public.govdelivery.com Open in urlscan Pro
2001:18c8:17f:fc75:20:1:1:2  Public Scan

Form analysis
1 forms found in the DOM

POST /accounts/WAOIC/subscriber/qualify

<form action="/accounts/WAOIC/subscriber/qualify" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"><input type="hidden" name="authenticity_token"
    value="VDuzu4ZuVDChW15+rRN1f2mMWLfz4ZLusopaGEcASycCsphhy78c81Eh9gWSBJrWAof21wcHX/BrR5M2d9cA0g==">
  <fieldset id="quick_subscribe_new">
    <legend>
      <h1> Insurance Updates </h1>
    </legend>
    <div id="quick_subscribe_new_instructions">
      <p>Subscribe to email or text alerts from the Insurance Commissioner about rule changes, legislation, industry information and consumer news.&nbsp;</p>
    </div>
    <ol class="form">
      <li>
        <label for="subscription_type">Subscription Type</label>
        <div class="input_group">
          <select name="subscription_type" id="subscription_type">
            <option value="email">Email</option>
            <option value="phone">SMS/Text Message</option>
          </select>
        </div>
      </li>
      <li class="wireless_fields" style="display: none">
        <label for="phone"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Wireless Number</label>
        <div class="input_group">
          <select name="country_code_display" id="country_code_display" disabled="disabled" aria-label="Country code">
            <option value="1 (US)">1 (US)</option>
            <option value="1">1</option>
          </select>
          <input type="hidden" name="country_code" id="country_code" value="1" title="Country code">
          <input type="tel" name="phone" id="phone" value="" class="medium wireless_text_field" title="Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123"
            oninvalid="setCustomValidity('Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123')" pattern="[0-9]{10}"
            oninput="if (validity.patternMismatch) { setCustomValidity('Provide your full phone number without country code or characters such as a dash or space. e.g 5555550123'); } else { setCustomValidity(''); }" disabled="disabled">
        </div>
      </li>
      <li class="email_fields" style="display: block">
        <label for="email"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Email Address</label>
        <input type="email" name="email" id="email" value="" class="long email_text_field" required="required">
      </li>
    </ol>
    <span aria-hidden="aria-hidden" style="display: none">
      <label for="name"><img class="required" alt="" aria-hidden="true" src="https://content.govdelivery.com/images/required.gif">Name</label>
      <input type="text" name="name" id="name" value="" aria-disabled="true" autocomplete="off">
    </span>
    <div class="button_panel">
      <input type="submit" name="commit" value="Submit" data-disable-with="Submit"><input type="button" value="Cancel" class="cancel_button">
    </div>
  </fieldset>
</form>

Text Content

We only use cookies that are necessary for this site to function to provide you
with the best experience. The controller of this site may choose to place
supplementary cookies to support additional functionality such as support
analytics, and has an obligation to disclose these cookies. Learn more in our
Cookie Statement.


INSURANCE UPDATES

Subscribe to email or text alerts from the Insurance Commissioner about rule
changes, legislation, industry information and consumer news. 

 1. Subscription Type
    Email SMS/Text Message
 2. Wireless Number
    1 (US) 1
 3. Email Address

Name


Your contact information is used to deliver requested updates or to access your
subscriber preferences.

--------------------------------------------------------------------------------

Privacy Policy | Cookie Statement | Help