staging.conqueridigital.com
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2a02:4780:2b:1554:0:3568:de55:3
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Submitted URL: https://staging.conqueridigital.com/
Effective URL: https://staging.conqueridigital.com/index.php/it-support-and-services
Submission: On October 02 via api from US — Scanned from DE
Effective URL: https://staging.conqueridigital.com/index.php/it-support-and-services
Submission: On October 02 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form action="">
<div class="row">
<div class="col-lg-12">
<div class="form-group col-sm-6" style="padding-left: 0;">
<label for="">CUSTOMER ID <span>*</span>
</label>
<input type="text" name="customer_id" class="form-control">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="">FIRST NAME <span>*</span>
</label>
<input type="text" name="firstname" class="form-control">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="">LAST NAME <span>*</span>
</label>
<input type="text" name="lastname" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<label for="">EMAIL <span>*</span>
</label>
<input type="email" name="email" class="form-control">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="">PHONE NUMBER <span>*</span>
</label>
<input type="text" name="phone" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="">COMPANY / ORGANIZATION NAME</label>
<input type="text" name="company" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<label for="">ADDRESS 1 <span>*</span>
</label>
<input type="text" name="address1" class="form-control">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="">ADDRESS 2</label>
<input type="text" name="address2" class="form-control">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<label for="">CITY <span>*</span>
</label>
<input type="text" name="city" class="form-control">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="">STATE <span>*</span></label>
<select required="" class="SelectInput-select form-control mb-2 mr-sm-2 mb-sm-0" name="state" id="billingState">
<option value="">Select State</option>
<option value="AL"> Alabama </option>
<option value="AK"> Alaska </option>
<option value="AS"> American Samoa </option>
<option value="AZ"> Arizona </option>
<option value="AR"> Arkansas </option>
<option value="AF"> Armed Forces Africa </option>
<option value="AA"> Armed Forces Americas </option>
<option value="AC"> Armed Forces Canada </option>
<option value="AE"> Armed Forces Europe </option>
<option value="AM"> Armed Forces Middle East </option>
<option value="AP"> Armed Forces Pacific </option>
<option value="CA"> California </option>
<option value="CO"> Colorado </option>
<option value="CT"> Connecticut </option>
<option value="DE"> Delaware </option>
<option value="DC"> District of Columbia </option>
<option value="FM"> Federated States Of Micronesia </option>
<option value="FL"> Florida </option>
<option value="GA"> Georgia </option>
<option value="GU"> Guam </option>
<option value="HI"> Hawaii </option>
<option value="ID"> Idaho </option>
<option value="IL"> Illinois </option>
<option value="IN"> Indiana </option>
<option value="IA"> Iowa </option>
<option value="KS"> Kansas </option>
<option value="KY"> Kentucky </option>
<option value="LA"> Louisiana </option>
<option value="ME"> Maine </option>
<option value="MH"> Marshall Islands </option>
<option value="MD"> Maryland </option>
<option value="MA"> Massachusetts </option>
<option value="MI"> Michigan </option>
<option value="MN"> Minnesota </option>
<option value="MS"> Mississippi </option>
<option value="MO"> Missouri </option>
<option value="MT"> Montana </option>
<option value="NE"> Nebraska </option>
<option value="NV"> Nevada </option>
<option value="NH"> New Hampshire </option>
<option value="NJ"> New Jersey </option>
<option value="NM"> New Mexico </option>
<option value="NY"> New York </option>
<option value="NC"> North Carolina </option>
<option value="ND"> North Dakota </option>
<option value="MP"> Northern Mariana Islands </option>
<option value="OH"> Ohio </option>
<option value="OK"> Oklahoma </option>
<option value="OR"> Oregon </option>
<option value="PW"> Palau </option>
<option value="PA"> Pennsylvania </option>
<option value="PR"> Puerto Rico </option>
<option value="RI"> Rhode Island </option>
<option value="SC"> South Carolina </option>
<option value="SD"> South Dakota </option>
<option value="TN"> Tennessee </option>
<option value="TX"> Texas </option>
<option value="UT"> Utah </option>
<option value="VT"> Vermont </option>
<option value="VI"> Virgin Islands </option>
<option value="VA"> Virginia </option>
<option value="WA"> Washington </option>
<option value="WV"> West Virginia </option>
<option value="WI"> Wisconsin </option>
<option value="WY"> Wyoming </option>
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<label for="">ZIP/POSTAL <span>*</span>
</label>
<input type="text" name="zipcode" class="form-control">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<label for="">COUNTRY <span>*</span>
</label>
<select class="SelectInput-select form-control mb-2 mr-sm-2 mb-sm-0" data-recurly="country" name="country" id="billing_info_country" required="" onchange="changeCountry(this)"> ; <option value="" data-country-id="0"></option>
<option value="CA" data-country-id="38"> Canada </option>
<option value="US" data-country-id="223" selected=""> United States </option>
</select>
</div>
</div>
</div>
</form>Text Content
(866) 742-7635 * 1. Select Plan * 2. Billing Info * 3. 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IT Support & Services -------------------------------------------------------------------------------- Home Tech Care Plan - IT Support & Service Select a plan 2 Years 3 Years 4 Years 5 Years $00.00 Add-on 1 Main Device Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Add-on 1 Peripheral Device Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 -------------------------------------------------------------------------------- Smart Home Care Plans - IT Support & Services -------------------------------------------------------------------------------- Smart Home Care Plan - IT Support & Service Select a plan 2 Years 3 Years 4 Years 5 Years $00.00 Add-on 1 Main Device Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Add-on 1 Peripheral Device Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 -------------------------------------------------------------------------------- Peripheral Tech Care Plan - IT Support & Services -------------------------------------------------------------------------------- Basic Peripheral Tech Care Plan - IT Support & Service Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Premium Peripheral Tech Care Plan - IT Support & Service Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 -------------------------------------------------------------------------------- Computer Tech Care Plan - 1 Device -------------------------------------------------------------------------------- Basic Computer Tech Care Plan - IT Support & Service - 1 Device Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Premium Computer Tech Care Plan - IT Support & Service - 1 Device Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 -------------------------------------------------------------------------------- -------------------------------------------------------------------------------- Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Break Fix IT Support & Service Plans -------------------------------------------------------------------------------- Printer Service & Tune up - 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IT Support & Service - 1 Device Home Tech Care Plan - IT Support & Service Smart Home Care Plan - IT Support & Service Basic Peripheral Tech Care Plan - IT Support & Service Premium Peripheral Tech Care Plan - IT Support & Service Duration 1 Year 2 Years 3 Years 4 Years 5 Years Add Service Extension : Extend to Basic Computer Tech Care Plan - IT Support & Service - 1 Device Premium Computer Tech Care Plan - IT Support & Service - 1 Device Home Tech Care Plan - IT Support & Service Smart Home Care Plan - IT Support & Service Basic Peripheral Tech Care Plan - IT Support & Service Premium Peripheral Tech Care Plan - IT Support & Service Duration 1 Year 2 Years 3 Years 4 Years 5 Years Add -------------------------------------------------------------------------------- IT Support & Service Renewals -------------------------------------------------------------------------------- Home Tech Care Plan - IT Support & Service - Renewal Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Smart Home Care Plan - IT Support & Service - Renewal Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Basic Peripheral Complete Care Plan - IT Support & Service - Renewal Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 Premium Peripheral Complete Care Plan - IT Support & Service - Renewal Select a plan 1 Year 2 Years 3 Years 4 Years 5 Years $00.00 -------------------------------------------------------------------------------- Continue BILLING INFORMATION CUSTOMER ID * FIRST NAME * LAST NAME * EMAIL * PHONE NUMBER * COMPANY / ORGANIZATION NAME ADDRESS 1 * ADDRESS 2 CITY * STATE * Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP/POSTAL * COUNTRY * ; Canada United States Continue Back Card Holder Name * Card Number * Expiry Date * January February March April May June July August September October November December 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 CVV/CVC * I accept the Terms and Conditions Pay ORDER SUMMARY Plan Name Price Sub Total $0.00 Shipping $00.00 Coupon Discount $ 0.00 Tax $ 0.00 Total $0.00 (We Accept All Major Credit Cards) Apply Share Cart Need Help? 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