Contact

Votre bureau local

Belgique

Aliaxis Belgium S.A.
Kalderberg 1
3700 Tongeren

+32 (0)4 248 89 40
info.be@aliaxis.com

Aliaxis Group | HQ

Belgique

info@aliaxis.com

Form Field:

title_gender

Parameter for E-Mail: {{title_gender}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Title (gender) options:

Form Field:

firstname

Parameter for E-Mail: {{firstname}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Form Field:

lastname

Parameter for E-Mail: {{lastname}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Form Field:

Parameter for E-Mail: {{email}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Form Field:

phone_number

Parameter for E-Mail: {{phone_number}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Form Field:

company

Parameter for E-Mail: {{company}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

lastname

Field layout:

col1

Form Field:

postal_code

Parameter for E-Mail: {{postal_code}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Form Field:

segment

Parameter for E-Mail: {{segment}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Segment options: Option text → Send to address(es) email(s) info [OPTIONAL]
If the option is selected, the addresses set for this option will be added to the internal email.
Multiple addresses can be specified by separating the email addresses with a semicolon.
Example: receiver@pimcore.org; receiver2@pimcore.org

Form Field:

subject

Parameter for E-Mail: {{subject}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Subject options: Option text → Send to address(es) email(s) info [OPTIONAL]
If the option is selected, the addresses set for this option will be added to the internal email.
Multiple addresses can be specified by separating the email addresses with a semicolon.
Example: receiver@pimcore.org; receiver2@pimcore.org

Form Field:

comment

Parameter for E-Mail: {{comment}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Add a limit to comment text: (0 or empty means no limit)

Minimum of characters:

Maximum of characters:

Form Field:

opt_in

Parameter for E-Mail: {{opt_in}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Oui, j'aimerais recevoir des e-mails d'Aliaxis concernant des informations, des ressources, des invitations à des événements et des services. Je comprends que je peux retirer mon consentement à tout moment, conformément à la Politique de confidentialité.

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Aliaxis utilisera ces informations pour répondre au mieux à votre demande. En soumettant ce formulaire, vous reconnaissez qu'Aliaxis pourra vous contacter si nécessaire.