velvetsuppliers.co.za Open in urlscan Pro
95.216.89.230  Public Scan

Form analysis
1 forms found in the DOM

POST

<form role="form" method="post" id="reused_form">
  <div class="row">
    <div class="col-sm-6 form-group">
      <label for="name"> First Name:</label>
      <input type="text" class="form-control" id="firstname" name="firstname" maxlength="50">
    </div>
    <div class="col-sm-6 form-group">
      <label for="name"> Last Name:</label>
      <input type="text" class="form-control" id="lastname" name="lastname" maxlength="50">
    </div>
  </div>
  <div class="row">
    <div class="col-sm-6 form-group">
      <label for="email"> Email:</label>
      <input type="text" class="form-control" id="email" name="email" maxlength="50">
    </div>
    <div class="col-sm-6 form-group">
      <label for="email"> Phone:</label>
      <input type="tel" class="form-control" id="phone" name="phone" required="" maxlength="50">
    </div>
  </div>
  <div class="row">
    <div class="col-sm-12 form-group">
      <label for="name"> Message:</label>
      <textarea class="form-control" type="textarea" id="message" name="message" placeholder="Your Message Here" maxlength="6000" rows="7"></textarea>
    </div>
  </div>
  <div class="row">
    <div class="col-sm-12 form-group">
      <button type="submit" class="btn btn-lg btn-success btn-block" id="btnContactUs">Send</button>
    </div>
  </div>
</form>

Text Content

CONTACT US

Send Message regarding our products and we will get back to you

First Name:
Last Name:
Email:
Phone:
Message:
Send


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