retechcon.com Open in urlscan Pro
43.225.55.240  Public Scan

Form analysis
2 forms found in the DOM

Name: contactForm — POST

<form method="post" id="contactForm" name="contactForm">
  <div class="row">
    <div class="col-md-6">
      <div class="form-group">
        <input type="text" name="first_name" class="form-control " placeholder="First Name" required="">
      </div>
    </div>
    <div class="col-md-6">
      <div class="form-group">
        <input type="text" name="last_name" class="form-control " placeholder="Last Name" required="">
      </div>
    </div>
  </div>
  <div class="form-group">
    <input type="tel" name="mobile" class="form-control " placeholder="Enter Mobile No." required="">
  </div>
  <div class="form-group">
    <input type="email" name="lgxemail" class="form-control " placeholder="Enter email" required="">
  </div>
  <div class="form-group">
    <input type="text" name="company" class="form-control " placeholder="Company Name" required="">
  </div>
  <div class="form-group">
    <input type="text" name="designation" class="form-control " placeholder="Designation" required="">
  </div>
  <div class="form-group">
    <input type="text" name="lgxsubject" class="form-control " placeholder="Subject" required="">
  </div>
  <div class="form-group">
    <textarea class="form-control " name="lgxmessage" rows="3" placeholder="We expect drop some line from you..." required=""></textarea>
  </div>
  <div class="form-group">
    <div class="row">
      <div class="col-lg-10">
        <input type="text" class="form-control" id="captcha" placeholder="Enter captcha" name="captcha">
      </div>
      <div class="col-lg-2">
        <img src="captcha.php">
      </div>
    </div>
  </div>
  <button type="button" id="btnsub" class="btn btn-default btn-lg btn-block" style="background-color:#5249b3;color:white;text-decoration:none;padding:10px;border:none;" onclick="submit_data()">Submit</button>
  <!--  <button type="submit" id="btn" class="btn btn-lg btn-block" value="Submit Now" style="background-color:#5249b3;color:white;text-decoration:none;padding:10px;border:none;">Submit Now</button>


                                 <button type="submit" name="submit" value="contact-form" class="lgx-btn hvr-glow hvr-radial-out lgxsend lgx-send"><span>Send Message</span></button> -->
</form>

Name: subForm — POST

<form class="lgx-subscribe-form" method="post" id="subForm" name="subForm">
  <div class="form-group form-group-email">
    <input type="email" name="email" placeholder="Enter your email Address  ..." class="form-control lgx-input-form form-control" required="">
  </div>
  <div class="form-group form-group-submit">
    <button type="submit" id="btn1" class="lgx-btn hvr-glow hvr-radial-out lgxsend lgx-send" value="Submit Now">Subscribe</button>
  </div>
</form>

Text Content

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For Partnership, Contact

Dr. Hitesh Bhatt, +91 9987343344, hitesh@rai.net.in


For Delegate Registration, Contact:

Avinash Chaudhary, 09833382232, avinash@rai.net.in




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