feature-eze-58391-billing-wrong-working-hours.eezee-it.test.eezee-box.com Open in urlscan Pro
141.94.254.35  Public Scan

URL: https://feature-eze-58391-billing-wrong-working-hours.eezee-it.test.eezee-box.com/
Submission: On December 16 via automatic, source certstream-suspicious — Scanned from IT

Form analysis 1 forms found in the DOM

POST /website/form/

<form action="/website/form/" method="post" data-model_name="crm.lead" class="eze_contactus_form_lead s_website_form container-fluid bg-white pb-2 pt-5" enctype="multipart/form-data" data-editable-form="false" data-snippet="s_website_form">
  <input type="hidden" name="name">
  <input type="hidden" name="contact_name">
  <input type="hidden" name="user_id">
  <input type="hidden" name="applications_ids">
  <input type="hidden" name="module_ids">
  <input type="hidden" name="campaign_id" value="8">
  <input type="hidden" name="medium_id" value="16">
  <input type="hidden" name="referred" value="/">
  <div class="form-row">
    <div class="offset-lg-2 col-lg-4 offset-md-1 col-md-5 offset-1 col-10">
      <div class="form-group form-field o_website_form_required_custom">
        <label class="col-form-label d-none" for="first_name">First Name</label>
        <input type="text" class="form-control o_website_form_input" name="first_name" placeholder="* First name" required="">
      </div>
    </div>
    <div class="offset-lg-0 col-lg-4 offset-md-0 col-md-5 offset-1 col-10">
      <div class="form-group form-field o_website_form_required_custom">
        <label class="col-form-label d-none" for="last_name">Last Name</label>
        <input type="text" class="form-control o_website_form_input" name="last_name" placeholder="* Last name" required="">
      </div>
    </div>
  </div>
  <div class="form-row">
    <div class="offset-lg-2 col-lg-4 offset-md-1 col-md-5 offset-1 col-10">
      <div class="form-group form-field o_website_form_required_custom">
        <label class="col-form-label d-none" for="email_from">E-mail</label>
        <input type="text" class="form-control o_website_form_input" name="email_from" placeholder="* E-mail address" required="">
      </div>
    </div>
    <div class="offset-lg-0 col-lg-4 offset-md-0 col-md-5 offset-1 col-10">
      <div class="form-group form-field o_website_form_required_custom">
        <label class="col-form-label d-none" for="phone">Phone number</label>
        <input type="text" class="form-control o_website_form_input" name="phone" placeholder="* Phone number" required="">
      </div>
    </div>
  </div>
  <div class="form-row">
    <div class="offset-lg-2 col-lg-8 offset-md-1 col-md-10 offset-1 col-10">
      <div class="form-group form-field o_website_form_required_custom">
        <label class="col-form-label d-none" for="message">Message</label>
        <textarea type="text" class="form-control o_website_form_input" name="message" placeholder="* Your message..." required="" rows="4"></textarea>
      </div>
    </div>
  </div>
  <div class="form-row mt-3">
    <div class="offset-lg-2 col-lg-8 offset-md-1 col-md-10 offset-1 col-10 text-center">
      <div class="form-check form-check-inline">
        <input class="form-check-input invisible" type="radio">
        <label class="form-check-label font-weight-bold"> Should we contact you: </label>
      </div>
      <div class="form-check form-check-inline">
        <div class="custom-control custom-radio">
          <input class="form-check-input custom-control-input" type="radio" name="contact_preferences" id="by_mail" value="mail">
          <label class="form-check-label custom-control-label" for="by_mail">By e-mail</label>
        </div>
      </div>
      <div class="form-check form-check-inline">
        <div class="custom-control custom-radio">
          <input class="form-check-input custom-control-input" type="radio" name="contact_preferences" id="by_phone" value="phone">
          <label class="form-check-label custom-control-label" for="by_phone">By phone</label>
        </div>
      </div>
    </div>
  </div>
  <div class="form-group row">
    <div class="offset-lg-2 col-lg-8 offset-md-1 col-md-10 offset-1 col-10 text-center">
      <hr class="my-4">
    </div>
  </div>
  <div class="form-group row">
    <div class="offset-lg-2 col-lg-8 offset-md-1 col-md-10 offset-1 col-10 text-center">
      <a href="#" role="button" class="btn btn-primary btn-lg rounded-circle o_website_form_send">Send</a>
    </div>
  </div>
  <div class="row">
    <div class="col text-center">
      <span id="o_website_form_result">&nbsp;</span>
    </div>
  </div>
</form>

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