18.consumertestconnect.com
Open in
urlscan Pro
34.196.133.128
Public Scan
URL:
https://18.consumertestconnect.com/iphone
Submission Tags: @phish_report
Submission: On December 18 via api from FI — Scanned from FI
Submission Tags: @phish_report
Submission: On December 18 via api from FI — Scanned from FI
Form analysis
1 forms found in the DOMPOST /flow?uid=b714167f-483b-4d83-8f33-b25444f9d0d2
<form id="formSubmit" action="/flow?uid=b714167f-483b-4d83-8f33-b25444f9d0d2" method="POST" data-effect="" data-effect-duration="">
<div id="f1" class="dynamic-form form-step form1 form1-1">
<div class="row row-spacing" data-row-id="1">
<div id="col-field-title" class="col title form-field-col" data-col-id="1" data-autohide="">
<label class="label">Title</label>
<select id="gender" data-type="title" name="gender" title="Title" class="path-form-field-with-feedback required path-dynamic-field">
<option value=""> Select Title </option>
<option value="M">Mr.</option>
<option value="F">Ms.</option>
<option value="F">Mrs.</option>
</select>
<span id="gender-title-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#gender[data-type=title]').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#gender-title-error-feedback')
var elem = this
evt.detail.assignToState('gender')
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select Title
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="2">
<div id="col-field-first_name" class="col first-name form-field-col" data-col-id="1" data-autohide="">
<label class="label">First Name</label>
<input id="first_name" type="text" name="first_name" class="path-form-field-with-feedback path-dynamic-field required" title="First Name" value="">
<span id="first_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#first_name').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#first_name-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('first_name')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-last_name" class="col last-name form-field-col" data-col-id="2" data-autohide="">
<label class="label">Last Name</label>
<input id="last_name" type="text" name="last_name" class="path-form-field-with-feedback path-dynamic-field required" title="Last Name" value="">
<span id="last_name-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#last_name').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#last_name-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('last_name')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="3">
<div id="col-field-email" class="col e-mail form-field-col" data-col-id="1" data-autohide="">
<label class="label">E-mail</label>
<input id="email" list="email_domains" type="email" name="email" class="path-form-field-with-feedback path-dynamic-field required" title="Email" data-session-verification="-1" value="">
<span id="emailmessage" class="invalid-feedback hidden path-form-feedback"></span>
<datalist id="email_domains"></datalist>
<script>
document.querySelector('#email').addEventListener('path-dynamic-field-register', function(evt) {
var domains = ["gmail.com", "yahoo.com", "hotmail.com", "aol.com", "hotmail.co.uk", "hotmail.fr", "msn.com", "yahoo.fr", "wanadoo.fr", "orange.fr", "comcast.net", "yahoo.co.uk", "yahoo.co.in", "live.com", "rediffmail.com", "free.fr",
"gmx.de", "web.de", "yandex.ru", "ymail.com", "libero.it", "outlook.com", "uol.com", "bol.com", "mail.ru", "cox.net", "hotmail.it", "sbcglobal.net", "sfr.fr", "live.fr", "verizon.net", "live.co.uk", "googlemail.com", "yahoo.es",
"ig.com", "live.nl", "bigpond.com", "terra.com", "yahoo.it", "neuf.fr", "yahoo.de", "alice.it", "rocketmail.com", "att.net", "laposte.net", "facebook.com", "bellsouth.net", "yahoo.in", "hotmail.es", "charter.net", "yahoo.ca",
"yahoo.com.au", "rambler.ru", "hotmail.de", "tiscali.it", "shaw.ca", "yahoo.co.jp", "sky.com"
]
var feedbackElem = document.querySelector('#emailmessage')
var emailDomains = document.querySelector('#email_domains')
var elem = this
evt.detail.overrideOnChangeListener(function() {
elem.addEventListener('input', evt.detail.listener(function(evt, setValue) {
var value = evt.target.value
setValue(value)
var split = value.split('@')
var username = split[0]
var domain = split[1]
var regex = domain && new RegExp('@' + domain)
emailDomains.innerHTML = ''
domains.forEach(function(domain) {
if (regex && regex.test('@' + domain) && username + '@' + domain !== value) {
var option = emailDomains.appendChild(document.createElement('option'))
option.setAttribute('value', username + '@' + domain)
}
})
}))
})
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('test')
evt.detail.assignToState('email', evt.detail.effects.test)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="4">
<div id="col-field-html" class="col html form-field-col-ignored" data-col-id="1" data-autohide="">
<div id="path-field-html-1-4-1" class="path-dynamic-field">
<input type="hidden" id="cf_hbf" name="cf_hbf" value="">
</div>
<script>
document.querySelector('#path-field-html-1-4-1').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
elem.fieldContent = elem.innerHTML
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillMergetagsHTML(elem)
},
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="5">
<div id="col-field-address1" class="col-8 address-1 form-field-col" data-col-id="1" data-autohide="">
<label class="label">Street Address</label>
<input id="addressform" type="text" name="addressform" title="Address" value="" class="path-dynamic-field path-form-field-with-feedback required" autocomplete="address-line1">
<span id="address1-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-postal"></span>
<input id="address1" type="hidden" name="address1" title="Address" value="">
<script>
document.querySelector('#addressform').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#address1-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('address1')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-address2" class="col address-2 form-field-col" data-col-id="2" data-autohide="">
<label class="label">Suite</label>
<input id="address2" type="text" name="address2" value="" class="path-form-field-with-feedback path-dynamic-field " autocomplete="address-line2">
<span id="address2-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#address2').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#address2-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('address2')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="6">
<div id="col-field-city" class="col city form-field-col" data-col-id="1" data-autohide="">
<label class="label">City</label>
<input id="city" type="text" name="city" title="City" value="" class="path-form-field-with-feedback path-dynamic-field required" autocomplete="address-level2">
<span id="city-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#city').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#city-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('city')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="7">
<div id="col-field-state" class="col-7 state form-field-col" data-col-id="1" data-autohide="">
<label class="label">State</label>
<select id="state" name="state" title="State" class="path-form-field-with-feedback path-dynamic-field required" value="" datavalue="">
<option value=""> Select State </option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
<span id="state-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#state').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#state-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('state')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Select State
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
<div id="col-field-zip" class="col zip-code form-field-col" data-col-id="2" data-autohide="">
<label class="label">Zip Code</label>
<input id="zip" type="text" name="zip" title="Zipcode" maxlength="5" data-session-verification="-1" value="" class="path-form-field-with-feedback required path-dynamic-field" pattern="[0-9]*" inputmode="numeric" autocomplete="postal-code">
<span id="zip-error-feedback" class="invalid-feedback hidden path-form-feedback"></span>
<script>
document.querySelector('#zip').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#zip-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('zip')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillZip(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
$(elem).change()
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="8">
<div id="col-field-phone" class="col phone form-field-col" data-col-id="1" data-autohide="">
<label class="label">Phone</label>
<input id="phone" type="tel" name="phone" title="Phone" data-session-verification="-1" value="" class="path-dynamic-field path-form-field-with-feedback required" pattern="[0-9]*" inputmode="numeric" autocomplete="tel-national">
<span id="phone-error-feedback" class="invalid-feedback hidden path-form-feedback invalid-phone"></span>
<script>
document.querySelector('#phone').addEventListener('path-dynamic-field-register', function(evt) {
var feedbackElem = document.querySelector('#phone-error-feedback')
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('phone')
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
prepopulate_with: renders.fillInputPhone(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
</script>
</div>
</div>
<div class="row row-spacing" data-row-id="9">
<div id="col-field-dob" class="col date-of-birth form-field-col" data-col-id="1" data-autohide="">
<label class="label">Date of Birth</label>
<div class="row path-form-field-with-feedback-control">
<div class="col">
<select id="dob_month" name="dob_month" title="Dob Month" autocomplete="bday-month" class="path-dynamic-field required">
<option value=""> Month </option>
<option value="01">Jan</option>
<option value="02">Feb</option>
<option value="03">Mar</option>
<option value="04">Apr</option>
<option value="05">May</option>
<option value="06">Jun</option>
<option value="07">Jul</option>
<option value="08">Aug</option>
<option value="09">Sep</option>
<option value="10">Oct</option>
<option value="11">Nov</option>
<option value="12">Dec</option>
</select>
</div>
<div class="col">
<select id="dob_day" name="dob_day" title="Dob Day" autocomplete="bday-day" class="path-dynamic-field required">
<option value=""> Day </option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
</div>
<div class="col">
<select id="dob_year" name="dob_year" title="Dob Year" autocomplete="bday-year" class="path-dynamic-field required">
<option value=""> Year </option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
</select>
</div>
</div>
<span id="dobmessage" class="invalid-feedback hidden path-form-feedback"></span>
<script>
var feedbackElem = document.querySelector('#dobmessage')
document.querySelector('#dob_day').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('dob_day', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Day
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
document.querySelector('#dob_year').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('age')
evt.detail.assignToState('dob_year', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
Year
`),
prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
document.querySelector('#dob_month').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.assignToState('dob_month', evt.detail.effects.age)
evt.detail.render(function(renders) {
return {
hide: renders.hideParentFieldForm(elem),
show: renders.hideParentFieldForm(elem, false),
populate: {
populate_options: renders.fillSelectOptions(elem, `
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prepopulate_with: renders.fillInput(elem)
},
validation: renders.fillFeedbackMessage(feedbackElem)
}
})
})
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</div>
<div class="row row-spacing" data-row-id="10">
<div id="col-field-twyne_registration" class="col twyne-registration form-field-col" data-col-id="1" data-autohide="">
<div class="form-row">
<div id="sploffrs" class="x-12 sploffrs">
<script type="text/javascript" src="https://shopgala.api.twyne.io/assets/form.js"></script>
<script type="text/javascript" id="twyne-embed" class="twyne-embed">
(function(global) {
function twyne_load() {
var data = {};
data.pid = '6';
data.sid = '27';
data.first = '';
data.last = '';
data.email = '';
data.address1 = '';
data.address2 = '';
data.city = '';
data.gender = '';
data.state = '';
data.zip = '';
data.phone = '';
data.dob = '//';
data.istest = 'n';
data.externalgroup = 'SeYds-B0fYXpP-wu-C86';
data.country = 'US';
data.subid1 = '1000';
data.subid2 = '';
data.loading = {
enabled: false
};
data.embedUrlOverride = 'https://shopgala.api.twyne.io/';
data.formRegistration = {
binders: {
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'last': 'last_name',
'email': 'email',
'address1': 'addressform',
'address2': 'address2',
'city': 'city',
'gender': 'gender',
'state': 'state',
'zip': 'zip',
'phone': 'phone'
},
customFields: ['dob'],
optionalFields: ['address2'],
percent: 0
}
global.twyne.initEmbed(data);
}
document.addEventListener("DOMContentLoaded", twyne_load);
})(this);
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<script async="" type="text/javascript"
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<div id="twy-placement-627" class="twyne-path-content"></div>
</div>
</div>
</div>
</div>
<div class="row row-spacing" data-row-id="11">
<div id="col-field-tcpa_consent" class="col tcpa-consent form-field-col" data-col-id="1" data-autohide="">
<div class="tcpa-terms">
<input type="checkbox" class="chkbox path-dynamic-field " "="" id=" leadid_tcpa_disclosure" name="chktcpa">
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Relief Center, Biologistics, DH Insurance Group, Gotham Healthcare, Your Savings Advisor, GoQuote, Karma Financial Group, and Mass Nexus LLC on the landline or mobile number I provided even if I am on the federal or state do not call
registry. I understand these calls and SMS text messages may be generated using an autodialer and that consenting is not required to participate in the offers promoted. I understand that I may revoke consent at any time. Text STOP to opt
out and HELP to receive help. </label>
<script>
document.querySelector('#leadid_tcpa_disclosure').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.assignToState('tcpaConsent', function(value) {
return elem.checked
})
evt.detail.setControls('eyJwb3B1bGF0ZSI6bnVsbCwidmlzaWJpbGl0eSI6bnVsbCwidmFsaWRhdGlvbnMiOm51bGx9')
evt.detail.render(function(renders) {
return {
validation: renders.overrideTcpaConsentAlertText
}
})
})
</script>
</div>
</div>
</div>
<div class="row row-spacing" data-row-id="12">
<div id="col-field-registration_consent" class="col registration-consent form-field-col" data-col-id="1" data-autohide="false">
<div class="terms termschk">
<input type="checkbox" class="chkbox path-dynamic-field" id="chkterms" name="chkterms" checked="" value="on">
<label class="term-label terms-label--checkbox" for="chkterms"> By checking the box, I agree that I am a US resident over the age of 18 and agree to the <a href="/terms-conditions" target="_blank">Terms of Use</a> and
<a href="/privacy-policy" target="_blank">Privacy Policy</a>, and site visit recordation by TrustedForm and Jornaya, I agree to 3rd party marketing from GreenDot Bank. I also agree to receive email from ConsumerTestConnect and affiliated
brands that may be of interest. </label>
<script>
document.querySelector('#chkterms').addEventListener('path-dynamic-field-register', function(evt) {
var elem = this
evt.detail.assignToState('registrationConsent', function(value) {
elem.dispatchEvent(new CustomEvent('path-event-registration-consent-changed'))
return elem.checked
})
})
</script>
</div>
</div>
</div>
</div>
<div class="form-row">
<div class="x-12 col-mobile center">
<button class="btn form-button submitbutton form-submit-button" type="button" id="submitbutton">
<span>CONTINUE</span>
<i class="fa fa-spinner fa-spin"></i>
</button>
<div id="recaptcha" class="g-recaptcha" data-sitekey="6Lf-_IcUAAAAALoHTuCfN0wKz8KXPQPvGUtBRiG2" data-callback="submitRecaptcha" data-size="invisible">
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<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-h7prlo6o9ydc" frameborder="0" scrolling="no"
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</div><iframe style="display: none;"></iframe>
</div>
</div>
</div>
<div class="hidden">
<input type="hidden" id="numForms" name="numForms" value="1">
<input type="hidden" id="tcpaStep" name="tcpaStep" value="1">
<input type="hidden" id="registrationStep" name="registrationStep" value="1">
<input type="hidden" id="currentForm" name="currentForm" value="1">
<input type="hidden" id="uid" name="uid" value="b714167f-483b-4d83-8f33-b25444f9d0d2">
<input type="hidden" id="tcpaconsent" name="tcpaconsent" value="">
<input type="hidden" id="consent" name="consent" value="">
<input type="hidden" id="pathAid" name="pathAid" value="1034">
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<input type="hidden" id="registrationCheck" name="registrationCheck" value="true">
<input type="hidden" id="addressCheck" name="addressCheck" value="false">
<input type="hidden" id="fraudCheck" name="fraudCheck" value="false">
<input type="hidden" id="emailValid" name="emailValid" value="false">
<input type="hidden" id="addressValid" name="addressValid" value="false">
<input type="hidden" name="origin" value="submit">
<input type="hidden" id="haddress1" value="">
<input type="hidden" id="haddress2" value="">
<input type="hidden" id="hcity" value="">
<input type="hidden" id="hstate" value="">
<input type="hidden" id="hzipcode" value="">
<div id="pixel"></div>
<script type="text/javascript">
(function() {
var field = 'xxTrustedFormCertUrl';
var provideReferrer = false;
var invertFieldSensitivity = false;
var tf = document.createElement('script');
tf.type = 'text/javascript';
tf.async = true;
tf.src = 'http' + ('https:' == document.location.protocol ? 's' : '') + '://api.trustedform.com/trustedform.js?field=' + escape(field) + '&l=' + new Date().getTime() + Math.random() + '&invert_field_sensitivity=' + invertFieldSensitivity;
var s = document.getElementsByTagName('script')[0];
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<img src="//api.trustedform.com/ns.gif">
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<input id="leadid_token" name="universal_leadid" type="hidden" value="BCBFCA1B-AA66-B492-79F2-2C92F9C90200">
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<input type="hidden" name="xxTrustedFormCertUrl" value="https://cert.trustedform.com/458ce6021fee756b5cd71195fa2b267630450aa7" id="xxTrustedFormCertUrl_0"><input type="hidden" name="xxTrustedFormToken"
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Text Content
$999 IPHONE 16 Value $999 MIN Entries 100,000 Nº Winners 1 EXP Date 09/12/2025 Contest Rules Title Select Title Mr. Ms. Mrs. First Name Last Name E-mail Street Address Suite City State Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Phone Date of Birth Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 20062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924 By checking the box, I consent to receive phone sales calls or SMS text messages - Msg and data rates may apply - from Surveys2Cash, LegalFinderHQ, PLM, Consumer Concierge, Financial Relief Center, Biologistics, DH Insurance Group, Gotham Healthcare, Your Savings Advisor, GoQuote, Karma Financial Group, and Mass Nexus LLC on the landline or mobile number I provided even if I am on the federal or state do not call registry. I understand these calls and SMS text messages may be generated using an autodialer and that consenting is not required to participate in the offers promoted. I understand that I may revoke consent at any time. Text STOP to opt out and HELP to receive help. By checking the box, I agree that I am a US resident over the age of 18 and agree to the Terms of Use and Privacy Policy, and site visit recordation by TrustedForm and Jornaya, I agree to 3rd party marketing from GreenDot Bank. I also agree to receive email from ConsumerTestConnect and affiliated brands that may be of interest. CONTINUE HOW IT WORKS REGISTER FOR A MONTHLY CONTEST Your are now registered for the contest. No other action is required. COMPLETE OPTIONAL SPONSORED QUESTIONNAIRE Some of these questions may be sponsored by our advertising partners. VIEW AND RECEIVE SPECIALIZED OFFERS If an offer interest you great! If not, simply pass on it. This helps keep the site free. WE'LL CONTACT WINNERS VIA EMAIL: FULFILLMENT@CONSUMERTESTCONNECT.COM Minimum number of entries are required for contest to be drawn. Make sure to respond to the above email. * Privacy Policy * Terms & Conditions * Contest Rules * Unsubscribe * CA Consumers: * Privacy Policy * Do not sell my information Copyright © 2018 - 2022, All Rights Reserved. -------------------------------------------------------------------------------- Welcome to ConsumerTestConnect (collectively “ConsumerTestConnect”), an ad-supported/lead generation web property of prizes and promotions. By entering your email address and clicking "Continue", you agree to receive information in electronic (including email) or physical formats from ConsumerTestConnect and/or trusted third parties containing promotions and other special Offers and that ConsumerTestConnect may provide your email address and corresponding information to such third parties for email purposes. If you do not wish to continue receiving such emails, you may unsubscribe at any time by following the instructions included in each newsletter or email. ConsumerTestConnect functions solely as a provider of Contest and Sweepstakes. We also aggregate third-party Offers such as surveys, free samples, deals, coupons, freebies and other Offers (collectively "Offers") to present to you the user while being a registered user of our site. No Offer participation or purchase is necessary to enter a Contest or Sweepstake. These Contest and Offers change often. To enter a Contest you must complete the Contest registration page providing your name, address, date of birth, phone and email address. Upon registration you are now entered entered into that monthly Contest and no other action is needed. Upon choosing certain Offers you will be redirected to the respective Offers website. ConsumerTestConnect does not have any control over the content and performance of such third-party websites and respective Offers. We cannot guarantee that you will receive any compensation for these surveys or fulfillment of Offers that you request. We are not responsible if such surveys or Offers are no longer available, change, if you do not receive the Offers, if you do not qualify for the surveys or Offers, or if any other issues arise. The third-party product names, logos, brands, and trademarks shown on this website are the property of their respective owners. MARKETING PARTNERS ConsumerTestConnect.com is currently or has previously entered into strategic relationships with various partner companies "Marketing Partners" in an effort to help fulfill the requests you have made on our website concerning various deals, offers, or opportunities (the "Offers"). By requesting such information you are providing a digital signature and expressly consenting to receiving a phone call and/or SMS/Text Messages from such Marketing Partners, at the phone number provided on our signup page regarding financial, home, travel, energy, home warranty, digital services and health products. In an effort to be as transparent as possible, below we have aggregated a list of our current marketing partners who may be in contact with you based on the Offers you have asked to receive more information about. All State ADT ADT Solar Advertising Inc American Police Officers Alliance Autistic Childern of America Callsiva Choice home warranty Complete Home Services Consumer Council Dart Data Deliver Marketing Front Point Grand Caribbean Cruise Health Coverage Helpers Home Support Group IDT Energy Innovative Teleservices Insurance Guide Med Advantage Advisors Medical Support Group Mixed Media Holdings Mojo Media My Home Helpers NationalHomeProject National Police National Association of Chiefs of Police New Strata Senior Aid Helper Senior Benfits Sheriffs Coalition PAC Spark Energy Sun Power SunPro Solar Sunrun Superior Home The-Solar-Project.com Titan Energy Town Square Energy USA Rate Center www.LocalSolarClients.com