manage.kmail-lists.com Open in urlscan Pro
3.208.238.82  Public Scan

Form analysis
1 forms found in the DOM

POST

<form class="klaviyo_subscription_form" action="" method="POST">
  <input type="hidden" name="csrfmiddlewaretoken" value="JT3gvR1SC05qSYzH8hBXN3P3OKePCpcraTlZTaGRGeL57Fbur95f66Tj3raHjYMu">
  <div class="form_body">
    <div class="form_fields">
      <div class="control-group text  ">
        <label for="id_$email" class="control-label">Email</label>
        <div class="controls">
          <span class="required">*</span>
          <input type="text" name="$email" value="andrea.lehman@providence.org" required="" id="id_$email">
        </div>
      </div>
      <div class="control-group text  ">
        <label for="id_$first_name" class="control-label">First Name</label>
        <div class="controls">
          <input type="text" name="$first_name" value="Andrea" id="id_$first_name">
        </div>
      </div>
      <div class="control-group text  ">
        <label for="id_$last_name" class="control-label">Last Name</label>
        <div class="controls">
          <input type="text" name="$last_name" value="Lehman" id="id_$last_name">
        </div>
      </div>
    </div>
    <div class="form_actions">
      <button class="btn btn-large btn-primary subscribe_button" type="submit">Update Preferences</button>
    </div>
  </div>
</form>

Text Content

EMAIL PREFERENCES

Email
*
First Name

Last Name

Update Preferences
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