credit.dalestudios.co.uk Open in urlscan Pro
2606:4700:3030::ac43:c658  Public Scan

Form analysis
1 forms found in the DOM

POST /

<form action="/" method="POST">
  <input type="hidden" name="_token" value="oBN7ZRDuBDSTV13aTb91LwJLNotrojIdQzzI5DoK">
  <div id="my_name_tH8qy5gEi83O9WfF_wrap" style="display:none;">
    <input name="my_name_tH8qy5gEi83O9WfF" type="text" value="" id="my_name_tH8qy5gEi83O9WfF">
    <input name="valid_from" type="text" value="eyJpdiI6InRRc3hqVndsQk5UOVFidzFrclFmZ2c9PSIsInZhbHVlIjoiQzBCVk9RVjFZNzFiV3d6ZFFLRXlUZz09IiwibWFjIjoiODA2YmMxMjM1NzljNmNjZTliZjNjMzE1OTEyNjVjMzM2ZjA5ZDYxNGEyYWUyZWI2ZTZiY2MyZTJmNTg5YzcxZSJ9">
  </div>
  <div class="grid grid-cols-1 lg:grid-cols-2 xl:grid-cols-3 gap-6 row-gap-10">
    <div class="form-input relative required">
      <label for="full-name" class="">
        <span class="text-base text-grey font-thin">Full name</span>
        <input type="text" id="full-name" name="full-name" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="position" class="">
        <span class="text-base text-grey font-thin">Position</span>
        <input type="text" id="position" name="position" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="date" class="">
        <span class="text-base text-grey font-thin">Date</span>
        <input type="date" id="date" name="date" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="company-name" class="">
        <span class="text-base text-grey font-thin">Full company name</span>
        <input type="text" id="company-name" name="company-name" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="phone" class="">
        <span class="text-base text-grey font-thin">Contact number</span>
        <input type="tel" id="phone" name="phone" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-name" class="">
        <span class="text-base text-grey font-thin">Name of business</span>
        <input type="text" id="business-name" name="business-name" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="registration-number" class="">
        <span class="text-base text-grey font-thin">Company regisitration number</span>
        <input type="text" id="registration-number" name="registration-number" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="company-reg-date" class="">
        <span class="text-base text-grey font-thin">Date of company registration</span>
        <input type="date" id="company-reg-date" name="company-reg-date" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="company-years-trading" class="">
        <span class="text-base text-grey font-thin">Years trading</span>
        <select name="company-years-trading" id="company-years-trading" value="" required="">
          <option disabled="">Select an option</option>
          <option value="-1">Less than 1</option>
          <option value="1">1</option>
          <option value="2">2</option>
          <option value="3">3</option>
          <option value="4">4</option>
          <option value="5">5</option>
          <option value="5+">More than 5</option>
        </select>
      </label>
    </div>
    <div class="form-input relative required xl:col-span-2">
      <label for="trading-address" class="">
        <span class="text-base text-grey font-thin">Trading address</span>
        <input type="text" id="trading-address" name="trading-address" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="post-code" class="">
        <span class="text-base text-grey font-thin">Post code</span>
        <input type="text" id="post-code" name="post-code" value="" required="">
      </label>
    </div>
    <div class="form-input relative xl:col-span-2">
      <label for="invoice-address" class="">
        <span class="text-base text-grey font-thin">Invoice address</span>
        <input type="text" id="invoice-address" name="invoice-address" value="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="purchase-orders" class="">
        <span class="text-base text-grey font-thin">Purchase orders</span>
        <select name="purchase-orders" id="purchase-orders" value="" required="">
          <option disabled="">Select an option</option>
          <option value="Always required">Always required</option>
          <option value="Not required">Not required</option>
        </select>
      </label>
    </div>
    <div class="form-input relative required">
      <label for="accounts-department-email" class="">
        <span class="text-base text-grey font-thin">Accounts department email</span>
        <input type="email" id="accounts-department-email" name="accounts-department-email" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="accounts-department-contact" class="">
        <span class="text-base text-grey font-thin">Accounts department contact</span>
        <input type="text" id="accounts-department-contact" name="accounts-department-contact" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="required-credit-limit" class="">
        <span class="text-base text-grey font-thin">Required credit limit</span>
        <input type="text" id="required-credit-limit" name="required-credit-limit" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="bank-name" class="">
        <span class="text-base text-grey font-thin">Bank name</span>
        <input type="text" id="bank-name" name="bank-name" value="" required="">
      </label>
    </div>
    <div class="form-input relative required lg:col-span-2">
      <label for="bank-address" class="">
        <span class="text-base text-grey font-thin">Bank address</span>
        <input type="text" id="bank-address" name="bank-address" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-name-1" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference name - (1)</span>
        <input type="text" id="business-trade-reference-name-1" name="business-trade-reference-name-1" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-email-1" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference email - (1)</span>
        <input type="email" id="business-trade-reference-email-1" name="business-trade-reference-email-1" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-phone-1" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference phone - (1)</span>
        <input type="tel" id="business-trade-reference-phone-1" name="business-trade-reference-phone-1" value="" required="">
      </label>
    </div>
    <div class="form-input relative required xl:col-span-2">
      <label for="business-trade-reference-address-1" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference address - (1)</span>
        <input type="text" id="business-trade-reference-address-1" name="business-trade-reference-address-1" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-post-code-1" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference post code - (1)</span>
        <input type="text" id="business-trade-reference-post-code-1" name="business-trade-reference-post-code-1" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-name-2" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference name - (2)</span>
        <input type="text" id="business-trade-reference-name-2" name="business-trade-reference-name-2" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-email-2" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference email - (2)</span>
        <input type="email" id="business-trade-reference-email-2" name="business-trade-reference-email-2" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-phone-2" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference phone - (2)</span>
        <input type="tel" id="business-trade-reference-phone-2" name="business-trade-reference-phone-2" value="" required="">
      </label>
    </div>
    <div class="form-input relative required xl:col-span-2">
      <label for="business-trade-reference-address-2" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference address - (2)</span>
        <input type="text" id="business-trade-reference-address-2" name="business-trade-reference-address-2" value="" required="">
      </label>
    </div>
    <div class="form-input relative required">
      <label for="business-trade-reference-post-code-2" class="">
        <span class="text-base text-grey font-thin">Business/Trade reference post code - (2)</span>
        <input type="text" id="business-trade-reference-post-code-2" name="business-trade-reference-post-code-2" value="" required="">
      </label>
    </div>
    <div class="form-input checkbox lg:col-span-3">
      <label for="invoice-payment-agreement" class="">
        <input type="checkbox" name="invoice-payment-agreement" id="invoice-payment-agreement" required="">
        <span class="text-base text-grey font-thin cursor-pointer"> By ticking this box, you agree to pay all invoices within 30 days of the date of invoicing * </span>
      </label>
    </div>
    <div class="form-input checkbox lg:col-span-3">
      <label for="claims-acknowledgement" class="">
        <input type="checkbox" name="claims-acknowledgement" id="claims-acknowledgement" required="">
        <span class="text-base text-grey font-thin cursor-pointer"> By ticking this box, you acknowledge that any claims arising from invoices MUST be made within 7 working days of the date of invoicing * </span>
      </label>
    </div>
    <div class="form-input checkbox lg:col-span-3">
      <label for="authorise-acknowledgement" class="">
        <input type="checkbox" name="authorise-acknowledgement" id="authorise-acknowledgement" required="">
        <span class="text-base text-grey font-thin cursor-pointer"> By ticking this box, you authorise Dale Studios (Leicester) Ltd. to make enquiries in line with the information you have supplied * </span>
      </label>
    </div>
  </div>
  <div class="my-16 flex items-center justify-center">
    <input type="submit" value="Submit" class="button">
  </div>
</form>

Text Content

Get in touch


CREATE ACCOUNT APPLICATION

Full name
Position
Date
Full company name
Contact number
Name of business
Company regisitration number
Date of company registration
Years trading Select an option Less than 1 1 2 3 4 5 More than 5
Trading address
Post code
Invoice address
Purchase orders Select an option Always required Not required
Accounts department email
Accounts department contact
Required credit limit
Bank name
Bank address
Business/Trade reference name - (1)
Business/Trade reference email - (1)
Business/Trade reference phone - (1)
Business/Trade reference address - (1)
Business/Trade reference post code - (1)
Business/Trade reference name - (2)
Business/Trade reference email - (2)
Business/Trade reference phone - (2)
Business/Trade reference address - (2)
Business/Trade reference post code - (2)
By ticking this box, you agree to pay all invoices within 30 days of the date of
invoicing *
By ticking this box, you acknowledge that any claims arising from invoices MUST
be made within 7 working days of the date of invoicing *
By ticking this box, you authorise Dale Studios (Leicester) Ltd. to make
enquiries in line with the information you have supplied *