justdigin.in Open in urlscan Pro
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Form analysis
1 forms found in the DOM

POST /stores-request

<form action="/stores-request" method="POST">
  <input type="hidden" name="_token" value="Ipimz7w3P9Tx9sbnU1ZJCwhkEoZkXwn4h7o4TvAq">
  <input type="hidden" name="pid" value="doll">
  <div class="form-group">
    <input type="text" class="form-control" placeholder="Full Name *" id="name" name="name" required="">
  </div><!-- End .form-group -->
  <div class="form-group">
    <input type="text" class="form-control" placeholder="Email *" id="singin-email" name="email" required="">
  </div><!-- End .form-group -->
  <div class="form-group">
    <input type="text" class="form-control" placeholder="Mobile *" id="mobile" name="mobile" required="">
  </div><!-- End .form-group -->
  <div class="form-group">
    <textarea class="form-control" id="message" required="" placeholder="Shipping Address*" name="address"></textarea>
  </div><!-- End .form-group -->
  <div class="form-group">
    <textarea class="form-control" id="message" placeholder="Message" name="message"></textarea>
  </div><!-- End .form-group -->
  <div class="form-group">
    <div class="captcha">
      <span class="float-left"><img src="https://justdigin.in/captcha/default?DPl0eMt4"></span>
      <a href="#" class="btn" onclick="loadCaptcha()"><i class="icon-refresh"></i></a>
    </div>
  </div>
  <div class="form-group">
    <input id="captcha" type="text" required="" class="form-control" placeholder="Captcha *" name="captcha">
  </div>
  <div class="form-footer">
    <button type="submit" class="btn btn-outline-primary-2">
      <span>REQUEST</span>
      <i class="icon-long-arrow-right"></i>
    </button>
  </div><!-- End .form-footer -->
</form>

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