info.mijn-offertes.be
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Submitted URL: http://151.115.72.152/r.php?t=c&d=33454&l=7669&c=5228
Effective URL: https://info.mijn-offertes.be/gevelreiniging/?aff=bheads_nl&utm_source=873&pixel_id=682
Submission: On August 23 via api from BE — Scanned from DE
Effective URL: https://info.mijn-offertes.be/gevelreiniging/?aff=bheads_nl&utm_source=873&pixel_id=682
Submission: On August 23 via api from BE — Scanned from DE
Form analysis 1 forms found in the DOM
POST /fsg?pageId=473842e9-deb9-400e-b3eb-3ae57a562d70&variant=a
<form action="/fsg?pageId=473842e9-deb9-400e-b3eb-3ae57a562d70&variant=a" method="POST"><input type="hidden" name="pageId" value="473842e9-deb9-400e-b3eb-3ae57a562d70"><input type="hidden" name="pageVariant" value="a">
<div class="fields">
<div class="lp-pom-form-field radio-group multi-group" id="container_XML_extra_radio2" style="top: 0px;"><label class="main lp-form-label" for="XML_extra_radio2" id="label_XML_extra_radio2" style="height: auto;"><span class="label-style">Hoeveel
gevels dienen bewerkt te worden?</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_XML_extra_radio2">
<div class="option" id="ub-option-XML_extra_radio2-item-0"><input type="radio" id="XML_extra_radio2_1" name="XML_extra_radio2" value="2" class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label for="XML_extra_radio2_1"
class="opt-label form-builder-radio-label"><span class="label-style">1</span></label></div>
<div class="option" id="ub-option-XML_extra_radio2-item-1"><input type="radio" id="XML_extra_radio2_2" name="XML_extra_radio2" value="2" class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label for="XML_extra_radio2_2"
class="opt-label form-builder-radio-label"><span class="label-style">2</span></label></div>
<div class="option" id="ub-option-XML_extra_radio2-item-2"><input type="radio" id="XML_extra_radio2_3" name="XML_extra_radio2" value="3" class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label for="XML_extra_radio2_3"
class="opt-label form-builder-radio-label"><span class="label-style">3</span></label></div>
<div class="option" id="ub-option-XML_extra_radio2-item-3"><input type="radio" id="XML_extra_radio2_4_of_meer" name="XML_extra_radio2" value="4" class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label
for="XML_extra_radio2_4_of_meer" class="opt-label form-builder-radio-label"><span class="label-style">4 of meer</span></label></div>
</div>
</div>
<div class="lp-pom-form-field radio-group multi-group hide" id="container_XML_extra_radio3" style="top: 0px;"><label class="main lp-form-label" for="XML_extra_radio3" id="label_XML_extra_radio3" style="height: auto;"><span
class="label-style">Wanneer wenst u de gevelwerken op te starten?</span></label>
<div class="ub-input-item input-wrap optionsList" id="group_XML_extra_radio3">
<div class="option" id="ub-option-XML_extra_radio3-item-0"><input type="radio" id="XML_extra_radio3_binnen_1_tot_3_maanden" name="XML_extra_radio3" value="1" class="radio form-builder-radio-input form_elem_XML_extra_radio3"><label
for="XML_extra_radio3_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_radio3-item-1"><input type="radio" id="XML_extra_radio3_binnen_3_tot_6_maanden" name="XML_extra_radio3" value="2" class="radio form-builder-radio-input form_elem_XML_extra_radio3"><label
for="XML_extra_radio3_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 class="option" id="ub-option-XML_extra_radio3-item-2"><input type="radio" id="XML_extra_radio3_binnen_7_tot_12_maanden" name="XML_extra_radio3" value="3" class="radio form-builder-radio-input form_elem_XML_extra_radio3"><label
for="XML_extra_radio3_binnen_7_tot_12_maanden" class="opt-label form-builder-radio-label"><span class="label-style">Binnen 7 tot 12 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 *</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 *</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 *</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 *</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 *</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 *</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 *</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="bheads_nl"><input id="utm_source" name="utm_source" type="hidden" class="hidden" value="873"><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="11986"><input id="rem_id" name="rem_id" type="hidden" class="hidden"
value="20230823105839686"><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="682"><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=""><input id="XML_extra_check" name="XML_extra_check"
type="hidden" class="hidden" value="1">
</div><button class="lp-element lp-pom-button hide" id="lp-pom-button-44" type="submit"><span class="label">Verzenden</span></button>
</form>Text Content
Uw gevel reinigen? Vind de beste gevelwerker uit uw buurt in 2 minuten! VolgendeVorige Bespaar tijd & geld Ontvang offertes op maat voor de reiniging van uw gevel. Uw aanvraag is gratis en volledig vrijblijvend! Hoeveel gevels dienen bewerkt te worden? 1 2 3 4 of meer Wanneer wenst u de gevelwerken op te starten? Binnen 1 tot 3 maanden Binnen 3 tot 6 maanden Binnen 7 tot 12 maanden Voornaam * Achternaam * Adres * Postcode * E-mail * Telefoonnummer * Bevestiging * Ja, ik wens gratis offertes te ontvangen. Verzenden 1 of 9 Gratis offertes Erkende gevelwerkers Volledig vrijblijvend Copyright 2021 Mijn-Offertes.be Privacybeleid | Gegevensbescherming (GDPR)