staging.dndijk.nl Open in urlscan Pro
185.104.30.173  Public Scan

Form analysis
1 forms found in the DOM

POST https://staging.dndijk.nl/

<form class="w-form  layout_ver for_cform us_form_1" autocomplete="off" action="https://staging.dndijk.nl/" method="post">
  <div class="w-form-h">
    <div class="w-form-row for_text with_icon">
      <div class="w-form-row-field">
        <i class="material-icons">person</i> <input aria-label="Name" type="text" name="us_form_1_text_1" value="" placeholder="Name">
      </div>
      <div class="w-form-row-state">Dit is een verplicht veld</div>
    </div>
    <div class="w-form-row for_text required with_icon">
      <div class="w-form-row-field">
        <i class="material-icons">phone</i> <input aria-label="Phone Number" inputmode="tel" type="text" name="us_form_1_text_2" value="" placeholder="Phone Number *" data-required="true" aria-required="true">
      </div>
      <div class="w-form-row-state">Dit is een verplicht veld</div>
    </div>
    <div class="w-form-row for_date with_icon">
      <div class="w-form-row-field">
        <i class="material-icons">calendar_today</i> <input type="text" name="us_form_1_date_1" value="" inputmode="none" data-date-format="d MM, D" aria-label="Date of booking" placeholder="Date of booking" id="dp1716370128873"
          class="hasDatepicker">
      </div>
      <div class="w-form-row-state">Dit is een verplicht veld</div>
    </div>
    <div class="w-form-row for_textarea required with_icon">
      <div class="w-form-row-field">
        <i class="material-icons">create</i> <textarea aria-label="Message" name="us_form_1_textarea_1" placeholder="Message *" data-required="true" aria-required="true"></textarea>
      </div>
      <div class="w-form-row-state">Dit is een verplicht veld</div>
    </div>
    <input type="hidden" name="action" value="us_ajax_cform">
    <input type="hidden" name="post_id" value="17">
    <input type="hidden" name="form_index" value="1">
    <input type="hidden" name="queried_object_id" value="17">
    <input type="hidden" name="queried_object_type" value="post">
    <div class="w-form-row for_submit align_none">
      <button class="w-btn  us-btn-style_1" aria-label="Send Message" type="submit">
        <span class="g-preloader type_1"></span>
        <span class="w-btn-label">Send Message</span>
      </button>
    </div>
  </div>
  <div class="w-form-message"></div>
</form>

Text Content

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Bestel nu
+321 123 4567


CONTACT

Dear Customers!

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amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper
mattis, pulvinar dapibus leo.


person
Dit is een verplicht veld
phone
Dit is een verplicht veld
calendar_today
Dit is een verplicht veld
create
Dit is een verplicht veld
Send Message

location_on

BOLSHAYA DMITROVKA, 32/4, MOSCOW


phone

+321 123 4567, +321 123 4568


access_time

MON-SUN FROM 10:00 TO 23:00

Business Lunchs — Mon-Fri from 12:00 to 15:00


Leaflet | © OpenStreetMap contributors
Information


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risus varius blandit sit amet non magna.

Contact

location_on
Bolshaya Dmitrovka St., 32/4, Moscow

phone
+321 123 4567, +321 123 4568
Social Links

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