www.livestudio.one
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52.220.3.228
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URL:
https://www.livestudio.one/event/register/BSN-SpartanNetwork-summit
Submission: On August 29 via manual from CH — Scanned from DE
Submission: On August 29 via manual from CH — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="text-white show-invalid-feedback" autocomplete="off" x-data="RegisterForm" @submit.prevent="submitForm">
<h2 class="text-center text-white fw-bold mb-3">Register Now</h2>
<input type="hidden" name="csrftoken" value="9f546359bf42a81e6e48f9f10ca7df3a7599ce75e318cdb4bb65965ebaeb10df">
<div class="alert alert-danger my-3" role="alert" x-show="(errors.login || errors.csrf || Object.keys(errors).length) && !errors.loginlocked" x-text="errors.login || errors.csrf || 'Please check the fields again.'" style="display: none;">
Please check the fields again.</div>
<div class="row my-2">
<div class="col-12 col-lg-3">
<label for="input-last_name" class="form-label my-1">Name</label>
</div>
<div class="col-12 col-lg-9">
<div class="row">
<div class="col-6">
<input type="text" name="last_name" class="form-control form-control-sm py-0 rounded-1" id="input-last_name" placeholder="Last Name">
</div>
<div class="col-6">
<input type="text" name="first_name" class="form-control form-control-sm py-0 rounded-1" id="input-first_name" placeholder="First Name">
</div>
</div>
<div class="invalid-feedback" x-text="errors.last_name"></div>
<div class="invalid-feedback" x-text="errors.first_name"></div>
</div>
</div>
<div class="row my-2">
<div class="col-12 col-lg-3">
<label for="input-company_name" class="form-label my-1">Company Name</label>
</div>
<div class="col-12 col-lg-9">
<input type="text" name="company_name" class="form-control form-control-sm py-0 rounded-1" id="input-company_name">
<div class="invalid-feedback" x-text="errors.company_name"></div>
</div>
</div>
<div class="row my-2">
<div class="col-12 col-lg-3">
<label for="input-title" class="form-label my-1">Title</label>
</div>
<div class="col-12 col-lg-9">
<input type="text" name="title" class="form-control form-control-sm py-0 rounded-1" id="input-title">
<div class="invalid-feedback" x-text="errors.title"></div>
</div>
</div>
<div class="row my-2">
<div class="col-12 col-lg-3">
<label for="input-work_email" class="form-label my-1">Email Address</label>
</div>
<div class="col-12 col-lg-9">
<input type="text" name="work_email" class="form-control form-control-sm py-0 rounded-1" id="input-work_email">
<div class="invalid-feedback" x-text="errors.email"></div>
<div class="invalid-feedback" x-text="errors.work_email"></div>
</div>
</div>
<div class="row my-2">
<div class="col-12 col-lg-3">
<label for="input-work_phone" class="form-label my-1">Contact Number</label>
</div>
<div class="col-12 col-lg-9">
<input type="text" name="work_phone" class="form-control form-control-sm py-0 rounded-1" id="input-work_phone">
<div class="invalid-feedback" x-text="errors.work_phone"></div>
</div>
</div>
<div class="row my-2">
<div class="col-12 col-lg-auto">
<label for="input-others" class="form-label my-1">Do you want to attend in person?</label>
</div>
<div class="col-12 col-lg-auto flex-grow-1">
<select name="others" id="input-others" class="form-select form-select-sm rounded-1">
<option>Please Select</option>
<option value="yes">Yes</option>
<option value="no">No</option>
</select>
<div class="invalid-feedback" x-text="errors.others"></div>
</div>
</div>
<div class="my-2 text-danger" x-show="errors.loginlocked" x-text="errors.loginlocked" style="display: none;"></div>
<div class="my-2 text-center">
<button type="submit" :disabled="formLoading" class="btn btn-primary px-4 rounded-1 w-100">Register</button>
</div>
</form>Text Content
REGISTER NOW Please check the fields again. Name Company Name Title Email Address Contact Number Do you want to attend in person? Please Select Yes No Register