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info.consortiuminsights.com Open in urlscan Pro
104.160.77.184  Public Scan

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Submitted URL: https://info.consortiuminsights.com/click.html?x=a62e&lc=dR&mc=u&s=i0a&u=s&z=I5MgQ4S&
Effective URL: https://info.consortiuminsights.com/site2/subscribe?u=B&webforms_id=5
Submission: On June 02 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST /add_contact_webform_v2.html?u=B&webforms_id=5

<form data-editable="container.form" data-bg-image="url(&quot;http://consortium.getresponse360.com/images/common/templates/webform/11/5/img/bg.png&quot;)" class="editor-loaded" data-spacing="16;80;16;80;5"
  action="/add_contact_webform_v2.html?u=B&amp;webforms_id=5" method="post" novalidate="" style="overflow: hidden;">
  <div>
    <div data-editable="static-image" style="left: 0px; top: 0px; width: 313px; height: 279px; background-image: url(&quot;https://info.consortiuminsights.com/images/common/templates/webform/11/5/img/2.png&quot;); background-size: 313px;">
      <img src="/images/common/templates/webform/11/5/img/2.png" width="313" alt="" draggable="false" hidden="">
    </div>
    <div data-editable="static-box" id="s_wqw8i" style="width: 315px; left: 87px; top: 38px;">
      <div hidden=""></div>
    </div>
    <div data-editable="static-text" style="left: 99px; top: 46px; width: 295px; height: 66px;" id="s_iwdwf">
      <div style="font-family: Lato, sans-serif; color: rgb(255, 255, 255); text-align: center;" class="text-content"><span style="">Keep in touch.&nbsp;</span><br>Subscribe to Consortium communications.</div>
    </div>
    <div data-editable="custom" style="left: 110px; top: 151px; width: 278px;" id="c_vbvb3">
      <div class="container label-position-inside">
        <div class="label"><label for="webform_c_e33l3">Email</label></div>
        <div class="box">
          <div class="field">
            <div class="block border"><input id="webform_c_e33l3" class="placeholder padding" name="webform[email]" type="text" value="" placeholder="EMAIL" maxlength="128" minlength="" data-tab-index="" tabindex="1" aria-required="true"><span
                class="placeholder like-placeholder" style="display:none;"></span></div>
          </div>
          <div class="info-error" hidden="">
            <p></p>
          </div>
          <div class="info">
            <p></p>
          </div>
        </div>
        <div class="label position-right"><label for="webform_c_e33l3">Email</label></div>
      </div>
    </div>
    <div data-editable="custom" style="left: 110px; top: 229px; width: 278px;" id="c_8hhh3">
      <div class="container label-position-inside">
        <div class="label"><label for="webform_c_l3lxk">First name</label></div>
        <div class="box">
          <div class="field">
            <div class="block border"><input id="webform_c_l3lxk" class="placeholder padding" name="webform[first_name]" type="text" value="" placeholder="FIRST NAME" maxlength="64" minlength="" data-tab-index="" tabindex="2"><span
                class="placeholder like-placeholder" style="display:none;"></span></div>
          </div>
          <div class="info-error" hidden="">
            <p></p>
          </div>
          <div class="info">
            <p></p>
          </div>
        </div>
        <div class="label position-right"><label for="webform_c_l3lxk">First name</label></div>
      </div>
    </div>
    <div data-editable="custom" style="left: 151px; top: 619px; width: 174px;" class="submit" id="c_3vv8u">
      <div class="container"><button class="button border" type="submit" data-tab-index="" tabindex="15"><span>SIGN UP</span></button></div>
    </div>
    <div data-editable="custom" style="width: 278px; left: 110px; top: 307px;" id="c_l9uwl">
      <div class="container label-position-inside">
        <div class="label"><label for="webform_c_033e3">LAST NAME</label></div>
        <div class="box">
          <div class="field">
            <div class="block border"><input id="webform_c_033e3" class="placeholder padding" name="webform[last_name]" type="text" value="" placeholder="LAST NAME" maxlength="64" minlength="" data-tab-index="" tabindex="3"><span
                class="placeholder like-placeholder" style="display:none;"></span></div>
          </div>
          <div class="info-error" hidden="">
            <p></p>
          </div>
          <div class="info">
            <p></p>
          </div>
        </div>
        <div class="label position-right"><label for="webform_c_033e3">LAST NAME</label></div>
      </div>
    </div>
    <div data-editable="custom" style="width: 278px; left: 110px; top: 385px;" id="c_b8bu8">
      <div class="container label-position-inside">
        <div class="label"><label for="webform_c_w3w33">TITLE</label></div>
        <div class="box">
          <div class="field">
            <div class="block border"><input id="webform_c_w3w33" class="placeholder padding" name="webform[title]" type="text" value="" placeholder="TITLE" maxlength="255" minlength="" data-tab-index="" tabindex="4"><span
                class="placeholder like-placeholder" style="display:none;"></span></div>
          </div>
          <div class="info-error" hidden="">
            <p></p>
          </div>
          <div class="info">
            <p></p>
          </div>
        </div>
        <div class="label position-right"><label for="webform_c_w3w33">TITLE</label></div>
      </div>
    </div>
    <div data-editable="custom" style="width: 278px; left: 110px; top: 463px;" id="c_8bjjj">
      <div class="container label-position-inside">
        <div class="label"><label for="webform_c_330e3">COMPANY</label></div>
        <div class="box">
          <div class="field">
            <div class="block border"><input id="webform_c_330e3" class="placeholder padding" name="webform[company]" type="text" value="" placeholder="COMPANY" maxlength="255" minlength="" data-tab-index="" tabindex="5"><span
                class="placeholder like-placeholder" style="display:none;"></span></div>
          </div>
          <div class="info-error" hidden="">
            <p></p>
          </div>
          <div class="info">
            <p></p>
          </div>
        </div>
        <div class="label position-right"><label for="webform_c_330e3">COMPANY</label></div>
      </div>
    </div>
    <div data-editable="custom" style="width: 278px; left: 108px; top: 540px;" id="c_g9gwf">
      <div class="container label-position-inside">
        <div class="label"><label for="webform_c_x3330">CHOOSE A COMMUNITY</label></div>
        <div class="box">
          <div id="webform_c_x3330" class="field field-icon select">
            <div class="block border">
              <div class="ico-placement"><input class="placeholder padding" type="text" value="" data-placeholder="CHOOSE A COMMUNITY" readonly="readonly" data-tab-index="" tabindex="6" placeholder="CHOOSE A COMMUNITY">
                <div class="field-icon-sign"></div>
              </div>
            </div>
            <div class="select-backdrop"></div>
            <ul class="list border">
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="community[all]" value="" data-tab-index="" tabindex="7"></div><span class="item-label">Select all</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Actuarial &amp; Underwriting" data-tab-index="" tabindex="8"></div><span class="item-label">Actuarial &amp; Underwriting</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Clinical Strategy" data-tab-index="" tabindex="9"></div><span class="item-label">Clinical Strategy</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Consultant Relations" data-tab-index="" tabindex="10"></div><span class="item-label">Consultant Relations</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Marketing &amp; Communication" data-tab-index="" tabindex="11"></div><span class="item-label">Marketing &amp; Communication</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Network" data-tab-index="" tabindex="12"></div><span class="item-label">Network</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Proposal" data-tab-index="" tabindex="13"></div><span class="item-label">Proposal</span>
                </label></li>
              <li class="list-item"><label class="checkmark-label">
                  <div class="checkmark-container"><input type="checkbox" name="webform[community][]" value="Sales &amp; Account Management" data-tab-index="" tabindex="14"></div><span class="item-label">Sales &amp; Account Management</span>
                </label></li>
            </ul>
          </div>
          <div class="info-error" hidden="">
            <p></p>
          </div>
          <div class="info">
            <p></p>
          </div>
        </div>
        <div class="label position-right"><label for="webform_c_x3330">CHOOSE A COMMUNITY</label></div>
      </div>
    </div>
  </div>
</form>

Text Content

Keep in touch. 
Subscribe to Consortium communications.
Email



Email
First name



First name
SIGN UP
LAST NAME



LAST NAME
TITLE



TITLE
COMPANY



COMPANY
CHOOSE A COMMUNITY
 * 
   Select all
 * 
   Actuarial & Underwriting
 * 
   Clinical Strategy
 * 
   Consultant Relations
 * 
   Marketing & Communication
 * 
   Network
 * 
   Proposal
 * 
   Sales & Account Management





CHOOSE A COMMUNITY