public.govdelivery.com Open in urlscan Pro
2001:18c8:17f:fc75:20:1:1:2  Public Scan

Form analysis
1 forms found in the DOM

POST /accounts/TXINSUR/subscriber/qualify

<form action="/accounts/TXINSUR/subscriber/qualify" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="authenticity_token"
    value="hcTqISq3WP+VZSv9cyREhmSi2WO65SP0/lVP0ltL5LNn8PbylBX8M7EomZp488B7IL/4EFuW/QI48m/27XVQHA==">
  <fieldset id="quick_subscribe_new">
    <legend>
      <h1> Set up your email or text messages </h1>
    </legend>
    <div id="quick_subscribe_new_instructions">
      <p>To sign up for messages or change your account, enter your contact information below.&nbsp;</p>
      <p><span style="font-size: 12.0pt; font-family: 'Segoe UI',sans-serif;">If you want email and text alerts, you will need to subscribe two times. Once with your email and again with your phone number. Choose email or text by clicking on the
          “Subscription type” dropdown.</span></p>
      <p><span style="font-size: 12.0pt; font-family: 'Segoe UI',sans-serif;">If you subscribe to text alerts, you’ll see only the topics that allow text alerts. If you subscribe to emails, you’ll see all topics.</span></p>
    </div>
    <ol class="form">
      <li>
        <label for="subscription_type">Subscription type</label>
        <div class="input_group">
          <select name="subscription_type" id="subscription_type">
            <option value="email">Email</option>
            <option value="phone">SMS/Text Message</option>
          </select>
        </div>
      </li>
      <li class="wireless_fields" style="display: none">
        <label for="phone"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Wireless number</label>
        <div class="input_group">
          <select name="country_code_display" id="country_code_display" disabled="disabled" aria-label="Country code">
            <option value="1 (US)">1 (US)</option>
            <option value="1">1</option>
          </select>
          <input type="hidden" name="country_code" id="country_code" value="1" title="Country code">
          <input type="tel" name="phone" id="phone" value="" class="medium wireless_text_field" title="Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123"
            oninvalid="setCustomValidity('Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123')" pattern="[0-9]{10}"
            oninput="if (validity.patternMismatch) { setCustomValidity('Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123'); } else { setCustomValidity(''); }" disabled="disabled">
        </div>
      </li>
      <li class="email_fields" style="display: block">
        <label for="email"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Email address</label>
        <input type="email" name="email" id="email" value="" class="long email_text_field" aria-describedby="errorExplanation" required="required">
      </li>
    </ol>
    <span aria-hidden="aria-hidden" style="display: none">
      <label for="name"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Name</label>
      <input type="text" name="name" id="name" value="" aria-disabled="true" autocomplete="off">
    </span>
    <div class="button_panel">
      <input type="submit" name="commit" value="Submit" data-disable-with="Submit"><input type="button" value="Cancel" class="cancel_button">
    </div>
  </fieldset>
</form>

Text Content

We only use cookies that are necessary for this site to function to provide you
with the best experience. The controller of this site may choose to place
supplementary cookies to support additional functionality such as support
analytics, and has an obligation to disclose these cookies. Learn more in our
Cookie Statement.


SET UP YOUR EMAIL OR TEXT MESSAGES

To sign up for messages or change your account, enter your contact information
below. 

If you want email and text alerts, you will need to subscribe two times. Once
with your email and again with your phone number. Choose email or text by
clicking on the “Subscription type” dropdown.

If you subscribe to text alerts, you’ll see only the topics that allow text
alerts. If you subscribe to emails, you’ll see all topics.

 1. Subscription type
    Email SMS/Text Message
 2. Wireless number
    1 (US) 1
 3. Email address

Name


Your contact information is used to deliver requested updates or to access your
subscriber preferences.

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