{"id":23034,"date":"2026-09-03T13:00:30","date_gmt":"2026-09-03T11:00:30","guid":{"rendered":"https:\/\/www.servethecity.brussels\/?page_id=23034"},"modified":"2026-09-03T13:00:31","modified_gmt":"2026-09-03T11:00:31","slug":"david-lloyd","status":"publish","type":"page","link":"https:\/\/www.servethecity.brussels\/nl\/doneer\/david-lloyd\/","title":{"rendered":"David Lloyd Sterrebeek supports Serve the City"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row fullwidth=&#8221;true&#8221; fullwidth_content=&#8221;false&#8221; css=&#8221;.vc_custom_1784144587961{background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;][vc_column][vc_single_image image=&#8221;23047&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; css_animation=&#8221;none&#8221; css=&#8221;.vc_custom_1784144449147{margin-bottom: 50px !important;padding-top: 50px !important;padding-bottom: 0px !important;}&#8221; el_class=&#8221;retina&#8221;][\/vc_column][\/vc_row][vc_row fullwidth=&#8221;true&#8221; equal_columns=&#8221;true&#8221; css=&#8221;.vc_custom_1784145991756{background-color: #EEEEEE !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}&#8221;][vc_column width=&#8221;1\/2&#8243; css=&#8221;.vc_custom_1784149128870{background: #82285F url(\/\/cdn.servethecity.net\/wp-content\/uploads\/sites\/2\/2026\/07\/bg-purple.png?id=23067) !important;}&#8221;][vc_single_image image=&#8221;22228&#8243; img_size=&#8221;full&#8221; alignment=&#8221;center&#8221; css_animation=&#8221;none&#8221; css=&#8221;.vc_custom_1784144989782{margin-bottom: 50px !important;padding-top: 50px !important;padding-bottom: 0px !important;}&#8221;][\/vc_column][vc_column width=&#8221;1\/2&#8243; css=&#8221;.vc_custom_1784145297063{padding-left: 30px !important;}&#8221;][mk_fancy_title color=&#8221;#000000&#8243; size=&#8221;30&#8243; line_height=&#8221;200&#8243; font_weight=&#8221;400&#8243; letter_spacing=&#8221;2&#8243; margin_top=&#8221;50&#8243; margin_bottom=&#8221;50&#8243; font_family=&#8221;none&#8221;]Join a growing community of David Lloyd members supporting Serve the City with a monthly donation.[\/mk_fancy_title][vc_column_text css=&#8221;.vc_custom_1784146174839{margin-bottom: 0px !important;}&#8221;]<div class=\"gwpm-container\">\n\t\t\t<div class=\"gwpm-meter\">\n\t\t\t\t<div class=\"gwpm-fill\" style=\"width:0%;\"><\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"gwpm-count\">\n\t\t\t\tMonthly donations <span class=\"gwpm-count-number\">\u20ac0<\/span>\n\t\t\t<\/div>\n\t\t\t<div class=\"gwpm-goal\">\n\t\t\t\tGoal <span class=\"gwpm-goal-number\">\u20ac5,000<\/span>\n\t\t\t<\/div>\n\t\t<\/div>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1784146466464{margin-top: 50px !important;margin-bottom: 50px !important;}&#8221; id=&#8221;form&#8221;][vc_column][vc_column_text 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class='gppt-has-page-transitions gform-theme__no-reset--el ' action='\/nl\/wp-json\/wp\/v2\/pages\/23034' data-formid='169' novalidate><div id=\"payments-sdk__contingency-lightbox\"><\/div>\n        <div id='gf_progressbar_wrapper_169' class='gf_progressbar_wrapper' data-start-at-zero=''>\n        \t<p class=\"gf_progressbar_title\">Stap <span class='gf_step_current_page'>1<\/span> van <span class='gf_step_page_count'>3<\/span><span class='gf_step_label'><\/span>\n        \t<\/p>\n            <div class='gf_progressbar gf_progressbar_orange' aria-hidden='true'>\n                <div class='gf_progressbar_percentage percentbar_orange percentbar_33' style='width:33%;'><span>33%<\/span><\/div>\n            <\/div><\/div>\n                        <div class='gform-body gform_body'><div id='gform_page_169_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_169' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_169_55\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"><label id='gfield_label_169_55' class='gfield_label gform-field-label' for='input_169_55'><span class='gform-field-label__text'>Instagram<\/span><\/label><div class='gfield_description' id='gfield_description_169_55'>Dit veld is bedoeld voor validatiedoeleinden en moet niet worden gewijzigd.<\/div><div class='ginput_container'><input name='input_55' id='input_169_55' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_169_30\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"45cd8b47\" data-field-span=\"12\"><h3 class=\"gsection_title\">Kom in actie<\/h3><\/div><div id=\"field_169_42\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"221b56fb\" data-field-span=\"12\"><p>Zet uw steun om in een maandelijkse bijdrage<\/p><\/div><fieldset id=\"field_169_3\" class=\"gfield gfield--type-product gfield--type-choice gfield--input-type-radio gfield--width-full radio_amounts gfield_price gfield_price_169_3 gfield_product_169_3 gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"d9c2c623\" data-field-span=\"12\"><legend id='gfield_label_169_3' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Kies je maandelijkse bijdrage<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_169_3'>\n\t\t\t<div class='gchoice gchoice_169_3_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='10|10'  id='choice_169_3_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_169_3_0 gfield_label_169_3\"   \/>\n\t\t\t\t\t<label for='choice_169_3_0' id='label_169_3_0' class='gform-field-label gform-field-label--type-inline'>10 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_169_3_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='25|25' checked='checked' id='choice_169_3_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_169_3_1' id='label_169_3_1' class='gform-field-label gform-field-label--type-inline'>25 EUR - Meest voorkomend<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_169_3_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='50|50'  id='choice_169_3_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_169_3_2' id='label_169_3_2' class='gform-field-label gform-field-label--type-inline'>50 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_169_3_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='100|100'  id='choice_169_3_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_169_3_3' id='label_169_3_3' class='gform-field-label gform-field-label--type-inline'>100 EUR<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_169_3_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_3' type='radio' value='Other amount|0'  id='choice_169_3_4' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_169_3_4' id='label_169_3_4' class='gform-field-label gform-field-label--type-inline'>Ander bedrag<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_169_4\" class=\"gfield gfield--type-product gfield--input-type-price gfield--width-full input_amount gfield_price gfield_price_169_4 gfield_product_169_4 gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\" data-group-id=\"236a0629\" data-field-span=\"12\"><label id='gfield_label_169_4' class='gfield_label gform-field-label' for='input_169_4'><span class='gform-field-label__text'>Geef het bedrag aan<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_4' id='input_169_4' type='text' value='' class='large ginput_amount'  placeholder='bijv. 75,00 \u20ac' aria-required=\"true\" aria-invalid=\"false\"  \/>\n\t\t\t\t<\/div><\/div><fieldset id=\"field_169_24\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_above gfield--has-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"2f671cd1\" data-field-span=\"12\"><legend id='gfield_label_169_24' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Organisation<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_169_24'><div class='gchoice gchoice_169_24_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_24.1' type='checkbox'  value='This donation is on behalf of an organisation'  id='choice_169_24_1'   aria-describedby=\"gfield_description_169_24\" aria-labelledby=\"label_169_24_1 gfield_label_169_24\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_169_24_1' id='label_169_24_1' class='gform-field-label gform-field-label--type-inline'>Deze donatie is namens een organisatie<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_169_24'>Vink dit vakje alleen aan als de donatie afkomstig is van de organisatie zelf.<\/div><\/fieldset><div id=\"field_169_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"b7351ace\" data-field-span=\"12\"><h3 class=\"gsection_title\">Informatie over de organisatie<\/h3><\/div><div id=\"field_169_25\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e920465e\" data-field-span=\"6\"><label id='gfield_label_169_25' class='gfield_label gform-field-label' for='input_169_25'><span class='gform-field-label__text'>Organisatie naam<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_25' id='input_169_25' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_169_26\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"e920465e\" data-field-span=\"6\"><label id='gfield_label_169_26' class='gfield_label gform-field-label' for='input_169_26'><span class='gform-field-label__text'>BTW nummer<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_169_26' type='text' value='' class='large'  aria-describedby=\"gfield_description_169_26\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_169_26'>Optioneel<\/div><\/div><fieldset id=\"field_169_27\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"7827f94b\" data-field-span=\"12\"><legend id='gfield_label_169_27' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Adres van de organisatie<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_169_27' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_169_27_1_container' >\n                                        <label for='input_169_27_1' id='input_169_27_1_label' class='gform-field-label gform-field-label--type-sub '>Straat + huisnummer<\/label>\n                                        <input type='text' name='input_27.1' id='input_169_27_1' value=''    aria-required='true'    aria-labelledby=\"input_169_27_1_label gfield_label_169_27\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_169_27_3_container' >\n                                    <label for='input_169_27_3' id='input_169_27_3_label' class='gform-field-label gform-field-label--type-sub '>Plaats<\/label>\n                                    <input type='text' name='input_27.3' id='input_169_27_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_27.4' id='input_169_27_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_169_27_5_container' >\n                                    <label for='input_169_27_5' id='input_169_27_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_27.5' id='input_169_27_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_169_27_6_container' >\n                                        <label for='input_169_27_6' id='input_169_27_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                        <select name='input_27.6' id='input_169_27_6'   aria-required='true'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AL' >Albania<\/option><option value='DZ' >Algeria<\/option><option value='AS' >American Samoa<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctica<\/option><option value='AG' >Antigua and Barbuda<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BY' >Belarus<\/option><option value='BE' selected='selected'>Belgium<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhutan<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, Sint Eustatius and Saba<\/option><option value='BA' >Bosnia and Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet Island<\/option><option value='BR' >Brazil<\/option><option value='IO' >British Indian Ocean Territory<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='CV' >Cabo Verde<\/option><option value='KH' >Cambodia<\/option><option value='CM' >Cameroon<\/option><option value='CA' >Canada<\/option><option value='KY' >Cayman Islands<\/option><option value='CF' >Central African Republic<\/option><option value='TD' >Chad<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CX' >Christmas Island<\/option><option value='CC' >Cocos Islands<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoros<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratic Republic of the<\/option><option value='CK' >Cook Islands<\/option><option value='CR' >Costa Rica<\/option><option value='HR' >Croatia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='CZ' >Czechia<\/option><option value='CI' >C\u00f4te d&#039;Ivoire<\/option><option value='DK' >Denmark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominican Republic<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypt<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatorial Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopia<\/option><option value='FK' >Falkland Islands<\/option><option value='FO' >Faroe Islands<\/option><option value='FJ' >Fiji<\/option><option value='FI' >Finland<\/option><option value='FR' >France<\/option><option value='GF' >French Guiana<\/option><option value='PF' >French Polynesia<\/option><option value='TF' >French Southern Territories<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='DE' >Germany<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Greece<\/option><option value='GL' >Greenland<\/option><option value='GD' >Grenada<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GW' >Guinea-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Haiti<\/option><option value='HM' >Heard Island and McDonald Islands<\/option><option value='VA' >Holy See<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungary<\/option><option value='IS' >Iceland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IR' >Iran<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Ireland<\/option><option value='IM' >Isle of Man<\/option><option value='IL' >Israel<\/option><option value='IT' >Italy<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordan<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KI' >Kiribati<\/option><option value='KP' >Korea, Democratic People&#039;s Republic of<\/option><option value='KR' >Korea, Republic of<\/option><option value='' >Kosovo<\/option><option value='KW' >Kuwait<\/option><option value='KG' >Kyrgyzstan<\/option><option value='LA' >Lao People&#039;s Democratic Republic<\/option><option value='LV' >Latvia<\/option><option value='LB' >Lebanon<\/option><option value='LS' >Lesotho<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libya<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lithuania<\/option><option value='LU' >Luxemburg<\/option><option value='MO' >Macao<\/option><option value='MG' >Madagascar<\/option><option value='MW' >Malawi<\/option><option value='MY' >Malaysia<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='MH' >Marshall Islands<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritania<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldova<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MA' >Morocco<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NL' >Netherlands<\/option><option value='NC' >New Caledonia<\/option><option value='NZ' >New Zealand<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NF' >Norfolk Island<\/option><option value='MK' >North Macedonia<\/option><option value='MP' >Northern Mariana Islands<\/option><option value='NO' >Norway<\/option><option value='OM' >Oman<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestine, State of<\/option><option value='PA' >Panama<\/option><option value='PG' >Papua New Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PH' >Philippines<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Poland<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='RO' >Romania<\/option><option value='RU' >Russian Federation<\/option><option value='RW' >Rwanda<\/option><option value='RE' >R\u00e9union<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='SH' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='KN' >Saint Kitts and Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre and Miquelon<\/option><option value='VC' >Saint Vincent and the Grenadines<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tome and Principe<\/option><option value='SA' >Saudi Arabia<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovakia<\/option><option value='SI' >Slovenia<\/option><option value='SB' >Solomon Islands<\/option><option value='SO' >Somalia<\/option><option value='ZA' >South Africa<\/option><option value='GS' >South Georgia and the South Sandwich Islands<\/option><option value='SS' >South Sudan<\/option><option value='ES' >Spain<\/option><option value='LK' >Sri Lanka<\/option><option value='SD' >Sudan<\/option><option value='SR' >Suriname<\/option><option value='SJ' >Svalbard and Jan Mayen<\/option><option value='SE' >Sweden<\/option><option value='CH' >Switzerland<\/option><option value='SY' >Syria Arab Republic<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzania, the United Republic of<\/option><option value='TH' >Thailand<\/option><option value='TL' >Timor-Leste<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad and Tobago<\/option><option value='TN' >Tunisia<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks and Caicos Islands<\/option><option value='TV' >Tuvalu<\/option><option value='TR' >T\u00fcrkiye<\/option><option value='UM' >US Minor Outlying Islands<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='AE' >United Arab Emirates<\/option><option value='GB' >United Kingdom<\/option><option value='US' >United States<\/option><option value='UY' >Uruguay<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Viet Nam<\/option><option value='VG' >Virgin Islands, British<\/option><option value='VI' >Virgin Islands, U.S.<\/option><option value='WF' >Wallis and Futuna<\/option><option value='EH' >Western Sahara<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><option value='AX' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <button type='button' id='gform_next_button_169_43' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Verder gaan<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_169_2' class='gform_page' data-js='page-field-id-43' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_169_2' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_169_32\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c437bc3f\" data-field-span=\"12\"><h3 class=\"gsection_title\">Wie je bent<\/h3><\/div><fieldset id=\"field_169_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1dda644b\" data-field-span=\"12\"><legend id='gfield_label_169_1' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Je naam<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_169_1'>\n                            \n                            <span id='input_169_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <label for='input_169_1_3' id='input_169_1_3_label' class='gform-field-label gform-field-label--type-sub '>Voornaam<\/label>\n                                                    <input type='text' name='input_1.3' id='input_169_1_3' value=''   aria-required='true'    autocomplete=\"given-name\" aria-labelledby=\"input_169_1_3_label gfield_label_169_1\"\/>\n                                                <\/span>\n                            \n                            <span id='input_169_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                            <label for='input_169_1_6' id='input_169_1_6_label' class='gform-field-label gform-field-label--type-sub '>Achternaam<\/label>\n                                                            <input type='text' name='input_1.6' id='input_169_1_6' value=''   aria-required='true'    autocomplete=\"family-name\" \/>\n                                                        <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_169_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"acd2da09\" data-field-span=\"12\"><label id='gfield_label_169_2' class='gfield_label gform-field-label' for='input_169_2'><span class='gform-field-label__text'>Je e-mailadres<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_169_2' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"email\"\/>\n                        <\/div><\/div><div id=\"field_169_35\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"a524ebb6\" data-field-span=\"12\"><label id='gfield_label_169_35' class='gfield_label gform-field-label' for='input_169_35'><span class='gform-field-label__text'>Contact ID<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_35' id='input_169_35' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_169_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"d5ad699d\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_40' id='input_169_40' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='701P400000w7UjAIAU' \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                        <button type='button' id='gform_previous_button_169_44' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='button' id='gform_next_button_169_44' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' >Verder gaan<\/button> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_169_3' class='gform_page' data-js='page-field-id-44' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_169_3' class='gform_fields top_label form_sublabel_above description_above validation_below' data-column-layout='fill'><div id=\"field_169_33\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"1d821d2c\" data-field-span=\"12\"><h3 class=\"gsection_title\">Maak het officieel<\/h3><\/div><fieldset id=\"field_169_28\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full taxdeduction field_sublabel_above gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"44603ff0\" data-field-span=\"12\"><legend id='gfield_label_169_28' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Provide address<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_169_28'><div class='gchoice gchoice_169_28_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_28.1' type='checkbox'  value='Get your tax deduction (Belgium)'  id='choice_169_28_1'    aria-labelledby=\"label_169_28_1 gfield_label_169_28\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_169_28_1' id='label_169_28_1' class='gform-field-label gform-field-label--type-inline'>Profiteer van uw belastingaftrek (Belgi\u00eb)<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_169_47\" class=\"gfield gfield--type-section gfield--input-type-section gsection group-start field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4ce2fc61\" data-field-span=\"12\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_169_41\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half group-row gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"fae04470\" data-field-span=\"6\"><label id='gfield_label_169_41' class='gfield_label gform-field-label' for='input_169_41'><span class='gform-field-label__text'>Rijksregisternummer<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_169_41'>Om in aanmerking te komen voor belastingaftrek, moet u ons uw nationaal registratienummer doorgeven, dat op uw Belgische identiteitskaart staat vermeld (<a href=\"https:\/\/fin.belgium.be\/nl\/particulieren\/belastingvoordelen\/giften\" target=\"_blank\">meer informatie<\/a>).<\/div><div class='ginput_container ginput_container_text'><input name='input_41' id='input_169_41' type='text' value='' class='large'  aria-describedby=\"gfield_description_169_41\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_169_16\" class=\"gfield gfield--type-address gfield--input-type-address gfield--width-half group-row gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"fae04470\" data-field-span=\"6\"><legend id='gfield_label_169_16' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Je adres<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_zip has_country ginput_container_address gform-grid-row' id='input_169_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_169_16_1_container' >\n                                        <label for='input_169_16_1' id='input_169_16_1_label' class='gform-field-label gform-field-label--type-sub '>Straat + huisnummer<\/label>\n                                        <input type='text' name='input_16.1' id='input_169_16_1' value=''    aria-required='true'    aria-labelledby=\"input_169_16_1_label gfield_label_169_16\"\/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_169_16_3_container' >\n                                    <label for='input_169_16_3' id='input_169_16_3_label' class='gform-field-label gform-field-label--type-sub '>Plaats<\/label>\n                                    <input type='text' name='input_16.3' id='input_169_16_3' value=''    aria-required='true'    \/>\n                                 <\/span><input type='hidden' class='gform_hidden' name='input_16.4' id='input_169_16_4' value=''\/><span class='ginput_right address_zip ginput_address_zip gform-grid-col' id='input_169_16_5_container' >\n                                    <label for='input_169_16_5' id='input_169_16_5_label' class='gform-field-label gform-field-label--type-sub '>Postcode<\/label>\n                                    <input type='text' name='input_16.5' id='input_169_16_5' value=''    aria-required='true'    \/>\n                                <\/span><span class='ginput_left address_country ginput_address_country gform-grid-col' id='input_169_16_6_container' >\n                                        <label for='input_169_16_6' id='input_169_16_6_label' class='gform-field-label gform-field-label--type-sub '>Land<\/label>\n                                        <select name='input_16.6' id='input_169_16_6'   aria-required='true'    ><option value='' ><\/option><option value='AF' >Afghanistan<\/option><option value='AL' >Albania<\/option><option value='DZ' >Algeria<\/option><option value='AS' >American Samoa<\/option><option value='AD' >Andorra<\/option><option value='AO' >Angola<\/option><option value='AI' >Anguilla<\/option><option value='AQ' >Antarctica<\/option><option value='AG' >Antigua and Barbuda<\/option><option value='AR' >Argentina<\/option><option value='AM' >Armenia<\/option><option value='AW' >Aruba<\/option><option value='AU' >Australia<\/option><option value='AT' >Austria<\/option><option value='AZ' >Azerbaijan<\/option><option value='BS' >Bahamas<\/option><option value='BH' >Bahrain<\/option><option value='BD' >Bangladesh<\/option><option value='BB' >Barbados<\/option><option value='BY' >Belarus<\/option><option value='BE' selected='selected'>Belgium<\/option><option value='BZ' >Belize<\/option><option value='BJ' >Benin<\/option><option value='BM' >Bermuda<\/option><option value='BT' >Bhutan<\/option><option value='BO' >Bolivia<\/option><option value='BQ' >Bonaire, Sint Eustatius and Saba<\/option><option value='BA' >Bosnia and Herzegovina<\/option><option value='BW' >Botswana<\/option><option value='BV' >Bouvet Island<\/option><option value='BR' >Brazil<\/option><option value='IO' >British Indian Ocean Territory<\/option><option value='BN' >Brunei Darussalam<\/option><option value='BG' >Bulgaria<\/option><option value='BF' >Burkina Faso<\/option><option value='BI' >Burundi<\/option><option value='CV' >Cabo Verde<\/option><option value='KH' >Cambodia<\/option><option value='CM' >Cameroon<\/option><option value='CA' >Canada<\/option><option value='KY' >Cayman Islands<\/option><option value='CF' >Central African Republic<\/option><option value='TD' >Chad<\/option><option value='CL' >Chile<\/option><option value='CN' >China<\/option><option value='CX' >Christmas Island<\/option><option value='CC' >Cocos Islands<\/option><option value='CO' >Colombia<\/option><option value='KM' >Comoros<\/option><option value='CG' >Congo<\/option><option value='CD' >Congo, Democratic Republic of the<\/option><option value='CK' >Cook Islands<\/option><option value='CR' >Costa Rica<\/option><option value='HR' >Croatia<\/option><option value='CU' >Cuba<\/option><option value='CW' >Cura\u00e7ao<\/option><option value='CY' >Cyprus<\/option><option value='CZ' >Czechia<\/option><option value='CI' >C\u00f4te d&#039;Ivoire<\/option><option value='DK' >Denmark<\/option><option value='DJ' >Djibouti<\/option><option value='DM' >Dominica<\/option><option value='DO' >Dominican Republic<\/option><option value='EC' >Ecuador<\/option><option value='EG' >Egypt<\/option><option value='SV' >El Salvador<\/option><option value='GQ' >Equatorial Guinea<\/option><option value='ER' >Eritrea<\/option><option value='EE' >Estonia<\/option><option value='SZ' >Eswatini<\/option><option value='ET' >Ethiopia<\/option><option value='FK' >Falkland Islands<\/option><option value='FO' >Faroe Islands<\/option><option value='FJ' >Fiji<\/option><option value='FI' >Finland<\/option><option value='FR' >France<\/option><option value='GF' >French Guiana<\/option><option value='PF' >French Polynesia<\/option><option value='TF' >French Southern Territories<\/option><option value='GA' >Gabon<\/option><option value='GM' >Gambia<\/option><option value='GE' >Georgia<\/option><option value='DE' >Germany<\/option><option value='GH' >Ghana<\/option><option value='GI' >Gibraltar<\/option><option value='GR' >Greece<\/option><option value='GL' >Greenland<\/option><option value='GD' >Grenada<\/option><option value='GP' >Guadeloupe<\/option><option value='GU' >Guam<\/option><option value='GT' >Guatemala<\/option><option value='GG' >Guernsey<\/option><option value='GN' >Guinea<\/option><option value='GW' >Guinea-Bissau<\/option><option value='GY' >Guyana<\/option><option value='HT' >Haiti<\/option><option value='HM' >Heard Island and McDonald Islands<\/option><option value='VA' >Holy See<\/option><option value='HN' >Honduras<\/option><option value='HK' >Hong Kong<\/option><option value='HU' >Hungary<\/option><option value='IS' >Iceland<\/option><option value='IN' >India<\/option><option value='ID' >Indonesia<\/option><option value='IR' >Iran<\/option><option value='IQ' >Iraq<\/option><option value='IE' >Ireland<\/option><option value='IM' >Isle of Man<\/option><option value='IL' >Israel<\/option><option value='IT' >Italy<\/option><option value='JM' >Jamaica<\/option><option value='JP' >Japan<\/option><option value='JE' >Jersey<\/option><option value='JO' >Jordan<\/option><option value='KZ' >Kazakhstan<\/option><option value='KE' >Kenya<\/option><option value='KI' >Kiribati<\/option><option value='KP' >Korea, Democratic People&#039;s Republic of<\/option><option value='KR' >Korea, Republic of<\/option><option value='' >Kosovo<\/option><option value='KW' >Kuwait<\/option><option value='KG' >Kyrgyzstan<\/option><option value='LA' >Lao People&#039;s Democratic Republic<\/option><option value='LV' >Latvia<\/option><option value='LB' >Lebanon<\/option><option value='LS' >Lesotho<\/option><option value='LR' >Liberia<\/option><option value='LY' >Libya<\/option><option value='LI' >Liechtenstein<\/option><option value='LT' >Lithuania<\/option><option value='LU' >Luxemburg<\/option><option value='MO' >Macao<\/option><option value='MG' >Madagascar<\/option><option value='MW' >Malawi<\/option><option value='MY' >Malaysia<\/option><option value='MV' >Maldives<\/option><option value='ML' >Mali<\/option><option value='MT' >Malta<\/option><option value='MH' >Marshall Islands<\/option><option value='MQ' >Martinique<\/option><option value='MR' >Mauritania<\/option><option value='MU' >Mauritius<\/option><option value='YT' >Mayotte<\/option><option value='MX' >Mexico<\/option><option value='FM' >Micronesia<\/option><option value='MD' >Moldova<\/option><option value='MC' >Monaco<\/option><option value='MN' >Mongolia<\/option><option value='ME' >Montenegro<\/option><option value='MS' >Montserrat<\/option><option value='MA' >Morocco<\/option><option value='MZ' >Mozambique<\/option><option value='MM' >Myanmar<\/option><option value='NA' >Namibia<\/option><option value='NR' >Nauru<\/option><option value='NP' >Nepal<\/option><option value='NL' >Netherlands<\/option><option value='NC' >New Caledonia<\/option><option value='NZ' >New Zealand<\/option><option value='NI' >Nicaragua<\/option><option value='NE' >Niger<\/option><option value='NG' >Nigeria<\/option><option value='NU' >Niue<\/option><option value='NF' >Norfolk Island<\/option><option value='MK' >North Macedonia<\/option><option value='MP' >Northern Mariana Islands<\/option><option value='NO' >Norway<\/option><option value='OM' >Oman<\/option><option value='PK' >Pakistan<\/option><option value='PW' >Palau<\/option><option value='PS' >Palestine, State of<\/option><option value='PA' >Panama<\/option><option value='PG' >Papua New Guinea<\/option><option value='PY' >Paraguay<\/option><option value='PE' >Peru<\/option><option value='PH' >Philippines<\/option><option value='PN' >Pitcairn<\/option><option value='PL' >Poland<\/option><option value='PT' >Portugal<\/option><option value='PR' >Puerto Rico<\/option><option value='QA' >Qatar<\/option><option value='RO' >Romania<\/option><option value='RU' >Russian Federation<\/option><option value='RW' >Rwanda<\/option><option value='RE' >R\u00e9union<\/option><option value='BL' >Saint Barth\u00e9lemy<\/option><option value='SH' >Saint Helena, Ascension and Tristan da Cunha<\/option><option value='KN' >Saint Kitts and Nevis<\/option><option value='LC' >Saint Lucia<\/option><option value='MF' >Saint Martin<\/option><option value='PM' >Saint Pierre and Miquelon<\/option><option value='VC' >Saint Vincent and the Grenadines<\/option><option value='WS' >Samoa<\/option><option value='SM' >San Marino<\/option><option value='ST' >Sao Tome and Principe<\/option><option value='SA' >Saudi Arabia<\/option><option value='SN' >Senegal<\/option><option value='RS' >Serbia<\/option><option value='SC' >Seychelles<\/option><option value='SL' >Sierra Leone<\/option><option value='SG' >Singapore<\/option><option value='SX' >Sint Maarten<\/option><option value='SK' >Slovakia<\/option><option value='SI' >Slovenia<\/option><option value='SB' >Solomon Islands<\/option><option value='SO' >Somalia<\/option><option value='ZA' >South Africa<\/option><option value='GS' >South Georgia and the South Sandwich Islands<\/option><option value='SS' >South Sudan<\/option><option value='ES' >Spain<\/option><option value='LK' >Sri Lanka<\/option><option value='SD' >Sudan<\/option><option value='SR' >Suriname<\/option><option value='SJ' >Svalbard and Jan Mayen<\/option><option value='SE' >Sweden<\/option><option value='CH' >Switzerland<\/option><option value='SY' >Syria Arab Republic<\/option><option value='TW' >Taiwan<\/option><option value='TJ' >Tajikistan<\/option><option value='TZ' >Tanzania, the United Republic of<\/option><option value='TH' >Thailand<\/option><option value='TL' >Timor-Leste<\/option><option value='TG' >Togo<\/option><option value='TK' >Tokelau<\/option><option value='TO' >Tonga<\/option><option value='TT' >Trinidad and Tobago<\/option><option value='TN' >Tunisia<\/option><option value='TM' >Turkmenistan<\/option><option value='TC' >Turks and Caicos Islands<\/option><option value='TV' >Tuvalu<\/option><option value='TR' >T\u00fcrkiye<\/option><option value='UM' >US Minor Outlying Islands<\/option><option value='UG' >Uganda<\/option><option value='UA' >Ukraine<\/option><option value='AE' >United Arab Emirates<\/option><option value='GB' >United Kingdom<\/option><option value='US' >United States<\/option><option value='UY' >Uruguay<\/option><option value='UZ' >Uzbekistan<\/option><option value='VU' >Vanuatu<\/option><option value='VE' >Venezuela<\/option><option value='VN' >Viet Nam<\/option><option value='VG' >Virgin Islands, British<\/option><option value='VI' >Virgin Islands, U.S.<\/option><option value='WF' >Wallis and Futuna<\/option><option value='EH' >Western Sahara<\/option><option value='YE' >Yemen<\/option><option value='ZM' >Zambia<\/option><option value='ZW' >Zimbabwe<\/option><option value='AX' >\u00c5land Islands<\/option> <\/select>\n                                    <\/span>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_169_48\" class=\"gfield gfield--type-section gfield--input-type-section gsection group-end field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"c3caa322\" data-field-span=\"12\"><h3 class=\"gsection_title\"><\/h3><\/div><div id=\"field_169_49\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"e87273eb\" data-field-span=\"12\"><h3 class=\"gsection_title\"><\/h3><\/div><fieldset id=\"field_169_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full radio_payment gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"ce92311f\" data-field-span=\"12\"><legend id='gfield_label_169_12' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Betaalmethode<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_169_12'>\n\t\t\t<div class='gchoice gchoice_169_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Credit Card'  id='choice_169_12_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_169_12_0 gfield_label_169_12\"   \/>\n\t\t\t\t\t<label for='choice_169_12_0' id='label_169_12_0' class='gform-field-label gform-field-label--type-inline'>Creditcard<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_169_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Paypal'  id='choice_169_12_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_169_12_1' id='label_169_12_1' class='gform-field-label gform-field-label--type-inline'>Paypal<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_169_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Bank Transfer' checked='checked' id='choice_169_12_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_169_12_2' id='label_169_12_2' class='gform-field-label gform-field-label--type-inline'>Bankoverschrijving<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_169_5\" class=\"gfield gfield--type-total gfield--input-type-total gfield--width-full hidden gfield_price gfield_price_169_ gfield_total gfield_total_169_ field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" aria-atomic=\"true\" aria-live=\"polite\" data-group-id=\"65080507\" data-field-span=\"12\" data-currency-format='1'><label id='gfield_label_169_5' class='gfield_label gform-field-label' for='input_169_5'><span class='gform-field-label__text'>Total summary<\/span><\/label><div class='ginput_container ginput_container_total'>\n\t\t\t\t\t\t\t<input type='text' readonly name='input_5' id='input_169_5' value='0,00 &#8364;' class='gform-text-input-reset ginput_total ginput_total_169'  \/>\n\t\t\t\t\t\t<\/div><\/div><div id=\"field_169_52\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"e880def2\" data-field-span=\"12\"><p>Je doneert <strong><span data-gppa-live-merge-tag=\"@{:5:currency}\"><\/span><\/strong> per maand.<\/p><\/div><div id=\"field_169_13\" class=\"gfield gfield--type-stripe_creditcard gfield--input-type-stripe_creditcard gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--type-stripe_creditcard-payment-element\" data-group-id=\"3b074362\" data-field-span=\"12\"><label id='gfield_label_169_13' class='gfield_label gfield_label_before_complex gform-field-label' for='input_169_13_1'><span class='gform-field-label__text'>Creditcard<\/span><\/label><div class='ginput_complex ginput_container ginput_container_creditcard ginput_stripe_creditcard gform-grid-row' id='input_169_13'><div class='ginput_full gform-grid-col' id='input_169_13_1_container' data-payment-element='true'><div id='input_169_13_1' class='StripeElement--payment-element'><\/div><\/div><!-- .ginput_full --><\/div><!-- .ginput_container -->\r\n\t\t\t<style type=\"text\/css\">\r\n\t\t\t\t:root {\r\n  \t\t\t\t\t--link-login-string: \"Link login\"\r\n\t\t\t\t}\r\n\t\t\t<\/style><\/div><div id=\"field_169_14\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"5b6652d5\" data-field-span=\"12\"><p><small><strong>Opmerking:<\/strong> Betalingen worden veilig verwerkt via <a href=\"https:\/\/www.stripe.com\" target=\"_blank\">Stripe<\/a>. Wij slaan geen creditcardgegevens op onze servers op.<\/small><\/p><\/div><fieldset id=\"field_169_36\" class=\"gfield gfield--type-paypal gfield--input-type-paypal gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gform_ppcp_custom_card_fields\" data-field-class=\"gform_ppcp_custom_card_fields\" data-group-id=\"caac54fb\" data-field-span=\"12\"><legend class='gfield_label gfield_label_before_complex gform-field-label' for='input_169_36_1' ><label class='gfield_label gform-field-label'>Betaalmethode<\/label><\/legend><div class='ginput_container ginput_container_select gform_ppcp_payment_method' style=\"display:none;\"><select name='input_36.6' id='input_36_6' class='medium gfield_select' aria-label='Betaalmethode' ><option value='PayPal Checkout' selected='selected'>PayPal checkout<\/option><\/select><\/div><div class='ginput_complex ginput_container ginput_container_custom_card_fields gform-grid-row' id='input_169_36' style=\"display:none;\"><span class='ginput_full gform-grid-col' id='input_169_36_1_container' >\n                                    <div class='gform_card_icon_container gform_card_icon_style1'><div class='gform_card_icon gform_card_icon_mastercard' >MasterCard<\/div><div class='gform_card_icon gform_card_icon_visa' >Visa<\/div><span class='screen-reader-text' id='field_169_36_supported_creditcards'>Ondersteunde creditcards: MasterCard, Visa<\/span><\/div>\n                                    <label for='input_169_36_1' id='input_169_36_1_label'  class='gform-field-label gform-field-label--type-sub'>Kaartnummer<\/label>\n                                    <span id='input_169_36_1' class='ginput_card_field ginput_card_number gform-theme-field-control'><\/span>\n                                 <\/span><span class='ginput_full ginput_cardextras gform-grid-col gform-grid-row' id='input_169_36_2_container'>\n                                            <span class='ginput_cardinfo_left gform-grid-col' id='input_169_36_2_cardinfo_left'>\n                                                <label for='input_169_36_2'  class='gform-field-label gform-field-label--type-sub'>Vervaldatum<\/label>\n                                                <span id='input_169_36_2' class='ginput_card_field ginput_card_expiration gform-theme-field-control'><\/span>\n                                            <\/span><span class='ginput_cardinfo_right gform-grid-col' id='input_169_36_2_cardinfo_right'>\n                                                <label for='input_169_36_3'  class='gform-field-label gform-field-label--type-sub'>Beveiligingscode<\/label>\n                                                <span id='input_169_36_3' class='ginput_card_field ginput_card_security_code gform-theme-field-control'><\/span>\n                                                <span class='ginput_card_security_code_icon'>&nbsp;<\/span>\n                                             <\/span>\n                                        <\/span><span class='ginput_full gform-grid-col' id='input_169_36_5_container'>\n                                            <label for='input_169_36_5' id='input_169_36_5_label'  class='gform-field-label gform-field-label--type-sub'>Naam kaarthouder<\/label>\n                                            <input type='text' name='input_36.5' id='input_169_36_5' value=''  \/>\n                                        <\/span> <\/div><\/fieldset><div id=\"field_169_15\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2c2882c1\" data-field-span=\"12\"><p>Zodra je het formulier hebt verzonden, word je doorgestuurd naar PayPal.<\/p><\/div><div id=\"field_169_34\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"5019565b\" data-field-span=\"12\"><p>Stel via je bankapp een maandelijkse overschrijving in met behulp van de onderstaande gegevens. <em>(We sturen je deze ook per e-mail toe.)<\/em><\/p><\/div><div id=\"field_169_50\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4ff7f9a9\" data-field-span=\"6\"><p><b>Serve the City VZW<\/b><br>\n227 Kroonlaan<br>\n1050 Brussel<\/p><\/div><div id=\"field_169_51\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-half gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"4ff7f9a9\" data-field-span=\"6\"><p><b>IBAN: <\/b>BE45 5230 8122 9289<br>\n<b>BIC: <\/b>TRIOBEBB <small>(Triodos Bank)<\/small><br>\n<b>BTW:\u00a0<\/b>BE0886.257.326<\/p><\/div><fieldset id=\"field_169_21\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full privacypolicy gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"73fc0c4e\" data-field-span=\"12\"><legend id='gfield_label_169_21' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Privacy Policy<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Vereist)<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_169_21'><div class='gchoice gchoice_169_21_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_21.1' type='checkbox'  value='I have read and agree to the &lt;a href=&quot;\/privacy-policy\/&quot; target=&quot;_blank&quot;&gt;Privacy Policy&lt;\/a&gt; and authorise Serve the City to store my information securely.'  id='choice_169_21_1'    aria-labelledby=\"label_169_21_1 gfield_label_169_21\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_169_21_1' id='label_169_21_1' class='gform-field-label gform-field-label--type-inline'>Ik heb het <a href=\"https:\/\/www.servethecity.brussels\/nl\/data-protection-policy\/\" target=\"_blank\">Privacybeleid<\/a> gelezen en ga ermee akkoord en geef Serve the City toestemming om mijn gegevens veilig op te slaan.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_169_38\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"9f5a212a\" data-field-span=\"12\"><label id='gfield_label_169_38' class='gfield_label gform-field-label' for='input_169_38'><span class='gform-field-label__text'>Posted<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_38' id='input_169_38' type='text' value='Posted' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_169_39\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_hidden\" data-group-id=\"4fdf1e09\" data-field-span=\"12\"><label id='gfield_label_169_39' class='gfield_label gform-field-label' for='input_169_39'><span class='gform-field-label__text'>Pledged<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_39' id='input_169_39' type='text' value='Pledged' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_169_54\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"a036678b\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_54' id='input_169_54' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='22' \/><\/div><\/div><div id=\"field_169_53\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"2e83ebee\" data-field-span=\"12\"><div class='ginput_container ginput_container_text'><input name='input_53' id='input_169_53' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='DavidLloyd' \/><\/div><\/div><\/div><\/div>\n        <div class='gform-page-footer gform_page_footer top_label'><button type='submit' id='gform_previous_button_169' class='gform_previous_button gform-theme-button gform-theme-button--secondary button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='previous' >Vorige<\/button> <button type='submit' id='gform_submit_button_169' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Word een Community Builder<\/button><div id=\"gform_ppcp_smart_payment_buttons_169\" class=\"medium gform_ppcp_smart_payment_buttons\"><\/div> <input type='hidden' name='gform_ajax' value='form_id=169&amp;title=&amp;description=&amp;tabindex=0&amp;theme=gravity-theme&amp;styles=[]&amp;hash=007545315faa8aedfb2fecaf0d8e9c4e' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_169' 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the City brings people together to build community in many different ways:<\/strong> visiting care homes, cooking meals for neighbours, teaching languages to those who want to learn\u2026<\/p>\n<p>Some people give their time and energy directly in our projects. Others support the work behind the scenes, making everything possible for our volunteers and the communities we serve.<\/p>\n<p><strong>Donors are community builders too.<\/strong><br \/>\nBy giving financially, they help create spaces where people connect, belong, and grow together.[\/mk_fancy_title][\/vc_column][vc_column width=&#8221;1\/3&#8243;][mk_testimonials style=&#8221;boxed&#8221; text_color=&#8221;#230101&#8243; skill_color=&#8221;#d6821c&#8221; font_size=&#8221;14&#8243; font_weight=&#8221;400&#8243; letter_spacing=&#8221;1&#8243; categories=&#8221;community-builder&#8221;][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1782479322674{margin-top: 50px !important;margin-bottom: 50px !important;}&#8221;][vc_column][mk_fancy_title strip_tags=&#8221;true&#8221; tag_name=&#8221;h4&#8243; color=&#8221;#222222&#8243; size=&#8221;22&#8243; font_weight=&#8221;bold&#8221; letter_spacing=&#8221;1&#8243; margin_bottom=&#8221;0&#8243; font_family=&#8221;none&#8221; el_class=&#8221;no-padding no-margin&#8221;]A word from our Executive Director[\/mk_fancy_title][mk_testimonials style=&#8221;boxed&#8221; show_as=&#8221;column&#8221; column=&#8221;1&#8243; count=&#8221;1&#8243; font_size=&#8221;16&#8243; font_weight=&#8221;400&#8243; letter_spacing=&#8221;1&#8243; animation=&#8221;fade-in&#8221; el_class=&#8221;edquote&#8221; testimonials=&#8221;22305&#8243;][mk_fancy_title color=&#8221;#000000&#8243; size=&#8221;20&#8243; line_height=&#8221;120&#8243; font_weight=&#8221;400&#8243; letter_spacing=&#8221;1&#8243; margin_bottom=&#8221;0&#8243; font_family=&#8221;none&#8221; align=&#8221;center&#8221;]\n<div>\n<p><!--ScriptorStartFragment--><\/p>\n<div class=\"scriptor-paragraph\" style=\"text-align: center\">Build community every month<!--ScriptorEndFragment--><\/div>\n<\/div>\n[\/mk_fancy_title][mk_button dimension=&#8221;flat&#8221; corner_style=&#8221;rounded&#8221; size=&#8221;large&#8221; url=&#8221;#form&#8221; nofollow=&#8221;true&#8221; align=&#8221;center&#8221; margin_top=&#8221;-10&#8243; margin_right=&#8221;0&#8243; bg_color=&#8221;#82285f&#8221;]Start donating[\/mk_button][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1662467653823{margin-bottom: 50px !important;}&#8221;][vc_column][mk_fancy_title strip_tags=&#8221;true&#8221; color=&#8221;#222222&#8243; size=&#8221;30&#8243; line_height=&#8221;150&#8243; font_weight=&#8221;500&#8243; letter_spacing=&#8221;1&#8243; margin_top=&#8221;20&#8243; font_family=&#8221;none&#8221; animation=&#8221;bottom-to-top&#8221;]\n<p style=\"text-align: left\">What does your monthly support make possible?<\/p>\n[\/mk_fancy_title][mk_fancy_title tag_name=&#8221;span&#8221; color=&#8221;#222222&#8243; size=&#8221;18&#8243; line_height=&#8221;150&#8243; font_weight=&#8221;300&#8243; letter_spacing=&#8221;1&#8243; font_family=&#8221;none&#8221; animation=&#8221;fade-in&#8221;]Your donation helps us bring people together, support volunteers, and create spaces where people feel seen, valued, and connected.<\/p>\n<p>Monthly support allows us to plan ahead, sustain our projects, and grow our impact throughout the year.[\/mk_fancy_title][\/vc_column][\/vc_row][vc_row][vc_column][vc_separator color=&#8221;custom&#8221; align=&#8221;align_left&#8221; border_width=&#8221;3&#8243; el_width=&#8221;10&#8243; css=&#8221;.vc_custom_1784146618977{margin-bottom: 50px !important;}&#8221; accent_color=&#8221;#82285F&#8221;][mk_fancy_title margin_bottom=&#8221;0&#8243; font_family=&#8221;none&#8221; animation=&#8221;fade-in&#8221;]\n<h4>You give, you get back!<\/h4>\n[\/mk_fancy_title][mk_fancy_title tag_name=&#8221;span&#8221; color=&#8221;#222222&#8243; size=&#8221;18&#8243; line_height=&#8221;150&#8243; font_weight=&#8221;300&#8243; letter_spacing=&#8221;1&#8243; margin_bottom=&#8221;0&#8243; font_family=&#8221;none&#8221; animation=&#8221;fade-in&#8221;]Serve the City is a non-profit organisation recognised by the Belgian government. 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