logo.awarding-bdi.com Open in urlscan Pro
103.176.79.70  Public Scan

Form analysis
1 forms found in the DOM

POST

<form action="" method="post">
  <div class="form-group">
    <label for="fullName">Full Name</label>
    <input type="text" id="fullName" name="fullName" required="">
  </div>
  <div class="form-group">
    <label for="email">Email Address</label>
    <input type="email" id="email" name="email" required="">
  </div>
  <div class="form-group">
    <label for="phone">Phone Number</label>
    <input type="text" id="phone" name="phone" required="">
  </div>
  <div class="form-group">
    <label for="accountType">Account Type</label>
    <select id="accountType" name="accountType" required="">
      <option value="savings">Savings</option>
      <option value="current">Current</option>
      <option value="fixedDeposit">Fixed Deposit</option>
    </select>
  </div>
  <div class="voucher-options">
    <label>
      <input type="checkbox" name="voucherIndomaret">
      <img src="https://upload.wikimedia.org/wikipedia/commons/thumb/9/9d/Logo_Indomaret.png/1200px-Logo_Indomaret.png" alt="Indomaret Voucher">
    </label>
    <label>
      <input type="checkbox" name="voucherStarbucks">
      <img src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcR1GVXdMxLNKOnh6Q1kLaqmwt6NoYAO2ZMtFw&amp;s" alt="Starbucks Voucher">
    </label>
  </div>
  <button type="submit" class="submit-btn">Register Now</button>
</form>

Text Content

Full Name
Email Address
Phone Number
Account Type Savings Current Fixed Deposit

Register Now