Array
(
[id] => 59
[user_id] => 71
[name] => Particulierformulier impat
[date_added] => 2007-10-30 17:12:55
[template] =>
[successmessage] => 8255
[type] => 1
[submitgroup] => 16
[success] => Array
(
[1] => Bedankt voor uw aanvraag, wij nemen zo snel mogelijk contact met u op.
[2] => Thank you for your request, we will contact you soon.
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
[types] => Array
(
[0] => 1
)
[subject] => Aanvraag particuliere impat verzekering
[from] => ISEP
[fromemail] => info@isep.nl
[toemail2] => Paulus.Fleskens@telenet.be
[toemail] => info@isep.nl
[header] =>
[fields] => Array
(
[0] => Array
(
[form_id] => 59
[c_name_id] => 8256
[type] => textfield
[obligated] => 1
[order] => 0
[className] =>
[name] => Array
(
[1] => Naam
[2] => Name
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[1] => Array
(
[form_id] => 59
[c_name_id] => 8257
[type] => textfield
[obligated] => 1
[order] => 1
[className] =>
[name] => Array
(
[1] => Adres
[2] => Address
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[2] => Array
(
[form_id] => 59
[c_name_id] => 8258
[type] => postcode
[obligated] => 1
[order] => 2
[className] =>
[name] => Array
(
[1] => Postcode
[2] => Postal code
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[3] => Array
(
[form_id] => 59
[c_name_id] => 8259
[type] => textfield
[obligated] => 1
[order] => 3
[className] =>
[name] => Array
(
[1] => Woonplaats
[2] => Home country
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[4] => Array
(
[form_id] => 59
[c_name_id] => 97223
[type] => textfield
[obligated] => 0
[order] => 4
[className] =>
[name] => Array
(
[1] => Skype naam
[2] =>
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[5] => Array
(
[form_id] => 59
[c_name_id] => 8260
[type] => phone
[obligated] => 1
[order] => 5
[className] =>
[name] => Array
(
[1] => Telefoonnummer
[2] => Phonenumber
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[6] => Array
(
[form_id] => 59
[c_name_id] => 8261
[type] => email
[obligated] => 1
[order] => 6
[className] =>
[name] => Array
(
[1] => Email Adres
[2] => Email Address
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[7] => Array
(
[form_id] => 59
[c_name_id] => 8262
[type] => combobox
[obligated] => 1
[order] => 7
[className] =>
[name] => Array
(
[1] => Aanhef
[2] => Gender
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
[selectbox] => Array
(
[0] => Dhr.
[1] => Mevr.
)
)
[8] => Array
(
[form_id] => 59
[c_name_id] => 8263
[type] => textfield
[obligated] => 1
[order] => 8
[className] =>
[name] => Array
(
[1] => Land waar u gaat werken
[2] => Country where you'r going to work
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[9] => Array
(
[form_id] => 59
[c_name_id] => 8264
[type] => textfield
[obligated] => 1
[order] => 9
[className] =>
[name] => Array
(
[1] => Uw vaderland
[2] => Home country
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[10] => Array
(
[form_id] => 59
[c_name_id] => 8265
[type] => textarea
[obligated] => 1
[order] => 10
[className] =>
[name] => Array
(
[1] => Wat worden daar uw werkzaamheden?
[2] => Short discription of work
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[11] => Array
(
[form_id] => 59
[c_name_id] => 8266
[type] => textarea
[obligated] => 0
[order] => 11
[className] =>
[name] => Array
(
[1] => Specifieke vraag?
[2] => Specifice qeustions
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[12] => Array
(
[form_id] => 59
[c_name_id] => 8267
[type] => textfield
[obligated] => 0
[order] => 12
[className] =>
[name] => Array
(
[1] => Voorletters gezinslid 1 + geboortedatum
[2] => initial familymember 1 + date of birth
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[13] => Array
(
[form_id] => 59
[c_name_id] => 8268
[type] => textfield
[obligated] => 0
[order] => 13
[className] =>
[name] => Array
(
[1] => Voorletters gezinslid 2 + geboortedatum
[2] => initial familymember 2 + date of birth
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[14] => Array
(
[form_id] => 59
[c_name_id] => 8269
[type] => textfield
[obligated] => 0
[order] => 14
[className] =>
[name] => Array
(
[1] => Voorletters gezinslid 3 + geboortedatum
[2] => initial familymember 3 + date of birth
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[15] => Array
(
[form_id] => 59
[c_name_id] => 8270
[type] => textfield
[obligated] => 0
[order] => 15
[className] =>
[name] => Array
(
[1] => Voorletters gezinslid 4 + geboortedatum
[2] => initial familymember 4 + date of birth
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[16] => Array
(
[form_id] => 59
[c_name_id] => 8271
[type] => textfield
[obligated] => 0
[order] => 16
[className] =>
[name] => Array
(
[1] => Voorletters gezinslid 5 + geboortedatum
[2] => initial familymember 5 + date of birth
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[17] => Array
(
[form_id] => 59
[c_name_id] => 8272
[type] => title
[obligated] => 0
[order] => 17
[className] =>
[name] => Array
(
[1] => Ik ben ook geinteresseerd in de volgende verzekeringen:
[2] => I am also interested in receiving more information about the following insurances
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[18] => Array
(
[form_id] => 59
[c_name_id] => 8273
[type] => checkboxoff
[obligated] => 0
[order] => 18
[className] => caution_error
[name] => Array
(
[1] => Arbeidsongeschiktheid
[2] => Disability
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[19] => Array
(
[form_id] => 59
[c_name_id] => 8274
[type] => checkboxoff
[obligated] => 0
[order] => 19
[className] =>
[name] => Array
(
[1] => Doorlopende reisverzekering
[2] => Continuous travel
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[20] => Array
(
[form_id] => 59
[c_name_id] => 8275
[type] => checkboxoff
[obligated] => 0
[order] => 20
[className] =>
[name] => Array
(
[1] => Opstal- en inboedelverzekering
[2] => Private InsurancePackage (House; household contents; private liabiliy etc.)
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
[show_info] => 1
)
[21] => Array
(
[form_id] => 59
[c_name_id] => 8276
[type] => checkboxoff
[obligated] => 0
[order] => 21
[className] =>
[name] => Array
(
[1] => Persoonlijk ongevallenverzekering
[2] => Personal Accident
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[22] => Array
(
[form_id] => 59
[c_name_id] => 8277
[type] => checkboxoff
[obligated] => 0
[order] => 22
[className] =>
[name] => Array
(
[1] => Overlijdensverzekering
[2] => Term Life Cover
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
[23] => Array
(
[form_id] => 59
[c_name_id] => 8278
[type] => checkboxoff
[obligated] => 0
[order] => 23
[className] =>
[name] => Array
(
[1] => Pensioenverzekering
[2] => Pension
[3] =>
[4] =>
[5] =>
[6] =>
[7] =>
[8] =>
[9] =>
[10] =>
[11] =>
)
)
)
[images] => Array
(
[0] => Array
(
[id] => 1
[user_id] => 0
[filetype_id] => 5
[filename] => 378755168_1197539925.gif
[original_filename] => verzenden.gif
[filesize] => 546
[date_added] => 1197539925
[language] => 1
[group_id] => 16
[c_desc_id] => 0
[abbreviation] => NL
[name] => Nederlands
[own_language] => Nederlands
)
[1] => Array
(
[id] => 2
[user_id] => 0
[filetype_id] => 5
[filename] => 402641150_1197539925.gif
[original_filename] => verzenden_uk.gif
[filesize] => 415
[date_added] => 1197539925
[language] => 2
[group_id] => 16
[c_desc_id] => 0
[abbreviation] => UK
[name] => Engels
[own_language] => English
)
)
[button] => Array
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[user_id] => 0
[filetype_id] => 5
[filename] => 378755168_1197539925.gif
[original_filename] => verzenden.gif
[filesize] => 546
[date_added] => 1197539925
[language] => 1
[group_id] => 16
[c_desc_id] => 0
[abbreviation] => NL
[name] => Nederlands
[own_language] => Nederlands
)
)
