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<div class="wFormContainer" >
    <div class="wFormHeader"></div>
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            </style><div class=""><div class="wForm" id="4960021-WRPR" dir="ltr">
<div class="codesection" id="code-4960021"></div>
<h3 class="wFormTitle" data-testid="form-title" id="4960021-T">Devenir point PostNL</h3>
<form method="post" action="https://postnl.tfaforms.net/api_v2/rest/workflow/processor" class="hintsBelow labelsAbove" id="4960021" role="form">
<div class="oneField field-container-D    " id="tfa_143-D">
<label id="tfa_143-L" class="label preField reqMark" for="tfa_143">Prénom</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_143" name="tfa_143" value="" autocomplete="off" title="Prénom" class="validate-alphanum required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_145-D">
<label id="tfa_145-L" class="label preField reqMark" for="tfa_145">Nom</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_145" name="tfa_145" value="" autocomplete="off" title="Nom" class="validate-alphanum required"></div>
</div>
<div class="oneField field-container-D   hintsBelow " id="tfa_19-D">
<label id="tfa_19-L" class="label preField reqMark" for="tfa_19">Numéro de téléphone</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_19" name="tfa_19" value="" autocomplete="off" title="Numéro de téléphone" class="validate-integer required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_262-D">
<label id="tfa_262-L" class="label preField reqMark" for="tfa_262">Adresses e-mail</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_262" name="tfa_262" value="" autocomplete="off" title="Adresses e-mail" class="validate-email required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_132-D">
<label id="tfa_132-L" class="label preField reqMark" for="tfa_132">Fonction</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_132" name="tfa_132" title="Fonction" class="required"><option value="">Veuillez sélectionner</option>
<option value="tfa_136" id="tfa_136" class="">Directeur</option>
<option value="tfa_137" id="tfa_137" class="">Propriétaire</option>
<option value="tfa_138" id="tfa_138" class="">Chef d'équipe</option>
<option value="tfa_139" id="tfa_139" class="">Manager</option>
<option value="tfa_140" id="tfa_140" class="">Employé</option>
<option value="tfa_141" id="tfa_141" class="">Autre</option></select></div>
</div>
<div class="oneField field-container-D    " id="tfa_309-D" role="radiogroup" aria-labelledby="tfa_309-L" data-tfa-labelledby="-L tfa_309-L">
<label id="tfa_309-L" class="label preField reqMark" data-tfa-check-label-for="tfa_309">Êtes-vous déjà client PostNL?</label><br><div class="inputWrapper"><span id="tfa_309" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_310" class="" id="tfa_310" name="tfa_309" aria-required="true" data-conditionals="#tfa_315" aria-labelledby="tfa_310-L" data-tfa-labelledby="tfa_309-L tfa_310-L" data-tfa-parent-id="tfa_309"><label class="label postField" id="tfa_310-L" for="tfa_310"><span class="input-radio-faux"></span>Oui</label></span><span class="oneChoice"><input type="radio" value="tfa_311" class="" id="tfa_311" name="tfa_309" aria-required="true" data-conditionals="#tfa_347" aria-labelledby="tfa_311-L" data-tfa-labelledby="tfa_309-L tfa_311-L" data-tfa-parent-id="tfa_309"><label class="label postField" id="tfa_311-L" for="tfa_311"><span class="input-radio-faux"></span>Non</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_315-D">
<label id="tfa_315-L" class="label preField reqMark" for="tfa_315">Numéro client PostNL</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_315" name="tfa_315" value="" data-condition="`#tfa_310`" title="Numéro client PostNL" class="validate-integer required"></div>
</div>
<div class="htmlSection" id="tfa_280"><div class="htmlContent" id="tfa_280-HTML"><b>Entreprise</b></div></div>
<div class="oneField field-container-D    " id="tfa_319-D" role="radiogroup" aria-labelledby="tfa_319-L" data-tfa-labelledby="-L tfa_319-L">
<label id="tfa_319-L" class="label preField reqMark" data-tfa-check-label-for="tfa_319">Offrez-vous déjà des services à un concurrent?</label><br><div class="inputWrapper"><span id="tfa_319" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_320" class="" id="tfa_320" name="tfa_319" aria-required="true" aria-labelledby="tfa_320-L" data-tfa-labelledby="tfa_319-L tfa_320-L" data-tfa-parent-id="tfa_319"><label class="label postField" id="tfa_320-L" for="tfa_320"><span class="input-radio-faux"></span>Oui</label></span><span class="oneChoice"><input type="radio" value="tfa_321" class="" id="tfa_321" name="tfa_319" aria-required="true" aria-labelledby="tfa_321-L" data-tfa-labelledby="tfa_319-L tfa_321-L" data-tfa-parent-id="tfa_319"><label class="label postField" id="tfa_321-L" for="tfa_321"><span class="input-radio-faux"></span>Non</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_325-D" role="radiogroup" aria-labelledby="tfa_325-L" data-tfa-labelledby="-L tfa_325-L">
<label id="tfa_325-L" class="label preField reqMark" data-tfa-check-label-for="tfa_325">Votre magasin fait-il partie d'une chaîne?</label><br><div class="inputWrapper"><span id="tfa_325" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_326" class="" id="tfa_326" name="tfa_325" aria-required="true" aria-labelledby="tfa_326-L" data-tfa-labelledby="tfa_325-L tfa_326-L" data-tfa-parent-id="tfa_325"><label class="label postField" id="tfa_326-L" for="tfa_326"><span class="input-radio-faux"></span>Oui</label></span><span class="oneChoice"><input type="radio" value="tfa_327" class="" id="tfa_327" name="tfa_325" aria-required="true" aria-labelledby="tfa_327-L" data-tfa-labelledby="tfa_325-L tfa_327-L" data-tfa-parent-id="tfa_325"><label class="label postField" id="tfa_327-L" for="tfa_327"><span class="input-radio-faux"></span>Non</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_331-D">
<label id="tfa_331-L" class="label preField reqMark" for="tfa_331">Quel secteur</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_331" name="tfa_331" title="Quel secteur" class="required"><option value="">Veuillez sélectionner</option>
<option value="tfa_332" id="tfa_332" class="">Station d'essence</option>
<option value="tfa_333" id="tfa_333" class="">Librairie</option>
<option value="tfa_334" id="tfa_334" class="">Magasin de bricolage</option>
<option value="tfa_335" id="tfa_335" class="">Pharmacie</option>
<option value="tfa_336" id="tfa_336" class="">bureau</option>
<option value="tfa_337" id="tfa_337" class="">Organisation sociale</option>
<option value="tfa_338" id="tfa_338" class="">Institut d'éducation</option>
<option value="tfa_339" id="tfa_339" class="">Loisirs</option>
<option value="tfa_340" id="tfa_340" class="">Supermarché</option>
<option value="tfa_341" id="tfa_341" class="">Boutique de tabac</option>
<option value="tfa_342" id="tfa_342" class="">Centre jardinage</option>
<option value="tfa_343" id="tfa_343" class="">Etablissement de soins</option></select></div>
</div>
<div class="oneField field-container-D    " id="tfa_347-D" role="radiogroup" aria-labelledby="tfa_347-L" data-tfa-labelledby="-L tfa_347-L">
<label id="tfa_347-L" class="label preField reqMark" data-tfa-check-label-for="tfa_347">Avez-vous déjà fait affaire avec PostNL?</label><br><div class="inputWrapper"><span id="tfa_347" class="choices vertical required" data-condition="`#tfa_311`"><span class="oneChoice"><input type="radio" value="tfa_348" class="" id="tfa_348" name="tfa_347" aria-required="true" aria-labelledby="tfa_348-L" data-tfa-labelledby="tfa_347-L tfa_348-L" data-tfa-parent-id="tfa_347"><label class="label postField" id="tfa_348-L" for="tfa_348"><span class="input-radio-faux"></span>Oui</label></span><span class="oneChoice"><input type="radio" value="tfa_349" class="" id="tfa_349" name="tfa_347" aria-required="true" aria-labelledby="tfa_349-L" data-tfa-labelledby="tfa_347-L tfa_349-L" data-tfa-parent-id="tfa_347"><label class="label postField" id="tfa_349-L" for="tfa_349"><span class="input-radio-faux"></span>Non</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_353-D" role="radiogroup" aria-labelledby="tfa_353-L" data-tfa-labelledby="-L tfa_353-L">
<label id="tfa_353-L" class="label preField reqMark" data-tfa-check-label-for="tfa_353">Vous reprenez un détaillant qui a déjà des relations avec PostNL?</label><br><div class="inputWrapper"><span id="tfa_353" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_354" class="" id="tfa_354" name="tfa_353" aria-required="true" data-conditionals="#tfa_359" aria-labelledby="tfa_354-L" data-tfa-labelledby="tfa_353-L tfa_354-L" data-tfa-parent-id="tfa_353"><label class="label postField" id="tfa_354-L" for="tfa_354"><span class="input-radio-faux"></span>Oui</label></span><span class="oneChoice"><input type="radio" value="tfa_355" class="" id="tfa_355" name="tfa_353" aria-required="true" aria-labelledby="tfa_355-L" data-tfa-labelledby="tfa_353-L tfa_355-L" data-tfa-parent-id="tfa_353"><label class="label postField" id="tfa_355-L" for="tfa_355"><span class="input-radio-faux"></span>Non</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_359-D">
<label id="tfa_359-L" class="label preField reqMark" for="tfa_359">Saisissez ici le numéro de client du commerçant que vous reprenez</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_359" name="tfa_359" value="" data-condition="`#tfa_354`" title="Saisissez ici le numéro de client du commerçant que vous reprenez" class="validate-integer required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_1-D">
<label id="tfa_1-L" class="label preField reqMark" for="tfa_1">Nom de entreprise</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_1" name="tfa_1" value="" autocomplete="off" title="Nom de entreprise" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_361-D">
<label id="tfa_361-L" class="label preField reqMark" for="tfa_361">Numéro&nbsp;Banque-Carrefour des Entreprises</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_361" name="tfa_361" value="" autocomplete="off" title="Numéro Banque-Carrefour des Entreprises" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_47-D">
<label id="tfa_47-L" class="label preField reqMark" for="tfa_47">Rue</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_47" name="tfa_47" value="" autocomplete="off" title="Rue" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_21-D">
<label id="tfa_21-L" class="label preField reqMark" for="tfa_21">Numéro de maison</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_21" name="tfa_21" value="" autocomplete="off" title="Numéro de maison" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_186-D">
<label id="tfa_186-L" class="label preField " for="tfa_186">Ajout de numéro de maison</label><br><div class="inputWrapper"><input type="text" id="tfa_186" name="tfa_186" value="" autocomplete="off" title="Ajout de numéro de maison" class=""></div>
</div>
<div class="oneField field-container-D    " id="tfa_17-D">
<label id="tfa_17-L" class="label preField reqMark" for="tfa_17">Code Postal</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_17" name="tfa_17" value="" autocomplete="off" placeholder="1234" title="Code Postal" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_48-D">
<label id="tfa_48-L" class="label preField reqMark" for="tfa_48">Ville</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_48" name="tfa_48" value="" autocomplete="off" title="Ville" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_12-D">
<label id="tfa_12-L" class="label preField reqMark" for="tfa_12">Pays</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_12" name="tfa_12" title="Pays" class="required"><option value="">Veuillez sélectionner</option>
<option value="tfa_299" id="tfa_299" class="">NL</option>
<option value="tfa_300" id="tfa_300" class="">BE</option></select></div>
</div>
<div class="oneField field-container-D    " id="tfa_301-D">
<label id="tfa_301-L" class="label preField " for="tfa_301">Autres informations que vous aimeriez partager avec nous</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_301" name="tfa_301" title="Autres informations que vous aimeriez partager avec nous" class=""></textarea></div>
</div>
<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="fr_BE" default="fr_BE" maxlength="50" title="Taal" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_59-D">
<label id="tfa_59-L" class="label preField " for="tfa_59">E-mail tekst</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_59" name="tfa_59" title="E-mail tekst" class=""></textarea></div>
</div>
<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="postnl punt" default="postnl punt" maxlength="50" title="Categorie" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_53-D">
<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="postnl punt be" default="postnl punt be" title="Webform Source" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_243-D">
<label id="tfa_243-L" class="label preField reqMark" for="tfa_243">Record Type ID</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_243" name="tfa_243" value="0120J000000opbTQAQ" default="0120J000000opbTQAQ" title="Record Type ID" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_273-D">
<label id="tfa_273-L" class="label preField reqMark" for="tfa_273">Formulier_titel</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_273" name="tfa_273" value="Devenir point PostNL" default="Devenir point PostNL" title="Formulier_titel" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_275-D">
<label id="tfa_275-L" class="label preField " for="tfa_275">Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_275" name="tfa_275" title="Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)" class=""></textarea></div>
</div>
<div class="actions" id="4960021-A" data-contentid="submit_button"><input type="submit" data-label="Envoyer" class="primaryAction" id="submit_button" value="Envoyer"></div>
<div style="clear:both"></div>
<input type="hidden" value="626-f06641501c9636ee012a673703f43d29" name="tfa_dbCounters" id="tfa_dbCounters" autocomplete="off"><input type="hidden" value="4960021" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value="" name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="3be0a037754ff56006517b7e0d3374e6" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="" name="tfa_dbWorkflowSessionUuid" id="tfa_dbWorkflowSessionUuid"><input type="hidden" value="1695673382" name="tfa_dbTimeStarted" id="tfa_dbTimeStarted" autocomplete="off"><input type="hidden" value="15" name="tfa_dbVersionId" id="tfa_dbVersionId"><input type="hidden" value="" name="tfa_switchedoff" id="tfa_switchedoff">
</form>
</div></div><div class="wFormFooter"><p class="supportInfo"><br></p></div>
  <p class="supportInfo" >
      </p>
 </div>

Devenir point PostNL                                                                                        

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