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<div class="codesection" id="code-4959974"></div>
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<label id="tfa_1-L" class="label preField reqMark" for="tfa_1">Voornaam</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_1" name="tfa_1" value="" autocomplete="off" title="Voornaam" class="validate-alphanum required"></div>
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<label id="tfa_26-L" class="label preField reqMark" for="tfa_26">Achternaam</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_26" name="tfa_26" value="" autocomplete="off" title="Achternaam" class="validate-alphanum required"></div>
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<label id="tfa_27-L" class="label preField reqMark" for="tfa_27">Bedrijfsnaam</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_27" name="tfa_27" value="" title="Bedrijfsnaam" class="required"></div>
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<div class="oneField field-container-D   hintsBelow " id="tfa_19-D">
<label id="tfa_19-L" class="label preField reqMark" for="tfa_19">Telefoonnummer</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_19" name="tfa_19" value="" autocomplete="off" title="Telefoonnummer" class="validate-integer required"></div>
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<label id="tfa_12-L" class="label preField reqMark" for="tfa_12">E-mailadres</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_12" name="tfa_12" value="" autocomplete="off" title="E-mailadres" class="validate-email required"></div>
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<div class="oneField field-container-D   hintsBelow " id="tfa_44-D">
<label id="tfa_44-L" class="label preField reqMark" for="tfa_44">Mijn vraag</label><br><div class="inputWrapper"><textarea aria-required="true" maxlength="250" id="tfa_44" name="tfa_44" title="Mijn vraag" class="required"></textarea></div>
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<div class="oneField field-container-D    " id="tfa_82-D" role="radiogroup" aria-labelledby="tfa_82-L" data-tfa-labelledby="-L tfa_82-L">
<label id="tfa_82-L" class="label preField reqMark" data-tfa-check-label-for="tfa_82">Ik geef toestemming voor het gebruik van mijn gegevens voor gepersonaliseerde communicatie.</label><br><div class="inputWrapper"><span id="tfa_82" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_83" class="calc-total calcval-1" id="tfa_83" name="tfa_82" aria-required="true" aria-labelledby="tfa_83-L" data-tfa-labelledby="tfa_82-L tfa_83-L" data-tfa-parent-id="tfa_82"><label class="label postField" id="tfa_83-L" for="tfa_83"><span class="input-radio-faux"></span>Ja</label></span><span class="oneChoice"><input type="radio" value="tfa_84" class="calc-total calcval-1" id="tfa_84" name="tfa_82" aria-required="true" aria-labelledby="tfa_84-L" data-tfa-labelledby="tfa_82-L tfa_84-L" data-tfa-parent-id="tfa_82"><label class="label postField" id="tfa_84-L" for="tfa_84"><span class="input-radio-faux"></span>Nee</label></span></span></div>
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<div class="oneField field-container-D     wf-acl-hidden" id="tfa_49-D">
<label id="tfa_49-L" class="label preField reqMark" for="tfa_49">Taal</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_49" name="tfa_49" value="nl_BE" default="nl_BE" maxlength="50" title="Taal" class="required"></div>
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<label id="tfa_59-L" class="label preField " for="tfa_59">E-mail tekst</label><br><div class="inputWrapper"><textarea default="We waarderen je vertrouwen in onze dienstverlening en komen zo snel mogelijk bij je terug. Fijne werkdag" maxlength="300" id="tfa_59" name="tfa_59" title="E-mail tekst" class="">We waarderen je vertrouwen in onze dienstverlening en komen zo snel mogelijk bij je terug. Fijne werkdag</textarea></div>
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<div class="oneField field-container-D     wf-acl-hidden" id="tfa_51-D">
<label id="tfa_51-L" class="label preField reqMark" for="tfa_51">Categorie</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_51" name="tfa_51" value="contact pakket" default="contact pakket" maxlength="50" title="Categorie" class="required"></div>
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<label id="tfa_53-L" class="label preField reqMark" for="tfa_53">Webform Source</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_53" name="tfa_53" value="Contact zakelijk pakket BE" default="Contact zakelijk pakket BE" title="Webform Source" class="required"></div>
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<div class="oneField field-container-D     wf-acl-hidden" id="tfa_61-D">
<label id="tfa_61-L" class="label preField reqMark" for="tfa_61">Record Type ID</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_61" name="tfa_61" value="0120J000000opbSQAQ" default="0120J000000opbSQAQ" title="Record Type ID" class="required"></div>
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<label id="tfa_65-L" class="label preField reqMark" for="tfa_65">Formulier_titel</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_65" name="tfa_65" value="Contact zakelijk pakket" default="Contact zakelijk pakket" title="Formulier_titel" class="required"></div>
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<label id="tfa_63-L" class="label preField " for="tfa_63">Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_63" name="tfa_63" title="Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)" class=""></textarea></div>
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<div style="clear:both"></div>
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</form>
</div></div><div class="wFormFooter"><p class="supportInfo"><br></p></div>
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