Service Anfragen

<form id="service-Anfragen-81" enctype="multipart/form-data" action="/service-anfragen?tx_form_formframework%5Baction%5D=perform&amp;tx_form_formframework%5Bcontroller%5D=FormFrontend&amp;cHash=7d4038422b3e404b6ee5a936a6dcdfb8#service-Anfragen-81" method="post"><div><p>&lt;input type="hidden" name="tx_form_formframework[service-Anfragen-81][__state]" value="TzozOToiVFlQTzNcQ01TXEZvcm1cRG9tYWluXFJ1bnRpbWVcRm9ybVN0YXRlIjoyOntzOjI1OiIAKgBsYXN0RGlzcGxheWVkUGFnZUluZGV4IjtpOjA7czoxMzoiACoAZm9ybVZhbHVlcyI7YTowOnt9fQ==871e2d8bec88add8da5401807c7e2407b2d3fc9d"&gt;&lt;input type="hidden" name="tx_form_formframework[__trustedProperties]" value="{&amp;quot;service-Anfragen-81&amp;quot;:{&amp;quot;R9WJG763BbajsPDANdH&amp;quot;:1,&amp;quot;radiobutton-1&amp;quot;:1,&amp;quot;fullname&amp;quot;:1,&amp;quot;text-1&amp;quot;:1,&amp;quot;text-5&amp;quot;:1,&amp;quot;text-2&amp;quot;:1,&amp;quot;radiobutton-2&amp;quot;:1,&amp;quot;email&amp;quot;:1,&amp;quot;telephone-1&amp;quot;:1,&amp;quot;text-6&amp;quot;:1,&amp;quot;text-3&amp;quot;:1,&amp;quot;text-4&amp;quot;:1,&amp;quot;imageupload-1&amp;quot;:{&amp;quot;name&amp;quot;:1,&amp;quot;type&amp;quot;:1,&amp;quot;tmp_name&amp;quot;:1,&amp;quot;error&amp;quot;:1,&amp;quot;size&amp;quot;:1},&amp;quot;radiobutton-3&amp;quot;:1,&amp;quot;textarea-1&amp;quot;:1,&amp;quot;checkbox-1&amp;quot;:1,&amp;quot;__currentPage&amp;quot;:1}}4853794c5708186671720c6cd7cf00d756462901"&gt;</p></div><h2>Reparatur Anfragen</h2><div class="clearfix"><p></p><h2>Ihre persönlichen Daten</h2><p>Pflichtfelder sind mit einem * gekennzeichnet.</p></div><p><input aria-hidden="true" data-id="R9WJG763BbajsPDANdH" id="service-Anfragen-81-R9WJG763BbajsPDANdH" tabindex="-1" style="position:absolute; margin:0 0 0 -999em;" type="text" name="tx_form_formframework[service-Anfragen-81][R9WJG763BbajsPDANdH]"></p><div class="row"><div class="col-12 col-sm-6 col-md-6 col-lg-6 col-xl-6 col-xxl-6"><div class="form-group"><div class="input"><p><label class="form-label">Anrede</label></p> <p><span class="required">*</span></p><div class="input"><div id="service-Anfragen-81-radiobutton-1" class="inputs-list"><div class="form-group"><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-1-0" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-1]" value="Frau" checked="checked"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-1-0"><span>Frau</span></label></p></div><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-1-1" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-1]" value="HerrHerr"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-1-1"><span>Herr</span></label></p></div><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-1-2" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-1]" value="Divers"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-1-2"><span>Divers</span></label></p></div></div></div></div></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-fullname">Vor- und Nachname:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="Vor- und Nachname" id="service-Anfragen-81-fullname" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][fullname]" value&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-text-1">Straße:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="Strasse" id="service-Anfragen-81-text-1" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][text-1]" value&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-text-5">PLZ:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="PLZ" id="service-Anfragen-81-text-5" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][text-5]" value&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-text-2">Ort:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="Ort" id="service-Anfragen-81-text-2" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][text-2]" value&gt;</p></div></div><div class="form-group"><div class="input"><p><label class="form-label">Wie können wir Sie am Besten erreichen?</label></p> <p><span class="required">*</span></p><div class="input"><div id="service-Anfragen-81-radiobutton-2" class="inputs-list"><div class="form-group"><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-2-0" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-2]" value="per E-Mail" checked="checked"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-2-0"><span>per E-Mail</span></label></p></div><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-2-1" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-2]" value="per Telefon"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-2-1"><span>per Telefon</span></label></p></div></div></div></div></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-email">E-Mail Adresse:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="E-Mail" id="service-Anfragen-81-email" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][email]" value&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-telephone-1">Telefonnummer:</label></p><div class="input"><p>&lt;input placeholder="Telefonnummer" id="service-Anfragen-81-telephone-1" class=" form-control" type="tel" name="tx_form_formframework[service-Anfragen-81][telephone-1]" value&gt;</p></div></div></div><div class="col-12 col-sm-6 col-md-6 col-lg-6 col-xl-6 col-xxl-6"><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-text-6">Gerätedaten</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="Gerätedaten" id="service-Anfragen-81-text-6" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][text-6]" value&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-text-3">Modelnummer </label></p><div class="input"><p>&lt;input placeholder="A" id="service-Anfragen-81-text-3" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][text-3]" value="A"&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-text-4">Seriennummer:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;input required="required" placeholder="Seriennummer" id="service-Anfragen-81-text-4" class=" form-control" type="text" name="tx_form_formframework[service-Anfragen-81][text-4]" value&gt;</p></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-imageupload-1">Bildupload</label></p><div class="input"><p>&lt;input id="service-Anfragen-81-imageupload-1" class="lightbox" accept="image/jpeg" type="file" name="tx_form_formframework[service-Anfragen-81][imageupload-1]"&gt;</p></div></div><div class="form-group"><div class="input"><p><label class="form-label">Datensicherung:</label></p> <p><span class="required">*</span></p><div class="input"><div id="service-Anfragen-81-radiobutton-3" class="inputs-list"><div class="form-group"><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-3-0" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-3]" value="Meine Daten bitte kostenpflichtig sichern"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-3-0"><span>Meine Daten bitte kostenpflichtig sichern</span></label></p></div><div class="form-check"><p>&lt;input required="required" id="service-Anfragen-81-radiobutton-3-1" class="xlarge form-check-input" type="radio" name="tx_form_formframework[service-Anfragen-81][radiobutton-3]" value="Ich brauche keine Datensicherung" checked="checked"&gt;<label class="form-check-label" for="service-Anfragen-81-radiobutton-3-1"><span>Ich brauche keine Datensicherung</span></label></p></div></div></div></div></div></div><div class="form-group"><p><label class="form-label" for="service-Anfragen-81-textarea-1">Detaillierte Fehlerbeschreibung:</label></p> <p><span class="required">*</span></p><div class="input"><p>&lt;textarea required="required" placeholder="Fehlerbeschreibung" minlength="20" maxlength="400" id="service-Anfragen-81-textarea-1" class="xxlarge form-control" name="tx_form_formframework[service-Anfragen-81][textarea-1]"&gt;&lt;/textarea&gt;</p></div></div><div class="form-group"><div class="input checkbox"><div class="form-check"><p><label class="add-on form-check-label" for="service-Anfragen-81-checkbox-1">&lt;input type="hidden" name="tx_form_formframework[service-Anfragen-81][checkbox-1]" value&gt;&lt;input required="required" autocomplete="off" id="service-Anfragen-81-checkbox-1" class="add-on" type="checkbox" name="tx_form_formframework[service-Anfragen-81][checkbox-1]" value="1"&gt;<span>Ich stimme zu </span></label></p> <p><span class="required">*</span></p></div><div class="form-text"><p>Meine Angaben werden zwecks Bearbeitung der Anfrage sowie für den Fall, dass Anschlussfragen entstehen, gespeichert. Meine E-Mail Adresse darf an Apple weitergegeben werden. Ihre E-Mail wird hierbei für die Bewertung und Benachrichtigung (ausschließlich zu dieser Reparatur) verwendet. Ich bin damit einverstanden, dass hardwarebezogene Daten an Apple weitergeleitet werden. Diese werden im Zuge einer reinen Hardware-Diagnose erhoben. Datenschutzerklärung: Mit Setzen des Häkchens erklärst du dich (oder deine Erziehungsberechtigten) einverstanden, dass die von dir angegebenen Daten zweckgebunden zur Beantwortung deiner Anfrage elektronisch erhoben und gespeichert werden. Diese Einwilligung kann jederzeit durch eine Nachricht an uns widerrufen werden. In diesem Fall werden deine Daten umgehend gelöscht. Weitere Informationen entnehme bitte unserer Datenschutzerklärung. </p></div></div></div></div></div><div class="actions"><nav class="form-navigation"><div class="btn-toolbar" role="toolbar"><div class="btn-group" role="group"><p><span class="btn-group next submit"><button class="btn btn-primary"></button></span></p> <p> Senden</p> <p> </p></div></div></nav></div><p></p></form>