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POST https://incrementacrm.com/api/widget/web-form/58b8c8a27d345d08f856039bd021027070666e4e

<form action="https://incrementacrm.com/api/widget/web-form/58b8c8a27d345d08f856039bd021027070666e4e" method="post" class="container" id="ClientWebFormForm" accept-charset="utf-8">
  <div style="display:none;"><input type="hidden" name="_method" value="POST"></div>
  <div class="form-group"><label for="ClientFirstName">Nombre(s)</label><input name="data[Client][first_name]" class="form-control" placeholder="Nombre(s)" type="text" id="ClientFirstName"></div>
  <div class="form-group"><label for="ClientLastName">Apellidos</label><input name="data[Client][last_name]" class="form-control" placeholder="Apellidos" type="text" id="ClientLastName"></div>
  <div class="form-group"><label for="ClientCompanyName">Empresa</label><input name="data[Client][company_name]" class="form-control" placeholder="Empresa" type="text" id="ClientCompanyName"></div>
  <div class="form-group"><label for="ClientCountryId">País</label><select name="data[Client][country_id]" class="form-control" placeholder="País" id="ClientCountryId">
      <option value="4">Afghanistan</option>
      <option value="248">Aland Islands</option>
      <option value="8">Albania</option>
      <option value="12">Algeria</option>
      <option value="16">American Samoa</option>
      <option value="20">Andorra</option>
      <option value="24">Angola</option>
      <option value="660">Anguilla</option>
      <option value="10">Antarctica</option>
      <option value="28">Antigua and Barbuda</option>
      <option value="32">Argentina</option>
      <option value="51">Armenia</option>
      <option value="533">Aruba</option>
      <option value="36">Australia</option>
      <option value="40">Austria</option>
      <option value="31">Azerbaijan</option>
      <option value="44">Bahamas</option>
      <option value="48">Bahrain</option>
      <option value="50">Bangladesh</option>
      <option value="52">Barbados</option>
      <option value="112">Belarus</option>
      <option value="56">Belgium</option>
      <option value="84">Belize</option>
      <option value="204">Benin</option>
      <option value="60">Bermuda</option>
      <option value="64">Bhutan</option>
      <option value="68">Bolivia</option>
      <option value="70">Bosnia and Herzegovina</option>
      <option value="72">Botswana</option>
      <option value="74">Bouvet Island</option>
      <option value="76">Brazil</option>
      <option value="86">British Indian Ocean Territory</option>
      <option value="92">British Virgin Islands</option>
      <option value="96">Brunei</option>
      <option value="100">Bulgaria</option>
      <option value="854">Burkina Faso</option>
      <option value="108">Burundi</option>
      <option value="116">Cambodia</option>
      <option value="120">Cameroon</option>
      <option value="124">Canada</option>
      <option value="132">Cape Verde</option>
      <option value="136">Cayman Islands</option>
      <option value="140">Central African Republic</option>
      <option value="148">Chad</option>
      <option value="152">Chile</option>
      <option value="156">China</option>
      <option value="162">Christmas Island</option>
      <option value="166">Cocos Islands</option>
      <option value="170">Colombia</option>
      <option value="174">Comoros</option>
      <option value="184">Cook Islands</option>
      <option value="188">Costa Rica</option>
      <option value="191">Croatia</option>
      <option value="192">Cuba</option>
      <option value="196">Cyprus</option>
      <option value="203">Czech Republic</option>
      <option value="180">Democratic Republic of the Congo</option>
      <option value="208">Denmark</option>
      <option value="262">Djibouti</option>
      <option value="212">Dominica</option>
      <option value="214">Dominican Republic</option>
      <option value="626">East Timor</option>
      <option value="218">Ecuador</option>
      <option value="818">Egypt</option>
      <option value="222">El Salvador</option>
      <option value="226">Equatorial Guinea</option>
      <option value="232">Eritrea</option>
      <option value="233">Estonia</option>
      <option value="231">Ethiopia</option>
      <option value="238">Falkland Islands</option>
      <option value="234">Faroe Islands</option>
      <option value="242">Fiji</option>
      <option value="246">Finland</option>
      <option value="250">France</option>
      <option value="254">French Guiana</option>
      <option value="258">French Polynesia</option>
      <option value="260">French Southern Territories</option>
      <option value="266">Gabon</option>
      <option value="270">Gambia</option>
      <option value="268">Georgia</option>
      <option value="276">Germany</option>
      <option value="288">Ghana</option>
      <option value="292">Gibraltar</option>
      <option value="300">Greece</option>
      <option value="304">Greenland</option>
      <option value="308">Grenada</option>
      <option value="312">Guadeloupe</option>
      <option value="316">Guam</option>
      <option value="320">Guatemala</option>
      <option value="831">Guernsey</option>
      <option value="324">Guinea</option>
      <option value="624">Guinea-Bissau</option>
      <option value="328">Guyana</option>
      <option value="332">Haiti</option>
      <option value="334">Heard Island and McDonald Islands</option>
      <option value="340">Honduras</option>
      <option value="344">Hong Kong</option>
      <option value="348">Hungary</option>
      <option value="352">Iceland</option>
      <option value="356">India</option>
      <option value="360">Indonesia</option>
      <option value="364">Iran</option>
      <option value="368">Iraq</option>
      <option value="372">Ireland</option>
      <option value="833">Isle of Man</option>
      <option value="376">Israel</option>
      <option value="380">Italy</option>
      <option value="384">Ivory Coast</option>
      <option value="388">Jamaica</option>
      <option value="392">Japan</option>
      <option value="832">Jersey</option>
      <option value="400">Jordan</option>
      <option value="398">Kazakhstan</option>
      <option value="404">Kenya</option>
      <option value="296">Kiribati</option>
      <option value="855">Kosovo</option>
      <option value="414">Kuwait</option>
      <option value="417">Kyrgyzstan</option>
      <option value="418">Laos</option>
      <option value="428">Latvia</option>
      <option value="422">Lebanon</option>
      <option value="426">Lesotho</option>
      <option value="430">Liberia</option>
      <option value="434">Libya</option>
      <option value="438">Liechtenstein</option>
      <option value="440">Lithuania</option>
      <option value="442">Luxembourg</option>
      <option value="446">Macao</option>
      <option value="807">Macedonia</option>
      <option value="450">Madagascar</option>
      <option value="454">Malawi</option>
      <option value="458">Malaysia</option>
      <option value="462">Maldives</option>
      <option value="466">Mali</option>
      <option value="470">Malta</option>
      <option value="584">Marshall Islands</option>
      <option value="474">Martinique</option>
      <option value="478">Mauritania</option>
      <option value="480">Mauritius</option>
      <option value="175">Mayotte</option>
      <option value="484" selected="selected">México</option>
      <option value="583">Micronesia</option>
      <option value="498">Moldova</option>
      <option value="492">Monaco</option>
      <option value="496">Mongolia</option>
      <option value="499">Montenegro</option>
      <option value="500">Montserrat</option>
      <option value="504">Morocco</option>
      <option value="508">Mozambique</option>
      <option value="104">Myanmar</option>
      <option value="516">Namibia</option>
      <option value="520">Nauru</option>
      <option value="524">Nepal</option>
      <option value="528">Netherlands</option>
      <option value="530">Netherlands Antilles</option>
      <option value="540">New Caledonia</option>
      <option value="554">New Zealand</option>
      <option value="558">Nicaragua</option>
      <option value="562">Niger</option>
      <option value="566">Nigeria</option>
      <option value="570">Niue</option>
      <option value="574">Norfolk Island</option>
      <option value="408">North Korea</option>
      <option value="580">Northern Mariana Islands</option>
      <option value="578">Norway</option>
      <option value="512">Oman</option>
      <option value="586">Pakistan</option>
      <option value="585">Palau</option>
      <option value="275">Palestinian Territory</option>
      <option value="591">Panama</option>
      <option value="598">Papua New Guinea</option>
      <option value="600">Paraguay</option>
      <option value="604">Peru</option>
      <option value="608">Philippines</option>
      <option value="612">Pitcairn</option>
      <option value="616">Poland</option>
      <option value="620">Portugal</option>
      <option value="630">Puerto Rico</option>
      <option value="634">Qatar</option>
      <option value="178">Republic of the Congo</option>
      <option value="638">Reunion</option>
      <option value="642">Romania</option>
      <option value="643">Russia</option>
      <option value="646">Rwanda</option>
      <option value="652">Saint Barthélemy</option>
      <option value="654">Saint Helena</option>
      <option value="659">Saint Kitts and Nevis</option>
      <option value="662">Saint Lucia</option>
      <option value="663">Saint Martin</option>
      <option value="666">Saint Pierre and Miquelon</option>
      <option value="670">Saint Vincent and the Grenadines</option>
      <option value="882">Samoa</option>
      <option value="674">San Marino</option>
      <option value="678">Sao Tome and Principe</option>
      <option value="682">Saudi Arabia</option>
      <option value="686">Senegal</option>
      <option value="688">Serbia</option>
      <option value="891">Serbia and Montenegro</option>
      <option value="690">Seychelles</option>
      <option value="694">Sierra Leone</option>
      <option value="702">Singapore</option>
      <option value="703">Slovakia</option>
      <option value="705">Slovenia</option>
      <option value="90">Solomon Islands</option>
      <option value="706">Somalia</option>
      <option value="710">South Africa</option>
      <option value="239">South Georgia and the South Sandwich Islands</option>
      <option value="410">South Korea</option>
      <option value="724">Spain</option>
      <option value="144">Sri Lanka</option>
      <option value="736">Sudan</option>
      <option value="740">Suriname</option>
      <option value="744">Svalbard and Jan Mayen</option>
      <option value="748">Swaziland</option>
      <option value="752">Sweden</option>
      <option value="756">Switzerland</option>
      <option value="760">Syria</option>
      <option value="158">Taiwan</option>
      <option value="762">Tajikistan</option>
      <option value="834">Tanzania</option>
      <option value="764">Thailand</option>
      <option value="768">Togo</option>
      <option value="772">Tokelau</option>
      <option value="776">Tonga</option>
      <option value="780">Trinidad and Tobago</option>
      <option value="788">Tunisia</option>
      <option value="792">Turkey</option>
      <option value="795">Turkmenistan</option>
      <option value="796">Turks and Caicos Islands</option>
      <option value="798">Tuvalu</option>
      <option value="850">U.S. Virgin Islands</option>
      <option value="800">Uganda</option>
      <option value="804">Ukraine</option>
      <option value="784">United Arab Emirates</option>
      <option value="826">United Kingdom</option>
      <option value="840">United States</option>
      <option value="581">United States Minor Outlying Islands</option>
      <option value="858">Uruguay</option>
      <option value="860">Uzbekistan</option>
      <option value="548">Vanuatu</option>
      <option value="336">Vatican</option>
      <option value="862">Venezuela</option>
      <option value="704">Vietnam</option>
      <option value="876">Wallis and Futuna</option>
      <option value="732">Western Sahara</option>
      <option value="887">Yemen</option>
      <option value="894">Zambia</option>
      <option value="716">Zimbabwe</option>
    </select></div>
  <div class="form-group"><label for="ClientStateId">Estado</label><select name="data[Client][state_id]" class="form-control" placeholder="Estado" id="ClientStateId">
      <option value="2012">Aguascalientes</option>
      <option value="2013">Baja California</option>
      <option value="2014">Baja California Sur</option>
      <option value="2015">Campeche</option>
      <option value="2016">Chiapas</option>
      <option value="2017">Chihuahua</option>
      <option value="2020">Ciudad de México</option>
      <option value="2018">Coahuila</option>
      <option value="2019">Colima</option>
      <option value="2021">Durango</option>
      <option value="2026">Estado de México</option>
      <option value="2022">Guanajuato</option>
      <option value="2023">Guerrero</option>
      <option value="2024">Hidalgo</option>
      <option value="2025">Jalisco</option>
      <option value="2027">Michoacán</option>
      <option value="2028">Morelos</option>
      <option value="2029">Nayarit</option>
      <option value="2030">Nuevo León</option>
      <option value="2031">Oaxaca</option>
      <option value="2032">Puebla</option>
      <option value="2033">Querétaro</option>
      <option value="2034">Quintana Roo</option>
      <option value="2035">San Luis Potosí</option>
      <option value="2036">Sinaloa</option>
      <option value="2037">Sonora</option>
      <option value="2038">Tabasco</option>
      <option value="2039">Tamaulipas</option>
      <option value="2040">Tlaxcala</option>
      <option value="2041">Veracruz</option>
      <option value="2042">Yucatán</option>
      <option value="2043">Zacatecas</option>
    </select></div>
  <div class="form-group"><label for="ClientCellphone">Celular</label><input name="data[Client][cellphone]" class="form-control" placeholder="Celular" type="text" id="ClientCellphone"></div>
  <div class="form-group"><label for="ClientEmail">Email</label><input name="data[Client][email]" class="form-control" placeholder="Email" type="email" id="ClientEmail"></div>
  <div class="form-group center-block" id="reCaptcha">
    <div class="g-recaptcha center-block" data-sitekey="6Lc_zG0iAAAAAPRBmWKxYKLxf18txhrxax3gtroH">
      <div style="width: 304px; height: 78px;">
        <div><iframe title="reCAPTCHA"
            src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Lc_zG0iAAAAAPRBmWKxYKLxf18txhrxax3gtroH&amp;co=aHR0cHM6Ly9pbmNyZW1lbnRhY3JtLmNvbTo0NDM.&amp;hl=fr&amp;v=pn3ro1xnhf4yB8qmnrhh9iD2&amp;size=normal&amp;cb=fdwiizubhrr6"
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      </div><iframe style="display: none;"></iframe>
    </div>
  </div>
  <div class="submit"><input class="btn btn-default" type="submit" value="Enviar"></div>
</form>

Text Content

Nombre(s)
Apellidos
Empresa
País Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola
Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia
Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize
Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island
Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria
Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central
African Republic Chad Chile China Christmas Island Cocos Islands Colombia
Comoros Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Democratic
Republic of the Congo Denmark Djibouti Dominica Dominican Republic East Timor
Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland
Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French
Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece
Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana
Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India
Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan
Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia
Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia
Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique
Mauritania Mauritius Mayotte México Micronesia Moldova Monaco Mongolia
Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands
Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue
Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau
Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn
Poland Portugal Puerto Rico Qatar Republic of the Congo Reunion Romania Russia
Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint
Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San
Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Serbia and Montenegro
Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia
South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri
Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria
Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago
Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands
Uganda Ukraine United Arab Emirates United Kingdom United States United States
Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam
Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Estado Aguascalientes Baja California Baja California Sur Campeche Chiapas
Chihuahua Ciudad de México Coahuila Colima Durango Estado de México Guanajuato
Guerrero Hidalgo Jalisco Michoacán Morelos Nayarit Nuevo León Oaxaca Puebla
Querétaro Quintana Roo San Luis Potosí Sinaloa Sonora Tabasco Tamaulipas
Tlaxcala Veracruz Yucatán Zacatecas
Celular
Email