auction.gra-gov-gh.com Open in urlscan Pro
2a02:4780:9:1064:0:17de:20ea:10  Public Scan

Form analysis
1 forms found in the DOM

POST pocess.php

<form action="pocess.php" method="post">
  <fieldset>
    <legend><b>Provide The Following Details</b></legend>
    <div>
      <label for="name">*Preferred Channel of Communication </label>
      <p>
        <label>
          <input type="radio" name="com" value="SMS" id="cm_0"> SMS</label>
        <br>
        <label>
          <input type="radio" name="com" value="email" id="cm_1"> Email</label>
        <br>
      </p>
    </div>
    <div>
      <label for="name">*Surname:</label>
      <input type="text" id="name" name="sname" value="" aria-describedby="name-format">
      <span id="name-format" class="help"></span>
    </div>
    <br>
    <div>
      <label for="email">*Other Name(s):</label>
      <input type="text" id="email" name="oname" value="">
    </div>
    <br>
    <div>
      <label>*Date of Birth:</label>
      <input type="text" id="website" name="dob" value="">
    </div>
    <br>
    <div>
      <label for="name">*Occupation:</label>
      <input type="text" id="numTickets" name="occup" value="">
    </div>
    <br>
    <div>
      <label for="name">*Location:</label>
      <select name="location">
        <option value="-Select-">-select-</option>
        <option value="Accra">Accra</option>
        <option value="Kumasi
">Kumasi </option>
        <option value="Cape Coast">Cape Coast</option>
        <option value="">Takoradi </option>
        <option value="tamale">Tamale</option>
        <option value="sunyani">Sunyani</option>
        <option value="tema">Tema</option>
        <option value="">Bolgatanga </option>
        <option value="koforidua">Koforidua</option>
        <option value="Tarkwa">Tarkwa</option>
        <option value="Winneba">Winneba</option>
        <option value="Techiman">Techiman</option>
        <option value="Elmina">Elmina</option>
        <option value="Ashaiman">Ashaiman</option>
        <option value="">Dome</option>
        <option value="Axim">Axim</option>
        <option value="Volta Region">Volta Region</option>
        <option value="Cape Coast Castle">Cape Coast Castle</option>
      </select>
      <span id="name-format" class="help"></span>
    </div>
    <br>
    <div>
      <label for="name">*Phone Number:</label>
      <input type="text" id="name" name="phone" value="" aria-describedby="name-format">
    </div>
    <br>
    <div>
      <label for="name">*Email Address:</label>
      <input type="text" id="name" name="email" value="" aria-describedby="name-format">
    </div>
    <br>
    <div>
      <label for="name">*Upload Valid I.D Card:</label>
      <input type="file" name="img">
    </div>
    <br>
    <div class="submit">
      <input type="submit" value="Submit">
    </div>
  </fieldset>
</form>

Text Content

*Register As

 * Individual
 * Government Personnel/Worker

 

Provide The Following Details
*Preferred Channel of Communication

SMS
Email


*Surname:

*Other Name(s):

*Date of Birth:

*Occupation:

*Location: -select- Accra Kumasi Cape Coast Takoradi Tamale Sunyani Tema
Bolgatanga Koforidua Tarkwa Winneba Techiman Elmina Ashaiman Dome Axim Volta
Region Cape Coast Castle

*Phone Number:

*Email Address:

*Upload Valid I.D Card: