{"id":1065,"date":"2024-05-26T14:41:37","date_gmt":"2024-05-26T14:41:37","guid":{"rendered":"https:\/\/brusselsfamily-staging.springbok.agency\/geboortepremie-aanvragen\/"},"modified":"2025-09-26T12:39:23","modified_gmt":"2025-09-26T12:39:23","slug":"application-for-birth-allowance","status":"publish","type":"page","link":"https:\/\/www.brusselsfamily.be\/en\/application-for-birth-allowance\/","title":{"rendered":"Application for birth allowance"},"content":{"rendered":"<div class=\"lazyblock-bf-geboortepremie-aanvragen-Z1qKuRu wp-block-lazyblock-bf-geboortepremie-aanvragen\"><link rel=\"stylesheet\" type=\"text\/css\" href=\"\/wp-content\/themes\/brusselsfamily\/blocks\/forms-css\/style.css\" \/>\n<div id=\"kraamgeld_form\" class=\"autoContainer\">\n    <form id=\"geboortepremie_v1\" name=\"oka\" class=\"overview-forms\" action=\"#\" enctype=\"multipart\/form-data\" method=\"post\" novalidate=\"novalidate\">\n        <!--1st condition child is born -->\n        <fieldset id=\"oka1\" name=\"oka1\">\n            <button class=\"burger backLink\" id=\"backLink\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                    <path\n                        d=\"M7.8248 13L12.7248 17.9C12.9248 18.1 13.0206 18.3334 13.0123 18.6C13.004 18.8667 12.8998 19.1 12.6998 19.3C12.4998 19.4834 12.2665 19.5792 11.9998 19.5875C11.7331 19.5959 11.4998 19.5 11.2998 19.3L4.6998 12.7C4.5998 12.6 4.52897 12.4917 4.4873 12.375C4.44564 12.2584 4.4248 12.1334 4.4248 12C4.4248 11.8667 4.44564 11.7417 4.4873 11.625C4.52897 11.5084 4.5998 11.4 4.6998 11.3L11.2998 4.70005C11.4831 4.51672 11.7123 4.42505 11.9873 4.42505C12.2623 4.42505 12.4998 4.51672 12.6998 4.70005C12.8998 4.90005 12.9998 5.13755 12.9998 5.41255C12.9998 5.68755 12.8998 5.92505 12.6998 6.12505L7.8248 11H18.9998C19.2831 11 19.5206 11.0959 19.7123 11.2875C19.904 11.4792 19.9998 11.7167 19.9998 12C19.9998 12.2834 19.904 12.5209 19.7123 12.7125C19.5206 12.9042 19.2831 13 18.9998 13H7.8248Z\"\n                        fill=\"#00256E\"\n                    \/>\n                <\/svg>\n            <\/button>\n            <span style=\"width: 10%;\" class=\"progress-bar\"><\/span>\n            <div class=\"grid-title\">\n                                       <img decoding=\"async\" src=\"https:\/\/www.brusselsfamily.be\/wp-content\/uploads\/2024\/05\/overview-image.png\" alt=\"Forms\" \/>\n                                                                        <div>\n<h1 style=\"text-align: center\">When are you expecting your child?<\/h1>\n<\/div>                                <p><\/p>\n            <\/div>\n            <fieldset name=\"date\" id=\"dob\">\n                <div class=\"input\">\n                <input autocomplete=\"off\" class=\"date_new\" data-date-format=\"dd-mm-yy\" id=\"thedate\" name=\"thedate\" onkeyup=\"showHint_okav8(this.value,'checkDate')\" placeholder=\"_ _ \/ _ _ \/ _ _ _ _\" type=\"text\" maxlength=\"10\" aria-invalid=\"false\">\n                <\/div>\n                <span id=\"checkDateVal\" class=\"error\">Enter a valid expected birth date<\/span>\n            <\/fieldset>\n            <fieldset>\n                  <input autocomplete=\"off\" id=\"when\" name=\"wanneer\" type=\"checkbox\" value=\"1\">\n                  <label for=\"when\">I am expecting more than one child.<\/label>\n            <\/fieldset>\n            <fieldset name=\"kids\" id=\"more_kids\">\n              <input type=\"radio\" id=\"two_kid\" name=\"kid\" value=\"\u20ac 2.681,80\" required=\"\" \/>\n              <label for=\"two_kid\" class=\"radio_btn\">2 children<\/label>\n\n              <input type=\"radio\" id=\"three_kid\" name=\"kid\" value=\"\u20ac 4.022,70\" required=\"\" \/>\n              <label for=\"three_kid\" class=\"radio_btn\">3 children<\/label>\n\n              <input type=\"radio\" id=\"four_kid\" name=\"kid\" value=\"\u20ac 5.363,60\" required=\"\" \/>\n              <label for=\"four_kid\" class=\"radio_btn\">4 children<\/label>\n\n              <div class=\"error\" id=\"family_error\">Choose one of these options<\/div>\n            <\/fieldset>\n\n            <fieldset>\n                    <input autocomplete=\"off\" id=\"first_child\" name=\"first_child\" type=\"checkbox\" value=\"2\">\n                    <label for=\"first_child\"> It is the first child of one of the parents.<\/label>\n            <\/fieldset>\n            <fieldset>\n                    <input autocomplete=\"off\" id=\"atteste\" name=\"atteste\" type=\"checkbox\" value=\"3\">\n                    <label for=\"atteste\">I already have a pregnancy attestation.<\/label>\n            <!--  Upload file  -->\n              <div id=\"attest_upload\">\n                  <label for=\"new_upload\">\n                      <div class=\"fileupload fileupload-new\" id=\"fileupload-attest\" data-provides=\"fileupload\">\n                        <div class=\"input input--file\">\n                            <input type=\"file\" id=\"file\" \/>\n                            <span class=\"ico\">\n                                <img decoding=\"async\" src=\"\/wp-content\/uploads\/2024\/05\/upload.svg\" alt=\"upload\" \/>\n                            <\/span>\n                            <span class=\"input__text\">\n                                Upload .pdf, .png, .jpg                            <\/span>\n                        <\/div>\n                          <input autocomplete=\"off\" type=\"file\" name=\"file-uploader\" id=\"new_upload\" \/>\n                          <div class=\"fileupload-preview\" id=\"fileupload-preview-attest\"><\/div>\n                          <a href=\"javascript:;\" id=\"close1\" class=\"close fileupload-exists wpel-icon-right\" data-dismiss=\"fileupload\" style=\"float: none;\" data-wpel-link=\"internal\" rel=\"noopener noreferrer\">\u00d7<\/a>\n                      <\/div>\n                  <\/label>\n              <\/div>\n              <!--  Upload file end -->\n                <span class=\"small-text\">You can provide us with the pregnancy certificate later.<\/span>\n            <\/fieldset>\n                        <button type=\"button\" id=\"checkDate\" class=\"next_btn button button--primary _ico\">\n            Next step                <span class=\"ico\">\n                    <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                        <path\n                            d=\"M16.175 13H5C4.71667 13 4.47917 12.9042 4.2875 12.7125C4.09583 12.5208 4 12.2833 4 12C4 11.7167 4.09583 11.4792 4.2875 11.2875C4.47917 11.0958 4.71667 11 5 11H16.175L11.275 6.1C11.075 5.9 10.9792 5.66667 10.9875 5.4C10.9958 5.13334 11.1 4.9 11.3 4.7C11.5 4.51667 11.7333 4.42084 12 4.4125C12.2667 4.40417 12.5 4.5 12.7 4.7L19.3 11.3C19.4 11.4 19.4708 11.5083 19.5125 11.625C19.5542 11.7417 19.575 11.8667 19.575 12C19.575 12.1333 19.5542 12.2583 19.5125 12.375C19.4708 12.4917 19.4 12.6 19.3 12.7L12.7 19.3C12.5167 19.4833 12.2875 19.575 12.0125 19.575C11.7375 19.575 11.5 19.4833 11.3 19.3C11.1 19.1 11 18.8625 11 18.5875C11 18.3125 11.1 18.075 11.3 17.875L16.175 13Z\"\n                            fill=\"white\"\n                        ><\/path>\n                    <\/svg>\n                <\/span>\n            <\/button>\n        <\/fieldset>\n\n        <fieldset id=\"family_contact-info\" name=\"contact_info\" class=\"step\">\n            <button class=\"burger backLink\" id=\"terug1\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                    <path\n                        d=\"M7.8248 13L12.7248 17.9C12.9248 18.1 13.0206 18.3334 13.0123 18.6C13.004 18.8667 12.8998 19.1 12.6998 19.3C12.4998 19.4834 12.2665 19.5792 11.9998 19.5875C11.7331 19.5959 11.4998 19.5 11.2998 19.3L4.6998 12.7C4.5998 12.6 4.52897 12.4917 4.4873 12.375C4.44564 12.2584 4.4248 12.1334 4.4248 12C4.4248 11.8667 4.44564 11.7417 4.4873 11.625C4.52897 11.5084 4.5998 11.4 4.6998 11.3L11.2998 4.70005C11.4831 4.51672 11.7123 4.42505 11.9873 4.42505C12.2623 4.42505 12.4998 4.51672 12.6998 4.70005C12.8998 4.90005 12.9998 5.13755 12.9998 5.41255C12.9998 5.68755 12.8998 5.92505 12.6998 6.12505L7.8248 11H18.9998C19.2831 11 19.5206 11.0959 19.7123 11.2875C19.904 11.4792 19.9998 11.7167 19.9998 12C19.9998 12.2834 19.904 12.5209 19.7123 12.7125C19.5206 12.9042 19.2831 13 18.9998 13H7.8248Z\"\n                        fill=\"#00256E\"\n                    ><\/path>\n                <\/svg>\n            <\/button>\n            <span style=\"width: 20%;\" class=\"progress-bar\"><\/span>\n            <div class=\"grid-title\">\n                                       <img decoding=\"async\" src=\"https:\/\/www.brusselsfamily.be\/wp-content\/uploads\/2024\/05\/overview-image.png\" alt=\"Forms\" \/>\n                                                                            <div>\n<h2 style=\"text-align: center\">How can we contact you?<\/h2>\n<\/div>                                <\/div>\n\n            <div class=\"family-info\">\n                <fieldset name=\"email\" id=\"email_field\">\n                    <label for=\"email\">Email*<\/label>\n                    <div class=\"input\">\n                       <input autocomplete=\"off\" id=\"email\" name=\"email\" placeholder=\"Your email address\" type=\"email\" onkeydown=\"validation()\" \/>\n                    <\/div>\n                    <span id=\"email_error\" class=\"error\">Enter a valid email<\/span>\n                    <span class=\"small-text\">So that we can keep you informed about your application.<\/span>\n                <\/fieldset>\n\n                <fieldset name=\"telephone\">\n                    <label class=\"text-left\" for=\"telmother\">Phone number<\/label>\n                    <div class=\"input\">\n                       <input autocomplete=\"off\" class=\"phone_be\" id=\"telmother\" name=\"telmother\" placeholder=\"+32 000 000 000\" type=\"tel\" \/>\n                    <\/div>\n                    <span class=\"small-text\">We recommend you fill it in so we can contact you more easily and quickly.<\/span>\n                <\/fieldset>\n\n                <fieldset>\n                    <input type=\"checkbox\" id=\"privacy\" name=\"privacy\" value=\"1\" \/>\n                    <label for=\"privacy\">My privacy is important. I agree that Brussels Family uses my data securely and responsibly according to the <a href=\"https:\/\/www.brusselsfamily.be\/en\/privacy-policy\/\" target=\"_blank\" rel=\"noreferrer noopener\">Brussels Family privacy policy.<\/a><\/label>\n                <\/fieldset>\n                                <button type=\"button\" id=\"step_1\" data-fieldset-target=\"family-info\" class=\"next_btn button button--primary _ico\">\n                Next step                    <span class=\"ico\">\n                        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                            <path\n                                d=\"M16.175 13H5C4.71667 13 4.47917 12.9042 4.2875 12.7125C4.09583 12.5208 4 12.2833 4 12C4 11.7167 4.09583 11.4792 4.2875 11.2875C4.47917 11.0958 4.71667 11 5 11H16.175L11.275 6.1C11.075 5.9 10.9792 5.66667 10.9875 5.4C10.9958 5.13334 11.1 4.9 11.3 4.7C11.5 4.51667 11.7333 4.42084 12 4.4125C12.2667 4.40417 12.5 4.5 12.7 4.7L19.3 11.3C19.4 11.4 19.4708 11.5083 19.5125 11.625C19.5542 11.7417 19.575 11.8667 19.575 12C19.575 12.1333 19.5542 12.2583 19.5125 12.375C19.4708 12.4917 19.4 12.6 19.3 12.7L12.7 19.3C12.5167 19.4833 12.2875 19.575 12.0125 19.575C11.7375 19.575 11.5 19.4833 11.3 19.3C11.1 19.1 11 18.8625 11 18.5875C11 18.3125 11.1 18.075 11.3 17.875L16.175 13Z\"\n                                fill=\"white\"\n                            ><\/path>\n                        <\/svg>\n                    <\/span>\n                <\/button>\n            <\/div>\n        <\/fieldset>\n\n        <fieldset id=\"personal_info\" name=\"personal_info\" class=\"step\">\n            <button class=\"burger backLink\" id=\"terug2\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                    <path\n                        d=\"M7.8248 13L12.7248 17.9C12.9248 18.1 13.0206 18.3334 13.0123 18.6C13.004 18.8667 12.8998 19.1 12.6998 19.3C12.4998 19.4834 12.2665 19.5792 11.9998 19.5875C11.7331 19.5959 11.4998 19.5 11.2998 19.3L4.6998 12.7C4.5998 12.6 4.52897 12.4917 4.4873 12.375C4.44564 12.2584 4.4248 12.1334 4.4248 12C4.4248 11.8667 4.44564 11.7417 4.4873 11.625C4.52897 11.5084 4.5998 11.4 4.6998 11.3L11.2998 4.70005C11.4831 4.51672 11.7123 4.42505 11.9873 4.42505C12.2623 4.42505 12.4998 4.51672 12.6998 4.70005C12.8998 4.90005 12.9998 5.13755 12.9998 5.41255C12.9998 5.68755 12.8998 5.92505 12.6998 6.12505L7.8248 11H18.9998C19.2831 11 19.5206 11.0959 19.7123 11.2875C19.904 11.4792 19.9998 11.7167 19.9998 12C19.9998 12.2834 19.904 12.5209 19.7123 12.7125C19.5206 12.9042 19.2831 13 18.9998 13H7.8248Z\"\n                        fill=\"#00256E\"\n                    ><\/path>\n                <\/svg>\n            <\/button>\n            <span style=\"width: 40%;\" class=\"progress-bar\"><\/span>\n            <div class=\"grid-title\">\n                                       <img decoding=\"async\" src=\"https:\/\/www.brusselsfamily.be\/wp-content\/uploads\/2024\/05\/overview-image.png\" alt=\"Forms\" \/>\n                                                                           <h2 style=\"text-align: center\">What are your details?<\/h2>\n<p>&nbsp;<\/p>                            <\/div>\n\n            <div class=\"personal-info\">\n                <fieldset name=\"naam\" id=\"firstname\">\n                    <label for=\"naam\">First name*<\/label>\n                    <div class=\"input\">\n                       <input autocomplete=\"off\" type=\"text\" id=\"voornaam\" name=\"voornaam\" aria-required=\"true\" placeholder=\"Your first name\">\n                    <\/div>\n                    <span id=\"name_error\" class=\"error\">This is a required field<\/span>\n                <\/fieldset>\n\n                <fieldset name=\"family_naam\" id=\"lastname\">\n                    <label for=\"family_naam\">Last name*<\/label>\n                    <div class=\"input\">\n                       <input autocomplete=\"off\" type=\"text\" id=\"achternaam\" name=\"achternaam\" placeholder=\"Your last name\" aria-required=\"true\">\n                    <\/div>\n                    <span id=\"lastname_error\" class=\"error\">This is a required field<\/span>\n                <\/fieldset>\n\n                <fieldset name=\"rijksregisternummer\" id=\"register\">\n                    <label for=\"oka_rijkregister\">National registry number<\/label>\n                    <div class=\"input\">\n                       <input autocomplete=\"off\" class=\"rijkregister\" id=\"oka_rijkregister\" name=\"oka_rijksregisternummer\" onkeyup=\"showHint_new_rijks(this.value,'oka_rijkregisterBtn')\" placeholder=\"00.00.00 - 000.00\" type=\"text\" maxlength=\"17\">\n                    <\/div>\n                    <span id=\"oka_rijkregisterBtnVal\" class=\"error\">Enter a valid national registry number<\/span>\n                <\/fieldset>\n\n                <fieldset>\n                    <input autocomplete=\"off\" id=\"oka_check\" name=\"oka_checkbox\" type=\"checkbox\" value=\"I don't know my national registry number.\">\n                    <label for=\"oka_check\">I don&#8217;t know my national registry number.<\/label>\n                <\/fieldset>\n\n                <fieldset id=\"mom-details\" style=\"display: none;\">\n                  <label for=\"dob_mama\">Date of birth of mom<\/label>\n                    <div class=\"input\">\n                       <input autocomplete=\"off\" type=\"text\" id=\"dob_mama\" class=\"date_new valid\" name=\"DobMama\" placeholder=\"_ _ \/ _ _ \/ _ _ _ _\" maxlength=\"10\" aria-invalid=\"false\" style=\"padding: 0; text-align: center;\"\/>\n                    <\/div>\n                    <span id=\"mamadob_error\" class=\"error\">This is a required field<\/span>\n                <\/fieldset>\n\n                <fieldset>\n                    <input autocomplete=\"off\" id=\"navo\" name=\"navo\" type=\"checkbox\" value=\"1\">\n                    <label for=\"navo\">I or my partner works for an international institution (NATO, EU, etc.)<\/label>\n                <\/fieldset>\n                                <button type=\"button\" id=\"step_2\" data-fieldset-target=\"personal-info\" class=\"next_btn button button--primary _ico\">\n                Next step                    <span class=\"ico\">\n                        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                            <path\n                                d=\"M16.175 13H5C4.71667 13 4.47917 12.9042 4.2875 12.7125C4.09583 12.5208 4 12.2833 4 12C4 11.7167 4.09583 11.4792 4.2875 11.2875C4.47917 11.0958 4.71667 11 5 11H16.175L11.275 6.1C11.075 5.9 10.9792 5.66667 10.9875 5.4C10.9958 5.13334 11.1 4.9 11.3 4.7C11.5 4.51667 11.7333 4.42084 12 4.4125C12.2667 4.40417 12.5 4.5 12.7 4.7L19.3 11.3C19.4 11.4 19.4708 11.5083 19.5125 11.625C19.5542 11.7417 19.575 11.8667 19.575 12C19.575 12.1333 19.5542 12.2583 19.5125 12.375C19.4708 12.4917 19.4 12.6 19.3 12.7L12.7 19.3C12.5167 19.4833 12.2875 19.575 12.0125 19.575C11.7375 19.575 11.5 19.4833 11.3 19.3C11.1 19.1 11 18.8625 11 18.5875C11 18.3125 11.1 18.075 11.3 17.875L16.175 13Z\"\n                                fill=\"white\"\n                            ><\/path>\n                        <\/svg>\n                    <\/span>\n                <\/button>\n            <\/div>\n        <\/fieldset>\n\n        <fieldset id=\"bank_info\" name=\"bank_info\" class=\"step\">\n            <button class=\"burger backLink\" id=\"terug3\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                    <path\n                        d=\"M7.8248 13L12.7248 17.9C12.9248 18.1 13.0206 18.3334 13.0123 18.6C13.004 18.8667 12.8998 19.1 12.6998 19.3C12.4998 19.4834 12.2665 19.5792 11.9998 19.5875C11.7331 19.5959 11.4998 19.5 11.2998 19.3L4.6998 12.7C4.5998 12.6 4.52897 12.4917 4.4873 12.375C4.44564 12.2584 4.4248 12.1334 4.4248 12C4.4248 11.8667 4.44564 11.7417 4.4873 11.625C4.52897 11.5084 4.5998 11.4 4.6998 11.3L11.2998 4.70005C11.4831 4.51672 11.7123 4.42505 11.9873 4.42505C12.2623 4.42505 12.4998 4.51672 12.6998 4.70005C12.8998 4.90005 12.9998 5.13755 12.9998 5.41255C12.9998 5.68755 12.8998 5.92505 12.6998 6.12505L7.8248 11H18.9998C19.2831 11 19.5206 11.0959 19.7123 11.2875C19.904 11.4792 19.9998 11.7167 19.9998 12C19.9998 12.2834 19.904 12.5209 19.7123 12.7125C19.5206 12.9042 19.2831 13 18.9998 13H7.8248Z\"\n                        fill=\"#00256E\"\n                    ><\/path>\n                <\/svg>\n            <\/button>\n            <span style=\"width: 60%;\" class=\"progress-bar\"><\/span>\n            <div class=\"grid-title\">\n                                    <img decoding=\"async\" src=\"https:\/\/www.brusselsfamily.be\/wp-content\/uploads\/2024\/05\/overview-image.png\" alt=\"Forms\" \/>\n                                                                            <h2 style=\"text-align: center\">How would you like to receive your birth grant?<\/h2>                                <\/div>\n\n            <div class=\"bank-info\">\n                <div class=\"results\">\n                    <div style=\"text-align: center;\" class=\"amount-overview\">You are entitled to <b style=\"color: #003296\" id=\"bedrag\">\u20ac 1.395,02<\/b> for <br>the birth of your child(ren).<\/div>\n                    <div style=\"text-align: center;\" class=\"amount-overview-second\">You are entitled to <b style=\"color: #003296\" id=\"bedrag\">\u20ac 634,10<\/b> for <br>the birth of your child(ren).<\/div>\n                <\/div><br>\n                <fieldset name=\"bank\" id=\"bank-account\">\n                    <label for=\"bank\">Bank account number*<\/label>\n                    <div class=\"input\">\n                        <input autocomplete=\"off\" id=\"rekeningnummer\" class=\"iban\" name=\"rekeningnummer\" onkeyup=\"showHint_new_bank(this.value, 'rekeningnummerBtn')\" placeholder=\"BE00 0000 0000 0000\" type=\"text\" maxlength=\"16\">\n                    <\/div>\n                    <span id=\"rekeningnummerBtnVal\" class=\"error\">Fill in a valid IBAN number.<\/span>\n                <\/fieldset>\n\n                <fieldset>\n                    <input autocomplete=\"off\" id=\"account_check\" name=\"account_check\" class=\"bank-check\" type=\"checkbox\" value=\"Brussels Family knows my account number.\">\n                    <label for=\"account_check\">Brussels Family knows my account number.<\/label>\n                <\/fieldset>\n\n                <fieldset>\n                    <input autocomplete=\"off\" id=\"no-account\" name=\"account_check\" type=\"checkbox\" class=\"bank-check\" value=\"I do not have a Belgian bank account.\">\n                    <label for=\"no-account\">I do not have a Belgian bank account.<\/label>\n                <\/fieldset>\n                                <button type=\"button\" id=\"step_3\" data-fieldset-target=\"bank-info\" class=\"next_btn button button--primary _ico\">\n                Next step                    <span class=\"ico\">\n                        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                            <path\n                                d=\"M16.175 13H5C4.71667 13 4.47917 12.9042 4.2875 12.7125C4.09583 12.5208 4 12.2833 4 12C4 11.7167 4.09583 11.4792 4.2875 11.2875C4.47917 11.0958 4.71667 11 5 11H16.175L11.275 6.1C11.075 5.9 10.9792 5.66667 10.9875 5.4C10.9958 5.13334 11.1 4.9 11.3 4.7C11.5 4.51667 11.7333 4.42084 12 4.4125C12.2667 4.40417 12.5 4.5 12.7 4.7L19.3 11.3C19.4 11.4 19.4708 11.5083 19.5125 11.625C19.5542 11.7417 19.575 11.8667 19.575 12C19.575 12.1333 19.5542 12.2583 19.5125 12.375C19.4708 12.4917 19.4 12.6 19.3 12.7L12.7 19.3C12.5167 19.4833 12.2875 19.575 12.0125 19.575C11.7375 19.575 11.5 19.4833 11.3 19.3C11.1 19.1 11 18.8625 11 18.5875C11 18.3125 11.1 18.075 11.3 17.875L16.175 13Z\"\n                                fill=\"white\"\n                            ><\/path>\n                        <\/svg>\n                    <\/span>\n                <\/button>\n            <\/div>\n        <\/fieldset>\n\n         <!-- Step 4 -->\n        <fieldset id=\"details_info\" name=\"details_info\" class=\"step\">\n            <button class=\"burger backLink\" id=\"terug4\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                <path d=\"M7.8248 13L12.7248 17.9C12.9248 18.1 13.0206 18.3334 13.0123 18.6C13.004 18.8667 12.8998 19.1 12.6998 19.3C12.4998 19.4834 12.2665 19.5792 11.9998 19.5875C11.7331 19.5959 11.4998 19.5 11.2998 19.3L4.6998 12.7C4.5998 12.6 4.52897 12.4917 4.4873 12.375C4.44564 12.2584 4.4248 12.1334 4.4248 12C4.4248 11.8667 4.44564 11.7417 4.4873 11.625C4.52897 11.5084 4.5998 11.4 4.6998 11.3L11.2998 4.70005C11.4831 4.51672 11.7123 4.42505 11.9873 4.42505C12.2623 4.42505 12.4998 4.51672 12.6998 4.70005C12.8998 4.90005 12.9998 5.13755 12.9998 5.41255C12.9998 5.68755 12.8998 5.92505 12.6998 6.12505L7.8248 11H18.9998C19.2831 11 19.5206 11.0959 19.7123 11.2875C19.904 11.4792 19.9998 11.7167 19.9998 12C19.9998 12.2834 19.904 12.5209 19.7123 12.7125C19.5206 12.9042 19.2831 13 18.9998 13H7.8248Z\" fill=\"#00256E\"\/>\n                <\/svg>\n            <\/button>\n           <span style=\"width: 80%;\" class=\"progress-bar\"><\/span>\n            <div class=\"grid-title\">\n                                    <img decoding=\"async\" src=\"https:\/\/www.brusselsfamily.be\/wp-content\/uploads\/2024\/05\/overview-image.png\" alt=\"Forms\" \/>\n                                                                        <h2 style=\"text-align: center\">Just sign up and we&#8217;re done!<\/h2>                            <\/div>\n            <div class=\"person-details\">\n                <div class=\"p-name\">\n                  <h5 class=\"name\"><span id=\"first\"><\/span> <span id=\"last\"><\/span><\/h5>\n                  <span id=\"email-view\"><\/span>\n                <\/div>\n\n                <div class=\"p-rijksregisternummer\">\n                <span class=\"small\">National registry number<\/span>\n                  <span id=\"r-number-view\"><\/span>\n                <\/div>\n\n                <div class=\"p-tel\">\n                <span class=\"small\">Phone number<\/span>\n                  <span id=\"tel-view\">Onbekend<\/span>\n                <\/div>\n\n                <div class=\"p-account\">\n                <span class=\"small\">Bank account number<\/span>\n                  <span id=\"bank-view\">Onbekend<\/span>\n                <\/div>\n\n                <div class=\"kid-date\">\n                  <span class=\"small\">Expected birth date <\/span>\n                  <span id=\"date-view\"><\/span>\n                <\/div>\n\n                <hr class=\"child-divider\" \/>\n\n                <span class=\"p-change2\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"25\" height=\"25\" viewBox=\"0 0 25 25\" fill=\"none\">\n                  <path d=\"M5.5 19.5H6.925L16.7 9.725L15.275 8.3L5.5 18.075V19.5ZM3.5 21.5V17.25L16.7 4.075C16.9 3.89167 17.1208 3.75 17.3625 3.65C17.6042 3.55 17.8583 3.5 18.125 3.5C18.3917 3.5 18.65 3.55 18.9 3.65C19.15 3.75 19.3667 3.9 19.55 4.1L20.925 5.5C21.125 5.68333 21.2708 5.9 21.3625 6.15C21.4542 6.4 21.5 6.65 21.5 6.9C21.5 7.16667 21.4542 7.42083 21.3625 7.6625C21.2708 7.90417 21.125 8.125 20.925 8.325L7.75 21.5H3.5ZM15.975 9.025L15.275 8.3L16.7 9.725L15.975 9.025Z\" fill=\"white\"\/>\n                  <path d=\"M5.5 19.5H6.925L16.7 9.725L15.275 8.3L5.5 18.075V19.5ZM3.5 21.5V17.25L16.7 4.075C16.9 3.89167 17.1208 3.75 17.3625 3.65C17.6042 3.55 17.8583 3.5 18.125 3.5C18.3917 3.5 18.65 3.55 18.9 3.65C19.15 3.75 19.3667 3.9 19.55 4.1L20.925 5.5C21.125 5.68333 21.2708 5.9 21.3625 6.15C21.4542 6.4 21.5 6.65 21.5 6.9C21.5 7.16667 21.4542 7.42083 21.3625 7.6625C21.2708 7.90417 21.125 8.125 20.925 8.325L7.75 21.5H3.5ZM15.975 9.025L15.275 8.3L16.7 9.725L15.975 9.025Z\" fill=\"#003296\" fill-opacity=\"0.4\"\/>\n                  <\/svg> Modify information<\/span>\n            <\/div>\n\n            <div id=\"signature-pad-1\" class=\"signature-pad\">\n                <div class=\"signature-pad--body\">\n                    <canvas><\/canvas>\n                    <input type=\"hidden\" name=\"sign_\" id=\"sign_\" value=\"\" \/>\n                    <button type=\"button\" class=\"clear\" data-action=\"clear\" id=\"clear1\">\n                      <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                        <path d=\"M7 21C6.45 21 5.97917 20.8042 5.5875 20.4125C5.19583 20.0208 5 19.55 5 19V6C4.71667 6 4.47917 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8.09583 13.2875 8.2875C13.0958 8.47917 13 8.71667 13 9V16C13 16.2833 13.0958 16.5208 13.2875 16.7125C13.4792 16.9042 13.7167 17 14 17Z\" fill=\"white\"\/>\n                        <path d=\"M7 21C6.45 21 5.97917 20.8042 5.5875 20.4125C5.19583 20.0208 5 19.55 5 19V6C4.71667 6 4.47917 5.90417 4.2875 5.7125C4.09583 5.52083 4 5.28333 4 5C4 4.71667 4.09583 4.47917 4.2875 4.2875C4.47917 4.09583 4.71667 4 5 4H9C9 3.71667 9.09583 3.47917 9.2875 3.2875C9.47917 3.09583 9.71667 3 10 3H14C14.2833 3 14.5208 3.09583 14.7125 3.2875C14.9042 3.47917 15 3.71667 15 4H19C19.2833 4 19.5208 4.09583 19.7125 4.2875C19.9042 4.47917 20 4.71667 20 5C20 5.28333 19.9042 5.52083 19.7125 5.7125C19.5208 5.90417 19.2833 6 19 6V19C19 19.55 18.8042 20.0208 18.4125 20.4125C18.0208 20.8042 17.55 21 17 21H7ZM17 6H7V19H17V6ZM10 17C10.2833 17 10.5208 16.9042 10.7125 16.7125C10.9042 16.5208 11 16.2833 11 16V9C11 8.71667 10.9042 8.47917 10.7125 8.2875C10.5208 8.09583 10.2833 8 10 8C9.71667 8 9.47917 8.09583 9.2875 8.2875C9.09583 8.47917 9 8.71667 9 9V16C9 16.2833 9.09583 16.5208 9.2875 16.7125C9.47917 16.9042 9.71667 17 10 17ZM14 17C14.2833 17 14.5208 16.9042 14.7125 16.7125C14.9042 16.5208 15 16.2833 15 16V9C15 8.71667 14.9042 8.47917 14.7125 8.2875C14.5208 8.09583 14.2833 8 14 8C13.7167 8 13.4792 8.09583 13.2875 8.2875C13.0958 8.47917 13 8.71667 13 9V16C13 16.2833 13.0958 16.5208 13.2875 16.7125C13.4792 16.9042 13.7167 17 14 17Z\" fill=\"#003296\" fill-opacity=\"0.4\"\/>\n                      <\/svg>\n                    <\/button>\n                <\/div>\n            <\/div>\n\n            <fieldset>\n                    <input autocomplete=\"off\" id=\"voorwaarden1\" name=\"voorwaarden1\" type=\"checkbox\" value=\"1\">\n                    <label for=\"voorwaarden1\">I want to join Brussels Family so that Brussels Family can pay my birth grant and Brussels child benefits.*<\/label>\n            <\/fieldset>\n\n            <fieldset>\n                    <input autocomplete=\"off\" id=\"voorwaarden2\" name=\"voorwaarden2\" type=\"checkbox\" value=\"1\">\n                    <label for=\"voorwaarden2\">I have read  <span class=\"geboortepremie\"> affiliation information.*<\/span><\/label>\n            <\/fieldset>\n\n            <fieldset>\n                    <input autocomplete=\"off\" id=\"voorwaarden3\" name=\"voorwaarden3\" type=\"checkbox\" value=\"1\">\n                    <label for=\"voorwaarden3\">Brussels Family respects the protection of my personal data. I agree.*<\/label>\n            <\/fieldset>\n\n            <fieldset>\n                    <input autocomplete=\"off\" id=\"voorwaarden4\" name=\"voorwaarden4\" type=\"checkbox\" value=\"1\">\n                    <label for=\"voorwaarden4\">I am already affiliated with another family allowance payer.<\/label>\n            <\/fieldset>\n\n            <fieldset name=\"_uitbetaler\" id=\"_uitbetaler\">\n                <div class=\"chevron\" id=\"uitbetaler\">\n                <select name=\"uitbetaler\">\n                   <option value=\"\" selected=\"\" disabled=\"\">Select current payer<\/option>\n<option value=\"Infino\">Infino<\/option>\n<option value=\"Parentia\">Parentia<\/option>\n<option value=\"Kidslife\">Kidslife<\/option>\n<option value=\"Famiris\">Famiris<\/option>                <\/select>\n                <\/div>\n                <div class=\"error\" id=\"uitbetalerError\">Choose one of these options<\/div>\n            <\/fieldset>\n                        <button type=\"submit\" id=\"submit\" data-fieldset-target=\"bank-info\" class=\"next_btn button button--primary _ico\">\n                I join                    <span class=\"ico\">\n                        <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                            <path\n                                d=\"M16.175 13H5C4.71667 13 4.47917 12.9042 4.2875 12.7125C4.09583 12.5208 4 12.2833 4 12C4 11.7167 4.09583 11.4792 4.2875 11.2875C4.47917 11.0958 4.71667 11 5 11H16.175L11.275 6.1C11.075 5.9 10.9792 5.66667 10.9875 5.4C10.9958 5.13334 11.1 4.9 11.3 4.7C11.5 4.51667 11.7333 4.42084 12 4.4125C12.2667 4.40417 12.5 4.5 12.7 4.7L19.3 11.3C19.4 11.4 19.4708 11.5083 19.5125 11.625C19.5542 11.7417 19.575 11.8667 19.575 12C19.575 12.1333 19.5542 12.2583 19.5125 12.375C19.4708 12.4917 19.4 12.6 19.3 12.7L12.7 19.3C12.5167 19.4833 12.2875 19.575 12.0125 19.575C11.7375 19.575 11.5 19.4833 11.3 19.3C11.1 19.1 11 18.8625 11 18.5875C11 18.3125 11.1 18.075 11.3 17.875L16.175 13Z\"\n                                fill=\"white\"\n                            ><\/path>\n                        <\/svg>\n                    <\/span>\n                <\/button>\n        <\/fieldset>\n\n        <fieldset id=\"thank_you\" name=\"thank_you\">\n            <a href=\"\/overzicht-formulieren\/\" class=\"burger backLink\">\n                <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                <path d=\"M7.8248 13L12.7248 17.9C12.9248 18.1 13.0206 18.3334 13.0123 18.6C13.004 18.8667 12.8998 19.1 12.6998 19.3C12.4998 19.4834 12.2665 19.5792 11.9998 19.5875C11.7331 19.5959 11.4998 19.5 11.2998 19.3L4.6998 12.7C4.5998 12.6 4.52897 12.4917 4.4873 12.375C4.44564 12.2584 4.4248 12.1334 4.4248 12C4.4248 11.8667 4.44564 11.7417 4.4873 11.625C4.52897 11.5084 4.5998 11.4 4.6998 11.3L11.2998 4.70005C11.4831 4.51672 11.7123 4.42505 11.9873 4.42505C12.2623 4.42505 12.4998 4.51672 12.6998 4.70005C12.8998 4.90005 12.9998 5.13755 12.9998 5.41255C12.9998 5.68755 12.8998 5.92505 12.6998 6.12505L7.8248 11H18.9998C19.2831 11 19.5206 11.0959 19.7123 11.2875C19.904 11.4792 19.9998 11.7167 19.9998 12C19.9998 12.2834 19.904 12.5209 19.7123 12.7125C19.5206 12.9042 19.2831 13 18.9998 13H7.8248Z\" fill=\"#00256E\"\/>\n                <\/svg>\n            <\/a>\n          <span style=\"width: 100%;\" class=\"progress-bar\"><\/span>\n              <div class=\"grid-title\">\n                                    <img decoding=\"async\" src=\"https:\/\/www.brusselsfamily.be\/wp-content\/uploads\/2024\/05\/overview-image.png\" alt=\"Forms\" \/>\n                                                                            <h2 style=\"text-align: center\">Thank you for your application!<\/h2>\n<p style=\"text-align: center\">We will process your application as soon as possible. Do you have any questions? <a href=\"https:\/\/www.brusselsfamily.be\/en\/contact\/\"><span style=\"text-decoration: underline\">Feel free to contact us here<\/span><\/a>!<\/p>                                      <div class=\"person-details thankyou\">\n                      <h4>Next steps<\/h4>\n                      <p>If your application is approved, you can expect the following steps:<\/p>\n                      <div class=\"shape-list\">\n                          <span class=\"_shape\">1<\/span>\n                          <div>\n                            <h6>An email confirming that your application has been processed<\/h6>\n                          <\/div>\n                      <\/div>\n\n                      <div class=\"shape-list\">\n                          <span class=\"_shape\">2<\/span>\n                          <div>\n                            <h6>The birth grant will be paid<\/h6>\n                          <\/div>\n                      <\/div>\n\n                      <div class=\"shape-list\">\n                          <span class=\"_shape\">3<\/span>\n                          <div>\n                            <h6>Birth of your child(ren)<\/h6>\n                          <\/div>\n                      <\/div>\n\n                      <div class=\"shape-list\">\n                          <span class=\"_shape\">4<\/span>\n                          <div>\n                            <h6>First payment of your family allowances<\/h6>\n                          <\/div>\n                      <\/div>                  <\/div>\n              <\/div>\n\n              <a href=\"https:\/\/www.brusselsfamily.be\/en\/\" class=\"next_btn button button--primary _ico\">\n                Go to homepage                    <span class=\"ico\">\n                    <svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"24\" height=\"24\" viewBox=\"0 0 24 24\" fill=\"none\">\n                      <path d=\"M16.0008 9.4L7.10078 18.3C6.91745 18.4833 6.68411 18.575 6.40078 18.575C6.11745 18.575 5.88411 18.4833 5.70078 18.3C5.51745 18.1167 5.42578 17.8833 5.42578 17.6C5.42578 17.3167 5.51745 17.0833 5.70078 16.9L14.6008 8H7.00078C6.71745 8 6.47995 7.90417 6.28828 7.7125C6.09661 7.52083 6.00078 7.28333 6.00078 7C6.00078 6.71667 6.09661 6.47917 6.28828 6.2875C6.47995 6.09583 6.71745 6 7.00078 6H17.0008C17.2841 6 17.5216 6.09583 17.7133 6.2875C17.9049 6.47917 18.0008 6.71667 18.0008 7V17C18.0008 17.2833 17.9049 17.5208 17.7133 17.7125C17.5216 17.9042 17.2841 18 17.0008 18C16.7174 18 16.4799 17.9042 16.2883 17.7125C16.0966 17.5208 16.0008 17.2833 16.0008 17V9.4Z\" fill=\"white\"\/>\n                    <\/svg>\n                    <\/span>\n                <\/a>\n                        <\/fieldset>\n    <\/form>\n<\/div>\n<script src=\"https:\/\/code.jquery.com\/jquery-3.7.1.min.js\"><\/script>\n<script src=\"\/wp-content\/themes\/brusselsfamily\/blocks\/bf-kb\/js\/signature_pad.umd.js\"><\/script>\n<script src=\"\/wp-content\/themes\/brusselsfamily\/blocks\/bf-kb\/js\/sign.js\"><\/script>\n<script src=\"\/wp-content\/themes\/brusselsfamily\/blocks\/geboortepremie_v1\/js\/oka_new.js\"><\/script>\n<\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"forms.php","meta":{"inline_featured_image":false,"ghostkit_customizer_options":"","ghostkit_custom_css":"","ghostkit_custom_js_head":"","ghostkit_custom_js_foot":"","ghostkit_typography":"","footnotes":""},"class_list":["post-1065","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/pages\/1065","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/comments?post=1065"}],"version-history":[{"count":12,"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/pages\/1065\/revisions"}],"predecessor-version":[{"id":5000,"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/pages\/1065\/revisions\/5000"}],"wp:attachment":[{"href":"https:\/\/www.brusselsfamily.be\/en\/wp-json\/wp\/v2\/media?parent=1065"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}