application.mtib.ac.ke Open in urlscan Pro
5.9.146.16  Public Scan

Form analysis
1 forms found in the DOM

POST https://application.mtib.ac.ke/

<form action="https://application.mtib.ac.ke/" method="post" accept-charset="utf-8">
  <div class="container">
    <!--dasboard-wrap-->
    <div class="dasboard-wrap fl-wrap">
      <!-- dashboard-content-->
      <div class="dashboard-content fl-wrap">
        <div class="box-widget-item-header">
          <h3> Basic Information</h3>
        </div>
        <!-- profile-edit-container-->
        <div class="profile-edit-container">
          <div class="custom-form">
            <label>First Name <i class="far fa-user"></i></label>
            <input type="text" name="fname" id="fname" placeholder="Your first name">
            <label>Middle Name <i class="far fa-user"></i></label>
            <input type="text" name="mname" id="mname" placeholder="Your Middle name">
            <label>Last Name <i class="far fa-user"></i></label>
            <input type="text" name="lname" id="lname" placeholder="Your Last name">
          </div>
        </div>
        <!-- profile-edit-container end-->
        <div class="box-widget-item-header">
          <h3>Contacts</h3>
        </div>
        <!-- profile-edit-container-->
        <div class="profile-edit-container">
          <div class="custom-form">
            <label>Email Address<i class="far fa-envelope"></i> </label>
            <input type="email" name="email" id="email" placeholder="Your email Address">
            <label>Phone<i class="far fa-phone"></i> </label>
            <input type="tel" name="phone" id="phone" placeholder="Phone Number">
          </div>
        </div>
        <!-- profile-edit-container-->
        <div class="profile-edit-container">
          <div class="custom-form">
            <button type="submit" class="btn color2-bg float-btn" id="register">Register<i class="fal fa-paper-plane"></i></button>
          </div>
        </div>
        <!-- profile-edit-container end-->
      </div>
      <!-- dashboard-list-box end-->
    </div>
    <!-- dasboard-wrap end-->
  </div>
</form>

Text Content

Apply Course


WELCOME TO MTIB

Appy Course




BASIC INFORMATION

First Name Middle Name Last Name


CONTACTS

Email Address Phone
Register

© Machakos Technical Institute For the Blind 2024 . All rights reserved.