18.consumertestconnect.com Open in urlscan Pro
3.220.195.66  Public Scan

Submitted URL: http://bynobot.com/sl/42k6o
Effective URL: https://18.consumertestconnect.com/star-bucks
Submission: On November 19 via manual from TR — Scanned from US

Form analysis 1 forms found in the DOM

POST /flow?uid=db52a580-90e8-4b4c-9cb6-dd3b184dd7f5

<form id="formSubmit" action="/flow?uid=db52a580-90e8-4b4c-9cb6-dd3b184dd7f5" method="POST" data-effect="" data-effect-duration="">
  <div id="f1" class="dynamic-form form-step form1 form1-1">
    <div class="row row-spacing" data-row-id="1">
      <div id="col-field-email" class="col e-mail form-field-col" data-col-id="1" data-autohide="">
        <label class="label">E-mail</label>
        <input id="email" list="email_domains" type="email" name="email" class="path-form-field-with-feedback path-dynamic-field required" title="Email" data-session-verification="-1" value="">
        <span id="emailmessage" class="invalid-feedback hidden path-form-feedback"></span>
        <datalist id="email_domains"></datalist>
        <script>
          document.querySelector('#email').addEventListener('path-dynamic-field-register', function(evt) {
            var domains = ["gmail.com", "yahoo.com", "hotmail.com", "aol.com", "hotmail.co.uk", "hotmail.fr", "msn.com", "yahoo.fr", "wanadoo.fr", "orange.fr", "comcast.net", "yahoo.co.uk", "yahoo.co.in", "live.com", "rediffmail.com", "free.fr",
              "gmx.de", "web.de", "yandex.ru", "ymail.com", "libero.it", "outlook.com", "uol.com", "bol.com", "mail.ru", "cox.net", "hotmail.it", "sbcglobal.net", "sfr.fr", "live.fr", "verizon.net", "live.co.uk", "googlemail.com", "yahoo.es",
              "ig.com", "live.nl", "bigpond.com", "terra.com", "yahoo.it", "neuf.fr", "yahoo.de", "alice.it", "rocketmail.com", "att.net", "laposte.net", "facebook.com", "bellsouth.net", "yahoo.in", "hotmail.es", "charter.net", "yahoo.ca",
              "yahoo.com.au", "rambler.ru", "hotmail.de", "tiscali.it", "shaw.ca", "yahoo.co.jp", "sky.com"
            ]
            var feedbackElem = document.querySelector('#emailmessage')
            var emailDomains = document.querySelector('#email_domains')
            var elem = this
            evt.detail.overrideOnChangeListener(function() {
              elem.addEventListener('input', evt.detail.listener(function(evt, setValue) {
                var value = evt.target.value
                setValue(value)
                var split = value.split('@')
                var username = split[0]
                var domain = split[1]
                var regex = domain && new RegExp('@' + domain)
                emailDomains.innerHTML = ''
                domains.forEach(function(domain) {
                  if (regex && regex.test('@' + domain) && username + '@' + domain !== value) {
                    var option = emailDomains.appendChild(document.createElement('option'))
                    option.setAttribute('value', username + '@' + domain)
                  }
                })
              }))
            })
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('test')
            evt.detail.assignToState('email', evt.detail.effects.test)
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="2">
      <div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
        <div id="path-field-html-1-2-1" class="path-dynamic-field">
          <input type="hidden" id="cf_hbf" name="cf_hbf" value="">
        </div>
        <script>
          document.querySelector('#path-field-html-1-2-1').addEventListener('path-dynamic-field-register', function(evt) {
            var elem = this
            elem.fieldContent = elem.innerHTML
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillMergetagsHTML(elem)
                },
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="3">
      <div id="col-field-twyne_registration" class="col twyne-registration form-field-col" data-col-id="1" data-autohide="">
        <div class="form-row">
          <div id="sploffrs" class="x-12 sploffrs">
            <script type="text/javascript" src="https://shopgala.api.twyne.io/assets/form.js"></script>
            <script type="text/javascript" id="twyne-embed" class="twyne-embed">
              (function(global) {
                function twyne_load() {
                  var data = {};
                  data.pid = '6';
                  data.sid = '27';
                  data.first = '';
                  data.last = '';
                  data.email = '';
                  data.address1 = '';
                  data.address2 = '';
                  data.city = '';
                  data.gender = '';
                  data.state = '';
                  data.zip = '';
                  data.phone = '';
                  data.dob = '//';
                  data.istest = 'n';
                  data.externalgroup = 'Q_lBY-ByH8bEZ-wu-C03';
                  data.country = 'US';
                  data.subid1 = '1088';
                  data.subid2 = '161410';
                  data.loading = {
                    enabled: false
                  };
                  data.embedUrlOverride = 'https://shopgala.api.twyne.io/';
                  data.formRegistration = {
                    binders: {
                      'first': 'first_name',
                      'last': 'last_name',
                      'email': 'email',
                      'address1': 'addressform',
                      'address2': 'address2',
                      'city': 'city',
                      'gender': 'gender',
                      'state': 'state',
                      'zip': 'zip',
                      'phone': 'phone'
                    },
                    customFields: ['dob'],
                    optionalFields: ['address2'],
                    percent: 0
                  }
                  global.twyne.initEmbed(data);
                }
                document.addEventListener("DOMContentLoaded", twyne_load);
              })(this);
            </script>
            <script async="" type="text/javascript"
              src="https://shopgala.api.twyne.io//aserving/index?pid=6&amp;sid=27&amp;first=&amp;last=&amp;email=&amp;address1=&amp;address2=&amp;city=&amp;gender=&amp;state=&amp;zip=&amp;phone=&amp;dob=%2F%2F&amp;istest=n&amp;externalgroup=Q_lBY-ByH8bEZ-wu-C03&amp;country=US&amp;subid1=1088&amp;subid2=161410&amp;twid=27d15dfd1cd942ffba6809c8c7642636&amp;domainUrl=https%3A%2F%2F18.consumertestconnect.com%2Fstar-bucks&amp;browserLanguages=en-US,en&amp;optout=false">
            </script>
            <div id="twy-placement-627" class="twyne-path-content"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="4">
      <div id="col-field-registration_consent" class="col registration-consent form-field-col" data-col-id="1" data-autohide="false">
        <div class="terms termschk">
          <input type="checkbox" class="chkbox path-dynamic-field" id="chkterms" name="chkterms" checked="" value="on">
          <label class="term-label terms-label--checkbox" for="chkterms"> By checking the box, I agree that I am a US resident over the age of 18 and agree to the <a href="/terms-conditions" target="_blank">Terms of Use</a> and
            <a href="/privacy-policy" target="_blank">Privacy Policy</a>, and site visit recordation by TrustedForm and Jornaya, I agree to 3rd party marketing from GreenDot Bank. I also agree to receive email from ConsumerTestConnect and affiliated
            brands that may be of interest. </label>
          <script>
            document.querySelector('#chkterms').addEventListener('path-dynamic-field-register', function(evt) {
              var elem = this
              evt.detail.assignToState('registrationConsent', function(value) {
                elem.dispatchEvent(new CustomEvent('path-event-registration-consent-changed'))
                return elem.checked
              })
            })
          </script>
        </div>
      </div>
    </div>
  </div>
  <div id="f2" class="dynamic-form form-step form2 form1-2 hidden">
    <div class="row row-spacing" data-row-id="1">
      <div id="col-field-title" class="col title form-field-col" data-col-id="1" data-autohide="">
        <label class="label">Title</label>
        <select id="gender" data-type="title" name="gender" title="Title" class="path-form-field-with-feedback required path-dynamic-field">
          <option value=""> Select Title </option>
          <option value="M">Mr.</option>
          <option value="F">Ms.</option>
          <option value="F">Mrs.</option>
        </select>
        <span id="gender-title-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#gender[data-type=title]').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#gender-title-error-feedback')
            var elem = this
            evt.detail.assignToState('gender')
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  populate_options: renders.fillSelectOptions(elem, `
                    Select Title
              `),
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="2">
      <div id="col-field-first_name" class="col first-name form-field-col" data-col-id="1" data-autohide="">
        <label class="label">First Name</label>
        <input id="first_name" type="text" name="first_name" class="path-form-field-with-feedback path-dynamic-field required" title="First Name" value="">
        <span id="first_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#first_name').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#first_name-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('first_name')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
      <div id="col-field-last_name" class="col last-name form-field-col" data-col-id="2" data-autohide="">
        <label class="label">Last Name</label>
        <input id="last_name" type="text" name="last_name" class="path-form-field-with-feedback path-dynamic-field required" title="Last Name" value="">
        <span id="last_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#last_name').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#last_name-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('last_name')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="3">
      <div id="col-field-address1" class="col-8 address-1 form-field-col" data-col-id="1" data-autohide="">
        <label class="label">Street Address</label>
        <input id="addressform" type="text" name="addressform" title="Address" value="" class="path-dynamic-field path-form-field-with-feedback required" autocomplete="address-line1">
        <span id="address1-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-postal"></span>
        <input id="address1" type="hidden" name="address1" title="Address" value="">
        <script>
          document.querySelector('#addressform').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#address1-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('address1')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
      <div id="col-field-address2" class="col address-2 form-field-col" data-col-id="2" data-autohide="">
        <label class="label">Suite</label>
        <input id="address2" type="text" name="address2" value="" class="path-form-field-with-feedback path-dynamic-field " autocomplete="address-line2">
        <span id="address2-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#address2').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#address2-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('address2')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="4">
      <div id="col-field-city" class="col city form-field-col" data-col-id="1" data-autohide="">
        <label class="label">City</label>
        <input id="city" type="text" name="city" title="City" value="" class="path-form-field-with-feedback path-dynamic-field required" autocomplete="address-level2">
        <span id="city-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#city').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#city-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('city')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="5">
      <div id="col-field-state" class="col-7 state form-field-col" data-col-id="1" data-autohide="">
        <label class="label">State</label>
        <select id="state" name="state" title="State" class="path-form-field-with-feedback path-dynamic-field required" value="" datavalue="">
          <option value=""> Select State </option>
          <option value="AL">Alabama</option>
          <option value="AK">Alaska</option>
          <option value="AZ">Arizona</option>
          <option value="AR">Arkansas</option>
          <option value="CA">California</option>
          <option value="CO">Colorado</option>
          <option value="CT">Connecticut</option>
          <option value="DE">Delaware</option>
          <option value="DC">District Of Columbia</option>
          <option value="FL">Florida</option>
          <option value="GA">Georgia</option>
          <option value="HI">Hawaii</option>
          <option value="ID">Idaho</option>
          <option value="IL">Illinois</option>
          <option value="IN">Indiana</option>
          <option value="IA">Iowa</option>
          <option value="KS">Kansas</option>
          <option value="KY">Kentucky</option>
          <option value="LA">Louisiana</option>
          <option value="ME">Maine</option>
          <option value="MD">Maryland</option>
          <option value="MA">Massachusetts</option>
          <option value="MI">Michigan</option>
          <option value="MN">Minnesota</option>
          <option value="MS">Mississippi</option>
          <option value="MO">Missouri</option>
          <option value="MT">Montana</option>
          <option value="NE">Nebraska</option>
          <option value="NV">Nevada</option>
          <option value="NH">New Hampshire</option>
          <option value="NJ">New Jersey</option>
          <option value="NM">New Mexico</option>
          <option value="NY">New York</option>
          <option value="NC">North Carolina</option>
          <option value="ND">North Dakota</option>
          <option value="OH">Ohio</option>
          <option value="OK">Oklahoma</option>
          <option value="OR">Oregon</option>
          <option value="PA">Pennsylvania</option>
          <option value="RI">Rhode Island</option>
          <option value="SC">South Carolina</option>
          <option value="SD">South Dakota</option>
          <option value="TN">Tennessee</option>
          <option value="TX">Texas</option>
          <option value="UT">Utah</option>
          <option value="VT">Vermont</option>
          <option value="VA">Virginia</option>
          <option value="WA">Washington</option>
          <option value="WV">West Virginia</option>
          <option value="WI">Wisconsin</option>
          <option value="WY">Wyoming</option>
        </select>
        <span id="state-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#state').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#state-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('state')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  populate_options: renders.fillSelectOptions(elem, `
                Select State
          `),
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
      <div id="col-field-zip" class="col zip-code form-field-col" data-col-id="2" data-autohide="">
        <label class="label">Zip Code</label>
        <input id="zip" type="text" name="zip" title="Zipcode" maxlength="5" data-session-verification="-1" value="" class="path-form-field-with-feedback required path-dynamic-field" pattern="[0-9]*" inputmode="numeric" autocomplete="postal-code">
        <span id="zip-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          document.querySelector('#zip').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#zip-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('zip')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillZip(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
            $(elem).change()
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="6">
      <div id="col-field-phone" class="col phone form-field-col" data-col-id="1" data-autohide="">
        <label class="label">Phone</label>
        <input id="phone" type="tel" name="phone" title="Phone" data-session-verification="-1" value="" class="path-dynamic-field path-form-field-with-feedback required" pattern="[0-9]*" inputmode="numeric" autocomplete="tel-national">
        <span id="phone-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-phone"></span>
        <script>
          document.querySelector('#phone').addEventListener('path-dynamic-field-register', function(evt) {
            var feedbackElem = document.querySelector('#phone-error-feedback')
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('phone')
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  prepopulate_with: renders.fillInputPhone(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="7">
      <div id="col-field-dob" class="col date-of-birth form-field-col" data-col-id="1" data-autohide="">
        <label class="label">Date of Birth</label>
        <div class="row path-form-field-with-feedback-control">
          <div class="col">
            <select id="dob_month" name="dob_month" title="Dob Month" autocomplete="bday-month" class="path-dynamic-field required">
              <option value=""> Month </option>
              <option value="01">Jan</option>
              <option value="02">Feb</option>
              <option value="03">Mar</option>
              <option value="04">Apr</option>
              <option value="05">May</option>
              <option value="06">Jun</option>
              <option value="07">Jul</option>
              <option value="08">Aug</option>
              <option value="09">Sep</option>
              <option value="10">Oct</option>
              <option value="11">Nov</option>
              <option value="12">Dec</option>
            </select>
          </div>
          <div class="col">
            <select id="dob_day" name="dob_day" title="Dob Day" autocomplete="bday-day" class="path-dynamic-field required">
              <option value=""> Day </option>
              <option value="01">01</option>
              <option value="02">02</option>
              <option value="03">03</option>
              <option value="04">04</option>
              <option value="05">05</option>
              <option value="06">06</option>
              <option value="07">07</option>
              <option value="08">08</option>
              <option value="09">09</option>
              <option value="10">10</option>
              <option value="11">11</option>
              <option value="12">12</option>
              <option value="13">13</option>
              <option value="14">14</option>
              <option value="15">15</option>
              <option value="16">16</option>
              <option value="17">17</option>
              <option value="18">18</option>
              <option value="19">19</option>
              <option value="20">20</option>
              <option value="21">21</option>
              <option value="22">22</option>
              <option value="23">23</option>
              <option value="24">24</option>
              <option value="25">25</option>
              <option value="26">26</option>
              <option value="27">27</option>
              <option value="28">28</option>
              <option value="29">29</option>
              <option value="30">30</option>
              <option value="31">31</option>
            </select>
          </div>
          <div class="col">
            <select id="dob_year" name="dob_year" title="Dob Year" autocomplete="bday-year" class="path-dynamic-field required">
              <option value=""> Year </option>
              <option value="2006">2006</option>
              <option value="2005">2005</option>
              <option value="2004">2004</option>
              <option value="2003">2003</option>
              <option value="2002">2002</option>
              <option value="2001">2001</option>
              <option value="2000">2000</option>
              <option value="1999">1999</option>
              <option value="1998">1998</option>
              <option value="1997">1997</option>
              <option value="1996">1996</option>
              <option value="1995">1995</option>
              <option value="1994">1994</option>
              <option value="1993">1993</option>
              <option value="1992">1992</option>
              <option value="1991">1991</option>
              <option value="1990">1990</option>
              <option value="1989">1989</option>
              <option value="1988">1988</option>
              <option value="1987">1987</option>
              <option value="1986">1986</option>
              <option value="1985">1985</option>
              <option value="1984">1984</option>
              <option value="1983">1983</option>
              <option value="1982">1982</option>
              <option value="1981">1981</option>
              <option value="1980">1980</option>
              <option value="1979">1979</option>
              <option value="1978">1978</option>
              <option value="1977">1977</option>
              <option value="1976">1976</option>
              <option value="1975">1975</option>
              <option value="1974">1974</option>
              <option value="1973">1973</option>
              <option value="1972">1972</option>
              <option value="1971">1971</option>
              <option value="1970">1970</option>
              <option value="1969">1969</option>
              <option value="1968">1968</option>
              <option value="1967">1967</option>
              <option value="1966">1966</option>
              <option value="1965">1965</option>
              <option value="1964">1964</option>
              <option value="1963">1963</option>
              <option value="1962">1962</option>
              <option value="1961">1961</option>
              <option value="1960">1960</option>
              <option value="1959">1959</option>
              <option value="1958">1958</option>
              <option value="1957">1957</option>
              <option value="1956">1956</option>
              <option value="1955">1955</option>
              <option value="1954">1954</option>
              <option value="1953">1953</option>
              <option value="1952">1952</option>
              <option value="1951">1951</option>
              <option value="1950">1950</option>
              <option value="1949">1949</option>
              <option value="1948">1948</option>
              <option value="1947">1947</option>
              <option value="1946">1946</option>
              <option value="1945">1945</option>
              <option value="1944">1944</option>
              <option value="1943">1943</option>
              <option value="1942">1942</option>
              <option value="1941">1941</option>
              <option value="1940">1940</option>
              <option value="1939">1939</option>
              <option value="1938">1938</option>
              <option value="1937">1937</option>
              <option value="1936">1936</option>
              <option value="1935">1935</option>
              <option value="1934">1934</option>
              <option value="1933">1933</option>
              <option value="1932">1932</option>
              <option value="1931">1931</option>
              <option value="1930">1930</option>
              <option value="1929">1929</option>
              <option value="1928">1928</option>
              <option value="1927">1927</option>
              <option value="1926">1926</option>
              <option value="1925">1925</option>
              <option value="1924">1924</option>
            </select>
          </div>
        </div>
        <span id="dobmessage" class="invalid-feedback hidden path-form-feedback"></span>
        <script>
          var feedbackElem = document.querySelector('#dobmessage')
          document.querySelector('#dob_day').addEventListener('path-dynamic-field-register', function(evt) {
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('dob_day', evt.detail.effects.age)
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  populate_options: renders.fillSelectOptions(elem, `
                Day
          `),
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
          document.querySelector('#dob_year').addEventListener('path-dynamic-field-register', function(evt) {
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('age')
            evt.detail.assignToState('dob_year', evt.detail.effects.age)
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  populate_options: renders.fillSelectOptions(elem, `
                Year
          `),
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
          document.querySelector('#dob_month').addEventListener('path-dynamic-field-register', function(evt) {
            var elem = this
            evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
            evt.detail.assignToState('dob_month', evt.detail.effects.age)
            evt.detail.render(function(renders) {
              return {
                hide: renders.hideParentFieldForm(elem),
                show: renders.hideParentFieldForm(elem, false),
                populate: {
                  populate_options: renders.fillSelectOptions(elem, `
                Month
          `),
                  prepopulate_with: renders.fillInput(elem)
                },
                validation: renders.fillFeedbackMessage(feedbackElem)
              }
            })
          })
        </script>
      </div>
    </div>
    <div class="row row-spacing" data-row-id="8">
      <div id="col-field-tcpa_consent" class="col tcpa-consent form-field-col" data-col-id="1" data-autohide="">
        <div class="tcpa-terms">
          <input type="checkbox" class="chkbox path-dynamic-field " "="" id=" leadid_tcpa_disclosure" name="chktcpa">
          <label class="term-label" for="leadid_tcpa_disclosure"> By checking the box, I consent to receive phone sales calls or SMS text messages - Msg and data rates may apply - from Surveys2Cash, LegalFinderHQ, PLM, Consumer Concierge, Financial
            Relief Center, Biologistics, DH Insurance Group, Gotham Healthcare, Public iQ, Your Savings Advisor, GoQuote, Karma Financial Group, and Mass Nexus LLC on the landline or mobile number I provided even if I am on the federal or state do
            not call registry. I understand these calls and SMS text messages may be generated using an autodialer and that consenting is not required to participate in the offers promoted. I understand that I may revoke consent at any time. Text
            STOP to opt out and HELP to receive help. </label>
          <script>
            document.querySelector('#leadid_tcpa_disclosure').addEventListener('path-dynamic-field-register', function(evt) {
              var elem = this
              evt.detail.assignToState('tcpaConsent', function(value) {
                return elem.checked
              })
              evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
              evt.detail.render(function(renders) {
                return {
                  validation: renders.overrideTcpaConsentAlertText
                }
              })
            })
          </script>
        </div>
      </div>
    </div>
  </div>
  <div class="form-row">
    <div class="x-12 col-mobile center">
      <button class="btn form-button submitbutton form-submit-button" type="button" id="submitbutton">
        <span>CONTINUE</span>
        <i class="fa fa-spinner fa-spin"></i>
      </button>
    </div>
  </div>
  <div class="hidden">
    <input type="hidden" id="numForms" name="numForms" value="2">
    <input type="hidden" id="tcpaStep" name="tcpaStep" value="2">
    <input type="hidden" id="registrationStep" name="registrationStep" value="1">
    <input type="hidden" id="currentForm" name="currentForm" value="1">
    <input type="hidden" id="uid" name="uid" value="db52a580-90e8-4b4c-9cb6-dd3b184dd7f5">
    <input type="hidden" id="tcpaconsent" name="tcpaconsent" value="">
    <input type="hidden" id="consent" name="consent" value="">
    <input type="hidden" id="pathAid" name="pathAid" value="9682">
    <input type="hidden" id="pathPid" name="pathPid" value="1088">
    <input type="hidden" id="pathSid1" name="pathSid1" value="161410">
    <input type="hidden" id="registrationCheck" name="registrationCheck" value="false">
    <input type="hidden" id="addressCheck" name="addressCheck" value="false">
    <input type="hidden" id="fraudCheck" name="fraudCheck" value="true">
    <input type="hidden" id="emailValid" name="emailValid" value="false">
    <input type="hidden" id="addressValid" name="addressValid" value="false">
    <input type="hidden" name="origin" value="submit">
    <input type="hidden" id="haddress1" value="">
    <input type="hidden" id="haddress2" value="">
    <input type="hidden" id="hcity" value="">
    <input type="hidden" id="hstate" value="">
    <input type="hidden" id="hzipcode" value="">
    <div id="pixel"></div>
    <script type="text/javascript">
      (function() {
        var field = 'xxTrustedFormCertUrl';
        var provideReferrer = false;
        var invertFieldSensitivity = false;
        var tf = document.createElement('script');
        tf.type = 'text/javascript';
        tf.async = true;
        tf.src = 'http' + ('https:' == document.location.protocol ? 's' : '') + '://api.trustedform.com/trustedform.js?field=' + escape(field) + '&l=' + new Date().getTime() + Math.random() + '&invert_field_sensitivity=' + invertFieldSensitivity;
        var s = document.getElementsByTagName('script')[0];
        s.parentNode.insertBefore(tf, s);
      })();
    </script>
    <noscript>
      <img src="//api.trustedform.com/ns.gif">
    </noscript>
    <input id="leadid_token" name="universal_leadid" type="hidden" value="61F4A39A-B338-C9AC-788B-7C715A11BD76">
  </div>
  <input type="hidden" name="xxTrustedFormCertUrl" value="https://cert.trustedform.com/c194e5f0f5cccb9c00cd911cd12f0ccf061624de" id="xxTrustedFormCertUrl_0"><input type="hidden" name="xxTrustedFormToken"
    value="https://cert.trustedform.com/c194e5f0f5cccb9c00cd911cd12f0ccf061624de" id="xxTrustedFormToken_0"><input type="hidden" name="xxTrustedFormPingUrl"
    value="https://ping.trustedform.com/0.hy2AaFt4ob644s-66Nf9F3Sb4wb4Fc5HQSyw2uEVUQYBSxbDojfHnytnGShCqUR0eJAb1rc.ctwg0hfNaWPYotHpYGDt1w.oY4ozsoLMm67s5bxF3CNfw" id="xxTrustedFormPingUrl_0">
</form>

Text Content

$100 STARBUCKS


Value $100
MIN Entries 5,000
Nº Winners 1
EXP Date 11/30/2024
Contest Rules
E-mail


By checking the box, I agree that I am a US resident over the age of 18 and
agree to the Terms of Use and Privacy Policy, and site visit recordation by
TrustedForm and Jornaya, I agree to 3rd party marketing from GreenDot Bank. I
also agree to receive email from ConsumerTestConnect and affiliated brands that
may be of interest.
Title Select Title Mr. Ms. Mrs.
First Name
Last Name
Street Address
Suite
City
State Select State Alabama Alaska Arizona Arkansas California Colorado
Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois
Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan
Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey
New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon
Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah
Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code
Phone
Date of Birth
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
26 27 28 29 30 31
Year
20062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924
By checking the box, I consent to receive phone sales calls or SMS text messages
- Msg and data rates may apply - from Surveys2Cash, LegalFinderHQ, PLM, Consumer
Concierge, Financial Relief Center, Biologistics, DH Insurance Group, Gotham
Healthcare, Public iQ, Your Savings Advisor, GoQuote, Karma Financial Group, and
Mass Nexus LLC on the landline or mobile number I provided even if I am on the
federal or state do not call registry. I understand these calls and SMS text
messages may be generated using an autodialer and that consenting is not
required to participate in the offers promoted. I understand that I may revoke
consent at any time. Text STOP to opt out and HELP to receive help.
CONTINUE





HOW IT WORKS


REGISTER FOR A
MONTHLY CONTEST

Your are now registered for
the contest. No other action
is required.


COMPLETE OPTIONAL
SPONSORED QUESTIONNAIRE

Some of these questions may
be sponsored by our advertising
partners.


VIEW AND RECEIVE
SPECIALIZED OFFERS

If an offer interest you great! If
not, simply pass on it. This helps
keep the site free.


WE'LL CONTACT WINNERS VIA EMAIL: FULFILLMENT@CONSUMERTESTCONNECT.COM

Minimum number of entries
are required for contest to be drawn.
Make sure to respond to the above email.

 * Privacy Policy
 * Terms & Conditions
 * Contest Rules
 * Unsubscribe
 * CA Consumers:
 * Privacy Policy
 * Do not sell my information

Copyright © 2018 - 2022, All Rights Reserved.

--------------------------------------------------------------------------------

Welcome to ConsumerTestConnect (collectively “ConsumerTestConnect”), an
ad-supported/lead generation web property of prizes and promotions. By entering
your email address and clicking "Continue", you agree to receive information in
electronic (including email) or physical formats from ConsumerTestConnect and/or
trusted third parties containing promotions and other special Offers and that
ConsumerTestConnect may provide your email address and corresponding information
to such third parties for email purposes. If you do not wish to continue
receiving such emails, you may unsubscribe at any time by following the
instructions included in each newsletter or email. ConsumerTestConnect functions
solely as a provider of Contest and Sweepstakes. We also aggregate third-party
Offers such as surveys, free samples, deals, coupons, freebies and other Offers
(collectively "Offers") to present to you the user while being a registered user
of our site. No Offer participation or purchase is necessary to enter a Contest
or Sweepstake. These Contest and Offers change often. To enter a Contest you
must complete the Contest registration page providing your name, address, date
of birth, phone and email address. Upon registration you are now entered entered
into that monthly Contest and no other action is needed. Upon choosing certain
Offers you will be redirected to the respective Offers website.
ConsumerTestConnect does not have any control over the content and performance
of such third-party websites and respective Offers. We cannot guarantee that you
will receive any compensation for these surveys or fulfillment of Offers that
you request. We are not responsible if such surveys or Offers are no longer
available, change, if you do not receive the Offers, if you do not qualify for
the surveys or Offers, or if any other issues arise. The third-party product
names, logos, brands, and trademarks shown on this website are the property of
their respective owners.



MARKETING PARTNERS

ConsumerTestConnect.com is currently or has previously entered into strategic
relationships with various partner companies "Marketing Partners" in an effort
to help fulfill the requests you have made on our website concerning various
deals, offers, or opportunities (the "Offers"). By requesting such information
you are providing a digital signature and expressly consenting to receiving a
phone call and/or SMS/Text Messages from such Marketing Partners, at the phone
number provided on our signup page regarding financial, home, travel, energy,
home warranty, digital services and health products. In an effort to be as
transparent as possible, below we have aggregated a list of our current
marketing partners who may be in contact with you based on the Offers you have
asked to receive more information about.


All State

ADT

ADT Solar

Advertising Inc

American Police Officers Alliance

Autistic Childern of America

Callsiva

Choice home warranty

Complete Home Services

Consumer Council

Dart Data

Deliver Marketing

Front Point

Grand Caribbean Cruise

Health Coverage Helpers

Home Support Group

IDT Energy

Innovative Teleservices

Insurance Guide

Med Advantage Advisors

Medical Support Group

Mixed Media Holdings

Mojo Media

My Home Helpers

NationalHomeProject

National Police

National Association of Chiefs of Police

New Strata

Senior Aid Helper

Senior Benfits

Sheriffs Coalition PAC

Spark Energy

Sun Power

SunPro Solar

Sunrun

Superior Home

The-Solar-Project.com

Titan Energy

Town Square Energy

USA Rate Center

www.LocalSolarClients.com