<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
    <meta name="referrer" content="no-referrer-when-downgrade">
    
    
            

    <link href="https://postnl.tfaforms.net/dist/form-builder/5.0.0/wforms-layout.css?v=02c56e273d0dffbee8431cda4b61b3f646e19fd2" rel="stylesheet" type="text/css" />

    <link href="https://postnl.tfaforms.net/uploads/themes/theme-64.css" rel="stylesheet" type="text/css" />
    <link href="https://postnl.tfaforms.net/dist/form-builder/5.0.0/wforms-jsonly.css?v=02c56e273d0dffbee8431cda4b61b3f646e19fd2" rel="alternate stylesheet" title="This stylesheet activated by javascript" type="text/css" />
    
    
    


<div class="wFormContainer" >
    <div class="wFormHeader"></div>
    <style type="text/css">
                #tfa_44,
                *[id^="tfa_44["] {
                    width: 400px !important;
                }
                #tfa_44-D,
                *[id^="tfa_44["][class~="field-container-D"] {
                    width: auto !important;
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                #tfa_56,
                *[id^="tfa_56["] {
                    width: 400px !important;
                }
                #tfa_56-D,
                *[id^="tfa_56["][class~="field-container-D"] {
                    width: auto !important;
                }
            
                #tfa_60,
                *[id^="tfa_60["] {
                    width: 400px !important;
                }
                #tfa_60-D,
                *[id^="tfa_60["][class~="field-container-D"] {
                    width: auto !important;
                }
            
                #tfa_44,
                *[id^="tfa_44["] {
                    height: 200px !important
                }
                #tfa_44-D,
                *[id^="tfa_44["][class~="field-container-D"] {
                    height: auto !important;
                }
                #tfa_44-L,
                label[id^="tfa_44["],
                *[id^="tfa_44["][id$="-L"] {
                    height: auto !important;
                }
            
                #tfa_56,
                *[id^="tfa_56["] {
                    height: 130px !important
                }
                #tfa_56-D,
                *[id^="tfa_56["][class~="field-container-D"] {
                    height: auto !important;
                }
                #tfa_56-L,
                label[id^="tfa_56["],
                *[id^="tfa_56["][id$="-L"] {
                    height: auto !important;
                }
            
                #tfa_60,
                *[id^="tfa_60["] {
                    height:  !important
                }
                #tfa_60-D,
                *[id^="tfa_60["][class~="field-container-D"] {
                    height: auto !important;
                }
                #tfa_60-L,
                label[id^="tfa_60["],
                *[id^="tfa_60["][id$="-L"] {
                    height: auto !important;
                }
            </style><div class=""><div class="wForm" id="4959956-WRPR" data-language="en_GB" dir="ltr">
<div class="codesection" id="code-4959956">
</div>
<h3 class="wFormTitle" data-testid="form-title" id="4959956-T">Extra@Home</h3>
<form method="post" action="https://postnl.tfaforms.net/api_v2/rest/workflow/processor" class="hintsBelow labelsAbove" id="4959956">
<div class="htmlSection" id="tfa_68"><div class="htmlContent" id="tfa_68-HTML">Feel free to contact us</div></div>
<div class="oneField field-container-D    " id="tfa_1-D">
<label id="tfa_1-L" class="label preField reqMark" for="tfa_1">First name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_1" name="tfa_1" value="" autocomplete="off" title="First name" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_26-D">
<label id="tfa_26-L" class="label preField reqMark" for="tfa_26">Last name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_26" name="tfa_26" value="" autocomplete="off" title="Last name" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_58-D">
<label id="tfa_58-L" class="label preField reqMark" for="tfa_58">Phone number</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_58" name="tfa_58" value="" autocomplete="off" title="Phone number" class="validate-integer required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_12-D">
<label id="tfa_12-L" class="label preField reqMark" for="tfa_12">E-mail address</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_12" name="tfa_12" value="" autocomplete="off" title="E-mail address" class="validate-email required"></div>
</div>
<div class="oneField field-container-D   hintsBelow " id="tfa_44-D">
<label id="tfa_44-L" class="label preField " for="tfa_44">My question</label><br><div class="inputWrapper"><textarea maxlength="400" id="tfa_44" name="tfa_44" title="My question" class=""></textarea></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_49-D">
<label id="tfa_49-L" class="label preField reqMark" for="tfa_49">Taal</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_49" name="tfa_49" value="en_BE" default="en_BE" maxlength="50" title="Taal" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_56-D">
<label id="tfa_56-L" class="label preField " for="tfa_56">E-mail tekst</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_56" name="tfa_56" title="E-mail tekst" class=""></textarea></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_51-D">
<label id="tfa_51-L" class="label preField reqMark" for="tfa_51">Categorie</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_51" name="tfa_51" value="Contact opnemen" default="Contact opnemen" maxlength="50" title="Categorie" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_62-D">
<label id="tfa_62-L" class="label preField reqMark" for="tfa_62">Formulier_titel</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_62" name="tfa_62" value="Contact Extra@Home" default="Contact Extra@Home" maxlength="50" title="Formulier_titel" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_60-D">
<label id="tfa_60-L" class="label preField " for="tfa_60">Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_60" name="tfa_60" title="Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)" class=""></textarea></div>
</div>
<div class="actions" id="4959956-A" data-contentid="submit_button"><input type="submit" data-label="Submit" class="primaryAction" id="submit_button" value="Submit"></div>
<div style="clear:both"></div>
<input type="hidden" value="144-d4ec37fd80bc61689f93bc91dd4e95a9" name="tfa_dbCounters" id="tfa_dbCounters" autocomplete="off"><input type="hidden" value="4959956" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value="" name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="434e53879749dd31899e6616d7d0dd0a" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="" name="tfa_dbWorkflowSessionUuid" id="tfa_dbWorkflowSessionUuid"><input type="hidden" value="1731968070" name="tfa_dbTimeStarted" id="tfa_dbTimeStarted" autocomplete="off"><input type="hidden" value="4" name="tfa_dbVersionId" id="tfa_dbVersionId"><input type="hidden" value="" name="tfa_switchedoff" id="tfa_switchedoff">
</form>
</div></div><div class="wFormFooter"><p class="supportInfo"><br></p></div>
  <p class="supportInfo" >
      </p>
 </div>

<pnl-chatbot-trigger base-url="https://jouw.postnl.nl/services/swp/middleman" locale="en_GB"></pnl-chatbot-trigger>

Chatbot trigger - Webcomponent

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