Admin - Plateforme Administration Editions Préference

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Contenu HTML

<table border="0" cellpadding="1" cellspacing="2" style="width: 100%;">
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			<td style="vertical-align: bottom; width: 50%;"><span style="font-size:12px;"><span style="font-family:ITCAvantGardePro;">{% select_tag name=&quot;2a6cec09&quot; data_label=&quot;Civilit&eacute;&quot; data_map_field=&quot;civilite&quot; data_help=&quot;Civilit&eacute;&quot; data_choices=&quot;Aanhef|civilite; Mevrouw|madame; Meneer|monsieur;&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}<strong>&nbsp;</strong>Naam :</span></span></td>
			<td style="vertical-align: bottom; width: 50%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Voornaam :</span></td>
		</tr>
		<tr>
			<td style="vertical-align: middle; width: 50%;"><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;f1d9a812&quot; data_label=&quot;Naam van de ondertekenaar&quot; data_map_field=&quot;nom&quot; data_help=&quot;Naam van de ondertekenaar&quot; maxlength=&quot;50&quot; relation_ids_list=&quot;087a9c2a&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
			<td style="vertical-align: middle; width: 50%;"><span style="font-size:12px;"><span style="font-family:ITCAvantGardePro;">{% textinput_tag name=&quot;e7d938b6&quot; data_label=&quot;Voornaam van de ondertekenaar&quot; data_map_field=&quot;prenom&quot; data_help=&quot;Voornaam van de ondertekenaar&quot; maxlength=&quot;50&quot; relation_ids_list=&quot;002cb93f&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Adres :</span></td>
		</tr>
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			<td style="width: 68px;"><span style="font-size:12px;">{% textinput_tag name=&quot;109d7745&quot; data_label=&quot;Postadres van de ondertekenaar&quot; data_map_field=&quot;adresse&quot; data_help=&quot;Postadres van de ondertekenaar&quot; maxlength=&quot;100&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td style="width: 20%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Postcode :</span></td>
			<td style="width: 55%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Stad :</span></td>
			<td style="width: 25%;"><span style="font-size:12px"><span style="font-family:ITCAvantGardePro"><span style="font-weight:200"><font face="ITCAvantGardePro">Land :</font></span></span></span></td>
		</tr>
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			<td style="width: 20%;"><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;de0ac6cf&quot; data_label=&quot;Postcode&quot; data_map_field=&quot;zipcode&quot; data_help=&quot;Postcode&quot; maxlength=&quot;10&quot; relation_ids_list=&quot;f5e66571&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
			<td style="width: 55%;"><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;729bba52&quot; data_label=&quot;Stad&quot; data_map_field=&quot;ville&quot; data_help=&quot;Stad&quot; maxlength=&quot;80&quot; relation_ids_list=&quot;ed0a66fe&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
			<td style="width: 25%;"><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;4e0fc70a&quot; placeholder=&quot;Luxemburg&quot; data_label=&quot;Land van de ondertekenaar&quot; data_map_field=&quot;pays&quot; data_help=&quot;Land van de ondertekenaar&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="1" cellspacing="2" style="width: 100%;">
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			<td style="vertical-align: middle; width: 70%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">E-mail :&nbsp;</span></td>
			<td style="vertical-align: middle; width: 30%;"><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">&nbsp;Tel :&nbsp;&nbsp;</span></td>
		</tr>
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			<td style="vertical-align: middle; width: 70%;"><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;70dab79e&quot; data_label=&quot;Email&quot; data_map_field=&quot;email&quot; data_help=&quot;Email &quot; maxlength=&quot;50&quot; relation_ids_list=&quot;4ce94e90&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
			<td style="vertical-align: middle; width: 30%;"><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;6dc1dd0c&quot; data_label=&quot;Telefoon&quot; data_map_field=&quot;tel&quot; data_help=&quot;Telefoon van de ondertekenaar&quot; maxlength=&quot;25&quot; relation_ids_list=&quot;983649b0&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
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</table>

<table style="width:100%;">
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Beroep&nbsp;:</span></td>
			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Nationaliteit&nbsp;:</span></td>
		</tr>
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			<td><span style="font-family:ITCAvantGardePro;"><span style="font-size:12px;">{% textinput_tag name=&quot;9bb31b8e&quot; data_label=&quot;Beroep&quot; data_map_field=&quot;job&quot; data_help=&quot;Beroep&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
			<td><span style="font-size:12px;"><span style="font-family:ITCAvantGardePro;">{% textinput_tag name=&quot;1f8f2318&quot; data_label=&quot;Nationaliteit&quot; data_map_field=&quot;nationality&quot; data_help=&quot;Nationaliteit&quot; maxlength=&quot;50&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
		</tr>
	</tbody>
</table>

<table style="width:100%; border:undefined">
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			<td><span style="font-size:12px;"><span style="font-family: ITCAvantGardePro; font-weight: 200;">Burgerlijke staat: </span></span><span><span style="font-family: ITCAvantGardePro; font-weight: 200;">{% radio_tag name=&quot;d8242156f&quot; data_label=&quot;Burgerlijke staat&quot; data_map_field=&quot;nomap&quot; data_help=&quot;Burgerlijke staat&quot; data_choices=&quot;Ongehuwd&nbsp; |Ongehuwd; Getrouwd&nbsp; |Getrouwd; Geregistreerd partnerschap&nbsp; |Geregistreerd partnerschap; Gescheiden&nbsp; |Gescheiden; Weduwe/weduwnaar&nbsp; |Weduwe/weduwnaar;&quot; %}</span></span></td>
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			<td><span style="font-size:12px"><span style="font-family:ITCAvantGardePro"><span style="font-weight:200">Details burgerlijke staat:</span></span></span></td>
		</tr>
		<tr>
			<td><span style="font-size:12px;"><span style="font-family:ITCAvantGardePro;">{% textarea_tag name=&quot;dcb41cd9&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Details burgerlijke staat&quot; data_map_field=&quot;family_situation&quot; data_help=&quot;Geef de datum en plaats van het huwelijk en het huwelijksgoederenregime op. Geef ook de datum en plaats van de geregistreerde partnerschapsregistratie op.&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
		</tr>
	</tbody>
</table>

<table border="0" cellpadding="2" cellspacing="2" style="width:100%;">
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			<td><span style="font-family:ITCAvantGardePro;font-size:12px;font-weight:200;">Andere nuttige informatie :</span></td>
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			<td><span style="font-size:12px;"><span style="font-family:ITCAvantGardePro;">{% textarea_tag name=&quot;740db238&quot; data_width=&quot;100&quot; rows=&quot;1&quot; data_label=&quot;Andere nuttige informatie&quot; data_map_field=&quot;comment&quot; data_help=&quot;Voer hier andere nuttige informatie in.&quot; relation_ids_list=&quot;1256,1728,1111,7056,6290,10507,525,1206,1728,2248,6286,8701,0782e38f&quot; data_required_field=&quot;false&quot; data_bold_text=&quot;false&quot; %}</span></span></td>
		</tr>
	</tbody>
</table>

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