{"id":172,"date":"2021-06-24T12:25:40","date_gmt":"2021-06-24T12:25:40","guid":{"rendered":"https:\/\/www.pelvitec.nl\/site\/?page_id=172"},"modified":"2021-06-24T13:00:29","modified_gmt":"2021-06-24T13:00:29","slug":"probe-ruil-aanmelden","status":"publish","type":"page","link":"https:\/\/www.pelvitec.nl\/site\/proberuil\/probe-ruil-aanmelden\/","title":{"rendered":"probe ruil aanmelden"},"content":{"rendered":"<p>[vc_section el_class=&#8221;formsec&#8221;][vc_row][vc_column width=&#8221;1\/6&#8243;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Aanmelden voor het<br \/>\n<b>Probe Ruil systeem<\/b>&#8221; font_container=&#8221;tag:h2|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;lichtblauwb&#8221;][\/vc_column][vc_column width=&#8221;1\/6&#8243;][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/12&#8243;][\/vc_column][vc_column width=&#8221;10\/12&#8243;]\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f171-o1\" lang=\"nl-NL\" dir=\"ltr\" data-wpcf7-id=\"171\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/site\/wp-json\/wp\/v2\/pages\/172#wpcf7-f171-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contactformulier\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"171\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.6\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"nl_NL\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f171-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7dtx_version\" value=\"5.0.5\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<p>velden met * zijn verplicht\n<\/p>\n<p> Datum : <span class=\"wpcf7-form-control-wrap your-date\" data-name=\"your-date\"><input type=\"text\" name=\"your-date\" class=\"wpcf7-form-control wpcf7-text wpcf7dtx wpcf7dtx-text\" aria-invalid=\"false\" value=\"10\/08\/2026\"><\/span>\n<\/p>\n<p> Geslacht* : <span class=\"wpcf7-form-control-wrap\" data-name=\"geslacht\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"geslacht\" value=\"vrouw\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">vrouw<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"geslacht\" value=\"man\" \/><span class=\"wpcf7-list-item-label\">man<\/span><\/span><\/span><\/span>\n<\/p>\n<p> Voorletter(s)* : <span class=\"wpcf7-form-control-wrap\" data-name=\"voorletters\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"voorletters\" \/><\/span>\n<\/p>\n<p> Achternaam* : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span>\n<\/p>\n<p> Praktijknaam* : <span class=\"wpcf7-form-control-wrap\" data-name=\"praktijknaam\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"praktijknaam\" \/><\/span>\n<\/p>\n<p> Adres* : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-adres\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-adres\" \/><\/span>\n<\/p>\n<p> Postcode* : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-postcode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-postcode\" \/><\/span>\n<\/p>\n<p> Plaats* : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-plaats\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-plaats\" \/><\/span>\n<\/p>\n<p> Land* : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-land\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"your-land\" value=\"Nederland\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Nederland<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"your-land\" value=\"Belgi\u00eb\" \/><span class=\"wpcf7-list-item-label\">Belgi\u00eb<\/span><\/span><\/span><\/span>\n<\/p>\n<p> Email* : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span>\n<\/p>\n<p> Telefoon : <span class=\"wpcf7-form-control-wrap\" data-name=\"your-telefoon\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-telefoon\" \/><\/span>\n<\/p>\n<p> Klantnummer Pelvitec : <span class=\"wpcf7-form-control-wrap\" data-name=\"klantnummer\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"klantnummer\" \/><\/span>\n<\/p>\n<p> Vraag: <span class=\"wpcf7-form-control-wrap\" data-name=\"your-message\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"your-message\"><\/textarea><\/span>\n<\/p>\n<hr \/>\n<p>Door aanmelding bij het probe ruilsysteem geeft U aan op de hoogte te zijn van de voorwaarden betreffende dit ruil systeem<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"voorwaarden\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"voorwaarden\" value=\"1\" aria-invalid=\"false\" \/><\/span><\/span><\/span> Akkoord met de voorwaarden\n<\/p>\n<p>Geef antwoord op onderstaande vraag om Spam te voorkomen\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap kc_captcha\" data-name=\"kc_captcha\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"captcha-image\" ><span class=\"cf7ic_instructions\">Bewijs dat je menselijk bent door het selecteren van<span> boom<\/span>.<\/span><label><input aria-label=\"1\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M350 99c-54 0-98-35-166-35-25 0-47 4-68 12a56 56 0 004-24C118 24 95 1 66 0a56 56 0 00-34 102v386c0 13 11 24 24 24h16c13 0 24-11 24-24v-94c28-12 64-23 114-23 54 0 98 35 166 35 48 0 86-16 122-41 9-6 14-15 14-26V96c0-23-24-39-45-29-35 16-77 32-117 32z\"\/><\/svg><\/label><label><input aria-label=\"2\" type=\"radio\" name=\"kc_captcha\" value=\"bot\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 512 512\"><path fill=\"currentColor\" d=\"M512 176a176 176 0 01-209 173l-24 27a24 24 0 01-18 8h-37v40c0 13-11 24-24 24h-40v40c0 13-11 24-24 24H24c-13 0-24-11-24-24v-78c0-6 3-13 7-17l162-162a176 176 0 11343-55zm-176-48a48 48 0 1096 0 48 48 0 00-96 0z\"\/><\/svg><\/label><label><input aria-label=\"3\" type=\"radio\" name=\"kc_captcha\" value=\"kc_human\" \/><svg aria-hidden=\"true\" role=\"img\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 384 512\"><path fill=\"currentColor\" d=\"M377 375l-83-87h34c21 0 32-25 17-40l-82-88h33c21 0 32-25 18-40L210 8c-10-11-26-11-36 0L70 120c-14 15-3 40 18 40h33l-82 88c-15 15-4 40 17 40h34L7 375c-15 16-4 41 17 41h120c0 33-11 49-34 68-12 9-5 28 10 28h144c15 0 22-19 10-28-20-16-34-32-34-68h120c21 0 32-25 17-41z\"\/><\/svg><\/label>\r\n    <\/span>\r\n    <span style=\"display:none\">\r\n        <input type=\"text\" name=\"kc_honeypot\">\r\n    <\/span><\/span><\/span>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Verzenden\" \/>\n<\/p>\n<p>Let op:\n<\/p>\n<p>Geen postbusnummer opgeven, daar onze vervoerder uitsluitend op huisadressen kan leveren!\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n[\/vc_column][vc_column width=&#8221;1\/12&#8243;][\/vc_column][\/vc_row][\/vc_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>[vc_section el_class=&#8221;formsec&#8221;][vc_row][vc_column width=&#8221;1\/6&#8243;][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_custom_heading text=&#8221;Aanmelden voor het Probe Ruil systeem&#8221; font_container=&#8221;tag:h2|text_align:center&#8221; use_theme_fonts=&#8221;yes&#8221; el_class=&#8221;lichtblauwb&#8221;][\/vc_column][vc_column width=&#8221;1\/6&#8243;][\/vc_column][\/vc_row][vc_row][vc_column width=&#8221;1\/12&#8243;][\/vc_column][vc_column width=&#8221;10\/12&#8243;][\/vc_column][vc_column width=&#8221;1\/12&#8243;][\/vc_column][\/vc_row][\/vc_section]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":129,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-172","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with 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