www.acqui-city.com
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194.78.134.30
Public Scan
Submitted URL: https://marketing.spa.be/nl/link?c=b1fd&d=b0g&h=1ppbhru2b6obcrfvs7hkv517jd&i=508&iw=10&p=H207508243&s=gu&sn=o7&url64=aHR0...
Effective URL: https://www.acqui-city.com/202401_SPA_CLUB_JAN_/nl/?p=eyJFQyI6IkVDX0MxNDU2NTU5IiwiQ29udGFjdElEIjoiNjQyZGFlMmVkOGUyODA1YmFkN...
Submission: On January 18 via api from BE — Scanned from IT
Effective URL: https://www.acqui-city.com/202401_SPA_CLUB_JAN_/nl/?p=eyJFQyI6IkVDX0MxNDU2NTU5IiwiQ29udGFjdElEIjoiNjQyZGFlMmVkOGUyODA1YmFkN...
Submission: On January 18 via api from BE — Scanned from IT
Form analysis 1 forms found in the DOM
Name: register — POST
<form name="register" method="POST" onsubmit="javascript: return checkForm(this);" class="RespTable">
<div id="errmsg"></div>
<div class="center instructions">
<p>Gelieve onderstaande velden eerst nog in te vullen:</p>
<p>
<input type="radio" id="gender-1" name="register[SexCode]" value="M"> <label for="gender-1">Mijnheer</label>
<input type="radio" id="gender-2" name="register[SexCode]" value="F" style="margin-left:30px;"><label for="gender-2">Mevrouw</label>
</p>
<p><label for="EmailAddress">E-mailadres</label><input type="text" name="register[EmailAddress]" value="paul.de.backer4@telenet.be" placeholder="E-mailadres" id="EmailAddress" readonly=""></p>
<p><label for="FirstName">Voornaam</label><input type="text" name="register[FirstName]" value="" placeholder="Voornaam" id="FirstName"></p>
<p><label for="LastName">Naam</label><input type="text" name="register[LastName]" value="" placeholder="Naam" id="LastName"></p>
<p><input type="hidden" name="register[ZipCode]" value="" placeholder="Gemeente" id="ZipCode"></p>
<p><input type="hidden" name="register[City]" value="" placeholder="Postcode" id="City"></p>
<div class="c-form-step" data-step="3" data-step-reference="spa-usage" style="display:block;">
<div class="c-form-heading u-text-center">
<h2 class="c-form-title bold">Nog een laatste vraagje, om je aanbiedingen op maat te kunnen geven</h2>
<p>Hoeveel liter flessenwater koop jij per week?<br>(voor jezelf en je gelukkige huisgenoten)</p>
</div>
<div class="c-form-group c-form-group-bottles [ u-flex u-flex-wrap u-flex-space-between ]">
<div class="c-form-block">
<p class="bold">Plat water</p>
<div class="c-bottles-holder [ u-flex u-flex-space-between ]">
<div data-id="spa-flat-slider" data-amount="1" class="bottle u-flat"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-flat-slider" data-amount="2" class="bottle u-flat"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-flat-slider" data-amount="3" class="bottle u-flat"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-flat-slider" data-amount="4" class="bottle u-flat"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-flat-slider" data-amount="5" class="bottle u-flat"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
</div>
<div class="[ u-flex-grow ] c-rangeslider__slider ">
<input id="spa-flat-slider" class="c-form-entity" type="range" name="register[spaflatamount]" data-required="false" value="0" min="0" max="6" step="1" style="position: absolute; width: 1px; height: 1px; overflow: hidden; opacity: 0;">
<div class="rangeslider" id="js-rangeslider-js-0">
<div class="rangeslider__fill__bg"></div>
<div class="rangeslider__fill" style="width: 10px;"></div>
<div class="rangeslider__handle" style="transform: translate(0px, -50%);">
<div class="c-rangeslider-value js-rangeslider-value">0 L</div>
</div>
</div>
</div>
<div class="c-spa-percent">
<p>Op hoeveel procent van die flessen schittert een etiket van SPA?</p>
<div class="c-spa-percent--selector [u-flex u-flex-wrap]">
<span class="c-spa-percent-item active" data-ref="spa-flat-percent" data-value="0">0%</span>
<span class="c-spa-percent-item" data-ref="spa-flat-percent" data-value="25">25%</span>
<span class="c-spa-percent-item" data-ref="spa-flat-percent" data-value="50">50%</span>
<span class="c-spa-percent-item" data-ref="spa-flat-percent" data-value="75">75%</span>
<span class="c-spa-percent-item" data-ref="spa-flat-percent" data-value="100">100%</span>
</div>
<input class="c-form-entity c-form-entity--hidden" type="hidden" data-ref="spa-flat-percent" name="register[spaflatpercent]" data-required="false" value="0">
</div>
</div>
<div class="c-form-block">
<p class="bold">Bruisend water</p>
<div class="c-bottles-holder [ u-flex u-flex-space-between ]">
<div data-id="spa-sparkling-slider" data-amount="1" class="bottle u-spark"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-sparkling-slider" data-amount="2" class="bottle u-spark"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-sparkling-slider" data-amount="3" class="bottle u-spark"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-sparkling-slider" data-amount="4" class="bottle u-spark"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
<div data-id="spa-sparkling-slider" data-amount="5" class="bottle u-spark"><img src="/202401_SPA_CLUB_JAN_/themes/default/img/icon-bottle-empty.svg"></div>
</div>
<div class="[ u-flex-grow ] c-rangeslider__slider c-rangeslider__slider_sparkling ">
<input id="spa-sparkling-slider" class="c-form-entity" type="range" name="register[spasparklingamount]" data-required="false" value="0" min="0" max="6" step="1"
style="position: absolute; width: 1px; height: 1px; overflow: hidden; opacity: 0;">
<div class="rangeslider" id="js-rangeslider-js-1">
<div class="rangeslider__fill__bg"></div>
<div class="rangeslider__fill" style="width: 10px;"></div>
<div class="rangeslider__handle" style="transform: translate(0px, -50%);">
<div class="c-rangeslider-value js-rangeslider-value">0 L</div>
</div>
</div>
</div>
<div class="c-spa-percent">
<p>Op hoeveel procent van die flessen schittert een etiket van SPA?</p>
<div class="c-spa-percent--selector [u-flex u-flex-wrap]">
<span class="c-spa-percent-item active" data-ref="spa-sparkling-percent" data-value="0">0%</span>
<span class="c-spa-percent-item" data-ref="spa-sparkling-percent" data-value="25">25%</span>
<span class="c-spa-percent-item" data-ref="spa-sparkling-percent" data-value="50">50%</span>
<span class="c-spa-percent-item" data-ref="spa-sparkling-percent" data-value="75">75%</span>
<span class="c-spa-percent-item" data-ref="spa-sparkling-percent" data-value="100">100%</span>
</div>
<input class="c-form-entity c-form-entity--hidden" type="hidden" data-ref="spa-sparkling-percent" name="register[spasparklingpercent]" data-required="false" value="0">
</div>
</div>
</div>
<p><input type="hidden" value="EC_C1456559" name="ec"></p>
<p> </p>
<p><input type="hidden" name="register[ContactID]" value="642dae2ed8e2805bad5833be6aefe42d1b1dc76bc6e54e5ad534368a111749f0361965" placeholder="" id="ContactID"></p>
<p></p>
<div class="c-form-bottom u-text-center">
<p><input class="c-button c-button-primary js-next bold" type="submit" value="OK"></p>
</div>
</div>
</div>
</form>Text Content
PRINT JE KORTINGSBON Gelieve onderstaande velden eerst nog in te vullen: Mijnheer Mevrouw E-mailadres Voornaam Naam NOG EEN LAATSTE VRAAGJE, OM JE AANBIEDINGEN OP MAAT TE KUNNEN GEVEN Hoeveel liter flessenwater koop jij per week? (voor jezelf en je gelukkige huisgenoten) Plat water 0 L Op hoeveel procent van die flessen schittert een etiket van SPA? 0% 25% 50% 75% 100% Bruisend water 0 L Op hoeveel procent van die flessen schittert een etiket van SPA? 0% 25% 50% 75% 100% -------------------------------------------------------------------------------- © Spa - privacybeleid Powered by © Black Tiger Belgium - privacybeleid