www.alfaromeo.be
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23.45.110.32
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Submitted URL: http://mails.gowienl.be/UWnBeHNTE33_Gp7OCL6w2UZA9ebMAnG-OXn50krhTgclLFRnWn4keK3IsjcfAnrkgi8ors7yIR9njlOvQMIV3-atQH4hLusY...
Effective URL: https://www.alfaromeo.be/nl/proefrit-offerte-brochure
Submission: On February 01 via api from BE — Scanned from FR
Effective URL: https://www.alfaromeo.be/nl/proefrit-offerte-brochure
Submission: On February 01 via api from BE — Scanned from FR
Form analysis 6 forms found in the DOM
<form role="form" class="formAnagrafic mui-form">
<div class="row">
<div class="col-xs-12">
<div class="new-form-radios brochure">
<div class="mui-radio mui-radio-inline" style="display:none">
<input id="bro-yes" type="radio" name="brochure" class="BROCHURETYPE required-field" value="GAB" data-required="" checked="checked" adobe-input="download-brochure">
<label for="bro-yes">#bro#</label>
</div>
<div class="mui-radio mui-radio-inline" style="display:none">
<input id="bro-no" type="radio" name="brochure" class="BROCHURETYPE required-field" value="PBR" data-required="" adobe-input="paper-brochure">
<label for="bro-no">#pbr#</label>
</div>
</div>
</div>
</div>
<h4 class="label_mittente" style="display:none">#label_mittente#</h4>
<div class="row">
<div class="col-xs-12 col-sm-6" data-div-name="TITLE_PERSON">
<div class="new-select-form required-field">
<select class="TITLE_PERSON" name="TITLE_PERSON" data-required="">
<option value=""></option>
<option value="Dhr.">Dhr.</option>
<option value="Mevr.">Mevr.</option>
</select>
<label>Aanspreektitel*</label>
<div class="error-label">Required field</div>
<div class="dropdownSelect" data-name="TITLE_PERSON"></div>
<div class="list">
<div data-value=""></div>
<div data-value="Dhr.">Dhr.</div>
<div data-value="Mevr.">Mevr.</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6" data-div-name="nome" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="nome" adobe-input="name" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>Voornaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="cognome" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="cognome" adobe-input="surname" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>Achternaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="SECOND_SURNAME" style="display: none;">
<div class="mui-textfield mui-textfield--float-label field">
<input id="" class="SECOND_SURNAME mui--is-empty mui--is-untouched mui--is-pristine" type="text" name="secondsurname" adobe-input="second-surname">
<label>Second Surname</label>
<div class="error-label">Required field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="COMPANY" style="display:none">
<div class="mui-textfield mui-textfield--float-label field">
<input type="text" class="COMPANY mui--is-empty mui--is-untouched mui--is-pristine" data-required="" name="company" adobe-input="company-name">
<label>Bedrijfsnaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<!--<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label ">
<input id="" type="" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Second Surname<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required field</div>
</div>
</div>
</div>-->
<div class="col-xs-12 col-sm-6" data-div-name="email" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input id="gaq-email-field" type="text" data-required="" name="Email" adobe-input="email" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>E-mail*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<!-- start CR CAR CONFIGURATOR-->
<h4 class="label_destinatario" style="display:none">#label_destinatario#</h4>
<div class="col-xs-12 col-sm-6" data-div-name="NOME_DESTINATARIO" style="display:none; clear:both">
<div class="mui-textfield mui-textfield--float-label">
<input id="" class="NOME_DESTINATARIO mui--is-empty mui--is-untouched mui--is-pristine" data-required="" type="text" name="nome_destinatario" adobe-input="nome_dest">
<label>Voornaam*</label>
<div class="error-label">Required field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="EMAIL_DESTINATARIO" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input id="gaq-email-field" type="text" data-required="" name="email_destinatario" adobe-input="email_dest" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label><sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<!-- end CR CAR CONFIGURATOR-->
<div class="col-xs-12 col-sm-6" data-div-name="cellulare" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="tel" data-required="" name="cellulare" adobe-input="mobile" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>GSM*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="address" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="address" class="address_autocomplete form-control placeholder mui--is-empty mui--is-untouched mui--is-pristine" placeholder="" adobe-input="address">
<label>Vul uw postcode of volledig adres in*</label>
<div class="error-label autocomplete-error"></div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input type="text" data-required="" name="address_" placeholder="" adobe-input="post-code-address-city" class="placeholder mui--is-empty mui--is-untouched mui--is-pristine">
<label>Enter Your Post Code*<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="formAddress_" adobe-input="smart-address:address" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>formAddress<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="city_" adobe-input="smart-address:city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>city<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="cap_" adobe-input="smart-address:post-code" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>cap<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="COMMUNICATIONCHANNEL" style="">
<div class="new-select-form field success selected">
<select class="select-standard COMMUNICATIONCHANNEL select" name="COMMUNICATIONCHANNEL">
<option value=""></option>
<option value="T">Mobile</option>
<option value="V">Virtuele afspraak</option>
</select>
<label>Hoe mogen we contact met u opnemen?</label>
<div class="error-label"></div>
<div class="dropdownSelect" data-name="COMMUNICATIONCHANNEL">Mobile</div>
<div class="list" style="display: none;">
<div data-value=""></div>
<div data-value="T" class="selected">Mobile</div>
<div data-value="V">Virtuele afspraak</div>
</div>
</div>
<div href="#" class="js-modal-open" rel="">
<div class="channel fa fa-info-circle ico-richiesta_info" style="height: 0px; display: block;"></div>
<div class="channel-info" style="display: none;">Wanneer u voor 'virtuele afspraak' kiest, zal u telefonisch worden gecontacteerd om een virtuele afspraak vast te leggen via Google Meet, de videoconferentiedienst van Google. Op de dag en het
uur van uw afspraak klikt u op de link die u van uw verdeler ondertussen gekregen zal hebben en… klaar! U bent dan meteen via video/audioconferentie verbonden met uw verdeler.</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="APPOINTMENTNOTES" style="display:none">
<div class="new-select-form field">
<select class="APPOINTMENTNOTES" name="APPOINTMENTNOTES" data-required="">
<option value="">
</option>
<option value="8">08:00 - 10:00</option>
<option value="10">10:00 - 12:00</option>
<option value="12">12:00 - 14:00</option>
<option value="14">14:00 - 16:00</option>
<option value="16">16:00 - 18:00</option>
<option value="18">18:00 - 20:00</option>
</select>
<label>Voorkeur voor afspraak</label>
<div class="error-label">Required field</div>
<div class="dropdownSelect" data-name="APPOINTMENTNOTES"></div>
<div class="list">
<div data-value=""></div>
<div data-value="8">08:00 - 10:00</div>
<div data-value="10">10:00 - 12:00</div>
<div data-value="12">12:00 - 14:00</div>
<div data-value="14">14:00 - 16:00</div>
<div data-value="16">16:00 - 18:00</div>
<div data-value="18">18:00 - 20:00</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="formAddress" adobe-input="post-code-address-city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Adres</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="city" adobe-input="city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Plaats*</label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="cap" class="mui--is-empty mui--is-untouched mui--is-pristine" adobe-input="post-code">
<label>Postcode*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="state_prov" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>state_prov<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 piva" data-div-name="PIVA_FLAGS" style="">
<div class="new-form-radios-label"> Bent u van plan om deze wagen te kopen als bedrijfswagen? </div>
<div class="new-form-radios">
<div class="mui-radio mui-radio-inline field">
<input class="PIVA_FLAGS" id="piva-yes-td" type="radio" name="flagpiva" value="Y" data-required="" adobe-input="vat-owner-yes">
<label for="piva-yes-td">Ja</label>
</div>
<div class="mui-radio mui-radio-inline field">
<input class="PIVA_FLAGS" id="piva-no-td" type="radio" name="flagpiva" value="N" data-required="" adobe-input="vat-owner-no">
<label for="piva-no-td">Nee</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="PIVA_VALUE" style="display:none">
<div class="mui-textfield mui-textfield--float-label field">
<input type="text" class="PIVA_VALUE mui--is-empty mui--is-untouched mui--is-pristine" data-required="" name="PIVA_VALUE" adobe-input="vat-number">
<label>Vat Number</label>
<div class="error-label">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12" data-div-name="FLEET_SIZE" style="display:none">
<div class="new-form-radios fleet">
<p class="radio-desc"> Wat is de grootte van het wagenpark in uw bedrijf*:</p>
<div class="form-radios-group form-radios-group-blocks">
<div class="mui-radio field">
<input class="FLEET_SIZE" id="#fleetsize1#" type="radio" value="1-19" name="flagFleetSize" adobe-input="">
<label for="#fleetsize1-lbl#">1-19</label>
</div>
<div class="mui-radio field">
<input class="FLEET_SIZE " id="#fleetsize2#" type="radio" value="20-99" name="flagFleetSize" adobe-input="">
<label for="#fleetsize2-lbl#">20-99</label>
</div>
<div class="mui-radio field">
<input class="FLEET_SIZE treshold" id="#fleetsize3#" type="radio" value="100+" name="flagFleetSize" adobe-input="">
<label for="#fleetsize3-lbl#">100+</label>
</div>
</div>
</div>
</div>
</div>
<!--<div class="row">
<div class="col-xs-12 piva">
<div class="form-testdrive-radios-label">
#QuestionLabel#
</div>
<div class="form-testdrive-radios">
<div class="mui-radio mui-radio-inline">
<input class="PIVAINFORMATION" id="piva-yes-td" type="radio" name="flagpiva" value="Y" data-required="">
<label for="piva-yes-td">#YesLabel#</label>
</div>
<div class="mui-radio mui-radio-inline">
<input class="PIVAINFORMATION" id="piva-no-td" type="radio" name="flagpiva" value="N" data-required="">
<label for="piva-no-td">#NoLabel#</label>
</div>
</div>
</div>
</div>-->
<div class="row">
<div class="col-xs-12 col-sm-6">
<span class="form-testdrive-mandatory-label text_below_button"> * Verplicht veld</span>
</div>
</div>
<div class="section-privacy informative">
<div class="row">
<div class="col-xs-12">
<div class="new-form-text">
<div class="new-form-text-title">TOESTEMMING</div>
<div class="new-form-text-content"> Na de <div class="new-form-linktext" style="display:inline;"><a href="javascript:void(0)" class="js-privacy-infotoggle-form"><ins>privacy kennisgeving*</ins> </a> te hebben gelezen</div>
<div class="form-radios-group-infos-form informativeBox" style="display: none;">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span></span>
</a> -->
<div class="form-radios-group-infos-content">
<div class="privacyMask"></div>
<iframe src="https://staticpromo.fiat.com/privacy/BE/informative-be_nl.html?brand=jeep" style="width: 100%;height:155px"></iframe>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="marketing-yes-td" class="MARKETING_MAIL1" type="radio" name="isPrivacyMarketing" value="Y" data-required="" adobe-input="marketing-yes">
<label for="marketing-yes-td">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="marketing-no-td" class="MARKETING_MAIL1" type="radio" name="isPrivacyMarketing" value="N" data-required="" adobe-input="marketing-no">
<label class="large" for="marketing-no-td">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">om marketing communicatie te krijgen</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_8">Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A voor marketing doeleinden zoals uiteengezet in punt c) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder
via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps).</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="profilazione-yes-td" class="PRIVACYPROFILATION" type="radio" name="isPrivacyProfilation" value="Y" data-required="" adobe-input="profilation-yes">
<label for="profilazione-yes-td">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="profilazione-no-td" class="PRIVACYPROFILATION" type="radio" name="isPrivacyProfilation" value="N" data-required="" adobe-input="profilation-no">
<label for="profilazione-no-td">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">dat mijn gegevens voor profilering gebruikt worden</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_12">Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A om mijn voorkeuren te analyseren en aangepaste commerciële communicatie te ontvangen zoals uiteengezet in punt d) van de privacy kennisgeving.
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="terzi-yes-td" class="PRIVACYTHIRDPARTY" type="radio" name="isPrivacyThirdPart" value="Y" data-required="" adobe-input="third-party-yes">
<label for="terzi-yes-td">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="terzi-no-td" class="PRIVACYTHIRDPARTY" type="radio" name="isPrivacyThirdPart" value="N" data-required="" adobe-input="third-party-no">
<label for="terzi-no-td">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">dat mijn gegevens aan derden voor hun eigen marketing communicatie meegedeeld worden</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_16">Voor het communiceren van mijn persoonsgegevens aan dochterondernemingen en gelieerde ondernemingen van FCA Italy S.p.A evenals hun partners in de automobiel-, financiële, verzekerings- en telecommunicatiesector,
die deze zullen verwerken voor de marketing doeleinden uiteengezet in punt e) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde
telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps).</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12">
<div class="new-form-submit submit">
<button type="button" data-type="anagraphic-btn" class="rect-btn rect-btn-yellow submit-btn-td" data-adobe="cta:click-submit"> VERDER <span class="new-icon-alfa-romeo_arrow_cta"></span>
</button>
</div>
</div>
</div>
<section-fields>
<input type="hidden" id="owned_brand" name="owned_brand" value="">
<input type="hidden" id="owned_model" name="owned_model" value="">
<input type="hidden" id="id_timestamp" name="ID_TIMESTAMP" value="">
<input type="hidden" id="field10" name="RedirectLink" value="">
<input type="hidden" id="field11" name="Country" value="be">
<input type="hidden" id="field12" name="Language" value="nl">
<input type="hidden" id="field13" name="Brand" value="alfa-romeo">
<input type="hidden" id="field14" name="SpecifyPrivacy" value="">
<input type="hidden" id="field15" name="LEADSOURCECODE" value="MAT">
<input type="hidden" id="" name="EXTENDEDPRIVACYALL" value="">
<input type="hidden" id="field17" name="Market" value="be">
<input type="hidden" id="field18" name="MODELDESCRIPTION" value="">
<input type="hidden" id="field19" name="MODELCOMMERCIALCODE" value="">
<input type="hidden" id="field20" name="REQUESTDATE" value="">
<input type="hidden" id="field21" name="OFFER" value="">
<input type="hidden" id="field22" name="TYPE" value="TD">
<input type="hidden" id="field23" name="LEVEL1" value="web corporate">
<input type="hidden" id="field24" name="LEVEL2" value="alfa-romeo:be:contact">
<input type="hidden" id="field25" name="LEVEL3" value="lead:test-drive-request">
<input type="hidden" id="field26" name="LEVEL4" value="brand">
<input type="hidden" name="CAMPAIGN" value="83">
<input type="hidden" id="field28" name="USEDDEVICE" value="desktop">
<input type="hidden" id="field29" name="DISCLAIMER" value="722">
<input type="hidden" id="" name="PRIVACYPROFILATION" value="">
<input type="hidden" id="" name="PRIVACYTHIRDPARTY" value="">
<input type="hidden" id="" name="PRIVACYEXTRAEU" value="">
<input type="hidden" id="" name="PRIVACYGEOLOCATION" value="">
<input type="hidden" id="BASEURL" name="BASEURL" value="">
<input type="hidden" id="field46" name="IOPROD1">
<input type="hidden" id="field47" name="IOSCOR1">
<input type="hidden" id="field48" name="IOPROD2">
<input type="hidden" id="field49" name="IOSCOR2">
<input type="hidden" id="field50" name="IOPROD3">
<input type="hidden" id="field51" name="IOSCOR3">
<input type="hidden" id="field52" name="IOSCORGLOBAL">
<input type="hidden" id="field53" name="EXTERNID">
<input type="hidden" id="field54" name="BUSAREA" value="sales">
<input type="hidden" id="field55" name="SOURCEQUERYSTRING">
<input type="hidden" id="field57" name="REFERRER" value="">
<input type="hidden" id="field56" name="FULLQUERYSTRING" value="">
<input type="hidden" id="field59" name="publisher" value="">
<input type="hidden" id="" name="MARKETING_POST1" value="">
<input type="hidden" id="" name="MARKETING_MAIL1" value="">
<input type="hidden" id="" name="MARKETING_SMS1" value="">
<input type="hidden" id="" name="MARKETING_PHONE1" value="">
<input type="hidden" id="field62" name="LPID" value="33677">
<input id="field90" name="PIVAINFORMATION" type="hidden" value="">
<input id="field91" name="DTM_CTA" type="hidden" value="lead:test-drive-request">
<input id="field92" name="DTM_ENABLED" type="hidden" value="1">
<input id="field93" name="REQUESTORIGIN" type="hidden" value="">
<input id="field94" name="DTM_CAMPAIGN" type="hidden" value="">
<input id="field95" name="Fleet_Size" type="hidden" value="">
<input id="" name="MULTIREQUESTS" type="hidden" value="">
<input id="" name="VisitorID" type="hidden" value="">
<input type="hidden" name="gab_multiselected_models" class="gab_multiselected_models" value="">
<input id="" name="SConfigID" type="hidden" value="">
<input id="" name="PREVIOUS_URL" type="hidden" value="">
<input id="" name="DownloadModel1" type="hidden" value="">
<input id="field96" name="comment" type="hidden" value="">
<input id="" name="FUEL" type="hidden" value="">
<input id="" name="MODELCODE" type="hidden" value="">
<input id="" name="GEAR" type="hidden" value="">
<input id="" name="EQPM" type="hidden" value="">
<input id="" name="BODY" type="hidden" value="">
<input id="" name="DRVE" type="hidden" value="">
<input id="" name="SEAT" type="hidden" value="">
<input id="" name="ENGN" type="hidden" value="">
<input id="" name="WHEL" type="hidden" value="">
<input id="" name="CONFIGURATIONDESCRIPTION" type="hidden" value="">
<input id="" name="MODELNAME" type="hidden" value="">
<input id="" name="URLCARCONFIGURATOR" type="hidden" value="">
<input id="" name="CCURL" type="hidden" value="">
<input id="" name="CONFIGURATIONTYPE" type="hidden" value="">
<input id="" name="IMAGEPICKER" type="hidden" value="">
</section-fields>
</form>POST
<form method="post" id="form70" class="formDealer">
<input id="field0" type="hidden" value="" name="DEALERSINCOM">
<input id="" type="hidden" value="" name="DEALERSITECODE">
<input id="field2" type="hidden" value="" name="DEALERCITY">
<input id="field3" type="hidden" value="" name="DEALERADDRESS">
<input id="field4" type="hidden" value="" name="DEALERMKT">
<input id="field5" type="hidden" value="" name="DEALERPHONE">
<input id="field6" type="hidden" value="" name="DEALERMAIL">
<input id="field7" type="hidden" value="" name="DEALERPROVINCE">
<input id="field8" type="hidden" value="" name="DEALERZIPCODE">
<input id="field9" type="hidden" value="" name="NAME">
<input id="field22" type="hidden" value="TD" name="TYPE">
<input id="field43" type="hidden" value="" name="RedirectLink">
<input id="timestamp_DL" type="hidden" value="" name="id_timestamp">
<input type="hidden" id="field18" name="MODELDESCRIPTION" value="">
<input type="hidden" id="field19" name="MODELCOMMERCIALCODE" value="">
<input type="hidden" id="field62" name="LPID" value="33677">
</form><form role="form" class="formAnagrafic mui-form">
<div class="row">
<div class="col-xs-12">
<div class="new-form-radios brochure">
<div class="mui-radio mui-radio-inline" style="display:none">
<input id="bro-yes" type="radio" name="brochure" class="BROCHURETYPE required-field" value="GAB" data-required="" checked="checked" adobe-input="download-brochure">
<label for="bro-yes">#bro#</label>
</div>
<div class="mui-radio mui-radio-inline" style="display:none">
<input id="bro-no" type="radio" name="brochure" class="BROCHURETYPE required-field" value="PBR" data-required="" adobe-input="paper-brochure">
<label for="bro-no">#pbr#</label>
</div>
</div>
</div>
</div>
<h4 class="label_mittente" style="display:none">#label_mittente#</h4>
<div class="row">
<div class="col-xs-12 col-sm-6" data-div-name="TITLE_PERSON">
<div class="new-select-form required-field">
<select class="TITLE_PERSON" name="TITLE_PERSON" data-required="">
<option value=""></option>
<option value="Dhr.">Dhr.</option>
<option value="Mevr.">Mevr.</option>
</select>
<label>Aanspreektitel*</label>
<div class="error-label">Required field</div>
<div class="dropdownSelect" data-name="TITLE_PERSON"></div>
<div class="list">
<div data-value=""></div>
<div data-value="Dhr.">Dhr.</div>
<div data-value="Mevr.">Mevr.</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6" data-div-name="nome" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="nome" adobe-input="name" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>Voornaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="cognome" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="cognome" adobe-input="surname" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>Achternaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="SECOND_SURNAME" style="display: none;">
<div class="mui-textfield mui-textfield--float-label field">
<input id="" class="SECOND_SURNAME mui--is-empty mui--is-untouched mui--is-pristine" type="text" name="secondsurname" adobe-input="second-surname">
<label>Second Surname</label>
<div class="error-label">Required field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="COMPANY" style="display:none">
<div class="mui-textfield mui-textfield--float-label field">
<input type="text" class="COMPANY mui--is-empty mui--is-untouched mui--is-pristine" data-required="" name="company" adobe-input="company-name">
<label>Bedrijfsnaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<!--<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label ">
<input id="" type="" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Second Surname<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required field</div>
</div>
</div>
</div>-->
<div class="col-xs-12 col-sm-6" data-div-name="email" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input id="gaq-email-field" type="text" data-required="" name="Email" adobe-input="email" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>E-mail*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<!-- start CR CAR CONFIGURATOR-->
<h4 class="label_destinatario" style="display:none">#label_destinatario#</h4>
<div class="col-xs-12 col-sm-6" data-div-name="NOME_DESTINATARIO" style="display:none; clear:both">
<div class="mui-textfield mui-textfield--float-label">
<input id="" class="NOME_DESTINATARIO mui--is-empty mui--is-untouched mui--is-pristine" data-required="" type="text" name="nome_destinatario" adobe-input="nome_dest">
<label>Voornaam*</label>
<div class="error-label">Required field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="EMAIL_DESTINATARIO" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input id="gaq-email-field" type="text" data-required="" name="email_destinatario" adobe-input="email_dest" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label><sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<!-- end CR CAR CONFIGURATOR-->
<div class="col-xs-12 col-sm-6" data-div-name="cellulare" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="tel" data-required="" name="cellulare" adobe-input="mobile" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>GSM*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="address" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="address" class="address_autocomplete placeholder form-control mui--is-empty mui--is-untouched mui--is-pristine" placeholder="" adobe-input="address">
<label>Vul uw postcode of volledig adres in*</label>
<div class="error-label autocomplete-error"></div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input type="text" data-required="" name="address_" placeholder="" adobe-input="post-code-address-city" class="placeholder mui--is-empty mui--is-untouched mui--is-pristine">
<label>Enter Your Post Code*<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="formAddress_" adobe-input="smart-address:address" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>formAddress<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="city_" adobe-input="smart-address:city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>city<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="cap_" adobe-input="smart-address:post-code" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>cap<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="COMMUNICATIONCHANNEL" style="">
<div class="new-select-form field success selected">
<select class="select-standard COMMUNICATIONCHANNEL select" name="COMMUNICATIONCHANNEL">
<option value=""></option>
<option value="T">Mobile</option>
<option value="V">Virtuele afspraak</option>
</select>
<label>Hoe mogen we contact met u opnemen?</label>
<div class="error-label"></div>
<div class="dropdownSelect" data-name="COMMUNICATIONCHANNEL">Mobile</div>
<div class="list" style="display: none;">
<div data-value=""></div>
<div data-value="T" class="selected">Mobile</div>
<div data-value="V">Virtuele afspraak</div>
</div>
</div>
<div href="#" class="js-modal-open" rel="">
<div class="channel fa fa-info-circle ico-richiesta_info" style="height: 0px; display: block;"></div>
<div class="channel-info" style="display: none;">Wanneer u voor 'virtuele afspraak' kiest, zal u telefonisch worden gecontacteerd om een virtuele afspraak vast te leggen via Google Meet, de videoconferentiedienst van Google. Op de dag en het
uur van uw afspraak klikt u op de link die u van uw verdeler ondertussen gekregen zal hebben en… klaar! U bent dan meteen via video/audioconferentie verbonden met uw verdeler.</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="APPOINTMENTNOTES" style="display:none">
<div class="new-select-form field">
<select class="APPOINTMENTNOTES" name="APPOINTMENTNOTES" data-required="">
<option value="">
</option>
<option value="8">08:00 - 10:00</option>
<option value="10">10:00 - 12:00</option>
<option value="12">12:00 - 14:00</option>
<option value="14">14:00 - 16:00</option>
<option value="16">16:00 - 18:00</option>
<option value="18">18:00 - 20:00</option>
</select>
<label>Voorkeur voor afspraak</label>
<div class="error-label">Required field</div>
<div class="dropdownSelect" data-name="APPOINTMENTNOTES"></div>
<div class="list">
<div data-value=""></div>
<div data-value="8">08:00 - 10:00</div>
<div data-value="10">10:00 - 12:00</div>
<div data-value="12">12:00 - 14:00</div>
<div data-value="14">14:00 - 16:00</div>
<div data-value="16">16:00 - 18:00</div>
<div data-value="18">18:00 - 20:00</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="formAddress" adobe-input="post-code-address-city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Adres</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="city" adobe-input="city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Plaats*</label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="cap" class="mui--is-empty mui--is-untouched mui--is-pristine" adobe-input="post-code">
<label>Postcode*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="state_prov" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>state_prov<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 piva" data-div-name="PIVA_FLAGS" style="">
<div class="new-form-radios-label"> Bent u van plan om deze wagen te kopen als bedrijfswagen? </div>
<div class="new-form-radios">
<div class="mui-radio mui-radio-inline field">
<input class="PIVA_FLAGS" id="piva-yes-gaq" type="radio" name="flagpiva" value="Y" data-required="" adobe-input="vat-owner-yes">
<label for="piva-yes-gaq">Ja</label>
</div>
<div class="mui-radio mui-radio-inline field">
<input class="PIVA_FLAGS" id="piva-no-gaq" type="radio" name="flagpiva" value="N" data-required="" adobe-input="vat-owner-no">
<label for="piva-no-gaq">Nee</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="PIVA_VALUE" style="display:none">
<div class="mui-textfield mui-textfield--float-label field">
<input type="text" class="PIVA_VALUE mui--is-empty mui--is-untouched mui--is-pristine" data-required="" name="PIVA_VALUE" adobe-input="vat-number">
<label>Vat Number</label>
<div class="error-label">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12" data-div-name="FLEET_SIZE" style="display:none">
<div class="new-form-radios fleet">
<p class="radio-desc"> Wat is de grootte van het wagenpark in uw bedrijf*:</p>
<div class="form-radios-group form-radios-group-blocks">
<div class="mui-radio field">
<input class="FLEET_SIZE" id="#fleetsize1#" type="radio" value="1-19" name="flagFleetSize" adobe-input="">
<label for="#fleetsize1-lbl#">1-19</label>
</div>
<div class="mui-radio field">
<input class="FLEET_SIZE " id="#fleetsize2#" type="radio" value="20-99" name="flagFleetSize" adobe-input="">
<label for="#fleetsize2-lbl#">20-99</label>
</div>
<div class="mui-radio field">
<input class="FLEET_SIZE treshold" id="#fleetsize3#" type="radio" value="100+" name="flagFleetSize" adobe-input="">
<label for="#fleetsize3-lbl#">100+</label>
</div>
</div>
</div>
</div>
</div>
<!--<div class="row">
<div class="col-xs-12 piva">
<div class="form-testdrive-radios-label">
#QuestionLabel#
</div>
<div class="form-testdrive-radios">
<div class="mui-radio mui-radio-inline">
<input class="PIVAINFORMATION" id="piva-yes-td" type="radio" name="flagpiva" value="Y" data-required="">
<label for="piva-yes-td">#YesLabel#</label>
</div>
<div class="mui-radio mui-radio-inline">
<input class="PIVAINFORMATION" id="piva-no-td" type="radio" name="flagpiva" value="N" data-required="">
<label for="piva-no-td">#NoLabel#</label>
</div>
</div>
</div>
</div>-->
<div class="row">
<div class="col-xs-12 col-sm-6">
<span class="form-testdrive-mandatory-label text_below_button"> * Verplicht veld</span>
</div>
</div>
<div class="section-privacy informative">
<div class="row">
<div class="col-xs-12">
<div class="new-form-text">
<div class="new-form-text-title">TOESTEMMING</div>
<div class="new-form-text-content"> Na de <div class="new-form-linktext" style="display:inline;"><a href="javascript:void(0)" class="js-privacy-infotoggle-form"><ins>privacy kennisgeving*</ins> </a> te hebben gelezen</div>
<div class="form-radios-group-infos-form informativeBox" style="display: none;">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span></span>
</a> -->
<div class="form-radios-group-infos-content">
<div class="privacyMask"></div>
<iframe src="https://staticpromo.fiat.com/privacy/BE/informative-be_nl.html?brand=jeep" style="width: 100%;height:155px"></iframe>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="marketing-yes-gaq" class="MARKETING_MAIL1" type="radio" name="isPrivacyMarketing" value="Y" data-required="" adobe-input="marketing-yes">
<label for="marketing-yes-gaq">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="marketing-no-gaq" class="MARKETING_MAIL1" type="radio" name="isPrivacyMarketing" value="N" data-required="" adobe-input="marketing-no">
<label class="large" for="marketing-no-gaq">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">om marketing communicatie te krijgen</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_8">Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A voor marketing doeleinden zoals uiteengezet in punt c) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder
via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps).</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="profilazione-yes-gaq" class="PRIVACYPROFILATION" type="radio" name="isPrivacyProfilation" value="Y" data-required="" adobe-input="profilation-yes">
<label for="profilazione-yes-gaq">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="profilazione-no-gaq" class="PRIVACYPROFILATION" type="radio" name="isPrivacyProfilation" value="N" data-required="" adobe-input="profilation-no">
<label for="profilazione-no-gaq">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">dat mijn gegevens voor profilering gebruikt worden</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_12">Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A om mijn voorkeuren te analyseren en aangepaste commerciële communicatie te ontvangen zoals uiteengezet in punt d) van de privacy kennisgeving.
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="terzi-yes-gaq" class="PRIVACYTHIRDPARTY" type="radio" name="isPrivacyThirdPart" value="Y" data-required="" adobe-input="third-party-yes">
<label for="terzi-yes-gaq">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="terzi-no-gaq" class="PRIVACYTHIRDPARTY" type="radio" name="isPrivacyThirdPart" value="N" data-required="" adobe-input="third-party-no">
<label for="terzi-no-gaq">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">dat mijn gegevens aan derden voor hun eigen marketing communicatie meegedeeld worden</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_16">Voor het communiceren van mijn persoonsgegevens aan dochterondernemingen en gelieerde ondernemingen van FCA Italy S.p.A evenals hun partners in de automobiel-, financiële, verzekerings- en telecommunicatiesector,
die deze zullen verwerken voor de marketing doeleinden uiteengezet in punt e) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde
telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps).</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12">
<div class="new-form-submit submit">
<button type="button" data-type="anagraphic-btn" class="rect-btn rect-btn-yellow submit-btn-gaq" data-adobe="cta:click-submit"> VERDER <span class="new-icon-alfa-romeo_arrow_cta"></span>
</button>
</div>
</div>
</div>
<section-fields>
<input type="hidden" id="owned_brand" name="owned_brand" value="">
<input type="hidden" id="owned_model" name="owned_model" value="">
<input type="hidden" id="id_timestamp" name="ID_TIMESTAMP" value="">
<input type="hidden" id="field10" name="RedirectLink" value="">
<input type="hidden" id="field11" name="Country" value="be">
<input type="hidden" id="field12" name="Language" value="nl">
<input type="hidden" id="field13" name="Brand" value="alfa-romeo">
<input type="hidden" id="field14" name="SpecifyPrivacy" value="">
<input type="hidden" id="field15" name="LEADSOURCECODE" value="MAT">
<input type="hidden" id="" name="EXTENDEDPRIVACYALL" value="">
<input type="hidden" id="field17" name="Market" value="be">
<input type="hidden" id="field18" name="MODELDESCRIPTION" value="">
<input type="hidden" id="field19" name="MODELCOMMERCIALCODE" value="">
<input type="hidden" id="field20" name="REQUESTDATE" value="">
<input type="hidden" id="field21" name="OFFER" value="">
<input type="hidden" id="field22" name="TYPE" value="GAQ">
<input type="hidden" id="field23" name="LEVEL1" value="web corporate">
<input type="hidden" id="field24" name="LEVEL2" value="alfa-romeo:be:contact">
<input type="hidden" id="field25" name="LEVEL3" value="lead:test-drive-request">
<input type="hidden" id="field26" name="LEVEL4" value="brand">
<input type="hidden" name="CAMPAIGN" value="83">
<input type="hidden" id="field28" name="USEDDEVICE" value="desktop">
<input type="hidden" id="field29" name="DISCLAIMER" value="722">
<input type="hidden" id="" name="PRIVACYPROFILATION" value="">
<input type="hidden" id="" name="PRIVACYTHIRDPARTY" value="">
<input type="hidden" id="" name="PRIVACYEXTRAEU" value="">
<input type="hidden" id="" name="PRIVACYGEOLOCATION" value="">
<input type="hidden" id="BASEURL" name="BASEURL" value="">
<input type="hidden" id="field46" name="IOPROD1">
<input type="hidden" id="field47" name="IOSCOR1">
<input type="hidden" id="field48" name="IOPROD2">
<input type="hidden" id="field49" name="IOSCOR2">
<input type="hidden" id="field50" name="IOPROD3">
<input type="hidden" id="field51" name="IOSCOR3">
<input type="hidden" id="field52" name="IOSCORGLOBAL">
<input type="hidden" id="field53" name="EXTERNID">
<input type="hidden" id="field54" name="BUSAREA" value="sales">
<input type="hidden" id="field55" name="SOURCEQUERYSTRING">
<input type="hidden" id="field57" name="REFERRER" value="">
<input type="hidden" id="field56" name="FULLQUERYSTRING" value="">
<input type="hidden" id="field59" name="publisher" value="">
<input type="hidden" id="" name="MARKETING_POST1" value="">
<input type="hidden" id="" name="MARKETING_MAIL1" value="">
<input type="hidden" id="" name="MARKETING_SMS1" value="">
<input type="hidden" id="" name="MARKETING_PHONE1" value="">
<input type="hidden" id="field62" name="LPID" value="33677">
<input id="field90" name="PIVAINFORMATION" type="hidden" value="">
<input id="field91" name="DTM_CTA" type="hidden" value="lead:test-drive-request">
<input id="field92" name="DTM_ENABLED" type="hidden" value="1">
<input id="field93" name="REQUESTORIGIN" type="hidden" value="">
<input id="field94" name="DTM_CAMPAIGN" type="hidden" value="">
<input id="field95" name="Fleet_Size" type="hidden" value="">
<input id="" name="MULTIREQUESTS" type="hidden" value="">
<input id="" name="VisitorID" type="hidden" value="">
<input type="hidden" name="gab_multiselected_models" class="gab_multiselected_models" value="">
<input id="" name="SConfigID" type="hidden" value="">
<input id="" name="PREVIOUS_URL" type="hidden" value="">
<input id="" name="DownloadModel1" type="hidden" value="">
<input id="field96" name="comment" type="hidden" value="">
<input id="" name="FUEL" type="hidden" value="">
<input id="" name="MODELCODE" type="hidden" value="">
<input id="" name="GEAR" type="hidden" value="">
<input id="" name="EQPM" type="hidden" value="">
<input id="" name="BODY" type="hidden" value="">
<input id="" name="DRVE" type="hidden" value="">
<input id="" name="SEAT" type="hidden" value="">
<input id="" name="ENGN" type="hidden" value="">
<input id="" name="WHEL" type="hidden" value="">
<input id="" name="CONFIGURATIONDESCRIPTION" type="hidden" value="">
<input id="" name="MODELNAME" type="hidden" value="">
<input id="" name="URLCARCONFIGURATOR" type="hidden" value="">
<input id="" name="CCURL" type="hidden" value="">
<input id="" name="CONFIGURATIONTYPE" type="hidden" value="">
<input id="" name="IMAGEPICKER" type="hidden" value="">
</section-fields>
</form>POST
<form method="post" id="form70" class="formDealer">
<input id="field0" type="hidden" value="" name="DEALERSINCOM">
<input id="" type="hidden" value="" name="DEALERSITECODE">
<input id="field2" type="hidden" value="" name="DEALERCITY">
<input id="field3" type="hidden" value="" name="DEALERADDRESS">
<input id="field4" type="hidden" value="" name="DEALERMKT">
<input id="field5" type="hidden" value="" name="DEALERPHONE">
<input id="field6" type="hidden" value="" name="DEALERMAIL">
<input id="field7" type="hidden" value="" name="DEALERPROVINCE">
<input id="field8" type="hidden" value="" name="DEALERZIPCODE">
<input id="field9" type="hidden" value="" name="NAME">
<input id="field22" type="hidden" value="GAQ" name="TYPE">
<input id="field43" type="hidden" value="" name="RedirectLink">
<input id="timestamp_DL" type="hidden" value="" name="id_timestamp">
<input type="hidden" id="field18" name="MODELDESCRIPTION" value="">
<input type="hidden" id="field19" name="MODELCOMMERCIALCODE" value="">
<input type="hidden" id="field62" name="LPID" value="33677">
</form>POST
<form method="post" id="form70" class="formDealer">
<input id="field0" type="hidden" value="" name="DEALERSINCOM">
<input id="" type="hidden" value="" name="DEALERSITECODE">
<input id="field2" type="hidden" value="" name="DEALERCITY">
<input id="field3" type="hidden" value="" name="DEALERADDRESS">
<input id="field4" type="hidden" value="" name="DEALERMKT">
<input id="field5" type="hidden" value="" name="DEALERPHONE">
<input id="field6" type="hidden" value="" name="DEALERMAIL">
<input id="field7" type="hidden" value="" name="DEALERPROVINCE">
<input id="field8" type="hidden" value="" name="DEALERZIPCODE">
<input id="field9" type="hidden" value="" name="NAME">
<input id="field22" type="hidden" value="GAB" name="TYPE">
<input id="field43" type="hidden" value="" name="RedirectLink">
<input id="timestamp_DL" type="hidden" value="" name="id_timestamp">
<input type="hidden" id="field18" name="MODELDESCRIPTION" value="">
<input type="hidden" id="field19" name="MODELCOMMERCIALCODE" value="">
<input type="hidden" id="field62" name="LPID" value="33677">
</form><form role="form" class="formAnagrafic mui-form">
<div class="row">
<div class="col-xs-12">
<div class="new-form-radios brochure">
<div class="mui-radio mui-radio-inline" style="display:none">
<input id="bro-yes" type="radio" name="brochure" class="BROCHURETYPE required-field" value="GAB" data-required="" checked="checked" adobe-input="download-brochure">
<label for="bro-yes">#bro#</label>
</div>
<div class="mui-radio mui-radio-inline" style="display:none">
<input id="bro-no" type="radio" name="brochure" class="BROCHURETYPE required-field" value="PBR" data-required="" adobe-input="paper-brochure">
<label for="bro-no">#pbr#</label>
</div>
</div>
</div>
</div>
<h4 class="label_mittente" style="display:none">#label_mittente#</h4>
<div class="row">
<div class="col-xs-12 col-sm-6" data-div-name="TITLE_PERSON">
<div class="new-select-form required-field">
<select class="TITLE_PERSON" name="TITLE_PERSON" data-required="">
<option value=""></option>
<option value="Dhr.">Dhr.</option>
<option value="Mevr.">Mevr.</option>
</select>
<label>Aanspreektitel*</label>
<div class="error-label">Required field</div>
<div class="dropdownSelect" data-name="TITLE_PERSON"></div>
<div class="list">
<div data-value=""></div>
<div data-value="Dhr.">Dhr.</div>
<div data-value="Mevr.">Mevr.</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6" data-div-name="nome" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="nome" adobe-input="name" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>Voornaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="cognome" style="display: block;">
<div class="mui-textfield mui-textfield--float-label required-field">
<input type="text" data-required="" name="cognome" adobe-input="surname" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>Achternaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="SECOND_SURNAME" style="display: none;">
<div class="mui-textfield mui-textfield--float-label field">
<input id="" class="SECOND_SURNAME mui--is-empty mui--is-untouched mui--is-pristine" type="text" name="secondsurname" adobe-input="second-surname">
<label>Second Surname</label>
<div class="error-label">Required field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="COMPANY" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input type="text" class="COMPANY mui--is-empty mui--is-untouched mui--is-pristine" data-required="" name="company" adobe-input="company-name">
<label>Bedrijfsnaam*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<!--<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label ">
<input id="" type="" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Second Surname<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required field</div>
</div>
</div>
</div>-->
<div class="col-xs-12 col-sm-6" data-div-name="email">
<div class="mui-textfield mui-textfield--float-label required-field">
<input id="gaq-email-field" type="text" data-required="" name="Email" adobe-input="email" class="form-control mui--is-empty mui--is-untouched mui--is-pristine">
<label>E-mail*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<!-- start CR CAR CONFIGURATOR-->
<h4 class="label_destinatario" style="display:none">#label_destinatario#</h4>
<div class="col-xs-12 col-sm-6" data-div-name="NOME_DESTINATARIO" style="display:none; clear:both">
<div class="mui-textfield mui-textfield--float-label">
<input id="" class="NOME_DESTINATARIO mui--is-empty mui--is-untouched mui--is-pristine" data-required="" type="text" name="nome_destinatario" adobe-input="nome_dest">
<label>Voornaam*</label>
<div class="error-label">Required field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="EMAIL_DESTINATARIO" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input id="gaq-email-field" type="text" data-required="" name="email_destinatario" adobe-input="email_dest" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label><sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<!-- end CR CAR CONFIGURATOR-->
<div class="col-xs-12 col-sm-6" data-div-name="cellulare" style="display: none;">
<div class="mui-textfield mui-textfield--float-label">
<input type="tel" data-required="" name="cellulare" adobe-input="mobile" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>GSM*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="address" style="display: none;">
<div class="mui-textfield mui-textfield--float-label">
<input type="text" data-required="" name="address" class="address_autocomplete placeholder form-control mui--is-empty mui--is-untouched mui--is-pristine" placeholder="" adobe-input="address">
<label>Vul uw postcode of volledig adres in*</label>
<div class="error-label autocomplete-error"></div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input type="text" data-required="" name="address_" placeholder="" adobe-input="post-code-address-city" class="placeholder mui--is-empty mui--is-untouched mui--is-pristine">
<label>Enter Your Post Code*<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="formAddress_" adobe-input="smart-address:address" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>formAddress<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="city_" adobe-input="smart-address:city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>city<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="smart_address" style="display:none">
<div class="mui-textfield mui-textfield--float-label ">
<input type="text" readonly="" name="cap_" adobe-input="smart-address:post-code" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>cap<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="COMMUNICATIONCHANNEL" style="display:none">
<div class="new-select-form ">
<select class="select-standard COMMUNICATIONCHANNEL select" name="COMMUNICATIONCHANNEL">
</select>
<label>Hoe mogen we contact met u opnemen?</label>
<div class="error-label"></div>
<div class="dropdownSelect" data-name="COMMUNICATIONCHANNEL"></div>
<div class="list"></div>
</div>
<div href="#" class="js-modal-open" rel="">
<div class="channel fa fa-info-circle ico-richiesta_info" style="height: 0px;display: none;"></div>
<div class="channel-info" style="display: none;"> Lorem ipsum </div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="APPOINTMENTNOTES" style="display:none">
<div class="new-select-form ">
<select class="APPOINTMENTNOTES" name="APPOINTMENTNOTES" data-required="">
<option value="">
</option>
<option value="8">08:00 - 10:00</option>
<option value="10">10:00 - 12:00</option>
<option value="12">12:00 - 14:00</option>
<option value="14">14:00 - 16:00</option>
<option value="16">16:00 - 18:00</option>
<option value="18">18:00 - 20:00</option>
</select>
<label>Voorkeur voor afspraak</label>
<div class="error-label">Required field</div>
<div class="dropdownSelect" data-name="APPOINTMENTNOTES"></div>
<div class="list">
<div data-value=""></div>
<div data-value="8">08:00 - 10:00</div>
<div data-value="10">10:00 - 12:00</div>
<div data-value="12">12:00 - 14:00</div>
<div data-value="14">14:00 - 16:00</div>
<div data-value="16">16:00 - 18:00</div>
<div data-value="18">18:00 - 20:00</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="formAddress" adobe-input="post-code-address-city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Adres</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="city" adobe-input="city" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>Plaats*</label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="cap" class="mui--is-empty mui--is-untouched mui--is-pristine" adobe-input="post-code">
<label>Postcode*</label>
<div class="error-label">Required Field</div>
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="mui-textfield mui-textfield--float-label hidden">
<input type="text" data-required="" name="state_prov" class="mui--is-empty mui--is-untouched mui--is-pristine">
<label>state_prov<sup class="required">*<span class="required-double">*</span></sup></label>
<div class="error-label autocomplete-error">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 piva" data-div-name="PIVA_FLAGS" style="display:none">
<div class="new-form-radios-label"> Bent u van plan om deze wagen te kopen als bedrijfswagen? </div>
<div class="new-form-radios">
<div class="mui-radio mui-radio-inline">
<input class="PIVA_FLAGS" id="piva-yes-gab" type="radio" name="flagpiva" value="Y" data-required="" adobe-input="vat-owner-yes">
<label for="piva-yes-gab">Ja</label>
</div>
<div class="mui-radio mui-radio-inline">
<input class="PIVA_FLAGS" id="piva-no-gab" type="radio" name="flagpiva" value="N" data-required="" adobe-input="vat-owner-no">
<label for="piva-no-gab">Nee</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-6" data-div-name="PIVA_VALUE" style="display:none">
<div class="mui-textfield mui-textfield--float-label">
<input type="text" class="PIVA_VALUE mui--is-empty mui--is-untouched mui--is-pristine" data-required="" name="PIVA_VALUE" adobe-input="vat-number">
<label>Vat Number</label>
<div class="error-label">Required Field</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12" data-div-name="FLEET_SIZE" style="display:none">
<div class="new-form-radios fleet">
<p class="radio-desc"> Wat is de grootte van het wagenpark in uw bedrijf*:</p>
<div class="form-radios-group form-radios-group-blocks">
<div class="mui-radio">
<input class="FLEET_SIZE" id="#fleetsize1#" type="radio" value="1-19" name="flagFleetSize" adobe-input="">
<label for="#fleetsize1-lbl#">1-19</label>
</div>
<div class="mui-radio">
<input class="FLEET_SIZE " id="#fleetsize2#" type="radio" value="20-99" name="flagFleetSize" adobe-input="">
<label for="#fleetsize2-lbl#">20-99</label>
</div>
<div class="mui-radio">
<input class="FLEET_SIZE treshold" id="#fleetsize3#" type="radio" value="100+" name="flagFleetSize" adobe-input="">
<label for="#fleetsize3-lbl#">100+</label>
</div>
</div>
</div>
</div>
</div>
<!--<div class="row">
<div class="col-xs-12 piva">
<div class="form-testdrive-radios-label">
#QuestionLabel#
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<div class="form-testdrive-radios">
<div class="mui-radio mui-radio-inline">
<input class="PIVAINFORMATION" id="piva-yes-td" type="radio" name="flagpiva" value="Y" data-required="">
<label for="piva-yes-td">#YesLabel#</label>
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<div class="mui-radio mui-radio-inline">
<input class="PIVAINFORMATION" id="piva-no-td" type="radio" name="flagpiva" value="N" data-required="">
<label for="piva-no-td">#NoLabel#</label>
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</div>
</div>
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<div class="row">
<div class="col-xs-12 col-sm-6">
<span class="form-testdrive-mandatory-label text_below_button"> * Verplicht veld</span>
</div>
</div>
<div class="section-privacy informative">
<div class="row">
<div class="col-xs-12">
<div class="new-form-text">
<div class="new-form-text-title">TOESTEMMING</div>
<div class="new-form-text-content"> Na de <div class="new-form-linktext" style="display:inline;"><a href="javascript:void(0)" class="js-privacy-infotoggle-form"><ins>privacy kennisgeving*</ins> </a> te hebben gelezen</div>
<div class="form-radios-group-infos-form informativeBox" style="display: none;">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span></span>
</a> -->
<div class="form-radios-group-infos-content">
<div class="privacyMask"></div>
<iframe src="https://staticpromo.fiat.com/privacy/BE/informative-be_nl.html?brand=jeep" style="width: 100%;height:155px"></iframe>
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</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="marketing-yes-gab" class="MARKETING_MAIL1" type="radio" name="isPrivacyMarketing" value="Y" data-required="" adobe-input="marketing-yes">
<label for="marketing-yes-gab">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="marketing-no-gab" class="MARKETING_MAIL1" type="radio" name="isPrivacyMarketing" value="N" data-required="" adobe-input="marketing-no">
<label class="large" for="marketing-no-gab">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">om marketing communicatie te krijgen</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_8">Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A voor marketing doeleinden zoals uiteengezet in punt c) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder
via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps).</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="profilazione-yes-gab" class="PRIVACYPROFILATION" type="radio" name="isPrivacyProfilation" value="Y" data-required="" adobe-input="profilation-yes">
<label for="profilazione-yes-gab">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="profilazione-no-gab" class="PRIVACYPROFILATION" type="radio" name="isPrivacyProfilation" value="N" data-required="" adobe-input="profilation-no">
<label for="profilazione-no-gab">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">dat mijn gegevens voor profilering gebruikt worden</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_12">Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A om mijn voorkeuren te analyseren en aangepaste commerciële communicatie te ontvangen zoals uiteengezet in punt d) van de privacy kennisgeving.
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-7 col-md-7 col-lg-6 col-xl-6">
<div class="new-form-radios-consent">
<div class="mui-radio large mui-radio-inline required-field">
<input id="terzi-yes-gab" class="PRIVACYTHIRDPARTY" type="radio" name="isPrivacyThirdPart" value="Y" data-required="" adobe-input="third-party-yes">
<label for="terzi-yes-gab">
<span>Ik geef toestemming</span>
</label>
</div>
<div class="mui-radio large mui-radio-inline required-field">
<input id="terzi-no-gab" class="PRIVACYTHIRDPARTY" type="radio" name="isPrivacyThirdPart" value="N" data-required="" adobe-input="third-party-no">
<label for="terzi-no-gab">
<span>Ik geef geen toestemming</span>
</label>
</div>
</div>
</div>
<div class="col-xs-12 col-sm-5 col-md-5 col-lg-6 col-xl-6">
<div class="new-form-linktext accordionpromo">
<a href="javascript:void(0)" class="js-privacy-infotoggle-form">dat mijn gegevens aan derden voor hun eigen marketing communicatie meegedeeld worden</a>
</div>
</div>
<div class="col-xs-12 col-sm-12 col-md-12 col-lg-12 col-xl-12">
<div class="form-radios-group-infos-form">
<!-- <a href="javascript:void(0)" class="form-radios-group-infos--close">
<span class="fa fa-times">✖</span>
</a> -->
<div class="form-radios-group-infos-content">
<div id="informative_16">Voor het communiceren van mijn persoonsgegevens aan dochterondernemingen en gelieerde ondernemingen van FCA Italy S.p.A evenals hun partners in de automobiel-, financiële, verzekerings- en telecommunicatiesector,
die deze zullen verwerken voor de marketing doeleinden uiteengezet in punt e) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde
telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps).</div>
</div>
</div>
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12">
<div class="new-form-submit submit">
<button type="button" data-type="anagraphic-btn" class="rect-btn rect-btn-yellow submit-btn-gab" data-adobe="cta:click-submit"> VERDER <span class="new-icon-alfa-romeo_arrow_cta"></span>
</button>
</div>
</div>
</div>
<section-fields>
<input type="hidden" id="owned_brand" name="owned_brand" value="">
<input type="hidden" id="owned_model" name="owned_model" value="">
<input type="hidden" id="id_timestamp" name="ID_TIMESTAMP" value="">
<input type="hidden" id="field10" name="RedirectLink" value="">
<input type="hidden" id="field11" name="Country" value="be">
<input type="hidden" id="field12" name="Language" value="nl">
<input type="hidden" id="field13" name="Brand" value="alfa-romeo">
<input type="hidden" id="field14" name="SpecifyPrivacy" value="">
<input type="hidden" id="field15" name="LEADSOURCECODE" value="MAT">
<input type="hidden" id="" name="EXTENDEDPRIVACYALL" value="">
<input type="hidden" id="field17" name="Market" value="be">
<input type="hidden" id="field18" name="MODELDESCRIPTION" value="">
<input type="hidden" id="field19" name="MODELCOMMERCIALCODE" value="">
<input type="hidden" id="field20" name="REQUESTDATE" value="">
<input type="hidden" id="field21" name="OFFER" value="">
<input type="hidden" id="field22" name="TYPE" value="GAB">
<input type="hidden" id="field23" name="LEVEL1" value="web corporate">
<input type="hidden" id="field24" name="LEVEL2" value="alfa-romeo:be:contact">
<input type="hidden" id="field25" name="LEVEL3" value="lead:test-drive-request">
<input type="hidden" id="field26" name="LEVEL4" value="brand">
<input type="hidden" name="CAMPAIGN" value="83">
<input type="hidden" id="field28" name="USEDDEVICE" value="desktop">
<input type="hidden" id="field29" name="DISCLAIMER" value="722">
<input type="hidden" id="" name="PRIVACYPROFILATION" value="">
<input type="hidden" id="" name="PRIVACYTHIRDPARTY" value="">
<input type="hidden" id="" name="PRIVACYEXTRAEU" value="">
<input type="hidden" id="" name="PRIVACYGEOLOCATION" value="">
<input type="hidden" id="BASEURL" name="BASEURL" value="">
<input type="hidden" id="field46" name="IOPROD1">
<input type="hidden" id="field47" name="IOSCOR1">
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<input type="hidden" id="field49" name="IOSCOR2">
<input type="hidden" id="field50" name="IOPROD3">
<input type="hidden" id="field51" name="IOSCOR3">
<input type="hidden" id="field52" name="IOSCORGLOBAL">
<input type="hidden" id="field53" name="EXTERNID">
<input type="hidden" id="field54" name="BUSAREA" value="sales">
<input type="hidden" id="field55" name="SOURCEQUERYSTRING">
<input type="hidden" id="field57" name="REFERRER" value="">
<input type="hidden" id="field56" name="FULLQUERYSTRING" value="">
<input type="hidden" id="field59" name="publisher" value="">
<input type="hidden" id="" name="MARKETING_POST1" value="">
<input type="hidden" id="" name="MARKETING_MAIL1" value="">
<input type="hidden" id="" name="MARKETING_SMS1" value="">
<input type="hidden" id="" name="MARKETING_PHONE1" value="">
<input type="hidden" id="field62" name="LPID" value="33677">
<input id="field90" name="PIVAINFORMATION" type="hidden" value="">
<input id="field91" name="DTM_CTA" type="hidden" value="lead:test-drive-request">
<input id="field92" name="DTM_ENABLED" type="hidden" value="1">
<input id="field93" name="REQUESTORIGIN" type="hidden" value="">
<input id="field94" name="DTM_CAMPAIGN" type="hidden" value="">
<input id="field95" name="Fleet_Size" type="hidden" value="">
<input id="" name="MULTIREQUESTS" type="hidden" value="">
<input id="" name="VisitorID" type="hidden" value="">
<input type="hidden" name="gab_multiselected_models" class="gab_multiselected_models" value="">
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<input id="" name="PREVIOUS_URL" type="hidden" value="">
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</form>Text Content
* modellen * AANBIEDINGEN * Aankoop & Financiering * My Alfa Romeo * Over ons * Racing nl modellen Stelvio Vanaf € 45.890 ONTDEK MEER Giulia Vanaf € 40.750 ONTDEK MEER Al een Giulia vanaf € 36.300 6C VILLA D’ESTE ONTDEK MEER GT JUNIOR ONTDEK MEER Quadrifoglio ONTDEK MEER GIULIA GTA ONTDEK MEER TONALE CONCEPT ONTDEK MEER * modellen * AANBIEDINGEN * Aankoop & Financiering * My Alfa Romeo * Over ons * Racing NEDERLANDS Kies een taal Français Stelvio Vanaf € 45.890 ONTDEK MEER Giulia Vanaf € 40.750 ONTDEK MEER Al een Giulia vanaf € 36.300 6C VILLA D’ESTE ONTDEK MEER GT JUNIOR ONTDEK MEER Quadrifoglio ONTDEK MEER GIULIA GTA ONTDEK MEER TONALE CONCEPT ONTDEK MEER Aanbiedingen * Onze promoties * Stelvio * Giulia PARTICULIEREN * Stockwagens * TWEEDEHANDSWAGENS * Overname van uw voertuig * FINANCIERING * LANGETERMIJNHUUR * Virtuele afspraak BUSINESS * ALFA VOOR PROFESSIONALS * LANGETERMIJNHUUR TESTRIT BROCHURE Vraag een offerte Vind een verdeler ONDERDELEN EN ACCESSOIRES * Diensten * Accessoires * Merchandising * AANBIEDINGEN DIENSTEN EN ONDERHOUD * Auto Service * BEREKEN UW ONDERHOUDSKOSTEN * Diensten * Onderhoud * Fabrieksgarantie * Customer First CONNECTIVITEIT * CONNECTED SERVICES Vind een verdeler MAAK EEN AFSPRAAK Klantendienst My Alfa Romeo ALFA ROMEO SOUL * Alfa Romeo Soul * TECHNOLOGIE EN INNOVATIES * Design * SUV * Q4-vierwielaandrijving * WLTP CONTACT Nieuwsbrief ALFA ROMEO RACING ORLEN ONTDEK ALFA ROMEO RACING ORLEN GP 2021 RACING * RESERVEER ONLINE * CONFIGUREREN * BROCHURE * * Vraag een offerte * TESTRIT * Vind een verdeler * TWEEDEHANDSWAGENS * Stockwagens * OVERNAME Kies een taal Français ONTDEK MEER Stelvio Vanaf € 45.890 ONTDEK MEER Giulia Vanaf € 40.750 ONTDEK MEER 6C VILLA D’ESTE ONTDEK MEER GT JUNIOR ONTDEK MEER Quadrifoglio ONTDEK MEER GIULIA GTA ONTDEK MEER TONALE CONCEPT Stelvio Alfa™ Link ophanging 5 sterren EURO NCAP Italiaans design, ongeëvenaarde stijl stijl Q4 vierwielaandrijving Integrated Brake System ONTDEK MEER -------------------------------------------------------------------------------- Al een Stelvio vanaf € 40.890 Aanbiedingen TWEEDEHANDSWAGENS TESTRIT Stelvio Giulia Alfa™ Link ophanging Van 160pk tot 280pk 50/50 gewichtsverdeling Onmiskenbaar Italiaans design RWD of Q4 vierwielaandrijving Integrated Brake System ONTDEK MEER -------------------------------------------------------------------------------- Al een Giulia vanaf € 36.300 Aanbiedingen TWEEDEHANDSWAGENS TESTRIT Giulia 6C VILLA D’ESTE De Giulia en Stelvio 6C Villa d'Este zijn een eerbetoon aan de grandeur en de geschiedenis van Alfa Romeo. ONTDEK MEER Vind een verdeler Vraag een offerte GT JUNIOR Een eerbetoon aan de elegante en gedurfde stijl die ons roemrijke verleden kenmerkt. Laat u betoveren door de stijl van de nieuwe Giulia en Stelvio GT Junior. ONTDEK MEER GT JUNIOR Quadrifoglio De Quadrifoglio is het embleem dat onze meest competitieve modellen onderscheidt. In 1923 geboren als sportlegende, maar uitgegroeid tot Alfa Romeo's symbool van uitmuntendheid. ONTDEK MEER Stelvio Quadrifoglio Giulia Quadrifoglio Limited edition Nring Alfa Romeo racing limited edition GIULIA GTA Een herboren legende. ONTDEK MEER Car configurator GIULIA GTA TONALE CONCEPT Dagelijkse opwinding dankzij de Tonale ONTDEK MEER Nieuwsbrief De echte betekenis van SUV | Alfa Romeo België Aanbiedingen * Onze promoties * Stelvio * Giulia PARTICULIEREN * Stockwagens * TWEEDEHANDSWAGENS * Overname van uw voertuig * FINANCIERING * LANGETERMIJNHUUR * Virtuele afspraak BUSINESS * ALFA VOOR PROFESSIONALS * LANGETERMIJNHUUR TESTRIT BROCHURE Vraag een offerte Vind een verdeler ONDERDELEN EN ACCESSOIRES * Diensten * Accessoires * Merchandising * AANBIEDINGEN DIENSTEN EN ONDERHOUD * Auto Service * BEREKEN UW ONDERHOUDSKOSTEN * Diensten * Onderhoud * Fabrieksgarantie * Customer First CONNECTIVITEIT * CONNECTED SERVICES Vind een verdeler MAAK EEN AFSPRAAK Klantendienst My Alfa Romeo ALFA ROMEO SOUL * Alfa Romeo Soul * TECHNOLOGIE EN INNOVATIES * Design * SUV * Q4-vierwielaandrijving * WLTP CONTACT Nieuwsbrief SOCIAL ALFA ROMEO RACING ORLEN Sauber, Alfa Romeo en ORLEN bundelen hun krachten voor een nieuw en spannend hoofdstuk in de motorsport. ONTDEK ALFA ROMEO RACING ORLEN -------------------------------------------------------------------------------- GP 2021 RACING HET STARTPUNT VAN NIEUWE EMOTIES VUL HET FORMULIER HIERONDER IN EN STAP DE WERELD VAN ALFA ROMEO BINNEN Testrit Offerte brochure 1 Uw keuze: 2 Vul uw gegevens in 3 Kies uw verdeler 1 Uw keuze: 2 Vul uw gegevens in 3 Kies uw verdeler 1 Model KIES EEN MODEL NAAR KEUZE Stelvio Selecteren Giulia Selecteren Stelvio Quadrifoglio Selecteren Giulia Quadrifoglio Selecteren 2 Uw gegevens MELD U AAN EN BLIJF OP DE HOOGTE: U ONTVANGT HET MEEST RECENTE NIEUWS OVER AANBIEDINGEN, ACTIES, NIEUWE MODELLEN EN NOG VEEL MEER. WACHT NIET LANGER! VUL HET FORMULIER IN MET UW GEGEVENS Uw keuze: _ Kies een ander model Andere dealer #bro# #pbr# #LABEL_MITTENTE# Dhr.Mevr. Aanspreektitel* Required field Dhr. Mevr. Voornaam* Required Field Achternaam* Required Field Second Surname Required field Bedrijfsnaam* Required Field E-mail* Required Field #LABEL_DESTINATARIO# Voornaam* Required field ** Required Field GSM* Required Field Vul uw postcode of volledig adres in* Enter Your Post Code*** Required Field formAddress** Required Field city** Required Field cap** Required Field MobileVirtuele afspraak Hoe mogen we contact met u opnemen? Mobile Mobile Virtuele afspraak Wanneer u voor 'virtuele afspraak' kiest, zal u telefonisch worden gecontacteerd om een virtuele afspraak vast te leggen via Google Meet, de videoconferentiedienst van Google. Op de dag en het uur van uw afspraak klikt u op de link die u van uw verdeler ondertussen gekregen zal hebben en… klaar! U bent dan meteen via video/audioconferentie verbonden met uw verdeler. 08:00 - 10:00 10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00 - 18:00 18:00 - 20:00 Voorkeur voor afspraak Required field 08:00 - 10:00 10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00 - 18:00 18:00 - 20:00 Adres Required Field Plaats* Required Field Postcode* Required Field state_prov** Required Field Bent u van plan om deze wagen te kopen als bedrijfswagen? Ja Nee Vat Number Required Field Wat is de grootte van het wagenpark in uw bedrijf*: 1-19 20-99 100+ * Verplicht veld TOESTEMMING Na de privacy kennisgeving* te hebben gelezen Ik geef toestemming Ik geef geen toestemming om marketing communicatie te krijgen Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A voor marketing doeleinden zoals uiteengezet in punt c) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps). Ik geef toestemming Ik geef geen toestemming dat mijn gegevens voor profilering gebruikt worden Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A om mijn voorkeuren te analyseren en aangepaste commerciële communicatie te ontvangen zoals uiteengezet in punt d) van de privacy kennisgeving. Ik geef toestemming Ik geef geen toestemming dat mijn gegevens aan derden voor hun eigen marketing communicatie meegedeeld worden Voor het communiceren van mijn persoonsgegevens aan dochterondernemingen en gelieerde ondernemingen van FCA Italy S.p.A evenals hun partners in de automobiel-, financiële, verzekerings- en telecommunicatiesector, die deze zullen verwerken voor de marketing doeleinden uiteengezet in punt e) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps). VERDER 3 Handel KIES UW VERDELER Geef een postcode in om te zoeken Kies een ander model Andere dealer Terms of use© 1987–2022 HERE 5 km Wijzigen Zie lijst Wijzigen #LABEL#. #NAME# Diensten: Business Center | Specialist #ADDRESS#, #CITY# #PROVINCE# Afstand #DISTANCE# km Selecteer Selecteer Nu bellen #NAME# #ADDRESS# Afstand #DISTANCE# Km CHIAMA ORA SELEZIONA ONLINE BOOKING #TITOLO_BOX_1# #NOME# #COGNOME# #TITOLO_BOX_2# #TITOLO_BOX_3# #DEALERNAME# #DEALERADDRESS# #DEALERCAP# #DEALERCITY# -------------------------------------------------------------------------------- #button_box_home# 1 Uw keuze: 2 Vul uw gegevens in 3 Kies uw verdeler 1 Uw keuze: 2 Vul uw gegevens in 3 Kies uw verdeler 1 Model KIES EEN MODEL NAAR KEUZE Stelvio Selecteren Giulia Selecteren Stelvio Quadrifoglio Selecteren Giulia Quadrifoglio Selecteren 2 Uw gegevens MELD U AAN EN BLIJF OP DE HOOGTE: U ONTVANGT HET MEEST RECENTE NIEUWS OVER AANBIEDINGEN, ACTIES, NIEUWE MODELLEN EN NOG VEEL MEER. WACHT NIET LANGER! VUL HET FORMULIER IN MET UW GEGEVENS Uw keuze: _ Kies een ander model Andere dealer #bro# #pbr# #LABEL_MITTENTE# Dhr.Mevr. Aanspreektitel* Required field Dhr. Mevr. Voornaam* Required Field Achternaam* Required Field Second Surname Required field Bedrijfsnaam* Required Field E-mail* Required Field #LABEL_DESTINATARIO# Voornaam* Required field ** Required Field GSM* Required Field Vul uw postcode of volledig adres in* Enter Your Post Code*** Required Field formAddress** Required Field city** Required Field cap** Required Field MobileVirtuele afspraak Hoe mogen we contact met u opnemen? Mobile Mobile Virtuele afspraak Wanneer u voor 'virtuele afspraak' kiest, zal u telefonisch worden gecontacteerd om een virtuele afspraak vast te leggen via Google Meet, de videoconferentiedienst van Google. Op de dag en het uur van uw afspraak klikt u op de link die u van uw verdeler ondertussen gekregen zal hebben en… klaar! U bent dan meteen via video/audioconferentie verbonden met uw verdeler. 08:00 - 10:00 10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00 - 18:00 18:00 - 20:00 Voorkeur voor afspraak Required field 08:00 - 10:00 10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00 - 18:00 18:00 - 20:00 Adres Required Field Plaats* Required Field Postcode* Required Field state_prov** Required Field Bent u van plan om deze wagen te kopen als bedrijfswagen? Ja Nee Vat Number Required Field Wat is de grootte van het wagenpark in uw bedrijf*: 1-19 20-99 100+ * Verplicht veld TOESTEMMING Na de privacy kennisgeving* te hebben gelezen Ik geef toestemming Ik geef geen toestemming om marketing communicatie te krijgen Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A voor marketing doeleinden zoals uiteengezet in punt c) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps). Ik geef toestemming Ik geef geen toestemming dat mijn gegevens voor profilering gebruikt worden Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A om mijn voorkeuren te analyseren en aangepaste commerciële communicatie te ontvangen zoals uiteengezet in punt d) van de privacy kennisgeving. Ik geef toestemming Ik geef geen toestemming dat mijn gegevens aan derden voor hun eigen marketing communicatie meegedeeld worden Voor het communiceren van mijn persoonsgegevens aan dochterondernemingen en gelieerde ondernemingen van FCA Italy S.p.A evenals hun partners in de automobiel-, financiële, verzekerings- en telecommunicatiesector, die deze zullen verwerken voor de marketing doeleinden uiteengezet in punt e) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps). VERDER 3 Handel KIES UW VERDELER Geef een postcode in om te zoeken Kies een ander model Andere dealer Terms of use© 1987–2022 HERE Wijzigen Zie lijst Wijzigen #LABEL#. #NAME# Diensten: Business Center | Specialist #ADDRESS#, #CITY# #PROVINCE# Afstand #DISTANCE# km Selecteer Selecteer Nu bellen #NAME# #ADDRESS# Afstand #DISTANCE# Km CHIAMA ORA SELEZIONA ONLINE BOOKING #TITOLO_BOX_1# #NOME# #COGNOME# #TITOLO_BOX_2# #TITOLO_BOX_3# #DEALERNAME# #DEALERADDRESS# #DEALERCAP# #DEALERCITY# -------------------------------------------------------------------------------- #button_box_home# 1 Uw keuze: 2 Vul uw gegevens in 1 Uw keuze: 2 Vul uw gegevens in 3 Handel KIES UW VERDELER Geef een postcode in om te zoeken Kies een ander model Andere dealer Terms of use© 1987–2022 HERE Wijzigen Zie lijst Wijzigen #LABEL#. #NAME# Diensten: Business Center | Specialist #ADDRESS#, #CITY# #PROVINCE# Afstand #DISTANCE# km Selecteer Selecteer Nu bellen #NAME# #ADDRESS# Afstand #DISTANCE# Km CHIAMA ORA SELEZIONA ONLINE BOOKING 1 Model KIES EEN MODEL NAAR KEUZE Stelvio Selecteren Giulia Selecteren Stelvio Quadrifoglio Selecteren Giulia Quadrifoglio Selecteren 2 Uw gegevens MELD U AAN EN BLIJF OP DE HOOGTE: U ONTVANGT HET MEEST RECENTE NIEUWS OVER AANBIEDINGEN, ACTIES, NIEUWE MODELLEN EN NOG VEEL MEER. WACHT NIET LANGER! VUL HET FORMULIER IN MET UW GEGEVENS Uw keuze: _ Kies een ander model Andere dealer #bro# #pbr# #LABEL_MITTENTE# Dhr.Mevr. Aanspreektitel* Required field Dhr. Mevr. Voornaam* Required Field Achternaam* Required Field Second Surname Required field Bedrijfsnaam* Required Field E-mail* Required Field #LABEL_DESTINATARIO# Voornaam* Required field ** Required Field GSM* Required Field Vul uw postcode of volledig adres in* Enter Your Post Code*** Required Field formAddress** Required Field city** Required Field cap** Required Field Hoe mogen we contact met u opnemen? Lorem ipsum 08:00 - 10:00 10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00 - 18:00 18:00 - 20:00 Voorkeur voor afspraak Required field 08:00 - 10:00 10:00 - 12:00 12:00 - 14:00 14:00 - 16:00 16:00 - 18:00 18:00 - 20:00 Adres Required Field Plaats* Required Field Postcode* Required Field state_prov** Required Field Bent u van plan om deze wagen te kopen als bedrijfswagen? Ja Nee Vat Number Required Field Wat is de grootte van het wagenpark in uw bedrijf*: 1-19 20-99 100+ * Verplicht veld TOESTEMMING Na de privacy kennisgeving* te hebben gelezen Ik geef toestemming Ik geef geen toestemming om marketing communicatie te krijgen Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A voor marketing doeleinden zoals uiteengezet in punt c) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps). Ik geef toestemming Ik geef geen toestemming dat mijn gegevens voor profilering gebruikt worden Voor de verwerking van mijn persoonsgegevens door FCA Italy S.p.A om mijn voorkeuren te analyseren en aangepaste commerciële communicatie te ontvangen zoals uiteengezet in punt d) van de privacy kennisgeving. Ik geef toestemming Ik geef geen toestemming dat mijn gegevens aan derden voor hun eigen marketing communicatie meegedeeld worden Voor het communiceren van mijn persoonsgegevens aan dochterondernemingen en gelieerde ondernemingen van FCA Italy S.p.A evenals hun partners in de automobiel-, financiële, verzekerings- en telecommunicatiesector, die deze zullen verwerken voor de marketing doeleinden uiteengezet in punt e) van de privacy kennisgeving, op papier, op geautomatiseerde of elektronische wijze, waaronder via post of e-mail, telefoon (bijvoorbeeld geautomatiseerde telefoonoproepen, SMS, MMS), fax en elk ander middel (bijvoorbeeld websites, mobiele apps). VERDER #TITOLO_BOX_1# #NOME# #COGNOME# #TITOLO_BOX_2# #TITOLO_BOX_3# #DEALERNAME# #DEALERADDRESS# #DEALERCAP# #DEALERCITY# -------------------------------------------------------------------------------- #button_box_home# VOLG ONS 1. facebook 2. youtube 3. instagram 4. linkedin Shop On Line KLANTENSERVICE ALLE ONDERSTEUNING DIE U NODIG HEBT * 00 800 2532 0000 Gratis nummer 0800 55 666 (via gsm) WILT U MEER WETEN? 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