carahevents.carahsoft.com
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Submitted URL: https://carah.io/mailinginfoconfirmation
Effective URL: https://carahevents.carahsoft.com/Event/Form/551472-5042c127ec0a4325814fcdfdbda3136e
Submission: On December 02 via manual from IN — Scanned from DE
Effective URL: https://carahevents.carahsoft.com/Event/Form/551472-5042c127ec0a4325814fcdfdbda3136e
Submission: On December 02 via manual from IN — Scanned from DE
Form analysis 1 forms found in the DOM
POST /Event/Form/551472-5042c127ec0a4325814fcdfdbda3136e
<form id="regWrapper" method="post" action="/Event/Form/551472-5042c127ec0a4325814fcdfdbda3136e" novalidate="novalidate">
<input data-val="true" data-val-required="The MailTemplate_ID field is required." id="Template_MailTemplate_ID" name="Template.MailTemplate_ID" type="hidden" value="551472">
<input id="Auth" name="Auth" type="hidden" value="">
<input data-val="true" data-val-required="The Route_ID field is required." id="Route_ID" name="Route_ID" type="hidden" value="551472-5042c127ec0a4325814fcdfdbda3136e">
<input data-val="true" data-val-required="The PartialLayout field is required." id="PartialLayout" name="PartialLayout" type="hidden" value="_PartialForm">
<input data-val="true" data-val-required="The IsEditMode field is required." id="IsEditMode" name="IsEditMode" type="hidden" value="False">
<input data-val="true" data-val-required="The RouteAction field is required." id="RouteAction" name="RouteAction" type="hidden" value="Form">
<div b-nbzllcq3pt="">
<div b-nbzllcq3pt="" id="registerWrapper">
<div b-nbzllcq3pt="" class="container" style="max-width: 600px; min-width: 320px;">
<div b-nbzllcq3pt="" class="row">
<img b-nbzllcq3pt="" src="/images/header/24277rp.jpg" style="width: 100%; padding:0;">
</div>
</div>
<div b-nbzllcq3pt="" class="container" style="max-width: 600px; min-width: 320px; background-color: white; padding: 25px 20px 47px;">
<div b-nbzllcq3pt="" id="regHtmlWrapper" contenteditable="false">
<div data-color="#005a9c" id="themeColor" style="display:none"> </div>
<div class="mainBody" contenteditable="false" id="registerBlurb" line-height="140%" style="line-height: 140%;">
<h4 style="text-align: center;"><b>Please Confirm Your Contact Info & Mailing Address</b></h4>
<p><span style="font-family:Arial,Helvetica,sans-serif;"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-size:12.0pt">We are taking the time now to confirm that our partner contact information is current
and accurate. Please fill out the form below with your preferred mailing address and contact information. </span></span></span></span></p>
<div id="bottomTextBox" style="display:none;">
<p style="font-style: italic;"> </p>
<p style="font-style: italic;"><span style="font-size:11px;">By supplying my contact information, I authorize <span id="organizationName">Carahsoft</span>, its partner companies, and its vendors and partner community to contact me with
personalized communications about their products and services. Please review our <a href="https://www.carahsoft.com/privacy-policy" style="color: #9a9a9a; text-decoration: none !important;" target="_blank">Privacy Policy</a> for
more details or to <a href="https://www.carahsoft.com/opt-out" style="color: #9a9a9a; text-decoration: none !important;" target="_blank">opt-out</a> at any time.</span></p>
</div>
</div>
</div>
<hr b-nbzllcq3pt="">
<div b-nbzllcq3pt="">
<div class="text-danger validation-summary-valid" data-valmsg-summary="true">
<ul>
<li style="display:none"></li>
</ul>
</div>
<div b-nbzllcq3pt="" class="mb-3">
<div class="row" id="details">
<div class="container">
<div style="display: none;">
<select class="form-control form-control-sm" id="Details_defaultStates" name="Details.defaultStates">
<option value=""></option>
<option value="VI">(U.S.) Virgin Islands</option>
<option value="AB">Alberta</option>
<option value="BC">British Columbia</option>
<option value="MB">Manitoba</option>
<option value="NB">New Brunswick</option>
<option value="NL">Newfoundland and Labrador</option>
<option value="NS">Nova Scotia</option>
<option value="ON">Ontario</option>
<option value="PE">Prince Edward Island</option>
<option value="QC">Quebec</option>
<option value="SK">Saskatchewan</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AS">American Samoa</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="DC">District of Columbia</option>
<option value="FM">Fed. States of Micronesia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="GU">Guam</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">Louisiana</option>
<option value="ME">Maine</option>
<option value="MH">Marshall Islands</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="MP">Northern Marianas</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="PR">Puerto Rico</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>
</select>
</div>
<!-- First Name -->
<div class="row mb-2">
<label class="col-3 col-sm-3 col-form-label-sm" for="Details_FirstName" required="required">First Name<span class="carah-required"> *</span></label>
<div class="col-sm-6 col-9">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field First Name must be a string with a maximum length of 20." data-val-length-max="20" id="Details_FirstName" maxlength="20"
name="Details.FirstName" required="required" type="text" value="">
</div>
<div class="d-block d-sm-none">
<div class="col-3"></div>
</div>
<div class="col-sm-3 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.FirstName" data-valmsg-replace="true"></span>
</div>
</div>
<!-- Last Name -->
<div class="row mb-2">
<label class="col-3 col-sm-3 col-form-label-sm" for="Details_LastName" required="required">Last Name<span class="carah-required"> *</span></label>
<div class="col-sm-6 col-9">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field Last Name must be a string with a maximum length of 20." data-val-length-max="20" id="Details_LastName" maxlength="20" name="Details.LastName"
required="required" type="text" value="">
</div>
<div class="d-block d-sm-none">
<div class="col-3"></div>
</div>
<div class="col-sm-3 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.LastName" data-valmsg-replace="true"></span>
</div>
</div>
<!-- Organization -->
<div class="row mb-2">
<label class="col-3 col-sm-3 col-form-label-sm" for="Details_Organization" required="required">Organization<span class="carah-required"> *</span></label>
<div class="col-sm-6 col-9">
<input class="form-control form-control-sm ui-autocomplete-input" data-val="true" data-val-length="The field Organization must be a string with a maximum length of 100." data-val-length-max="100" id="Details_Organization"
maxlength="100" name="Details.Organization" required="required" type="text" value="" autocomplete="off">
</div>
<div class="d-block d-sm-none">
<div class="col-3"></div>
</div>
<div class="col-sm-3 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.Organization" data-valmsg-replace="true"></span>
</div>
</div>
<!-- Title -->
<div class="row mb-2">
<label class="col-3 col-sm-3 col-form-label-sm" for="Details_JobTitle">Job Title</label>
<div class="col-sm-6 col-9">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field Job Title must be a string with a maximum length of 50." data-val-length-max="50" id="Details_JobTitle" maxlength="50" name="Details.JobTitle"
type="text" value="">
</div>
<div class="d-block d-sm-none">
<div class="col-3"></div>
</div>
<div class="col-sm-3 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.JobTitle" data-valmsg-replace="true"></span>
</div>
</div>
<div class="mb-2">
<div class="row">
<label class="col-3 col-sm-3 col-form-label-sm" for="Details_Email" required="required">Email<span class="carah-required"> *</span></label>
<div class="col-sm-6 col-9">
<input class="form-control form-control-sm" data-val="true" data-val-email="The Email field is not a valid e-mail address." data-val-length="The field Email must be a string with a maximum length of 50." data-val-length-max="50"
data-val-required="The Email field is required." id="Details_Email" maxlength="50" name="Details.Email" required="required" type="text" value="">
</div>
<div class="d-block d-sm-none">
<div class="col-3"></div>
</div>
<div class="col-sm-3 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.Email" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<!-- Phone -->
<div class="row mb-2">
<label class="col-3 col-sm-3 col-form-label-sm" for="Details_Phone" required="required">Phone<span class="carah-required"> *</span></label>
<div class="col-sm-4 col-6">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field Phone must be a string with a maximum length of 18." data-val-length-max="18" id="Details_Phone" maxlength="18" name="Details.Phone"
required="required" type="text" value="">
</div>
<div class="col-sm-2 col-3">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field Ext must be a string with a maximum length of 10." data-val-length-max="10" id="Details_Ext" maxlength="10" name="Details.Ext"
placeholder="ext" type="text" value="">
</div>
<div class="d-block d-sm-none">
<div class="col-3"></div>
</div>
<div class="col-sm-3 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.Phone" data-valmsg-replace="true"></span>
<span class="field-validation-valid" data-valmsg-for="Details.Ext" data-valmsg-replace="true"></span>
</div>
</div>
<!--Cell-->
<!-- Country -->
<input data-val="true" data-val-length="The field Country must be a string with a maximum length of 25." data-val-length-max="25" id="Details_Country" name="Details.Country" type="hidden" value="">
<!-- Address -->
<input data-val="true" data-val-length="The field Address must be a string with a maximum length of 50." data-val-length-max="50" id="Details_Address" name="Details.Address" type="hidden" value="" class="ui-autocomplete-input"
autocomplete="off">
<!-- City -->
<input data-val="true" data-val-length="The field City must be a string with a maximum length of 50." data-val-length-max="50" id="Details_City" name="Details.City" type="hidden" value="">
<!-- State -->
<input data-val="true" data-val-length="The field State/Province must be a string with a maximum length of 2." data-val-length-max="2" id="Details_State" name="Details.State" type="hidden" value="">
<!-- Zip -->
<input data-val="true" data-val-length="The field Zip must be a string with a maximum length of 10." data-val-length-max="10" id="Details_Zip" name="Details.Zip" type="hidden" value="" class="ui-autocomplete-input" autocomplete="off">
<!-- Fax -->
<!--Twitter-->
<!-- Government Option for PayPal -->
<!-- Remember -->
<div class="row mb-2 form-check">
<div class="container">
<div class="container">
<input class="form-check-input" data-val="true" data-val-required="The Remember my information on this computer field is required." id="Details_Remember" name="Details.Remember" type="checkbox" value="true">
<label class="form-check-label" for="Details_Remember">Remember my information on this computer</label>
</div>
<div class="col-sm-3 col-xs-12 text-danger">
<span class="field-validation-valid" data-valmsg-for="Details.Remember" data-valmsg-replace="true"></span>
</div>
</div>
</div>
<!-- Tech Questions-->
<input data-val="true" data-val-number="The field Latitude must be a number." id="Details_Latitude" name="Details.Latitude" type="hidden" value="">
<input data-val="true" data-val-number="The field Longitude must be a number." id="Details_Longitude" name="Details.Longitude" type="hidden" value="">
</div>
</div> <!-- End of Row -->
<script>
$(document).ready(function() {
var disableZipAutocomplete = false;
let token = null;
$(document).on('change', '#Details_Country', function(e) {
var value = document.getElementById("Details_Country").value;
changeStates(value);
});
// Autocomplete for Agency
$("#Details_Organization").autocomplete({
source: function(request, response) {
if (request.term.length < 3) return;
else return $.ajax({
url: "/Helper/SearchAgency",
type: "POST",
dataType: "json",
delay: 300,
data: {
input: request.term
},
success: function(data) {
response($.map(data, function(item) {
return {
label: item,
value: item
};
}))
}
});
},
messages: {
noResults: "",
results: function(resultsCount) {}
}
});
$("#Details_Address").autocomplete({
delay: 300,
source: function(request, response) {
if (request.term.length < 6) {
return;
} else {
if (token == null) token = chance.guid();
console.log("Token: ", token);
return $.ajax({
url: "/Helper/SearchLocation",
data: {
searchAddress: request.term,
placeType: 1,
sessionToken: token
},
dataType: "json",
type: "GET",
success: function(data) {
response($.map(data, function(item) {
return {
label: item.Description,
value: item.Place_ID
}
}));
},
error: function(x, y, z) {
var result = [{
label: 'No matches found',
value: response.term
}];
response(result);
}
});
}
},
messages: {
noResults: "We couldn't find the address",
results: function(resultsCount) {}
},
select: function(event, ui) {
$('#Details_Address').val(ui.item.label.split(',')[0]);
getDetail(ui.item.value, 1);
disableZipAutocomplete = true;
return false;
},
focus: function(event, ui, request) {
event.preventDefault();
}
});
$("#Details_Zip").autocomplete({
delay: 500,
source: function(request, response) {
if (request.term.length < 3) {
return;
} else {
if (token == null) token = chance.guid();
console.log("Token", token);
return $.ajax({
url: "/Helper/SearchLocation",
data: {
searchAddress: request.term,
placeType: 3,
sessionToken: token
},
dataType: "json",
type: "GET",
success: function(data) {
response($.map(data, function(item) {
return {
label: item.Description,
value: item.Place_ID
}
}));
},
error: function(x, y, z) {
var result = [{
label: 'No matches found',
value: response.term
}];
response(result);
}
});
}
},
messages: {
noResults: "We couldn't find the address",
results: function(resultsCount) {}
},
select: function(event, ui) {
getDetail(ui.item.value, 3);
disableZipAutocomplete = true;
return false;
},
focus: function(event, ui, request) {
event.preventDefault();
}
});
$("#Details_Zip").on("blur", function() {
if ($("#Details_Zip").val() && $("#Details_Zip").val().length > 4 && !disableZipAutocomplete) {
if (token == null) token = chance.guid();
$.ajax({
url: "/Helper/SearchLocation",
data: {
searchAddress: $("#Details_Zip").val(),
placeType: 3,
sessionToken: token
},
dataType: "json",
type: "GET",
success: function(data) {
return data;
},
error: function() {
console.log("error");
cleanAddress();
}
}).then(function(data) {
getDetail(data[0].Place_ID, 3);
});
} else if ($("#Details_Zip").val().length == 0) {
cleanAddress();
}
});
function getDetail(placeid, placeType) {
$.ajax({
url: "/Helper/GetPlaceDetail",
data: {
placeid: placeid
},
dataType: "json",
type: "GET",
success: function(data) {
changeStates(data.Country);
$('#Details_City').val(data.City);
$('#Details_State').val(data.State);
$('#Details_Zip').val(data.Zip);
$('#Details_Country').val(data.Country);
$('#Details_Latitude').val(data.Latitude);
$('#Details_Longitude').val(data.Longitude);
token = null;
console.log(token);
},
});
}
function cleanAddress() {
$('#Details_City').val('');
$('#Details_State').val('');
$('#Details_Country').val('');
$('#Details_Latitude').val('');
$('#Details_Longitude').val('');
}
function changeStates(country) {
if (country == 'Canada') {
$('#stateContainer select').empty();
$('#stateContainer select').append("<option value></option>");
$('#stateContainer select').append("<option value='AB'>Alberta</option>");
$('#stateContainer select').append("<option value='BC'> British Columbia </option>");
$('#stateContainer select').append("<option value='MB'> Manitoba </option>");
$('#stateContainer select').append("<option value='NB'> New Brunswick </option>");
$('#stateContainer select').append("<option value='NL'> Newfoundland and Labrador </option>");
$('#stateContainer select').append("<option value='NT'> Northwest Territories </option>");
$('#stateContainer select').append("<option value='NS'> Nova Scotia </option>");
$('#stateContainer select').append("<option value='NU'> Nunavut </option>");
$('#stateContainer select').append("<option value='ON'> Ontario </option>");
$('#stateContainer select').append("<option value='PE'> Prince Edward Island </option>");
$('#stateContainer select').append("<option value='QC'> Quebec </option>");
$('#stateContainer select').append("<option value='SK'> Saskatchewan </option>");
$('#stateContainer select').append("<option value='YT'> Yukon </option>");
} else {
$('#stateContainer select').empty();
$('#Details_defaultStates option').each(function() {
$('#stateContainer select').append("<option value='" + $(this).val() + "'> " + $(this).text() + "</option>");
});
}
}
});
</script>
</div>
<!-- Questions -->
<div b-nbzllcq3pt="" class="questionWrap mb-3">
<div class="container mb-3">
<input data-val="true" data-val-required="The Question_ID field is required." id="Questions_0__Question_ID" name="Questions[0].Question_ID" type="hidden" value="153891">
<input id="Questions_0__Question" name="Questions[0].Question" type="hidden" value="Address 1 Street # and Street Name">
<input data-val="true" data-val-required="The Optional field is required." id="Questions_0__Optional" name="Questions[0].Optional" type="hidden" value="False">
<input data-val="true" data-val-required="The Type field is required." id="Questions_0__Type" name="Questions[0].Type" type="hidden" value="TextBox">
<div class="row">
<label class="form-label-sm">Address 1 Street # and Street Name<span class="carah-required"> *</span></label>
</div>
<div class="row">
<div class="col-sm-8 col-12">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field AnswerText must be a string with a maximum length of 1500." data-val-length-max="1500" id="Questions_0__AnswerText" maxlength="1500"
name="Questions[0].AnswerText" required="required" type="text" value="">
</div>
<div class="col-sm-4 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Questions[0].AnswerText" data-valmsg-replace="true"></span>
</div>
</div> <!-- end of row -->
</div>
<div class="container mb-3">
<input data-val="true" data-val-required="The Question_ID field is required." id="Questions_1__Question_ID" name="Questions[1].Question_ID" type="hidden" value="153893">
<input id="Questions_1__Question" name="Questions[1].Question" type="hidden" value="Address 2">
<input data-val="true" data-val-required="The Optional field is required." id="Questions_1__Optional" name="Questions[1].Optional" type="hidden" value="True">
<input data-val="true" data-val-required="The Type field is required." id="Questions_1__Type" name="Questions[1].Type" type="hidden" value="TextBox">
<div class="row">
<label class="form-label-sm">Address 2</label>
</div>
<div class="row">
<div class="col-sm-8 col-12">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field AnswerText must be a string with a maximum length of 1500." data-val-length-max="1500" id="Questions_1__AnswerText" maxlength="1500"
name="Questions[1].AnswerText" type="text" value="">
</div>
<div class="col-sm-4 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Questions[1].AnswerText" data-valmsg-replace="true"></span>
</div>
</div> <!-- end of row -->
</div>
<div class="container mb-3">
<input data-val="true" data-val-required="The Question_ID field is required." id="Questions_2__Question_ID" name="Questions[2].Question_ID" type="hidden" value="153895">
<input id="Questions_2__Question" name="Questions[2].Question" type="hidden" value="City">
<input data-val="true" data-val-required="The Optional field is required." id="Questions_2__Optional" name="Questions[2].Optional" type="hidden" value="False">
<input data-val="true" data-val-required="The Type field is required." id="Questions_2__Type" name="Questions[2].Type" type="hidden" value="TextBox">
<div class="row">
<label class="form-label-sm">City<span class="carah-required"> *</span></label>
</div>
<div class="row">
<div class="col-sm-8 col-12">
<input class="form-control form-control-sm" data-val="true" data-val-length="The field AnswerText must be a string with a maximum length of 1500." data-val-length-max="1500" id="Questions_2__AnswerText" maxlength="1500"
name="Questions[2].AnswerText" required="required" type="text" value="">
</div>
<div class="col-sm-4 col-9 text-danger">
<span class="field-validation-valid" data-valmsg-for="Questions[2].AnswerText" data-valmsg-replace="true"></span>
</div>
</div> <!-- end of row -->
</div>
<div class="container mb-3">
<input data-val="true" data-val-required="The Question_ID field is required." id="Questions_3__Question_ID" name="Questions[3].Question_ID" type="hidden" value="153896">
<input id="Questions_3__Question" name="Questions[3].Question" type="hidden" value="State/Province">
<input data-val="true" data-val-required="The Optional field is required." id="Questions_3__Optional" name="Questions[3].Optional" type="hidden" value="False">
<input data-val="true" data-val-required="The Type field is required." id="Questions_3__Type" name="Questions[3].Type" type="hidden" value="Dropdown">
<div class="row">
<label class="form-label-sm">State/Province<span class="carah-required"> *</span></label>
</div>
<div class="row">
<div class="col-sm-8 col-12">
<select autocomplete="off" class="form-control form-control-sm form-select form-select-sm" data-val="true" data-val-length="The field AnswerText must be a string with a maximum length of 1500." data-val-length-max="1500"
id="Questions_3__AnswerText" name="Questions[3].AnswerText" required="required">
<option value=""></option>
<option value="AL">AL</option>
<option value="AK">AK</option>
<option value="AR">AR</option>
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