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| Url | https://www.acett.lu/formulaire-commercial/ |
| --- | --- |
| MetaTitle | Demande d’abonnement - Antenne Collective Ettelbruck asbl |
| MetaDescription | Formulaire commercial. Antenne Collective Ettelbruck asbl, 10A, Place de l'hôtel de Ville, 9087 Ettelbruck Luxembourg |

# Demande d’abonnement

<fieldset id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step1" class="multistepstep" role="tabpanel" aria-labelledby="progress-tab-1">
				<legend>Produits (1/4)</legend>

                <div id="products" class="row">
                    
                    <div class="col-12 col-lg-6">
                        <fieldset class="formblock internet form-group"><legend>Internet</legend><div class="form-check" data-item-key="EttStream 15" data-item-type="List"></div><div class="form-check" data-item-key="EttStream 250" data-item-type="List"></div><div class="form-check" data-item-key="EttStream 500" data-item-type="List"></div><div class="form-check" data-item-key="EttStream 1000" data-item-type="List"></div><div class="form-check" data-item-key="onlyInternet-EttStream 15" data-item-type="List"></div><div class="form-check" data-item-key="onlyInternet-EttStream 250" data-item-type="List"></div><div class="form-check" data-item-key="onlyInternet-EttStream 500" data-item-type="List"></div><div class="form-check" data-item-key="onlyInternet-EttStream 1000" data-item-type="List"></div></fieldset>
                    </div>
                    <div class="col-12 col-lg-6">
                        <fieldset class="formblock tv form-group"><legend>TV</legend><div class="form-check" data-item-key="TV" data-item-type="List"></div><div class="form-check" data-item-key="TV+" data-item-type="List"></div><div class="form-check" data-item-key="TV+ ZEN" data-item-type="List"></div><div class="form-check" data-item-key="TV+ MAX" data-item-type="List"></div></fieldset>   
                    </div>
                    <div class="col-12 col-lg-6">
                        <fieldset class="formblock telephone form-group"><legend>Téléphone</legend><div class="form-check" data-item-key="EttPhone" data-item-type="List"></div></fieldset>
                    </div>
                    <div class="col-12 col-lg-6">
                        <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step1_calculatedPrice_pnlcalculatedPrice" class="calculatedprice form-group" data-item-key="calculatedPrice" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step1_calculatedPrice_txtcalculatedPrice" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step1_calculatedPrice_lblcalculatedPrice" title="products_price">products_price</label>
				</div>
                        <span class="prod-asterisk">*  Tarifs indiqués par mois. Possibilité d’opter pour la formule “Adhésion”.</span>
                        <div class="prod-total">
                            <span class="total-txt">
                                <span class="title">Notre offre :</span>
                                <span class="sm-txt"></span>
                            </span>
                            <div class="total-nbr">
                                <span class="choose">Veuillez sélectionnez  un produit</span>
                                <div id="totalprod"></div>
                            </div>
                        </div>
                    </div>
                </div>
            <div class="buttonpanel"></div>
			</fieldset>

<fieldset id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step2" class="multistepstep" role="tabpanel" aria-labelledby="progress-tab-2" hidden="hidden">
				<legend>Hardware (2/4)</legend>

                <div class="row">
                    
                    <div class="col-12 col-lg-5 installation-block">
                        <span class="infos">Sélectionnez l’option d’installation souhaitée</span>
                        <fieldset class="formblock installation form-group"><legend>Installation</legend><div class="form-check" data-item-key="With-ACE-HW" data-item-type="List"></div><div class="form-check" data-item-key="Without-ACE-HW" data-item-type="List"></div></fieldset>
                    </div>
                    <div class="col-12 col-lg-7 hardware-blocks">
                        <fieldset class="formblock hardwareinternet form-group"><legend>Fritzbox</legend><div class="form-check" data-item-key="FB-6490" data-item-type="List"></div><div class="form-check" data-item-key="FB-6660" data-item-type="List"></div></fieldset>   
                        <fieldset class="formblock disabled hardwaretv form-group"><legend>TV+ BOX</legend><div class="form-check" data-item-key="TV+BOX" data-item-type="List"></div><div class="form-check" data-item-key="TV+BOX-Location" data-item-type="List"></div></fieldset>   
                    </div>
                </div>

            <div class="buttonpanel"></div>
			</fieldset>

<fieldset id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3" class="multistepstep" role="tabpanel" aria-labelledby="progress-tab-3" hidden="hidden">
				<legend>Coordonnées (3/4)</legend>
                <div class="formblock">
                    <span class="formblock-title">Coordonnées</span>
                    <div class="row row-gutter-small">
                        <div class="col-12 col-lg-6">
                            <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_FirstName_pnlFirstName" class="firstname form-group required" data-item-key="FirstName" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_FirstName_txtFirstName" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_FirstName_lblFirstName" title="Prénom">Prénom</label>
				</div>
                            <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_LastName_pnlLastName" class="lastname form-group required" data-item-key="LastName" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_LastName_txtLastName" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_LastName_lblLastName" title="Nom">Nom</label>
				</div>
                            <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Email_pnlEmail" class="email form-group required" data-item-key="Email" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Email_txtEmail" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Email_lblEmail" title="E-mail">E-mail</label>
				</div>
                        </div>
                        <div class="col-12 col-lg-6">
                            <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Phone_pnlPhone" class="phone form-group" data-item-key="Phone" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Phone_txtPhone" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Phone_lblPhone" title="Téléphone">Téléphone</label>
				</div>
                            <div class="row row-gutter-small addressfieldset">
                                <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Street_pnlStreet" class="col-12 col-sm-8 street form-group required" data-item-key="Street" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Street_txtStreet" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_Street_lblStreet" title="Rue">Rue</label>
				</div>
                                <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_HouseNbr_pnlHouseNbr" class="col-12 col-sm-4 housenbr form-group required" data-item-key="HouseNbr" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_HouseNbr_txtHouseNbr" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_HouseNbr_lblHouseNbr" title="Numéro">Numéro</label>
				</div>
                                <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_ZipCode_pnlZipCode" class="col-12 col-sm-4 zipcode form-group required" data-item-key="ZipCode" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_ZipCode_txtZipCode" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_ZipCode_lblZipCode" title="Code Postal">Code Postal</label>
				</div>
                                <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_City_pnlCity" class="col-12 col-sm-8 city form-group required" data-item-key="City" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_City_txtCity" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step3_City_lblCity" title="Ville">Ville</label>
				</div>
                            </div>
                        </div>
                    </div>
                </div>
                
            <div class="buttonpanel"></div>
			</fieldset>

<fieldset id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step4" class="multistepstep" role="tabpanel" aria-labelledby="progress-tab-4" hidden="hidden">
				<legend>Commentaire (4/4)</legend>
                <div class="formblock">
                    <div class="comment-intro">
					<h2> Votre demande est presque finalisée !</h2>
<p>Veuillez ajouter un commentaire ou une instruction particulière dans le champ ci‑dessous. Après envoi, notre équipe vous contactera pour confirmer votre abonnement et planifier l’installation.</p>
				</div>
                    <div id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step4_Comment_pnlComment" class="comment form-group" data-item-key="Comment" data-item-type="Text">
					<label for="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step4_Comment_txtComment" id="C_T_DefaultRegion_M9678_Form_pnlForm_MultiStepForm_Step4_Comment_lblComment" title="Commentaire">Commentaire</label>
				</div>
                </div>
                

                <div class="privacy alert alert-info">
					<span>Nous respectons votre vie privée et n’utilisons vos données que dans le but de traiter votre demande. En envoyant la demande, vous acceptez notre </span><span><a href="/mentions-legales/#privacy">Politique de vie privée</a></span>
				</div>
                

            <div class="buttonpanel"></div>
			</fieldset>