Contactez-nous | Aliaxis France

Enter some introduction text here to encourage the user to complete and submit the contact form.

Don't go crazy here, but use this section to help the user complete the form if you think it is needed.

Form Field:

title_gender

Parameter for E-Mail: {{title_gender}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Title (gender) options:

Form Field:

firstname

Parameter for E-Mail: {{firstname}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col2

Form Field:

lastname

Parameter for E-Mail: {{lastname}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col2

Form Field:

Parameter for E-Mail: {{email}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col2

You can add some domains, delimited by semicolon to allowlist or blocklist some domains (i.e. gmail.com;yahoo.fr) :

Blacklist domain emails:

Whitelist domain emails:

Form Field:

phone_number

Parameter for E-Mail: {{phone_number}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

lastname

Field layout:

col2

Form Field:

company

Parameter for E-Mail: {{company}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col2

Form Field:

postal_code

Parameter for E-Mail: {{postal_code}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

company

Field layout:

col2

Form Field:

segment

Parameter for E-Mail: {{segment}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

subject

Field layout:

col1

Segment options: Option text → Send to address(es) email(s) info [OPTIONAL]
If the option is selected, the addresses set for this option will be added to the internal email.
Multiple addresses can be specified by separating the email addresses with a semicolon.
Example: receiver@pimcore.org; receiver2@pimcore.org

Form Field:

subject

Parameter for E-Mail: {{subject}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Field layout:

col1

Subject options: Option text → Send to address(es) email(s) info [OPTIONAL]
If the option is selected, the addresses set for this option will be added to the internal email.
Multiple addresses can be specified by separating the email addresses with a semicolon.
Example: receiver@pimcore.org; receiver2@pimcore.org

Form Field:

comment

Parameter for E-Mail: {{comment}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Put after the template field:

--reset--

Add a limit to comment text: (0 or empty means no limit)

Minimum of characters:

Maximum of characters:

Form Field:

opt_in

Parameter for E-Mail: {{opt_in}}

Mandatory field?

Disabled field?

Exclude from email info ? Exclude the field in all email parameters

Oui, j'aimerais recevoir des e-mails d'Aliaxis concernant des informations, des ressources, des invitations à des événements et des services. Je comprends que je peux retirer mon consentement à tout moment, conformément à la Politique de confidentialité.

Civilité *

Prénom *

Nom *

Téléphone *

E-mail *

Profession *

Fonction

Nom de l'entreprise

Numéro d'entreprise

Ville *

Pays *

Code postal *

Sujet *

Type de demande *

Domaine d'application

Message *

Produit concerné

* Obligatoire

Aliaxis utilisera ces informations pour répondre au mieux à votre demande. En soumettant ce formulaire, vous reconnaissez qu'Aliaxis pourra vous contacter si nécessaire.