e-news.sfpd.fgov.be Open in urlscan Pro
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Form analysis
1 forms found in the DOM

POST ?pName=edit_data&MIDRID=S7Y1_p9ra2n5v8jWxMDYyMTof05_sm2qbl5qebFecVpBil5aen6ZXlLq.1Tb1JTMEgAA80&Z=-1630932893

<form action="?pName=edit_data&amp;MIDRID=S7Y1_p9ra2n5v8jWxMDYyMTof05_sm2qbl5qebFecVpBil5aen6ZXlLq.1Tb1JTMEgAA80&amp;Z=-1630932893" method="post" onsubmit="return checkForm(this)">
  <!--____________________ EDIT DATA FORM ________________-->
  <input type="hidden" name="email_old" value="eriktanghe@skynet.be">
  <p><b>Utilisez le formulaire ci-dessous pour mettre à jour vos informations personnelles.</b></p>
  <p>Les <span class="req">red</span> champs sont requis.</p>
  <fieldset id="emailCtn" class="odd">
    <legend>
      <label class="req">Email</label>
    </legend>
    <div class="input">
      <input type="text" name="email" value="eriktanghe@skynet.be" title="Email" size="60" alt="1|email|100" maxlength="100">
    </div>
  </fieldset>
  <fieldset id="langCtn" class="even">
    <legend>
      <label class="req">Langue</label>
    </legend>
    <div class="input">
      <input id="lang0" type="radio" name="lang" title="Langue" alt="1|varchar|15" value="nl">
      <label style="font-weight:normal" for="lang0">Nederlands (Dutch)</label><br>
      <input id="lang1" type="radio" name="lang" title="" alt="" value="fr">
      <label style="font-weight:normal" for="lang1">Français (French)</label><br>
      <input checked="checked" id="lang2" type="radio" name="lang" title="" alt="" value="de">
      <label style="font-weight:normal" for="lang2">Deutsch (German)</label><br>
    </div>
  </fieldset>
  <fieldset id="firstnameCtn" class="odd">
    <legend>
      <label class="req">Prénom</label>
    </legend>
    <div class="input">
      <input type="text" name="firstname" value="Sanne" title="Prénom" size="60" alt="1|varchar|100" maxlength="100">
    </div>
  </fieldset>
  <fieldset id="lastnameCtn" class="even">
    <legend>
      <label class="req">Nom</label>
    </legend>
    <div class="input">
      <input type="text" name="lastname" value="Hendriks" title="Nom" size="60" alt="1|varchar|100" maxlength="100">
    </div>
  </fieldset>
  <fieldset id="typeCtn" class="odd">
    <legend>
      <label class="req">Abonnement au bulletin d'information</label>
    </legend>
    <div class="input">
      <input id="type0" type="checkbox" name="type[]" title="Abonnement au bulletin d'information" alt="1|varchar|100" value="Burgers">
      <label style="font-weight:normal" for="type0">Citoyen</label><br>
      <input checked="checked" id="type1" type="checkbox" name="type[]" title="" alt="" value="Professionals">
      <label style="font-weight:normal" for="type1">Professionnels</label><br>
    </div>
  </fieldset>
  <fieldset id="otherlanguagesCtn" class="even">
    <legend>
      <label class="req">Langue newsletter</label>
    </legend>
    <div class="input">
      <input id="otherlanguages0" type="checkbox" name="otherlanguages[]" title="Langue newsletter" alt="1|varchar|100" value="nl">
      <label style="font-weight:normal" for="otherlanguages0">Néerlandais</label><br>
      <input checked="checked" id="otherlanguages1" type="checkbox" name="otherlanguages[]" title="" alt="" value="fr">
      <label style="font-weight:normal" for="otherlanguages1">Français</label><br>
      <input checked="checked" id="otherlanguages2" type="checkbox" name="otherlanguages[]" title="" alt="" value="de">
      <label style="font-weight:normal" for="otherlanguages2">Allemand</label><br>
    </div>
  </fieldset>
  <p class="buttons">
    <button type="submit" name="DMDtask[edit-data]">Ok</button>
  </p>
  <!--____________________ EDIT DATA FORM ________________-->
</form>

Text Content

Editer des informations personnelles

Service fédéral des Pensions

Utilisez le formulaire ci-dessous pour mettre à jour vos informations
personnelles.

Les red champs sont requis.

Email

Langue
Nederlands (Dutch)
Français (French)
Deutsch (German)

Prénom

Nom

Abonnement au bulletin d'information
Citoyen
Professionnels

Langue newsletter
Néerlandais
Français
Allemand


Ok