<form action="https://www.e-act.nl/ah/action" method="POST" accept-charset="UTF-8"><input type="hidden" name="admin_id" value="2744"/><input type="hidden" name="trigger_code" value="SUBSCR_1529326389295"/><input type="hidden" name="confirm" value="false"/><input type="hidden" name="relation_avg1_text" id="relation_avg1_text" value="Ik ga akkoord met het privacy reglement"/><input type="hidden" name="relation_avg1_url" id="relation_avg1_url" value="https://www.jouw-website.nl"/><input type="hidden" name="relation_avg2_text" id="relation_avg2_text" value="We zullen deze gegevens gebruiken voor..."/>Voornaam <input type="text" id="relation_firstName" name="relation_firstName"/><br/>E-mailadres <input type="text" id="relation_email" name="relation_email"/><br/>We zullen deze gegevens gebruiken voor... <input type="checkbox" id="relation_avg2" name="relation_avg2"/><br/>Ik ga akkoord met het privacy reglement <a target="_blank" href="https://www.jouw-website.nl">Lees</a> <input type="checkbox" id="relation_avg1" name="relation_avg1"/><br/><input type="submit" value="submit"/></form>