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2a02:26f0:3500:894::2d5b  Public Scan

Form analysis
2 forms found in the DOM

Name: enrollForm —

<form id="enrollForm" name="enrollForm" novalidate="" role="form" data-ng-submit="submit()" translate-container="text" autocomplete="off" class="ng-pristine ng-valid ng-valid-required">
  <div data-ng-show="errors" class="required row ng-hide">
    <div class="col-xs-12 error" role="alert" id="enrollForm-errors">
      <span key="publicEnrollment.confirmEnrollment.promoEnroll.notFound" ng-show="enrollmentError === 'PROSPECT_NOT_FOUND'" class="ng-hide"></span>
      <span key="publicEnrollment.confirmEnrollment.enrollForm.alreadyEnrolled" ng-show="enrollmentError === 'ALREADY_ENROLLED'" class="ng-hide"></span>
      <span key="publicEnrollment.confirmEnrollment.enrollForm.unableToEnroll" ng-show="enrollmentError === 'UNABLE_TO_ENROLL' || enrollmentError === 'ACCOUNT_ON_HOLD'" class="ng-hide"></span>
      <span ng-show="enrollmentError === 'UNABLE_TO_ACTIVATE_OA'" class="ng-hide">Sorry, we are having some technical issues activating your Online Advice account. Please try again later.</span>
      <span ng-show="enrollmentError === 'API_FAILURE' || enrollmentError === 'UNAUTHORIZED_ACCESS'" class="ng-binding ng-hide">Sorry, we are having some technical issues. Please try again later, or call us at .</span>
      <span ng-show="enrollmentError === 'LOGIN_FAILED'" class="ng-binding ng-hide">Sorry, we don't recognize the information you entered. Please double check your entries and try again, or call us at </span>
    </div>
  </div>
  <div class="col-xs-12 signup-label" id="signUpLabel">
    <strong ng-bind-html="pmSignUpButtonTitle" class="ng-binding"></strong>
  </div>
  <div class="form-group required row" data-ng-class="{true: ['has-error','has-feedback']} [enrollForm.firstName.$invalid &amp;&amp; enrollForm.submitted]">
    <label for="firstName" class="col-xs-12">
      <span key="publicEnrollment.confirmEnrollment.enrollForm.firstName"></span>
    </label>
    <div class="col-xs-12">
      <!-- ngIf: (!user.isPrePopulated || !user.hasFirstName) && user.formIsReady -->
      <!-- ngIf: user.formIsReady && user.isPrePopulated && user.hasFirstName -->
    </div>
    <div class="col-xs-12">
      <small class="error ng-hide" id="enrollForm-firstName-error" data-ng-show="enrollForm.firstName.$error.required &amp;&amp; enrollForm.submitted" key="publicEnrollment.confirmEnrollment.enrollForm.firstName.error"></small>
    </div>
  </div>
  <div class="form-group required row" data-ng-class="{true: ['has-error','has-feedback']} [enrollForm.lastName.$invalid &amp;&amp; enrollForm.submitted]">
    <label for="lastName" class="col-xs-12">
      <span key="publicEnrollment.confirmEnrollment.enrollForm.lastName"></span>
    </label>
    <div class="col-xs-12">
      <!-- ngIf: (!user.isPrePopulated || !user.hasLastName) && user.formIsReady -->
      <!-- ngIf: user.formIsReady && user.isPrePopulated && user.hasLastName -->
      <small class="error ng-hide" id="enrollForm-lastName-error" data-ng-show="enrollForm.lastName.$error.required &amp;&amp; enrollForm.submitted" key="publicEnrollment.confirmEnrollment.enrollForm.lastName.error"></small>
    </div>
  </div>
  <div class="form-group required row" data-ng-class="{true: ['has-error','has-feedback']} [enrollForm.zipCode.$invalid &amp;&amp; enrollForm.submitted &amp;&amp; isZipcodeMandatory]">
    <label for="zipCode" class="col-xs-12" id="zipCodeLabel">
      <span key="publicEnrollment.confirmEnrollment.enrollForm.zipCode"></span>
    </label>
    <div class="col-xs-5 zipcode-float" id="zipCodeField" data-ng-class="{'zipcode-float': !isZipcodeMandatory}">
      <!-- ngIf: user.formIsReady -->
      <!-- ngIf: user.formIsReady && user.hasZipCode -->
    </div>
    <div id="enrollForm-zipCode-error" class="col-xs-12">
      <small class="error ng-hide" aria-hidden="true" data-ng-show="enrollForm.zipCode.$invalid &amp;&amp; enrollForm.submitted &amp;&amp; isZipcodeMandatory" key="publicEnrollment.confirmEnrollment.enrollForm.zipCode.error"></small>
      <span class="sr-only" key="publicEnrollment.confirmEnrollment.enrollForm.zipCode.error.srText"></span>
    </div>
    <div class="col-xs-12">
      <span id="zipCodeHelp" data-ng-show="enrollForm.zipCode.inFocus" key="publicEnrollment.confirmEnrollment.enrollForm.zipCode.help" class="ng-hide"></span>
    </div>
  </div>
  <!-- ngIf: user.formIsReady && !user.isPrePopulated -->
  <!-- ngIf: isSSNRequired && !user.isPrePopulated -->
  <div class="form-group row ng-hide" data-ng-show="isEmpIDRequired &amp;&amp; !user.isPrePopulated" data-ng-class="{true: ['has-error','has-feedback']} [enrollForm.employeeID.$invalid &amp;&amp; enrollForm.submitted]">
    <label for="employeeID" class="col-xs-12" key="publicEnrollment.confirmEnrollment.enrollForm.employeeID">
    </label>
    <div class="col-xs-12">
      <input class="form-control ng-pristine ng-untouched ng-valid ng-empty ng-valid-required" id="employeeID" name="employeeID" data-ng-model="user.employeeID" data-ng-required="isEmpIDRequired" data-fe-validation=""
        aria-describedby="enrollForm-employeeID-error">
      <small class="error ng-hide" id="enrollForm-employeeID-error" data-ng-show="enrollForm.employeeID.$error.required &amp;&amp; enrollForm.submitted" key="publicEnrollment.confirmEnrollment.enrollForm.employeeID.error"></small>
    </div>
  </div>
  <!-- ngIf: isEmailSupported && !user.isPrePopulated -->
  <!-- ngIf: isEmailSupported && user.isPrePopulated -->
  <!-- ngIf: isPhoneSupported && !user.isPrePopulated -->
  <!-- ngIf: isPhoneSupported && user.isPrePopulated -->
  <!-- extra text placeholder for sponsor customization -->
  <div class="row extra-text ng-hide" ng-show="extraTextForSignUpButtonEnabled &amp;&amp; options.signUpContext === 'MA'">
    <span key="maoachoice.aboutma.extraTextForSignUpButton"></span>
  </div>
  <!-- disclosure -->
  <!-- ngIf: checkboxEnabled && options.signUpContext === 'MA' -->
  <div id="please-wait-label-enrollment" class="row ng-hide" data-ng-show="enrollForm.submittedPost">
    <div class="col-xs-12" id="waitMessage">
      <h2>
        <strong>
          <span>Please wait...&nbsp;&nbsp;</span>
          <i class="fa fa-spinner fa-spin fa-lg"></i>
        </strong>
      </h2>
    </div>
  </div>
  <div class="row">
    <div class="col-xs-12" id="signUpButton">
      <!-- PM enrollment button -->
      <!-- ngIf: options.signUpContext === 'MA' -->
      <div data-ng-if="options.signUpContext === 'MA'" class="ng-scope">
        <button id="confirm-enrollment-button" data-ng-hide="enrollForm.submittedPost" type="submit" class="btn btn-warning btn-lg btn-block" style="width:100%;">
          <span ng-bind-html="pmSignUpButtonLabel" class="ng-binding"></span>
        </button>
      </div><!-- end ngIf: options.signUpContext === 'MA' -->
      <!-- OA enrollment button -->
      <!-- ngIf: options.signUpContext === 'OA' -->
    </div>
    <!-- ngInclude: -->
    <div data-ng-include="" src="&quot;app/components/sign-up-form/common/sign-up-form-disclaimer.html&quot;" class="ng-scope">
      <div class="col-xs-12 promobox-signup-disc ng-scope" id="promoBoxSignUpDisc" data-ng-controller="SignUpDisclaimerController">
        <!-- ngIf: options.signUpContext !== 'OA' -->
        <div data-ng-if="options.signUpContext !== 'OA'" class="ng-scope">
          <div>
            <small id="signup-form-disclaimer-one" key-recompile="" key=""></small>
            <br>
            <!-- ngIf: showTaxDisclosure -->
            <small id="signup-form-disclaimer-two" key-recompile="" key=""></small>
            <!-- ngIf: showUpdatedDisclaimer && page.context.isFeChannel -->
          </div>
        </div><!-- end ngIf: options.signUpContext !== 'OA' -->
        <!-- ngIf: options.signUpContext === 'OA' -->
      </div>
      <!--
oaIsaUrl -> doc.isa
oaPrivacyUrl -> doc.oa-privacy
oaTermsUrl -> doc.oa-terms
-->
    </div>
    <div class="lis-disclosure ng-hide" data-ng-show="showLisDisclosure">
      <span id="lis-disclosure-content" key-recompile="" key=""></span> <a href="" target="_blank"><span id="lis-disclosure-link-text" key-recompile="" key=""></span></a>
    </div>
  </div>
</form>

Name: contactForm —

<form id="contactForm" name="contactForm" novalidate="" role="form" ng-submit="saveUserEmail()" autocomplete="off" class="ng-pristine ng-valid">
  <!-- email -->
  <!-- ngIf: isEmailSupported -->
  <div class="row">
    <div class="col-xs-12" id="contactFormButton">
      <button id="contact-form-button" ng-show="!contactForm.submittedPost" type="submit" class="btn btn-warning btn-lg btn-block" style="width:100%;">
        <span>SUBMIT</span>
      </button>
    </div>
  </div>
</form>

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