datacapture.mobiliscase.com Open in urlscan Pro
145.239.71.39 Public Scan

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Submitted URL:
https://protect-de.mimecast.com/s/f40OCnR2y7tmZ4wNiJHlgg?domain=clicks.messengeo.net
Effective URL:
https://datacapture.mobiliscase.com/fr/nous-contacter?objet=echantillon&utm_source=newsletterfr&utm_medium=emailfr&utm_campaign=%C3%...
Submission: On March 20 via manual (March 20th 2023, 8:24:57 am UTC) from BE — Scanned from DE

Form analysis
2 forms found in the DOM

POST https://datacapture.mobiliscase.com/fr/form/nous-contacter-g2.html

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;0&quot;,&quot;condition&quot;:&quot;IS_EQUAL&quot;,&quot;conditionvalue&quot;:&quot;&quot;}}}}"><input
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  <div class="gformbuilderpro_content">
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12 bg-white text-xs-center">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_25" class="itemfield">
            <div id="html_1103" class="html_box html_1103">
              <h1><em>Contactez</em>-nous</h1>
              <p>Notre <a href="/fr/content/9-notre-equipe">équipe dédiée DataCapture</a> est à votre écoute pour vous accompagner dans vos projets de protection et portabilité de vos appareils !</p>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column bg-black-wave text-xs-center col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_19" class="itemfield">
            <div id="html_93663" class="html_box html_93663">
              <p>N’hésitez pas à nous contacter directement au <strong><a href="tel:+33450632410" target="_blank" rel="noreferrer noopener">04 50 63 24 10</a>, du lundi au vendredi de 9h à 12h et de 14h à 17h</strong> ou à nous adresser votre demande
                via ce formulaire. <strong>Nous vous répondrons dans les plus brefs délais.</strong></p>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12 p-top">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_16" class="itemfield">
            <div class="form-group select_box"><label for="objet" class=" required_label toplabel">Objet de votre demande</label><select name="objet" id="objet" class="objet form-control select_chosen" required="required">
                <option value="Question">Question</option>
                <option value="Demander un devis">Demander un devis</option>
                <option value="Échantillon GRATUIT">Échantillon GRATUIT</option>
                <option value="Demander un rappel">Demander un rappel</option>
                <option value="Programmer une présentation vidéo">Programmer une présentation vidéo</option>
                <option value="Candidature">Candidature</option>
                <option value="Autre">Autre</option>
              </select></div>
          </div>
        </div>
      </div>
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp"></div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_21" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control prenom " id="prenom" placeholder="Prénom*" name="prenom" required="required"></div>
          </div>
        </div>
      </div>
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_22" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control nom " id="nom" placeholder="Nom*" name="nom" required="required"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_17" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control societe " id="societe" placeholder="Société" name="societe"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_7" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control adresse " id="adresse" placeholder="Adresse*" name="adresse" required="required"></div>
          </div>
        </div>
      </div>
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_11" class="itemfield">
            <div class="form-group select_box"><label for="pays" class=" required_label toplabel">Pays</label><select name="pays" id="pays" class="pays form-control select_chosen" required="required">
                <option value="Afrique du Sud">Afrique du Sud</option>
                <option value="Albanie">Albanie</option>
                <option value="Algérie">Algérie</option>
                <option value="Allemagne">Allemagne</option>
                <option value="Andorre">Andorre</option>
                <option value="Argentine">Argentine</option>
                <option value="Australie">Australie</option>
                <option value="Belgique">Belgique</option>
                <option value="Brésil">Brésil</option>
                <option value="Bulgarie">Bulgarie</option>
                <option value="Canada">Canada</option>
                <option value="Chili">Chili</option>
                <option value="Chine">Chine</option>
                <option value="Chypre">Chypre</option>
                <option value="Colombie">Colombie</option>
                <option value="Croatie">Croatie</option>
                <option value="Danemark">Danemark</option>
                <option value="Dominique">Dominique</option>
                <option value="Espagne">Espagne</option>
                <option value="Estonie">Estonie</option>
                <option value="États-Unis">États-Unis</option>
                <option value="Finlande">Finlande</option>
                <option value="France">France</option>
                <option value="Grèce">Grèce</option>
                <option value="Guadeloupe">Guadeloupe</option>
                <option value="Guyane française">Guyane française</option>
                <option value="Hongrie">Hongrie</option>
                <option value="Irlande">Irlande</option>
                <option value="Islande">Islande</option>
                <option value="Italie">Italie</option>
                <option value="Japon">Japon</option>
                <option value="Lettonie">Lettonie</option>
                <option value="Liechtenstein">Liechtenstein</option>
                <option value="Lituanie">Lituanie</option>
                <option value="Macédoine du Nord">Macédoine du Nord</option>
                <option value="Maldives">Maldives</option>
                <option value="Malte">Malte</option>
                <option value="Maroc">Maroc</option>
                <option value="Martinique">Martinique</option>
                <option value="Maurice">Maurice</option>
                <option value="Mayotte">Mayotte</option>
                <option value="Mexique">Mexique</option>
                <option value="Monaco">Monaco</option>
                <option value="Norvège">Norvège</option>
                <option value="Nouvelle-Calédonie">Nouvelle-Calédonie</option>
                <option value="Nouvelle-Zélande">Nouvelle-Zélande</option>
                <option value="Pays-Bas">Pays-Bas</option>
                <option value="Pérou">Pérou</option>
                <option value="Pologne">Pologne</option>
                <option value="Polynésie française">Polynésie française</option>
                <option value="Portugal">Portugal</option>
                <option value="République dominicaine">République dominicaine</option>
                <option value="République tchèque">République tchèque</option>
                <option value="Roumanie">Roumanie</option>
                <option value="Royaume-Uni">Royaume-Uni</option>
                <option value="Russie">Russie</option>
                <option value="Saint-Barthélemy">Saint-Barthélemy</option>
                <option value="Saint-Martin">Saint-Martin</option>
                <option value="Saint-Pierre-et-Miquelon">Saint-Pierre-et-Miquelon</option>
                <option value="Slovaquie">Slovaquie</option>
                <option value="Slovénie">Slovénie</option>
                <option value="Suède">Suède</option>
                <option value="Suisse">Suisse</option>
                <option value="Tunisie">Tunisie</option>
                <option value="Turquie">Turquie</option>
                <option value="Ukraine">Ukraine</option>
                <option value="Wallis-et-Futuna">Wallis-et-Futuna</option>
              </select></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_9" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control cp " id="cp" placeholder="Code postal*" name="cp" required="required"></div>
          </div>
        </div>
      </div>
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_10" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control ville " id="ville" placeholder="Ville*" name="ville" required="required"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_12" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control telephone " id="telephone" placeholder="Téléphone" name="telephone" required="required"></div>
          </div>
        </div>
      </div>
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_23" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control email " id="email" placeholder="E-mail*" name="email" required="required"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_13" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control appareil " id="appareil" placeholder="Appareils à équiper (Marque, modèle)" name="appareil"></div>
          </div>
        </div>
      </div>
      <div class="formbuilder_column col-md-6 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_40" class="itemfield">
            <div class="form-group input_box"><input type="text" value="" class="form-control quantite " id="quantite" placeholder="Quantité*" name="quantite" required="required"></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_24" class="itemfield">
            <div class="form-group input_box"><label for="commentaire">Commentaires</label><textarea class="form-control commentaire " name="commentaire" id="commentaire" placeholder="" rows="7"></textarea></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_14" class="itemfield">
            <div class="form-group fileupload_box"><label for="documents">Joindre un document</label><input type="file" name="documents" id="documents" class="form-control documents filestyle" data-buttonname="btn-primary"
                data-buttontext="Joindre un document" tabindex="-1" style="position: absolute; clip: rect(0px, 0px, 0px, 0px);">
              <div class="bootstrap-filestyle input-group"><input type="text" class="form-control " placeholder="" disabled=""> <span class="group-span-filestyle input-group-btn" tabindex="0"><label for="documents" class="btn btn-primary "><span
                      class="icon-span-filestyle glyphicon glyphicon-folder-open"></span> <span class="buttonText">Joindre un document</span></label></span></div>
              <p class="help-block">Si vous souhaitez joindre un document, vous pouvez nous le transmettre via ce formulaire</p>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_15" class="itemfield">
            <div class="form-group checkbox_box">
              <div class="checkbox_item_wp">
                <div class="privacy_wp"><input id="checkbox_privacy_53256" type="checkbox" name="privacy_53256" class="checkbox_privacy privacy_53256" value="1" required="required">
                  <div class="privacy_des">
                    <p><span>Je consens au traitement de mes données, conformément à
                        la&nbsp;</span><a href="/fr/content/3-politique-de-confidentialite" target="_blank" rel="noreferrer noopener">politique de confidentialité et de protection des données</a><span>.</span></p>
                  </div>
                </div>
              </div>
            </div>
          </div>
          <div id="gformbuilderpro_38" class="itemfield">
            <div class="form-group capcha_box"><label for="captcha_61669">reCAPTCHA</label>
              <div id="captcha_61669" class="g-recaptcha added_grecaptcha" data-sitekey="6LeMlngjAAAAAKK78BfErvukZIdjGgeRIPYnko4C" style="transform:scale(0.77);-webkit-transform:scale(0.77);transform-origin:0;-webkit-transform-origin:0;">
                <div style="width: 304px; height: 78px;">
                  <div><iframe title="reCAPTCHA"
                      src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LeMlngjAAAAAKK78BfErvukZIdjGgeRIPYnko4C&amp;co=aHR0cHM6Ly9kYXRhY2FwdHVyZS5tb2JpbGlzY2FzZS5jb206NDQz&amp;hl=de&amp;v=Trd6gj1dhC_fx0ma_AWHc1me&amp;size=normal&amp;cb=q7qi97m9ypaz"
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                      sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
                    class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
                </div><iframe style="display: none;"></iframe>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_20" class="itemfield">
            <div class="submit_btn_center"><button type="button" name="submitForm" id="submitForm" class="button btn btn-default button-medium"><span>Valider</span></button></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formbuilder_group">
      <div class="formbuilder_column col-md-12 col-sm-12 col-xs-12">
        <div class="itemfield_wp">
          <div id="gformbuilderpro_28" class="itemfield">
            <div id="html_36721" class="html_box html_36721">
              <p><br><span style="color:#30bbd1;">* Champs obligatoires. Réservé aux professionnels pour des projets de minimum 20 unités.</span></p>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div style="clear:both;"></div>
</form>

POST https://datacapture.mobiliscase.com/fr/nous-contacter?objet=echantillon&utm_source=newsletterfr&utm_medium=emailfr&utm_campaign=%C3%A9chantillon+fr&utm_id=mailing-echantillon#blockEmailSubscription_displayFooterBefore

<form action="https://datacapture.mobiliscase.com/fr/nous-contacter?objet=echantillon&amp;utm_source=newsletterfr&amp;utm_medium=emailfr&amp;utm_campaign=%C3%A9chantillon+fr&amp;utm_id=mailing-echantillon#blockEmailSubscription_displayFooterBefore"
  method="post">
  <input class="btn btn-primary float-xs-right hidden-xs-down" name="submitNewsletter" type="submit" value="S’abonner">
  <input class="btn btn-primary float-xs-right hidden-sm-up" name="submitNewsletter" type="submit" value="ok">
  <div class="input-wrapper">
    <input name="email" type="email" value="" placeholder="Votre mail" aria-labelledby="block-newsletter-label" required="">
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  <input type="hidden" name="blockHookName" value="displayFooterBefore">
  <input type="hidden" name="action" value="0">
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</form>

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