{"id":4872,"date":"2014-09-27T21:25:37","date_gmt":"2014-09-27T19:25:37","guid":{"rendered":"http:\/\/www.kantoorblyaert.be\/?page_id=4872"},"modified":"2016-11-19T23:02:58","modified_gmt":"2016-11-19T22:02:58","slug":"formulaire-contact","status":"publish","type":"page","link":"https:\/\/fvcharlier.be\/fr\/formulaire-contact\/","title":{"rendered":"Contact \/ Demande Informations"},"content":{"rendered":"<h2 class=\"node\">Formulaire de contact<\/h2>\n<div id=\"vfb-form-7\" class=\"visual-form-builder-container\"><form id=\"contact-demande-informations-7\" class=\"visual-form-builder vfb-form-7  \" method=\"post\" enctype=\"multipart\/form-data\" action=\"\">\n\t\t<input type=\"hidden\" name=\"form_id\" value=\"7\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 vos-coordonnees    \" id=\"item-vfb-151\"><div class=\"vfb-legend\"><h3>Vos coordonn\u00e9es<\/h3><\/div><ul class=\"vfb-section vfb-section-1\"><li class=\"vfb-item vfb-item-text    \" id=\"item-vfb-155\"><label for=\"vfb-155\" class=\"vfb-desc\">Pr\u00e9nom + nom  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-155\" id=\"vfb-155\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li>\n<li class=\"vfb-item vfb-item-text    \" id=\"item-vfb-157\"><label for=\"vfb-157\" class=\"vfb-desc\">T\u00e9l\u00e9phone <\/label><input type=\"text\" name=\"vfb-157\" id=\"vfb-157\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li>\n<li class=\"vfb-item vfb-item-text    \" id=\"item-vfb-158\"><label for=\"vfb-158\" class=\"vfb-desc\">Votre adresse Email  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-158\" id=\"vfb-158\" value=\"\" class=\"vfb-text  vfb-medium  required  email \" \/><\/li>\n<li class=\"vfb-item vfb-item-select    \" id=\"item-vfb-159\"><label for=\"vfb-159\" class=\"vfb-desc\">Raison de contact <\/label><select name=\"vfb-159\" id=\"vfb-159\" class=\"vfb-select  vfb-medium  \"><option value=\"T\u00e9l\u00e9phonez-moi\">T\u00e9l\u00e9phonez-moi<\/option><option value=\"Je souhaite un RDV\">Je souhaite un RDV<\/option><option value=\"Informations assurances\">Informations assurances<\/option><option value=\"Demande r\u00e9vision de mon de dossier\">Demande r\u00e9vision de mon de dossier<\/option><option value=\"Je souhaite devenir client chez vous\">Je souhaite devenir client chez vous<\/option><option value=\"J&#039;ai un sinistre\">J'ai un sinistre<\/option><option value=\"Autres\">Autres<\/option><\/select><\/li>\n<li class=\"vfb-item vfb-item-textarea    \" id=\"item-vfb-156\"><label for=\"vfb-156\" class=\"vfb-desc\">Votre message <\/label><div><textarea name=\"vfb-156\" id=\"vfb-156\" class=\"vfb-textarea  vfb-medium   \"><\/textarea><\/div><\/li>\n<\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 validatie  \" id=\"item-vfb-152\"><div class=\"vfb-legend\"><h3>Validatie<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-secret\" ><label for=\"item-vfb-153\" class=\"vfb-desc\">Geef een willlekeurig getal van 2 cijfers zonder spaties <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-153\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-153\" id=\"item-vfb-153\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" \/><label>Voorbeeld: 12<\/label><\/span><li style=\"display:none;\"><label>Cette bo\u00eete est pour la protection contre le spam - <strong>Veuillez laisser en blanc<\/strong><\/label><div><input name=\"vfb-spam\" \/><\/div><\/li><li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-154\">\n\t\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-154\" value=\"Verzenden\" class=\"vfb-submit \" \/>\n\t\t\t\t\t<\/li><\/ul>\n\t\t &nbsp;\n\t\t <\/fieldset><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/fr\/wp-json\/wp\/v2\/pages\/4872\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n","protected":false},"excerpt":{"rendered":"<p>Formulaire de contact<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/pages\/4872"}],"collection":[{"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/comments?post=4872"}],"version-history":[{"count":0,"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/pages\/4872\/revisions"}],"wp:attachment":[{"href":"https:\/\/fvcharlier.be\/fr\/wp-json\/wp\/v2\/media?parent=4872"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}