autismepas.liga-autisme-vlaanderen.php82.tesuta.be
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URL:
https://autismepas.liga-autisme-vlaanderen.php82.tesuta.be/
Submission: On August 01 via api from US — Scanned from DE
Submission: On August 01 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMName: front_step_form — POST
<form name="front_step_form" method="post" data-role="front-step-form">
<article class="card card-primary card-front shadow" style="background-image: url(/build/images/text-blue.80f5730e.png);">
<div class="card-body">
<div class="card-front-name">Mijn naam is</div>
<div class="card-front-name text-white" data-role="front-step-name-preview">Voornaam Achternaam</div>
<div class="card-front-title">Ik heb autisme.</div>
</div>
<div class="card-footer">
<div class="d-flex justify-content-between align-items-end">
<img src="/build/images/logo.529ee96f.png" alt="">
<div class="bg-danger logo-autismepas">AUTISME<span>PAS</span></div>
</div>
</div>
</article>
<div class="card card-primary bg-white">
<div class="card-body">
<div id="front_step_form" data-role="front-step-form">
<div class="form-group"><label for="front_step_form_firstName" class="form-label">Wat is je voornaam? <abbr title="dit veld is verplicht">*</abbr></label><input type="text" id="front_step_form_firstName" name="front_step_form[firstName]"
required="required" data-role="front-step-first-name" placeholder="Voornaam" maxlength="40" class="form-control"> </div>
<div class="form-group"><label for="front_step_form_lastName" class="form-label">Wat is je achternaam? <abbr title="dit veld is verplicht">*</abbr></label><input type="text" id="front_step_form_lastName" name="front_step_form[lastName]"
required="required" data-role="front-step-last-name" placeholder="Achternaam" maxlength="40" class="form-control"> </div><input type="hidden" id="front_step_form__token" name="front_step_form[_token]"
value="a58cce11947e25b502.8cbhi9GcqO5OeUY2Qi2EQA-xQpUsgc5ADzNK_8KgiEY.goWpspOx-qcYEQdecnXrcHbzDKIZ8qBwWFA5kbfT6ymJs7PinsyQgBk0Aw">
</div>
<button type="submit" class="float-end btn btn-primary">Volgende stap</button>
</div>
</div>
</form>
Text Content
1 Voorkant 2 Achterkant 3Jouw gegevens Mijn naam is Voornaam Achternaam Ik heb autisme. AUTISMEPAS Wat is je voornaam? * Wat is je achternaam? * Volgende stap De Autismepas is een initiatief van Liga Autisme Vlaanderen. Meer info over de Autismepas vind je op www.ligaautismevlaanderen.be/autismepas. … Annuleer Ok