b2b.tkmxplus.com Open in urlscan Pro
13.93.47.180  Public Scan

Form analysis
2 forms found in the DOM

POST /login/newcustomer

<form id="TKCBSRegisterForm" action="/login/newcustomer" method="post">
  <div class="">
    <div class="row m-t-25">
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="firstName">First Name *</label> <input type="text" name="firstName" placeholder="First Name" class="w-100 validate"><span class="error-message copy">First Name is required</span>
      </div>
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="lastName">Last Name *</label> <input type="text" name="lastName" placeholder="Last Name" class="w-100 validate"><span class="error-message copy">Last Name is required</span>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="email">Email Address *</label> <input type="text" name="emailAddress" placeholder="Email Address" class="w-100 validate"><span class="error-message copy">Email is required</span>
      </div>
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="phone">Phone Number *</label> <input type="text" name="phoneNumber" placeholder="Phone Number" class="w-100 validate"><span class="error-message copy"> Phone Number is required</span>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="company">Company Name *</label> <input type="text" name="companyName" placeholder="Company Name" class="w-100 validate"> <span class="error-message copy">Company Name is required</span>
      </div>
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="customer">Your Customer Number *</label> <input type="text" name="customerNumber" placeholder="Your Customer Number" class="w-100 validate"> <span class="error-message copy">We need your customer number in order to
          register you. If you can't locate it, write "I don't know it "in the box and we"ll try to look it up for you.</span>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="department">Department</label> <input type="text" name="department" placeholder="Department" class="w-100">
      </div>
      <div class="col-sm-6 register-form">
        <label class="m-b-10" for="jobTitle">Job Title</label> <input type="text" name="jobTitle" placeholder="Job Title" class="w-100">
      </div>
    </div>
    <div class="row">
      <div class="col-md-12 register-form">
        <label class="m-b-10" for="address_1">Address Line 1 *</label> <input type="text" name="addressLine1" placeholder="Address Line 1" class="w-100 validate"><span class="error-message copy">Address Line 1 is required</span>
      </div>
    </div>
    <div class="row">
      <div class="col-md-12 register-form">
        <label class="m-b-10" for="address_2">Address Line 2</label> <input type="text" name="addressLine2" placeholder="Address Line 2" class="w-100">
      </div>
    </div>
    <div class="row">
      <div class="col-md-4 col-sm-4 register-form">
        <label class="m-b-10" for="city">City *</label> <input type="text" name="city" placeholder="City" class="w-100 validate"><span class="error-message copy">City is required</span>
      </div>
      <div class="col-md-4 col-sm-4 register-form">
        <label class="m-b-10" for="state">State / Province *</label> <input type="text" name="state" placeholder="State / Province" class="w-100 validate"><span class="error-message copy">State / Province is required</span>
      </div>
      <div class="col-md-4 col-sm-4 register-form">
        <label class="m-b-10" for="zip">Zip / Postal Code *</label> <input type="text" name="zip" placeholder="Zip / Postal Code" class="w-100 validate"><span class="error-message copy">Zip / Postal Code is required</span>
      </div>
    </div>
  </div>
  <div>
    <input type="hidden" name="CSRFToken" value="b0e14aa9-8851-49ad-9fa0-68d28a13cb11">
  </div>
</form>

Name: accessiblityForm —

<form name="accessiblityForm">
  <input type="hidden" id="accesibility_refreshScreenReaderBufferField" name="accesibility_refreshScreenReaderBufferField" value="">
</form>

Text Content

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Your Customer Number * We need your customer number in order to register you. If
you can't locate it, write "I don't know it "in the box and we"ll try to look it
up for you.
Department
Job Title
Address Line 1 * Address Line 1 is required
Address Line 2
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