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[fluentform id="19"]
<div class='fluentform fluentform_wrapper_19'>
<style id="fluentform_custom_css_19" type="text/css">
/*input style*/
.fluent_form_17 frm-fluent-form{
margin-bottom: 10px;
}
.fluent_form_17 .ff-el-input--content{
padding: 6px 12px; /*change padding*/
background-color: #fff; /*change background color*/
border: 1px solid #ced4da; /*change border width and color*/
border-radius: 10px; /*change corner round/ border radius*/
margin-bottom: 10px;
}
.fluent_form_17 .ff-el-form-control{
padding: 6px 12px; /*change padding*/
background-color: #fff; /*change background color*/
border: 1px solid #ced4da; /*change border width and color*/
border-radius: 10px; /*change corner round/ border radius*/
margin-bottom: 10px;
} </style>
<style id="fluentform_styler_css_19" type="text/css">
.fluentform_wrapper_19{ margin: px; } .fluentform_wrapper_19{ padding: px; } .fluentform_wrapper_19 .ff-el-input--content input, .fluentform_wrapper_19 .ff-el-input--content textarea, .fluentform_wrapper_19 .ff-el-input--content select, .fluentform_wrapper_19 .choices__list--single, .fluentform_wrapper_19 .choices[data-type*='select-multiple'] { color: rgba(21, 49, 88, 1);border-style: solid;border-color: rgba(245, 137, 68, 1);border-width: 1px;border-radius: 10px; } .fluentform_wrapper_19 .frm-fluent-form .choices__list--dropdown { border-style: solid;border-color: rgba(245, 137, 68, 1);border-width: 1px;border-radius: 10px; } .fluentform_wrapper_19 .ff_submit_btn_wrapper .ff-btn-submit { background-color: rgba(245, 137, 68, 1);color: rgba(21, 49, 88, 1);padding: px;margin: px; } </style>
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style="display:none !important;" tabindex="-1"></span>
<input type='hidden' name='__fluent_form_embded_post_id' value='1594' /><input type="hidden" id="_fluentform_19_fluentformnonce" name="_fluentform_19_fluentformnonce" value="116bfb9f67" /><input type="hidden" name="_wp_http_referer" value="/en/support_en/" /><div data-type="name-element" data-name="FirstName" class=" ff-field_container ff-name-field-wrapper" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_19_FirstName_last_name_'>Voornaam</label> </div><div class='ff-el-input--content'><input type="text" name="FirstName[last_name]" id="ff_19_FirstName_last_name_" class="ff-el-form-control" placeholder="Voornaam" ></div></div></div></div></div><div class='ff-el-group' data-name="custom_html-19_1" ><br /></div><div data-type="name-element" data-name="LastName" class=" ff-field_container ff-name-field-wrapper" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_19_LastName_last_name_'>Achternaam</label> </div><div class='ff-el-input--content'><input type="text" name="LastName[last_name]" id="ff_19_LastName_last_name_" class="ff-el-form-control" placeholder="Achternaam" ></div></div></div></div></div><div class='ff-el-group' data-name="custom_html-19_2" ><br /></div><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_19_Mailaddress'>E-mail</label> </div><div class='ff-el-input--content'><input type="email" name="Mailaddress" id="ff_19_Mailaddress" class="ff-el-form-control" placeholder="E-mail Adres" data-name="Mailaddress" ></div></div><div class='ff-el-group' data-name="custom_html-19_3" ><br /></div><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label asterisk-right'><label for='ff_19_Company'>Bedrijfsnaam</label> </div><div class='ff-el-input--content'><input type="text" name="Company" class="ff-el-form-control" placeholder="Bedrijfsnaam" data-name="Company" id="ff_19_Company" ></div></div><div class='ff-el-group' data-name="custom_html-19_4" ><br /></div><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_checkbox_m0tavp_1_e4cc9b79a74a5efd76e188059f6a8438><input type="checkbox" name="input_checkbox_m0tavp_1[]" data-name="input_checkbox_m0tavp_1" class="ff-el-form-check-input ff-el-form-check-checkbox" value="Ja, ik wil wil meer weten over Basedriver en geef toestemming mijn gegevens veilig op te slaan, conform onze <a href="https://basedriver.com/privacyverklaring/">Privacy verklaring</a>." id='input_checkbox_m0tavp_1_e4cc9b79a74a5efd76e188059f6a8438'> <span>Ja, ik wil wil meer weten over Basedriver en geef toestemming mijn gegevens veilig op te slaan, conform onze <a href="https://basedriver.com/privacyverklaring/">Privacy verklaring</a>.</span></label></div></div></div><div class='ff-el-group' data-name="custom_html-19_5" ><br /></div><div class='ff-el-group' data-name="custom_html-19_6" ><br /></div><input type="hidden" name="optRouteToAdd" value="SubscriptionFormNewsLetterAPI" data-name="optRouteToAdd" ><input type="hidden" name="attribute" value="2021 webinar omzetkansen" data-name="attribute" ><input type="hidden" name="campaignId" value="52" data-name="campaignId" ><input type="hidden" name="contactmomentId" value="11" data-name="contactmomentId" ><input type="hidden" name="FormName" value="OptinMonster_webinar_omzetkansen" data-name="FormName" ><input type="hidden" name="marketingLabelShortCode" value="BD" data-name="marketingLabelShortCode" ><input type="hidden" name="okForOptCodes" value="N" data-name="okForOptCodes" ><input type="hidden" name="conditions" value="Ja, ik wil wil meer weten over Basedriver en geef toestemming mijn gegevens veilig op te slaan, conform onze privacy verklaring." data-name="conditions" ><div class='ff-el-group ff-text-right ff_submit_btn_wrapper'><button type="submit" class="ff-btn ff-btn-submit ff-btn-md ff_btn_style" >Nu verzenden</button><style>form.fluent_form_19 .ff-btn-submit { background-color: #409EFF; color: #ffffff; }</style></div></form><div id='fluentform_19_errors' class='ff-errors-in-stack ff_form_instance_19_3 ff-form-loading_errors ff_form_instance_19_3_errors'></div></div> <script type="text/javascript">
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[fluentform id="17"]
<div class='fluentform fluentform_wrapper_17'>
<style id="fluentform_custom_css_17" type="text/css">
/*input style*/
.fluent_form_17 frm-fluent-form{
margin-bottom: 10px;
}
.fluent_form_17 .ff-el-input--content{
padding: 6px 12px; /*change padding*/
background-color: #fff; /*change background color*/
border: 1px solid #ced4da; /*change border width and color*/
border-radius: 10px; /*change corner round/ border radius*/
margin-bottom: 10px;
}
.fluent_form_17 .ff-el-form-control{
padding: 6px 12px; /*change padding*/
background-color: #fff; /*change background color*/
border: 1px solid #ced4da; /*change border width and color*/
border-radius: 10px; /*change corner round/ border radius*/
margin-bottom: 10px;
} </style>
<style id="fluentform_styler_css_17" type="text/css">
.fluentform_wrapper_17{ margin: px; } .fluentform_wrapper_17{ padding: px; } .fluentform_wrapper_17 .ff-el-input--content input, .fluentform_wrapper_17 .ff-el-input--content textarea, .fluentform_wrapper_17 .ff-el-input--content select, .fluentform_wrapper_17 .choices__list--single, .fluentform_wrapper_17 .choices[data-type*='select-multiple'] { color: rgba(21, 49, 88, 1);border-style: solid;border-color: rgba(245, 137, 68, 1);border-width: 1px;border-radius: 10px; } .fluentform_wrapper_17 .frm-fluent-form .choices__list--dropdown { border-style: solid;border-color: rgba(245, 137, 68, 1);border-width: 1px;border-radius: 10px; } .fluentform_wrapper_17 .ff_submit_btn_wrapper .ff-btn-submit { background-color: rgba(245, 137, 68, 1);color: rgba(21, 49, 88, 1);padding: px;margin: px; } </style>
<form data-form_id="17" id="fluentform_17" class="frm-fluent-form fluent_form_17 ff-el-form-top ff_form_instance_17_4 ff-form-loading" data-form_instance="ff_form_instance_17_4" method="POST" > <span style="display: none !important;"><input type="checkbox" name="item__17__fluent_checkme_" value="1"
style="display:none !important;" tabindex="-1"></span>
<input type='hidden' name='__fluent_form_embded_post_id' value='1594' /><input type="hidden" id="_fluentform_17_fluentformnonce" name="_fluentform_17_fluentformnonce" value="116bfb9f67" /><input type="hidden" name="_wp_http_referer" value="/en/support_en/" /><div data-type="name-element" data-name="LastName" class=" ff-field_container ff-name-field-wrapper" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_17_LastName_last_name_'>Naam</label> </div><div class='ff-el-input--content'><input type="text" name="LastName[last_name]" id="ff_17_LastName_last_name_" class="ff-el-form-control" placeholder="Naam" ></div></div></div></div></div><div class='ff-el-group' data-name="custom_html-17_1" ><br /></div><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label ff-el-is-required asterisk-right'><label for='ff_17_Mailaddress'>E-mail</label> </div><div class='ff-el-input--content'><input type="email" name="Mailaddress" id="ff_17_Mailaddress" class="ff-el-form-control" placeholder="E-mail Adres" data-name="Mailaddress" ></div></div><div class='ff-el-group' data-name="custom_html-17_2" ><br /></div><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--label asterisk-right'><label for='ff_17_Company'>LinkedIn profiel</label> </div><div class='ff-el-input--content'><input type="text" name="Company" class="ff-el-form-control" placeholder="LinkedIn profiel" data-name="Company" id="ff_17_Company" ></div></div><div class='ff-el-group' data-name="custom_html-17_3" ><br /></div><div class='ff-el-group ff-el-form-hide_label'><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for=input_checkbox_m0tavp_1_242dc3d2d057dd2977a4032adb84c343><input type="checkbox" name="input_checkbox_m0tavp_1[]" data-name="input_checkbox_m0tavp_1" class="ff-el-form-check-input ff-el-form-check-checkbox" value="Ja, ik wil wil meer weten over Basedriver en geef toestemming mijn gegevens veilig op te slaan, conform onze privacy verklaring." id='input_checkbox_m0tavp_1_242dc3d2d057dd2977a4032adb84c343'> <span>Ja, ik wil wil meer weten over Basedriver en geef toestemming mijn gegevens veilig op te slaan, conform onze privacy verklaring.</span></label></div></div></div><div class='ff-el-group' data-name="custom_html-17_4" ><br /></div><input type="hidden" name="optRouteToAdd" value="SubscriptionFormNewsLetterAPI" data-name="optRouteToAdd" ><input type="hidden" name="attribute" value="Sollicitant" data-name="attribute" ><input type="hidden" name="campaignId" value="65" data-name="campaignId" ><input type="hidden" name="contactmomentId" value="1" data-name="contactmomentId" ><input type="hidden" name="FormName" value="OptinMonster_Sollicitatie_popup" data-name="FormName" ><input type="hidden" name="marketingLabelShortCode" value="BD" data-name="marketingLabelShortCode" ><input type="hidden" name="okForOptCodes" value="N" data-name="okForOptCodes" ><input type="hidden" name="conditions" value="Ja, ik wil wil meer weten over Basedriver en geef toestemming mijn gegevens veilig op te slaan, conform onze privacy verklaring." data-name="conditions" ><div class='ff-el-group ff-text-right ff_submit_btn_wrapper'><button type="submit" class="ff-btn ff-btn-submit ff-btn-md ff_btn_style" >Nu verzenden</button><style>form.fluent_form_17 .ff-btn-submit { background-color: #409EFF; color: #ffffff; }</style></div></form><div id='fluentform_17_errors' class='ff-errors-in-stack ff_form_instance_17_4 ff-form-loading_errors ff_form_instance_17_4_errors'></div></div> <script type="text/javascript">
window.fluent_form_ff_form_instance_17_4 = {"id":"17","settings":{"layout":{"labelPlacement":"top","helpMessagePlacement":"with_label","errorMessagePlacement":"inline"},"id":"95","restrictions":{"denyEmptySubmission":{"enabled":false}}},"form_instance":"ff_form_instance_17_4","form_id_selector":"fluentform_17","rules":{"LastName[last_name]":{"required":{"value":true,"message":"Dit veld is verplicht"}},"Mailaddress":{"required":{"value":true,"message":"Dit veld is verplicht!"},"email":{"value":true,"message":"Dit veld moet een geldig e-mailadres bevatten"}},"Company":{"required":{"value":false,"message":"Dit veld is verplicht"}},"input_checkbox_m0tavp_1":{"required":{"value":true,"message":"This field is required"}}}};
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