providencefoundation.org.ng
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Submitted URL: http://providencefoundation.org.ng/
Effective URL: https://providencefoundation.org.ng/
Submission: On March 04 via api from US — Scanned from US
Effective URL: https://providencefoundation.org.ng/
Submission: On March 04 via api from US — Scanned from US
Form analysis 1 forms found in the DOM
<form class="flex-col flex mx-auto max-w-screen-md py-12 px-4 gap-6">
<header class="pb-4">
<h1 class="flex font-bold pb-2 text-2xl gap-2 uppercase">
<div class="text-primary">Let's get you </div>
<div class="text-accent">started</div>
</h1>
<p class="text-sm tracking-wide text-dark-50">Please fill the form below to continue</p>
</header>
<section class="grid gap-6 grid-cols-1 sm:grid-cols-2"><label class="flex-col flex justify-between">
<h5 class="text-sm pb-1">Name<!-- -->: <strong class="text-red-500">*</strong></h5><input required="" id="entry.1550790662" placeholder="Ciroma Chukwuma Adekunle" class="border border-black outline-accent w-full p-2 sm:p-4">
</label><label class="flex-col flex justify-between">
<h5 class="text-sm pb-1">Gender<!-- -->: <strong class="text-red-500">*</strong></h5><select required="" id="entry.484949697" class="border border-black outline-accent w-full p-2 sm:p-4">
<option value="">Select</option>
<option>Male</option>
<option>Female</option>
</select>
</label></section>
<section class="grid gap-6 grid-cols-1 sm:grid-cols-2"><label class="flex-col flex justify-between">
<h5 class="text-sm pb-1">Email Address<!-- -->: <strong class="text-red-500">*</strong></h5><input required="" type="email" id="entry.648954864" placeholder="email@example.com" class="border-black border outline-accent w-full p-2 sm:p-4">
</label><label class="flex-col flex justify-between">
<h5 class="text-sm pb-1">Phone Number<!-- -->: <strong class="text-red-500">*</strong></h5><input required="" type="tel" id="entry.196082792" placeholder="+2348012345678" class="border-black border outline-accent w-full p-2 sm:p-4">
</label></section><label class="flex-col flex justify-between">
<h5 class="text-sm pb-1">Location<!-- -->: </h5><input id="entry.1439484136" placeholder="E.g, Ikorodu, Lagos" class="border-black border outline-accent w-full p-2 sm:p-4">
</label><label class="flex-col flex justify-between">
<h5 class="text-sm pb-1">Photo<!-- -->: <strong class="text-red-500">*</strong></h5>
<div class="text-xs pb-1 text-dark-100">We Recommend Square Photos With The Face Centred (Portraits)</div><input required="" id="photo" type="file" accept="image/png, image/jpeg" placeholder="Ciroma Chukwuma Adekunle"
class="border border-black outline-accent text-sm w-full file:border-r file:border-0 file:border-light-900 file:text-xs file:p-3 file:text-dark-100 file:sm:p-4">
</label>
<section class="flex py-4 gap-4"><button type="reset" class="border-black border text-center p-2 w-1/4 sm:p-4 hover:outline hover:outline-black ">Reset</button><button type="submit"
class="bg-black flex-grow text-white text-center p-2 sm:p-4 hover:bg-primary">Continue</button></section>
</form>Text Content
Providence Humanitarian Foundation LET'S GET YOU STARTED Please fill the form below to continue NAME: * GENDER: * SelectMaleFemale EMAIL ADDRESS: * PHONE NUMBER: * LOCATION: PHOTO: * We Recommend Square Photos With The Face Centred (Portraits) ResetContinue Made with ♥ by Ogbeni Tech Copyright © 2022. All rights reserved.