info.mijn-offertes.be Open in urlscan Pro
3.69.136.55  Public Scan

Submitted URL: https://news.onlinebesparen.be/UVRNXwXB2RZCQA/AA0F_qRJZHDBFjGZOGlzmWopEly4iv794IQ2ql3AMDrE2T0KzKOyOi-tyNs6B_aJ0YlR6f3m7G7n4oycd...
Effective URL: https://info.mijn-offertes.be/airco/?aff=viena_nl&utm_source=RP2-21484147&pixel_id=522
Submission: On May 28 via api from BE — Scanned from ES

Form analysis 1 forms found in the DOM

POST /fsg?pageId=574055ab-2467-4d8f-85d3-ca48313f8028&variant=a

<form action="/fsg?pageId=574055ab-2467-4d8f-85d3-ca48313f8028&amp;variant=a" method="POST"><input type="hidden" name="pageId" value="574055ab-2467-4d8f-85d3-ca48313f8028"><input type="hidden" name="pageVariant" value="a">
  <div class="fields">
    <div class="lp-pom-form-field radio-group multi-group" id="container_XML_extra_radio" style="top: 0px;"><label class="main lp-form-label" for="XML_extra_radio" id="label_XML_extra_radio" style="height: auto;"><span class="label-style">In hoeveel
          ruimtes wenst u airco te plaatsen?</span></label>
      <div class="ub-input-item input-wrap optionsList" id="group_XML_extra_radio">
        <div class="option" id="ub-option-XML_extra_radio-item-0"><input type="radio" id="XML_extra_radio_1_ruimte" name="XML_extra_radio" value="1" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_1_ruimte" class="opt-label form-builder-radio-label"><span class="label-style">1 ruimte</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio-item-1"><input type="radio" id="XML_extra_radio_2_ruimtes" name="XML_extra_radio" value="2" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_2_ruimtes" class="opt-label form-builder-radio-label"><span class="label-style">2 ruimtes</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio-item-2"><input type="radio" id="XML_extra_radio_3_ruimtes" name="XML_extra_radio" value="3" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_3_ruimtes" class="opt-label form-builder-radio-label"><span class="label-style">3 ruimtes</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio-item-3"><input type="radio" id="XML_extra_radio_4_of_meer_ruimtes" name="XML_extra_radio" value="4" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_4_of_meer_ruimtes" class="opt-label form-builder-radio-label"><span class="label-style">4 of meer ruimtes</span></label></div>
      </div>
    </div>
    <div class="lp-pom-form-field radio-group multi-group hide" id="container_XML_extra_radio5" style="top: 0px;"><label class="main lp-form-label" for="XML_extra_radio5" id="label_XML_extra_radio5" style="height: auto;"><span
          class="label-style">Wanneer wenst u de airco te laten plaatsen?</span></label>
      <div class="ub-input-item input-wrap optionsList" id="group_XML_extra_radio5">
        <div class="option" id="ub-option-XML_extra_radio5-item-0"><input type="radio" id="XML_extra_radio5_zo_snel_mogelijk" name="XML_extra_radio5" value="1" class="radio form-builder-radio-input form_elem_XML_extra_radio5"><label
            for="XML_extra_radio5_zo_snel_mogelijk" class="opt-label form-builder-radio-label"><span class="label-style">Zo snel mogelijk</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio5-item-1"><input type="radio" id="XML_extra_radio5_binnen_1_tot_3_maanden" name="XML_extra_radio5" value="2" class="radio form-builder-radio-input form_elem_XML_extra_radio5"><label
            for="XML_extra_radio5_binnen_1_tot_3_maanden" class="opt-label form-builder-radio-label"><span class="label-style">Binnen 1 tot 3 maanden</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio5-item-2"><input type="radio" id="XML_extra_radio5_binnen_3_tot_6_maanden" name="XML_extra_radio5" value="3" class="radio form-builder-radio-input form_elem_XML_extra_radio5"><label
            for="XML_extra_radio5_binnen_3_tot_6_maanden" class="opt-label form-builder-radio-label"><span class="label-style">Binnen 3 tot 6 maanden</span></label></div>
      </div>
    </div>
    <div class="lp-pom-form-field single-line-text hide" id="container_firstName" style="top: 0px;"><label class="main lp-form-label" for="firstName" id="label_firstName" style="height: auto;"><span
          class="label-style">Voornaam&nbsp;*</span></label><input id="firstName" name="firstName" type="text" class="ub-input-item single text form_elem_firstName" placeholder="Voornaam" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_lastName" style="top: 0px;"><label class="main lp-form-label" for="lastName" id="label_lastName" style="height: auto;"><span
          class="label-style">Achternaam&nbsp;*</span></label><input id="lastName" name="lastName" type="text" class="ub-input-item single text form_elem_lastName" placeholder="Achternaam" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_address1" style="top: 0px;"><label class="main lp-form-label" for="address1" id="label_address1" style="height: auto;"><span class="label-style">Adres&nbsp;*</span></label><input
        id="address1" name="address1" type="text" class="ub-input-item single text form_elem_address1" placeholder="Adres" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_XML_postcode" style="top: 0px;"><label class="main lp-form-label" for="XML_postcode" id="label_XML_postcode" style="height: auto;"><span
          class="label-style">Postcode&nbsp;*</span></label><input id="XML_postcode" name="XML_postcode" type="text" class="ub-input-item single text form_elem_XML_postcode" placeholder="Postcode" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_XML_email" style="top: 0px;"><label class="main lp-form-label" for="XML_email" id="label_XML_email" style="height: auto;"><span
          class="label-style">E-mail&nbsp;*</span></label><input id="XML_email" name="XML_email" type="text" class="ub-input-item single text form_elem_XML_email" placeholder="E-mail" required=""></div>
    <div class="lp-pom-form-field single-line-text hide" id="container_XML_telephone" style="top: 0px;"><label class="main lp-form-label" for="XML_telephone" id="label_XML_telephone" style="height: auto;"><span
          class="label-style">Telefoonnummer&nbsp;*</span></label><input id="XML_telephone" name="XML_telephone" type="tel" class="ub-input-item single text form_elem_XML_telephone" placeholder="Telefoonnummer" required=""
        pattern="^\+?( ?\(?-?\d\)?){6,13}$"></div>
    <div class="lp-pom-form-field checkbox-group multi-group hide" id="container_terms" style="top: 0px;"><label class="main lp-form-label" for="terms" id="label_terms" style="height: auto;"><span class="label-style">Bevestiging&nbsp;*</span></label>
      <div class="ub-input-item input-wrap optionsList" id="group_terms">
        <div class="option" id="ub-option-terms-item-0"><input type="checkbox" id="terms_ja_ik_wens_gratis_offertes_te_ontvangen" name="terms" value="Ja, ik wens gratis offertes te ontvangen."
            class="checkbox form-builder-checkbox-input form_elem_terms" data-required=""><label for="terms_ja_ik_wens_gratis_offertes_te_ontvangen" class="opt-label form-builder-checkbox-label"><span class="label-style">Ja, ik wens gratis offertes
              te ontvangen.</span></label></div>
      </div>
    </div><input id="aff" name="aff" type="hidden" class="hidden" value="viena_nl"><input id="utm_source" name="utm_source" type="hidden" class="hidden" value="RP2-21484147"><input id="utm_medium" name="utm_medium" type="hidden" class="hidden"
      value=""><input id="utm_campaign" name="utm_campaign" type="hidden" class="hidden" value=""><input id="type_id" name="type_id" type="hidden" class="hidden" value="11386"><input id="rem_id" name="rem_id" type="hidden" class="hidden"
      value="20230528173749649"><input id="rem_source" name="rem_source" type="hidden" class="hidden" value="Mijn-Offertes.be"><input id="pixel_id" name="pixel_id" type="hidden" class="hidden" value="522"><input id="click_id" name="click_id"
      type="hidden" class="hidden" value=""><input id="language" name="language" type="hidden" class="hidden" value="nl"><input id="promoOptin" name="promoOptin" type="hidden" class="hidden" value="true"><input id="bobx" name="bobx" type="hidden"
      class="hidden" value=""><input id="companyCity" name="companyCity" type="hidden" class="hidden" value=""><input id="XML_remarks" name="XML_remarks" type="hidden" class="hidden" value="Ik wens gratis airco offertes te ontvangen">
  </div><button class="lp-element lp-pom-button hide" id="lp-pom-button-44" type="submit"><span class="label">Verzenden</span></button>
</form>

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In hoeveel ruimtes wenst u airco te plaatsen?
1 ruimte
2 ruimtes
3 ruimtes
4 of meer ruimtes
Wanneer wenst u de airco te laten plaatsen?
Zo snel mogelijk
Binnen 1 tot 3 maanden
Binnen 3 tot 6 maanden
Voornaam *
Achternaam *
Adres *
Postcode *
E-mail *
Telefoonnummer *
Bevestiging *
Ja, ik wens gratis offertes te ontvangen.
Verzenden
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