exclusivecheckout.com Open in urlscan Pro
2606:4700:3037::ac43:daaf  Public Scan

Submitted URL: https://www.cocconelnextstep.com/
Effective URL: https://exclusivecheckout.com/n124lzvxz/checkout/?pub=461&click_id=c7a12f8a25c2446892b3567494ddaf4f&c1=cocconel.com%2Fproducts...
Submission: On March 15 via api from US — Scanned from US

Form analysis 2 forms found in the DOM

POST

<form class="checkout-form has-validation-callback" id="signup-form" method="post">
  <input type="hidden" name="action" value="checkout">
  <input type="hidden" name="x_amount" value="74.64" data-threeds="amount">
  <input type="hidden" name="x_transaction_id" value="" data-threeds="id">
  <h2 class="mb-2 like-legend" data-i18n="form-2-header-2-new">Shipping &amp; Billing Information</h2>
  <fieldset>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">First Name</label>
        <input value="" type="text" name="first_name" data-group="1" placeholder="First Name" required="" data-field="first_name" class="form-control  " data-validation="required">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Last Name</label>
        <input value="" type="text" name="last_name" data-group="1" placeholder="Last Name" required="" data-field="last_name" class="form-control  " data-validation="required">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Country</label>
        <select name="country" class="form-control " id="country" data-group="1" data-state="state" data-field="country">
          <option selected="selected" value="US"
            data-states="{&quot;AL&quot;:&quot;Alabama&quot;,&quot;AK&quot;:&quot;Alaska&quot;,&quot;AZ&quot;:&quot;Arizona&quot;,&quot;AR&quot;:&quot;Arkansas&quot;,&quot;CA&quot;:&quot;California&quot;,&quot;CO&quot;:&quot;Colorado&quot;,&quot;CT&quot;:&quot;Connecticut&quot;,&quot;DE&quot;:&quot;Delaware&quot;,&quot;FL&quot;:&quot;Florida&quot;,&quot;GA&quot;:&quot;Georgia&quot;,&quot;HI&quot;:&quot;Hawaii&quot;,&quot;ID&quot;:&quot;Idaho&quot;,&quot;IL&quot;:&quot;Illinois&quot;,&quot;IN&quot;:&quot;Indiana&quot;,&quot;IA&quot;:&quot;Iowa&quot;,&quot;KS&quot;:&quot;Kansas&quot;,&quot;KY&quot;:&quot;Kentucky&quot;,&quot;LA&quot;:&quot;Lousiana&quot;,&quot;ME&quot;:&quot;Maine&quot;,&quot;MD&quot;:&quot;Maryland&quot;,&quot;MA&quot;:&quot;Massachusetts&quot;,&quot;MI&quot;:&quot;Michigan&quot;,&quot;MN&quot;:&quot;Minnesota&quot;,&quot;MS&quot;:&quot;Mississippi&quot;,&quot;MO&quot;:&quot;Missouri&quot;,&quot;MT&quot;:&quot;Montana&quot;,&quot;NE&quot;:&quot;Nebraska&quot;,&quot;NV&quot;:&quot;Nevada&quot;,&quot;NH&quot;:&quot;New Hampshire&quot;,&quot;NJ&quot;:&quot;New Jersey&quot;,&quot;NM&quot;:&quot;New Mexico&quot;,&quot;NY&quot;:&quot;New York&quot;,&quot;NC&quot;:&quot;North Carolina&quot;,&quot;ND&quot;:&quot;North Dakota&quot;,&quot;OH&quot;:&quot;Ohio&quot;,&quot;OK&quot;:&quot;Oklahoma&quot;,&quot;OR&quot;:&quot;Oregon&quot;,&quot;PA&quot;:&quot;Pennsylvania&quot;,&quot;RI&quot;:&quot;Rhode Island&quot;,&quot;SC&quot;:&quot;South Carolina&quot;,&quot;SD&quot;:&quot;South Dakota&quot;,&quot;TN&quot;:&quot;Tennessee&quot;,&quot;TX&quot;:&quot;Texas&quot;,&quot;UT&quot;:&quot;Utah&quot;,&quot;VT&quot;:&quot;Vermont&quot;,&quot;VA&quot;:&quot;Virginia&quot;,&quot;WA&quot;:&quot;Washington&quot;,&quot;WV&quot;:&quot;West Virginia&quot;,&quot;WI&quot;:&quot;Wisconsin&quot;,&quot;WY&quot;:&quot;Wyoming&quot;,&quot;DC&quot;:&quot;Washington, DC&quot;}">
            United States</option>
        </select>
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Zip</label>
        <input value="" type="tel" pattern="^[0-9]{5}" name="zip" data-group="1" placeholder="Zip / Postal" required="" data-field="zip" class="form-control  " data-validation="required custom" data-validation-regexp="^[0-9]{5}" maxlength="5">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Address</label>
        <input value="" type="text" pattern="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" name="address" data-group="1" placeholder="Address" required="" data-field="address" class="form-control  "
          data-validation="required custom" data-validation-regexp="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Address 2</label>
        <input value="" type="text" pattern="^([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" name="address_2" data-group="1" placeholder="Apt / Suite #" data-field="address_2" class="form-control  " data-validation="custom"
          data-validation-regexp="^([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" data-validation-optional="true">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">City</label>
        <input value="" type="text" pattern="^[a-zA-Z. ]{3,}$" name="city" data-group="1" placeholder="City" required="" data-field="city" class="form-control  " data-validation="required custom" data-validation-regexp="^[a-zA-Z. ]{3,}$">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">State</label>
        <select name="state" required="" class="form-control   " data-field="state" data-group="1" id="state" data-default="" data-validation="required">
          <option value="" selected="selected">Select State</option>
          <option value="AL">Alabama</option>
          <option value="AK">Alaska</option>
          <option value="AZ">Arizona</option>
          <option value="AR">Arkansas</option>
          <option value="CA">California</option>
          <option value="CO">Colorado</option>
          <option value="CT">Connecticut</option>
          <option value="DE">Delaware</option>
          <option value="FL">Florida</option>
          <option value="GA">Georgia</option>
          <option value="HI">Hawaii</option>
          <option value="ID">Idaho</option>
          <option value="IL">Illinois</option>
          <option value="IN">Indiana</option>
          <option value="IA">Iowa</option>
          <option value="KS">Kansas</option>
          <option value="KY">Kentucky</option>
          <option value="LA">Lousiana</option>
          <option value="ME">Maine</option>
          <option value="MD">Maryland</option>
          <option value="MA">Massachusetts</option>
          <option value="MI">Michigan</option>
          <option value="MN">Minnesota</option>
          <option value="MS">Mississippi</option>
          <option value="MO">Missouri</option>
          <option value="MT">Montana</option>
          <option value="NE">Nebraska</option>
          <option value="NV">Nevada</option>
          <option value="NH">New Hampshire</option>
          <option value="NJ">New Jersey</option>
          <option value="NM">New Mexico</option>
          <option value="NY">New York</option>
          <option value="NC">North Carolina</option>
          <option value="ND">North Dakota</option>
          <option value="OH">Ohio</option>
          <option value="OK">Oklahoma</option>
          <option value="OR">Oregon</option>
          <option value="PA">Pennsylvania</option>
          <option value="RI">Rhode Island</option>
          <option value="SC">South Carolina</option>
          <option value="SD">South Dakota</option>
          <option value="TN">Tennessee</option>
          <option value="TX">Texas</option>
          <option value="UT">Utah</option>
          <option value="VT">Vermont</option>
          <option value="VA">Virginia</option>
          <option value="WA">Washington</option>
          <option value="WV">West Virginia</option>
          <option value="WI">Wisconsin</option>
          <option value="WY">Wyoming</option>
          <option value="DC">Washington, DC</option>
        </select>
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Phone</label>
        <input value="" type="tel" name="phone" data-group="1" placeholder="Phone Number" required="" data-field="phone" class="form-control  " data-validation="required" maxlength="14">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Email</label>
        <input value="" type="email" name="email" data-group="1" placeholder="Email Address" required="" data-field="email" class="form-control  " data-validation="required email">
      </div>
    </div>
  </fieldset>
  <div>&nbsp;</div>
  <h2 class="mb-2 like-legend" data-i18n="form-2-header-2-new">Payment Information</h2>
  <div class="weAccept" style="display:none;">We Accept: <img class="ccLogos" src="/flow_assets/e71d9181a67b/custom_image_2.png" alt="">
    <img class="ccLogos" src="/assets/images/visaCCLogo.png" alt="">
    <img class="ccLogos" src="/assets/images/discoverCCLogo.png" alt="">
  </div>
  <p class="mc-promo" style="background: url(/assets/images/masterCCLogo.png) 18px 11px no-repeat #fffa51; background-size: 17%; padding: 9px 10px 9px 96px; font-size: 13px; line-height: 1.5em;"> Good News: Get a $3 additional discount on shipping
    when you checkout with Mastercard! </p>
  <fieldset>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Card</label>
        <input type="tel" tabindex="1" class="formfield ib" name="ccnum" id="ccnum" required="" value="" pattern="(\D*\d){16,}" placeholder="____ ____ ____ ____" data-validation="required custom" data-validation-regexp="(\D*\d){16,}" maxlength="19">
        <input type="hidden" data-threeds="pan" id="3ds_ccnum" value="">
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">Expiration Date</label>
        <select id="ccexpmonth" name="exp_month" tabindex="2" class="half custom-select form-control" data-threeds="month">
          <option data-i18n="month-text-new" disabled="" selected="" value="">MM</option>
          <option value="01">01</option>
          <option value="02">02</option>
          <option value="03">03</option>
          <option value="04">04</option>
          <option value="05">05</option>
          <option value="06">06</option>
          <option value="07">07</option>
          <option value="08">08</option>
          <option value="09">09</option>
          <option value="10">10</option>
          <option value="11">11</option>
          <option value="12">12</option>
        </select>/ <select id="ccyear" tabindex="3" class="custom-select form-control" name="exp_year" data-threeds="year" data-parsley-cc-expires-year="" required="" data-parsley-trigger="change" data-tooltip-at="top right"
          data-tooltip-my="bottom right" data-validation="required">
          <option data-i18n="year-text-new" disabled="" selected="" value="">YY</option>
          <option value="24">2024</option>
          <option value="25">2025</option>
          <option value="26">2026</option>
          <option value="27">2027</option>
          <option value="28">2028</option>
          <option value="29">2029</option>
          <option value="30">2030</option>
          <option value="31">2031</option>
          <option value="32">2032</option>
          <option value="33">2033</option>
          <option value="34">2034</option>
          <option value="35">2035</option>
          <option value="36">2036</option>
          <option value="37">2037</option>
          <option value="38">2038</option>
          <option value="39">2039</option>
          <option value="40">2040</option>
          <option value="41">2041</option>
          <option value="42">2042</option>
          <option value="43">2043</option>
          <option value="44">2044</option>
        </select>
      </div>
    </div>
    <div class="form-row">
      <div class="form-group col-md-12">
        <label for="firstname" data-i18n="form-firstName">CVV</label>
        <input type="tel" tabindex="4" class="formfield short" id="cvv" name="cvv" placeholder="___" pattern="(\D*\d){3}" title="3 Digit Security Code" value="" required="" data-validation="required custom" data-validation-regexp="(\D*\d){3}"
          maxlength="3">
        <a href="#vmodal" data-modal-url="/n124lzvxz/cvv/"><img src="/assets/images/cvv-img.png" style="vertical-align: middle;  margin-left: 12px; width: 84px;"></a>
      </div>
    </div>
  </fieldset>
</form>

POST /

<form method="post" class="update-shipping-form has-validation-callback" action="/">
  <input type="hidden" name="action" value="prospect">
  <div class="shipping-fields">
    <label> First Name: </label>
    <div class="shipping-field">
      <input value="" type="text" name="first_name" data-group="1" placeholder="First Name" required="" data-field="first_name" class="form-control  " data-validation="required">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Last Name: </label>
    <div class="shipping-field">
      <input value="" type="text" name="last_name" data-group="1" placeholder="Last Name" required="" data-field="last_name" class="form-control  " data-validation="required">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Country: </label>
    <div class="shipping-field">
      <select name="country" class="form-control " id="country" data-group="1" data-state="state" data-field="country">
        <option selected="selected" value="US"
          data-states="{&quot;AL&quot;:&quot;Alabama&quot;,&quot;AK&quot;:&quot;Alaska&quot;,&quot;AZ&quot;:&quot;Arizona&quot;,&quot;AR&quot;:&quot;Arkansas&quot;,&quot;CA&quot;:&quot;California&quot;,&quot;CO&quot;:&quot;Colorado&quot;,&quot;CT&quot;:&quot;Connecticut&quot;,&quot;DE&quot;:&quot;Delaware&quot;,&quot;FL&quot;:&quot;Florida&quot;,&quot;GA&quot;:&quot;Georgia&quot;,&quot;HI&quot;:&quot;Hawaii&quot;,&quot;ID&quot;:&quot;Idaho&quot;,&quot;IL&quot;:&quot;Illinois&quot;,&quot;IN&quot;:&quot;Indiana&quot;,&quot;IA&quot;:&quot;Iowa&quot;,&quot;KS&quot;:&quot;Kansas&quot;,&quot;KY&quot;:&quot;Kentucky&quot;,&quot;LA&quot;:&quot;Lousiana&quot;,&quot;ME&quot;:&quot;Maine&quot;,&quot;MD&quot;:&quot;Maryland&quot;,&quot;MA&quot;:&quot;Massachusetts&quot;,&quot;MI&quot;:&quot;Michigan&quot;,&quot;MN&quot;:&quot;Minnesota&quot;,&quot;MS&quot;:&quot;Mississippi&quot;,&quot;MO&quot;:&quot;Missouri&quot;,&quot;MT&quot;:&quot;Montana&quot;,&quot;NE&quot;:&quot;Nebraska&quot;,&quot;NV&quot;:&quot;Nevada&quot;,&quot;NH&quot;:&quot;New Hampshire&quot;,&quot;NJ&quot;:&quot;New Jersey&quot;,&quot;NM&quot;:&quot;New Mexico&quot;,&quot;NY&quot;:&quot;New York&quot;,&quot;NC&quot;:&quot;North Carolina&quot;,&quot;ND&quot;:&quot;North Dakota&quot;,&quot;OH&quot;:&quot;Ohio&quot;,&quot;OK&quot;:&quot;Oklahoma&quot;,&quot;OR&quot;:&quot;Oregon&quot;,&quot;PA&quot;:&quot;Pennsylvania&quot;,&quot;RI&quot;:&quot;Rhode Island&quot;,&quot;SC&quot;:&quot;South Carolina&quot;,&quot;SD&quot;:&quot;South Dakota&quot;,&quot;TN&quot;:&quot;Tennessee&quot;,&quot;TX&quot;:&quot;Texas&quot;,&quot;UT&quot;:&quot;Utah&quot;,&quot;VT&quot;:&quot;Vermont&quot;,&quot;VA&quot;:&quot;Virginia&quot;,&quot;WA&quot;:&quot;Washington&quot;,&quot;WV&quot;:&quot;West Virginia&quot;,&quot;WI&quot;:&quot;Wisconsin&quot;,&quot;WY&quot;:&quot;Wyoming&quot;,&quot;DC&quot;:&quot;Washington, DC&quot;}">
          United States</option>
      </select>
    </div>
  </div>
  <div class="shipping-fields">
    <label> Zip: </label>
    <div class="shipping-field">
      <input value="" type="tel" pattern="^[0-9]{5}" name="zip" data-group="1" placeholder="Zip / Postal" required="" data-field="zip" class="form-control  " data-validation="required custom" data-validation-regexp="^[0-9]{5}" maxlength="5">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Address: </label>
    <div class="shipping-field">
      <input value="" type="text" pattern="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" name="address" data-group="1" placeholder="Address" required="" data-field="address" class="form-control  "
        data-validation="required custom" data-validation-regexp="^(?=.*[0-9])(?=.*[a-zA-Z])(?=.*[ ])([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$">
    </div>
  </div>
  <div class="shipping-fields">
    <label> Address 2: </label>
    <div class="shipping-field">
      <input value="" type="text" pattern="^([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" name="address_2" data-group="1" placeholder="Apt / Suite #" data-field="address_2" class="form-control  " data-validation="custom"
        data-validation-regexp="^([a-zA-Z0-9'\/\-\. #@%&amp;`´‘’]+)$" data-validation-optional="true">
    </div>
  </div>
  <div class="shipping-fields">
    <label> City: </label>
    <div class="shipping-field">
      <input value="" type="text" pattern="^[a-zA-Z. ]{3,}$" name="city" data-group="1" placeholder="City" required="" data-field="city" class="form-control  " data-validation="required custom" data-validation-regexp="^[a-zA-Z. ]{3,}$">
    </div>
  </div>
  <div class="shipping-fields">
    <label> State: </label>
    <div class="shipping-field">
      <select name="state" required="" class="form-control   " data-field="state" data-group="1" id="state" data-default="" data-validation="required">
        <option value="">Select a State</option>
        <option value="AL">Alabama</option>
        <option value="AK">Alaska</option>
        <option value="AZ">Arizona</option>
        <option value="AR">Arkansas</option>
        <option value="CA">California</option>
        <option value="CO">Colorado</option>
        <option value="CT">Connecticut</option>
        <option value="DE">Delaware</option>
        <option value="FL">Florida</option>
        <option value="GA">Georgia</option>
        <option value="HI">Hawaii</option>
        <option value="ID">Idaho</option>
        <option value="IL">Illinois</option>
        <option value="IN">Indiana</option>
        <option value="IA">Iowa</option>
        <option value="KS">Kansas</option>
        <option value="KY">Kentucky</option>
        <option value="LA">Lousiana</option>
        <option value="ME">Maine</option>
        <option value="MD">Maryland</option>
        <option value="MA">Massachusetts</option>
        <option value="MI">Michigan</option>
        <option value="MN">Minnesota</option>
        <option value="MS">Mississippi</option>
        <option value="MO">Missouri</option>
        <option value="MT">Montana</option>
        <option value="NE">Nebraska</option>
        <option value="NV">Nevada</option>
        <option value="NH">New Hampshire</option>
        <option value="NJ">New Jersey</option>
        <option value="NM">New Mexico</option>
        <option value="NY">New York</option>
        <option value="NC">North Carolina</option>
        <option value="ND">North Dakota</option>
        <option value="OH">Ohio</option>
        <option value="OK">Oklahoma</option>
        <option value="OR">Oregon</option>
        <option value="PA">Pennsylvania</option>
        <option value="RI">Rhode Island</option>
        <option value="SC">South Carolina</option>
        <option value="SD">South Dakota</option>
        <option value="TN">Tennessee</option>
        <option value="TX">Texas</option>
        <option value="UT">Utah</option>
        <option value="VT">Vermont</option>
        <option value="VA">Virginia</option>
        <option value="WA">Washington</option>
        <option value="WV">West Virginia</option>
        <option value="WI">Wisconsin</option>
        <option value="WY">Wyoming</option>
        <option value="DC">Washington, DC</option>
      </select>
    </div>
  </div>
  <div class="shipping-fields">
    <label> Phone: </label>
    <div class="shipping-field">
      <input value="" type="tel" name="phone" data-group="1" placeholder="Phone Number" required="" data-field="phone" class="form-control  " data-validation="required" maxlength="14">
    </div>
  </div>
  <div class="shipping-fields submit">
    <button type="submit">Update Shipping Address</button>
  </div>
</form>

Text Content

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SHIPPING & BILLING INFORMATION

First Name
Last Name
Country United States
Zip
Address
Address 2
City
State Select
StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLousianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth
DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth
DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest
VirginiaWisconsinWyomingWashington, DC
Phone
Email
 


PAYMENT INFORMATION

We Accept:

Good News: Get a $3 additional discount on shipping when you checkout with
Mastercard!

Card
Expiration Date MM 01 02 03 04 05 06 07 08 09 10 11 12 / YY
202420252026202720282029203020312032203320342035203620372038203920402041204220432044
CVV
I have read and agree to the terms and conditions and certify that I am at least
18 years of age.
Pay $6.95


SUBTOTAL

--------------------------------------------------------------------------------

1

COTTON NAPPER KNITTED BLANKET

-- X 1
$6.95

--------------------------------------------------------------------------------

SUBTOTAL

$9.95

MASTERCARD DISCOUNT

-$3.00

--------------------------------------------------------------------------------

TOTAL

$6.95



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First Name:

Last Name:

Country:
United States
Zip:

Address:

Address 2:

City:

State:
Select a
StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLousianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth
DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth
DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest
VirginiaWisconsinWyomingWashington, DC
Phone:

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