{"id":11779,"date":"2023-03-02T16:21:41","date_gmt":"2023-03-02T14:21:41","guid":{"rendered":"https:\/\/van-beek.nl\/questionnaire-offerte\/"},"modified":"2023-06-19T11:43:19","modified_gmt":"2023-06-19T09:43:19","slug":"questionnaire-quotation","status":"publish","type":"page","link":"https:\/\/www.van-beek.nl\/en\/questionnaire-quotation\/","title":{"rendered":"Questionnaire for price enquiry"},"content":{"rendered":"<script>\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 InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return 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<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_11' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/en\/wp-json\/wp\/v2\/pages\/11779' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><div id=\"field_11_4\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"240333cc\" data-field-span=\"12\"><h2>CLIENT INFORMATION<\/h2><\/div><div id=\"field_11_1\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"80117eae\" data-field-span=\"12\"><label id='gfield_label_11_1' class='gfield_label gform-field-label' for='input_11_1'><span class='gform-field-label__text'>Company name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_1' id='input_11_1' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_5\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"e3d476ac\" data-field-span=\"12\"><label id='gfield_label_11_5' class='gfield_label gform-field-label' for='input_11_5'><span class='gform-field-label__text'>Contact<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_5' id='input_11_5' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_26\" class=\"gfield gfield--type-email gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"007574ca\" data-field-span=\"12\"><label id='gfield_label_11_26' class='gfield_label gform-field-label' for='input_11_26'><span class='gform-field-label__text'>E-mail address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_26' id='input_11_26' type='email' value='' class='large'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_11_6\" class=\"gfield gfield--type-text gfield--width-full noedit gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"43fc6601\" data-field-span=\"12\"><label id='gfield_label_11_6' class='gfield_label gform-field-label' for='input_11_6'><span class='gform-field-label__text'>Van Beek reference number (see email)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_6' id='input_11_6' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_7\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"13b161dd\" data-field-span=\"12\"><h2>PRODUCT DETAILS<\/h2><\/div><div id=\"field_11_8\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"54bf6450\" data-field-span=\"12\"><label id='gfield_label_11_8' class='gfield_label gform-field-label' for='input_11_8'><span class='gform-field-label__text'>Product name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_11_8' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"29ad81e9\" data-field-span=\"12\"><legend id='gfield_label_11_9' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Composition<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_9'>\n\t\t\t<div class='gchoice gchoice_11_9_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Powder'  id='choice_11_9_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_9_0 gfield_label_11_9\"   \/>\n\t\t\t\t\t<label for='choice_11_9_0' id='label_11_9_0' class='gform-field-label gform-field-label--type-inline'>Powder<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Granule'  id='choice_11_9_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_9_1' id='label_11_9_1' class='gform-field-label gform-field-label--type-inline'>Granule<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Flakes'  id='choice_11_9_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_9_2' id='label_11_9_2' class='gform-field-label gform-field-label--type-inline'>Flakes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Coarse lumps'  id='choice_11_9_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_9_3' id='label_11_9_3' class='gform-field-label gform-field-label--type-inline'>Coarse lumps<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_9_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_9' type='radio' value='Crystalline'  id='choice_11_9_4' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_9_4' id='label_11_9_4' class='gform-field-label gform-field-label--type-inline'>Crystalline<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_10\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"052c83e0\" data-field-span=\"12\"><label id='gfield_label_11_10' class='gfield_label gform-field-label' for='input_11_10'><span class='gform-field-label__text'>mm x mm<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_11_10' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"6b0388a2\" data-field-span=\"12\"><legend id='gfield_label_11_11' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Explosive atmosphere (ATEX)<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_11'>\n\t\t\t<div class='gchoice gchoice_11_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='Yes (please also complete the ATEX questionnaire)'  id='choice_11_11_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_11_0 gfield_label_11_11\"   \/>\n\t\t\t\t\t<label for='choice_11_11_0' id='label_11_11_0' class='gform-field-label gform-field-label--type-inline'>Yes (please also complete the ATEX questionnaire)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='No'  id='choice_11_11_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_11_1' id='label_11_11_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_12\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"6291de45\" data-field-span=\"12\"><legend id='gfield_label_11_12' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Flow behaviour<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_12'>\n\t\t\t<div class='gchoice gchoice_11_12_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Poor'  id='choice_11_12_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_12_0 gfield_label_11_12\"   \/>\n\t\t\t\t\t<label for='choice_11_12_0' id='label_11_12_0' class='gform-field-label gform-field-label--type-inline'>Poor<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_12_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Moderate'  id='choice_11_12_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_12_1' id='label_11_12_1' class='gform-field-label gform-field-label--type-inline'>Moderate<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_12_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='Good'  id='choice_11_12_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_12_2' id='label_11_12_2' class='gform-field-label gform-field-label--type-inline'>Good<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_12_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_12' type='radio' value='high'  id='choice_11_12_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_12_3' id='label_11_12_3' class='gform-field-label gform-field-label--type-inline'>high<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_13\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7e203c39\" data-field-span=\"12\"><label id='gfield_label_11_13' class='gfield_label gform-field-label' for='input_11_13'><span class='gform-field-label__text'>Bulk density<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_13' id='input_11_13' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_14\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"f380e621\" data-field-span=\"12\"><label id='gfield_label_11_14' class='gfield_label gform-field-label' for='input_11_14'><span class='gform-field-label__text'>Capacity<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_11_14' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_15\" class=\"gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"525c76a6\" data-field-span=\"12\"><h2>SCREW SYSTEM DETAILS<\/h2><\/div><fieldset id=\"field_11_16\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"b1321698\" data-field-span=\"12\"><legend id='gfield_label_11_16' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Body design type<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_16'>\n\t\t\t<div class='gchoice gchoice_11_16_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Trough'  id='choice_11_16_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_16_0 gfield_label_11_16\"   \/>\n\t\t\t\t\t<label for='choice_11_16_0' id='label_11_16_0' class='gform-field-label gform-field-label--type-inline'>Trough<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_16_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_16' type='radio' value='Tube'  id='choice_11_16_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_16_1' id='label_11_16_1' class='gform-field-label gform-field-label--type-inline'>Tube<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_17\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"f600f5d0\" data-field-span=\"12\"><legend id='gfield_label_11_17' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Lid type<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_17'>\n\t\t\t<div class='gchoice gchoice_11_17_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Bolted'  id='choice_11_17_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_17_0 gfield_label_11_17\"   \/>\n\t\t\t\t\t<label for='choice_11_17_0' id='label_11_17_0' class='gform-field-label gform-field-label--type-inline'>Bolted<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_17_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_17' type='radio' value='Hinged'  id='choice_11_17_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_17_1' id='label_11_17_1' class='gform-field-label gform-field-label--type-inline'>Hinged<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_11_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"3e1b6705\" data-field-span=\"12\"><legend id='gfield_label_11_18' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Casing construction material<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_18'>\n\t\t\t<div class='gchoice gchoice_11_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Steel'  id='choice_11_18_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_18_0 gfield_label_11_18\"   \/>\n\t\t\t\t\t<label for='choice_11_18_0' id='label_11_18_0' class='gform-field-label gform-field-label--type-inline'>Steel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='SS 304'  id='choice_11_18_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_18_1' id='label_11_18_1' class='gform-field-label gform-field-label--type-inline'>SS 304<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_18_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='SS 316'  id='choice_11_18_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_18_2' id='label_11_18_2' class='gform-field-label gform-field-label--type-inline'>SS 316<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_18_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='Other'  id='choice_11_18_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_18_3' id='label_11_18_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_27\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"886f3946\" data-field-span=\"12\"><label id='gfield_label_11_27' class='gfield_label gform-field-label' for='input_11_27'><span class='gform-field-label__text'>Casing construction material other<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_27' id='input_11_27' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_11_19\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"c330a89c\" data-field-span=\"12\"><legend id='gfield_label_11_19' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Screw construction material<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_11_19'>\n\t\t\t<div class='gchoice gchoice_11_19_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Steel'  id='choice_11_19_0' onchange='gformToggleRadioOther( this )'  aria-labelledby=\"label_11_19_0 gfield_label_11_19\"   \/>\n\t\t\t\t\t<label for='choice_11_19_0' id='label_11_19_0' class='gform-field-label gform-field-label--type-inline'>Steel<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_19_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='SS 304'  id='choice_11_19_1' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_19_1' id='label_11_19_1' class='gform-field-label gform-field-label--type-inline'>SS 304<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_19_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='SS 316'  id='choice_11_19_2' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_19_2' id='label_11_19_2' class='gform-field-label gform-field-label--type-inline'>SS 316<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_11_19_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_19' type='radio' value='Other'  id='choice_11_19_3' onchange='gformToggleRadioOther( this )'     \/>\n\t\t\t\t\t<label for='choice_11_19_3' id='label_11_19_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_11_28\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"f17f0307\" data-field-span=\"12\"><label id='gfield_label_11_28' class='gfield_label gform-field-label' for='input_11_28'><span class='gform-field-label__text'>Screw construction material other<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_11_28' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_20\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"b3c8ed92\" data-field-span=\"12\"><label id='gfield_label_11_20' class='gfield_label gform-field-label' for='input_11_20'><span class='gform-field-label__text'>Length (inlet centre to outlet centre)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_11_20' type='text' value='' class='large'      aria-invalid=\"false\"   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type<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_11_22' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_23\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"437da9ce\" data-field-span=\"12\"><label id='gfield_label_11_23' class='gfield_label gform-field-label' for='input_11_23'><span class='gform-field-label__text'>Outlet dimensions\/flange type<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_23' id='input_11_23' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_24\" class=\"gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"41e66d74\" data-field-span=\"12\"><label id='gfield_label_11_24' class='gfield_label gform-field-label' for='input_11_24'><span class='gform-field-label__text'>How will the screw be filled?<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_24' id='input_11_24' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_11_25\" class=\"gfield gfield--type-fileupload gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"acb8ba22\" data-field-span=\"12\"><label id='gfield_label_11_25' class='gfield_label gform-field-label' for='input_11_25'><span class='gform-field-label__text'>Upload sketch<\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='2097152' \/><input name='input_25' id='input_11_25' type='file' class='large' 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