Mitglied werden
Form values and PDF mapping for testing purpose{
"firstname": "",
"lastname": "",
"gender": "",
"birthdate": "",
"nationality": "BE",
"nationalNumber": "",
"email": "",
"newsletter": false,
"inbox": false,
"phone": "",
"mobilePhone": "",
"mobilePhoneNational": "",
"mobilePhonePrefix": "",
"street": "",
"streetNumber": "",
"streetNumberAddition": "",
"zipCode": "",
"city": "",
"country": "BE",
"iban": "",
"bic": "",
"reimbursementAccountAuth": false,
"affiliationType": "",
"belgianStatus": "",
"belgianMutualityName": "",
"dependentHolderName": "",
"dependentHolderNationalNumber": "",
"dependentSchoolName": "",
"dependentSchoolAddress": "",
"otherRegimeUntil": "",
"otherRegimeName": "",
"otherRegimeAddress": "",
"foreignContinued": false,
"foreignName": "",
"foreignAddress": "",
"maritalStatus": "",
"partnerName": "",
"dependents": [],
"dependentsIncluded": false,
"professionalStatus": "",
"statusSince": "",
"employerName": "",
"employerAddress": "",
"unemploymentFundName": "",
"unemploymentFundAddress": "",
"incapacityOtherStatus": "",
"selfEmployedType": "",
"socialInsuranceFundName": "",
"socialInsuranceFundAddress": "",
"hospitalisationInterest": "",
"hospitalisationNoReason": "",
"hospInsuranceName": "",
"hospiKontinuiteOptIn": false,
"roomType": "",
"feeSupplementLevel": "",
"careGuaranteePeriod": "",
"seriousIllnessInsurance": "",
"dentalInterest": "",
"dentalNoReason": "",
"denInsuranceName": "",
"dentaliaUpOptIn": false,
"currentHospInsurance": false,
"currentHospInsuranceName": "",
"currentMedInsurance": false,
"currentMedInsuranceName": "",
"currentDentalInsurance": false,
"currentDenInsuranceName": "",
"selectedOffers": [],
"pdfValues": {
"date": "3/28/2026",
"name": "",
"firstname": "",
"nrn": "",
"nationality": "BE",
"gender": "",
"birthdate0": "",
"street": "",
"number": "",
"postBoxNumber": "",
"zipCode": "",
"city": "",
"countryDescription": "BE",
"phone": "",
"gsm": "",
"email": "",
"newsletter": "no",
"inbox": "no",
"currenmutualNumber": "",
"mutuality": "mutuality",
"insurance": "",
"belgian": "",
"iban": "",
"bic": "",
"kontonr": "no",
"officialLanguage": "",
"pacs": "no",
"jobDate": "",
"employee": "",
"employername": "",
"employeradress": "",
"independant": "",
"socialinsurancefond": "",
"socialdondaddress": "",
"status": "",
"titularName": "",
"titularNrn": "",
"stillForeign": "",
"foreignmutualName": "",
"foreignmutualaddress": "",
"school": "",
"schoolName": "",
"schooladdress": "",
"SNCB": "",
"SNCB/UE": "",
"othermutualdate": "",
"othermutual": "",
"othermutualaddress": "",
"hospital1": "",
"hospinsuranceName": "",
"room": "",
"honoraire": "",
"sickness": "",
"dental1": "",
"deninsuranceName": "",
"hospital2": "",
"medical2": "",
"medinsuranceName": "",
"dental2": "",
"hospiKont": "no",
"hospiCare": "no",
"hospiPlus": "no",
"hospiSmart": "no",
"maladieGrave": "no",
"dentaliaUp": "no"
}
}