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URL:
https://www.govapplicationccm.org/
Submission: On December 15 via api from US — Scanned from US
Submission: On December 15 via api from US — Scanned from US
Form analysis 2 forms found in the DOM
Name: New Form — POST
<form class="elementor-form" method="post" name="New Form">
<input type="hidden" name="post_id" value="10364">
<input type="hidden" name="form_id" value="9827f93">
<input type="hidden" name="referer_title" value="Central Core Media – Home Savings – Lander">
<input type="hidden" name="queried_id" value="10364">
<div class="elementor-form-fields-wrapper elementor-labels-">
<div class="elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-message elementor-col-100 elementor-field-required">
<label for="form-field-message" class="elementor-field-label elementor-screen-only"> Phone Number </label>
<input size="1" type="tel" name="form_fields[message]" id="form-field-message" class="elementor-field elementor-size-md elementor-field-textual" placeholder="Phone Number" required="required" aria-required="true" pattern="[0-9()#&+*-=.]+"
title="Only numbers and phone characters (#, -, *, etc) are accepted.">
</div>
<div class="elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_fe062b5 elementor-col-100">
<div class="elementor-field-subgroup "><span class="elementor-field-option"><input type="checkbox" value="I would like to receive SMS and MMS 2-5 messages per week." id="form-field-field_fe062b5-0" name="form_fields[field_fe062b5]"> <label
for="form-field-field_fe062b5-0">I would like to receive SMS and MMS 2-5 messages per week.</label></span></div>
</div>
<div class="elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_40acc79 elementor-col-100 elementor-field-required">
<div class="elementor-field-subgroup">
<span class="elementor-field-option">
<input type="checkbox" name="form_fields[field_40acc79]" id="form-field-field_40acc79" class="elementor-field elementor-size-md elementor-acceptance-field" required="required" aria-required="true">
<label for="form-field-field_40acc79">I have read and agreed to Privacy Policy and Terms and Conditions.</label> </span>
</div>
</div>
<div class="elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons">
<button type="submit" class="elementor-button elementor-size-md elementor-animation-pulse-shrink">
<span>
<span class="elementor-align-icon-right elementor-button-icon">
<i aria-hidden="true" class="fas fa-arrow-circle-right"></i> </span>
<span class="elementor-button-text">CONFIRM</span>
</span>
</button>
</div>
</div>
</form>Name: New Form — POST
<form class="elementor-form" method="post" name="New Form">
<input type="hidden" name="post_id" value="10364">
<input type="hidden" name="form_id" value="ea7b385">
<input type="hidden" name="referer_title" value="Central Core Media – Home Savings – Lander">
<input type="hidden" name="queried_id" value="10364">
<div class="elementor-form-fields-wrapper elementor-labels-">
<div class="elementor-field-type-tel elementor-field-group elementor-column elementor-field-group-message elementor-col-100 elementor-field-required">
<label for="form-field-message" class="elementor-field-label elementor-screen-only"> Phone Number </label>
<input size="1" type="tel" name="form_fields[message]" id="form-field-message" class="elementor-field elementor-size-md elementor-field-textual" placeholder="Phone Number" required="required" aria-required="true" pattern="[0-9()#&+*-=.]+"
title="Only numbers and phone characters (#, -, *, etc) are accepted.">
</div>
<div class="elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-field_fe062b5 elementor-col-100">
<div class="elementor-field-subgroup "><span class="elementor-field-option"><input type="checkbox" value="I would like to receive SMS and MMS 2-5 messages per week." id="form-field-field_fe062b5-0" name="form_fields[field_fe062b5]"> <label
for="form-field-field_fe062b5-0">I would like to receive SMS and MMS 2-5 messages per week.</label></span></div>
</div>
<div class="elementor-field-type-acceptance elementor-field-group elementor-column elementor-field-group-field_40acc79 elementor-col-100 elementor-field-required">
<div class="elementor-field-subgroup">
<span class="elementor-field-option">
<input type="checkbox" name="form_fields[field_40acc79]" id="form-field-field_40acc79" class="elementor-field elementor-size-md elementor-acceptance-field" required="required" aria-required="true">
<label for="form-field-field_40acc79">I have read and agreed to Privacy Policy and Terms and Conditions.</label> </span>
</div>
</div>
<div class="elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons">
<button type="submit" class="elementor-button elementor-size-md elementor-animation-pulse-shrink">
<span>
<span class="elementor-align-icon-right elementor-button-icon">
<i aria-hidden="true" class="fas fa-arrow-circle-right"></i> </span>
<span class="elementor-button-text">CONFIRM</span>
</span>
</button>
</div>
</div>
</form>Text Content
Book Your Consultation and Save Smart! CONFIRM YOUR PHONE NUMBER TO START YOUR PEACE OF MIND Phone Number I would like to receive SMS and MMS 2-5 messages per week. I have read and agreed to Privacy Policy and Terms and Conditions. CONFIRM By clicking “CONFIRM”, you electronically consent, acknowledge, and agree to Central Core Media‘s Terms of Use Agreement and Privacy Policy. We take your privacy seriously and commit that information gathered in the SMS campaign will not be shared with Third Parties or Affiliates for Marketing Purposes. By providing your consent, you are enrolling in Central Core Media’s Home Savings Alerts. Subscription to these alerts is not required to create your account, but you will receive important notices and other communications electronically. You are providing express written consent to be contacted (including through automated means; e.g., autodialing, text, and pre-recorded messaging) via telephone, mobile device (including SMS and MMS with a frequency of 2-5 messages per week), and/or email, even if your telephone number is currently listed on any internal, corporate, state, federal, or national Do-Not-Call (DNC) list or even if you are charged for the call. You can revoke this consent at any time by replying STOP to any text message received. For assistance, text HELP or call (1) 720-548-3292. Msg & data rates may apply. 1942 BROADWAY ST. STE 314C, BOULDER CO Terms of service & Privacy Policy Copyright 2023 © Central Core Media BOOK YOUR CONSULTATION AND SAVE SMART! CONFIRM YOUR PHONE NUMBER TO START YOUR PEACE OF MIND! Phone Number I would like to receive SMS and MMS 2-5 messages per week. I have read and agreed to Privacy Policy and Terms and Conditions. CONFIRM By clicking “CONFIRM”, you electronically consent, acknowledge, and agree to Central Core Media‘s Terms of Use Agreement and Privacy Policy. We take your privacy seriously and commit that information gathered in the SMS campaign will not be shared with Third Parties or Affiliates for Marketing Purposes. By providing your consent, you are enrolling in Central Core Media’s Home Savings Alerts. Subscription to these alerts is not required to create your account, but you will receive important notices and other communications electronically. You are providing express written consent to be contacted (including through automated means; e.g., autodialing, text, and pre-recorded messaging) via telephone, mobile device (including SMS and MMS with a frequency of 2-5 messages per week), and/or email, even if your telephone number is currently listed on any internal, corporate, state, federal, or national Do-Not-Call (DNC) list or even if you are charged for the call. You can revoke this consent at any time by replying STOP to any text message received. For assistance, text HELP or call (1) 720-548-3292. Msg & data rates may apply. 1942 Broadway St. STE 314C, Boulder CO Terms of service & Privacy Policy Copyright 2023 © Central Core Media