www.mybeerrebate.com Open in urlscan Pro
45.60.80.99  Public Scan

Form analysis
3 forms found in the DOM

Name: parentCustomForm —

<form name="parentCustomForm" class="ng-pristine ng-scope ng-invalid ng-invalid-required ng-valid-date">
  <div pccustomform="" customfields="accordion" class="ng-isolate-scope"><ng-form name="customForm" novalidate="" class="ng-pristine ng-invalid ng-invalid-required ng-valid-date"><!-- ngRepeat: field in fields -->
      <div class="form-group ng-scope" ng-repeat="field in fields">
        <div class="input-group dynamic-fields">
          <p class="noMargin ng-hide inactiveFieldLabel" ng-show="customForm[field.fieldName].$viewValue || customForm[field.fieldName].focused" ng-class="(customForm[field.fieldName].focused) ? 'activeFieldLabel' : 'inactiveFieldLabel'"><span
              translate="content.FD_HOME_CUSTOMSEARCH_0_CAMPAIGNCODE " class="ng-scope">Offer Number (AB-XXXX)</span></p><!-- ngIf: (field.type | uppercase) === 'SELECT' --><!-- ngIf: (field.type | uppercase) === 'TEXT' --><input
            ng-if="(field.type | uppercase) === 'TEXT'" border-color="" aria-label="Offer Number (AB-XXXX)" tabindex="0" ng-focus="customForm[field.fieldName].focused = true" ng-blur="customForm[field.fieldName].focused = false" name="CampaignCode"
            class="noBorderTextBox ng-pristine ng-untouched ng-scope ng-empty ng-invalid ng-invalid-required" type="text" placeholder="Offer Number (AB-XXXX)" ng-model="field.value" ng-required="true" pc-field="home-customSearch-CampaignCode" link=""
            pc-field-type="Text" required="required"><!-- end ngIf: (field.type | uppercase) === 'TEXT' --> <!-- ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: (field.type | uppercase) === 'DATE' -->
          <!-- ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: field.tinyMce_Text && !(field.MODAL) --> <!-- ngIf: field.MODAL && field.tinyMce_Text -->
        </div>
      </div><!-- end ngRepeat: field in fields -->
      <div class="form-group ng-scope" ng-repeat="field in fields">
        <div class="input-group dynamic-fields">
          <p class="noMargin ng-hide inactiveFieldLabel" ng-show="customForm[field.fieldName].$viewValue || customForm[field.fieldName].focused" ng-class="(customForm[field.fieldName].focused) ? 'activeFieldLabel' : 'inactiveFieldLabel'"><span
              translate="content.FD_HOME_CUSTOMSEARCH_0_PURCHASEDATE " class="ng-scope">Purchase Date</span></p><!-- ngIf: (field.type | uppercase) === 'SELECT' --><!-- ngIf: (field.type | uppercase) === 'TEXT' -->
          <!-- ngIf: (field.type | uppercase) === 'DATE' --><input ng-if="(field.type | uppercase) === 'DATE'" id="home-PurchaseDate-text" border-color="" tabindex="0" ng-focus="customForm[field.fieldName].focused = true"
            ng-blur="customFormCtrl.dateTextChange(field.fieldName, true ,this, false)" name="PurchaseDate" class="noBorderTextBox ng-pristine ng-untouched ng-scope ng-empty ng-invalid ng-invalid-required" type="text" placeholder="Purchase Date"
            ng-model="field.value" is-open="customFormCtrl.dates[field.fieldName]" ng-change="customFormCtrl.dateTextChange(field.fieldName, false ,this, true)" close-text="Close" pc-field="home-customSearch-PurchaseDate" link="" pc-field-type="Date"
            ng-required="true" required="required"><!-- end ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: (field.type | uppercase) === 'DATE' --><input ng-if="(field.type | uppercase) === 'DATE'" id="PurchaseDate-date" tabindex="0"
            name="PurchaseDate1" class="hidden-date-input ng-pristine ng-untouched ng-scope ng-isolate-scope ng-empty ng-valid-date ng-invalid ng-invalid-required" type="text" uib-datepicker-popup="MM/dd/yyyy" datepicker-options="dateOptions"
            ng-model="field.valueTemp" is-open="customFormCtrl.dates[field.fieldName]" ng-change="customFormCtrl.dateChange(field.fieldName,this)" close-text="Close" ng-required="true" aria-label="Purchase Date" required="required">
          <div uib-datepicker-popup-wrap="" ng-model-options="ngModelOptions" ng-model="date" ng-change="dateSelection(date)" template-url="uib/template/datepickerPopup/popup.html" class="ng-empty ng-valid">
            <!-- ngIf: isOpen -->
          </div><!-- end ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: (field.type | uppercase) === 'DATE' --><span class="input-group-btn ng-scope" ng-if="(field.type | uppercase) === 'DATE'"><button id="PurchaseDate-searchDate"
              type="button" class="btn form-icon" ng-click="customFormCtrl.toggleDate(field.fieldName)" aria-label="Date Selector" title="Date selector"
              alt="calendar"><i class="fa fa-calendar" aria-hidden="true"></i></button></span><!-- end ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: field.tinyMce_Text && !(field.MODAL) --> <!-- ngIf: field.MODAL && field.tinyMce_Text -->
        </div>
      </div><!-- end ngRepeat: field in fields -->
      <div class="form-group ng-scope" ng-repeat="field in fields">
        <div class="input-group dynamic-fields">
          <p class="noMargin ng-hide inactiveFieldLabel" ng-show="customForm[field.fieldName].$viewValue || customForm[field.fieldName].focused" ng-class="(customForm[field.fieldName].focused) ? 'activeFieldLabel' : 'inactiveFieldLabel'"><span
              translate="content.FD_HOME_CUSTOMSEARCH_0_EMAIL " class="ng-scope">Email Address</span></p><!-- ngIf: (field.type | uppercase) === 'SELECT' --><!-- ngIf: (field.type | uppercase) === 'TEXT' --><input
            ng-if="(field.type | uppercase) === 'TEXT'" border-color="" aria-label="Email Address" tabindex="0" ng-focus="customForm[field.fieldName].focused = true" ng-blur="customForm[field.fieldName].focused = false" name="Email"
            class="noBorderTextBox ng-pristine ng-untouched ng-scope ng-empty ng-invalid ng-invalid-required" type="text" placeholder="Email Address" ng-model="field.value" ng-required="true" pc-field="home-customSearch-Email" link=""
            pc-field-type="Text" required="required"><!-- end ngIf: (field.type | uppercase) === 'TEXT' --> <!-- ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: (field.type | uppercase) === 'DATE' -->
          <!-- ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: field.tinyMce_Text && !(field.MODAL) --> <!-- ngIf: field.MODAL && field.tinyMce_Text -->
        </div>
      </div><!-- end ngRepeat: field in fields -->
      <div class="form-group ng-scope" ng-repeat="field in fields">
        <div class="input-group dynamic-fields">
          <p class="noMargin ng-hide inactiveFieldLabel" ng-show="customForm[field.fieldName].$viewValue || customForm[field.fieldName].focused" ng-class="(customForm[field.fieldName].focused) ? 'activeFieldLabel' : 'inactiveFieldLabel'"><span
              translate="content.FD_HOME_CUSTOMSEARCH_0_ZIPCODE " class="ng-scope">Zipcode</span></p><!-- ngIf: (field.type | uppercase) === 'SELECT' --><!-- ngIf: (field.type | uppercase) === 'TEXT' --><input
            ng-if="(field.type | uppercase) === 'TEXT'" border-color="" aria-label="Zipcode" tabindex="0" ng-focus="customForm[field.fieldName].focused = true" ng-blur="customForm[field.fieldName].focused = false" name="Zipcode"
            class="noBorderTextBox ng-pristine ng-untouched ng-scope ng-empty ng-invalid ng-invalid-required" type="text" placeholder="Zipcode" ng-model="field.value" ng-required="true" pc-field="home-customSearch-Zipcode" link=""
            pc-field-type="Text" required="required"><!-- end ngIf: (field.type | uppercase) === 'TEXT' --> <!-- ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: (field.type | uppercase) === 'DATE' -->
          <!-- ngIf: (field.type | uppercase) === 'DATE' --> <!-- ngIf: field.tinyMce_Text && !(field.MODAL) --> <!-- ngIf: field.MODAL && field.tinyMce_Text -->
        </div>
      </div><!-- end ngRepeat: field in fields -->
    </ng-form></div>
  <div class="row"><!-- ngIf: validationErrors --></div>
  <div class="row"><!-- ngIf: homeCtrl.isBackButtonEnabled -->
    <div class="col-md-6 col-sm-6 col-xs-6 pull-right"><button id="home-customSearch-0-continue" aria-label="Continue" class="btn btn-primary ng-binding" ng-click="homeCtrl.continue()" ng-disabled="parentCustomForm.customForm.$invalid"
        disabled="disabled">Continue <span class="fa fa-chevron-right" aria-hidden="true"></span></button></div>
  </div>
</form>

<form id="chatEntryForm" style="box-sizing: inherit !important;">
  <div class="input-wrapper" style="box-sizing: inherit !important;"><input type="text" name="firstName" value="" style="box-sizing: inherit !important;"><label
      style="box-sizing: inherit !important;"><i class="sharpen-icon sharpen-icon-user secondary color" style="box-sizing: inherit !important;"></i><span class="text-color-transparent color" style="box-sizing: inherit !important;">First
        Name</span></label></div>
  <div class="input-wrapper" style="box-sizing: inherit !important;"><input type="text" name="lastName" value="" style="box-sizing: inherit !important;"><label
      style="box-sizing: inherit !important;"><i class="sharpen-icon sharpen-icon-user secondary color" style="box-sizing: inherit !important;"></i><span class="text-color-transparent color" style="box-sizing: inherit !important;">Last
        Name</span></label></div>
  <div class="input-wrapper" style="box-sizing: inherit !important;"><input type="text" name="email" value="" style="box-sizing: inherit !important;"><label
      style="box-sizing: inherit !important;"><i class="sharpen-icon sharpen-icon-envelope secondary color" style="box-sizing: inherit !important;"></i><span class="text-color-transparent color"
        style="box-sizing: inherit !important;">Email</span></label></div>
  <div class="input-wrapper" style="box-sizing: inherit !important;"><input type="text" name="phoneNumber" value="" style="box-sizing: inherit !important;"><label
      style="box-sizing: inherit !important;"><i class="sharpen-icon sharpen-icon-phone secondary color" style="box-sizing: inherit !important;"></i><span class="text-color-transparent color"
        style="box-sizing: inherit !important;">Phone</span></label></div><input type="hidden" name="companyName" value="" style="box-sizing: inherit !important;"><input type="hidden" name="externalCRMID" value=""
    style="box-sizing: inherit !important;"><input type="hidden" name="externalCRMAccountID" value="" style="box-sizing: inherit !important;"><button id="chatEntryBtn" class="sharpen-chat-button secondary background text-color" type="button"
    style="box-sizing: inherit !important;">Enter Chat</button><span id="cancelChatEntryBtn" class="secondary color" style="box-sizing: inherit !important;">Cancel</span>
</form>

<form id="chatForm" style="box-sizing: inherit !important;"><textarea id="messageBox" class="transition" name="input" placeholder="Message" maxlength="1000" style="box-sizing: inherit !important;"></textarea><button id="sendChatBtn"
    class="sharpen-chat-button secondary background" type="button" style="box-sizing: inherit !important;"><i class="sharpen-icon sharpen-icon-paper-plane" style="box-sizing: inherit !important;"></i></button><span id="linebreak-msg"
    style="box-sizing: inherit !important;">(Press Shift + Enter for a line break)</span></form>

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