intake.utmspace.edu.my Open in urlscan Pro
210.19.157.141  Public Scan

Form analysis
1 forms found in the DOM

POST https://intake.utmspace.edu.my/signup

<form method="post" action="https://intake.utmspace.edu.my/signup">
  <input type="hidden" name="_token" value="mv2KwR89T7UDwF3V3GZHN9jHqzO9nH2imKWfJMgJ">
  <div class="form-group ">
    <label for="name"> Name </label>
    <input type="text" class="form-control" id="name" name="name" placeholder="" value="">
  </div>
  <div class="form-group ">
    <label for="email"> Email </label>
    <input type="email" class="form-control" id="email" name="email" placeholder="" value="">
  </div>
  <div class="form-group ">
    <label for="ic_no"> IC or Passport Number </label>
    <input type="text" class="form-control" id="ic_no" name="ic_no" placeholder="Example: 900402015149" value="">
    <small class="form-text text-muted">Your IC or Passport number will be your default password.</small>
  </div>
  <div class="form-group ">
    <label for="correspondence_phone"> Phone </label>
    <input type="text" class="form-control" id="correspondence_phone" name="correspondence_phone" placeholder="Example: 0161231234" value="">
  </div>
  <button type="submit" class="btn btn-secondary btn-block mb-2 text-uppercase"> Next → </button>
</form>

Text Content

 * Create an Account
 * Login

Please create an account to apply.

Name
Email
IC or Passport Number Your IC or Passport number will be your default password.
Phone
Next →
For further assistance please contact us at
+60197252856/ 0197348856/ 0197192667/0195724110 (Working operating hours: SUNDAY
: 8:00 am – 3:30 pm MON – THUR : 8:00 am – 5:00 pm)
or email us at:
ambilan@utmspace.edu.my