<div class="control-group ticket_section"> <label class=" control-label cf_liefhebberspas_nummer_593524-label " for="helpdesk_ticket_cf_liefhebberspas_nummer_593524">Liefhebberspas nummer</label> <div class="controls "> <input class=" number section_field span12" id="helpdesk_ticket_custom_field_cf_liefhebberspas_nummer_593524" name="helpdesk_ticket[custom_field][cf_liefhebberspas_nummer_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_soort_mobiele_telefoon_593524-label " for="helpdesk_ticket_cf_soort_mobiele_telefoon_593524">Soort mobiele telefoon</label> <div class="controls "> <select class=" dropdown_blank section_field dynamic_sections" id="helpdesk_ticket_custom_field_cf_soort_mobiele_telefoon_593524" name="helpdesk_ticket[custom_field][cf_soort_mobiele_telefoon_593524]"><option value="">...</option> <option value="Android" data-id="28000054996">Android</option> <option value="Iphone" data-id="28000054997">Iphone</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_soort_vraag_593524-label " for="helpdesk_ticket_cf_soort_vraag_593524">Soort vraag</label> <div class="controls "> <select class=" dropdown_blank section_field dynamic_sections" id="helpdesk_ticket_custom_field_cf_soort_vraag_593524" name="helpdesk_ticket[custom_field][cf_soort_vraag_593524]"><option value="">...</option> <option value="Registratie/account" data-id="28000055002">Registratie/account</option> <option value="Punten saldo" data-id="28000055003">Punten saldo</option> <option value="Punten verzilveren" data-id="28000055004">Punten verzilveren</option> <option value="Spaarprogramma" data-id="28000055005">Spaarprogramma</option> <option value="Gratis bij" data-id="28000055006">Gratis bij</option> <option value="Liefhebbers app" data-id="28000055190">Liefhebbers app</option> <option value="Geboortedatum" data-id="28000055191">Geboortedatum</option> <option value="Punten toekennen" data-id="28000055192">Punten toekennen</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" required control-label cf_adres_gegevens_593524-label " for="helpdesk_ticket_cf_adres_gegevens_593524">Adresgegevens</label> <div class="controls "> <input class=" required text section_field span12" id="helpdesk_ticket_custom_field_cf_adres_gegevens_593524" name="helpdesk_ticket[custom_field][cf_adres_gegevens_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_adresgegevens_593524-label " for="helpdesk_ticket_cf_adresgegevens_593524">Adresgegevens</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_adresgegevens_593524" name="helpdesk_ticket[custom_field][cf_adresgegevens_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_bestelnummer_593524-label " for="helpdesk_ticket_cf_bestelnummer_593524">Bestelnummer</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_bestelnummer_593524" name="helpdesk_ticket[custom_field][cf_bestelnummer_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_adresgegevens_593524-label " for="helpdesk_ticket_cf_adresgegevens_593524">Adresgegevens</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_adresgegevens_593524" name="helpdesk_ticket[custom_field][cf_adresgegevens_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_product_omschrijving_593524-label " for="helpdesk_ticket_cf_product_omschrijving_593524">Product omschrijving</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_product_omschrijving_593524" name="helpdesk_ticket[custom_field][cf_product_omschrijving_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_adresgegevens_593524-label " for="helpdesk_ticket_cf_adresgegevens_593524">Adresgegevens</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_adresgegevens_593524" name="helpdesk_ticket[custom_field][cf_adresgegevens_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_product_omschrijving_593524-label " for="helpdesk_ticket_cf_product_omschrijving_593524">Product omschrijving</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_product_omschrijving_593524" name="helpdesk_ticket[custom_field][cf_product_omschrijving_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_streepjescode_ean_593524-label " for="helpdesk_ticket_cf_streepjescode_ean_593524">Streepjescode (EAN)</label> <div class="controls "> <input class=" number section_field span12" id="helpdesk_ticket_custom_field_cf_streepjescode_ean_593524" name="helpdesk_ticket[custom_field][cf_streepjescode_ean_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_houdbaarheidsdatum_tht_593524-label " for="helpdesk_ticket_cf_houdbaarheidsdatum_tht_593524">Houdbaarheidsdatum (THT)</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_houdbaarheidsdatum_tht_593524" name="helpdesk_ticket[custom_field][cf_houdbaarheidsdatum_tht_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_adresgegevens_593524-label " for="helpdesk_ticket_cf_adresgegevens_593524">Adresgegevens</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_adresgegevens_593524" name="helpdesk_ticket[custom_field][cf_adresgegevens_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_product_omschrijving_593524-label " for="helpdesk_ticket_cf_product_omschrijving_593524">Product omschrijving</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_product_omschrijving_593524" name="helpdesk_ticket[custom_field][cf_product_omschrijving_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_streepjescode_ean_593524-label " for="helpdesk_ticket_cf_streepjescode_ean_593524">Streepjescode (EAN)</label> <div class="controls "> <input class=" number section_field span12" id="helpdesk_ticket_custom_field_cf_streepjescode_ean_593524" name="helpdesk_ticket[custom_field][cf_streepjescode_ean_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_houdbaarheidsdatum_tht_593524-label " for="helpdesk_ticket_cf_houdbaarheidsdatum_tht_593524">Houdbaarheidsdatum (THT)</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_houdbaarheidsdatum_tht_593524" name="helpdesk_ticket[custom_field][cf_houdbaarheidsdatum_tht_593524]" size="30" type="text" /> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_soort_spaaractie_593524-label " for="helpdesk_ticket_cf_soort_spaaractie_593524">Soort spaaractie</label> <div class="controls "> <select class=" dropdown_blank section_field dynamic_sections" id="helpdesk_ticket_custom_field_cf_soort_spaaractie_593524" name="helpdesk_ticket[custom_field][cf_soort_spaaractie_593524]"><option value="">...</option> <option value="Zomerspecials" data-id="28000052108">Zomerspecials</option> <option value="Fruitstruikjes" data-id="28000051410">Fruitstruikjes</option> <option value="Gezelschapsspellen" data-id="28000054506">Gezelschapsspellen</option> <option value="Guzzini" data-id="28000049197">Guzzini</option> <option value="Jamie Oliver" data-id="28000055064">Jamie Oliver</option> <option value="MasterChef" data-id="28000049194">MasterChef</option> <option value="Nature Spotters" data-id="28000049195">Nature Spotters</option> <option value="Tomorrow's Kitchen" data-id="28000049196">Tomorrow's Kitchen</option> <option value="Toppeez®" data-id="28000053651">Toppeez®</option> <option value="Toverland" data-id="28000050574">Toverland</option> <option value="Overig" data-id="28000049198">Overig</option> <option value="Carnaval" data-id="28000050051">Carnaval</option></select> </div> </div> <div class="control-group ticket_section"> <label class=" control-label cf_adresgegevens_593524-label " for="helpdesk_ticket_cf_adresgegevens_593524">Adresgegevens</label> <div class="controls "> <input class=" text section_field span12" id="helpdesk_ticket_custom_field_cf_adresgegevens_593524" name="helpdesk_ticket[custom_field][cf_adresgegevens_593524]" size="30" type="text" /> </div> </div>