www.mt-ins.com
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2606:4700:3031::6815:4c23
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URL:
https://www.mt-ins.com/UnSub_A/?id=6887&lead_id=58802342821&qid=2
Submission: On February 16 via api from IE — Scanned from DE
Submission: On February 16 via api from IE — Scanned from DE
Form analysis 1 forms found in the DOM
POST UnSub_A_Proc.php
<form action="UnSub_A_Proc.php" method="POST" style="text-align: left" onsubmit="return getParam(this)">
<input type="hidden" id="queryid" name="queryid" value="2">
<input type="hidden" id="CampaignID" name="CampaignID" value="6887">
<table border="0" cellpadding="2" width="102%">
<tbody>
<tr>
<td width="103%">
<font face="Verdana" size="1" color="#FFFFFF">.</font>
</td>
</tr>
<tr>
<td width="103%">
<p style="width:400px;margin:0 auto 0 auto;">
<font face="Verdana" size="2" color="#CE7B00">*</font>
<font face="Verdana" size="2">Email Address:::</font><br>
<font face="Verdana" size="1">
<!--webbot b-value-required="TRUE" bot="Validation" i-maximum-length="50" i-minimum-length="1" -->
<textarea name="EmailAddress" id="email" rows="5" cols="44" tabindex="1">mberndt@onesharehealth.com</textarea>
</font>
</p>
</td>
</tr>
<tr>
<td width="103%">
<font color="#FFFFFF">.</font>
</td>
</tr>
<tr>
<td width="103%">
<p style="width:400px;margin:0 auto 0 auto;">
<font face="Verdana" size="2" class="required">*</font>
<font face="Verdana" size="2">Unsubscribe Reason: </font>
<br>
<select id="reason" name="reason">
<option value="">--Please Select--</option>
<option value="Too many email">Too many email</option>
<option value="Not relevant">Not relevant</option>
<option value="Not interesting">Not interesting</option>
<option value="No longer there">No longer there</option>
<option value="None of the above">None of the above</option>
</select>
</p>
</td>
</tr>
<tr>
<td width="103%">
<font color="#FFFFFF">.</font>
</td>
</tr>
<tr>
<td width="103%">
<p style="width:400px;margin:0 auto 0 auto;">
<font face="Verdana" size="2">Comments:</font><br>
<textarea id="comment" name="comment" rows="4" cols="44" wrap="soft"></textarea>
</p>
</td>
</tr>
<tr>
<td width="103%" align="center">
<p style="width:400px;margin:0 auto 0 auto;">
<font face="Verdana" size="2">
</font>
</p>
<div id="imgCaptcha" width="5">
<h2>40727</h2>
</div>
<div id="captcha_status"></div>
<font face="Verdana" size="2"> <br>
<label for="captcha">Please enter the text as you see it in the image above:</label>
</font>
<p></p>
</td>
</tr>
<tr>
<td width="103%">
<p style="width:400px;margin:0 auto 0 auto;">
<input id="txtCaptcha" type="text" name="txtCaptcha" value="" maxlength="10" size="32">
</p>
</td>
</tr>
<tr valign="top">
<td width="103%" align="center">
<!-- <p><font face="Verdana" size="2"><input type="checkbox" checked="checked" name="email_confirmation" value="yes"/> Please send me an email confirmation that I have been unsubscribed</font></p> -->
</td>
</tr>
</tbody>
</table>
<div class="b1mainColor" style="width: 720; height: 54">
<p style="margin-top: 0; margin-bottom: 0">
<font face="Verdana" size="1">
</font>
</p>
<p style="margin-top: 0; margin-bottom: 0" align="center">
<font face="Verdana" size="1"> <input type="submit" value="Submit"></font>
</p>
<p style="margin-top: 0; margin-bottom: 0" align="center"> </p>
</div>
</form>Text Content
-------------------------------------------------------------------------------- Sorry to lose you as a reader. You can unsubscribe from all emailings below. We do not always read the comments * Required Field All data gathered from this page is being recorded. This includes the IP address, email address that is entered, and any other data that may be collected from your internet connection that uniquely identifies the unsubscriber. Please allow 72 hours to be completely removed from our system. Regards, Technology Department 702-458-9833 -------------------------------------------------------------------------------- . *Email Address::: mberndt@onesharehealth.com . *Unsubscribe Reason: --Please Select-- Too many email Not relevant Not interesting No longer there None of the above . Comments: 40727 Please enter the text as you see it in the image above: All data gathered from this page is being recorded. This includes the IP address, email address that is entered, and any other data that may be collected from your internet connection that uniquely identifies the unsubscriber. Please allow 72 hours to be completely removed from our system. Regards, Technology Department 702-458-9833 x104