[av_two_fifth first]

[av_contact email=’info@schmidt-koelewijn.nl’ title=’Offerte aanvraag PVC vloer’ button=’Verzenden’ on_send=” sent=’Uw offerte is verstuurd!’ link=’manually,http://’ subject=’Offerte PVC’ autorespond=” captcha=” color=”]
[av_contact_field label=’Type PVC stroken’ type=’select’ options=’Onbekend, Ambiant, Forbo’ check=’is_empty’ width=’element_half’][/av_contact_field]
[av_contact_field label=’Designnummer *optioneel’ type=’text’ options=” check=” width=’element_half’][/av_contact_field]
[av_contact_field label=’Oppervlakte’ type=’text’ options=” check=’is_number’ width=’element_half’][/av_contact_field]
[av_contact_field label=’Ondergrond’ type=’select’ options=’Onbekend, Hout, Zandcement, Anhydriet’ check=’is_empty’ width=’element_half’][/av_contact_field]
[av_contact_field label=’Naam’ type=’text’ options=” check=’is_empty’ width=’element_half’][/av_contact_field]
[av_contact_field label=’Type aanvraag’ type=’select’ options=’Particulier, Bedrijf’ check=” width=’element_half’][/av_contact_field]
[av_contact_field label=’E-mail’ type=’text’ options=” check=’is_email’ width=’element_third’][/av_contact_field]
[av_contact_field label=’Postcode’ type=’text’ options=” check=’is_empty’ width=’element_third’][/av_contact_field]
[av_contact_field label=’Telefoon’ type=’text’ options=” check=” width=’element_third’][/av_contact_field]
[av_contact_field label=’Opmerkingen’ type=’textarea’ options=” check=” width=”][/av_contact_field]
[/av_contact]

[/av_two_fifth]