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rbj.org.in Open in urlscan Pro
182.71.26.212  Public Scan

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Submitted URL: http://91lk2rq5.r.ap-south-1.awstrack.me/L0/http:%2F%2Frbj.org.in%2Fapi%2Ftrack%2FtrackEmail%2FgO9qzy2Rb5Yd/1/01090191a2860fd7-77777545-9...
Effective URL: http://rbj.org.in/api/track/trackEmail/gO9qzy2Rb5Yd
Submission: On August 30 via manual from IN — Scanned from US

Form analysis 1 forms found in the DOM

POST 

<form id="registrationForm" action="" method="post">
  <div class="list-wrap" style="background-color: White; border: 2px solid #f7e8d5">
    <div id="Contact_Mail" class="textarea">
      <div id="pnlMail">
        <div id="example-one">
          <br>
          <table width="70%" border="0" align="center" style="padding: 10px;" cellpadding="1" cellspacing="0">
            <caption>
              <br>
            </caption>
            <tbody>
              <tr>
                <td id="DisplayPane" align="left" class="text1" valign="top">
                  <h3 style="color:#313639;">Public Tech Platform - Registration</h3><br>
                </td>
              </tr>
            </tbody>
          </table>
          <table margin-top="10px" width="50%" align="center" cellpad-ding="3" cellspacing="0" cellpadding="3">
            <tbody>
              <tr>
                <td align="left" style="padding: 10px;"> Name of Employee <font color="red">*</font>
                </td>
                <td align="left">
                  <input style="width: 90%;" type="text" maxlength="30" id="txtEmployeeName" name="employeeName" required="" autocomplete="off">
                </td>
              </tr>
              <tr>
                <td align="left" style="padding: 10px"> Name of the Regulated Entity (RE) <font col-or="red">*</font>
                </td>
                <td align="left">
                  <input style="width: 90%;" type="text" maxlength="30" id="txtRegulatedEntity" name="regulatedEntity" required="" autocomplete="off">
                </td>
              </tr>
              <tr>
                <td align="left" style="padding: 10px"> Email ID of the Employee <font color="red">*</font>
                </td>
                <td align="left">
                  <input style="width: 90%;" type="email" maxlength="30" id="txtEmployeeEmail" name="employeeEmail" required="" autocomplete="off">
                </td>
              </tr>
              <tr>
                <td align="left" style="padding: 10px"> Mobile Number <font color="red">*</font>
                </td>
                <td align="left">
                  <input style="width: 90%;" type="tel" pattern="\d{10}" maxlength="10" id="txtMobileNumber" name="mobileNumber" required="" autocomplete="off">
                </td>
              </tr>
              <tr>
                <td align="left" style="padding: 10px"> Pan Number <font color="red">*</font>
                </td>
                <td align="left">
                  <input style="width: 90%;" type="text" maxlength="10" id="txtPanNumber" name="panNumber" required="" autocomplete="on">
                </td>
              </tr>
              <tr>
                <td align="left" style="padding: 10px"> AadharNumber <font color="red">*</font>
                </td>
                <td align="left">
                  <input name="aadhaar" style="width: 90%;" type="text" placeholder="xxxx-xxxx-xxxx" id="txtAadharNumber" maxlength="14" required="" autocomplete="off">
                </td>
              </tr>
              <tr>
                <td align="right"> &nbsp; </td>
                <td align="left" height="25">
                  <input name="btnNext" type="submit" id="btnNext" val-ue="Next" class="button"> &nbsp;&nbsp;
                </td>
              </tr>
            </tbody>
          </table>
          <p align="CENTER" class="text1" colspan="1" style="margin-left: -35%;">
            <font color="red">*</font> Marked fields are Mandatory.
          </p>
        </div>
      </div>
    </div>
  </div>
</form>

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PUBLIC TECH PLATFORM - REGISTRATION


Name of Employee * Name of the Regulated Entity (RE) * Email ID of the Employee
* Mobile Number * Pan Number * AadharNumber *     

* Marked fields are Mandatory.

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