[paytium name="Sushi Masterclass" description="Payment description"] ALGEMENE GEGEVENS [paytium_field type="firstname" label="Voornaam" default="Hoe heet je?" required="true"/] [paytium_field type="lastname" label="Achternaam" required="true" /] [paytium_field type="phone" label="Telefoon" required="true" /] [paytium_field type="email" label="Email" required="true" newsletter="activecampaign" newsletter_label="aanmelding_sushi_masterclass" newsletter_list="32" /] [paytium_field type="text" label="Bedrijfsnaam" required="true" ac_custom_field="NAAM_BEDRIJF" /] [paytium_field type="text" label="KvK nummer" required="true" ac_custom_field="KVK_NUMMER" /] FACTUURADRES [paytium_field type="text" label="Straat" required="true" ac_custom_field="STRAAT_HUISNUMMER" /] [paytium_field type="text" label="Postcode + plaats" required="true" ac_custom_field="POSTCODE_PLAATS" /] LOCATIE & STARTDATUM: [paytium_field type="radio" label="Opties" options="Maandag 27 september - Oostzaan" required="true" ac_custom_field="LOCATIE_DATUM_START_OPLEIDING" /] [paytium_field type="hidden" label="Opleiding" default="Sushi Masterclass" ac_custom_field="OPLEIDING" /] [paytium_field type="label" label="SUSHI MASTERCLASS (INCL 21% BTW)" amount="71,39" tax="21" quantity="true" quantity_min="1" /] [paytium_total /] [paytium_button label="VOLGENDE STAP" /] [/paytium]