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jacaruso.my.salesforce-sites.com Open in urlscan Pro
52.88.52.193  Public Scan

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Submitted URL: https://jacaruso.secure.force.com/EditPropertyLeadVF?oppid=0061R00000wFPA1
Effective URL: https://jacaruso.my.salesforce-sites.com/EditPropertyLeadVF?oppid=0061R00000wFPA1
Submission: On December 18 via manual from IN — Scanned from DE

Form analysis 1 forms found in the DOM

Name: j_id0:j_id15 — POST /EditPropertyLeadVF

<form id="j_id0:j_id15" name="j_id0:j_id15" method="post" action="/EditPropertyLeadVF" enctype="application/x-www-form-urlencoded">
  <input type="hidden" name="j_id0:j_id15" value="j_id0:j_id15">
  <span id="j_id0:j_id15:j_id16"></span>
  <div class="slds-box">
    <div class="slds-grid slds-gutters slds-wrap">
      <div class="slds-col slds-size_1-of-1">
        <span>
          <div class="slds-p-around_xsmall" style="text-align: center; background-image: linear-gradient(to right,#0a4d9d,#0a4d9d);color: #ffffff;">
            <p style="font-size:20px;">Required Information</p>
          </div>
        </span>
      </div>
      <div class="slds-hide slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label">Hotel Name</label>
        <div class="slds-form-element__control"><input class="slds-input" id="j_id0:j_id15:j_id43" maxlength="255" name="j_id0:j_id15:j_id43" size="20" type="text">
        </div>
      </div>
      <div class="slds-show slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label">Hotel Location</label>
        <div class="slds-form-element__control">
          <div class="requiredInput">
            <div class="requiredBlock"></div><input class="slds-input" id="j_id0:j_id15:j_id45" maxlength="255" name="j_id0:j_id15:j_id45" required="required" size="20" type="text">
          </div>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label" for="text-input-01">First Name</label>
        <div class="slds-form-element__control">
          <div class="requiredInput">
            <div class="requiredBlock"></div><input class="slds-input" id="j_id0:j_id15:j_id47" maxlength="40" name="j_id0:j_id15:j_id47" required="required" size="20" type="text">
          </div>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label" for="text-input-01">Last Name</label>
        <div class="slds-form-element__control">
          <div class="requiredInput">
            <div class="requiredBlock"></div><input class="slds-input" id="j_id0:j_id15:j_id49" maxlength="80" name="j_id0:j_id15:j_id49" required="required" size="20" type="text">
          </div>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label" for="text-input-01">Phone</label>
        <div class="slds-form-element__control">
          <div class="requiredInput">
            <div class="requiredBlock"></div><input class="slds-input" id="j_id0:j_id15:j_id51" maxlength="40" name="j_id0:j_id15:j_id51" onblur="formatPhone(this);" onkeydown="formatPhoneOnEnter(this, event);" required="required" size="20"
              type="text">
          </div>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label" for="text-input-01">Email</label>
        <div class="slds-form-element__control"><input type="email" name="j_id0:j_id15:j_id53" class="slds-input" required="required">
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Group or Company Name</label>
        <div class="slds-form-element__control">
          <div class="requiredInput">
            <div class="requiredBlock"></div><input class="slds-input" id="j_id0:j_id15:j_id55" maxlength="120" name="j_id0:j_id15:j_id55" required="required" size="20" type="text">
          </div>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Submited By (full name)</label>
        <div class="slds-form-element__control"><input type="text" name="j_id0:j_id15:j_id57" class="slds-input" required="required">
        </div>
      </div>
    </div>
  </div>
  <br>
  <div class="slds-box">
    <div class="slds-grid slds-gutters  slds-wrap">
      <div class="slds-col slds-size_1-of-1">
        <span>
          <div class="slds-p-around_xsmall" style="text-align: center; background-image: linear-gradient(to right,#0a4d9d,#0a4d9d);color: #ffffff;">
            <p style="font-size:20px;">Optional Additional Information</p>
          </div>
        </span>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Date of Interest(Arrival)</label>
        <div class="slds-form-element__control"><span class="dateInput dateOnlyInput"><input class="slds-input" id="j_id0:j_id15:arrivalDate" name="j_id0:j_id15:arrivalDate" onfocus="DatePicker.pickDate(true, 'j_id0:j_id15:arrivalDate', false);"
              size="12" type="text"><span class="dateFormat">[&nbsp;<a href="javascript:DatePicker.insertDate('12/18/2023', 'j_id0:j_id15:arrivalDate', true);">12/18/2023</a>&nbsp;]</span></span>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Date of Interest(Departure)</label>
        <div class="slds-form-element__control"><span class="dateInput dateOnlyInput"><input class="slds-input" id="j_id0:j_id15:departureDate" name="j_id0:j_id15:departureDate"
              onfocus="DatePicker.pickDate(true, 'j_id0:j_id15:departureDate', false);" size="12" type="text"><span
              class="dateFormat">[&nbsp;<a href="javascript:DatePicker.insertDate('12/18/2023', 'j_id0:j_id15:departureDate', true);">12/18/2023</a>&nbsp;]</span></span>
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Website</label>
        <div class="slds-form-element__control"><input class="slds-input" id="j_id0:j_id15:j_id61" maxlength="255" name="j_id0:j_id15:j_id61" size="20" type="text">
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex">Number of Rooms Required </label>
        <div class="slds-form-element__control"><input class="slds-input" id="j_id0:j_id15:j_id63" name="j_id0:j_id15:j_id63" size="20" type="text">
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Contact Title</label>
        <div class="slds-form-element__control"><input type="text" name="j_id0:j_id15:j_id65" class="slds-input">
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">What other Cities do you travel to?</label>
        <div class="slds-form-element__control"><input type="text" name="j_id0:j_id15:j_id67" class="slds-input">
        </div>
      </div>
      <div class="slds-col slds-form-element slds-size_1-of-1 slds-large-size_1-of-2">
        <label class="slds-form-element__label slds-no-flex" for="input-42">Comments</label>
        <div class="slds-form-element__control"><textarea class="slds-input" id="j_id0:j_id15:j_id69" maxlength="32768" name="j_id0:j_id15:j_id69"
            onchange="handleTextAreaElementChangeWithByteCheck('j_id0:j_id15:j_id69', 32768, 0, 'remaining', 'over limit', false);" onclick="handleTextAreaElementChangeWithByteCheck('j_id0:j_id15:j_id69', 32768, 0, 'remaining', 'over limit', false);"
            onkeydown="handleTextAreaElementChangeWithByteCheck('j_id0:j_id15:j_id69', 32768, 0, 'remaining', 'over limit', false);"
            onkeyup="handleTextAreaElementChangeWithByteCheck('j_id0:j_id15:j_id69', 32768, 0, 'remaining', 'over limit', false);"
            onmousedown="handleTextAreaElementChangeWithByteCheck('j_id0:j_id15:j_id69', 32768, 0, 'remaining', 'over limit', false);" rows="3" style="height: 3rem;" type="text" wrap="soft"></textarea>
        </div>
      </div>
    </div>
  </div>
  <div class="slds-align_absolute-center slds-p-bottom_large"><input type="submit" name="j_id0:j_id15:j_id71" value="SUBMIT INFO" style="margin-top:20px; background-color: #0a4d9d;color: #ffffff;" title="Required Field(s) Missing."
      class="btn slds-button slds-button_brand">
  </div>
  <div id="j_id0:j_id15:j_id75"></div>
</form>

Text Content

JAN Hotel Request Form

Complete the form below with your hotel needs
and we’ll respond with options that
are the right fit, at no cost to you.

JAN

Required Information

Hotel Name

Hotel Location

First Name

Last Name

Phone

Email

Group or Company Name

Submited By (full name)



Optional Additional Information

Date of Interest(Arrival)
[ 12/18/2023 ]
Date of Interest(Departure)
[ 12/18/2023 ]
Website

Number of Rooms Required

Contact Title

What other Cities do you travel to?

Comments



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