{"id":2766,"date":"2026-08-03T14:14:43","date_gmt":"2026-08-03T14:14:43","guid":{"rendered":"https:\/\/ubongo.afroskills.org\/formulaire-de-mise-en-relation\/"},"modified":"2026-08-05T08:18:31","modified_gmt":"2026-08-05T08:18:31","slug":"formulaire-de-mise-en-relation","status":"publish","type":"page","link":"https:\/\/ubongo.afroskills.org\/fr\/formulaire-de-mise-en-relation\/","title":{"rendered":"Formulaire de Mise en Relation"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"2766\" class=\"elementor elementor-2766 elementor-2640\" data-elementor-post-type=\"page\">\n\t\t\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-63a3ea5 e-flex e-con-boxed e-con e-parent\" data-id=\"63a3ea5\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-c0cf67b e-con-full e-flex e-con e-child\" data-id=\"c0cf67b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b205d68 elementor-widget__width-initial elementor-widget-mobile__width-inherit elementor-widget elementor-widget-text-editor\" data-id=\"b205d68\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><strong>UBONGO S.a.r.l<\/strong> s&rsquo;appuie sur sa plateforme propri\u00e9taire pour identifier, \u00e9valuer et vous mettre en relation avec des partenaires d&rsquo;affaires v\u00e9rifi\u00e9s, internationaux et intra-africains, en vue de coentreprises, d&rsquo;accords commerciaux, de co-investissements et de transferts de technologies.<\/p>\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 data-particle_enable=\"false\" data-particle-mobile-disabled=\"false\" class=\"elementor-element elementor-element-8ab6022 e-flex e-con-boxed e-con e-parent\" data-id=\"8ab6022\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c317acb elementor-widget elementor-widget-shortcode\" data-id=\"c317acb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><style id=\"wpforms-css-vars-2642\">\n\t\t\t\t#wpforms-2642 {\n\t\t\t\t--wpforms-field-size-input-height: 43px;\n--wpforms-field-size-input-spacing: 15px;\n--wpforms-field-size-font-size: 16px;\n--wpforms-field-size-line-height: 19px;\n--wpforms-field-size-padding-h: 14px;\n--wpforms-field-size-checkbox-size: 16px;\n--wpforms-field-size-sublabel-spacing: 5px;\n--wpforms-field-size-icon-size: 1;\n--wpforms-label-size-font-size: 16px;\n--wpforms-label-size-line-height: 19px;\n--wpforms-label-size-sublabel-font-size: 14px;\n--wpforms-label-size-sublabel-line-height: 17px;\n--wpforms-button-size-font-size: 17px;\n--wpforms-button-size-height: 41px;\n--wpforms-button-size-padding-h: 15px;\n--wpforms-button-size-margin-top: 10px;\n--wpforms-container-shadow-size-box-shadow: none;\n\t\t\t}\n\t\t\t<\/style><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-2642\"><form id=\"wpforms-form-2642\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"2642\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/fr\/wp-json\/wp\/v2\/pages\/2766\" data-token=\"949401afa953074b613febeb403c4365\" data-token-time=\"1789366021\"><noscript class=\"wpforms-error-noscript\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/noscript><div id=\"wpforms-error-noscript\" style=\"display: none;\">Veuillez activer JavaScript dans votre navigateur pour remplir ce formulaire.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-2642-field_8-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"8\"><h3 class=\"wpforms-field-label\">\n\t\t\t\t1. Profil du demandeur et de l&#039;Entreprise\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_9-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"9\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_9\">Raison Sociale de l&#039;Entreprise <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_9\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][9]\" placeholder=\"ex : Kivu renewables Ltd\" aria-errormessage=\"wpforms-2642-field_9-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_76-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-type=\"select\" data-field-id=\"76\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_76\">Pays d&#039;Origine \/ d&#039;Immatriculation<\/label><select id=\"wpforms-2642-field_76\" class=\"wpforms-field-medium choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"1\" name=\"wpforms[fields][76]\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'><\/option><option value=\"Afghanistan\"  class=\"choice-4 depth-1\"  >Afghanistan<\/option><option value=\"Albanie\"  class=\"choice-5 depth-1\"  >Albanie<\/option><option value=\"Alg\u00e9rie\"  class=\"choice-6 depth-1\"  >Alg\u00e9rie<\/option><option value=\"Samoa am\u00e9ricaines\"  class=\"choice-7 depth-1\"  >Samoa am\u00e9ricaines<\/option><option value=\"Andorre\"  class=\"choice-8 depth-1\"  >Andorre<\/option><option value=\"Angola\"  class=\"choice-9 depth-1\"  >Angola<\/option><option value=\"Anguilla\"  class=\"choice-10 depth-1\"  >Anguilla<\/option><option value=\"Antarctique\"  class=\"choice-11 depth-1\"  >Antarctique<\/option><option value=\"Antigua-et-Barbuda\"  class=\"choice-12 depth-1\"  >Antigua-et-Barbuda<\/option><option value=\"Argentine\"  class=\"choice-13 depth-1\"  >Argentine<\/option><option value=\"Arm\u00e9nie\"  class=\"choice-14 depth-1\"  >Arm\u00e9nie<\/option><option value=\"Aruba\"  class=\"choice-15 depth-1\"  >Aruba<\/option><option value=\"Australie\"  class=\"choice-16 depth-1\"  >Australie<\/option><option value=\"Autriche\"  class=\"choice-17 depth-1\"  >Autriche<\/option><option value=\"Azerba\u00efdjan\"  class=\"choice-18 depth-1\"  >Azerba\u00efdjan<\/option><option value=\"Bahamas\"  class=\"choice-19 depth-1\"  >Bahamas<\/option><option value=\"Bahre\u00efn\"  class=\"choice-20 depth-1\"  >Bahre\u00efn<\/option><option value=\"Bangladesh\"  class=\"choice-21 depth-1\"  >Bangladesh<\/option><option value=\"La Barbade\"  class=\"choice-22 depth-1\"  >La Barbade<\/option><option value=\"Bi\u00e9lorussie\"  class=\"choice-23 depth-1\"  >Bi\u00e9lorussie<\/option><option value=\"Belgique\"  class=\"choice-24 depth-1\"  >Belgique<\/option><option value=\"Belize\"  class=\"choice-25 depth-1\"  >Belize<\/option><option value=\"B\u00e9nin\"  class=\"choice-26 depth-1\"  >B\u00e9nin<\/option><option value=\"Bermudes\"  class=\"choice-27 depth-1\"  >Bermudes<\/option><option value=\"Bhoutan\"  class=\"choice-28 depth-1\"  >Bhoutan<\/option><option value=\"Bolivie (\u00c9tat plurinational de)\"  class=\"choice-29 depth-1\"  >Bolivie (\u00c9tat plurinational de)<\/option><option value=\"Bonaire, Saint-Eustache et Saba\"  class=\"choice-30 depth-1\"  >Bonaire, Saint-Eustache et Saba<\/option><option value=\"Bosnie-Herz\u00e9govine\"  class=\"choice-31 depth-1\"  >Bosnie-Herz\u00e9govine<\/option><option value=\"Botswana\"  class=\"choice-32 depth-1\"  >Botswana<\/option><option value=\"L&#039;\u00eele Bouvet\"  class=\"choice-33 depth-1\"  >L'\u00eele Bouvet<\/option><option value=\"Br\u00e9sil\"  class=\"choice-34 depth-1\"  >Br\u00e9sil<\/option><option value=\"Territoire britannique de l&#039;oc\u00e9an Indien\"  class=\"choice-35 depth-1\"  >Territoire britannique de l'oc\u00e9an Indien<\/option><option value=\"Brunei Darussalam\"  class=\"choice-36 depth-1\"  >Brunei Darussalam<\/option><option value=\"Bulgarie\"  class=\"choice-37 depth-1\"  >Bulgarie<\/option><option value=\"Burkina Faso\"  class=\"choice-38 depth-1\"  >Burkina Faso<\/option><option value=\"Burundi\"  class=\"choice-39 depth-1\"  >Burundi<\/option><option value=\"Cap-Vert\"  class=\"choice-40 depth-1\"  >Cap-Vert<\/option><option value=\"Cambodge\"  class=\"choice-41 depth-1\"  >Cambodge<\/option><option value=\"Cameroun\"  class=\"choice-42 depth-1\"  >Cameroun<\/option><option value=\"Canada\"  class=\"choice-43 depth-1\"  >Canada<\/option><option value=\"\u00celes Ca\u00efmans\"  class=\"choice-44 depth-1\"  >\u00celes Ca\u00efmans<\/option><option value=\"R\u00e9publique centrafricaine\"  class=\"choice-45 depth-1\"  >R\u00e9publique centrafricaine<\/option><option value=\"Tchad\"  class=\"choice-46 depth-1\"  >Tchad<\/option><option value=\"Chili\"  class=\"choice-47 depth-1\"  >Chili<\/option><option value=\"Chine\"  class=\"choice-48 depth-1\"  >Chine<\/option><option value=\"L&#039;\u00eele Christmas\"  class=\"choice-49 depth-1\"  >L'\u00eele Christmas<\/option><option value=\"\u00celes Cocos (Keeling)\"  class=\"choice-50 depth-1\"  >\u00celes Cocos (Keeling)<\/option><option value=\"Colombie\"  class=\"choice-51 depth-1\"  >Colombie<\/option><option value=\"Comores\"  class=\"choice-52 depth-1\"  >Comores<\/option><option value=\"Congo\"  class=\"choice-53 depth-1\"  >Congo<\/option><option value=\"Congo (R\u00e9publique d\u00e9mocratique du)\"  class=\"choice-54 depth-1\"  >Congo (R\u00e9publique d\u00e9mocratique du)<\/option><option value=\"\u00celes Cook\"  class=\"choice-55 depth-1\"  >\u00celes Cook<\/option><option value=\"Costa Rica\"  class=\"choice-56 depth-1\"  >Costa Rica<\/option><option value=\"Croatie\"  class=\"choice-57 depth-1\"  >Croatie<\/option><option value=\"Cuba\"  class=\"choice-58 depth-1\"  >Cuba<\/option><option value=\"Cura\u00e7ao\"  class=\"choice-59 depth-1\"  >Cura\u00e7ao<\/option><option value=\"Chypre\"  class=\"choice-60 depth-1\"  >Chypre<\/option><option value=\"R\u00e9publique tch\u00e8que\"  class=\"choice-61 depth-1\"  >R\u00e9publique tch\u00e8que<\/option><option value=\"C\u00f4te d&#039;Ivoire\"  class=\"choice-62 depth-1\"  >C\u00f4te d'Ivoire<\/option><option value=\"Danemark\"  class=\"choice-63 depth-1\"  >Danemark<\/option><option value=\"Djibouti\"  class=\"choice-64 depth-1\"  >Djibouti<\/option><option value=\"Dominica\"  class=\"choice-65 depth-1\"  >Dominica<\/option><option value=\"R\u00e9publique dominicaine\"  class=\"choice-66 depth-1\"  >R\u00e9publique dominicaine<\/option><option value=\"\u00c9quateur\"  class=\"choice-67 depth-1\"  >\u00c9quateur<\/option><option value=\"\u00c9gypte\"  class=\"choice-68 depth-1\"  >\u00c9gypte<\/option><option value=\"Le Salvador\"  class=\"choice-69 depth-1\"  >Le Salvador<\/option><option value=\"Guin\u00e9e \u00e9quatoriale\"  class=\"choice-70 depth-1\"  >Guin\u00e9e \u00e9quatoriale<\/option><option value=\"\u00c9rythr\u00e9e\"  class=\"choice-71 depth-1\"  >\u00c9rythr\u00e9e<\/option><option value=\"Estonie\"  class=\"choice-72 depth-1\"  >Estonie<\/option><option value=\"Eswatini (Royaume d&#039;)\"  class=\"choice-73 depth-1\"  >Eswatini (Royaume d')<\/option><option value=\"\u00c9thiopie\"  class=\"choice-74 depth-1\"  >\u00c9thiopie<\/option><option value=\"\u00celes Falkland (Malouines)\"  class=\"choice-75 depth-1\"  >\u00celes Falkland (Malouines)<\/option><option value=\"\u00celes F\u00e9ro\u00e9\"  class=\"choice-76 depth-1\"  >\u00celes F\u00e9ro\u00e9<\/option><option value=\"Fidji\"  class=\"choice-77 depth-1\"  >Fidji<\/option><option value=\"Finlande\"  class=\"choice-78 depth-1\"  >Finlande<\/option><option value=\"France\"  class=\"choice-79 depth-1\"  >France<\/option><option value=\"Guyane fran\u00e7aise\"  class=\"choice-80 depth-1\"  >Guyane fran\u00e7aise<\/option><option value=\"Polyn\u00e9sie fran\u00e7aise\"  class=\"choice-81 depth-1\"  >Polyn\u00e9sie fran\u00e7aise<\/option><option value=\"Territoires fran\u00e7ais du Sud\"  class=\"choice-82 depth-1\"  >Territoires fran\u00e7ais du Sud<\/option><option value=\"Gabon\"  class=\"choice-83 depth-1\"  >Gabon<\/option><option value=\"Gambie\"  class=\"choice-84 depth-1\"  >Gambie<\/option><option value=\"G\u00e9orgie\"  class=\"choice-85 depth-1\"  >G\u00e9orgie<\/option><option value=\"Allemagne\"  class=\"choice-86 depth-1\"  >Allemagne<\/option><option value=\"Ghana\"  class=\"choice-87 depth-1\"  >Ghana<\/option><option value=\"Gibraltar\"  class=\"choice-88 depth-1\"  >Gibraltar<\/option><option value=\"Gr\u00e8ce\"  class=\"choice-89 depth-1\"  >Gr\u00e8ce<\/option><option value=\"Groenland\"  class=\"choice-90 depth-1\"  >Groenland<\/option><option value=\"Grenade\"  class=\"choice-91 depth-1\"  >Grenade<\/option><option value=\"Guadeloupe\"  class=\"choice-92 depth-1\"  >Guadeloupe<\/option><option value=\"Guam\"  class=\"choice-93 depth-1\"  >Guam<\/option><option value=\"Guatemala\"  class=\"choice-94 depth-1\"  >Guatemala<\/option><option value=\"Guernesey\"  class=\"choice-95 depth-1\"  >Guernesey<\/option><option value=\"Guin\u00e9e\"  class=\"choice-96 depth-1\"  >Guin\u00e9e<\/option><option value=\"Guin\u00e9e-Bissau\"  class=\"choice-97 depth-1\"  >Guin\u00e9e-Bissau<\/option><option value=\"Guyane\"  class=\"choice-98 depth-1\"  >Guyane<\/option><option value=\"Ha\u00efti\"  class=\"choice-99 depth-1\"  >Ha\u00efti<\/option><option value=\"L&#039;\u00eele Heard et les \u00eeles McDonald\"  class=\"choice-100 depth-1\"  >L'\u00eele Heard et les \u00eeles McDonald<\/option><option value=\"Honduras\"  class=\"choice-101 depth-1\"  >Honduras<\/option><option value=\"Hong Kong\"  class=\"choice-102 depth-1\"  >Hong Kong<\/option><option value=\"Hongrie\"  class=\"choice-103 depth-1\"  >Hongrie<\/option><option value=\"Islande\"  class=\"choice-104 depth-1\"  >Islande<\/option><option value=\"Inde\"  class=\"choice-105 depth-1\"  >Inde<\/option><option value=\"Indon\u00e9sie\"  class=\"choice-106 depth-1\"  >Indon\u00e9sie<\/option><option value=\"Iran (R\u00e9publique islamique d&#039;)\"  class=\"choice-107 depth-1\"  >Iran (R\u00e9publique islamique d')<\/option><option value=\"Irak\"  class=\"choice-108 depth-1\"  >Irak<\/option><option value=\"Irlande (R\u00e9publique d&#039;)\"  class=\"choice-109 depth-1\"  >Irlande (R\u00e9publique d')<\/option><option value=\"\u00cele de Man\"  class=\"choice-110 depth-1\"  >\u00cele de Man<\/option><option value=\"Isra\u00ebl\"  class=\"choice-111 depth-1\"  >Isra\u00ebl<\/option><option value=\"Italie\"  class=\"choice-112 depth-1\"  >Italie<\/option><option value=\"Jama\u00efque\"  class=\"choice-113 depth-1\"  >Jama\u00efque<\/option><option value=\"Japon\"  class=\"choice-114 depth-1\"  >Japon<\/option><option value=\"Jersey\"  class=\"choice-115 depth-1\"  >Jersey<\/option><option value=\"Jordanie\"  class=\"choice-116 depth-1\"  >Jordanie<\/option><option value=\"Kazakhstan\"  class=\"choice-117 depth-1\"  >Kazakhstan<\/option><option value=\"Kenya\"  class=\"choice-118 depth-1\"  >Kenya<\/option><option value=\"Kiribati\"  class=\"choice-119 depth-1\"  >Kiribati<\/option><option value=\"Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)\"  class=\"choice-120 depth-1\"  >Cor\u00e9e (R\u00e9publique populaire d\u00e9mocratique de)<\/option><option value=\"Cor\u00e9e (R\u00e9publique de)\"  class=\"choice-121 depth-1\"  >Cor\u00e9e (R\u00e9publique de)<\/option><option value=\"Kosovo\"  class=\"choice-122 depth-1\"  >Kosovo<\/option><option value=\"Kowe\u00eft\"  class=\"choice-123 depth-1\"  >Kowe\u00eft<\/option><option value=\"Kirghizistan\"  class=\"choice-124 depth-1\"  >Kirghizistan<\/option><option value=\"R\u00e9publique d\u00e9mocratique populaire du Laos\"  class=\"choice-125 depth-1\"  >R\u00e9publique d\u00e9mocratique populaire du Laos<\/option><option value=\"Lettonie\"  class=\"choice-126 depth-1\"  >Lettonie<\/option><option value=\"Liban\"  class=\"choice-127 depth-1\"  >Liban<\/option><option value=\"Le Royaume du Lesotho\"  class=\"choice-128 depth-1\"  >Le Royaume du Lesotho<\/option><option value=\"Lib\u00e9ria\"  class=\"choice-129 depth-1\"  >Lib\u00e9ria<\/option><option value=\"Libye\"  class=\"choice-130 depth-1\"  >Libye<\/option><option value=\"Liechtenstein\"  class=\"choice-131 depth-1\"  >Liechtenstein<\/option><option value=\"Lituanie\"  class=\"choice-132 depth-1\"  >Lituanie<\/option><option value=\"Luxembourg\"  class=\"choice-133 depth-1\"  >Luxembourg<\/option><option value=\"Macao\"  class=\"choice-134 depth-1\"  >Macao<\/option><option value=\"Madagascar\"  class=\"choice-135 depth-1\"  >Madagascar<\/option><option value=\"Malawi\"  class=\"choice-136 depth-1\"  >Malawi<\/option><option value=\"Malaisie\"  class=\"choice-137 depth-1\"  >Malaisie<\/option><option value=\"Les Maldives\"  class=\"choice-138 depth-1\"  >Les Maldives<\/option><option value=\"Mali\"  class=\"choice-139 depth-1\"  >Mali<\/option><option value=\"Malte\"  class=\"choice-140 depth-1\"  >Malte<\/option><option value=\"\u00celes Marshall\"  class=\"choice-141 depth-1\"  >\u00celes Marshall<\/option><option value=\"Martinique\"  class=\"choice-142 depth-1\"  >Martinique<\/option><option value=\"Mauritanie\"  class=\"choice-143 depth-1\"  >Mauritanie<\/option><option value=\"Maurice\"  class=\"choice-144 depth-1\"  >Maurice<\/option><option value=\"Mayotte\"  class=\"choice-145 depth-1\"  >Mayotte<\/option><option value=\"Mexique\"  class=\"choice-146 depth-1\"  >Mexique<\/option><option value=\"Micron\u00e9sie (\u00c9tats f\u00e9d\u00e9r\u00e9s de)\"  class=\"choice-147 depth-1\"  >Micron\u00e9sie (\u00c9tats f\u00e9d\u00e9r\u00e9s de)<\/option><option value=\"Moldavie (R\u00e9publique de)\"  class=\"choice-148 depth-1\"  >Moldavie (R\u00e9publique de)<\/option><option value=\"Monaco\"  class=\"choice-149 depth-1\"  >Monaco<\/option><option value=\"Mongolie\"  class=\"choice-150 depth-1\"  >Mongolie<\/option><option value=\"Mont\u00e9n\u00e9gro\"  class=\"choice-151 depth-1\"  >Mont\u00e9n\u00e9gro<\/option><option value=\"Montserrat\"  class=\"choice-152 depth-1\"  >Montserrat<\/option><option value=\"Maroc\"  class=\"choice-153 depth-1\"  >Maroc<\/option><option value=\"Mozambique\"  class=\"choice-154 depth-1\"  >Mozambique<\/option><option value=\"Myanmar\"  class=\"choice-155 depth-1\"  >Myanmar<\/option><option value=\"Namibie\"  class=\"choice-156 depth-1\"  >Namibie<\/option><option value=\"Nauru\"  class=\"choice-157 depth-1\"  >Nauru<\/option><option value=\"N\u00e9pal\"  class=\"choice-158 depth-1\"  >N\u00e9pal<\/option><option value=\"Pays-Bas\"  class=\"choice-159 depth-1\"  >Pays-Bas<\/option><option value=\"Nouvelle-Cal\u00e9donie\"  class=\"choice-160 depth-1\"  >Nouvelle-Cal\u00e9donie<\/option><option value=\"Nouvelle-Z\u00e9lande\"  class=\"choice-161 depth-1\"  >Nouvelle-Z\u00e9lande<\/option><option value=\"Nicaragua\"  class=\"choice-162 depth-1\"  >Nicaragua<\/option><option value=\"Niger\"  class=\"choice-163 depth-1\"  >Niger<\/option><option value=\"Nig\u00e9ria\"  class=\"choice-164 depth-1\"  >Nig\u00e9ria<\/option><option value=\"Niue\"  class=\"choice-165 depth-1\"  >Niue<\/option><option value=\"\u00cele Norfolk\"  class=\"choice-166 depth-1\"  >\u00cele Norfolk<\/option><option value=\"Mac\u00e9doine du Nord (R\u00e9publique de)\"  class=\"choice-167 depth-1\"  >Mac\u00e9doine du Nord (R\u00e9publique de)<\/option><option value=\"\u00celes Mariannes du Nord\"  class=\"choice-168 depth-1\"  >\u00celes Mariannes du Nord<\/option><option value=\"Norv\u00e8ge\"  class=\"choice-169 depth-1\"  >Norv\u00e8ge<\/option><option value=\"Oman\"  class=\"choice-170 depth-1\"  >Oman<\/option><option value=\"Pakistan\"  class=\"choice-171 depth-1\"  >Pakistan<\/option><option value=\"Palau\"  class=\"choice-172 depth-1\"  >Palau<\/option><option value=\"Palestine (\u00c9tat de)\"  class=\"choice-173 depth-1\"  >Palestine (\u00c9tat de)<\/option><option value=\"Panama\"  class=\"choice-174 depth-1\"  >Panama<\/option><option value=\"Papouasie-Nouvelle-Guin\u00e9e\"  class=\"choice-175 depth-1\"  >Papouasie-Nouvelle-Guin\u00e9e<\/option><option value=\"Paraguay\"  class=\"choice-176 depth-1\"  >Paraguay<\/option><option value=\"P\u00e9rou\"  class=\"choice-177 depth-1\"  >P\u00e9rou<\/option><option value=\"Philippines\"  class=\"choice-178 depth-1\"  >Philippines<\/option><option value=\"Pitcairn\"  class=\"choice-179 depth-1\"  >Pitcairn<\/option><option value=\"Pologne\"  class=\"choice-180 depth-1\"  >Pologne<\/option><option value=\"Portugal\"  class=\"choice-181 depth-1\"  >Portugal<\/option><option value=\"Porto Rico\"  class=\"choice-182 depth-1\"  >Porto Rico<\/option><option value=\"Qatar\"  class=\"choice-183 depth-1\"  >Qatar<\/option><option value=\"Roumanie\"  class=\"choice-184 depth-1\"  >Roumanie<\/option><option value=\"F\u00e9d\u00e9ration de Russie\"  class=\"choice-185 depth-1\"  >F\u00e9d\u00e9ration de Russie<\/option><option value=\"Rwanda\"  class=\"choice-186 depth-1\"  >Rwanda<\/option><option value=\"R\u00e9union\"  class=\"choice-187 depth-1\"  >R\u00e9union<\/option><option value=\"Saint Barth\u00e9lemy\"  class=\"choice-188 depth-1\"  >Saint Barth\u00e9lemy<\/option><option value=\"Sainte-H\u00e9l\u00e8ne, l&#039;Ascension et Tristan da Cunha\"  class=\"choice-189 depth-1\"  >Sainte-H\u00e9l\u00e8ne, l'Ascension et Tristan da Cunha<\/option><option value=\"Saint-Christophe-et-Ni\u00e9v\u00e8s\"  class=\"choice-190 depth-1\"  >Saint-Christophe-et-Ni\u00e9v\u00e8s<\/option><option value=\"Saint Lucia\"  class=\"choice-191 depth-1\"  >Saint Lucia<\/option><option value=\"Saint-Martin (partie fran\u00e7aise)\"  class=\"choice-192 depth-1\"  >Saint-Martin (partie fran\u00e7aise)<\/option><option value=\"Saint-Pierre-et-Miquelon\"  class=\"choice-193 depth-1\"  >Saint-Pierre-et-Miquelon<\/option><option value=\"Saint-Vincent-et-les-Grenadines\"  class=\"choice-194 depth-1\"  >Saint-Vincent-et-les-Grenadines<\/option><option value=\"Samoa\"  class=\"choice-195 depth-1\"  >Samoa<\/option><option value=\"Saint-Marin\"  class=\"choice-196 depth-1\"  >Saint-Marin<\/option><option value=\"Sao Tom\u00e9 et Principe\"  class=\"choice-197 depth-1\"  >Sao Tom\u00e9 et Principe<\/option><option value=\"Arabie saoudite\"  class=\"choice-198 depth-1\"  >Arabie saoudite<\/option><option value=\"S\u00e9n\u00e9gal\"  class=\"choice-199 depth-1\"  >S\u00e9n\u00e9gal<\/option><option value=\"Serbie\"  class=\"choice-200 depth-1\"  >Serbie<\/option><option value=\"Seychelles\"  class=\"choice-201 depth-1\"  >Seychelles<\/option><option value=\"Sierra Leone\"  class=\"choice-202 depth-1\"  >Sierra Leone<\/option><option value=\"Singapour\"  class=\"choice-203 depth-1\"  >Singapour<\/option><option value=\"Saint-Martin (partie n\u00e9erlandaise)\"  class=\"choice-204 depth-1\"  >Saint-Martin (partie n\u00e9erlandaise)<\/option><option value=\"Slovaquie\"  class=\"choice-205 depth-1\"  >Slovaquie<\/option><option value=\"Slov\u00e9nie\"  class=\"choice-206 depth-1\"  >Slov\u00e9nie<\/option><option value=\"\u00celes Salomon\"  class=\"choice-207 depth-1\"  >\u00celes Salomon<\/option><option value=\"Somalie\"  class=\"choice-208 depth-1\"  >Somalie<\/option><option value=\"Afrique du Sud\"  class=\"choice-209 depth-1\"  >Afrique du Sud<\/option><option value=\"La G\u00e9orgie du Sud et les \u00eeles Sandwich du Sud\"  class=\"choice-210 depth-1\"  >La G\u00e9orgie du Sud et les \u00eeles Sandwich du Sud<\/option><option value=\"Soudan du Sud\"  class=\"choice-211 depth-1\"  >Soudan du Sud<\/option><option value=\"Espagne\"  class=\"choice-212 depth-1\"  >Espagne<\/option><option value=\"Sri Lanka\"  class=\"choice-213 depth-1\"  >Sri Lanka<\/option><option value=\"Soudan\"  class=\"choice-214 depth-1\"  >Soudan<\/option><option value=\"Suriname\"  class=\"choice-215 depth-1\"  >Suriname<\/option><option value=\"Svalbard et Jan Mayen\"  class=\"choice-216 depth-1\"  >Svalbard et Jan Mayen<\/option><option value=\"Su\u00e8de\"  class=\"choice-217 depth-1\"  >Su\u00e8de<\/option><option value=\"Suisse\"  class=\"choice-218 depth-1\"  >Suisse<\/option><option value=\"R\u00e9publique arabe syrienne\"  class=\"choice-219 depth-1\"  >R\u00e9publique arabe syrienne<\/option><option value=\"Ta\u00efwan, R\u00e9publique de Chine\"  class=\"choice-220 depth-1\"  >Ta\u00efwan, R\u00e9publique de Chine<\/option><option value=\"Tadjikistan\"  class=\"choice-221 depth-1\"  >Tadjikistan<\/option><option value=\"Tanzanie (R\u00e9publique-Unie de)\"  class=\"choice-222 depth-1\"  >Tanzanie (R\u00e9publique-Unie de)<\/option><option value=\"Tha\u00eflande\"  class=\"choice-223 depth-1\"  >Tha\u00eflande<\/option><option value=\"Timor-Oriental\"  class=\"choice-224 depth-1\"  >Timor-Oriental<\/option><option value=\"Togo\"  class=\"choice-225 depth-1\"  >Togo<\/option><option value=\"Tokelau\"  class=\"choice-226 depth-1\"  >Tokelau<\/option><option value=\"Tonga\"  class=\"choice-227 depth-1\"  >Tonga<\/option><option value=\"Trinit\u00e9-et-Tobago\"  class=\"choice-228 depth-1\"  >Trinit\u00e9-et-Tobago<\/option><option value=\"Tunisie\"  class=\"choice-229 depth-1\"  >Tunisie<\/option><option value=\"Turkm\u00e9nistan\"  class=\"choice-230 depth-1\"  >Turkm\u00e9nistan<\/option><option value=\"\u00celes Turques-et-Ca\u00efques\"  class=\"choice-231 depth-1\"  >\u00celes Turques-et-Ca\u00efques<\/option><option value=\"Tuvalu\"  class=\"choice-232 depth-1\"  >Tuvalu<\/option><option value=\"Turquie\"  class=\"choice-233 depth-1\"  >Turquie<\/option><option value=\"Ouganda\"  class=\"choice-234 depth-1\"  >Ouganda<\/option><option value=\"Ukraine\"  class=\"choice-235 depth-1\"  >Ukraine<\/option><option value=\"\u00c9mirats arabes unis\"  class=\"choice-236 depth-1\"  >\u00c9mirats arabes unis<\/option><option value=\"Royaume-Uni de Grande-Bretagne et d&#039;Irlande du Nord\"  class=\"choice-237 depth-1\"  >Royaume-Uni de Grande-Bretagne et d'Irlande du Nord<\/option><option value=\"\u00celes mineures \u00e9loign\u00e9es des \u00c9tats-Unis\"  class=\"choice-238 depth-1\"  >\u00celes mineures \u00e9loign\u00e9es des \u00c9tats-Unis<\/option><option value=\"\u00c9tats-Unis d&#039;Am\u00e9rique\"  class=\"choice-239 depth-1\"  >\u00c9tats-Unis d'Am\u00e9rique<\/option><option value=\"Uruguay\"  class=\"choice-240 depth-1\"  >Uruguay<\/option><option value=\"Ouzb\u00e9kistan\"  class=\"choice-241 depth-1\"  >Ouzb\u00e9kistan<\/option><option value=\"Vanuaatu\"  class=\"choice-242 depth-1\"  >Vanuaatu<\/option><option value=\"\u00c9tat de la Cit\u00e9 du Vatican\"  class=\"choice-243 depth-1\"  >\u00c9tat de la Cit\u00e9 du Vatican<\/option><option value=\"Venezuela (R\u00e9publique bolivarienne du)\"  class=\"choice-244 depth-1\"  >Venezuela (R\u00e9publique bolivarienne du)<\/option><option value=\"Vietnam\"  class=\"choice-245 depth-1\"  >Vietnam<\/option><option value=\"\u00celes Vierges (britanniques)\"  class=\"choice-246 depth-1\"  >\u00celes Vierges (britanniques)<\/option><option value=\"\u00celes Vierges (\u00c9tats-Unis)\"  class=\"choice-247 depth-1\"  >\u00celes Vierges (\u00c9tats-Unis)<\/option><option value=\"Wallis-et-Futuna\"  class=\"choice-248 depth-1\"  >Wallis-et-Futuna<\/option><option value=\"Sahara occidental\"  class=\"choice-249 depth-1\"  >Sahara occidental<\/option><option value=\"Y\u00e9men\"  class=\"choice-250 depth-1\"  >Y\u00e9men<\/option><option value=\"Zambie\"  class=\"choice-251 depth-1\"  >Zambie<\/option><option value=\"Zimbabwe\"  class=\"choice-252 depth-1\"  >Zimbabwe<\/option><option value=\"\u00celes \u00c5land\"  class=\"choice-253 depth-1\"  >\u00celes \u00c5land<\/option><\/select><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_11-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"11\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_11\">Secteur d&#039;Activit\u00e9 \/ Industrie Principale <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_11\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][11]\" placeholder=\"Voir secteurs d&#039;activit\u00e9s UBONGO.\" aria-errormessage=\"wpforms-2642-field_11-error\" aria-describedby=\"wpforms-2642-field_11-description\" required><div id=\"wpforms-2642-field_11-description\" class=\"wpforms-field-description\">Reportez-vous \u00e0 la classification sectorielle UBONGO pour trouver la correspondance la plus proche.<\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_12-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"12\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_12\">Site Web \/ Profil Num\u00e9rique de l&#039;Entreprise <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_12\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][12]\" placeholder=\"https:\/\/\" aria-errormessage=\"wpforms-2642-field_12-error\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_13-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_13\">Personne de Contact Principale <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_13\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][13]\" aria-errormessage=\"wpforms-2642-field_13-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_14-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"14\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_14\">Titre \/ Fonction Ex\u00e9cutive <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_14\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][14]\" placeholder=\"ex : Pr\u00e9sident-Directeur G\u00e9n\u00e9ral\" aria-errormessage=\"wpforms-2642-field_14-error\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_15-container\" class=\"wpforms-field wpforms-field-text wpforms-conditional-trigger\" data-field-type=\"text\" data-field-id=\"15\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_15\">E-mail Officiel &amp; T\u00e9l\u00e9phone Direct <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_15\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][15]\" placeholder=\"ex : 8\" aria-errormessage=\"wpforms-2642-field_15-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_84-container\" class=\"wpforms-field wpforms-field-number wpforms-conditional-trigger\" data-field-type=\"number\" data-field-id=\"84\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_84\">Ann\u00e9es d&#039;Activit\u00e9 &amp; Chiffre d&#039;Affaires Annuel (USD) <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"number\" id=\"wpforms-2642-field_84\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][84]\" step=\"any\" aria-errormessage=\"wpforms-2642-field_84-error\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_90-container\" class=\"wpforms-field wpforms-field-phone wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"phone\" data-field-id=\"90\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_90\">Direct Phone <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-2642-field_90\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][90]\" aria-label=\"Direct Phone\" aria-errormessage=\"wpforms-2642-field_90-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_91-container\" class=\"wpforms-field wpforms-field-number input-suffix-usd wpforms-conditional-field wpforms-conditional-show\" data-field-type=\"number\" data-field-id=\"91\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_91\">Annual Revenue (USD)<\/label><input type=\"number\" id=\"wpforms-2642-field_91\" class=\"wpforms-field-medium\" name=\"wpforms[fields][91]\" placeholder=\"e.g 2,000,000\" step=\"any\" aria-errormessage=\"wpforms-2642-field_91-error\" ><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-2642-field_19-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"19\"><h3 class=\"wpforms-field-label\">\n\t\t\t\t2. Objectif &amp; Type de Collaboration Recherch\u00e9\n\t\t\t<\/h3><div id=\"wpforms-2642-field_19-description\" class=\"wpforms-field-description\">Veuillez s\u00e9lectionner tous les mod\u00e8les de partenariat applicables<\/div><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-100\"><div id=\"wpforms-2642-field_64-container\" class=\"wpforms-field wpforms-field-checkbox wpforms-list-3-columns\" data-field-type=\"checkbox\" data-field-id=\"64\"><fieldset><legend class=\"wpforms-field-label wpforms-label-hide\" aria-hidden=\"false\">Objectif &amp; type de collaboration recherch\u00e9 <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2642-field_64\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_64_1\" name=\"wpforms[fields][64][]\" value=\"&lt;strong&gt;Cr\u00e9ation de Coentreprise (JV) :&lt;\/strong&gt; \u00c9tablissement d&#039;une entit\u00e9 op\u00e9rationnelle conjointe ou d&#039;un v\u00e9hicule op\u00e9rationnel local.\" aria-errormessage=\"wpforms-2642-field_64_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_64_1\"><strong>Cr\u00e9ation de Coentreprise (JV) :<\/strong> \u00c9tablissement d'une entit\u00e9 op\u00e9rationnelle conjointe ou d'un v\u00e9hicule op\u00e9rationnel local.<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_64_2\" name=\"wpforms[fields][64][]\" value=\"&lt;strong&gt;Co-investissement \/ Partenariat en Fonds Propres &lt;\/strong&gt;: Recherche de capital de croissance, syndication de dette ou co-parrainage de projet.\" aria-errormessage=\"wpforms-2642-field_64_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_64_2\"><strong>Co-investissement \/ Partenariat en Fonds Propres <\/strong>: Recherche de capital de croissance, syndication de dette ou co-parrainage de projet.<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_64_3\" name=\"wpforms[fields][64][]\" value=\"&lt;strong&gt;Partenariat Commercial et d&#039;Enl\u00e8vement (Offtake) :&lt;\/strong&gt; Distribution, int\u00e9gration de la cha\u00eene d&#039;approvisionnement ou contrat d&#039;enl\u00e8vement \u00e0 long terme dans le cadre des tarifs pr\u00e9f\u00e9rentiels de la ZLECAf.\" aria-errormessage=\"wpforms-2642-field_64_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_64_3\"><strong>Partenariat Commercial et d'Enl\u00e8vement (Offtake) :<\/strong> Distribution, int\u00e9gration de la cha\u00eene d'approvisionnement ou contrat d'enl\u00e8vement \u00e0 long terme dans le cadre des tarifs pr\u00e9f\u00e9rentiels de la ZLECAf.<\/label><\/li><li class=\"choice-7 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_64_7\" name=\"wpforms[fields][64][]\" value=\"&lt;strong&gt;Transfert de Technologie et Exploitation Technique : &lt;\/strong&gt;Concession de licences, int\u00e9gration d&#039;infrastructures num\u00e9riques ou partenariat d&#039;Exploitation &amp; Maintenance (O&amp;M) technique.\" aria-errormessage=\"wpforms-2642-field_64_7-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_64_7\"><strong>Transfert de Technologie et Exploitation Technique : <\/strong>Concession de licences, int\u00e9gration d'infrastructures num\u00e9riques ou partenariat d'Exploitation &amp; Maintenance (O&amp;M) technique.<\/label><\/li><li class=\"choice-8 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_64_8\" name=\"wpforms[fields][64][]\" value=\"&lt;strong&gt;Partenariat Public-Priv\u00e9 (PPP) \/ Concession :&lt;\/strong&gt; Soumission conjointe ou co-d\u00e9veloppement d&#039;infrastructures souveraines ou municipales\" aria-errormessage=\"wpforms-2642-field_64_8-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_64_8\"><strong>Partenariat Public-Priv\u00e9 (PPP) \/ Concession :<\/strong> Soumission conjointe ou co-d\u00e9veloppement d'infrastructures souveraines ou municipales<\/label><\/li><li class=\"choice-9 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_64_9\" name=\"wpforms[fields][64][]\" value=\"&lt;strong&gt;Contenu Local et Int\u00e9gration R\u00e9gionale :&lt;\/strong&gt; Recherche de partenaires op\u00e9rationnels locaux pour r\u00e9pondre aux exigences r\u00e9glementaires d&#039;un march\u00e9 africain cible.\" aria-errormessage=\"wpforms-2642-field_64_9-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_64_9\"><strong>Contenu Local et Int\u00e9gration R\u00e9gionale :<\/strong> Recherche de partenaires op\u00e9rationnels locaux pour r\u00e9pondre aux exigences r\u00e9glementaires d'un march\u00e9 africain cible.<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-2642-field_27-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"27\"><h3 class=\"wpforms-field-label\">\n\t\t\t\t3. G\u00e9ographie cible &amp; Expansion du March\u00e9\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_80-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-modern\" data-field-type=\"select\" data-field-id=\"80\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_80\">1. Pays \/ Zone(s) G\u00e9ographique(s) Cible(s) pour la Collaboration : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-2642-field_80\" class=\"wpforms-field-medium wpforms-field-required choicesjs-select\" data-size-class=\"wpforms-field-row wpforms-field-medium\" data-search-enabled=\"1\" name=\"wpforms[fields][80][]\" required=\"required\" multiple=\"multiple\"><option value=\"\" class=\"placeholder\" disabled ><\/option><option value=\"COMMUNAUTES REGIONALES (5)\"  class=\"choice-4 depth-1\"  >COMMUNAUTES REGIONALES (5)<\/option><option value=\"Afrique Centrale \/ CEEAC\"  class=\"choice-64 depth-1\"  >Afrique Centrale \/ CEEAC<\/option><option value=\"Afrique de l&#039;Ouest \/ CEDEAO\"  class=\"choice-5 depth-1\"  >Afrique de l'Ouest \/ CEDEAO<\/option><option value=\"Afrique de l&#039;Est \/ CAE\"  class=\"choice-6 depth-1\"  >Afrique de l'Est \/ CAE<\/option><option value=\"Afrique du Nord\"  class=\"choice-7 depth-1\"  >Afrique du Nord<\/option><option value=\"International\"  class=\"choice-8 depth-1\"  >International<\/option><option value=\"PAYS AFRICAINS (54)\"  class=\"choice-10 depth-1\"  >PAYS AFRICAINS (54)<\/option><option value=\"Afrique du Sud\"  class=\"choice-11 depth-1\"  >Afrique du Sud<\/option><option value=\"Alg\u00e9rie\"  class=\"choice-12 depth-1\"  >Alg\u00e9rie<\/option><option value=\"Angola\"  class=\"choice-13 depth-1\"  >Angola<\/option><option value=\"B\u00e9nin\"  class=\"choice-14 depth-1\"  >B\u00e9nin<\/option><option value=\"Botswana\"  class=\"choice-15 depth-1\"  >Botswana<\/option><option value=\"Burkina Faso\"  class=\"choice-16 depth-1\"  >Burkina Faso<\/option><option value=\"Burundi\"  class=\"choice-17 depth-1\"  >Burundi<\/option><option value=\"Cap-Vert\"  class=\"choice-18 depth-1\"  >Cap-Vert<\/option><option value=\"Cameroun\"  class=\"choice-19 depth-1\"  >Cameroun<\/option><option value=\"Comores\"  class=\"choice-20 depth-1\"  >Comores<\/option><option value=\"Congo-Brazzaville\"  class=\"choice-21 depth-1\"  >Congo-Brazzaville<\/option><option value=\"Congo-Kinshasa (RDC)\"  class=\"choice-22 depth-1\"  >Congo-Kinshasa (RDC)<\/option><option value=\"C\u00f4te d&#039;Ivoire\"  class=\"choice-23 depth-1\"  >C\u00f4te d'Ivoire<\/option><option value=\"Djibouti\"  class=\"choice-24 depth-1\"  >Djibouti<\/option><option value=\"\u00c9gypte\"  class=\"choice-25 depth-1\"  >\u00c9gypte<\/option><option value=\"\u00c9rythr\u00e9e\"  class=\"choice-26 depth-1\"  >\u00c9rythr\u00e9e<\/option><option value=\"Eswatini\"  class=\"choice-27 depth-1\"  >Eswatini<\/option><option value=\"\u00c9thiopie\"  class=\"choice-28 depth-1\"  >\u00c9thiopie<\/option><option value=\"Gabon\"  class=\"choice-29 depth-1\"  >Gabon<\/option><option value=\"La Gambie\"  class=\"choice-30 depth-1\"  >La Gambie<\/option><option value=\"Ghana\"  class=\"choice-31 depth-1\"  >Ghana<\/option><option value=\"Guin\u00e9e\"  class=\"choice-32 depth-1\"  >Guin\u00e9e<\/option><option value=\"Guin\u00e9e-Bissau\"  class=\"choice-33 depth-1\"  >Guin\u00e9e-Bissau<\/option><option value=\"Guin\u00e9e \u00e9quatoriale\"  class=\"choice-34 depth-1\"  >Guin\u00e9e \u00e9quatoriale<\/option><option value=\"Kenya\"  class=\"choice-35 depth-1\"  >Kenya<\/option><option value=\"Le Royaume du Lesotho\"  class=\"choice-36 depth-1\"  >Le Royaume du Lesotho<\/option><option value=\"Lib\u00e9ria\"  class=\"choice-37 depth-1\"  >Lib\u00e9ria<\/option><option value=\"Libye\"  class=\"choice-38 depth-1\"  >Libye<\/option><option value=\"Madagascar\"  class=\"choice-39 depth-1\"  >Madagascar<\/option><option value=\"Malawi\"  class=\"choice-40 depth-1\"  >Malawi<\/option><option value=\"Mali\"  class=\"choice-41 depth-1\"  >Mali<\/option><option value=\"Maroc\"  class=\"choice-42 depth-1\"  >Maroc<\/option><option value=\"Maurice\"  class=\"choice-43 depth-1\"  >Maurice<\/option><option value=\"Mauritanie\"  class=\"choice-44 depth-1\"  >Mauritanie<\/option><option value=\"Mozambique\"  class=\"choice-45 depth-1\"  >Mozambique<\/option><option value=\"Namibie\"  class=\"choice-46 depth-1\"  >Namibie<\/option><option value=\"Niger\"  class=\"choice-47 depth-1\"  >Niger<\/option><option value=\"Nig\u00e9ria\"  class=\"choice-48 depth-1\"  >Nig\u00e9ria<\/option><option value=\"Ouganda\"  class=\"choice-49 depth-1\"  >Ouganda<\/option><option value=\"Rwanda\"  class=\"choice-50 depth-1\"  >Rwanda<\/option><option value=\"S\u01ceo Tom\u00e9 and Principe\"  class=\"choice-51 depth-1\"  >S\u01ceo Tom\u00e9 and Principe<\/option><option value=\"S\u00e9n\u00e9gal\"  class=\"choice-52 depth-1\"  >S\u00e9n\u00e9gal<\/option><option value=\"Seychelles\"  class=\"choice-53 depth-1\"  >Seychelles<\/option><option value=\"Sierra Leone\"  class=\"choice-54 depth-1\"  >Sierra Leone<\/option><option value=\"Somalie\"  class=\"choice-55 depth-1\"  >Somalie<\/option><option value=\"Soudan\"  class=\"choice-56 depth-1\"  >Soudan<\/option><option value=\"Soudan du Sud\"  class=\"choice-57 depth-1\"  >Soudan du Sud<\/option><option value=\"Tanzanie\"  class=\"choice-58 depth-1\"  >Tanzanie<\/option><option value=\"Tchad\"  class=\"choice-59 depth-1\"  >Tchad<\/option><option value=\"Togo\"  class=\"choice-60 depth-1\"  >Togo<\/option><option value=\"Tunisie\"  class=\"choice-61 depth-1\"  >Tunisie<\/option><option value=\"Zambie\"  class=\"choice-62 depth-1\"  >Zambie<\/option><option value=\"Zimbabwe\"  class=\"choice-63 depth-1\"  >Zimbabwe<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_31-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-type=\"textarea\" data-field-id=\"31\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_31\">2. Mandat Sp\u00e9cifique d&#039;Entr\u00e9e sur le March\u00e9 \/ Cha\u00eene de Valeur : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-2642-field_31\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][31]\" placeholder=\"D\u00e9crivez bri\u00e8vement la cha\u00eene de valeur r\u00e9gionale (CVR) sp\u00e9cifique ou l&#039;opportunit\u00e9 de march\u00e9 que vous visitez dans le cadre des m\u00e9canismes de la ZLECAf.\" aria-errormessage=\"wpforms-2642-field_31-error\" required><\/textarea><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><\/div><\/div><\/div><\/div><div id=\"wpforms-2642-field_32-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"32\"><h3 class=\"wpforms-field-label\">\n\t\t\t\t4. Param\u00e8tres du Projet et Commerciaux\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-100\"><div id=\"wpforms-2642-field_75-container\" class=\"wpforms-field wpforms-field-radio wpforms-list-inline\" data-field-type=\"radio\" data-field-id=\"75\"><fieldset><legend class=\"wpforms-field-label\">Taille Estim\u00e9e de la Transaction \/ de l&#039;Investissement (USD) : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2642-field_75\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_75_1\" name=\"wpforms[fields][75]\" value=\"Inf\u00e9rieure \u00e0 1 Million $\" aria-errormessage=\"wpforms-2642-field_75_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_75_1\">Inf\u00e9rieure \u00e0 1 Million $<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_75_2\" name=\"wpforms[fields][75]\" value=\"$1 Million \u2013 $10 Millions\" aria-errormessage=\"wpforms-2642-field_75_2-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_75_2\">$1 Million \u2013 $10 Millions<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_75_3\" name=\"wpforms[fields][75]\" value=\"$10 Millions \u2013 $50 Millions\" aria-errormessage=\"wpforms-2642-field_75_3-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_75_3\">$10 Millions \u2013 $50 Millions<\/label><\/li><li class=\"choice-4 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_75_4\" name=\"wpforms[fields][75]\" value=\"$50 Millions \u2013 $200 Millions\" aria-errormessage=\"wpforms-2642-field_75_4-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_75_4\">$50 Millions \u2013 $200 Millions<\/label><\/li><li class=\"choice-5 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_75_5\" name=\"wpforms[fields][75]\" value=\"Plus de $200 Millions\" aria-errormessage=\"wpforms-2642-field_75_5-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_75_5\">Plus de $200 Millions<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-100\"><div id=\"wpforms-2642-field_34-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-type=\"textarea\" data-field-id=\"34\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_34\">Capital \/ Capacit\u00e9 Apport\u00e9s par le Demandeur : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-2642-field_34\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][34]\" placeholder=\"Quels fonds propres, actifs, technologies, licences ou acc\u00e8s au march\u00e9 poss\u00e9dez-vous actuellement et apportez-vous au partenariat potentiel ?\" aria-errormessage=\"wpforms-2642-field_34-error\" required><\/textarea><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-100\"><div id=\"wpforms-2642-field_35-container\" class=\"wpforms-field wpforms-field-textarea\" data-field-type=\"textarea\" data-field-id=\"35\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_35\">Exigences Cl\u00e9s Attendues du Partenaire Id\u00e9al : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><textarea id=\"wpforms-2642-field_35\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][35]\" placeholder=\"Quelles solidit\u00e9s de bilan, licences locales, expertises techniques, r\u00e9seaux de distribution ou connexions souveraines sp\u00e9cifiques le partenaire potentiel doit-il apporter ?\" aria-errormessage=\"wpforms-2642-field_35-error\" required><\/textarea><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-2642-field_38-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"38\"><h3 class=\"wpforms-field-label\">\n\t\t\t\t5. Alignement ZLECAf &amp; Conformit\u00e9\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_77-container\" class=\"wpforms-field wpforms-field-radio\" data-field-type=\"radio\" data-field-id=\"77\"><fieldset><legend class=\"wpforms-field-label\">1. \u00c9ligibilit\u00e9 aux Tarifs et R\u00e8gles d&#039;Origine de la ZLECAf : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2642-field_77\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_77_1\" name=\"wpforms[fields][77]\" value=\"Oui\" aria-errormessage=\"wpforms-2642-field_77_1-error\" aria-describedby=\"wpforms-2642-field_77-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_77_1\">Oui<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_77_2\" name=\"wpforms[fields][77]\" value=\"Non\" aria-errormessage=\"wpforms-2642-field_77_2-error\" aria-describedby=\"wpforms-2642-field_77-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_77_2\">Non<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_77_3\" name=\"wpforms[fields][77]\" value=\"N\u00e9cessite une \u00c9valuation par UBONGO\" aria-errormessage=\"wpforms-2642-field_77_3-error\" aria-describedby=\"wpforms-2642-field_77-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_77_3\">N\u00e9cessite une \u00c9valuation par UBONGO<\/label><\/li><\/ul><div id=\"wpforms-2642-field_77-description\" class=\"wpforms-field-description\">Votre produit, mati\u00e8re premi\u00e8re ou service est-il qualifi\u00e9 selon les r\u00e8gles d'origine ou les corridors commerciaux pr\u00e9f\u00e9rentiels de la ZLECAf ?<\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_78-container\" class=\"wpforms-field wpforms-field-radio\" data-field-type=\"radio\" data-field-id=\"78\"><fieldset><legend class=\"wpforms-field-label\">2. Crit\u00e8res Environnementaux, Sociaux et de Gouvernance (ESG) &amp; Contenu Local : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2642-field_78\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_78_1\" name=\"wpforms[fields][78]\" value=\"Pleinement Conforme\" aria-errormessage=\"wpforms-2642-field_78_1-error\" aria-describedby=\"wpforms-2642-field_78-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_78_1\">Pleinement Conforme<\/label><\/li><li class=\"choice-2 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_78_2\" name=\"wpforms[fields][78]\" value=\"En Cours\" aria-errormessage=\"wpforms-2642-field_78_2-error\" aria-describedby=\"wpforms-2642-field_78-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_78_2\">En Cours<\/label><\/li><li class=\"choice-3 depth-1\"><input type=\"radio\" id=\"wpforms-2642-field_78_3\" name=\"wpforms[fields][78]\" value=\"Non Applicable (N\/A)\" aria-errormessage=\"wpforms-2642-field_78_3-error\" aria-describedby=\"wpforms-2642-field_78-description\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_78_3\">Non Applicable (N\/A)<\/label><\/li><\/ul><div id=\"wpforms-2642-field_78-description\" class=\"wpforms-field-description\">Votre projet ou mod\u00e8le op\u00e9rationnel est-il conforme aux lois nationales sur le contenu local, aux normes r\u00e9gionales de durabilit\u00e9 et aux mandats de d\u00e9veloppement du capital humain ?<\/div><\/fieldset><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-2642-field_42-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"42\"><h3 class=\"wpforms-field-label\">\n\t\t\t\tD\u00e9claration &amp; Autorisation\n\t\t\t<\/h3><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-100\"><div id=\"wpforms-2642-field_43-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-type=\"checkbox\" data-field-id=\"43\"><fieldset><legend class=\"wpforms-field-label\">En cochant cette case, je certifie que les informations fournies dans ce formulaire de demande de partenariat sont exactes et soumises de bonne foi afin de permettre \u00e0 UBONGO S.a.r.l d&#039;\u00e9valuer, de structurer et de faciliter des opportunit\u00e9s de mise en relation strat\u00e9gique. Je comprends que la soumission de cette demande ne constitue pas une transaction juridiquement contraignante jusqu&#039;\u00e0 la signature d&#039;accords formels (MOU\/MNDA\/JVA).  <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><ul id=\"wpforms-2642-field_43\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-2642-field_43_1\" name=\"wpforms[fields][43][]\" value=\"Je certifie les informations ci-dessus et j&#039;autorise UBONGO LLC \u00e0 proc\u00e9der \u00e0 l&#039;\u00e9valuation en vue d&#039;une mise en relation.\" aria-errormessage=\"wpforms-2642-field_43_1-error\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-2642-field_43_1\">Je certifie les informations ci-dessus et j'autorise UBONGO LLC \u00e0 proc\u00e9der \u00e0 l'\u00e9valuation en vue d'une mise en relation.<\/label><\/li><\/ul><\/fieldset><\/div><\/div><\/div><\/div><\/div>\t\t<div id=\"wpforms-2642-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-2642-field_1\" >&amp; page constitue<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-2642-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-2642-field_63-container\" class=\"wpforms-field wpforms-field-layout\" data-field-type=\"layout\" data-field-id=\"63\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_44-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"44\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_44\">Nom du Repr\u00e9sentant Autoris\u00e9 : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_44\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][44]\" aria-errormessage=\"wpforms-2642-field_44-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_45-container\" class=\"wpforms-field wpforms-field-text\" data-field-type=\"text\" data-field-id=\"45\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_45\"> Titre \/ Fonction : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-2642-field_45\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][45]\" aria-errormessage=\"wpforms-2642-field_45-error\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_52-container\" class=\"wpforms-field wpforms-field-email\" data-field-type=\"email\" data-field-id=\"52\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_52\">Adresse E-mail : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"email\" id=\"wpforms-2642-field_52\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][52]\" spellcheck=\"false\" aria-errormessage=\"wpforms-2642-field_52-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_50-container\" class=\"wpforms-field wpforms-field-phone\" data-field-type=\"phone\" data-field-id=\"50\"><label class=\"wpforms-field-label\" for=\"wpforms-2642-field_50\"> Num\u00e9ro de T\u00e9l\u00e9phone : <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"tel\" id=\"wpforms-2642-field_50\" class=\"wpforms-field-medium wpforms-field-required wpforms-smart-phone-field\" data-rule-smart-phone-field=\"true\" name=\"wpforms[fields][50]\" aria-label=\" Num\u00e9ro de T\u00e9l\u00e9phone :\" aria-errormessage=\"wpforms-2642-field_50-error\" required><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_49-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-type=\"date-time\" data-field-id=\"49\"><fieldset><legend class=\"wpforms-field-label\">Date \/ Heure <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/legend><div class=\"wpforms-field-row wpforms-field-medium\"><div class=\"wpforms-field-row-block wpforms-date-type-datepicker\"><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-2642-field_49\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required\" data-date-format=\"m\/d\/Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][49][date]\" aria-errormessage=\"wpforms-2642-field_49-error\" required><a title=\"Effacer la date\" data-clear role=\"button\" tabindex=\"0\" class=\"wpforms-datepicker-clear\" aria-label=\"Effacer la date\" style=\"display:none;\"><\/a><\/div><label for=\"wpforms-2642-field_49\" class=\"wpforms-field-sublabel after\">Date<\/label><\/div><div class=\"wpforms-field-row-block\"><input type=\"text\" id=\"wpforms-2642-field_49-time\" class=\"wpforms-field-date-time-time wpforms-timepicker wpforms-field-required\" data-time-format=\"g:i A\" data-step=\"30\" data-rule-time12h=\"true\" name=\"wpforms[fields][49][time]\" aria-errormessage=\"wpforms-2642-field_49-time-error\" required><label for=\"wpforms-2642-field_49-time\" class=\"wpforms-field-sublabel after\">Heure<\/label><\/div><\/div><\/fieldset><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-50\"><div id=\"wpforms-2642-field_82-container\" class=\"wpforms-field wpforms-field-hidden\" data-field-type=\"hidden\" data-field-id=\"82\"><input type=\"hidden\" id=\"wpforms-2642-field_82\" name=\"wpforms[fields][82]\" value=\"FtM79g1ZBpaEbj3N\"><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-50\"><\/div><\/div><\/div><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-2642-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-2642-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-2642-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} 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