[+validationmessage+]
<form method="post" action="[~[*id*]~]">
    <input type="hidden" name="formid" value="feedbackForm" />
    
    <p><label accesskey="n" for="name">Uw naam</label>
    <input type="text" name="name" maxlength="60" eform="Uw naam:1" /></p>

    <p><label accesskey="p" for="postcode">Postcode </label>
    <input type="text" name="postcode" maxlength="60" eform="Postcode" /></p>

    <p><label accesskey="s" for="plaats">Plaats</label>
    <input type="text" name="plaats" maxlength="60" eform="Plaats" /></p>

    <p><label accesskey="p" for="telefoon">Contact  Telefoon</label>
    <input type="text" name="telefoon" maxlength="60" eform="Contact  telefoon" /></p>

    <p><label accesskey="e" for="email">Uw e-mailadres</label>
    <input type="text" name="email" size="40" maxlength="40" eform="Uw e-mailadres:email:1" /></p>
    
    
    <p><label accesskey="c" for="comments">Vraag of opmerking </label>
    <textarea cols="40" rows="10" name="comments" eform="Vraag of opmerking:html:1"></textarea></p>

    <p>
Typ in het anti-spam code hieronder, grotte van letters is ook belgangerijk!:<br />
    <img src="[+verimageurl+]" alt="verification code" border="1"/>
    </p>
    <p>
    <label accesskey="c" for="vericode">code</label>
    <input type="text" name="vericode" size="20" />
    </p>
    
    <p><input type="submit" name="submit" value="Verzenden"></p>
</form>