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Form analysis
1 forms found in the DOM

inc/submit_form.php

<form action="inc/submit_form.php">
  <div class="form__field">
    <label for="name">Full name <span>*</span></label>
    <input type="text" name="name" class="required">
    <div class="form__field__validation">Please enter your name</div>
  </div>
  <div class="form__field">
    <label for="email">Email address <span>*</span></label>
    <input type="email" name="email" class="required">
    <div class="form__field__validation"> Please enter a valid email address </div>
  </div>
  <div class="form__field">
    <label for="country">Country <span>*</span></label>
    <input type="text" name="country" class="required">
    <div class="form__field__validation"> Please enter your country </div>
  </div>
  <div class="form__field">
    <label for="hospital">Hospital affiliation</label>
    <input type="text" name="hospital">
    <div class="form__field__validation"> Please enter your hospital </div>
  </div>
  <div class="form__field hidden">
    <input type="text" name="url" value="">
  </div>
  <div class="form__field">
    <input type="submit" name="submit" value="Submit and Enter">
    <img id="loading" src="assets/img/loading.gif" alt="...loading">
  </div>
  <div id="info">
    <div id="info__required"><span>*</span> required</div>
    <div id="info__result"></div>
  </div>
</form>

Text Content

QUICK REGISTRATION FORM


FOR DOCUMENTARY PURPOSE WE WOULD LIKE TO ASK YOU TO INSERT YOUR PERSONAL DETAILS
BELOW, BEFORE CONTINUING

Full name *
Please enter your name
Email address *
Please enter a valid email address
Country *
Please enter your country
Hospital affiliation
Please enter your hospital


* required