[et_pb_section fb_built=”1″ admin_label=”Header” _builder_version=”4.23.4″ _module_preset=”default” background_color=”gcid-b9600481-265f-4dfb-83dd-fdbea6b6c423″ background_enable_image=”off” background_size=”custom” background_image_width=”30%” background_position=”top_left” background_horizontal_offset=”-8vw” background_vertical_offset=”-8vw” da_disable_devices=”off|off|off” collapsed=”on” global_colors_info=”{%22gcid-b9600481-265f-4dfb-83dd-fdbea6b6c423%22:%91%22background_color%22%93}” da_is_popup=”off” da_exit_intent=”off” da_has_close=”on” da_alt_close=”off” da_dark_close=”off” da_not_modal=”on” da_is_singular=”off” da_with_loader=”off” da_has_shadow=”on”][et_pb_row custom_padding_last_edited=”on|phone” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” custom_padding=”|||2rem|false|false” custom_padding_tablet=”|||1rem|false|false” custom_padding_phone=”|||1rem|false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.19.1″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.24.2″ _module_preset=”555c2aeb-c281-4262-a28c-f8a47f4a9be7″ global_colors_info=”{}”]<\/p>\n
[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”2_3,1_3″ make_equal=”on” custom_padding_last_edited=”on|phone” _builder_version=”4.24.3″ _module_preset=”default” background_enable_color=”off” width=”100%” custom_margin=”||||false|false” custom_margin_tablet=”||||false|false” custom_margin_phone=”|0px||0px|false|true” custom_margin_last_edited=”on|phone” custom_padding=”||||false|false” custom_padding_tablet=”30px||30px||true|true” custom_padding_phone=”20px|0px|20px|0px|true|true” border_radii=”on|25px|25px|25px|25px” global_colors_info=”{}”][et_pb_column type=”2_3″ _builder_version=”4.23.4″ _module_preset=”default” background_color=”#FFFFFF” custom_padding=”3rem|3rem|3rem|3rem|true|true” border_radii=”on|25px|25px|25px|25px” global_colors_info=”{}”][et_pb_contact_form captcha=”off” email=”info@urba-kbau.be” custom_message=”Objet : Demande d'adh\u00e9sion – Nouveau message||et_pb_line_break_holder||||et_pb_line_break_holder||Informations du contact :||et_pb_line_break_holder||||et_pb_line_break_holder||Nom de l'entit\u00e9 : %%name%%||et_pb_line_break_holder||Adresse : %%address%%||et_pb_line_break_holder||E-mail : %%mail%%||et_pb_line_break_holder||T\u00e9l\u00e9phone : %%phone%%||et_pb_line_break_holder||Informations l\u00e9gales :||et_pb_line_break_holder||||et_pb_line_break_holder||Personne morale : %%legal_entities%%||et_pb_line_break_holder||N\u00b0 d'entreprise : %%legal_entities_company%%||et_pb_line_break_holder||Responsable : %%manager%%||et_pb_line_break_holder||||et_pb_line_break_holder||Description de l'objet et des activit\u00e9s :||et_pb_line_break_holder||%%activity%%||et_pb_line_break_holder||||et_pb_line_break_holder||Ann\u00e9e de cr\u00e9ation : %%creation_year%%||et_pb_line_break_holder||Nombre de membres : %%num_members%%” success_message=”Membership application sent” submit_button_text=”Send” _builder_version=”4.27.0″ _module_preset=”_initial” _unique_id=”2ad3e6aa-6e7a-4598-9312-124bec08592d” form_field_background_color=”RGBA(255,255,255,0)” form_field_text_color=”gcid-bcb1a8e8-5d44-4d4a-88da-a5657e36f50d” form_field_focus_background_color=”#FFFFFF” form_field_custom_padding=”12px|24px|12px|24px|true|true” form_field_font=”Karla||||||||” form_field_font_size=”16px” form_field_line_height=”1.8em” custom_button=”on” button_text_size=”15px” button_text_color=”#FFFFFF” button_bg_color=”gcid-bcb1a8e8-5d44-4d4a-88da-a5657e36f50d” button_border_width=”1px” button_border_color=”gcid-bcb1a8e8-5d44-4d4a-88da-a5657e36f50d” button_border_radius=”50px” button_letter_spacing=”2px” button_font=”Karla|600||on|||||” button_custom_margin=”1rem||||false|false” button_custom_margin_tablet=”1rem||||false|false” button_custom_margin_phone=”3rem||||false|false” button_custom_margin_last_edited=”on|phone” button_custom_padding=”16px|32px|16px|32px|true|true” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” form_field_font_size_tablet=”15px” form_field_font_size_phone=”14px” form_field_font_size_last_edited=”on|desktop” border_width_all=”1px” border_color_all=”#000000″ locked=”off” global_colors_info=”{%22gcid-bcb1a8e8-5d44-4d4a-88da-a5657e36f50d%22:%91%22form_field_text_color%22,%22button_bg_color%22,%22button_border_color%22%93}” button_text_color__hover_enabled=”on|desktop” button_text_color__hover=”#FFFFFF”][et_pb_contact_field field_id=”name” field_title=”Full name *” max_length=”64″ allowed_symbols=”letters” fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”address” field_title=”Full postal address *” fullwidth_field=”on” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”mail” field_title=”E-mail-adres” field_type=”email” required_mark=”off” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”phone” field_title=”Phone\/Mobile” required_mark=”off” _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}” button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”legal_entities” field_title=”Only for legal entities” field_type=”radio” radio_options=”%91{%22value%22:%22ASBL%22,%22checked%22:0,%22dragID%22:-1,%22link_url%22:%22%22,%22link_text%22:%22%22},{%22value%22:%22SRL%22,%22checked%22:0,%22dragID%22:0,%22link_url%22:%22%22,%22link_text%22:%22%22},{%22value%22:%22SA%22,%22checked%22:0,%22dragID%22:1,%22link_url%22:%22%22,%22link_text%22:%22%22},{%22value%22:%22Association de fait%22,%22checked%22:0,%22dragID%22:2},{%22value%22:%22Aucun%22,%22checked%22:0,%22dragID%22:3}%93″ fullwidth_field=”on” _builder_version=”4.27.0″ _module_preset=”default” custom_css_free_form=”.et_pb_contact_field_options_list {|| display: flex;|| gap: 1.5rem;||}” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”legal_entities_company” field_title=” Company number *” fullwidth_field=”on” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22ASBL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SRL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SA%22}%93″ _builder_version=”4.24.2″ _module_preset=”default” custom_margin=”0px||||false|false” custom_padding=”0px||||false|false” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”manager” field_title=”Manager * ” fullwidth_field=”on” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22ASBL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SRL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SA%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22Association de fait%22}%93″ _builder_version=”4.27.0″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”activity” field_title=”Summary description of activities *” field_type=”text” fullwidth_field=”on” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22ASBL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SRL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SA%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22Association de fait%22}%93″ _builder_version=”4.24.3″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”creation_year” field_title=”Year of incorporation *” max_length=”4″ allowed_symbols=”numbers” fullwidth_field=”on” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22ASBL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SRL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SA%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22Association de fait%22}%93″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”num_members” field_title=”Number of members *” allowed_symbols=”numbers” fullwidth_field=”on” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22ASBL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SRL%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22SA%22},{%22field%22:%22legal_entities%22,%22condition%22:%22is%22,%22value%22:%22Association de fait%22}%93″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][\/et_pb_contact_field][et_pb_contact_field field_id=”Disclaimers” field_title=” ” field_type=”checkbox” checkbox_options=”%91{%22dragID%22:-1,%22value%22:%22* Mandatory%22,%22checked%22:0},{%22value%22:%22I hereby declare that I support the objectives of URBA-KBAU and ask the Board of Directors of URBA-KBAU to consider my application for membership of the Union Royale Belgo-Africaine \\\/ Koninklijke Belgisch-Afrikaanse Unie.<br><br>If I am accepted, I undertake to pay at least the annual membership fee of \u20ac50 for legal entities and \u20ac30 for natural persons. Payment of a membership fee of at least \u20ac100 entitles me to the title of Honorary Member.<br><br>The membership fee should be paid into URBA-KBAU's BNP Paris Fortis account BE54 2100 5412 0897, mentioning \\%22membership fee 20. \\%22followed by name and address\\%22. %22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”off” fullwidth_field=”on” _builder_version=”4.24.3″ _module_preset=”default” custom_css_main_element=”.et_pb_contact_field_options_list {|| flex-direction: column;||}||.et_pb_contact_field_options_list label i {|| display: none !important;||}” custom_css_free_form=”#et_pb_contact_disclaimers_10_0 + label {|| font-size: 14px !important;|| font-weight: 500;|| line-height: 1.7em;|| color: #666;||}||||#et_pb_contact_disclaimers_10_0 + label:hover {|| cursor: default;||}||||#et_pb_contact_disclaimers_10_1 + label:hover {|| cursor: default;||}||||#et_pb_contact_disclaimers_10_1 + label {|| font-size: 14px !important;|| font-weight: 300;|| line-height: 1.7em;|| color: #242220;||}” global_colors_info=”{}”][\/et_pb_contact_field][\/et_pb_contact_form][et_pb_code _builder_version=”4.27.0″ _module_preset=”default” global_colors_info=”{}”]