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            </style><div class=""><div class="wForm" id="4960020-WRPR" data-language="en_GB" dir="ltr">
<div class="codesection" id="code-4960020"></div>
<h3 class="wFormTitle" data-testid="form-title" id="4960020-T">Become a PostNL location</h3>
<form method="post" action="https://postnl.tfaforms.net/api_v2/rest/workflow/processor" class="hintsBelow labelsAbove" id="4960020">
<div class="oneField field-container-D    " id="tfa_143-D">
<label id="tfa_143-L" class="label preField reqMark" for="tfa_143">First name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_143" name="tfa_143" value="" autocomplete="off" title="First name" class="validate-alphanum required"></div>
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<div class="oneField field-container-D    " id="tfa_145-D">
<label id="tfa_145-L" class="label preField reqMark" for="tfa_145">Last name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_145" name="tfa_145" value="" autocomplete="off" title="Last name" class="validate-alphanum required"></div>
</div>
<div class="oneField field-container-D   hintsBelow " id="tfa_19-D">
<label id="tfa_19-L" class="label preField reqMark" for="tfa_19">Phone number</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_19" name="tfa_19" value="" autocomplete="off" title="Phone number" class="validate-integer required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_262-D">
<label id="tfa_262-L" class="label preField reqMark" for="tfa_262">E-mail address</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_262" name="tfa_262" value="" autocomplete="off" title="E-mail address" class="validate-email required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_132-D">
<label id="tfa_132-L" class="label preField reqMark" for="tfa_132">Title</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_132" name="tfa_132" title="Title" class="required"><option value="">Please select...</option>
<option value="tfa_135" id="tfa_135" class="">Managing director</option>
<option value="tfa_137" id="tfa_137" class="">Owner</option>
<option value="tfa_138" id="tfa_138" class="">Team lead</option>
<option value="tfa_140" id="tfa_140" class="">Employee</option>
<option value="tfa_141" id="tfa_141" class="">Other</option></select></div>
</div>
<div class="oneField field-container-D    " id="tfa_1-D">
<label id="tfa_1-L" class="label preField reqMark" for="tfa_1">Company name</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_1" name="tfa_1" value="" autocomplete="off" title="Company name" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_362-D">
<label id="tfa_362-L" class="label preField reqMark" for="tfa_362">Crossroads Bank for Enterprises number</label><br><div class="inputWrapper">
<input aria-required="true" type="text" id="tfa_362" name="tfa_362" value="" autocomplete="off" maxlength="10" aria-describedby="tfa_362-HH" title="Crossroads Bank for Enterprises number" class="required"><span class="field-hint-inactive" id="tfa_362-H"><span id="tfa_362-HH" class="hint">Without BE</span></span>
</div>
</div>
<div class="oneField field-container-D    " id="tfa_47-D">
<label id="tfa_47-L" class="label preField reqMark" for="tfa_47">Street</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_47" name="tfa_47" value="" autocomplete="off" title="Street" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_21-D">
<label id="tfa_21-L" class="label preField reqMark" for="tfa_21">House number</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_21" name="tfa_21" value="" autocomplete="off" title="House number" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_186-D">
<label id="tfa_186-L" class="label preField " for="tfa_186">House number addition</label><br><div class="inputWrapper"><input type="text" id="tfa_186" name="tfa_186" value="" autocomplete="off" title="House number addition" class=""></div>
</div>
<div class="oneField field-container-D    " id="tfa_17-D">
<label id="tfa_17-L" class="label preField reqMark" for="tfa_17">Postal code</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_17" name="tfa_17" value="" autocomplete="off" placeholder="1234" title="Postal code" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_48-D">
<label id="tfa_48-L" class="label preField reqMark" for="tfa_48">City</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_48" name="tfa_48" value="" autocomplete="off" title="City" class="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">Country</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_12" name="tfa_12" title="Country" class="required"><option value="">Please select...</option>
<option value="tfa_299" id="tfa_299" class="">NL</option>
<option value="tfa_300" id="tfa_300" class="">BE</option></select></div>
</div>
<div class="oneField field-container-D    " id="tfa_310-D" role="radiogroup" aria-labelledby="tfa_310-L" data-tfa-labelledby="-L tfa_310-L">
<label id="tfa_310-L" class="label preField reqMark" data-tfa-check-label-for="tfa_310">Are you already a customer of PostNL?</label><br><div class="inputWrapper"><span id="tfa_310" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_311" class="" id="tfa_311" name="tfa_310" aria-required="true" data-conditionals="#tfa_316" aria-labelledby="tfa_311-L" data-tfa-labelledby="tfa_310-L tfa_311-L" data-tfa-parent-id="tfa_310"><label class="label postField" id="tfa_311-L" for="tfa_311"><span class="input-radio-faux"></span>Yes</label></span><span class="oneChoice"><input type="radio" value="tfa_312" class="" id="tfa_312" name="tfa_310" aria-required="true" data-conditionals="#tfa_348" aria-labelledby="tfa_312-L" data-tfa-labelledby="tfa_310-L tfa_312-L" data-tfa-parent-id="tfa_310"><label class="label postField" id="tfa_312-L" for="tfa_312"><span class="input-radio-faux"></span>No</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_316-D">
<label id="tfa_316-L" class="label preField reqMark" for="tfa_316">Customer number PostNL</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_316" name="tfa_316" value="" data-condition="`#tfa_311`" title="Customer number PostNL" class="required"></div>
</div>
<div class="htmlSection" id="tfa_280"><div class="htmlContent" id="tfa_280-HTML"><b>Company</b></div></div>
<div class="oneField field-container-D    " id="tfa_320-D" role="radiogroup" aria-labelledby="tfa_320-L" data-tfa-labelledby="-L tfa_320-L">
<label id="tfa_320-L" class="label preField reqMark" data-tfa-check-label-for="tfa_320">Are you already offering services to a competitor of PostNL?</label><br><div class="inputWrapper"><span id="tfa_320" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_321" class="" id="tfa_321" name="tfa_320" aria-required="true" aria-labelledby="tfa_321-L" data-tfa-labelledby="tfa_320-L tfa_321-L" data-tfa-parent-id="tfa_320"><label class="label postField" id="tfa_321-L" for="tfa_321"><span class="input-radio-faux"></span>Yes</label></span><span class="oneChoice"><input type="radio" value="tfa_322" class="" id="tfa_322" name="tfa_320" aria-required="true" aria-labelledby="tfa_322-L" data-tfa-labelledby="tfa_320-L tfa_322-L" data-tfa-parent-id="tfa_320"><label class="label postField" id="tfa_322-L" for="tfa_322"><span class="input-radio-faux"></span>No</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_326-D" role="radiogroup" aria-labelledby="tfa_326-L" data-tfa-labelledby="-L tfa_326-L">
<label id="tfa_326-L" class="label preField reqMark" data-tfa-check-label-for="tfa_326">Is your company part of chain?</label><br><div class="inputWrapper"><span id="tfa_326" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_327" class="" id="tfa_327" name="tfa_326" aria-required="true" aria-labelledby="tfa_327-L" data-tfa-labelledby="tfa_326-L tfa_327-L" data-tfa-parent-id="tfa_326"><label class="label postField" id="tfa_327-L" for="tfa_327"><span class="input-radio-faux"></span>Yes</label></span><span class="oneChoice"><input type="radio" value="tfa_328" class="" id="tfa_328" name="tfa_326" aria-required="true" aria-labelledby="tfa_328-L" data-tfa-labelledby="tfa_326-L tfa_328-L" data-tfa-parent-id="tfa_326"><label class="label postField" id="tfa_328-L" for="tfa_328"><span class="input-radio-faux"></span>No</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_332-D">
<label id="tfa_332-L" class="label preField reqMark" for="tfa_332">Which sector?</label><br><div class="inputWrapper"><select aria-required="true" id="tfa_332" name="tfa_332" title="Which sector?" class="required"><option value="">Please select...</option>
<option value="tfa_343" id="tfa_343" class="">Care institution</option>
<option value="tfa_363" id="tfa_363" class="">Clothing store</option>
<option value="tfa_334" id="tfa_334" class="">Book store</option>
<option value="tfa_335" id="tfa_335" class="">DIY store</option>
<option value="tfa_338" id="tfa_338" class="">Educational institute</option>
<option value="tfa_342" id="tfa_342" class="">Garden center</option>
<option value="tfa_333" id="tfa_333" class="">Gas station</option>
<option value="tfa_336" id="tfa_336" class="">Office</option>
<option value="tfa_339" id="tfa_339" class="">Recreation</option>
<option value="tfa_340" id="tfa_340" class="">Supermarket</option>
<option value="tfa_341" id="tfa_341" class="">Tobacco shop</option>
<option value="tfa_344" id="tfa_344" class="">Other</option></select></div>
</div>
<div class="oneField field-container-D    " id="tfa_348-D" role="radiogroup" aria-labelledby="tfa_348-L" data-tfa-labelledby="-L tfa_348-L">
<label id="tfa_348-L" class="label preField reqMark" data-tfa-check-label-for="tfa_348">Have you done business with PostNL before?</label><br><div class="inputWrapper"><span id="tfa_348" class="choices vertical required" data-condition="`#tfa_312`"><span class="oneChoice"><input type="radio" value="tfa_349" class="" id="tfa_349" name="tfa_348" aria-required="true" aria-labelledby="tfa_349-L" data-tfa-labelledby="tfa_348-L tfa_349-L" data-tfa-parent-id="tfa_348"><label class="label postField" id="tfa_349-L" for="tfa_349"><span class="input-radio-faux"></span>Yes</label></span><span class="oneChoice"><input type="radio" value="tfa_350" class="" id="tfa_350" name="tfa_348" aria-required="true" aria-labelledby="tfa_350-L" data-tfa-labelledby="tfa_348-L tfa_350-L" data-tfa-parent-id="tfa_348"><label class="label postField" id="tfa_350-L" for="tfa_350"><span class="input-radio-faux"></span>No</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_354-D" role="radiogroup" aria-labelledby="tfa_354-L" data-tfa-labelledby="-L tfa_354-L">
<label id="tfa_354-L" class="label preField reqMark" data-tfa-check-label-for="tfa_354">Do you take over a shop with existing relations with PostNL?</label><br><div class="inputWrapper"><span id="tfa_354" class="choices vertical required"><span class="oneChoice"><input type="radio" value="tfa_355" class="" id="tfa_355" name="tfa_354" aria-required="true" data-conditionals="#tfa_360" aria-labelledby="tfa_355-L" data-tfa-labelledby="tfa_354-L tfa_355-L" data-tfa-parent-id="tfa_354"><label class="label postField" id="tfa_355-L" for="tfa_355"><span class="input-radio-faux"></span>Yes</label></span><span class="oneChoice"><input type="radio" value="tfa_356" class="" id="tfa_356" name="tfa_354" aria-required="true" aria-labelledby="tfa_356-L" data-tfa-labelledby="tfa_354-L tfa_356-L" data-tfa-parent-id="tfa_354"><label class="label postField" id="tfa_356-L" for="tfa_356"><span class="input-radio-faux"></span>No</label></span></span></div>
</div>
<div class="oneField field-container-D    " id="tfa_360-D">
<label id="tfa_360-L" class="label preField reqMark" for="tfa_360">Please fill in the customer number of shop you are taking over</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_360" name="tfa_360" value="" data-condition="`#tfa_355`" title="Please fill in the customer number of shop you are taking over" class="required"></div>
</div>
<div class="oneField field-container-D    " id="tfa_301-D">
<label id="tfa_301-L" class="label preField " for="tfa_301">Other info that you would like to share with us</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_301" name="tfa_301" title="Other info that you would like to share with us" 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_59-D">
<label id="tfa_59-L" class="label preField " for="tfa_59">E-mail tekst</label><br><div class="inputWrapper"><textarea default="We will get back to you as soon as possible. Have a great working day!" maxlength="300" id="tfa_59" name="tfa_59" title="E-mail tekst" class="">We will get back to you as soon as possible. Have a great working day!</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="postnl punt" default="postnl punt" maxlength="50" title="Categorie" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_53-D">
<label id="tfa_53-L" class="label preField reqMark" for="tfa_53">Webform Source</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_53" name="tfa_53" value="postnl punt be" default="postnl punt be" title="Webform Source" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_243-D">
<label id="tfa_243-L" class="label preField reqMark" for="tfa_243">Record Type ID</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_243" name="tfa_243" value="0120J000000opbTQAQ" default="0120J000000opbTQAQ" title="Record Type ID" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_273-D">
<label id="tfa_273-L" class="label preField reqMark" for="tfa_273">Formulier_titel</label><br><div class="inputWrapper"><input aria-required="true" type="text" id="tfa_273" name="tfa_273" value="Become a PostNL location" default="Become a PostNL location" title="Formulier_titel" class="required"></div>
</div>
<div class="oneField field-container-D     wf-acl-hidden" id="tfa_275-D">
<label id="tfa_275-L" class="label preField " for="tfa_275">Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)</label><br><div class="inputWrapper"><textarea maxlength="300" id="tfa_275" name="tfa_275" title="Subjectline bevestigingsmail (bij leeg veld wordt default Marketing Cloud waarde gebruikt)" class=""></textarea></div>
</div>
<div class="actions" id="4960020-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="761-66fb14245b167e4c720597034cdee80f" name="tfa_dbCounters" id="tfa_dbCounters" autocomplete="off"><input type="hidden" value="4960020" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value="" name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="98e143418297bdcaff0a6ef9be8e119d" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="" name="tfa_dbWorkflowSessionUuid" id="tfa_dbWorkflowSessionUuid"><input type="hidden" value="1731965964" name="tfa_dbTimeStarted" id="tfa_dbTimeStarted" autocomplete="off"><input type="hidden" value="19" 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>

Become a PostNL location                                                                                               

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