www.confirm.globaltravel.mx Open in urlscan Pro
162.214.72.90  Public Scan

Form analysis
1 forms found in the DOM

POST survey.php

<form id="wrapped" method="POST" action="survey.php" class="wizard-form" novalidate="novalidate">
  <input id="website" name="website" type="text" value="">
  <!-- Leave for security protection, read docs for details -->
  <div id="middle-wizard" class="wizard-branch wizard-wrapper">
    <div class="submit step wizard-step current" style="">
      <h3 class="main_question wizard-header">Please fill with your details and confirm your attendance:</h3>
      <div class="form-group">
        <input type="text" name="nombre" id="nombre" class="form-control required" placeholder="Name">
      </div>
      <div class="form-group">
        <input type="email" name="email" id="email" class="form-control required" placeholder="Your Email">
      </div>
      <div class="form-group">
        <input type="text" name="telefono" id="telefono" class="form-control required" placeholder="Your Phone">
      </div>
      <div class="form-group">
        <input type="text" name="empresa" id="empresa" class="form-control required" placeholder="Company">
      </div>
      <div class="form-group">
        <input type="text" name="cargo" id="cargo" class="form-control required" placeholder="Your position at your Company">
      </div>
      <div class="row">
        <div class="col-5"> Will you attend the event?<br>
        </div>
        <div class="col-3" style="margin-top: -10px;">
          <div class="form-group radio_input">
            <label class="container_radio">Yes <input type="radio" name="confirmacion" id="confirmacion" value="1" class="required">
              <span class="checkmark"></span>
            </label>
            <label class="container_radio">No <input type="radio" name="confirmacion" id="confirmacion" value="0" class="required">
              <span class="checkmark"></span>
            </label>
          </div>
        </div>
      </div>
      <!-- /row -->
    </div>
  </div>
  <!-- /middle-wizard -->
  <div id="bottom-wizard">
    <button type="button" name="backward" class="backward" disabled="disabled">Prev</button>
    <button type="button" name="forward" class="forward" disabled="disabled">Next</button>
    <button type="submit" name="process" class="submit">Send</button>
  </div>
  <!-- /bottom-wizard -->
</form>

Text Content

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SATISFACTION SURVEY

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concludaturque usu, facete detracto patrioque an per, lucilius pertinacia eu
vel. Adhuc invidunt duo ex. Eu tantas dolorum ullamcorper qui.

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© 2020 Wilio


PLEASE FILL WITH YOUR DETAILS AND CONFIRM YOUR ATTENDANCE:






Will you attend the event?

Yes No
Prev Next Send



TERMS AND CONDITIONS

×

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mei ludus tamquam dolores id. No sit debitis meliore postulant, per ex prompta
alterum sanctus, pro ne quod dicunt sensibus.

Lorem ipsum dolor sit amet, in porro albucius qui, in nec quod novum accumsan,
mei ludus tamquam dolores id. No sit debitis meliore postulant, per ex prompta
alterum sanctus, pro ne quod dicunt sensibus. Lorem ipsum dolor sit amet, in
porro albucius qui, in nec quod novum accumsan, mei ludus tamquam dolores id. No
sit debitis meliore postulant, per ex prompta alterum sanctus, pro ne quod
dicunt sensibus.

Lorem ipsum dolor sit amet, in porro albucius qui, in nec quod novum accumsan,
mei ludus tamquam dolores id. No sit debitis meliore postulant, per ex prompta
alterum sanctus, pro ne quod dicunt sensibus.

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