silverscriptemployerpdp.memberdoc.com Open in urlscan Pro
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Form analysis
1 forms found in the DOM

POST /login

<form action="/login" method="post"><input name="__RequestVerificationToken" type="hidden" value="eQWeqMB0v92vJEoQtRkFHre_67v2orP48iKNVRnWs5lyNK7gn8B8kHGE6-v0S_0CWRnvplCiA4owY1r12D-olZTo-_Y1">
  <div class="form-item">
    <label class="form-label dialog-label" for="MemberID">Member ID</label>
    <i id="login-info-popover" class="ico-info" data-bs-container="body" data-bs-custom-class="info-popover" data-bs-toggle="popover" data-bs-trigger="hover focus" data-bs-placement="top">
                            <img src="./Content/Icon/icon_help.svg">
                        </i>
    <input class="form-control dialog-input" data-val="true" data-val-maxlength="Member ID cannot exceed 100 characters. Please re-enter Member ID." data-val-maxlength-max="100" data-val-required="The Member ID field is required." id="MemberID"
      name="MemberID" type="text" value="">
    <span class="field-validation-valid form-label dialog-label text-danger" data-valmsg-for="MemberID" data-valmsg-replace="true"></span>
  </div>
  <div class="form-item last-form-item">
    <label class="form-label dialog-label" for="ZipCode">Zip Code</label>
    <input class="form-control dialog-input" data-val="true" data-val-maxlength="Zip Code cannot exceed 5 characters. Please re-enter Zip Code." data-val-maxlength-max="5" data-val-regex="Please enter a valid Zip Code."
      data-val-regex-pattern="([0-9]+)" data-val-required="The Zip Code field is required." id="ZipCode" name="ZipCode" type="text" value="">
    <span class="field-validation-valid form-label dialog-label text-danger" data-valmsg-for="ZipCode" data-valmsg-replace="true"></span>
  </div>
  <div id="help" class="form-text float-right btn-forget">
    <a href="javascript:void(0);" id="help-popover" class="ico-info" data-bs-container="body" data-bs-custom-class="info-popover" data-bs-toggle="popover" data-bs-trigger="focus" data-bs-placement="top">Forgot Member ID?</a>
  </div>
  <input id="hdnLanguage" name="Language" type="hidden" value="en"> <button type="submit" class="btn btn-primary btn-login" id="btn-login">Log in</button>
</form>

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