{"id":1184,"date":"2014-05-26T15:14:30","date_gmt":"2014-05-26T14:14:30","guid":{"rendered":"http:\/\/www.succeswebsites.nl\/?page_id=1184"},"modified":"2020-01-28T12:23:29","modified_gmt":"2020-01-28T11:23:29","slug":"aanmeldformulier","status":"publish","type":"page","link":"https:\/\/helpcentrum.succeswebsites.nl\/aanmeldformulier\/","title":{"rendered":"Aanmeldformulier"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-10qtrmo-d720b2bc6e0951b81b89b4f495d890e2\">\n.avia-section.av-10qtrmo-d720b2bc6e0951b81b89b4f495d890e2{\nbackground-repeat:no-repeat;\nbackground-image:url(https:\/\/helpcentrum.succeswebsites.nl\/wp-content\/uploads\/sites\/14\/2016\/09\/Succeswebsites-1.jpg);\nbackground-position:50% 0%;\nbackground-attachment:scroll;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section av-10qtrmo-d720b2bc6e0951b81b89b4f495d890e2 main_color avia-section-default avia-no-border-styling  avia-builder-el-0  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type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-xdohgg-a45b8a981eb9f1077bfbfd56eea16b3d\">\n.flex_column.av-xdohgg-a45b8a981eb9f1077bfbfd56eea16b3d{\nborder-radius:0px 0px 0px 0px;\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-xdohgg-a45b8a981eb9f1077bfbfd56eea16b3d av_three_fifth  avia-builder-el-2  el_after_av_one_fifth  avia-builder-el-last  flex_column_div av-zero-column-padding '   ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-vz6xcw-4d6cbbd9a5b4cfa828d8f4348940b6ac\">\n#top .av-special-heading.av-vz6xcw-4d6cbbd9a5b4cfa828d8f4348940b6ac{\npadding-bottom:10px;\nfont-size:50px;\n}\nbody .av-special-heading.av-vz6xcw-4d6cbbd9a5b4cfa828d8f4348940b6ac .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-vz6xcw-4d6cbbd9a5b4cfa828d8f4348940b6ac .av-special-heading-tag{\nfont-size:50px;\n}\n.av-special-heading.av-vz6xcw-4d6cbbd9a5b4cfa828d8f4348940b6ac .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-vz6xcw-4d6cbbd9a5b4cfa828d8f4348940b6ac av-special-heading-h1 blockquote modern-quote  avia-builder-el-3  avia-builder-el-no-sibling  av-inherit-size'><h1 class='av-special-heading-tag'  itemprop=\"headline\"  >Aanmeldformulier<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><\/div>\n\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><div id='av_section_2'  class='avia-section av-ugmc1s-5e7770d6ace1c097c18dc24f2209bff5 main_color avia-section-default avia-no-border-styling  avia-builder-el-4  el_after_av_section  avia-builder-el-last  avia-bg-style-scroll av-minimum-height av-minimum-height-custom  container_wrap sidebar_right'  ><div class='container av-section-cont-open' style='height:150px'><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1184'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-smxkvk-fd755ceb621f4abc08aae5bf5702af4f\">\n.flex_column.av-smxkvk-fd755ceb621f4abc08aae5bf5702af4f{\nborder-radius:0px 0px 0px 0px;\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-smxkvk-fd755ceb621f4abc08aae5bf5702af4f av_one_fifth  avia-builder-el-5  el_before_av_three_fifth  avia-builder-el-first  first flex_column_div av-zero-column-padding '   ><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-s2ywyo-3fd10ec90b297e7d9a681300845c7a5f\">\n.flex_column.av-s2ywyo-3fd10ec90b297e7d9a681300845c7a5f{\nborder-radius:0px 0px 0px 0px;\n-webkit-border-radius:0px 0px 0px 0px;\n-moz-border-radius:0px 0px 0px 0px;\n}\n<\/style>\n<div class='flex_column av-s2ywyo-3fd10ec90b297e7d9a681300845c7a5f av_three_fifth  avia-builder-el-6  el_after_av_one_fifth  avia-builder-el-last  flex_column_div av-zero-column-padding '   ><p><section  class='av_textblock_section av-p3sgn4-c7161c858dac8a0e9773b1ba37eae756'  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Als je onderstaande gegevens correct invult en op de verzendknop klikt dan hebben we alle gegevens compleet voor onze administratie. Wij zien uit naar de samenwerking!<\/p>\n<\/div><\/section><br \/>\n<form action=\"https:\/\/helpcentrum.succeswebsites.nl\/aanmeldformulier\/\" method=\"post\"  class=\"avia_ajax_form av-form-labels-visible   avia-builder-el-8  el_after_av_textblock  avia-builder-el-last   \" data-avia-form-id=\"1\" data-avia-redirect='' ><fieldset><div id='avia_1_1' class='av-form-text'><\/p>\n<h3>Algemene gegevens<\/h3>\n<p>\n<\/div><p class='  first_form  form_element form_element_half' id='element_avia_2_1'><label for=\"avia_2_1\">Volledige naam <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_2_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_2_1\" value=\"\" \/><\/p><p class='  form_element form_element_half' id='element_avia_3_1'><label for=\"avia_3_1\">Bedrijfsnaam <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_3_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_3_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_half' id='element_avia_4_1'><label for=\"avia_4_1\">E-mailadres <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_4_1\" class=\"text_input is_email\" type=\"text\" id=\"avia_4_1\" value=\"\" \/><\/p><p class='  form_element form_element_half' id='element_avia_5_1'><label for=\"avia_5_1\">Telefoonnummer <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_5_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_5_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_element_third' id='element_avia_6_1'><label for=\"avia_6_1\">Adres <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_6_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_6_1\" value=\"\" \/><\/p><p class='  form_element form_element_third' id='element_avia_7_1'><label for=\"avia_7_1\">Postcode <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_7_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_7_1\" value=\"\" \/><\/p><p class='  form_element form_element_third' id='element_avia_8_1'><label for=\"avia_8_1\">Woonplaats <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_8_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_8_1\" value=\"\" \/><\/p><div id='avia_9_1' class='av-form-text'><\/p>\n<h3>Incasso machtiging (voor periodieke kosten)<\/h3>\n<p>\n<\/div><p class='  first_form  form_element form_fullwidth' id='element_avia_10_1'><label for=\"avia_10_1\">Rekeninghouder <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_10_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_10_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_11_1'><label for=\"avia_11_1\">Rekeningnummer (IBAN) <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label> <input name=\"avia_11_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_11_1\" value=\"\" \/><\/p><p class='  first_form  form_element form_fullwidth' id='element_avia_12_1'><label for=\"avia_12_1\">Periodieke betaling <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label><select  name=\"avia_12_1\" class=\"select is_empty\" id=\"avia_12_1\"><option  value ='Betaling per jaar'>Betaling per jaar<\/option><\/select><\/p><p class='  first_form  form_element form_fullwidth av-last-visible-form-element' id='element_avia_13_1'><input  name=\"avia_13_1\" class=\"input_checkbox is_empty\" type=\"checkbox\" id=\"avia_13_1\" value=\"true\"\/><label class=\"input_checkbox_label\" for=\"avia_13_1\">Hierbij verklaar ik dat ik kennis heb genomen en akkoord ga met de algemene voorwaarden en met de incasso machtiging. <abbr class=\"required\" title=\"vereist\">*<\/abbr><\/label><\/p><p class=\"hidden\"><input type=\"text\" name=\"avia_14_1\" class=\"hidden \" id=\"avia_14_1\" value=\"\" \/><\/p><p class=\"form_element \"><input type=\"hidden\" value=\"1\" 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