hlrihub.com Open in urlscan Pro
2a06:98c1:3120::3  Public Scan

Form analysis
1 forms found in the DOM

POST https://hlrihub.com/worksheetSubmit

<form action="https://hlrihub.com/worksheetSubmit" method="POST" enctype="multipart/form-data">
  <input type="hidden" name="_token" value="xktKwvsklEqUnlTkn6DxDE8lnm7qBpbVA6tCLDGE">
  <div class="container">
    <div class="row">
      <div class="col-md-8 offset-md-2">
        <br>
        <br>
        <br>
        <div class="row textCenter">
          <div class="col-md-10 offset-md-1" style="text-align: center;">
            <img style="margin: 0 auto;" src="/storage/prLogo/Mile-and-Creek-Condos-3.png" alt="">
          </div>
          <h1 id="title" class="title mt-4" style="text-align: center;">WORKSHEET</h1>
        </div>
        <br>
        <div class="row d-flex justify-content-center">
          <div class="col-md-1" style="min-width: 120px;">Agent name:</div>
          <div class="col-md-3"><input type="text" class="form-control" name="agent" required=""></div>
          <div class="row m-4 flex justify-content-md-center">
            <div class="col-md-3">Are you a realtor?</div>
            <div class="col-md-2" style="max-width:110px;">
              <label class="form-check-label" for="realtorYes">Yes</label>
              <input type="radio" class="form-check-input" id="realtorYes" name="realtor" value="yes">
            </div>
            <div class="col-md-2">
              <label class="form-check-label" for="realtorNo">No</label>
              <input type="radio" class="form-check-input" id="realtorNo" name="realtor" value="no">
            </div>
            <div id="agentVisitCard" class="hidden text-center">
              <label for="vCard"> Please upload your business card. <input type="file" name="vCard" id="vCard">
              </label>
            </div>
          </div>
        </div>
        <hr>
        <div class="row">
          <h3 class="secTitle">SUITE PREFERENCES</h3>
        </div>
        <div class="row textCenter fontBold">
          <div class="col-md-2"></div>
          <div class="form-group col-md-2">
            <label>Model</label>
          </div>
          <div class="form-group col-md-2">
            <label>Exposure</label>
          </div>
          <div class="form-group col-md-2">
            <label>Lowest Floor Preferred</label>
          </div>
          <div class="form-group col-md-2">
            <label>Highest Floor Preferred</label>
          </div>
          <div class="form-group col-md-1">
            <label>Parking</label>
          </div>
          <div class="form-group col-md-1">
            <label>Locker</label>
          </div>
        </div>
        <br>
        <div class="row textCenter">
          <div class="col-md-2 fontBold">1st Choice</div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="model1">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="exposur1">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="lowestFloor1">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="highestFloor1">
          </div>
          <div class="form-group col-md-1">
            <input type="checkbox" class="form-check-input" name="parking1">
          </div>
          <div class="form-group col-md-1">
            <input type="checkbox" class="form-check-input" name="locker1">
          </div>
        </div>
        <div class="row textCenter">
          <div class="col-md-2 fontBold">2st Choice</div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="model2">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="exposur2">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="lowestFloor2">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="highestFloor2">
          </div>
          <div class="form-group col-md-1">
            <input type="checkbox" class="form-check-input" name="parking2">
          </div>
          <div class="form-group col-md-1">
            <input type="checkbox" class="form-check-input" name="locker2">
          </div>
        </div>
        <div class="row textCenter">
          <div class="col-md-2 fontBold">3st Choice</div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="model3">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="exposur3">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="lowestFloor3">
          </div>
          <div class="form-group col-md-2">
            <input type="text" class="form-control" name="highestFloor3">
          </div>
          <div class="form-group col-md-1">
            <input type="checkbox" class="form-check-input" name="parking3">
          </div>
          <div class="form-group col-md-1">
            <input type="checkbox" class="form-check-input" name="locker3">
          </div>
        </div>
        <br>
        <div class="row">
          <p class="secTitle">PURCHASER(S) INFORMATION</p>
        </div>
        <div class="row">
          <div class="row d-xl-none d-lg-none">
            <div style="text-align: center;font-weight: bold;margin-bottom: 10px;" class="col-md-12"> Purchaser 1: </div>
          </div>
          <div class="form-group col-lg-6">
            <div class="row">
              <div class="col-md-2">Name:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_name" required="">
              </div>
            </div>
            <div class="row addressHolder">
              <div class="col-md-2">Address:</div>
              <div class="col-md-10" style="margin-bottom: 5px"><input type="text" class="form-control" name="buyer1address"></div>
              <div class="col-md-2"></div>
              <div class="col-md-10 grid grid-cols-4 gap-1">
                <div class=""><input type="text" class="form-control" name="buyer1_city" placeholder="City"></div>
                <div class=""><input type="text" class="form-control" name="buyer1_province" placeholder="Province"></div>
                <div class=""><input type="text" class="form-control" name="buyer1_postalCode" placeholder="Zip Code"></div>
                <div class=""><input type="text" class="form-control" name="buyer1_country" placeholder="Country"></div>
              </div>
            </div>
            <div class="row">
              <div class="col-md-2">Email:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_email" required="">
              </div>
            </div>
            <div class="row">
              <div class="col-md-2">Phone:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_phone" required="">
              </div>
            </div>
            <div class="row">
              <div class="col-md-2">Occupation:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_occupation">
              </div>
            </div>
            <div class="row">
              <div class="col-md-2">S.I.N:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_sin"></div>
            </div>
            <div class="row">
              <div class="col-md-2">D.O.B:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_dob" placeholder="Month / Day / Year"></div>
            </div>
            <div class="row">
              <div class="col-md-2">ID#:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer1_id"></div>
            </div>
            <div class="row">
              <div class="col-md-4">Type of ID:</div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer1_id_type" value="Driver's License"></div>
              <div class="col-md-6">Driver's License</div>
            </div>
            <div class="row">
              <div class="col-md-4"></div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer1_id_type" value="Passport"></div>
              <div class="col-md-6">Passport</div>
            </div>
            <div class="row">
              <div class="col-md-4"></div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer1_id_type" value="Permanent Resident Card"></div>
              <div class="col-md-6">Permanent Resident Card</div>
            </div>
            <div class="row">
              <div class="col-md-4"></div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer1_id_type" value="Photo Card"></div>
              <div class="col-md-6">Photo Card</div>
            </div>
            <div class="row">
              <div class="col-md-4">Upload ID user 1</div>
              <div wire:id="tb9VAOxoHQXl62GlzOhO">
                <div x-data="{ isUploading: false, progress: 0 }" x-on:livewire-upload-start="isUploading = true" x-on:livewire-upload-finish="isUploading = false" x-on:livewire-upload-error="isUploading = false"
                  x-on:livewire-upload-progress="progress = $event.detail.progress">
                  <input type="file" wire:model="photos" multiple="">
                  <div wire:loading="" wire:target="photo">Uploading...</div>
                  <!-- Progress Bar -->
                  <div x-show="isUploading" style="display: none;">
                    <progress max="100" x-bind:value="progress"></progress>
                  </div>
                </div>
              </div>
              <!-- Livewire Component wire-end:tb9VAOxoHQXl62GlzOhO --> <input type="hidden" class="form-control-file" name="user1Id" id="user1Id" accept="image/*" multiple="">
            </div>
          </div>
          <div class="row d-xl-none d-lg-none" style="margin-top:20px;">
            <br>
            <hr>
            <div style="text-align: center;font-weight: bold;margin-bottom: 10px;margin-top:20px;" class="col-md-12"> Purchaser 2: </div>
          </div>
          <div class="form-group col-lg-6">
            <div class="row">
              <div class="col-md-2">Name:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_name"></div>
            </div>
            <div class="row addressHolder">
              <div class="col-md-2">Address:</div>
              <div class="col-md-10" style="margin-bottom: 5px"><input type="text" class="form-control" name="buyer2address"></div>
              <div class="col-md-2"></div>
              <div class="col-md-10 grid grid-cols-4 gap-1">
                <div class=""><input type="text" class="form-control" name="buyer2_city" placeholder="City"></div>
                <div class=""><input type="text" class="form-control" name="buyer2_province" placeholder="Province"></div>
                <div class=""><input type="text" class="form-control" name="buyer2_postalCode" placeholder="Zip Code"></div>
                <div class=""><input type="text" class="form-control" name="buyer2_country" placeholder="Country"></div>
              </div>
            </div>
            <div class="row">
              <div class="col-md-2">Email:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_email"></div>
            </div>
            <div class="row">
              <div class="col-md-2">Phone:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_phone"></div>
            </div>
            <div class="row">
              <div class="col-md-2">Occupation:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_occupation">
              </div>
            </div>
            <div class="row">
              <div class="col-md-2">S.I.N:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_sin"></div>
            </div>
            <div class="row">
              <div class="col-md-2">D.O.B:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_dob" placeholder="Month / Day / Year"></div>
            </div>
            <div class="row">
              <div class="col-md-2">ID#:</div>
              <div class="col-md-10"><input type="text" class="form-control" name="buyer2_id"></div>
            </div>
            <div class="row">
              <div class="col-md-4">Type of ID:</div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer2_id_type" value="Driver's License"></div>
              <div class="col-md-6">Driver's License</div>
            </div>
            <div class="row">
              <div class="col-md-4"></div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer2_id_type" value="Passport"></div>
              <div class="col-md-6">Passport</div>
            </div>
            <div class="row">
              <div class="col-md-4"></div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer2_id_type" value="Permanent Resident Card"></div>
              <div class="col-md-6">Permanent Resident Card</div>
            </div>
            <div class="row">
              <div class="col-md-4"></div>
              <div class="col-md-1"><input type="radio" class="form-check-input" name="buyer2_id_type" value="Photo Card"></div>
              <div class="col-md-6">Photo Card</div>
            </div>
            <div class="row">
              <div class="col-md-4">Upload ID user 2</div>
              <div wire:id="l6o3CNgZdpSozN5UHFg4">
                <div x-data="{ isUploading: false, progress: 0 }" x-on:livewire-upload-start="isUploading = true" x-on:livewire-upload-finish="isUploading = false" x-on:livewire-upload-error="isUploading = false"
                  x-on:livewire-upload-progress="progress = $event.detail.progress">
                  <input type="file" wire:model="photos" multiple="">
                  <div wire:loading="" wire:target="photo">Uploading...</div>
                  <!-- Progress Bar -->
                  <div x-show="isUploading" style="display: none;">
                    <progress max="100" x-bind:value="progress"></progress>
                  </div>
                </div>
              </div>
              <!-- Livewire Component wire-end:l6o3CNgZdpSozN5UHFg4 --> <input type="hidden" class="form-control-file" name="user2Id" id="user2Id">
            </div>
          </div>
        </div>
        <div class="row">
          <p class="secTitle" style="color: #eee">|</p>
        </div>
        <div class="row">
          <div class="col-md-3">Are you a Canadian Resident? </div>
          <div class="row">
            <div class="col-md-1">
              <label class="form-check-label" for="residence1">Yes</label>
              <input type="radio" class="form-check-input" id="residence1" name="residence" value="Yes">
            </div>
            <div class="col-md-1">
              <label class="form-check-label" for="residence2">No</label>
              <input type="radio" class="form-check-input" id="residence2" name="residence" value="No">
            </div>
          </div>
          <hr style="margin-top:20px;">
          <div class="row">
            <div class="col-md-3">You are an:</div>
          </div>
          <div class="row">
            <div class="col-md-2" style="max-width:110px;">
              <label class="form-check-label" for="residence3">Investor</label>
              <input type="radio" class="form-check-input" id="residence3" name="invest_user" value="Investor">
            </div>
            <div class="col-md-2">
              <label class="form-check-label" for="residence4">User</label>
              <input type="radio" class="form-check-input" id="residence4" name="invest_user" value="User">
            </div>
          </div>
          <div class="form-group">
            <label for="comment">Note:</label>
            <textarea name="additionalComment" id="comment" class="form-control" rows="10"></textarea>
          </div>
          <br>
          <div class="row">
            <div class="col-md-12">
              <pre style="font-size: larger;">All Purchaser(s) must bring the following to qualify for purchase at the point of sale:
            1. A valid government issued photo ID
            2. A personal cheque book or a certified cheque if required by the builder otherwise
            </pre>
            </div>
          </div>
          <div class="row">
            <div class="col-md-12" style="text-align: center">
              <img src="/images/worksheetLogo.png" alt="logo" style="width: 80%">
            </div>
          </div>
          <input type="hidden" name="projectName" value="Mile-and-Creek-Condos-3">
          <button type="submit" class="btn btn-primary">Submit</button>
        </div>
      </div>
    </div>
    <br>
    <br>
    <br>
    <br>
    <br>
  </div>
</form>

Text Content

WORKSHEET


Agent name:

Are you a realtor?
Yes
No
Please upload your business card.

--------------------------------------------------------------------------------


SUITE PREFERENCES

Model
Exposure
Lowest Floor Preferred
Highest Floor Preferred
Parking
Locker

1st Choice






2st Choice






3st Choice








PURCHASER(S) INFORMATION

Purchaser 1:
Name:

Address:



Email:

Phone:

Occupation:

S.I.N:

D.O.B:

ID#:

Type of ID:

Driver's License
Passport
Permanent Resident Card
Photo Card
Upload ID user 1
Uploading...




--------------------------------------------------------------------------------

Purchaser 2:
Name:

Address:



Email:

Phone:

Occupation:

S.I.N:

D.O.B:

ID#:

Type of ID:

Driver's License
Passport
Permanent Resident Card
Photo Card
Upload ID user 2
Uploading...


|

Are you a Canadian Resident?
Yes
No

--------------------------------------------------------------------------------

You are an:
Investor
User
Note:


All Purchaser(s) must bring the following to qualify for purchase at the point of sale:
            1. A valid government issued photo ID
            2. A personal cheque book or a certified cheque if required by the builder otherwise
            


Submit