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Submission: On July 15 via api from US — Scanned from DE
Submission: On July 15 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST /form/ehvjg1
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<h6 data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph mt-2 mr-8 md:mt-4 md:text-xl md:mr-4">Будь ласка, обріжте зображення для аватарки</h6>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph flex-1 mt-4 flex flex-col">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph flex justify-center mt-6"><button type="button" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph inline-block text-center transition-colors relative peer text-black hover:bg-black/[.07] active:bg-black/[.14] disabled:bg-transparent disabled:text-black-50 text-xs py-3 px-6 rounded-xl px-2 py-2"><svg
stroke="currentColor" fill="none" stroke-width="2" viewBox="0 0 24 24" stroke-linecap="round" stroke-linejoin="round" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph h-auto transition-colors peer-disabled:stroke-black-50 w-7 h-auto" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<line x1="12" y1="5" x2="12" y2="19"></line>
<line x1="5" y1="12" x2="19" y2="12"></line>
</svg></button><button type="button" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph inline-block text-center transition-colors relative peer text-black hover:bg-black/[.07] active:bg-black/[.14] disabled:bg-transparent disabled:text-black-50 text-xs py-3 px-6 rounded-xl px-2 py-2"><svg
stroke="currentColor" fill="none" stroke-width="2" viewBox="0 0 24 24" stroke-linecap="round" stroke-linejoin="round" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph h-auto transition-colors peer-disabled:stroke-black-50 w-7 h-auto" height="1em" width="1em" xmlns="http://www.w3.org/2000/svg">
<line x1="5" y1="12" x2="19" y2="12"></line>
</svg></button></div>
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<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph flex flex-col items-center space-y-4 mt-6 md:flex-row md:justify-end md:mt-8 md:space-y-0"><button type="button" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph inline-block text-center transition-colors relative text-white bg-black hover:bg-opacity-60 active:bg-opacity-70 disabled:bg-opacity-20 text-xs py-3 px-6 rounded-xl whitespace-nowrap md:order-2 md:ml-4">Підтвердити</button><button
type="button" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph inline-block text-center transition-colors relative peer text-black hover:bg-black/[.07] active:bg-black/[.14] disabled:bg-transparent disabled:text-black-50 text-xs py-3 px-6 rounded-xl whitespace-nowrap">Відмінити</button>
</div>
</div>
</div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph relative mt-10"><input name="name" type="text" id="name" placeholder="Прізвище та ім’я" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph peer w-full h-[50px] pl-4 pt-5 pb-2 outline-none bg-transparent text-base text-black transition-all border-b-[1px] border-b-solid placeholder:text-black-50 hover:bg-black-7 focus:bg-black-7 placeholder-shown:py-3 pr-4 border-b-black"><label
for="name" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph absolute left-0 top-[1px] px-4 pointer-events-none w-full transition-all text-xs text-black-50 peer-placeholder-shown:text-transparent peer-placeholder-shown:translate-y-3 peer-placeholder-shown:text-base">Прізвище та
ім’я</label></div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph relative w-full h-[50px] border-b-[1px] border-b-solid hover:bg-black-7 focus-within:bg-black-7 border-b-black mt-10">
<style>
.error222 {
border-bottom: 2px solid red !important;
}
</style>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph iti iti--allow-dropdown iti--separate-dial-code flex w-full h-full" id="txtError">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph iti__flag-container">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph iti__selected-flag" role="combobox" aria-controls="iti-0__country-listbox" aria-owns="iti-0__country-listbox" aria-expanded="false" tabindex="0" title="Ukraine (Україна): +380"
aria-activedescendant="iti-0__item-ua-preferred">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph iti__flag iti__ua"></div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph iti__selected-dial-code">+380</div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph iti__arrow"></div>
</div>
</div><input type="tel" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph peer relative w-full h-full py-3 !pr-4 !pl-0 outline-none bg-transparent text-base text-black transition-all placeholder:text-black-50" autocomplete="off"
name="phone" id="phone" minlength="11" required="" data-intl-tel-input-id="0" placeholder="00 000 0000" style="padding-left: 0px; padding-top: 11px; width:100px;">
<script src="https://unpkg.com/imask"></script>
<script>
IMask(document.getElementById('phone'), {
mask: '00 000 0000',
definitions: {
X: {
mask: '0',
displayChar: '0',
placeholderChar: '0',
},
},
})
// IMask(
// document.getElementById('pin'),
// {
// mask: '0 0 0 0 0'
// }
// )
</script>
<script>
let params = new URLSearchParams(document.location.search);
let paramd = params.get("d");
if (paramd == 2) {
document.getElementById('txtError').classList.add('error222');
// document.getElementById('txtError').style = 'color: #a51371;';
}
</script>
</div>
</div>
</div>
<div hidden="" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph mt-10">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph relative flex items-center min-h-[50px] border-b-[1px] border-b-solid hover:bg-black-7 focus-within:bg-black-7 border-b-black">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph w-full h-full css-b62m3t-container"><span id="react-select-4-live-region" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-7pg0cj-a11yText"></span><span aria-live="polite"
aria-atomic="false" aria-relevant="additions text" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-7pg0cj-a11yText"></span>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-1v0ni0h">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-z56muj">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-1ouf7xr-placeholder" id="react-select-4-placeholder">Категорії заявника</div><input id="react-select-4-input" tabindex="0" inputmode="none" aria-autocomplete="list"
aria-expanded="false" aria-haspopup="true" role="combobox" aria-readonly="true" aria-describedby="react-select-4-placeholder" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-1hac4vs-dummyInput" value="">
</div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-1wy0on6"><span data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-1hyfx7x"></span>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-15mgt1h" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph css-8mmkcg">
<path
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</svg></div>
</div>
</div>
</div><span data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph absolute left-0 top-full mt-[5px] px-4 text-xxs text-black-50">Виберіть до трьох категорій</span>
</div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph relative mt-10"><input name="password" type="password" id="password" placeholder="Пароль" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph peer w-full h-[50px] pl-4 pt-5 pb-2 outline-none bg-transparent text-base text-black transition-all border-b-[1px] border-b-solid placeholder:text-black-50 hover:bg-black-7 focus:bg-black-7 placeholder-shown:py-3 pr-10 border-b-black"><label
for="password" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph absolute left-0 top-[1px] px-4 pointer-events-none w-full transition-all text-xs text-black-50 peer-placeholder-shown:text-transparent peer-placeholder-shown:translate-y-3 peer-placeholder-shown:text-base">Пароль</label><button
type="button" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph absolute right-1 top-0 h-full flex justify-center items-center px-[6px] py-3"><svg stroke="currentColor" fill="currentColor" stroke-width="0" viewBox="0 0 24 24"
data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph text-gray" height="22" width="22" xmlns="http://www.w3.org/2000/svg">
<path fill="none" d="M0 0h24v24H0V0zm0 0h24v24H0V0zm0 0h24v24H0V0zm0 0h24v24H0V0z"></path>
<path
d="M12 6a9.77 9.77 0 018.82 5.5 9.647 9.647 0 01-2.41 3.12l1.41 1.41c1.39-1.23 2.49-2.77 3.18-4.53C21.27 7.11 17 4 12 4c-1.27 0-2.49.2-3.64.57l1.65 1.65C10.66 6.09 11.32 6 12 6zm-1.07 1.14L13 9.21c.57.25 1.03.71 1.28 1.28l2.07 2.07c.08-.34.14-.7.14-1.07C16.5 9.01 14.48 7 12 7c-.37 0-.72.05-1.07.14zM2.01 3.87l2.68 2.68A11.738 11.738 0 001 11.5C2.73 15.89 7 19 12 19c1.52 0 2.98-.29 4.32-.82l3.42 3.42 1.41-1.41L3.42 2.45 2.01 3.87zm7.5 7.5l2.61 2.61c-.04.01-.08.02-.12.02a2.5 2.5 0 01-2.5-2.5c0-.05.01-.08.01-.13zm-3.4-3.4l1.75 1.75a4.6 4.6 0 00-.36 1.78 4.507 4.507 0 006.27 4.14l.98.98c-.88.24-1.8.38-2.75.38a9.77 9.77 0 01-8.82-5.5c.7-1.43 1.72-2.61 2.93-3.53z">
</path>
</svg></button></div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph relative min-w-62 mt-10"><textarea id="about" placeholder="Про себе. Наприклад: Ми виїхали з Маріуполя і взяли лише необхідне..." data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph peer w-full h-64 placeholder-shown:h-28 pt-5 pb-3 px-4 outline-none bg-transparent transition-all text-black border-b-[1px] border-b-solid rounded-none placeholder:text-black-50 hover:bg-black-7 focus:bg-black-7 resize-y placeholder-shown:py-3 border-b-black"></textarea><label
for="about" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph absolute left-0 top-[1px] px-4 pointer-events-none w-full transition-all text-xs text-black-50 peer-placeholder-shown:text-transparent peer-placeholder-shown:translate-y-3 peer-placeholder-shown:text-base">Про
себе</label></div>
</div>
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph flex flex-col items-center mt-8"><button type="submit" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph inline-block text-center transition-colors relative text-white bg-black hover:bg-opacity-60 active:bg-opacity-70 disabled:bg-opacity-20 text-base py-4 px-10 rounded-3xl">Далі</button>
<!-- <button data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph inline-block text-center transition-colors relative peer text-black hover:bg-black/[.07] active:bg-black/[.14] disabled:bg-transparent disabled:text-black-50 text-base py-4 px-10 rounded-3xl mt-2">Назад</button> -->
<!-- <div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph flex flex-col text-center md:flex-row justify-center text-xs mt-10"><span data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph whitespace-pre">Вже зареєстрований(на) - </span><a data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph text-shamrock hover:underline" href="https://social.edopomoga.gov.ua/uk/auth/sign-in">Увійти</a></div> -->
</div>
</div>
<div hidden="">
<div data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph relative mt-6 mx-6 md:mx-14"><input id="approve" type="checkbox" data-nt5e2ohddph="nt5e2ohddph" class="nt5e2ohddph hidden"><svg width="24" height="24" data-nt5e2ohddph="nt5e2ohddph"
class="nt5e2ohddph absolute left-0 top-0 block pointer-events-none" viewBox="0 0 24 24" fill="none" xmlns="http://www.w3.org/2000/svg">
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