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<div class="wFormContainer" >
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    <style type="text/css">
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            </style><div class=""><div class="wForm" id="4960048-WRPR" data-language="nl" dir="ltr">
<div class="codesection" id="code-4960048"></div>
<form method="post" action="https://postnl.tfaforms.net/api_v2/rest/workflow/processor" class="hintsBelow labelsAbove" id="4960048">
<div class="oneField field-container-D    " id="tfa_1-D">
<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-custom /^[A-Za-z\u00C0-\u024F\u1E00-\u1EFF\uFB00-\uFB06\u0153\u0152\u00DF\u1E9E\u00E6\u00C6\u01FD\u01FE\u018E\u018F\u01A9\u01AA\u01DD\u01DC\u01DF\u01DE\u1F00-\u1FFF\u2100-\u214F\uFB13-\uFB17\uAB30-\uAB6F\uA720-\uA7FF\u0400-\u04FF\u0500-\u052F\u2C60-\u2C7F\u2DE0-\u2DFF\uA640-\uA69F\u0524-\u052F\u1C80-\u1C8F\u13A0-\u13FF\u1F08-\u1F0F\u1F18-\u1F1D\u1F28-\u1F2F\u1F38-\u1F3F\u1F48-\u1F4D\u1F59\u1F5B\u1F5D\u1F5F-\u1F7D\u1F80-\u1FBF\u1FC2-\u1FCF\u1FD8-\u1FDF\u1FE8-\u1FEF\u1FF2-\u1FFD\uFB00-\uFB17\u1F00-\u1FFF\u2100-\u214F\uAB30-\uAB6F\uA720-\uA7FF\u0400-\u04FF\u0500-\u052F\u2C60-\u2C7F\u2DE0-\u2DFF\uA640-\uA69F\u0524-\u052F\u1C80-\u1C8F\u13A0-\u13FF\u1F08-\u1F0F\u1F18-\u1F1D\u1F28-\u1F2F\u1F38-\u1F3F\u1F48-\u1F4D\u1F59\u1F5B\u1F5D\u1F5F-\u1F7D\u1F80-\u1FBF\u1FC2-\u1FCF\u1FD8-\u1FDF\u1FE8-\u1FEF\u1FF2-\u1FFD\uFB00-\uFB17]*$/ required"></div>

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<div class="oneField field-container-D    " id="tfa_26-D">
<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="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_27-D">
<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="" autocomplete="off" 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-custom /^\d{10}$/ required"></div>

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<div class="oneField field-container-D    " id="tfa_12-D">
<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-custom /^[A-Za-z0-9._%+-]+@[A-Za-z0-9.-]+\.[A-Z|a-z]{2,}$/ required"></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_NL" default="nl_NL" maxlength="50" title="Taal" class="required"></div>
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<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>
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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="Standaard" default="Standaard" maxlength="50" title="Categorie" class="required"></div>
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<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="Dataoplossingen voor groei en klantinzicht" default="Dataoplossingen voor groei en klantinzicht" 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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<div class="oneField field-container-D     wf-acl-hidden" id="tfa_65-D">
<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="Aanvragen segmentatiescan" default="Aanvragen segmentatiescan" title="Formulier_titel" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_63-D">
<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>
</div>
<div class="actions" id="4960048-A" data-contentid="submit_button"><input type="submit" data-label="Verzenden" class="primaryAction" id="submit_button" value="Verzenden"></div>
<div style="clear:both"></div>
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</form>
</div></div><div class="wFormFooter"><p class="supportInfo"><br></p></div>
  <p class="supportInfo" >
      </p>
 </div>

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