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

Submitted URL: http://echo4.bluehornet.com/ct/101288069:TIju0eoNB:m:1:3469090089:B7DFFE09EC409818920886EA0913C6E9:r
Effective URL: https://info.mijn-offertes.be/spanplafond/?aff=ibiza_nl&utm_source=4245&pixel_id=560
Submission: On May 28 via api from BE — Scanned from DE

Form analysis 1 forms found in the DOM

POST /fsg?pageId=a77d9b99-2b2b-4ab9-8797-9c05a343d7e6&variant=a

<form action="/fsg?pageId=a77d9b99-2b2b-4ab9-8797-9c05a343d7e6&amp;variant=a" method="POST"><input type="hidden" name="pageId" value="a77d9b99-2b2b-4ab9-8797-9c05a343d7e6"><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 een spanplafond?</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_een_ruimte" name="XML_extra_radio" value="Eén ruimte" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_een_ruimte" class="opt-label form-builder-radio-label"><span class="label-style">Eén ruimte</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio-item-1"><input type="radio" id="XML_extra_radio_twee_ruimtes" name="XML_extra_radio" value="Twee ruimtes" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_twee_ruimtes" class="opt-label form-builder-radio-label"><span class="label-style">Twee ruimtes</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio-item-2"><input type="radio" id="XML_extra_radio_drie_ruimtes" name="XML_extra_radio" value="Drie ruimtes" class="radio form-builder-radio-input form_elem_XML_extra_radio"><label
            for="XML_extra_radio_drie_ruimtes" class="opt-label form-builder-radio-label"><span class="label-style">Drie ruimtes</span></label></div>
        <div class="option" id="ub-option-XML_extra_radio-item-3"><input type="radio" id="XML_extra_radio_meer_dan_drie_ruimtes" name="XML_extra_radio" value="Meer dan drie ruimtes"
            class="radio form-builder-radio-input form_elem_XML_extra_radio"><label for="XML_extra_radio_meer_dan_drie_ruimtes" class="opt-label form-builder-radio-label"><span class="label-style">Meer dan drie ruimtes</span></label></div>
      </div>
    </div>
    <div class="lp-pom-form-field radio-group multi-group hide" 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">Wanneer wenst u de plaatsing van het spanplafond?</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_zo_snel_mogelijk" name="XML_extra_radio2" value="Zo snel mogelijk" class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label
            for="XML_extra_radio2_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_radio2-item-1"><input type="radio" id="XML_extra_radio2_binnen_1_tot_3_maanden" name="XML_extra_radio2" value="Binnen 1 tot 3 maanden"
            class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label for="XML_extra_radio2_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_radio2-item-2"><input type="radio" id="XML_extra_radio2_binnen_4_tot_12_maanden" name="XML_extra_radio2" value="Binnen 4 tot 12 maanden"
            class="radio form-builder-radio-input form_elem_XML_extra_radio2"><label for="XML_extra_radio2_binnen_4_tot_12_maanden" class="opt-label form-builder-radio-label"><span class="label-style">Binnen 4 tot 12 maanden</span></label></div>
      </div>
    </div>
    <div class="lp-pom-form-field multi-line-text multi-group hide" id="container_XML_remarks" style="top: 0px;"><label class="main lp-form-label" for="XML_remarks" id="label_XML_remarks" style="height: auto;"><span class="label-style">Vragen /
          opmerkingen voor de installateurs</span></label><textarea id="XML_remarks" name="XML_remarks" class="ub-input-item single text form_elem_XML_remarks"></textarea></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_spanplafond_offertes_te_vergelijken" name="terms" value="Ja, ik wens gratis spanplafond offertes te vergelijken."
            class="checkbox form-builder-checkbox-input form_elem_terms" data-required=""><label for="terms_ja_ik_wens_gratis_spanplafond_offertes_te_vergelijken" class="opt-label form-builder-checkbox-label"><span class="label-style">Ja, ik wens
              gratis spanplafond offertes te vergelijken.</span></label></div>
      </div>
    </div><input id="aff" name="aff" type="hidden" class="hidden" value="ibiza_nl"><input id="utm_source" name="utm_source" type="hidden" class="hidden" value="4245"><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="12006"><input id="rem_id" name="rem_id" type="hidden" class="hidden"
      value="20220528103709417"><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="560"><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="false">
  </div><button class="lp-element lp-pom-button hide" id="lp-pom-button-44" type="submit"><span class="label"><strong>Verzenden</strong></span></button>
  <input type="hidden" name="ubafs-jev" id="ubafs-jev"
    value="{&quot;date&quot;:&quot;2022-05-28T10:37:09.396Z&quot;,&quot;agent&quot;:&quot;Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/102.0.5005.61 Safari/537.36&quot;,&quot;screen&quot;:{&quot;availWidth&quot;:1600,&quot;availHeight&quot;:1200,&quot;width&quot;:1600,&quot;height&quot;:1200},&quot;window&quot;:{&quot;innerWidth&quot;:1600,&quot;innerHeight&quot;:1200},&quot;hasPlugins&quot;:true}">
</form>

Text Content

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In hoeveel ruimtes wenst u een spanplafond?
Eén ruimte
Twee ruimtes
Drie ruimtes
Meer dan drie ruimtes
Wanneer wenst u de plaatsing van het spanplafond?
Zo snel mogelijk
Binnen 1 tot 3 maanden
Binnen 4 tot 12 maanden
Vragen / opmerkingen voor de installateurs
Voornaam *
Achternaam *
Adres *
Postcode *
E-mail *
Telefoonnummer *
Bevestiging *
Ja, ik wens gratis spanplafond offertes te vergelijken.
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