ccg.informz.net
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54.161.72.142
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URL:
http://ccg.informz.net/ccg/pages/CCG_Unsubscribe_Form?_zs=ShNMd&_zmi=x1XI
Submission: On May 05 via api from US — Scanned from DE
Submission: On May 05 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="formData" autocomplete="off">
<!-- H o n e y p o t -->
<label class="ohnohoney" for="name"></label>
<input class="ohnohoney" autocomplete="off" type="search" id="name" name="name" placeholder="Your name here">
<label class="ohnohoney" for="email"></label>
<input class="ohnohoney" autocomplete="off" type="search" id="email" name="email" placeholder="Your e-mail here">
<div class="form_messages" style="background-color:#ffffff;border-radius:4px;border:1px solid #999999;margin:40px;padding:5px;text-align: center;display:none"></div>
<div id="live" class="informzForm" style="display: block; position: relative; height: 890px; width: 695px; background-color: rgba(255, 255, 255, 0.9); border: 1px solid rgb(239, 239, 239); border-radius: 10px; margin: 10px auto; padding: 10px;">
<div id="sortableFormFramesLive">
<div>
<div style="position: absolute; top: 300px; left: 65px; cursor: text; border-radius: 4px;" class="form_designer_field" id="057343E9-3679-1A5B-7419-5FC114BD108C_live">
<div id="frame057343E9-3679-1A5B-7419-5FC114BD108C" style="width:580px;height:345px;border-radius:10px;border:0px solid #999999;background-color:#CCCCCC" class="ui-resizable"></div>
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<div id="sortableFormImagesLive">
<div>
<div style="position: absolute; top: 20px; left: 40px; cursor: text; border-radius: 4px;" class="form_designer_field" id="8EF426B1-BDFE-7DF7-9DAB-074974DD98E5_live">
<div class="ui-wrapper" style="overflow: hidden; position: relative; width: 430px; height: 145px; top: 0px; left: 0px; margin: 0px;"><img alt="" id="image8EF426B1-BDFE-7DF7-9DAB-074974DD98E5"
src="http://ccg.informz.net/ccg/data/images/CCG%20Logos/CCG_Logo_Long.png" class="ui-resizable" style="resize: none; position: static; display: block; height: 145px; width: 430px;" width="430" height="145"></div>
</div>
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<div id="sortableFormItemsLive">
<div>
<div style="position: absolute; top: 215px; left: 115px; cursor: text; border-radius: 4px;" class="form_designer_field" id="E054ACC4-91B1-D405-1533-C82ECCF791A9_live">
<div style="width: 510px; height: 70px; text-align: left; color: rgb(51, 51, 51); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
id="text_container_E054ACC4-91B1-D405-1533-C82ECCF791A9" class="text_style ui-resizable">
<div id="editable_E054ACC4-91B1-D405-1533-C82ECCF791A9" dataidval="E054ACC4-91B1-D405-1533-C82ECCF791A9" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true" role="textbox" aria-multiline="true"
data-medium-editor-editor-index="1" medium-editor-index="1489709a-a973-4495-5ca0-06d278572696" data-placeholder="Type your text">
<p style=""></p>
<h1 style="color: rgb(102, 102, 102); font-weight: bold; font-size: 24px; margin-top: 0px; margin-bottom: 0px; line-height: 24px; letter-spacing: 0px;">Do you really have to leave?</h1>
<p style=""></p>
<p style="">
<a href="http://ccg.informz.net/ccg/pages/CCG_Mailing_Preference_Update_Form" target="_blank" style="color: rgb(0, 0, 238); text-decoration: underline; font-size: inherit;">Click here to update your communication preferences instead.</a>
</p>
<h1 style="color: rgb(102, 102, 102); font-weight: bold; font-size: 24px; margin-top: 0px; margin-bottom: 0px; line-height: 24px; letter-spacing: 0px;">
<p></p>
</h1>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 310px; left: 125px; cursor: text; border-radius: 4px;" class="form_designer_field" id="4BC8F6B9-E69D-CDF7-EFAF-DBCB91707FAE_live">
<div style="width: 410px; height: 30px; text-align: left; color: rgb(51, 51, 51); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
id="text_container_4BC8F6B9-E69D-CDF7-EFAF-DBCB91707FAE" class="text_style ui-resizable">
<div id="editable_4BC8F6B9-E69D-CDF7-EFAF-DBCB91707FAE" dataidval="4BC8F6B9-E69D-CDF7-EFAF-DBCB91707FAE" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true" role="textbox" aria-multiline="true"
data-medium-editor-editor-index="2" medium-editor-index="71f1480b-9683-cb14-b27c-2e666889ae51" data-placeholder="Type your text">
<h2 style="color: rgb(102, 102, 102); font-weight: bold; font-size: 22px; margin-top: 0px; margin-bottom: 0px; line-height: 24px; letter-spacing: 0px;">
<p></p>
</h2>
<h1 style="color: rgb(102, 102, 102); font-weight: bold; font-size: 24px; margin-top: 0px; margin-bottom: 0px; line-height: 24px; letter-spacing: 0px;"><span style="font-size: 16px; font-weight: normal; letter-spacing: 0px;">If you must
go, please let us know why.</span></h1>
<p style=""></p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 350px; left: 125px; cursor: text; border-radius: 4px;" class="form_designer_field" id="70C33194-CCDF-8511-D9CE-4E8E39009946_live">
<div id="container70C33194-CCDF-8511-D9CE-4E8E39009946" class="ui-resizable"
style="width: 390px; margin-bottom: 0px; margin-top: 0px; color: rgb(51, 51, 51); font-weight: bold; font-size: 16px; font-family: Open Sans; border-color: transparent; border-style: solid; border-width: 1px 8px 1px 1px; border-image: none 100% / 1 / 0 stretch; border-radius: 2px 8px 8px 2px; padding-right: 8px; margin-right: 8px; float: left; min-width: 50px; min-height: 10px; padding-top: 0px; padding-bottom: 0px; height: 30px; line-height: 24px; letter-spacing: 0px;">
<table>
<tbody>
<tr>
<td> <input id="70C33194-CCDF-8511-D9CE-4E8E39009946" type="radio" name="radio_val" value="I no longer want to receive these emails." style="pointer-events: unset;" placeholder="I no longer want to receive these emails."
autocomplete="off"> </td>
<td>
<div style="display:inline-block;" id="editable_70C33194-CCDF-8511-D9CE-4E8E39009946" dataidval="70C33194-CCDF-8511-D9CE-4E8E39009946" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true"
role="textbox" aria-multiline="true" data-medium-editor-editor-index="3" medium-editor-index="737b4eba-6bb4-a425-db1f-9d168e81f60a" data-placeholder="Type your text">I no longer want to receive these emails.</div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 390px; left: 125px; cursor: text; border-radius: 4px;" class="form_designer_field" id="8EB2A120-8CC0-4554-5B77-CC185D79989E_live">
<div id="container8EB2A120-8CC0-4554-5B77-CC185D79989E" class="ui-resizable"
style="width: 395px; margin-bottom: 0px; margin-top: 0px; color: rgb(51, 51, 51); font-weight: bold; font-size: 16px; font-family: Open Sans; border-color: transparent; border-style: solid; border-width: 1px 8px 1px 1px; border-image: none 100% / 1 / 0 stretch; border-radius: 2px 8px 8px 2px; padding-right: 8px; margin-right: 8px; float: left; min-width: 50px; min-height: 10px; padding-top: 0px; padding-bottom: 0px; height: 30px; line-height: 24px; letter-spacing: 0px;">
<table>
<tbody>
<tr>
<td> <input id="8EB2A120-8CC0-4554-5B77-CC185D79989E" type="radio" name="radio_val" value="I receive too many emails." style="pointer-events: unset;" placeholder="I receive too many emails." autocomplete="off"> </td>
<td>
<div style="display:inline-block;" id="editable_8EB2A120-8CC0-4554-5B77-CC185D79989E" dataidval="8EB2A120-8CC0-4554-5B77-CC185D79989E" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true"
role="textbox" aria-multiline="true" data-medium-editor-editor-index="4" medium-editor-index="2adfa09d-8e37-ddf1-b7ca-1fb8fffe87c9" data-placeholder="Type your text">I receive too many emails.</div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 435px; left: 125px; cursor: text; border-radius: 4px;" class="form_designer_field" id="AF37662D-555F-0236-7B7A-9CF1EC6CF492_live">
<div id="containerAF37662D-555F-0236-7B7A-9CF1EC6CF492" class="ui-resizable"
style="width: 395px; margin-bottom: 0px; margin-top: 0px; color: rgb(51, 51, 51); font-weight: bold; font-size: 16px; font-family: Open Sans; border-color: transparent; border-style: solid; border-width: 1px 8px 1px 1px; border-image: none 100% / 1 / 0 stretch; border-radius: 2px 8px 8px 2px; padding-right: 8px; margin-right: 8px; float: left; min-width: 50px; min-height: 10px; padding-top: 0px; padding-bottom: 0px; height: 30px; line-height: 24px; letter-spacing: 0px;">
<table>
<tbody>
<tr>
<td> <input id="AF37662D-555F-0236-7B7A-9CF1EC6CF492" type="radio" name="radio_val" value="These emails are no longer relevant to me." style="pointer-events: unset;" placeholder="These emails are no longer relevant to me."
autocomplete="off"> </td>
<td>
<div style="display:inline-block;" id="editable_AF37662D-555F-0236-7B7A-9CF1EC6CF492" dataidval="AF37662D-555F-0236-7B7A-9CF1EC6CF492" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true"
role="textbox" aria-multiline="true" data-medium-editor-editor-index="9" medium-editor-index="91d9bc85-971c-d1eb-5bc3-e1219fa7aceb" data-placeholder="Type your text">These emails are no longer relevant to me.</div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 503px; left: 120px; cursor: text; border-radius: 4px;" class="form_designer_field" id="FF718AB6-513D-5269-DCE9-3E087CC50E50_live">
<div style="width: 240px; height: 30px; text-align: left; color: rgb(51, 51, 51); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
id="text_container_FF718AB6-513D-5269-DCE9-3E087CC50E50" class="text_style ui-resizable">
<div id="editable_FF718AB6-513D-5269-DCE9-3E087CC50E50" dataidval="FF718AB6-513D-5269-DCE9-3E087CC50E50" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true" role="textbox" aria-multiline="true"
data-medium-editor-editor-index="8" medium-editor-index="fe842ad9-068f-917b-06be-d6135d1ad038" data-placeholder="Type your text">
<p style=""><u>Other reason:</u></p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 545px; left: 120px; cursor: text; border-radius: 4px;" class="form_designer_field" id="29DAB16E-E79E-5081-F63B-C14F465F1180_live"><textarea name="text_area" maxlength="1000"
style="width: 400px; height: 60px; resize: none; font-family: Open Sans; font-size: 15px; line-height: 24px; border: 1px inset rgb(156, 156, 156); margin-top: 0px; margin-bottom: 0px; border-radius: 3px; background-color: rgb(239, 239, 239); color: rgb(0, 0, 0); padding: 8px; font-weight: normal; letter-spacing: 0px;"
id="text_area_container_29DAB16E-E79E-5081-F63B-C14F465F1180" class="text_area_input_field" <="" textarea=""></textarea></div>
</div>
<div>
<div style="position: absolute; top: 675px; left: 115px; cursor: text; border-radius: 4px;" class="form_designer_field" id="03A9DFCB-8274-3482-0AE2-EC037FDACD50_live">
<div style="width: 420px; height: 35px; text-align: left; color: rgb(51, 51, 51); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
id="text_container_03A9DFCB-8274-3482-0AE2-EC037FDACD50" class="text_style ui-resizable">
<div id="editable_03A9DFCB-8274-3482-0AE2-EC037FDACD50" dataidval="03A9DFCB-8274-3482-0AE2-EC037FDACD50" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true" role="textbox" aria-multiline="true"
data-medium-editor-editor-index="5" medium-editor-index="f690d093-33fc-1064-4006-1172ebf93ce4" data-placeholder="Type your text">
<p>You are unsubscribing <b>dburns@bcbsm.com</b>.</p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 720px; left: 115px; cursor: text; border-radius: 4px;" class="form_designer_field" id="75982862-2215-9328-DD36-17EC227171A1_live">
<div style="width: 425px; height: 40px; text-align: left; color: rgb(51, 51, 51); line-height: 24px; letter-spacing: 0px; font-weight: normal; font-size: 16px; margin-top: 0px; margin-bottom: 0px; overflow: hidden;"
id="text_container_75982862-2215-9328-DD36-17EC227171A1" class="text_style ui-resizable">
<div id="editable_75982862-2215-9328-DD36-17EC227171A1" dataidval="75982862-2215-9328-DD36-17EC227171A1" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true" role="textbox" aria-multiline="true"
data-medium-editor-editor-index="7" medium-editor-index="03e819eb-7962-f0ad-7dcd-34d11496d39d" data-placeholder="Type your text">
<p style=""><a href="http://ccg.informz.net/ccg/pages/CCG_Mailing_Preference_Update_Form" target="_blank" style="color: rgb(0, 0, 238); text-decoration: underline; font-size: inherit;">Update communication preferences instead.</a></p>
</div>
</div>
</div>
</div>
<div>
<div style="position: absolute; top: 805px; left: 205px; cursor: text; border-radius: 4px;" class="form_designer_field" id="submitButton_live">
<div style="display: block; width: 100%; cursor: pointer;" id="container_submitButton">
<div id="submitButton_button"
style="width: 200px; height: 30px; word-break: break-all; display: table-cell; vertical-align: middle; color: rgb(0, 0, 0); font-family: Open Sans; border: 1px solid rgb(204, 204, 204); border-radius: 6px; margin-top: 0px; margin-bottom: 0px; padding: 10px; background-color: rgb(204, 204, 204); font-size: 16px; text-align: center; box-shadow: rgb(153, 153, 153) 2px 2px 2px; letter-spacing: 0px; line-height: 24px;"
class="form_designer_button ui-resizable">
<div id="editable_submitButton" class="form_designer_field_editable" spellcheck="true" data-medium-editor-element="true" role="textbox" aria-multiline="true" data-medium-editor-editor-index="6"
medium-editor-index="a7f93dc6-c4f0-728c-57ea-ecda8fdb293d" data-placeholder="Type your text"><b>Unsubscribe</b></div>
</div><input name="submitButton" type="hidden" value="0" style="pointer-events: unset;" placeholder="0" id="submitButton" autocomplete="off"><input name="submitButton" type="hidden" value="7924" style="pointer-events: unset;"
placeholder="0" id="submitButton" autocomplete="off">
</div>
</div>
</div>
</div>
</div>
<input type="hidden" name="isf_form_id" value="7924"><input type="hidden" name="isf_id" value="423082594">
</form>Text Content
Template Name: Characters remaining: Template Description: Characters remaining: Name: Filename: Select the destination folder: Select a folder * Report * Edit * Test * Activate * Deactivate * Save As Template * Copy * Delete * Undelete * Archive * Set as In Progress * Form * Content Only * Unsubscribe Form * Custom Some non-required fields on this form are blank. Do you wish to save with blank values? CCG Email Unsubscribe Form DO YOU REALLY HAVE TO LEAVE? Click here to update your communication preferences instead. IF YOU MUST GO, PLEASE LET US KNOW WHY. I no longer want to receive these emails. I receive too many emails. These emails are no longer relevant to me. Other reason: You are unsubscribing dburns@bcbsm.com. Update communication preferences instead. Unsubscribe