<?

function my_get_post($name,$escape=false)
{
  $var_read = '';
  if (isset($_POST[$name]))
  {
    $var_read = $_POST[$name];
    if (get_magic_quotes_gpc()) $var_read=stripslashes($var_read);
	if ($escape) $var_read=htmlspecialchars($var_read,ENT_QUOTES);
  }
  return $var_read;
}


function form_13_count_spam($str)
{
$nb=0;
$word='http:';
if (stristr($str,$word)) $nb++;
$word='<';
if (stristr($str,$word)) $nb++;
$word='>';
if (stristr($str,$word)) $nb++;

return $nb;
}

function isEmail($str) 
{
  if(eregi("^[_a-z0-9-]+(\.[_a-z0-9-]+)*@[a-z0-9-]+(\.[a-z0-9-]+)*(\.[a-z]{2,4})$", $str)) 
    return true;
  else
    return false;
}
  
function isNumber($str) 
{
  if(is_numeric($str)) 
    return true;
  else
    return false;
}
  $form_13_class='form_13_error';
$form_13_error='';
  $form_13_spam=0;
  
$form_13_td_458_class='form_13_info';
$form_13_td_458_error='&nbsp;';
$form_13_td_458_value='';

$form_13_td_459_class='form_13_info';
$form_13_td_459_error='&nbsp;';
$form_13_td_459_value='';

$form_13_td_460_class='form_13_info';
$form_13_td_460_error='&nbsp;';
$form_13_td_460_value='';

$form_13_td_461_class='form_13_info';
$form_13_td_461_error='&nbsp;';
$form_13_td_461_value='';

$form_13_td_462_class='form_13_info';
$form_13_td_462_error='&nbsp;';
$form_13_td_462_value='';

$form_13_td_463_class='form_13_info';
$form_13_td_463_error='&nbsp;';
$form_13_td_463_value='';

$form_13_td_464_class='form_13_info';
$form_13_td_464_error='&nbsp;';
$form_13_td_464_value='';

$form_13_td_466_class='form_13_info';
$form_13_td_466_error='&nbsp;';
$form_13_td_466_value='';

$form_13_td_467_class='form_13_info';
$form_13_td_467_error='&nbsp;';
$form_13_td_467_value='';

$form_13_td_468_class='form_13_info';
$form_13_td_468_error='&nbsp;';
$form_13_td_468_value='';

$form_13_td_469_class='form_13_info';
$form_13_td_469_error='&nbsp;';
$form_13_td_469_value='';


if ('nAN0dqDQ'==my_get_post('form_13_submit'))
{
$form_13_error_string='Er zijn fouten gevonden!!';
$form_13_td_458_error_class='form_13_error';
$form_13_td_458_error_must='Dit is een verplicht veld';
$form_13_td_458_error_spam='http: < > zijn niet toegestaan';


$form_13_td_458_value=my_get_post('Naam' ,true);
$form_13_body.='Naam : '.my_get_post('Naam')."\r\n";


if (''==trim(my_get_post('Naam'))) {$form_13_td_458_class=$form_13_td_458_error_class; $form_13_td_458_error=$form_13_td_458_error_must; $form_13_error=$form_13_error_string;}
  

$form_13_td_458_spam=form_13_count_spam(my_get_post('Naam'));
if ($form_13_td_458_spam>0)
{
  if ($form_13_td_458_class!=$form_13_td_458_error_class) {$form_13_td_458_class=$form_13_td_458_error_class; $form_13_td_458_error=$form_13_td_458_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_458_spam;
}
  
$form_13_td_459_error_class='form_13_error';
$form_13_td_459_error_must='Dit is een verplicht veld';
$form_13_td_459_error_validation='Dit is geen bestaand e-mail adres';
$form_13_td_459_error_spam='http: < > zijn niet toegestaan';


$form_13_td_459_value=my_get_post('Email' ,true);
$form_13_body.='Email : '.my_get_post('Email')."\r\n";


if (''==trim(my_get_post('Email'))) {$form_13_td_459_class=$form_13_td_459_error_class; $form_13_td_459_error=$form_13_td_459_error_must; $form_13_error=$form_13_error_string;}
  

if ($form_13_td_459_class!=$form_13_td_459_error_class && ''!=trim(my_get_post('Email')) && !isEmail(my_get_post('Email'))) {$form_13_td_459_class=$form_13_td_459_error_class; $form_13_td_459_error=$form_13_td_459_error_validation; $form_13_error=$form_13_error_string;}
  

$form_13_td_459_spam=form_13_count_spam(my_get_post('Email'));
if ($form_13_td_459_spam>0)
{
  if ($form_13_td_459_class!=$form_13_td_459_error_class) {$form_13_td_459_class=$form_13_td_459_error_class; $form_13_td_459_error=$form_13_td_459_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_459_spam;
}
  
$form_13_td_460_error_class='form_13_error';
$form_13_td_460_error_spam='http: < > zijn niet toegestaan';


$form_13_td_460_value=my_get_post('Adres' ,true);
$form_13_body.='Adres : '.my_get_post('Adres')."\r\n";


$form_13_td_460_spam=form_13_count_spam(my_get_post('Adres'));
if ($form_13_td_460_spam>0)
{
  if ($form_13_td_460_class!=$form_13_td_460_error_class) {$form_13_td_460_class=$form_13_td_460_error_class; $form_13_td_460_error=$form_13_td_460_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_460_spam;
}
  
$form_13_td_461_error_class='form_13_error';
$form_13_td_461_error_must='Dit is een verplicht veld';
$form_13_td_461_error_spam='http: < > zijn niet toegestaan';


$form_13_td_461_value=my_get_post('Postcode' ,true);
$form_13_body.='Postcode : '.my_get_post('Postcode')."\r\n";


if (''==trim(my_get_post('Postcode'))) {$form_13_td_461_class=$form_13_td_461_error_class; $form_13_td_461_error=$form_13_td_461_error_must; $form_13_error=$form_13_error_string;}
  

$form_13_td_461_spam=form_13_count_spam(my_get_post('Postcode'));
if ($form_13_td_461_spam>0)
{
  if ($form_13_td_461_class!=$form_13_td_461_error_class) {$form_13_td_461_class=$form_13_td_461_error_class; $form_13_td_461_error=$form_13_td_461_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_461_spam;
}
  
$form_13_td_462_error_class='form_13_error';
$form_13_td_462_error_must='Dit is een verplicht veld';
$form_13_td_462_error_spam='http: < > zijn niet toegestaan';


$form_13_td_462_value=my_get_post('Plaats' ,true);
$form_13_body.='Plaats : '.my_get_post('Plaats')."\r\n";


if (''==trim(my_get_post('Plaats'))) {$form_13_td_462_class=$form_13_td_462_error_class; $form_13_td_462_error=$form_13_td_462_error_must; $form_13_error=$form_13_error_string;}
  

$form_13_td_462_spam=form_13_count_spam(my_get_post('Plaats'));
if ($form_13_td_462_spam>0)
{
  if ($form_13_td_462_class!=$form_13_td_462_error_class) {$form_13_td_462_class=$form_13_td_462_error_class; $form_13_td_462_error=$form_13_td_462_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_462_spam;
}
  
$form_13_td_463_error_class='form_13_error';
$form_13_td_463_error_must='Dit is een verplicht veld';
$form_13_td_463_error_validation='Alleen nummer invoer toegestaan';
$form_13_td_463_error_spam='http: < > zijn niet toegestaan';


$form_13_td_463_value=my_get_post('Telefoon' ,true);
$form_13_body.='Telefoon : '.my_get_post('Telefoon')."\r\n";


if (''==trim(my_get_post('Telefoon'))) {$form_13_td_463_class=$form_13_td_463_error_class; $form_13_td_463_error=$form_13_td_463_error_must; $form_13_error=$form_13_error_string;}
  

if ($form_13_td_463_class!=$form_13_td_463_error_class && ''!=trim(my_get_post('Telefoon')) && !isNumber(my_get_post('Telefoon'))) {$form_13_td_463_class=$form_13_td_463_error_class; $form_13_td_463_error=$form_13_td_463_error_validation; $form_13_error=$form_13_error_string;}
  

$form_13_td_463_spam=form_13_count_spam(my_get_post('Telefoon'));
if ($form_13_td_463_spam>0)
{
  if ($form_13_td_463_class!=$form_13_td_463_error_class) {$form_13_td_463_class=$form_13_td_463_error_class; $form_13_td_463_error=$form_13_td_463_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_463_spam;
}
  
$form_13_td_464_error_class='form_13_error';
$form_13_td_464_error_must='Dit is een verplicht veld';
$form_13_td_464_error_validation='Alleen nummer invoer toegestaan';
$form_13_td_464_error_spam='http: < > zijn niet toegestaan';


$form_13_td_464_value=my_get_post('Mobiel' ,true);
$form_13_body.='Mobiel : '.my_get_post('Mobiel')."\r\n";


if (''==trim(my_get_post('Mobiel'))) {$form_13_td_464_class=$form_13_td_464_error_class; $form_13_td_464_error=$form_13_td_464_error_must; $form_13_error=$form_13_error_string;}
  

if ($form_13_td_464_class!=$form_13_td_464_error_class && ''!=trim(my_get_post('Mobiel')) && !isNumber(my_get_post('Mobiel'))) {$form_13_td_464_class=$form_13_td_464_error_class; $form_13_td_464_error=$form_13_td_464_error_validation; $form_13_error=$form_13_error_string;}
  

$form_13_td_464_spam=form_13_count_spam(my_get_post('Mobiel'));
if ($form_13_td_464_spam>0)
{
  if ($form_13_td_464_class!=$form_13_td_464_error_class) {$form_13_td_464_class=$form_13_td_464_error_class; $form_13_td_464_error=$form_13_td_464_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_464_spam;
}
  
$form_13_td_466_error_class='form_13_error';
$form_13_td_466_error_validation='Alleen nummer invoer toegestaan';
$form_13_td_466_error_spam='http: < > zijn niet toegestaan';


$form_13_td_466_value=my_get_post('Artikelnr1' ,true);
$form_13_body.='Artikelnr1 : '.my_get_post('Artikelnr1')."\r\n";


if ($form_13_td_466_class!=$form_13_td_466_error_class && ''!=trim(my_get_post('Artikelnr1')) && !isNumber(my_get_post('Artikelnr1'))) {$form_13_td_466_class=$form_13_td_466_error_class; $form_13_td_466_error=$form_13_td_466_error_validation; $form_13_error=$form_13_error_string;}
  

$form_13_td_466_spam=form_13_count_spam(my_get_post('Artikelnr1'));
if ($form_13_td_466_spam>0)
{
  if ($form_13_td_466_class!=$form_13_td_466_error_class) {$form_13_td_466_class=$form_13_td_466_error_class; $form_13_td_466_error=$form_13_td_466_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_466_spam;
}
  
$form_13_td_467_error_class='form_13_error';
$form_13_td_467_error_spam='http: < > zijn niet toegestaan';


$form_13_td_467_value=my_get_post('Omschrijving1' ,true);
$form_13_body.='Omschrijving1 : '.my_get_post('Omschrijving1')."\r\n";


$form_13_td_467_spam=form_13_count_spam(my_get_post('Omschrijving1'));
if ($form_13_td_467_spam>0)
{
  if ($form_13_td_467_class!=$form_13_td_467_error_class) {$form_13_td_467_class=$form_13_td_467_error_class; $form_13_td_467_error=$form_13_td_467_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_467_spam;
}
  
$form_13_td_468_error_class='form_13_error';
$form_13_td_468_error_validation='Alleen nummer invoer toegestaan';
$form_13_td_468_error_spam='http: < > zijn niet toegestaan';


$form_13_td_468_value=my_get_post('Artikelnr2' ,true);
$form_13_body.='Artikelnr2 : '.my_get_post('Artikelnr2')."\r\n";


if ($form_13_td_468_class!=$form_13_td_468_error_class && ''!=trim(my_get_post('Artikelnr2')) && !isNumber(my_get_post('Artikelnr2'))) {$form_13_td_468_class=$form_13_td_468_error_class; $form_13_td_468_error=$form_13_td_468_error_validation; $form_13_error=$form_13_error_string;}
  

$form_13_td_468_spam=form_13_count_spam(my_get_post('Artikelnr2'));
if ($form_13_td_468_spam>0)
{
  if ($form_13_td_468_class!=$form_13_td_468_error_class) {$form_13_td_468_class=$form_13_td_468_error_class; $form_13_td_468_error=$form_13_td_468_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_468_spam;
}
  
$form_13_td_469_error_class='form_13_error';
$form_13_td_469_error_spam='http: < > zijn niet toegestaan';


$form_13_td_469_value=my_get_post('Omschrijving2' ,true);
$form_13_body.='Omschrijving2 : '.my_get_post('Omschrijving2')."\r\n";


$form_13_td_469_spam=form_13_count_spam(my_get_post('Omschrijving2'));
if ($form_13_td_469_spam>0)
{
  if ($form_13_td_469_class!=$form_13_td_469_error_class) {$form_13_td_469_class=$form_13_td_469_error_class; $form_13_td_469_error=$form_13_td_469_error_spam; $form_13_error=$form_13_error_string;}
  $form_13_spam += $form_13_td_469_spam;
}
  

if (''==trim($form_13_error) && 0==$form_13_spam)
{
$receiver='info@lachaleur.nl';
$subject='Bestelling La Chaleur';
$subject.=$form_13_td_35_value;

  $subject= substr($subject, 0, 255);
  $subject=str_replace("\n", " ", $subject);
  $subject=str_replace("\r", " ", $subject);

  $body=str_replace("\n.", "\n..", $form_13_body);


  if ($body!="")
  {
    $result=mail($receiver,$subject,$body,$header);
    if (!result)
    {
       echo 'ERROR: The PHP mail function mail($receiver,$subject,$body,$header); does not work properly on your server, please contact your web hosting.';
       exit;
    }
  }

  if ($result)
  {
    $url='http://www.lachaleur.nl/feedback-thank-you.php';
    if (!headers_sent()){    
        header('Location: '.$url); exit;
    }else{                    
        echo '<script type="text/javascript">';
        echo 'window.location.href="'.$url.'";';
        echo '</script>';
        echo '<noscript>';
        echo '<meta http-equiv="refresh" content="0;url='.$url.'" />';
        echo '</noscript>'; exit;
    }	
    exit;
  }
}

  if (trim($form_13_error)) $form_13_error="<tr><td colspan=3 class='$form_13_class'>$form_13_error</td></tr>";
}
if ($form_13_spam >= 3)  sleep(20);
if ($form_13_spam >= 3) $form_13_td_458_value='';

if ($form_13_spam >= 3) $form_13_td_459_value='';

if ($form_13_spam >= 3) $form_13_td_460_value='';

if ($form_13_spam >= 3) $form_13_td_461_value='';

if ($form_13_spam >= 3) $form_13_td_462_value='';

if ($form_13_spam >= 3) $form_13_td_463_value='';

if ($form_13_spam >= 3) $form_13_td_464_value='';

if ($form_13_spam >= 3) $form_13_td_466_value='';

if ($form_13_spam >= 3) $form_13_td_467_value='';

if ($form_13_spam >= 3) $form_13_td_468_value='';

if ($form_13_spam >= 3) $form_13_td_469_value='';


?><!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en" >
<head>
<link rel="stylesheet" type="text/css" href="./usertpl/1subtle/n007.css" media="screen,projection" />
<title>La Chaleur</title>
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" >
<meta name="description" content="La Chaleur" >
<meta name="keywords" content="La Chaleur" >
<meta name="GENERATOR" content="Ewisoft Website Builder eCommerce Software from http://www.ewisoft.com/" >
<LINK rel="stylesheet" type="text/css" href="./user/ecommerce-css/e_list_view.css" >
<LINK rel="stylesheet" type="text/css" href="./user/ecommerce-css/e_detail_view.css" >
<LINK rel="stylesheet" type="text/css" href="./user/ecommerce-css/e_grid_view.css" >
<style type="text/css" >
<!--
.link7984
{
	color:#7f7f7f;
}

--></style><link rel="stylesheet" type="text/css" href="./user/g-css-js/form-13.css" />
<script language="javascript" type="text/javascript" src="./user/g-css-js/form-13.js" ></script><script language="javascript" type="text/javascript" src="./user/g-css-js/common-form.js" ></script> </head>
<body>
<table class="container" width="100%" ><tr><td><table width="100%" border="0" align="center" cellpadding="5" cellspacing="0" class="banner" >
<tr>
<td colspan="1" align="center" ><img src="./usertpl/1subtle/banner_2-lachaleur.jpg" width="1060" height="234" border="0" align="center" style="text-align:center;margin-left:0px;margin-right:10px;" /></td></tr></table>
<div class="toppict" ></div>
<table class="topmenu" width="100%" ><tr><td>
<table id="topnavcontainer" width="100%" ><tr><td>
<ul id="topnavlist" >
<li id="topactive" ><a href="index.htm" target="_self" id="topcurrent" >Home</a></li>
<li><a href="feedback.php" target="_self" >Contact</a></li>
<li><a href="winkel.htm" target="_self" >Winkel</a></li></ul></td></tr></table></td></tr></table>
<div class="mainpict" ></div>
<table class="leftmenu" width="100%" ><tr><td>
<ul id="leftnavlist" >
<li><a href="news.htm" target="_self" >Markt agenda</a></li>
<li><a href="products.htm" target="_self" >Aanbiedingen</a></li>
<li><a href="new-page.php" target="_self" id="leftcurrent" >Bestelformulier</a></li>
<li><a href="algemene-voorwaarden.htm" target="_self" >Algemene Voorwaarden</a></li>
<li><a href="refernties.php" target="_self" >Referenties</a></li></ul>
<P><img src="./user/cimage/arzberg-logo.jpg" width="225" height="225" style="HEIGHT:82px;WIDTH:112px;" border="0" ></P>
<P><img src="./user/cimage/bavaria.png" width="160" height="160" style="HEIGHT:74px;WIDTH:114px;" border="0" ></P>
<P><img src="./user/cimage/boch-logo.png" width="240" height="121" style="HEIGHT:70px;WIDTH:115px;" border="0" ></P>
<P><img src="./user/cimage/maasstricht-logo.png" width="313" height="161" style="HEIGHT:76px;WIDTH:117px;" border="0" ></P>
<P><img src="./user/cimage/royal-alberts-logo.jpg" width="209" height="123" style="HEIGHT:82px;WIDTH:117px;" border="0" ></P>
<P>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; e.a.</P></td></tr></table>
<div class="contframe" >
<div class="contents" ><P align="left" ><FONT size="4" ><STRONG>&nbsp;Bestelformulier</STRONG></FONT></P>
<P>
<P>&nbsp;</P>
<P>
<form id="ewisoft_form-13" name="form13" method="post" action="#" onsubmit="return onsubmit_form_13();" >
<input type="hidden" name="form_13_submit" value="nAN0dqDQ" >
<table width="500" cellpadding="3" cellspacing="0" border="0" bgcolor="#c0c0c0" >
<? echo $form_13_error ?>
<tr><td class="form_13_td_458" >Naam:</td><td class="form_13_td" ><input type="text" name="Naam" value="<? echo $form_13_td_458_value ?>" class="form_13_input_458" onchange="validate_form_13_input_458(false);" /></td><td id="form_13_info_td_458" class="<? echo $form_13_td_458_class ?>" ><? echo $form_13_td_458_error ?></td></tr>
<tr><td class="form_13_td_459" >Email:</td><td class="form_13_td" ><input type="text" name="Email" value="<? echo $form_13_td_459_value ?>" class="form_13_input_459" onchange="validate_form_13_input_459(false);" /></td><td id="form_13_info_td_459" class="<? echo $form_13_td_459_class ?>" ><? echo $form_13_td_459_error ?></td></tr>
<tr><td class="form_13_td" >Adres:</td><td class="form_13_td" ><textarea name="Adres" rows="2" class="form_13_input_460" ><? echo $form_13_td_460_value ?></textarea></td><td id="form_13_info_td_460" class="<? echo $form_13_td_460_class ?>" ><? echo $form_13_td_460_error ?></td></tr>
<tr><td class="form_13_td" >Postcode:</td><td class="form_13_td" ><input type="text" name="Postcode" value="<? echo $form_13_td_461_value ?>" class="form_13_input_461" onchange="validate_form_13_input_461(false);" /></td><td id="form_13_info_td_461" class="<? echo $form_13_td_461_class ?>" ><? echo $form_13_td_461_error ?></td></tr>
<tr><td class="form_13_td" >Plaats:</td><td class="form_13_td" ><input type="text" name="Plaats" value="<? echo $form_13_td_462_value ?>" class="form_13_input_462" onchange="validate_form_13_input_462(false);" /></td><td id="form_13_info_td_462" class="<? echo $form_13_td_462_class ?>" ><? echo $form_13_td_462_error ?></td></tr>
<tr><td class="form_13_td" >Telefoon:</td><td class="form_13_td" ><input type="text" name="Telefoon" value="<? echo $form_13_td_463_value ?>" class="form_13_input_463" onchange="validate_form_13_input_463(false);" /></td><td id="form_13_info_td_463" class="<? echo $form_13_td_463_class ?>" ><? echo $form_13_td_463_error ?></td></tr>
<tr><td class="form_13_td" >Mobiel:</td><td class="form_13_td" ><input type="text" name="Mobiel" value="<? echo $form_13_td_464_value ?>" class="form_13_input_464" onchange="validate_form_13_input_464(false);" /></td><td id="form_13_info_td_464" class="<? echo $form_13_td_464_class ?>" ><? echo $form_13_td_464_error ?></td></tr>
<tr><td class="form_13_td" colspan="2" >Geef uw art.nr en omschrijving in.</td><td id="form_13_info_td_465" class="<? echo $form_13_td_465_class ?>" ><? echo $form_13_td_465_error ?></td></tr>
<tr><td class="form_13_td" >Artikelnr.1</td><td class="form_13_td" ><input type="text" name="Artikelnr1" value="<? echo $form_13_td_466_value ?>" class="form_13_input_466" onchange="validate_form_13_input_466(false);" /></td><td id="form_13_info_td_466" class="<? echo $form_13_td_466_class ?>" ><? echo $form_13_td_466_error ?></td></tr>
<tr><td class="form_13_td" >Omschrijving.1</td><td class="form_13_td" ><input type="text" name="Omschrijving1" value="<? echo $form_13_td_467_value ?>" class="form_13_input_467" onchange="validate_form_13_input_467(false);" /></td><td id="form_13_info_td_467" class="<? echo $form_13_td_467_class ?>" ><? echo $form_13_td_467_error ?></td></tr>
<tr><td class="form_13_td" >Artikelnr.2</td><td class="form_13_td" ><input type="text" name="Artikelnr2" value="<? echo $form_13_td_468_value ?>" class="form_13_input_468" onchange="validate_form_13_input_468(false);" /></td><td id="form_13_info_td_468" class="<? echo $form_13_td_468_class ?>" ><? echo $form_13_td_468_error ?></td></tr>
<tr><td class="form_13_td" >Omschrijving.2</td><td class="form_13_td" ><input type="text" name="Omschrijving2" value="<? echo $form_13_td_469_value ?>" class="form_13_input_469" onchange="validate_form_13_input_469(false);" /></td><td id="form_13_info_td_469" class="<? echo $form_13_td_469_class ?>" ><? echo $form_13_td_469_error ?></td></tr>
<tr><td align="center" class="form_13_td" colspan="2" ><input type="submit" value="Verzenden" /></td><td id="form_13_info_td_470" class="form_13_info" >&nbsp;</td></tr></table></form></P>
<P>Na verzending van bovenstaand formulier en goedkeuring krijgt u, via het door u opgegeven emailadres, een factuur en <BR>een betaalverzoek.<BR>De door u bestelde goederen zullen na ontvangst van uw betaling worden verzonden.</P></p></div></div>
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