(*) = Verplicht in te vullen.

"); mail("$myemail","$onderwerp2","$date$naam$btw$Email$straat$gemeente$telefoon$fax$gebruikersnaam$wachtwoord","From: Website <$van>"); echo "De account ( $naam ) is aangemaakt!"; } else{ echo "U vulde niet alles goed in!"; } } echo "
\n"; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo ""; echo "
Naam en voornaam*:
BTW nummer:
Straat + nummer*:
Gemeente + postnummer*:
Telefoon:
Fax:
E-mail*:
Gebruikersnaam:
Wachtwoord:
Wachtwoord (bevestiging):
"; echo "

"; echo "\n"; echo "
\n"; ?>