'   \/>\n                                        <label for='input_20_20_2' id='input_20_20_2_label' class='gform-field-label gform-field-label--type-sub '>Adresse ligne 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_20_20_3_container' >\n                                    <input type='text' name='input_20.3' id='input_20_20_3' value=''    aria-required='false'    \/>\n                                    <label for='input_20_20_3' id='input_20_20_3_label' class='gform-field-label gform-field-label--type-sub '>Ville<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_20_20_4_container' >\n                                        <input type='text' name='input_20.4' id='input_20_20_4' value=''      aria-required='false'    \/>\n                                        <label for='input_20_20_4' id='input_20_20_4_label' class='gform-field-label gform-field-label--type-sub '>\u00c9tat\/Province\/R\u00e9gion<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_20_20_5_container' >\n                                    <input type='text' name='input_20.5' id='input_20_20_5' value=''    aria-required='false'    \/>\n                                    <label for='input_20_20_5' id='input_20_20_5_label' class='gform-field-label gform-field-label--type-sub '>Code postal<\/label>\n                                <\/span><span class='ginput_right address_country ginput_address_country gform-grid-col' id='input_20_20_6_container' >\n                                        <select name='input_20.6' id='input_20_20_6'   aria-required='false'    ><option value='' ><\/option><option value='Afghanistan' >Afghanistan<\/option><option value='Afrique du Sud' >Afrique du Sud<\/option><option value='Albanie' >Albanie<\/option><option value='Alg\u00e9rie' >Alg\u00e9rie<\/option><option value='Allemagne' >Allemagne<\/option><option value='Andorre' >Andorre<\/option><option value='Angola' >Angola<\/option><option value='Anguilla' >Anguilla<\/option><option value='Antarctique' >Antarctique<\/option><option value='Antigua-et-Barbuda' >Antigua-et-Barbuda<\/option><option value='Arabie Saoudite' >Arabie Saoudite<\/option><option value='Argentine' >Argentine<\/option><option value='Arm\u00e9nie' >Arm\u00e9nie<\/option><option value='Aruba' >Aruba<\/option><option value='Australie' >Australie<\/option><option value='Autriche' >Autriche<\/option><option value='Azerba\u00efdjan' >Azerba\u00efdjan<\/option><option value='Bahamas' >Bahamas<\/option><option value='Bahre\u00efn' >Bahre\u00efn<\/option><option value='Bangladesh' >Bangladesh<\/option><option value='Belarus' >Belarus<\/option><option value='Belgique' >Belgique<\/option><option value='Belize' >Belize<\/option><option value='Bermudes' >Bermudes<\/option><option value='Bhoutan' >Bhoutan<\/option><option value='Bolivie' >Bolivie<\/option><option value='Bonaire, Saint-Eustache et Saba' >Bonaire, Saint-Eustache et Saba<\/option><option value='Bosnie-Herz\u00e9govine' >Bosnie-Herz\u00e9govine<\/option><option value='Botswana' >Botswana<\/option><option value='Brunei Darussalam' >Brunei Darussalam<\/option><option value='Br\u00e9sil' >Br\u00e9sil<\/option><option value='Bulgarie' >Bulgarie<\/option><option value='Burkina Faso' >Burkina Faso<\/option><option value='Burundi' >Burundi<\/option><option value='B\u00e9nin' >B\u00e9nin<\/option><option value='Cambodge' >Cambodge<\/option><option value='Cameroun' >Cameroun<\/option><option value='Canada' selected='selected'>Canada<\/option><option value='Cap-Vert' >Cap-Vert<\/option><option value='Chili' >Chili<\/option><option value='Chine' >Chine<\/option><option value='Chypre' >Chypre<\/option><option value='Colombie' >Colombie<\/option><option value='Comores' >Comores<\/option><option value='Congo' >Congo<\/option><option value='Cor\u00e9e (R\u00e9publique de)' >Cor\u00e9e (R\u00e9publique de)<\/option><option value='Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)' >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatie' >Croatie<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='C\u00f4te d\u2019Ivoire' >C\u00f4te d\u2019Ivoire<\/option><option value='Danemark' >Danemark<\/option><option value='Djibouti' >Djibouti<\/option><option value='Dominique' >Dominique<\/option><option value='Espagne' >Espagne<\/option><option value='Estonie' >Estonie<\/option><option value='Eswatini' >Eswatini<\/option><option value='Fidji' >Fidji<\/option><option value='Finlande' >Finlande<\/option><option value='France' >France<\/option><option value='F\u00e9d\u00e9ration Russe' >F\u00e9d\u00e9ration Russe<\/option><option value='Gabon' >Gabon<\/option><option value='Gambie' >Gambie<\/option><option value='Ghana' >Ghana<\/option><option value='Gibraltar' >Gibraltar<\/option><option value='Grenade' >Grenade<\/option><option value='Groenland' >Groenland<\/option><option value='Gr\u00e8ce' >Gr\u00e8ce<\/option><option value='Guadeloupe' >Guadeloupe<\/option><option value='Guam' >Guam<\/option><option value='Guatemala' >Guatemala<\/option><option value='Guernsey' >Guernsey<\/option><option value='Guin\u00e9e' >Guin\u00e9e<\/option><option value='Guin\u00e9e \u00e9quatoriale' >Guin\u00e9e \u00e9quatoriale<\/option><option value='Guin\u00e9e-Bissau' >Guin\u00e9e-Bissau<\/option><option value='Guyane' >Guyane<\/option><option value='Guyane' >Guyane<\/option><option value='G\u00e9orgie' >G\u00e9orgie<\/option><option value='G\u00e9orgie du Sud et \u00celes Sandwich du Sud' >G\u00e9orgie du Sud et \u00celes Sandwich du Sud<\/option><option value='Ha\u00efti' >Ha\u00efti<\/option><option value='Honduras' >Honduras<\/option><option value='Hong Kong' >Hong Kong<\/option><option value='Hongrie' >Hongrie<\/option><option value='Inde' >Inde<\/option><option value='Indon\u00e9sie' >Indon\u00e9sie<\/option><option value='Irak' >Irak<\/option><option value='Iran' >Iran<\/option><option value='Irlande' >Irlande<\/option><option value='Islande' >Islande<\/option><option value='Isra\u00ebl' >Isra\u00ebl<\/option><option value='Italie' >Italie<\/option><option value='Jama\u00efque' >Jama\u00efque<\/option><option value='Japon' >Japon<\/option><option value='Jersey' >Jersey<\/option><option value='Jordanie' >Jordanie<\/option><option value='Kazakhstan' >Kazakhstan<\/option><option value='Kenya' >Kenya<\/option><option value='Kirghizistan' >Kirghizistan<\/option><option value='Kiribati' >Kiribati<\/option><option value='Kowe\u00eft' >Kowe\u00eft<\/option><option value='La Barbade' >La Barbade<\/option><option value='La R\u00e9union' >La R\u00e9union<\/option><option value='Lesotho' >Lesotho<\/option><option value='Lettonie' >Lettonie<\/option><option value='Liban' >Liban<\/option><option value='Liberia' >Liberia<\/option><option value='Libye' >Libye<\/option><option value='Liechtenstein' >Liechtenstein<\/option><option value='Lituanie' >Lituanie<\/option><option value='Luxembourg' >Luxembourg<\/option><option value='Macao' >Macao<\/option><option value='Mac\u00e9doine du Nord' >Mac\u00e9doine du Nord<\/option><option value='Madagascar' >Madagascar<\/option><option value='Malaisie' >Malaisie<\/option><option value='Malawi' >Malawi<\/option><option value='Maldives' >Maldives<\/option><option value='Mali' >Mali<\/option><option value='Malte' >Malte<\/option><option value='Maroc' >Maroc<\/option><option value='Martinique' >Martinique<\/option><option value='Mauritanie' >Mauritanie<\/option><option value='Mayotte' >Mayotte<\/option><option value='Mexique' >Mexique<\/option><option value='Micron\u00e9sie' >Micron\u00e9sie<\/option><option value='Moldavie' >Moldavie<\/option><option value='Monaco' >Monaco<\/option><option value='Mongolie' >Mongolie<\/option><option value='Montserrat' >Montserrat<\/option><option value='Mont\u00e9n\u00e9gro' >Mont\u00e9n\u00e9gro<\/option><option value='Mozambique' >Mozambique<\/option><option value='Myanmar' >Myanmar<\/option><option value='Namibie' >Namibie<\/option><option value='Nauru' >Nauru<\/option><option value='Nicaragua' >Nicaragua<\/option><option value='Niger' >Niger<\/option><option value='Nig\u00e9ria' >Nig\u00e9ria<\/option><option value='Niu\u00e9' >Niu\u00e9<\/option><option value='Norv\u00e8ge' >Norv\u00e8ge<\/option><option value='Nouvelle-Cal\u00e9donie' >Nouvelle-Cal\u00e9donie<\/option><option value='Nouvelle-Z\u00e9lande' >Nouvelle-Z\u00e9lande<\/option><option value='N\u00e9pal' >N\u00e9pal<\/option><option value='Oman' >Oman<\/option><option value='Ouganda' >Ouganda<\/option><option value='Ouzb\u00e9kistan' >Ouzb\u00e9kistan<\/option><option value='Pakistan' >Pakistan<\/option><option value='Palau' >Palau<\/option><option value='Panama' >Panama<\/option><option value='Papouasie-Nouvelle-Guin\u00e9e' >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value='Paraguay' >Paraguay<\/option><option value='Pays-Bas' >Pays-Bas<\/option><option value='Philippines' >Philippines<\/option><option value='Pologne' >Pologne<\/option><option value='Polyn\u00e9sie fran\u00e7aise' >Polyn\u00e9sie fran\u00e7aise<\/option><option value='Porto Rico' >Porto Rico<\/option><option value='Portugal' >Portugal<\/option><option value='P\u00e9rou' >P\u00e9rou<\/option><option value='Qatar' >Qatar<\/option><option value='Roumanie' >Roumanie<\/option><option value='Royaume-Uni' >Royaume-Uni<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9publique Dominicaine' >R\u00e9publique Dominicaine<\/option><option value='R\u00e9publique Tch\u00e8que' >R\u00e9publique Tch\u00e8que<\/option><option value='R\u00e9publique arabe syrienne' >R\u00e9publique arabe syrienne<\/option><option value='R\u00e9publique centrafricaine' >R\u00e9publique centrafricaine<\/option><option value='R\u00e9publique d\u00e9mocratique du Congo' >R\u00e9publique d\u00e9mocratique du Congo<\/option><option value='R\u00e9publique d\u00e9mocratique populaire du Laos' >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value='Sahara occidental' >Sahara occidental<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre et Miquelon' >Saint Pierre et Miquelon<\/option><option value='Saint-Christophe-et-Nevis' >Saint-Christophe-et-Nevis<\/option><option value='Saint-Marin' >Saint-Marin<\/option><option value='Saint-Si\u00e8ge' >Saint-Si\u00e8ge<\/option><option value='Saint-Vincent-et-les Grenadines' >Saint-Vincent-et-les Grenadines<\/option><option value='Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha' >Sainte-H\u00e9l\u00e8ne, Ascension et Tristan da Cunha<\/option><option value='Sainte-Lucie' >Sainte-Lucie<\/option><option value='Salvador' >Salvador<\/option><option value='Samoa' >Samoa<\/option><option value='Samoa am\u00e9ricaines' >Samoa am\u00e9ricaines<\/option><option value='Sao Tom\u00e9 et Principe' >Sao Tom\u00e9 et Principe<\/option><option value='Serbie' >Serbie<\/option><option value='Seychelles' >Seychelles<\/option><option value='Sierra Leone' >Sierra Leone<\/option><option value='Singapour' >Singapour<\/option><option value='Sint Maarten' >Sint Maarten<\/option><option value='Slovaquie' >Slovaquie<\/option><option value='Slov\u00e9nie' >Slov\u00e9nie<\/option><option value='Somalie' >Somalie<\/option><option value='Soudan' >Soudan<\/option><option value='Soudan du Sud' >Soudan du Sud<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Suisse' >Suisse<\/option><option value='Suriname' >Suriname<\/option><option value='Su\u00e8de' >Su\u00e8de<\/option><option value='S\u00e9n\u00e9gal' >S\u00e9n\u00e9gal<\/option><option value='Tadjikistan' >Tadjikistan<\/option><option value='Tanzanie (R\u00e9publique-Unie de)' >Tanzanie (R\u00e9publique-Unie de)<\/option><option value='Ta\u00efwan' >Ta\u00efwan<\/option><option value='Tchad' >Tchad<\/option><option value='Terres Australes Fran\u00e7aises' >Terres Australes Fran\u00e7aises<\/option><option value='Territoire britannique de l\u2019oc\u00e9an Indien' >Territoire britannique de l\u2019oc\u00e9an Indien<\/option><option value='Tha\u00eflande' >Tha\u00eflande<\/option><option value='Timor oriental' >Timor oriental<\/option><option value='Togo' >Togo<\/option><option value='Tokelau' >Tokelau<\/option><option value='Tonga' >Tonga<\/option><option value='Trinit\u00e9 et Tobago' >Trinit\u00e9 et Tobago<\/option><option value='Tunisie' >Tunisie<\/option><option value='Turkm\u00e9nistan' >Turkm\u00e9nistan<\/option><option value='Turquie' >Turquie<\/option><option value='Tuvalu' >Tuvalu<\/option><option value='Ukraine' >Ukraine<\/option><option value='Uruguay' >Uruguay<\/option><option value='Vanuatu' >Vanuatu<\/option><option value='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/option><option value='Wallis et Futuna' >Wallis et Futuna<\/option><option value='Y\u00e9men' >Y\u00e9men<\/option><option value='Zambie' >Zambie<\/option><option value='Zimbabwe' 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