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inscription.prix-eco-neoaquitains.fr Open in urlscan Pro
13.107.226.38  Public Scan

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Submitted URL: http://9rrx.mjt.lu/lnk/AUYAACnRTf4AAc2-VRgAALTCjFgAAABEpeIAnYCiAAxNawBlN2wPD4buYmAvRrWul-uf93wDaQAIe4k/1/gmKXR5m8zD...
Effective URL: https://inscription.prix-eco-neoaquitains.fr/registration/register?utm_source=mailjet&utm_medium=email&utm_campaign=invitation&utm_content=su...
Submission: On October 24 via manual from CA — Scanned from CA

Form analysis 1 forms found in the DOM

#

<form action="#" class="entityform pendingupdate-false">
  <div>
    <div class="entityform-group group-0 depth-0">
      <div class="group-title"></div>
      <div class="collapsiblepanel group-content">
        <div class="collapsiblepanel-content">
          <div class="fields"></div>
          <div class="childgroups">
            <div class="entityform-group group-0 depth-1 display-columns">
              <div class="group-title"></div>
              <div class="collapsiblepanel group-content">
                <div class="collapsiblepanel-content">
                  <div class="fields">
                    <div class="entityfield entityfield-firstname type-text">
                      <div class="fieldwrapper "><label class="" for="fld-createform-0--Personfirstname" data-trad="person.firstname">Prénom<span class="requiredmark">*</span></label>
                        <div class="input-wrapper"><input id="fld-createform-0--Personfirstname" name="firstname" placeholder="" class="bloc-lightborder" type="text" value=""></div>
                      </div>
                    </div>
                    <div class="entityfield entityfield-lastname type-text">
                      <div class="fieldwrapper "><label class="" for="fld-createform-0--Personlastname" data-trad="person.lastname">Nom<span class="requiredmark">*</span></label>
                        <div class="input-wrapper"><input id="fld-createform-0--Personlastname" name="lastname" placeholder="" class="bloc-lightborder" type="text" value=""></div>
                      </div>
                    </div>
                    <div class="entityfield entityfield-mail type-mail">
                      <div class="fieldwrapper "><label class="" for="fld-createform-0--Personmail" data-trad="person.mail">Email<span class="requiredmark">*</span></label>
                        <div class="input-wrapper"><input id="fld-createform-0--Personmail" name="mail" placeholder="" class="bloc-lightborder" type="mail" value=""></div>
                      </div>
                    </div>
                    <div class="entityfield entityfield-company type-text">
                      <div class="fieldwrapper "><label class="" for="fld-createform-0--Personcompany" data-trad="person.company">Société<span class="requiredmark">*</span></label>
                        <div class="input-wrapper"><input id="fld-createform-0--Personcompany" name="company" placeholder="" class="bloc-lightborder" type="text" value=""></div>
                      </div>
                    </div>
                    <div class="entityfield entityfield-jobTitle type-text">
                      <div class="fieldwrapper "><label class="" for="fld-createform-0--PersonjobTitle" data-trad="person.jobtitle">Poste<span class="requiredmark">*</span></label>
                        <div class="input-wrapper"><input id="fld-createform-0--PersonjobTitle" name="jobTitle" placeholder="" class="bloc-lightborder" type="text" value=""></div>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
            <div class="entityform-group group-0 depth-1">
              <div class="group-title"></div>
              <div class="collapsiblepanel group-content">
                <div class="collapsiblepanel-content">
                  <div class="fields">
                    <div class="entityfield entityfield-gdpropt-in type-checkbox">
                      <div class="fieldwrapper "><input id="fldd0d1922d-c6cc-4627-fac7-6c2b07cf3910" name="gdpropt-in" type="checkbox" checked=""><label class="forcheckbox" for="fldd0d1922d-c6cc-4627-fac7-6c2b07cf3910"
                          data-trad="person.gdpropt-in">J'accepte de recevoir les communications liées à l'événement</label>
                        <div class="htmlcontent-wrapper description">
                          <div class="htmlcontent">Pour finaliser votre inscription, merci d'accepter de recevoir les emails liés à l'événement (Informations pratiques, confirmation d'inscription, photos des soirées)</div>
                        </div>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

Je m'inscris
Accueil

Programme

Je m'inscris



INSCRIPTION




FORMULAIRE D'INSCRIPTION AUX SOIRÉES DÉPARTEMENTALES





Prénom*

Nom*

Email*

Société*

Poste*

J'accepte de recevoir les communications liées à l'événement
Pour finaliser votre inscription, merci d'accepter de recevoir les emails liés à
l'événement (Informations pratiques, confirmation d'inscription, photos des
soirées)
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POLITIQUE DE CONFIDENTIALITÉ




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