[paytium name="Formulier naam" description="Opleiding Helpende (HZW niv2)" amount="19,95"]
[paytium_field type="text" label="Naam en Achternaam" required="true" /]
[paytium_field type="text" label="Burgerservice nummer (bsn) " required="true" /][paytium_field type="textarea" label="Opmerking" required="true" /]
[paytium_field type="email" label="Email" required="true" /]
[paytium_total /]
[/paytium]