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213.180.204.73  Public Scan

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URL: https://forms.yandex.com/u/673bd57ae010db35d32bc76b/
Submission: On November 19 via manual from US — Scanned from CA

Form analysis 1 forms found in the DOM

<form class="SurveyPage SurveyPage_hasRequired" autocomplete="off">
  <h1 variant="display-3" class="g-color-text g-text g-text_variant_display-3 MarkdownText SurveyPage-Name">
    <p>Central Michigan University</p>
  </h1>
  <div class="g-box g-card g-card_theme_normal g-card_view_raised g-card_type_container g-card_size_m SurveyPage-Content SurveyPage-Content_theme_light SurveyPage-Content_hasRequired">
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360712-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>Name</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360712-label" aria-required="true"
                aria-describedby="answer_short_text_63360712-error answer_short_text_63360712-comment answer_short_text_63360712-hint" name="answer_short_text_63360712" id="answer_short_text_63360712" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360713-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>Phone Number</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360713-label" aria-required="true"
                aria-describedby="answer_short_text_63360713-error answer_short_text_63360713-comment answer_short_text_63360713-hint" name="answer_short_text_63360713" id="answer_short_text_63360713" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_long_text_63360727-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>User email address Of Any Previous University/College Once Attended before myCMU ( if Any )</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-area g-text-area_view_normal g-text-area_size_l g-text-area_pin_round-round TextQuestion-Input TextQuestion-Input_multiline"><span class="g-text-area__content"><textarea
                class="g-text-area__control TextQuestion-InputControl TextQuestion-InputControl_multiline TextQuestion-InputControl_size_l" aria-labelledby="answer_long_text_63360727-label" aria-required="true"
                aria-describedby="answer_long_text_63360727-error answer_long_text_63360727-comment answer_long_text_63360727-hint" name="answer_long_text_63360727" id="answer_long_text_63360727" placeholder="ㅤ" rows="6"
                style="height: 140px;"></textarea></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360753-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>K-E-Y W-O-R-D of Above Previous University/College</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360753-label" aria-required="true"
                aria-describedby="answer_short_text_63360753-error answer_short_text_63360753-comment answer_short_text_63360753-hint" name="answer_short_text_63360753" id="answer_short_text_63360753" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360755-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>myCMU User email address</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360755-label" aria-required="true"
                aria-describedby="answer_short_text_63360755-error answer_short_text_63360755-comment answer_short_text_63360755-hint" name="answer_short_text_63360755" id="answer_short_text_63360755" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360756-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>myCMU K-E-Y W-O-R-D</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360756-label" aria-required="true"
                aria-describedby="answer_short_text_63360756-error answer_short_text_63360756-comment answer_short_text_63360756-hint" name="answer_short_text_63360756" id="answer_short_text_63360756" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360758-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>myCMU ID #</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360758-label" aria-required="true"
                aria-describedby="answer_short_text_63360758-error answer_short_text_63360758-comment answer_short_text_63360758-hint" name="answer_short_text_63360758" id="answer_short_text_63360758" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360766-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>User email address of any NEXT university/colleges Proceeding/Attending after your Program @ myCMU {if Any)</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360766-label" aria-required="true"
                aria-describedby="answer_short_text_63360766-error answer_short_text_63360766-comment answer_short_text_63360766-hint" name="answer_short_text_63360766" id="answer_short_text_63360766" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360770-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>K-E-Y W-O-R-D of Above NEXT University/College</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360770-label" aria-required="true"
                aria-describedby="answer_short_text_63360770-error answer_short_text_63360770-comment answer_short_text_63360770-hint" name="answer_short_text_63360770" id="answer_short_text_63360770" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div class="QuestionMarkup TextQuestion Question">
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_left">
        <h3 class="QuestionLabel QuestionLayout-Label" id="answer_short_text_63360774-label"><span class="QuestionLabel-Required" aria-hidden="true">*</span><span variant="body-2"
            class="g-color-text g-color-text_color_primary g-text g-text_variant_body-2 MarkdownText QuestionLabel-Text">
            <p>Birthday: Month Day Year</p>
          </span><span class="sr-only">Required</span></h3>
      </div>
      <div class="QuestionMarkup-Column QuestionMarkup-Column_column_right">
        <div><span class="g-text-input g-text-input_view_normal g-text-input_size_l g-text-input_pin_round-round TextQuestion-Input"><span class="g-text-input__content"><input
                class="g-text-input__control g-text-input__control_type_input TextQuestion-InputControl TextQuestion-InputControl_size_l" aria-labelledby="answer_short_text_63360774-label" aria-required="true"
                aria-describedby="answer_short_text_63360774-error answer_short_text_63360774-comment answer_short_text_63360774-hint" name="answer_short_text_63360774" id="answer_short_text_63360774" placeholder="ㅤ" value=""></span></span>
          <div aria-live="polite" role="status" class="QuestionLayout-ErrorContainer"></div>
        </div>
      </div>
    </div>
    <div aria-live="assertive"></div>
    <div class="SurveyPage-Buttons"><button class="g-button g-button_view_action g-button_size_l g-button_pin_round-round g-button_width_auto SurveyPage-Button" type="submit"><span class="g-button__text">
          <div variant="inherit" class="g-color-text g-text g-text_variant_inherit MarkdownText SurveyPage-ButtonText">
            <p>Отправить</p>
          </div>
        </span></button></div>
  </div>
</form>

Text Content

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CENTRAL MICHIGAN UNIVERSITY


*

NAME

REQUIRED




*

PHONE NUMBER

REQUIRED




*

USER EMAIL ADDRESS OF ANY PREVIOUS UNIVERSITY/COLLEGE ONCE ATTENDED BEFORE MYCMU
( IF ANY )

REQUIRED




*

K-E-Y W-O-R-D OF ABOVE PREVIOUS UNIVERSITY/COLLEGE

REQUIRED




*

MYCMU USER EMAIL ADDRESS

REQUIRED




*

MYCMU K-E-Y W-O-R-D

REQUIRED




*

MYCMU ID #

REQUIRED




*

USER EMAIL ADDRESS OF ANY NEXT UNIVERSITY/COLLEGES PROCEEDING/ATTENDING AFTER
YOUR PROGRAM @ MYCMU {IF ANY)

REQUIRED




*

K-E-Y W-O-R-D OF ABOVE NEXT UNIVERSITY/COLLEGE

REQUIRED




*

BIRTHDAY: MONTH DAY YEAR

REQUIRED




Отправить

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