{"id":14095,"date":"2019-02-05T10:09:13","date_gmt":"2019-02-05T09:09:13","guid":{"rendered":"https:\/\/dev.hertsensvastgoed.eu\/contact\/"},"modified":"2023-10-06T14:18:32","modified_gmt":"2023-10-06T12:18:32","slug":"contact","status":"publish","type":"page","link":"https:\/\/dev.hertsensvastgoed.eu\/fr\/contact\/","title":{"rendered":"Contact"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=&#8221;stretch_row_content_no_spaces&#8221;][vc_column][vc_gmaps link=&#8221;#E-8_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&#8221; size=&#8221;350px&#8221; el_class=&#8221;map&#8221;][\/vc_column][\/vc_row][vc_row][vc_column][vc_empty_space height=&#8221;50px&#8221;][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\">Contactez nous<\/h1>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row gap=&#8221;20&#8243; content_placement=&#8221;top&#8221;][vc_column width=&#8221;1\/3&#8243; el_class=&#8221;colored&#8221; css=&#8221;.vc_custom_1663935780932{padding-top: 40px !important;padding-right: 40px !important;padding-bottom: 10px !important;padding-left: 40px !important;background-color: #e54e42 !important;}&#8221;][vc_column_text]<\/p>\n<h4><strong>Hertsens Beheer bvba<\/strong><\/h4>\n<p>Heirbaan 9<br \/>\n9150 Kruibeke<br \/>\nTVA BE0627.895.450<\/p>\n<p>T : <a href=\"tel:+3232501223\">+32 3 250 12 23<\/a><br \/>\nM : <a href=\"mailto:beheer@hertsens.eu\">beheer@hertsens.eu<\/a>[\/vc_column_text][\/vc_column][vc_column width=&#8221;2\/3&#8243;][vc_column_text]<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_1' style='display:none'>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Contactformulier<\/h3>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_1'  action='\/fr\/wp-json\/wp\/v2\/pages\/14095' data-formid='1' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_1' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_1_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_1\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Naam<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_1_1'>\n                            \n                            <span id='input_1_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_1_1_3' class='gform-field-label gform-field-label--type-sub '>Pr\u00e9nom<\/label>\n                                                    <input type='text' name='input_1.3' id='input_1_1_3' value=''   aria-required='true'     \/>\n                                                <\/span>\n                            \n                            <span id='input_1_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_1_1_6' class='gform-field-label gform-field-label--type-sub '>Nom<\/label>\n                                                            <input type='text' name='input_1.6' id='input_1_1_6' value=''   aria-required='true'     \/>\n                                                        <\/span>\n                            \n                        <\/div><\/li><li id=\"field_1_18\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_18\" ><label class='gfield_label gform-field-label' for='input_1_18'>BTW nr<\/label><div class='ginput_container ginput_container_text'><input name='input_18' id='input_1_18' type='text' value='' class='large'  aria-describedby=\"gfield_description_1_18\"    aria-invalid=\"false\"   \/> <\/div><div class='gfield_description' id='gfield_description_1_18'>indien van toepassing<\/div><\/li><li id=\"field_1_2\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_2\" ><label class='gfield_label gform-field-label' for='input_1_2'>E-mailadres<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_1_2' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_1_3\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_3\" ><label class='gfield_label gform-field-label' for='input_1_3'>Onderwerp<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_1_3' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_1_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_9\" ><label class='gfield_label gform-field-label' >Regio<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_9'>\n\t\t\t<li class='gchoice gchoice_1_9_0'>\n\t\t\t\t<input name='input_9' type='radio' value='Brussel'  id='choice_1_9_0'    \/>\n\t\t\t\t<label for='choice_1_9_0' id='label_1_9_0' class='gform-field-label gform-field-label--type-inline'>Brussel<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_1'>\n\t\t\t\t<input name='input_9' type='radio' value='Limburg'  id='choice_1_9_1'    \/>\n\t\t\t\t<label for='choice_1_9_1' id='label_1_9_1' class='gform-field-label gform-field-label--type-inline'>Limburg<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_2'>\n\t\t\t\t<input name='input_9' type='radio' value='Antwerpen'  id='choice_1_9_2'    \/>\n\t\t\t\t<label for='choice_1_9_2' id='label_1_9_2' class='gform-field-label gform-field-label--type-inline'>Antwerpen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_3'>\n\t\t\t\t<input name='input_9' type='radio' value='Oost-Vlaanderen'  id='choice_1_9_3'    \/>\n\t\t\t\t<label for='choice_1_9_3' id='label_1_9_3' class='gform-field-label gform-field-label--type-inline'>Oost-Vlaanderen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_4'>\n\t\t\t\t<input name='input_9' type='radio' value='West-Vlaanderen'  id='choice_1_9_4'    \/>\n\t\t\t\t<label for='choice_1_9_4' id='label_1_9_4' class='gform-field-label gform-field-label--type-inline'>West-Vlaanderen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_5'>\n\t\t\t\t<input name='input_9' type='radio' value='Zeeland'  id='choice_1_9_5'    \/>\n\t\t\t\t<label for='choice_1_9_5' id='label_1_9_5' class='gform-field-label gform-field-label--type-inline'>Zeeland<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_6'>\n\t\t\t\t<input name='input_9' type='radio' value='Westerlo'  id='choice_1_9_6'    \/>\n\t\t\t\t<label for='choice_1_9_6' id='label_1_9_6' class='gform-field-label gform-field-label--type-inline'>Westerlo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_9_7'>\n\t\t\t\t<input name='input_9' type='radio' value='gf_other_choice'  id='choice_1_9_7'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_9_other' name='input_9_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_9'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_10\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_10\" ><label class='gfield_label gform-field-label' >Gemeente<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_10'>\n\t\t\t<li class='gchoice gchoice_1_10_0'>\n\t\t\t\t<input name='input_10' type='radio' value='Brussel - Sint-Joost-ten-Node'  id='choice_1_10_0'    \/>\n\t\t\t\t<label for='choice_1_10_0' id='label_1_10_0' class='gform-field-label gform-field-label--type-inline'>Brussel - Sint-Joost-ten-Node<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_10_1'>\n\t\t\t\t<input name='input_10' type='radio' value='Diegem'  id='choice_1_10_1'    \/>\n\t\t\t\t<label for='choice_1_10_1' id='label_1_10_1' class='gform-field-label gform-field-label--type-inline'>Diegem<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_10_2'>\n\t\t\t\t<input name='input_10' type='radio' value='Huizingen'  id='choice_1_10_2'    \/>\n\t\t\t\t<label for='choice_1_10_2' id='label_1_10_2' class='gform-field-label gform-field-label--type-inline'>Huizingen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_10_3'>\n\t\t\t\t<input name='input_10' type='radio' value='gf_other_choice'  id='choice_1_10_3'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_10_other' name='input_10_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_10'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_11\" ><label class='gfield_label gform-field-label' >Gemeente<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_11'>\n\t\t\t<li class='gchoice gchoice_1_11_0'>\n\t\t\t\t<input name='input_11' type='radio' value='Averbode'  id='choice_1_11_0'    \/>\n\t\t\t\t<label for='choice_1_11_0' id='label_1_11_0' class='gform-field-label gform-field-label--type-inline'>Averbode<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_1'>\n\t\t\t\t<input name='input_11' type='radio' value='Beringen'  id='choice_1_11_1'    \/>\n\t\t\t\t<label for='choice_1_11_1' id='label_1_11_1' class='gform-field-label gform-field-label--type-inline'>Beringen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_2'>\n\t\t\t\t<input name='input_11' type='radio' value='Bocholt'  id='choice_1_11_2'    \/>\n\t\t\t\t<label for='choice_1_11_2' id='label_1_11_2' class='gform-field-label gform-field-label--type-inline'>Bocholt<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_3'>\n\t\t\t\t<input name='input_11' type='radio' value='Hasselt (Alva Oude Truierbaan)'  id='choice_1_11_3'    \/>\n\t\t\t\t<label for='choice_1_11_3' id='label_1_11_3' class='gform-field-label gform-field-label--type-inline'>Hasselt (Alva Oude Truierbaan)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_4'>\n\t\t\t\t<input name='input_11' type='radio' value='Hasselt (Larego Trichterheideweg)'  id='choice_1_11_4'    \/>\n\t\t\t\t<label for='choice_1_11_4' id='label_1_11_4' class='gform-field-label gform-field-label--type-inline'>Hasselt (Larego Trichterheideweg)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_5'>\n\t\t\t\t<input name='input_11' type='radio' value='Hasselt (Sas Sasstraat)'  id='choice_1_11_5'    \/>\n\t\t\t\t<label for='choice_1_11_5' id='label_1_11_5' class='gform-field-label gform-field-label--type-inline'>Hasselt (Sas Sasstraat)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_6'>\n\t\t\t\t<input name='input_11' type='radio' value='Heusden-Zolder'  id='choice_1_11_6'    \/>\n\t\t\t\t<label for='choice_1_11_6' id='label_1_11_6' class='gform-field-label gform-field-label--type-inline'>Heusden-Zolder<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_7'>\n\t\t\t\t<input name='input_11' type='radio' value='Houthalen'  id='choice_1_11_7'    \/>\n\t\t\t\t<label for='choice_1_11_7' id='label_1_11_7' class='gform-field-label gform-field-label--type-inline'>Houthalen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_8'>\n\t\t\t\t<input name='input_11' type='radio' value='Maasmechelen'  id='choice_1_11_8'    \/>\n\t\t\t\t<label for='choice_1_11_8' id='label_1_11_8' class='gform-field-label gform-field-label--type-inline'>Maasmechelen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_9'>\n\t\t\t\t<input name='input_11' type='radio' value='Sint-Truiden'  id='choice_1_11_9'    \/>\n\t\t\t\t<label for='choice_1_11_9' id='label_1_11_9' class='gform-field-label gform-field-label--type-inline'>Sint-Truiden<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_11_10'>\n\t\t\t\t<input name='input_11' type='radio' value='gf_other_choice'  id='choice_1_11_10'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_11_other' name='input_11_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_11'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_12\" ><label class='gfield_label gform-field-label' >Gemeente<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_12'>\n\t\t\t<li class='gchoice gchoice_1_12_0'>\n\t\t\t\t<input name='input_12' type='radio' value='Kontich'  id='choice_1_12_0'    \/>\n\t\t\t\t<label for='choice_1_12_0' id='label_1_12_0' class='gform-field-label gform-field-label--type-inline'>Kontich<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_12_1'>\n\t\t\t\t<input name='input_12' type='radio' value='Westerlo'  id='choice_1_12_1'    \/>\n\t\t\t\t<label for='choice_1_12_1' id='label_1_12_1' class='gform-field-label gform-field-label--type-inline'>Westerlo<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_12_2'>\n\t\t\t\t<input name='input_12' type='radio' value='Zwijndrecht'  id='choice_1_12_2'    \/>\n\t\t\t\t<label for='choice_1_12_2' id='label_1_12_2' class='gform-field-label gform-field-label--type-inline'>Zwijndrecht<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_12_3'>\n\t\t\t\t<input name='input_12' type='radio' value='gf_other_choice'  id='choice_1_12_3'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_12_other' name='input_12_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_12'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_13\" ><label class='gfield_label gform-field-label' >Gemeente<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_13'>\n\t\t\t<li class='gchoice gchoice_1_13_0'>\n\t\t\t\t<input name='input_13' type='radio' value='Kruibeke' checked='checked' id='choice_1_13_0'    \/>\n\t\t\t\t<label for='choice_1_13_0' id='label_1_13_0' class='gform-field-label gform-field-label--type-inline'>Kruibeke<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_1'>\n\t\t\t\t<input name='input_13' type='radio' value='Melsele'  id='choice_1_13_1'    \/>\n\t\t\t\t<label for='choice_1_13_1' id='label_1_13_1' class='gform-field-label gform-field-label--type-inline'>Melsele<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_2'>\n\t\t\t\t<input name='input_13' type='radio' value='Oudenaarde'  id='choice_1_13_2'    \/>\n\t\t\t\t<label for='choice_1_13_2' id='label_1_13_2' class='gform-field-label gform-field-label--type-inline'>Oudenaarde<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_3'>\n\t\t\t\t<input name='input_13' type='radio' value='Sint-Niklaas'  id='choice_1_13_3'    \/>\n\t\t\t\t<label for='choice_1_13_3' id='label_1_13_3' class='gform-field-label gform-field-label--type-inline'>Sint-Niklaas<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_4'>\n\t\t\t\t<input name='input_13' type='radio' value='Steendorp'  id='choice_1_13_4'    \/>\n\t\t\t\t<label for='choice_1_13_4' id='label_1_13_4' class='gform-field-label gform-field-label--type-inline'>Steendorp<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_5'>\n\t\t\t\t<input name='input_13' type='radio' value='Zwijndrecht'  id='choice_1_13_5'    \/>\n\t\t\t\t<label for='choice_1_13_5' id='label_1_13_5' class='gform-field-label gform-field-label--type-inline'>Zwijndrecht<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_13_6'>\n\t\t\t\t<input name='input_13' type='radio' value='gf_other_choice'  id='choice_1_13_6'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_13_other' name='input_13_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_13'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_14\" ><label class='gfield_label gform-field-label' >Gemeente<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_14'>\n\t\t\t<li class='gchoice gchoice_1_14_0'>\n\t\t\t\t<input name='input_14' type='radio' value='Anzegem'  id='choice_1_14_0'    \/>\n\t\t\t\t<label for='choice_1_14_0' id='label_1_14_0' class='gform-field-label gform-field-label--type-inline'>Anzegem<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_1'>\n\t\t\t\t<input name='input_14' type='radio' value='Beveren-Leie'  id='choice_1_14_1'    \/>\n\t\t\t\t<label for='choice_1_14_1' id='label_1_14_1' class='gform-field-label gform-field-label--type-inline'>Beveren-Leie<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_2'>\n\t\t\t\t<input name='input_14' type='radio' value='Moorslede'  id='choice_1_14_2'    \/>\n\t\t\t\t<label for='choice_1_14_2' id='label_1_14_2' class='gform-field-label gform-field-label--type-inline'>Moorslede<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_3'>\n\t\t\t\t<input name='input_14' type='radio' value='Rumbeke'  id='choice_1_14_3'    \/>\n\t\t\t\t<label for='choice_1_14_3' id='label_1_14_3' class='gform-field-label gform-field-label--type-inline'>Rumbeke<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_4'>\n\t\t\t\t<input name='input_14' type='radio' value='Vichte'  id='choice_1_14_4'    \/>\n\t\t\t\t<label for='choice_1_14_4' id='label_1_14_4' class='gform-field-label gform-field-label--type-inline'>Vichte<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_5'>\n\t\t\t\t<input name='input_14' type='radio' value='Wervik'  id='choice_1_14_5'    \/>\n\t\t\t\t<label for='choice_1_14_5' id='label_1_14_5' class='gform-field-label gform-field-label--type-inline'>Wervik<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_6'>\n\t\t\t\t<input name='input_14' type='radio' value='Wielsbeke'  id='choice_1_14_6'    \/>\n\t\t\t\t<label for='choice_1_14_6' id='label_1_14_6' class='gform-field-label gform-field-label--type-inline'>Wielsbeke<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_14_7'>\n\t\t\t\t<input name='input_14' type='radio' value='gf_other_choice'  id='choice_1_14_7'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_14_other' name='input_14_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_14'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_15\" ><label class='gfield_label gform-field-label' >Gemeente<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_1_15'>\n\t\t\t<li class='gchoice gchoice_1_15_0'>\n\t\t\t\t<input name='input_15' type='radio' value='Axel'  id='choice_1_15_0'    \/>\n\t\t\t\t<label for='choice_1_15_0' id='label_1_15_0' class='gform-field-label gform-field-label--type-inline'>Axel<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_1'>\n\t\t\t\t<input name='input_15' type='radio' value='Goes'  id='choice_1_15_1'    \/>\n\t\t\t\t<label for='choice_1_15_1' id='label_1_15_1' class='gform-field-label gform-field-label--type-inline'>Goes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_2'>\n\t\t\t\t<input name='input_15' type='radio' value='Hulst'  id='choice_1_15_2'    \/>\n\t\t\t\t<label for='choice_1_15_2' id='label_1_15_2' class='gform-field-label gform-field-label--type-inline'>Hulst<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_3'>\n\t\t\t\t<input name='input_15' type='radio' value='Middelburg (Arnesteinweg)'  id='choice_1_15_3'    \/>\n\t\t\t\t<label for='choice_1_15_3' id='label_1_15_3' class='gform-field-label gform-field-label--type-inline'>Middelburg (Arnesteinweg)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_4'>\n\t\t\t\t<input name='input_15' type='radio' value='Middelburg (Industrieweg)'  id='choice_1_15_4'    \/>\n\t\t\t\t<label for='choice_1_15_4' id='label_1_15_4' class='gform-field-label gform-field-label--type-inline'>Middelburg (Industrieweg)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_5'>\n\t\t\t\t<input name='input_15' type='radio' value='Philippine'  id='choice_1_15_5'    \/>\n\t\t\t\t<label for='choice_1_15_5' id='label_1_15_5' class='gform-field-label gform-field-label--type-inline'>Philippine<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_6'>\n\t\t\t\t<input name='input_15' type='radio' value='Vlissingen'  id='choice_1_15_6'    \/>\n\t\t\t\t<label for='choice_1_15_6' id='label_1_15_6' class='gform-field-label gform-field-label--type-inline'>Vlissingen<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_1_15_7'>\n\t\t\t\t<input name='input_15' type='radio' value='gf_other_choice'  id='choice_1_15_7'   onfocus=\"jQuery(this).next('input').focus();\" \/>\n\t\t\t\t<input class='small' id='input_1_15_other' name='input_15_other' type='text' value='Autre' aria-label='Autre' onfocus='jQuery(this).prev(\"input\")[0].click(); if(jQuery(this).val() == \"Autre\") { jQuery(this).val(\"\"); }' onblur='if(jQuery(this).val().replace(\" \", \"\") == \"\") { jQuery(this).val(\"Autre\"); }'   \/>\n\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_1_15'>Geef aan over welke regio u info wenst.<\/div><\/li><li id=\"field_1_4\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_4\" ><label class='gfield_label gform-field-label' for='input_1_4'>Uw bericht<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_4' id='input_1_4' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_1_7\" class=\"gfield gfield--type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_1_7\" ><label class='gfield_label gform-field-label' for='input_1_7'>CAPTCHA<\/label><div id='input_1_7' class='ginput_container ginput_recaptcha' data-sitekey='6LesqXYdAAAAACUm0fkBIIEZRiFlGI9rrbwGB4-k'  data-theme='light' data-tabindex='0'  data-badge=''><\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_1' class='gform_button button' value='Versturen'  onclick='if(window[\"gf_submitting_1\"]){return false;}  if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_1\"]){return false;} if( !jQuery(\"#gform_1\")[0].checkValidity || jQuery(\"#gform_1\")[0].checkValidity()){window[\"gf_submitting_1\"]=true;}  jQuery(\"#gform_1\").trigger(\"submit\",[true]); }' \/> \n            <input type='hidden' class='gform_hidden' name='is_submit_1' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='1' \/>\n            \n            <input type='hidden' class='gform_hidden' name='gform_unique_id' value='' \/>\n            <input type='hidden' class='gform_hidden' name='state_1' value='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' 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