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[paytium name="Formulier naam" description="Product naam" amount="200.00"] [paytium_field type="label" label="Dit pakket is met €200,- bouwkosten"/] [paytium_field type="radio" label="Hosting expert" options="53.88 p.j. /77.88 p.j. /149.88 p.j. /293.88 p.j." options_are_amounts="true" tax="21" /][paytium_field type="radio" label="Domein" options="7.99 voor .nl /11.00 voor .com /5.55 voor .eu /10.00 voor .net" options_are_amounts="true" tax="21" /] [paytium_field type="dropdown" label="Extra opties" options="75,- simpel logo/100,- uitgebreid logo" options_are_amounts="true" /] [paytium_field type="text" label="Domeinnaam(check eerst op sidn.nl)" required="true" /] [paytium_field type="text" label="Eventuele Verhuiscode" required="false" /] [paytium_field type="email" label="Email" required="true" /] [paytium_field type="name" label="Naam" required="true" /] [paytium_field type="text" label="Adres" required="true" /] [paytium_field type="text" label="Postcode" required="true" /] [paytium_field type="text" label="Plaatsnaam" required="true" /] [paytium_field type="text" label="Land" required="true" /] [paytium_field type="file" /] [paytium_field type="label" label="Heeft u meerdere bestanden dan kunt u deze sturen naar info@powerontwerp.nl"/] [paytium_field type="terms" label="I accept the terms & conditions" link="https://url-to-your-terms-and-conditions.com" required="true" /] [paytium_total /] [/paytium]