• Richiesta Corsi di Aggiornamento

  • Richiesta Corsi di Aggiornamento

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Civico<span class="form-required">*</span> </label> <div id="cid_4" class="form-input jf-required"> <input type="text" id="input_4" name="q4_viaE" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" placeholder=" " data-component="textbox" aria-labelledby="label_4" required="" /> </div> </li> <li class="form-line jf-required form-field-hidden" style="display:none;" data-type="control_textbox" id="id_5"><label class="form-label form-label-left form-label-auto" id="label_5" for="input_5"> CAP<span class="form-required">*</span> </label> <div id="cid_5" class="form-input jf-required"> <input type="text" id="input_5" name="q5_cap" data-type="input-textbox" class="form-textbox validate[required, Numerico]" data-defaultvalue="" size="5" value="" maxLength="5" placeholder=" " data-component="textbox" aria-labelledby="label_5" required="" /> </div> </li> <li class="form-line jf-required form-field-hidden" style="display:none;" data-type="control_textbox" id="id_6"><label class="form-label form-label-left form-label-auto" id="label_6" for="input_6"> Località<span class="form-required">*</span> </label> <div id="cid_6" class="form-input jf-required"> <input type="text" id="input_6" name="q6_localita" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" placeholder=" " data-component="textbox" aria-labelledby="label_6" required="" /> </div> </li> <li class="form-line jf-required form-field-hidden" style="display:none;" data-type="control_textbox" id="id_7"><label class="form-label form-label-left form-label-auto" id="label_7" for="input_7"> Prov.<span class="form-required">*</span> </label> <div id="cid_7" class="form-input jf-required"> <input type="text" id="input_7" name="q7_prov" data-type="input-textbox" class="form-textbox validate[required, Alfabetico]" data-defaultvalue="" size="5" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_7" required="" /> </div> </li> <li class="form-line jf-required" data-type="control_textbox" id="id_8"><label class="form-label form-label-left form-label-auto" id="label_8" for="input_8"> Telefono<span class="form-required">*</span> </label> <div id="cid_8" class="form-input jf-required"> <input type="text" id="input_8" name="q8_telefono" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" size="20" value="" placeholder=" " data-component="textbox" aria-labelledby="label_8" required="" /> </div> </li> <li class="form-line jf-required" data-type="control_email" id="id_9"><label class="form-label form-label-left form-label-auto" id="label_9" for="input_9"> E-mail<span class="form-required">*</span> </label> <div id="cid_9" class="form-input jf-required"> <input type="email" id="input_9" name="q9_email9" class="form-textbox validate[required, Email]" data-defaultvalue="" size="30" value="" placeholder="es: mariorossi@esempio.com" data-component="email" aria-labelledby="label_9" required="" /> </div> </li> <li id="cid_62" class="form-input-wide" data-type="control_pagebreak"> <div class="form-pagebreak" data-component="pagebreak"> <div class="form-pagebreak-back-container"><button id="form-pagebreak-back_62" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back">Indietro</button></div> <div class="form-pagebreak-next-container"><button id="form-pagebreak-next_62" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next">Avanti</button></div> <div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_62"></div> </div> </li> </ul> <ul class="form-section page-section" style="display:none;"> <li class="form-line" data-type="control_footer" id="id_43"> <div id="cid_43" class="form-input-wide"> <div id="footer_43" style="text-align:left">La richiesta sarà valida solo per i corsi in cui è inserito il num. di partecipanti</div> </div> </li> <li class="form-line" data-type="control_footer" id="id_53"> <div id="cid_53" class="form-input-wide"> <div id="footer_53" style="text-align:left">48 ore - RSPP DATORE DI LAVORO</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_12"><label class="form-label form-label-left form-label-auto" id="label_12" for="input_12"> Num. di partecipanti </label> <div id="cid_12" class="form-input"> <input type="text" id="input_12" name="q12_numDi" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_12" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_65"><label class="form-label form-label-left form-label-auto" id="label_65" for="input_65"> Scelta zona </label> <div id="cid_65" class="form-input"> <select class="form-dropdown" id="input_65" name="q65_sceltaZona65" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_54"> <div id="cid_54" class="form-input-wide"> <div id="footer_54" style="text-align:left">32 ore - R.L.S. lavoratore</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_39"><label class="form-label form-label-left form-label-auto" id="label_39" for="input_39"> Num. di partecipanti </label> <div id="cid_39" class="form-input"> <input type="text" id="input_39" name="q39_numDi39" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_39" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_66"><label class="form-label form-label-left form-label-auto" id="label_66" for="input_66"> Scelta zona </label> <div id="cid_66" class="form-input"> <select class="form-dropdown" id="input_66" name="q66_sceltaZona" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_55"> <div id="cid_55" class="form-input-wide"> <div id="footer_55" style="text-align:left">16 ore - PRIMA FORMAZIONE lavoratore</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_38"><label class="form-label form-label-left form-label-auto" id="label_38" for="input_38"> Num. di partecipanti </label> <div id="cid_38" class="form-input"> <input type="text" id="input_38" name="q38_numDi38" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_38" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_67"><label class="form-label form-label-left form-label-auto" id="label_67" for="input_67"> Scelta zona </label> <div id="cid_67" class="form-input"> <select class="form-dropdown" id="input_67" name="q67_sceltaZona67" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_56"> <div id="cid_56" class="form-input-wide"> <div id="footer_56" style="text-align:left">8 ore - MOD. AGG. PREPOSTO (prima formazione obbligatoria)</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_37"><label class="form-label form-label-left form-label-auto" id="label_37" for="input_37"> Num. di partecipanti </label> <div id="cid_37" class="form-input"> <input type="text" id="input_37" name="q37_numDi37" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_37" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_68"><label class="form-label form-label-left form-label-auto" id="label_68" for="input_68"> Scelta zona </label> <div id="cid_68" class="form-input"> <select class="form-dropdown" id="input_68" name="q68_sceltaZona68" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CAGLIARI">CAGLIARI</option> <option value="CARBONIA">CARBONIA</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_57"> <div id="cid_57" class="form-input-wide"> <div id="footer_57" style="text-align:left">16 ore - ADDETTO PRIMO SOCCORSO</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_36"><label class="form-label form-label-left form-label-auto" id="label_36" for="input_36"> Num. di partecipanti </label> <div id="cid_36" class="form-input"> <input type="text" id="input_36" name="q36_numDi36" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_36" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_69"><label class="form-label form-label-left form-label-auto" id="label_69" for="input_69"> Scelta zona </label> <div id="cid_69" class="form-input"> <select class="form-dropdown" id="input_69" name="q69_sceltaZona69" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_58"> <div id="cid_58" class="form-input-wide"> <div id="footer_58" style="text-align:left">4 ore - PREVENZIONE/CONTRASTO INCENDI rischio basso</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_34"><label class="form-label form-label-left form-label-auto" id="label_34" for="input_34"> Num. di partecipanti </label> <div id="cid_34" class="form-input"> <input type="text" id="input_34" name="q34_numDi34" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_34" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_70"><label class="form-label form-label-left form-label-auto" id="label_70" for="input_70"> Scelta zona </label> <div id="cid_70" class="form-input"> <select class="form-dropdown" id="input_70" name="q70_sceltaZona70" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_59"> <div id="cid_59" class="form-input-wide"> <div id="footer_59" style="text-align:left">8 ore - PREVENZIONE/CONTRASTO INCENDI rischio medio</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_33"><label class="form-label form-label-left form-label-auto" id="label_33" for="input_33"> Num. di partecipanti </label> <div id="cid_33" class="form-input"> <input type="text" id="input_33" name="q33_numDi33" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_33" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_71"><label class="form-label form-label-left form-label-auto" id="label_71" for="input_71"> Scelta zona </label> <div id="cid_71" class="form-input"> <select class="form-dropdown" id="input_71" name="q71_sceltaZona71" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_footer" id="id_60"> <div id="cid_60" class="form-input-wide"> <div id="footer_60" style="text-align:left">28 ore - ADDETTO AL MONTAGGIO, USO, SMONTAGGIO PONTEGGI</div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_32"><label class="form-label form-label-left form-label-auto" id="label_32" for="input_32"> Num. di partecipanti </label> <div id="cid_32" class="form-input"> <input type="text" id="input_32" name="q32_numDi32" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_32" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_72"><label class="form-label form-label-left form-label-auto" id="label_72" for="input_72"> Scelta zona </label> <div id="cid_72" class="form-input"> <select class="form-dropdown" id="input_72" name="q72_sceltaZona72" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value="">Please Select</option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_text" id="id_77"> <div id="cid_77" class="form-input-wide"> <div id="text_77" class="form-html" data-component="text" tabindex="0"> <p>4 ore - AGGIORNAMENTO ADDESTRAMENTO D.P.I. TERZA CATEGORIA</p> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_75"><label class="form-label form-label-left form-label-auto" id="label_75" for="input_75"> Num. di partecipanti </label> <div id="cid_75" class="form-input"> <input type="text" id="input_75" name="q75_numDi75" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_75" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_76"><label class="form-label form-label-left form-label-auto" id="label_76" for="input_76"> Scelta zona </label> <div id="cid_76" class="form-input"> <select class="form-dropdown" id="input_76" name="q76_sceltaZona76" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value=""></option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_text" id="id_78"> <div id="cid_78" class="form-input-wide"> <div id="text_78" class="form-html" data-component="text" tabindex="0"> <p>4 ore - AGG. SICUREZZA CANTIERI STRADALI - LAVORATORI</p> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_79"><label class="form-label form-label-left form-label-auto" id="label_79" for="input_79"> Num. di partecipanti </label> <div id="cid_79" class="form-input"> <input type="text" id="input_79" name="q79_numDi79" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_79" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_80"><label class="form-label form-label-left form-label-auto" id="label_80" for="input_80"> Scelta zona </label> <div id="cid_80" class="form-input"> <select class="form-dropdown" id="input_80" name="q80_sceltaZona80" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value=""></option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_text" id="id_81"> <div id="cid_81" class="form-input-wide"> <div id="text_81" class="form-html" data-component="text" tabindex="0"> <p>4 ore - AGG. SICUREZZA CANTIERI STRADALI - PREPOSTI</p> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_82"><label class="form-label form-label-left form-label-auto" id="label_82" for="input_82"> Num. di partecipanti </label> <div id="cid_82" class="form-input"> <input type="text" id="input_82" name="q82_numDi82" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_82" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_83"><label class="form-label form-label-left form-label-auto" id="label_83" for="input_83"> Scelta zona </label> <div id="cid_83" class="form-input"> <select class="form-dropdown" id="input_83" name="q83_sceltaZona83" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value=""></option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line" data-type="control_text" id="id_84"> <div id="cid_84" class="form-input-wide"> <div id="text_84" class="form-html" data-component="text" tabindex="0"> <p>4 ore - AGG. SPAZI CONFINATI</p> </div> </div> </li> <li class="form-line" data-type="control_textbox" id="id_85"><label class="form-label form-label-left form-label-auto" id="label_85" for="input_85"> Num. di partecipanti </label> <div id="cid_85" class="form-input"> <input type="text" id="input_85" name="q85_numDi85" data-type="input-textbox" class="form-textbox validate[Numerico]" data-defaultvalue="" size="1" value="" maxLength="2" placeholder=" " data-component="textbox" aria-labelledby="label_85" /> </div> </li> <li class="form-line" data-type="control_dropdown" id="id_86"><label class="form-label form-label-left form-label-auto" id="label_86" for="input_86"> Scelta zona </label> <div id="cid_86" class="form-input"> <select class="form-dropdown" id="input_86" name="q86_sceltaZona86" style="width:150px" data-component="dropdown" aria-label="Scelta zona"> <option value=""></option> <option value="CARBONIA (minor frequenza)">CARBONIA (minor frequenza)</option> <option value="CAGLIARI">CAGLIARI</option> <option value="NUORO">NUORO</option> <option value="ORISTANO">ORISTANO</option> <option value="SASSARI">SASSARI</option> <option value="OLBIA">OLBIA</option> </select> </div> </li> <li class="form-line jf-required" data-type="control_radio" id="id_61"><label class="form-label form-label-left form-label-auto" id="label_61" for="input_61"> Consenso Privacy<span class="form-required">*</span> </label> <div id="cid_61" class="form-input jf-required"> <div class="form-single-column" role="group" aria-labelledby="label_61" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input type="radio" aria-describedby="label_61" class="form-radio validate[required]" id="input_61_0" name="q61_consensoPrivacy" value="Confermo di conoscere il d.leg. 196/03 sulla privacy e in particolare l&#x27;informativa di cui all&#x27;art. 13 e acconsento al trattamento e utilizzo dei miei dati personali allo scopo di ottenere il servizio richiesto." required="" /><label id="label_input_61_0" for="input_61_0">Confermo di conoscere il d.leg. 196/03 sulla privacy e in particolare l'informativa di cui all'art. 13 e acconsento al trattamento e utilizzo dei miei dati personali allo scopo di ottenere il servizio richiesto.</label></span></div> </div> </li> <li class="form-line jf-required" data-type="control_captcha" id="id_41"><label class="form-label form-label-left form-label-auto" id="label_41" for="input_41"> Compila il campo<span class="form-required">*</span> </label> <div id="cid_41" class="form-input jf-required"> <div class="form-captcha" data-component="captcha"><label for="input_41"><img alt="Captcha - Reload if not displayed" id="input_41_captcha" class="form-captcha-image" style="background:url(https://cdn.jotfor.ms/images/loader-big.gif) no-repeat center" src="https://cdn.jotfor.ms/images/blank.gif" width="150" height="41" /></label> <div style="white-space:nowrap"><input type="text" id="input_41" class="form-textbox validate[required]" name="captcha" style="width:130px" required="" /><img src="https://cdn.jotfor.ms/images/reload.png" alt="Reload" style="cursor:pointer;vertical-align:middle" id="input_41_reload" /><input type="hidden" name="captcha_id" id="input_41_captcha_id" value="0" /></div> </div> </div> </li> <li class="form-line" data-type="control_button" id="id_2"> <div id="cid_2" class="form-input-wide"> <div data-align="auto" class="form-buttons-wrapper form-buttons-auto jsTest-button-wrapperField"><button id="input_2" type="submit" class="form-submit-button submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content="">Invia il modulo</button></div> </div> </li> <li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li> </ul> </div> <script> JotForm.showJotFormPowered = "0"; </script> <script> JotForm.poweredByText = "Powered by Jotform"; </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="232333383075352" /> <script type="text/javascript"> var all_spc = document.querySelectorAll("form[id='232333383075352'] .si" + "mple" + "_spc"); for (var i = 0; i < all_spc.length; i++) { all_spc[i].value = "232333383075352-232333383075352"; } </script> </form><script type="text/javascript">JotForm.ownerView=true;</script><script type="text/javascript">JotForm.showAlternateHIPAABadge=true;</script><script type="text/javascript">JotForm.isNewSACL=true;</script>

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