sodexo.jotform.com
Open in
urlscan Pro
34.102.227.138
Public Scan
URL:
https://sodexo.jotform.com/220514073373347
Submission: On October 06 via api from BE — Scanned from DE
Submission: On October 06 via api from BE — Scanned from DE
Form analysis 1 forms found in the DOM
Name: form_220514073373347 — POST https://sodexo.jotform.com/submit/220514073373347/
<form class="jotform-form" action="https://sodexo.jotform.com/submit/220514073373347/" method="post" name="form_220514073373347" id="220514073373347" accept-charset="utf-8" autocomplete="on" novalidate="true">
<input type="hidden" name="formID" value="220514073373347">
<input type="hidden" id="JWTContainer" value="">
<input type="hidden" id="cardinalOrderNumber" value="">
<div role="main" class="form-all">
<style>
.form-all:before {
background: none;
}
</style>
<ul class="form-section page-section">
<li class="form-line" data-type="control_image" id="id_4">
<div id="cid_4" class="form-input-wide" data-layout="full">
<div style="text-align:right">
<img alt="" loading="lazy" class="form-image" style="border:0" src="https://www.jotform.com/uploads/digital.svc.be/form_files/sodexo-logo.61dc413dde6667.08008786.png" height="75px" width="231px" data-component="image">
</div>
</div>
</li>
<li id="cid_23" class="form-input-wide" data-type="control_head">
<div class="form-header-group header-default">
<div class="header-text httal htvam">
<h2 id="header_23" class="form-header" data-component="header"> Sodexo-stickers bestellen </h2>
</div>
</div>
</li>
<li class="form-line" data-type="control_text" id="id_22">
<div id="cid_22" class="form-input-wide" data-layout="full">
<div id="text_22" class="form-html" data-component="text" tabindex="0">
<p><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Beste handelaar, </span><br><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"> </span><br><span
style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Je kan bij ons stickers aanvragen voor in je zaak zodat je klanten weten dat je de cheques van Sodexo aanvaardt. Maak er gebruik van! </span><br><span
style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">De stickers worden je na je aanvraag zo snel mogelijk toegestuurd. </span><br><span
style="font-family: arial, helvetica, sans-serif; font-size: 12pt;"> </span><br><strong><span style="font-family: arial, helvetica, sans-serif; font-size: 12pt;">Het Sodexo Handelaars Team </span></strong></p>
</div>
</div>
</li>
<li class="form-line form-line-column form-col-1" data-type="control_image" id="id_18">
<div id="cid_18" class="form-input-wide" data-layout="full">
<div style="text-align:center">
<img alt="" loading="lazy" class="form-image" style="border:0" src="https://www.jotform.com/uploads/digital.svc.be/form_files/Lunchpass.620cfe5e4170b0.37274730.png" height="140px" width="270px" data-component="image">
</div>
</div>
</li>
<li class="form-line form-line-column form-col-2" data-type="control_image" id="id_20">
<div id="cid_20" class="form-input-wide" data-layout="full">
<div style="text-align:center">
<img alt="" loading="lazy" class="form-image" style="border:0" src="https://www.jotform.com/uploads/digital.svc.be/form_files/Ecopass.620cfecd1be9e5.77719592.png" height="140px" width="270px" data-component="image">
</div>
</div>
</li>
<li class="form-line form-line-column form-col-3" data-type="control_dropdown" id="id_19">
<label class="form-label form-label-top" id="label_19" for="input_19"> Sticker(s) LUNCH PASS (7cm x 11.5cm) </label>
<div id="cid_19" class="form-input-wide" data-layout="half">
<select class="form-dropdown" id="input_19" name="q19_stickersLunch" style="width:310px" data-component="dropdown">
<option value=""> Please Select </option>
<option value="1"> 1 </option>
<option value="2"> 2 </option>
<option value="3"> 3 </option>
<option value="4"> 4 </option>
<option value="5"> 5 </option>
<option value="6"> 6 </option>
<option value="7"> 7 </option>
<option value="8"> 8 </option>
<option value="9"> 9 </option>
<option value="10"> 10 </option>
</select>
</div>
</li>
<li class="form-line form-line-column form-col-4" data-type="control_dropdown" id="id_21">
<label class="form-label form-label-top" id="label_21" for="input_21"> Sticker(s) ECO PASS (7cm x 11.5cm) </label>
<div id="cid_21" class="form-input-wide" data-layout="half">
<select class="form-dropdown" id="input_21" name="q21_stickersEco" style="width:310px" data-component="dropdown">
<option value=""> Please Select </option>
<option value="1"> 1 </option>
<option value="2"> 2 </option>
<option value="3"> 3 </option>
<option value="4"> 4 </option>
<option value="5"> 5 </option>
<option value="6"> 6 </option>
<option value="7"> 7 </option>
<option value="8"> 8 </option>
<option value="9"> 9 </option>
<option value="10"> 10 </option>
</select>
</div>
</li>
<li class="form-line form-line-column form-col-5" data-type="control_image" id="id_16">
<div id="cid_16" class="form-input-wide" data-layout="full">
<div style="text-align:center">
<img alt="" loading="lazy" class="form-image" style="border:0" src="https://www.jotform.com/uploads/digital.svc.be/form_files/Cadeaupass.620cff0e529823.56853605.png" height="140px" width="270px" data-component="image">
</div>
</div>
</li>
<li class="form-line form-line-column form-col-6" data-type="control_image" id="id_26">
<div id="cid_26" class="form-input-wide" data-layout="full">
<div style="text-align:center">
<img alt="" loading="lazy" class="form-image" style="border:0" src="https://www.jotform.com/uploads/digital.svc.be/form_files/Commande%20sticker%20SC%20pass.62456857dc7393.88443346.png" height="140px" width="270px" data-component="image">
</div>
</div>
</li>
<li class="form-line form-line-column form-col-7" data-type="control_dropdown" id="id_27">
<label class="form-label form-label-top" id="label_27" for="input_27"> Sticker(s) GIFT PASS (7cm x 11.5cm) </label>
<div id="cid_27" class="form-input-wide" data-layout="half">
<select class="form-dropdown" id="input_27" name="q27_stickersGift27" style="width:310px" data-component="dropdown">
<option value=""> Please Select </option>
<option value="1"> 1 </option>
<option value="2"> 2 </option>
<option value="3"> 3 </option>
<option value="4"> 4 </option>
<option value="5"> 5 </option>
<option value="6"> 6 </option>
<option value="7"> 7 </option>
<option value="8"> 8 </option>
<option value="9"> 9 </option>
<option value="10"> 10 </option>
</select>
</div>
</li>
<li class="form-line form-line-column form-col-8" data-type="control_dropdown" id="id_17">
<label class="form-label form-label-top" id="label_17" for="input_17"> Sticker(s) SPORT&CULTURE PASS (7cm x 11.5cm) </label>
<div id="cid_17" class="form-input-wide" data-layout="half">
<select class="form-dropdown" id="input_17" name="q17_stickersSportampculture" style="width:310px" data-component="dropdown">
<option value=""> Please Select </option>
<option value="1"> 1 </option>
<option value="2"> 2 </option>
<option value="3"> 3 </option>
<option value="4"> 4 </option>
<option value="5"> 5 </option>
<option value="6"> 6 </option>
<option value="7"> 7 </option>
<option value="8"> 8 </option>
<option value="9"> 9 </option>
<option value="10"> 10 </option>
</select>
</div>
</li>
<li class="form-line form-line-column form-col-9" data-type="control_image" id="id_13">
<div id="cid_13" class="form-input-wide" data-layout="full">
<div style="text-align:center">
<img alt="" loading="lazy" class="form-image" style="border:0" src="https://www.jotform.com/uploads/digital.svc.be/form_files/Sodexo_terminal_stickers.621e49c0139a49.62605094.png" height="176px" width="280px" data-component="image">
</div>
</div>
</li>
<li class="form-line" data-type="control_dropdown" id="id_12">
<label class="form-label form-label-top" id="label_12" for="input_12"> Sticker(s) TERMINAL (3.2cm x 2.1cm) </label>
<div id="cid_12" class="form-input-wide" data-layout="half">
<select class="form-dropdown" id="input_12" name="q12_stickersTerminal" style="width:310px" data-component="dropdown">
<option value=""> Please Select </option>
<option value="1"> 1 </option>
<option value="2"> 2 </option>
<option value="3"> 3 </option>
<option value="4"> 4 </option>
<option value="5"> 5 </option>
<option value="6"> 6 </option>
<option value="7"> 7 </option>
<option value="8"> 8 </option>
<option value="9"> 9 </option>
<option value="10"> 10 </option>
</select>
</div>
</li>
<li id="cid_11" class="form-input-wide" data-type="control_pagebreak">
<div class="form-pagebreak" data-component="pagebreak">
<div class="form-pagebreak-back-container">
</div>
<div class="form-pagebreak-next-container">
<button id="form-pagebreak-next_11" type="button" class="form-pagebreak-next jf-form-buttons" data-component="pagebreak-next"> Volgende </button>
</div>
<div style="clear:both" class="pageInfo form-sub-label" id="pageInfo_11">
</div>
</div>
</li>
</ul>
<ul class="form-section page-section" style="display:none;">
<li class="form-line form-line-column form-col-1 jf-required" data-type="control_textbox" id="id_6">
<label class="form-label form-label-top" id="label_6" for="input_6"> BTW-nummer <span class="form-required"> * </span>
</label>
<div id="cid_6" class="form-input-wide jf-required" data-layout="half">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_6" name="q6_btwnummer" data-type="input-textbox" class="form-textbox validate[required, Fill Mask]" data-defaultvalue="" style="width:310px" size="310" data-masked="true" value="" data-component="textbox"
aria-labelledby="label_6 sublabel_input_6" required="" inputmode="text" maskvalue="BE##########">
<label class="form-sub-label" for="input_6" id="sublabel_input_6" style="min-height:13px" aria-hidden="false"> Format : BE0234123412 </label>
</span>
</div>
</li>
<li class="form-line form-line-column form-col-2 jf-required" data-type="control_textbox" id="id_7">
<label class="form-label form-label-top" id="label_7" for="input_7"> Naam van het verkooppunt <span class="form-required"> * </span>
</label>
<div id="cid_7" class="form-input-wide jf-required" data-layout="half">
<input type="text" id="input_7" name="q7_naamVan" data-type="input-textbox" class="form-textbox validate[required]" data-defaultvalue="" style="width:310px" size="310" value="" data-component="textbox" aria-labelledby="label_7" required="">
</div>
</li>
<li class="form-line jf-required" data-type="control_address" id="id_10">
<label class="form-label form-label-top" id="label_10" for="input_10_addr_line1"> Leveringsadres <span class="form-required"> * </span>
</label>
<div id="cid_10" class="form-input-wide jf-required" data-layout="full">
<div summary="" class="form-address-table jsTest-addressField">
<div class="form-address-line-wrapper jsTest-address-line-wrapperField">
<span class="form-address-line form-address-street-line jsTest-address-lineField">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_10_addr_line1" name="q10_leveringsadres[addr_line1]" class="form-textbox validate[required] form-address-line" data-defaultvalue="" autocomplete="section-input_10 address-line1" value=""
data-component="address_line_1" aria-labelledby="label_10 sublabel_10_addr_line1" required="">
<label class="form-sub-label" for="input_10_addr_line1" id="sublabel_10_addr_line1" style="min-height:13px" aria-hidden="false"> Straat en nummer </label>
</span>
</span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField">
<span class="form-address-line form-address-street-line jsTest-address-lineField">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_10_addr_line2" name="q10_leveringsadres[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autocomplete="section-input_10 address-line2" value="" data-component="address_line_2"
aria-labelledby="label_10 sublabel_10_addr_line2">
<label class="form-sub-label" for="input_10_addr_line2" id="sublabel_10_addr_line2" style="min-height:13px" aria-hidden="false"> Postbus </label>
</span>
</span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField">
<span class="form-address-line form-address-city-line jsTest-address-lineField ">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_10_city" name="q10_leveringsadres[city]" class="form-textbox validate[required] form-address-city" data-defaultvalue="" autocomplete="section-input_10 address-level2" value="" data-component="city"
aria-labelledby="label_10 sublabel_10_city" required="">
<label class="form-sub-label" for="input_10_city" id="sublabel_10_city" style="min-height:13px" aria-hidden="false"> Gemeente </label>
</span>
</span>
<span class="form-address-line form-address-state-line jsTest-address-lineField form-address-hiddenLine" style="display:none">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_10_state" name="q10_leveringsadres[state]" class="form-textbox form-address-state" data-defaultvalue="" autocomplete="section-input_10 address-level1" value="" data-component="state"
aria-labelledby="label_10 sublabel_10_state">
<label class="form-sub-label" for="input_10_state" id="sublabel_10_state" style="min-height:13px" aria-hidden="false"> State / Province </label>
</span>
</span>
</div>
<div class="form-address-line-wrapper jsTest-address-line-wrapperField">
<span class="form-address-line form-address-zip-line jsTest-address-lineField ">
<span class="form-sub-label-container" style="vertical-align:top">
<input type="text" id="input_10_postal" name="q10_leveringsadres[postal]" class="form-textbox validate[required] form-address-postal" data-defaultvalue="" autocomplete="section-input_10 postal-code" value="" data-component="zip"
aria-labelledby="label_10 sublabel_10_postal" required="">
<label class="form-sub-label" for="input_10_postal" id="sublabel_10_postal" style="min-height:13px" aria-hidden="false"> Postcode </label>
</span>
</span>
</div>
</div>
</div>
</li>
<li class="form-line" data-type="control_button" id="id_2">
<div id="cid_2" class="form-input-wide" data-layout="full">
<div data-align="auto" class="form-buttons-wrapper form-buttons-auto jsTest-button-wrapperField form-pagebreak">
<div class="form-pagebreak-back-container"><button id="form-pagebreak-back_11" type="button" class="form-pagebreak-back jf-form-buttons" data-component="pagebreak-back"> Terug </button></div><button id="input_2" type="submit"
class="form-submit-button submit-button jf-form-buttons jsTest-submitField" data-component="button" data-content=""> Verzenden </button>
</div>
</div>
</li>
<li style="clear:both">
</li>
<li style="display:none"> Should be Empty: <input type="text" name="website" value="">
</li>
</ul>
</div>
<script>
JotForm.showJotFormPowered = "0";
</script>
<script>
JotForm.poweredByText = "Powered by Jotform";
</script>
<input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="220514073373347-220514073373347">
<script type="text/javascript">
var all_spc = document.querySelectorAll("form[id='220514073373347'] .si" + "mple" + "_spc");
for (var i = 0; i < all_spc.length; i++) {
all_spc[i].value = "220514073373347-220514073373347";
}
</script>
<input type="hidden" name="event_id" value="1665065957055_220514073373347_HbhoRaU"><input id="enterprise_server" type="hidden" name="enterprise_server" value="sodexo.jotform.com">
</form>Text Content
* * SODEXO-STICKERS BESTELLEN * Beste handelaar, Je kan bij ons stickers aanvragen voor in je zaak zodat je klanten weten dat je de cheques van Sodexo aanvaardt. Maak er gebruik van! De stickers worden je na je aanvraag zo snel mogelijk toegestuurd. Het Sodexo Handelaars Team * * * Sticker(s) LUNCH PASS (7cm x 11.5cm) Please Select 1 2 3 4 5 6 7 8 9 10 * Sticker(s) ECO PASS (7cm x 11.5cm) Please Select 1 2 3 4 5 6 7 8 9 10 * * * Sticker(s) GIFT PASS (7cm x 11.5cm) Please Select 1 2 3 4 5 6 7 8 9 10 * Sticker(s) SPORT&CULTURE PASS (7cm x 11.5cm) Please Select 1 2 3 4 5 6 7 8 9 10 * * Sticker(s) TERMINAL (3.2cm x 2.1cm) Please Select 1 2 3 4 5 6 7 8 9 10 * Volgende * BTW-nummer * Format : BE0234123412 * Naam van het verkooppunt * * Leveringsadres * Straat en nummer Postbus Gemeente State / Province Postcode * Terug Verzenden * * Should be Empty: