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Submission: On June 06 via api from US — Scanned from DE
Submission: On June 06 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
<form class="formCont" id="formData" style="">
<div class="mb-2">
<div>
<input type="text" class="form-control" id="fname" name="name" aria-describedby="nameHelp" placeholder="Name">
</div>
<span id="nameError" style="color:red !important;font-size: 12px;"></span>
</div>
<div class="mb-2">
<div class="input-group">
<div class="input-group-prepend">
<span class="input-group-text" style="text-align: center;">+91</span>
</div>
<input type="number" class="form-control" id="phone" name="number" aria-describedby="numberHelp" placeholder="Phone Number" maxlength="10" oninput="validatePhone(this)">
</div>
<span id="phoneError" style="color:red !important;font-size: 12px;"></span>
</div>
<div class="mb-2">
<div>
<input type="email" class="form-control" id="email" name="email" aria-describedby="email" placeholder="Email">
</div>
<span id="emailError" style="color:red !important;font-size: 12px;"></span>
</div>
<div class="mb-2">
<div class="">
<select id="state" placeholder="State" class="form-control form-select minimal state-select" onchange="updatePlaceholder(this)">
<option class="option" value="">Select State</option>
<option class="option" value="Bihar">Bihar</option>
<option class="option" value="Delhi">Delhi</option>
<option class="option" value="Assam">Assam</option>
<option class="option" value="Telangana">Telangana</option>
<option class="option" value="Andhra Pradesh">Andhra Pradesh</option>
<option class="option" value="Madhya Pradesh">Madhya Pradesh</option>
<option class="option" value="Jammu and Kashmir">Jammu and Kashmir</option>
<option class="option" value="Tamil Nadu">Tamil Nadu</option>
<option class="option" value="Dadra and Nagar Haveli">Dadra and Nagar Haveli</option>
<option class="option" value="Puducherry">Puducherry</option>
<option class="option" value="Chhattisgarh">Chhattisgarh</option>
<option class="option" value="Daman & Diu (DDG)">Daman & Diu (DDG)</option>
<option class="option" value="Karnataka">Karnataka</option>
<option class="option" value="Mizoram">Mizoram</option>
<option class="option" value="Goa">Goa</option>
<option class="option" value="Odisha">Odisha</option>
<option class="option" value="West Bengal">West Bengal</option>
<option class="option" value="Maharashtra">Maharashtra</option>
<option class="option" value="Kerala">Kerala</option>
<option class="option" value="Chandigarh">Chandigarh</option>
<option class="option" value="Meghalaya">Meghalaya</option>
<option class="option" value="Punjab">Punjab</option>
<option class="option" value="Rajasthan">Rajasthan</option>
<option class="option" value="Tripura">Tripura</option>
<option class="option" value="Uttar Pradesh">Uttar Pradesh</option>
<option class="option" value="Jharkhand">Jharkhand</option>
<option class="option" value="Haryana">Haryana</option>
<option class="option" value="Himachal Pradesh">Himachal Pradesh</option>
<option class="option" value="Uttarakhand">Uttarakhand</option>
<option class="option" value="Arunachal Pradesh">Arunachal Pradesh</option>
<option class="option" value="Manipur">Manipur</option>
<option class="option" value="Nagaland">Nagaland</option>
</select>
</div>
<span id="stateDataError" style="color:red !important;font-size: 12px;"></span>
</div>
<div class="mb-2">
<select class="form-control form-select minimal city-select" id="city">
<option>Select City</option>
</select>
<span id="cityDataError" style="color:red !important;font-size: 12px;"></span>
</div>
<div class="p-2">
<!-- <div class="mb-2 form-check">
<input type="checkbox" class="form-check-input" id="check">
<label class="form-check-label" for="exampleCheck1">I affirm that I am above the legal
drinking age applicable in my state and accept the <a href="javascript:void(0);"
style="color: #b79268; text-decoration: none;">T&C</a> and <a href="javascript:void(0);" style="color: #b79268; text-decoration: none;">Privacy cookie Policy</a>.</label>
<span id="TnCError" style="color:red !important;font-size: 12px;"></span>
</div> -->
<div class="mb-2 form-check" id="form-check">
<input type="checkbox" class="form-check-input" id="check">
<label class="form-check-label" for="exampleCheck1">Agree to receive information related to alcoholic beverages and other communications from Diageo India (including affiliates, subsidiaries, and permitted agents).</label>
<span id="checkError" style="color:red !important;font-size: 12px;"></span>
</div>
</div>
<div class="d-block m-auto submitBt mt-3" id="submitBtn" onclick="validateForm()"><img src="submit.png" class="img img-fluid submitBtn" style="cursor: pointer;" alt="submitPng"></div>
</form>Text Content
+91 Select StateBiharDelhiAssamTelanganaAndhra PradeshMadhya PradeshJammu and KashmirTamil NaduDadra and Nagar HaveliPuducherryChhattisgarhDaman & Diu (DDG)KarnatakaMizoramGoaOdishaWest BengalMaharashtraKeralaChandigarhMeghalayaPunjabRajasthanTripuraUttar PradeshJharkhandHaryanaHimachal PradeshUttarakhandArunachal PradeshManipurNagaland Select City Agree to receive information related to alcoholic beverages and other communications from Diageo India (including affiliates, subsidiaries, and permitted agents).