theomertensplein2.site Open in urlscan Pro
2a0b:7280:100:0:1c00:4ff:fe00:20d6  Public Scan

Form analysis
2 forms found in the DOM

GET https://theomertensplein2.site/

<form role="search" action="https://theomertensplein2.site/" method="GET">
  <input type="text" name="s" value="" aria-label="Search" placeholder="Search">
  <span>Hit enter to search or ESC to close</span>
</form>

<form class="el-form">
  <div class="el-col el-col-24">
    <div class="bpa-front-module--bd-form">
      <div class="bpa-bd-fields-row el-row" style="margin-left: -12px; margin-right: -12px;">
        <div class="el-col el-col-24 el-col-xs-24 el-col-sm-24 el-col-md-8 el-col-lg-8 el-col-xl-8" style="padding-left: 12px; padding-right: 12px;">
          <div class="el-form-item is-required"><label for="customer_firstname" class="el-form-item__label"><span class="bpa-front-form-label">Firstname</span></label>
            <div class="el-form-item__content"> <!---->
              <div class="bpa-front-form-control el-input"><!----><input type="text" autocomplete="off" placeholder="Enter your firstname" class="el-input__inner"><!----><!----><!----><!----></div> <!----> <!----><!---->
            </div>
          </div> <!---->
        </div>
        <div class="el-col el-col-24 el-col-xs-24 el-col-sm-24 el-col-md-8 el-col-lg-8 el-col-xl-8" style="padding-left: 12px; padding-right: 12px;">
          <div class="el-form-item is-required"><label for="customer_lastname" class="el-form-item__label"><span class="bpa-front-form-label">Lastname</span></label>
            <div class="el-form-item__content"> <!---->
              <div class="bpa-front-form-control el-input"><!----><input type="text" autocomplete="off" placeholder="Enter your lastname" class="el-input__inner"><!----><!----><!----><!----></div> <!----> <!----><!---->
            </div>
          </div> <!---->
        </div>
        <div class="el-col el-col-24 el-col-xs-24 el-col-sm-24 el-col-md-8 el-col-lg-8 el-col-xl-8" style="padding-left: 12px; padding-right: 12px;">
          <div class="el-form-item is-required"><label for="customer_email" class="el-form-item__label"><span class="bpa-front-form-label">Email Address</span></label>
            <div class="el-form-item__content"> <!----> <!---->
              <div class="bpa-front-form-control el-input"><!----><input type="email" autocomplete="off" placeholder="Enter your email address" class="el-input__inner"><!----><!----><!----><!----></div> <!----><!---->
            </div>
          </div> <!---->
        </div>
        <div class="el-col el-col-24 el-col-xs-24 el-col-sm-24 el-col-md-8 el-col-lg-8 el-col-xl-8" style="padding-left: 12px; padding-right: 12px;"><!---->
          <div class="el-form-item is-required" data-tel-id="customer_phone"><label for="customer_phone" class="el-form-item__label"><span class="bpa-front-form-label">Phone Number</span></label>
            <div class="el-form-item__content">
              <div class="bpa-front-form-control --bpa-country-dropdown vue-tel-input">
                <div aria-label="Country Code Selector" aria-haspopup="listbox" role="button" tabindex="0" class="vti__dropdown"><span class="vti__selection"><span class="vti__flag be"></span><!----><svg xmlns="http://www.w3.org/2000/svg"
                      viewBox="0 0 24 24">
                      <path d="M8.12 9.29L12 13.17l3.88-3.88c.39-.39 1.02-.39 1.41 0 .39.39.39 1.02 0 1.41l-4.59 4.59c-.39.39-1.02.39-1.41 0L6.7 10.7c-.39-.39-.39-1.02 0-1.41.39-.38 1.03-.39 1.42 0z"></path>
                    </svg></span><!----></div><input placeholder="0470 12 34 56" class="vti__input">
              </div><!---->
            </div>
          </div>
        </div>
        <div class="el-col el-col-24 el-col-xs-24 el-col-sm-24 el-col-md-8 el-col-lg-8 el-col-xl-8" style="padding-left: 12px; padding-right: 12px;">
          <div class="el-form-item"><label for="appointment_note" class="el-form-item__label"><span class="bpa-front-form-label">Note</span></label>
            <div class="el-form-item__content">
              <div class="bpa-front-form-control el-textarea"><textarea autocomplete="off" placeholder="Enter note details" class="el-textarea__inner" style="min-height: 46px;"></textarea><!----></div> <!----> <!----> <!----><!---->
            </div>
          </div> <!---->
        </div>
      </div>
    </div>
  </div>
</form>

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THEO MERTENSPLEIN 2


UW DROOMWONING IN EDEGEM TE KOOP!

Schrijf u nu in voor de kijkdagen!

Wil je graag onze woning bezichtigen tijdens de kijkdagen op 29 en 30 Juni?
Schrijf je dan nu in!

Om iedereen de kans te geven om de woning te bezichtigen, werken we met
tijdsloten van 15 minuten. Maak dus snel je afspraak via het formulier

We kijken ernaar uit om je te zien!

Let op: Inschrijven is verplicht. Er is plaats voor een beperkt aantal bezoekers
per tijdslot.




THEO MERTENSPLEIN 2
KIES UW TIJDSLOT VOOR ZATERDAG 29/6

Service
Date & Time
Basic Details
Summary
Select Service
Visit

Duration: 15 m

Next: Date & Time
Date & Time
Time Slot
Date & Time

20/06/2024
Time Slot

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Basic Details
Firstname

Lastname

Email Address

Phone Number

Note

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Summary

Your appointment booking summary

Customer

Service

Date & Time
20/06/2024, Invalid date - Invalid date
Appointment Details
20/06/2024, Invalid date - Invalid date
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Book Appointment




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