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<form action="https://vandesteege.us7.list-manage.com/subscribe/post?u=f1113ceafd949293b61fe1e69&amp;id=502b9ac6bb" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
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    <h2>Schrijf je in voor onze nieuwbouw nieuwsbrief</h2>
    <div class="indicates-required"><span class="asterisk">*</span> is een verplicht veld</div>
    <div class="mc-field-group">
    <label for="mce-EMAIL">E-mail adres  <span class="asterisk">*</span>
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    <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL" />
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    <div class="mc-field-group">
    <label for="mce-FNAME">Voornaam </label>
    <input type="text" value="" name="FNAME" class="" id="mce-FNAME" />
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    <div class="mc-field-group">
    <label for="mce-LNAME">Achternaam </label>
    <input type="text" value="" name="LNAME" class="" id="mce-LNAME" />
    </div>
    <div class="mc-field-group size1of2">
    <label for="mce-MMERGE3">Telefoonnummer </label>
    <input type="text" name="MMERGE3" class="" value="" id="mce-MMERGE3" />
    </div>
    <div id="mce-responses" class="clear">
    <div class="response" id="mce-error-response" style="display:none"></div>
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    <div class="clear"><input type="submit" value="Inschrijven" name="subscribe" id="mc-embedded-subscribe" class="button" /></div>
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