{"id":1084,"date":"2020-07-15T15:10:11","date_gmt":"2020-07-15T15:10:11","guid":{"rendered":"https:\/\/www.mmc.nl\/fonds\/?page_id=1084"},"modified":"2020-07-22T06:28:03","modified_gmt":"2020-07-22T06:28:03","slug":"steun-het-maxima-mc-fonds-particulieren-doorlopende-machtiging","status":"publish","type":"page","link":"https:\/\/www.mmc.nl\/fonds\/steun-het-maxima-mc-fonds-particulieren-doorlopende-machtiging\/","title":{"rendered":"Steun het M\u00e1xima MC  Fonds &#8211; Particulieren &#8211; Doorlopende machtiging"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_19' style='display:none'><div id='gf_19' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_19'  action='\/fonds\/wp-json\/wp\/v2\/pages\/1084#gf_19' data-formid='19' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_page_19_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><ul id='gform_fields_19' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_19_36\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_36'>Facebook<\/label><div class='gfield_description' id='gfield_description_19_36'>Dit veld is bedoeld voor validatiedoeleinden en moet niet worden gewijzigd.<\/div><div class='ginput_container'><input name='input_36' id='input_19_36' type='text' value='' autocomplete='new-password'\/><\/div><\/li><li id=\"field_19_3\" class=\"gfield gfield--type-select field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_3'>Ik wil het M\u00e1xima MC Fonds maandelijks steunen<\/label><div class='gfield_description' id='gfield_description_19_3'>Ik machtig het fonds tot ik opzeg elke maand een bedrag van mijn rekening af te schrijven van:<\/div><div class='ginput_container ginput_container_select'><select name='input_3' id='input_19_3' class='medium gfield_select'  aria-describedby=\"gfield_description_19_3\"   aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Kies een bedrag<\/option><option value='5 euro' >5 euro<\/option><option value='10 euro' >10 euro<\/option><option value='15 euro' >15 euro<\/option><option value='Anders' >Anders<\/option><\/select><\/div><\/li><li id=\"field_19_5\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_5'>hoger bedrag, namelijk:<\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_19_5' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_9\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_9'>Mijn IBAN:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_9' id='input_19_9' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_32\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_32'>Naam rekeninghouder:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_32' id='input_19_32' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_11\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label screen-reader-text gfield_label_before_complex' >Met het verzenden van dit formulier machtig ik het M\u00e1xima MC Onderzoek &amp; Innovatie Fonds om het aangegeven bedrag (periodiek) af te schrijven van mijn bank- of girorekening, tot wederopzegging.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_19_11'>Met het verzenden van dit formulier machtig ik het M\u00e1xima MC Onderzoek & Innovatie Fonds om het aangegeven bedrag (periodiek) af te schrijven van mijn bank- of girorekening, tot wederopzegging.<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_11'><li class='gchoice gchoice_19_11_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_11.1' type='checkbox'  value='ja'  id='choice_19_11_1'   aria-describedby=\"gfield_description_19_11\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_19_11_1' id='label_19_11_1' class='gform-field-label gform-field-label--type-inline'>ja<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_14\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_14'>Voorletters<\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_19_14' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_15\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_15'>Tussenvoegsel<\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_19_15' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_16\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_16'>Achternaam<\/label><div class='ginput_container ginput_container_text'><input name='input_16' id='input_19_16' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_33\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_33'>Telefoonnummer:<\/label><div class='ginput_container ginput_container_text'><input name='input_33' id='input_19_33' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_19_24\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_19_24'>E-mailadres<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_24' id='input_19_24' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_19_23\" class=\"gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Nieuwsbrief Stichting Maxima<\/label><div class='gfield_description' id='gfield_description_19_23'>Wilt u graag per e-mail op de hoogte gehouden worden van het werk van het M\u00e1xima MC Fonds? Schrijf u hier in:<\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_19_23'><li class='gchoice gchoice_19_23_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_23.1' type='checkbox'  value='ja'  id='choice_19_23_1'   aria-describedby=\"gfield_description_19_23\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_19_23_1' id='label_19_23_1' class='gform-field-label gform-field-label--type-inline'>ja<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_19_26\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p><span style=\"font-size:10px\">Ingevulde gegevens worden gebruikt ten behoeve van de donatie voor het M\u00e1xima MC Onderzoek & Innovatie Fonds. 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