titanfuelorders.com
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35.208.171.119
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Submitted URL: http://titanfuelorders.com/
Effective URL: https://titanfuelorders.com/
Submission: On March 11 via manual from IE — Scanned from DE
Effective URL: https://titanfuelorders.com/
Submission: On March 11 via manual from IE — Scanned from DE
Form analysis 1 forms found in the DOM
POST /#gf_1
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_1" id="gform_1" action="/#gf_1" novalidate="">
<div class="gform_body gform-body">
<div id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_1_1" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_1">Account Name<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_1_1" type="text" value="" class="large" tabindex="123" aria-required="true" aria-invalid="false"> </div>
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<div id="field_1_19" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_19">City<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_19" id="input_1_19" type="text" value="" class="large" tabindex="124" aria-required="true" aria-invalid="false"> </div>
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<div id="field_1_18" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_18">State<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_18" id="input_1_18" class="large gfield_select" tabindex="125" aria-required="true" aria-invalid="false">
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Armed Forces Americas">Armed Forces Americas</option>
<option value="Armed Forces Europe">Armed Forces Europe</option>
<option value="Armed Forces Pacific">Armed Forces Pacific</option>
</select></div>
</div>
<div id="field_1_2" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_2">Contact Name<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_2" id="input_1_2" type="text" value="" class="large" tabindex="126" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_1_3" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_3">Telephone<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_3" id="input_1_3" type="tel" value="" class="large" tabindex="127" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_1_5" class="gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_5">Choose a Fuel Type...<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_5" id="input_1_5" class="large gfield_select" tabindex="128" aria-required="true" aria-invalid="false">
<option value="" selected="selected">Choose a Fuel Type...</option>
<option value="Jet">Jet NO Additive</option>
<option value="Jet with Additive">Jet WITH Additive</option>
<option value="Avgas">Avgas</option>
</select></div>
</div>
<div id="field_1_6" class="gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_6">Gallons Needed<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_6" id="input_1_6" type="text" value="" class="large" tabindex="129" aria-required="true" aria-invalid="false"> </div>
</div>
<fieldset id="field_1_7" class="gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible">
<legend class="gfield_label">Pump Needed:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_1_7">
<div class="gchoice gchoice_1_7_0">
<input class="gfield-choice-input" name="input_7" type="radio" value="YES" id="choice_1_7_0" onchange="gformToggleRadioOther( this )" tabindex="130">
<label for="choice_1_7_0" id="label_1_7_0">YES</label>
</div>
<div class="gchoice gchoice_1_7_1">
<input class="gfield-choice-input" name="input_7" type="radio" value="NO" id="choice_1_7_1" onchange="gformToggleRadioOther( this )" tabindex="131">
<label for="choice_1_7_1" id="label_1_7_1">NO</label>
</div>
</div>
</div>
</fieldset>
<div id="field_1_8" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_8">PO Number (Optional)</label>
<div class="ginput_container ginput_container_text"><input name="input_8" id="input_1_8" type="text" value="" class="medium" tabindex="132" aria-invalid="false"> </div>
</div>
<div id="field_1_9" class="gfield gfield--width-full gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_9">Delivery Date:<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date">
<input name="input_9" id="input_1_9" type="text" value="" class="datepicker mdy datepicker_with_icon gdatepicker_with_icon hasDatepicker initialized" tabindex="133" placeholder="mm/dd/yyyy" aria-describedby="input_1_9_date_format"
aria-invalid="false" aria-required="true"><img class="ui-datepicker-trigger" src="http://www.titanfuels.aero/wp-content/uploads/2015/04/FuelOrderingForm-CalendarIcon-sm.png" alt="Select date" title="Select date">
<span id="input_1_9_date_format" class="screen-reader-text">MM slash DD slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_1_9" class="gform_hidden" value="http://www.titanfuels.aero/wp-content/uploads/2015/04/FuelOrderingForm-CalendarIcon-sm.png">
</div>
<div id="field_1_11" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_11">Delivery Time (From):<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_1_11" type="text" value="" class="large" tabindex="134" aria-required="true" aria-invalid="false"> </div>
</div>
<fieldset id="field_1_12" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible">
<legend class="gfield_label">Delivery Time (From):<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_1_12">
<div class="gchoice gchoice_1_12_0">
<input class="gfield-choice-input" name="input_12" type="radio" value="AM" id="choice_1_12_0" onchange="gformToggleRadioOther( this )" tabindex="135">
<label for="choice_1_12_0" id="label_1_12_0">AM</label>
</div>
<div class="gchoice gchoice_1_12_1">
<input class="gfield-choice-input" name="input_12" type="radio" value="PM" id="choice_1_12_1" onchange="gformToggleRadioOther( this )" tabindex="136">
<label for="choice_1_12_1" id="label_1_12_1">PM</label>
</div>
</div>
</div>
</fieldset>
<div id="field_1_13" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_13">(To):<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_13" id="input_1_13" type="text" value="" class="large" tabindex="137" aria-required="true" aria-invalid="false"> </div>
</div>
<fieldset id="field_1_14" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below hidden_label gfield_visibility_visible">
<legend class="gfield_label">(To):<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_1_14">
<div class="gchoice gchoice_1_14_0">
<input class="gfield-choice-input" name="input_14" type="radio" value="AM" id="choice_1_14_0" onchange="gformToggleRadioOther( this )" tabindex="138">
<label for="choice_1_14_0" id="label_1_14_0">AM</label>
</div>
<div class="gchoice gchoice_1_14_1">
<input class="gfield-choice-input" name="input_14" type="radio" value="PM" id="choice_1_14_1" onchange="gformToggleRadioOther( this )" tabindex="139">
<label for="choice_1_14_1" id="label_1_14_1">PM</label>
</div>
</div>
</div>
</fieldset>
<div id="field_1_15" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_15">Contact Email<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_15" id="input_1_15" type="email" value="" class="large" tabindex="140" aria-required="true" aria-invalid="false">
</div>
</div>
<div id="field_1_16" class="gfield field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_16">Comments (Optional)...</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_16" id="input_1_16" class="textarea medium" tabindex="141" aria-invalid="false" rows="10" cols="50"></textarea></div>
</div>
<div id="field_1_20" class="gfield gform_validation_container field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_20">Comments</label>
<div class="ginput_container"><input name="input_20" id="input_1_20" type="text" value="" autocomplete="new-password"></div>
<div class="gfield_description" id="gfield_description_1_20">This field is for validation purposes and should be left unchanged.</div>
</div>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_1" class="gform_button button" value="Submit" tabindex="142"
onclick="if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} if( !jQuery("#gform_1")[0].checkValidity || jQuery("#gform_1")[0].checkValidity()){window["gf_submitting_1"]=true;} jQuery("#gform_1").trigger("submit",[true]); }">
<input type="hidden" name="gform_ajax" value="form_id=1&title=&description=&tabindex=123">
<input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="1">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsImZhZTNkMWUxMjgzYjVhNTQzODcwYzRlZThmNDVhNWZhIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>Text Content
Skip to content TITAN FUELS ORDERING Menu Close * Return to Titan Fuels FUEL ORDERING Account Name* City* State* AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Contact Name* Telephone* Choose a Fuel Type...* Choose a Fuel Type...Jet NO AdditiveJet WITH AdditiveAvgas Gallons Needed* Pump Needed:* YES NO PO Number (Optional) Delivery Date:* MM slash DD slash YYYY Delivery Time (From):* Delivery Time (From):* AM PM (To):* (To):* AM PM Contact Email* Comments (Optional)... Comments This field is for validation purposes and should be left unchanged. Proudly powered by WordPress. Notifications