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<!DOCTYPE html> <html> <head> <meta charset="utf-8"> <link rel="stylesheet" type="text/css" href="css/bootstrap.min.css"> <link rel="stylesheet" type="text/css" href="https://cdnjs.cloudflare.com/ajax/libs/selectize.js/0.12.1/css/selectize.bootstrap3.css"> <link rel="stylesheet" href="css/jquery-ui.min.css" /> <link rel="stylesheet" type="text/css" href="css/style.css"> <link rel="icon" type="image/png" href="https://www.kia.com/etc.clientlibs/settings/wcm/designs/eut/clientlib/resources/rbr/rbr-fav.ico"> <meta name="viewport" content="width=device-width"> <style type="text/css"> <!-- .subtitle { background: #05141F; } h3 { color: #05141F; } [type="radio"]:not(:checked) + label:after, [type="radio"]:checked + label:after { background-color: #05141F; } [type="checkbox"]:not(:checked) + label:after, [type="checkbox"]:checked + label:after { background-color: #05141F; } .btn-mq { background: #05141F; border: 2px solid #05141F; } .btn-mq:hover { color: #05141F!important; } .cta-mq { background: #05141F; border: 2px solid #05141F; } .cta-mq:hover { color: #05141F!important; } .ui-state-active, .ui-widget-content .ui-state-active, .ui-widget-header .ui-state-active, a.ui-button:active, .ui-button:active, .ui-button.ui-state-active:hover { border: 1px solid #05141F!important; background: #05141F!important; } --> </style> <title>Newsletter</title> </head> <body> <div class="main"> <div class="wrapper"> <a href="https://www.kia.com/be/" target="_blank"> <img class="banner banner-desktop" src="https://www.actito.be/wfa/WFPF_7276_51_12_YmFubmVyLmltYWdl_FR.act"> </a> <a href="https://www.kia.com/be/" target="_blank"> <img class="banner banner-mobile" src="https://www.actito.be/wfa/WFPF_7276_51_12_YmFubmVyLmltYWdlTW9iaWxl_FR.act"> </a> <div class="row subtitle"> <div class="col-md-12"> <h1>Toutes les actualit茅s Kia dans votre bo卯te mail</h1> </div> </div> <form method="post" action="/wf/7276/51/12/fr/Form0/Submit.act;jsessionid=2FB6CFB483303EAF1FC9F42169F79BD8" name="PageForm" id="contest"> <div class="row"> <div class="col-md-12"> <div class="form-group select " id="QA_type_question"> <label for="QA_type_val" >Priv&eacute;/Professionnel&nbsp;*</label> <select class="form-control selectized " name="QA_type_val" id="QA_type_val" > <option value="">---</option> <option value="private" >Priv&eacute;</option> <option value="fleet" >Professionnel</option> </select> </div> <input type="hidden" name="WFA_IFDKey_493" value="QA_type" id="WFA_IFDKey_493" /><input type="hidden" name="QA_type_presentationType" value="dropdown" id="QA_type_presentationType" /><div class="form-group select " id="QA_title_question"> <label for="QA_title_val" >Titre&nbsp;*</label> <select class="form-control selectized " name="QA_title_val" id="QA_title_val" > <option value="">---</option> <option value="Mr" >M.</option> <option value="Mrs" >Mme</option> </select> </div> <input type="hidden" name="WFA_IFDKey_494" value="QA_title" id="WFA_IFDKey_494" /><input type="hidden" name="QA_title_presentationType" value="dropdown" id="QA_title_presentationType" /><div class="form-group input " id="QA_firstname_question"> <label for="QA_firstname_val" >Pr&eacute;nom&nbsp;*</label> <input class="form-control " type="text" name="QA_firstname_val" id="QA_firstname_val" value="" /> </div> <input type="hidden" name="WFA_IFDKey_495" value="QA_firstname" id="WFA_IFDKey_495" /><input type="hidden" name="QA_firstname_presentationType" value="textfield" id="QA_firstname_presentationType" /><div class="form-group input " id="QA_lastname_question"> <label for="QA_lastname_val" >Nom&nbsp;*</label> <input class="form-control " type="text" name="QA_lastname_val" id="QA_lastname_val" value="" /> </div> <input type="hidden" name="WFA_IFDKey_496" value="QA_lastname" id="WFA_IFDKey_496" /><input type="hidden" name="QA_lastname_presentationType" value="textfield" id="QA_lastname_presentationType" /><div class="form-group input " id="QA_email_question"> <label for="QA_email_val" >E-mail&nbsp;*</label> <input class="form-control " type="email" name="QA_email_val" id="QA_email_val" value="" /> </div> <input type="hidden" name="WFA_IFDKey_497" value="QA_email" id="WFA_IFDKey_497" /><input type="hidden" name="QA_email_presentationType" value="textfield" id="QA_email_presentationType" /><p class="paragraph " id="iq5"><b>Notification Vie Priv茅e</b></p> <div class="form-group block-checkbox " id="QA_agreement_question"> <div class="custom-checkbox"> <input type="checkbox" name="QA_agreement_val" id="QA_agreement_val_Y" value="Y" /> <label class="simple-checkbox-label" for="QA_agreement_val_Y" id="QA_agreement_val_Y_label"><span style="color: #05141f;">Le respect de votre vie priv&eacute;e est tr&egrave;s important pour nous. Dans notre&nbsp;<b><a href="https://www.kia.com/be/fr/privacy" target="_blank">Politique Vie Priv&eacute;e Internet</a>,</b>&nbsp;nous exposons la fa&ccedil;on dont nous traitons vos donn&eacute;es &agrave; caract&egrave;re personnel.&nbsp;En nous envoyant ce formulaire, vous confirmez en avoir pris connaissance.</span></label> </div> </div> <input type="hidden" name="WFA_IFDKey_500" value="QA_agreement" id="WFA_IFDKey_500" /><input type="hidden" name="QA_agreement_presentationType" value="checkbox" id="QA_agreement_presentationType" /></div> </div> <div class="row"> <div class="col-md-12"> <p class="mandatory-field">* Champs obligatoires</p> </div> </div> <div class="row btn-container"> <div class="col-md-12"> <button type="submit" class="btn btn-mq next">Confirmer&nbsp;&nbsp;<span>&#9654;</span></button> </div> </div> </form> <script type="text/javascript"> window.checkDisplayConditionUrl = '/wf/7276/51/12/fr/Form0/CheckDisplayCondition.act;jsessionid=2FB6CFB483303EAF1FC9F42169F79BD8'; </script></div> </div> <img src="https://www.kia.com/be/" width="1" height="1"/> <script type="text/javascript" src="js/vendor/jquery-2.1.3.min.js"></script> <script type="text/javascript" src="//cdnjs.cloudflare.com/ajax/libs/selectize.js/0.12.1/js/standalone/selectize.js"></script> <script type="text/javascript" src="js/vendor/jquery-ui.min.js"></script> <script type="text/javascript" src="js/vendor/bootstrap-progressbar.js"></script> <script type="text/javascript" src="js/application.js"></script> <script type="text/javascript" src="js/main.js"></script> <script type="text/javascript"> $(document).ready(function() { $('.progress .progress-bar').progressbar(); }); console.log('nbpage = 1'); </script> </body> </html>

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