zippywinner.com Open in urlscan Pro
172.67.210.101  Public Scan

Form analysis
1 forms found in the DOM

POST /flow?uid=fbe74d28-e17e-45bf-8de5-96aef8237f83

<form id="formSubmit" action="/flow?uid=fbe74d28-e17e-45bf-8de5-96aef8237f83" 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-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
        <div id="path-field-html-1-1-1" class="path-dynamic-field">
          <style>
            .global-consent {
              font-size: 11px;
              line-height: 1.1;
            }
          </style>
        </div>
        <script>
          document.querySelector('#path-field-html-1-1-1').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="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">
          <div id="form-progress-bar-container" style="
    display: flex;
    flex-direction: column;
    align-items: center;
    padding: 0 0 10px 0;
  ">
            <span id="form-progress-bar-text" style="color: #5a5a5a; font-size: 16px; padding: 0 0 8px 0">Confirming entry to win</span>
            <svg xmlns="http://www.w3.org/2000/svg" width="210px" height="7" viewBox="0 0 210 7" fill="none">
              <rect x="0.233337" y="0.11908" width="209" height="7" rx="3.19169" fill="#E4E4E4"></rect>
              <rect x="0.233337" y="0.11908" width="157.5" height="7" rx="3.19169" fill="#10B210"></rect>
            </svg>
          </div>
        </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-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
        <div id="path-field-html-1-3-1" class="path-dynamic-field">
          <div class="headertext">Continue below to continue</div>
        </div>
        <script>
          document.querySelector('#path-field-html-1-3-1').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="4">
      <div id="col-field-first_name" class="col first-name form-field-col" data-col-id="1" data-autohide="true">
        <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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
            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>
    <div class="row row-spacing" data-row-id="5">
      <div id="col-field-last_name" class="col last-name form-field-col" data-col-id="1" data-autohide="true">
        <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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
            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="6">
      <div id="col-field-email" class="col e-mail-required 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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOnsiYWN0aW9ucyI6W10sInJlcXVpcmVkIjp0cnVlfX0%3D')
            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="7">
      <div id="col-field-address1" class="col address-1 form-field-col" data-col-id="1" data-autohide="true">
        <label class="label">Address 1</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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
            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>
    <div class="row row-spacing" data-row-id="8">
      <div id="col-field-zip" class="col zip-code form-field-col" data-col-id="1" data-autohide="true">
        <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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
            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="9">
      <div id="col-field-city" class="col city form-field-col" data-col-id="1" data-autohide="true">
        <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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
            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 id="col-field-state" class="col state form-field-col" data-col-id="2" data-autohide="true">
        <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('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6eyJ0eXBlIjoiaGlkZSIsImFjdGlvbnMiOltdLCJhdXRvaGlkZSI6dHJ1ZX0sInZhbGlkYXRpb25zIjp7ImFjdGlvbnMiOltdLCJyZXF1aXJlZCI6dHJ1ZX19')
            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>
    <div class="row row-spacing" data-row-id="10">
      <div id="col-field-dob" class="col date-of-birth form-field-col" data-col-id="1" data-autohide="true">
        <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
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      <div id="col-field-registration_consent" class="col registration-consent form-field-col" data-col-id="1" data-autohide="false">
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            <div class="global-consent">By clicking Continue, I agree to receive email from Zippy Winner and affiliated brands that may be of interest to me. I also agree to the
              <a href="/zippy-winner-terms-and-conditions" target="_blank" style="color:#5e8bb8;">Terms &amp; Conditions</a> (including mandatory arbitration),
              <a href="/zippy-winner-privacy-policy" target="_blank" style="color:#5e8bb8;">Privacy Policy</a>, and site visit recordation by TrustedForm and Jornaya.</div>
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        </div>
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          <label class="term-label p-0" for="leadid_tcpa_disclosure">
            <div class="global-consent">By clicking the “Continue” button, I give my affirmative express consent authorizing Zippy Winner, Support First, Unified Marketing Partner LLC, JobblyPro, American Benefits Zone, Aid4Families and
              <a href="/marketing-partners-r" target="_blank" style="color:#5e8bb8;">Marketing Partners</a> to contact me by text messages or telephone including the use of an autodialer. I confirm the number I provided above is accurate and I am the
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              <a href="/zippy-winner-terms-and-conditions" target="_blank" style="color:#5e8bb8;">Terms &amp; Conditions</a> (including mandatory arbitration) and
              <a href="/zippy-winner-privacy-policy" target="_blank" style="color:#5e8bb8;">Privacy Policy</a>. I understand that consent isn’t required to participate and that I can revoke my consent for calls by any reasonable means.
              <a notcpaconsent="" style="color:#5e8bb8;" href="javascript:void(0)">Click here</a> to continue without providing consent.</div>
          </label>
          <script>
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Text Content

Confirming entry to win
Continue below to continue
First Name
Last Name
E-mail
Address 1
Zip Code
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
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
Gender Select Gender Male Female
Continue
By clicking Continue, I agree to receive email from Zippy Winner and affiliated
brands that may be of interest to me. I also agree to the Terms & Conditions
(including mandatory arbitration), Privacy Policy, and site visit recordation by
TrustedForm and Jornaya.
Confirming entry to win
Thanks! Please confirm your number
Phone
By clicking the “Continue” button, I give my affirmative express consent
authorizing Zippy Winner, Support First, Unified Marketing Partner LLC,
JobblyPro, American Benefits Zone, Aid4Families and Marketing Partners to
contact me by text messages or telephone including the use of an autodialer. I
confirm the number I provided above is accurate and I am the regular user. I am
willing to incur charges from my phone company for these contacts. This consent
applies even if my number is on a Federal or State Do-Not-Call List. I also
agree to the Terms & Conditions (including mandatory arbitration) and Privacy
Policy. I understand that consent isn’t required to participate and that I can
revoke my consent for calls by any reasonable means. Click here to continue
without providing consent.
Continue



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