allocation-bonus.formstack.com Open in urlscan Pro
18.66.122.27  Public Scan

Submitted URL: https://app.getresponse.com/click.html?x=a62b&lc=hphuB4&mc=0M&s=BFdq62L&u=tDTlf&z=EIE2wkW&
Effective URL: https://allocation-bonus.formstack.com/forms/bonus_allocation_program
Submission: On November 20 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST https://allocation-bonus.formstack.com/forms/index.php

<form id="fsForm5533758" method="post" class="StyledForm-sc-1xaj75q-0 gZiXEE fsForm" action="https://allocation-bonus.formstack.com/forms/index.php" novalidate="" enctype="multipart/form-data"><input type="hidden" tabindex="-1"
    name="formstackFormSchemaVersion" value="4"><input type="hidden" tabindex="-1" name="formstackFormRendererVersion" value="master"><input type="hidden" tabindex="-1" name="form" value="5533758"><input type="hidden" tabindex="-1" name="viewkey"
    value="VwuxibOUOf"><input type="hidden" tabindex="-1" name="password" value=""><input type="hidden" tabindex="-1" name="hidden_fields" value=""><input type="hidden" tabindex="-1" name="_submit" value="1"><input type="hidden" tabindex="-1"
    name="incomplete" value=""><input type="hidden" tabindex="-1" name="incomplete_email" value=""><input type="hidden" tabindex="-1" name="incomplete_password" value=""><input type="hidden" tabindex="-1" name="latitude" value=""><input type="hidden"
    tabindex="-1" name="longitude" value=""><input id="fsUserAgent" type="hidden" tabindex="-1" name="fsUserAgent" value="Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/119.0.6045.159 Safari/537.36">
  <div id="fsPage5533758-1" class="StyledPage-sc-15mrpfq-0 hCMMok fsPage">
    <div data-testid="section0-col1" id="fsSection0" class="StyledSection-sc-1jyjf4h-0 gcHUoI fsSection"><span class="StyledLabel-sc-vn5hkq-0 evOLxK fsLabelVertical fsFieldFocused" id="label-field155037955" for="field155037955"
        data-testid="field-155037955"><a id="field-anchor-155037955" tabindex="-1" aria-hidden="true"></a>
        <div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel">Employee Name<span class="fsRequiredMarker">*</span></div>
        <div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
          <div class="StyledSubField-sc-1wt4t9i-0 bdsNVQ fsSubField fsNameFirst"><input autocomplete="given-name" class="StyledInput-sc-1cxwxcf-0 dDIdEu" id="field155037955-first" type="text" label="Employee Name" required="" maxlength="20"
              name="field155037955-first" data-fs-field-id="155037955" data-fs-field-name="name" data-fs-field-alias="first" value=""><label for="field155037955-first" class="StyledLabel-sc-vn5hkq-0 eOdDYB">First Name</label></div>
          <div class="StyledSubField-sc-1wt4t9i-0 bdsNVQ fsSubField fsNameLast"><input autocomplete="family-name" class="StyledInput-sc-1cxwxcf-0 dDIdEu" id="field155037955-last" type="text" label="Employee Name" required="" maxlength="20"
              name="field155037955-last" data-fs-field-id="155037955" data-fs-field-name="name" data-fs-field-alias="last" value=""><label for="field155037955-last" class="StyledLabel-sc-vn5hkq-0 eOdDYB">Last Name</label></div>
        </div>
      </span><label class="StyledLabel-sc-vn5hkq-0 evOLxK fsLabelVertical" id="label-field155083314" for="field155083314" data-testid="field-155083314"><a id="field-anchor-155083314" tabindex="-1" aria-hidden="true"></a>
        <div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel">Department </div>
        <div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
          <div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 dDIdEu" id="field155083314" type="text" label="Department " name="field155083314" placeholder="" data-fs-field-id="155083314"
              data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
        </div>
      </label><span class="StyledLabel-sc-vn5hkq-0 evOLxK fsLabelVertical" id="label-field155083374" for="field155083374" data-testid="field-155083374-vertical"><a id="field-anchor-155083374" tabindex="-1" aria-hidden="true"></a>
        <div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel">Acknowledgement <span class="fsRequiredMarker">*</span></div>
        <fieldset aria-labelledby="155083374-legend" role="group" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK PSYyM"><span style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
            <legend id="155083374-legend">Acknowledgement Required field</legend>
          </span>
          <div><label for="field155083374_1" class="StyledOptionLabel-sc-1bymt4x-0 czQxLs fsOptionLabel"><input label="Acknowledgement " required="" name="field155083374[]" class="StyledOptionButton-sc-wqe0tc-0 ezuKZu" type="checkbox"
                id="field155083374_1" data-fs-field-id="155083374" data-fs-field-name="checkbox" data-fs-field-alias="0" value="I agree that the allocated bonus will be added to my December  payroll">I agree that the allocated bonus will be added to
              my December payroll</label></div>
        </fieldset>
      </span></div>
  </div>
  <div id="fsSubmit5533758" class="StyledFormFooter-sc-9cjpwp-0 dPhaIv fsSubmit fsPagination">
    <div class="StyledFormNavigations-sc-t0vu6u-0 jnnwJH"><button id="fsSubmitButton5533758" class="StyledSubmitButton-sc-1ylq3c5-0 cfDACd fsSubmitButton" type="submit">Begin Enrollment</button></div>
  </div>
</form>

Text Content

Employee Name*
First Name
Last Name
Department

Acknowledgement *
Acknowledgement Required field
I agree that the allocated bonus will be added to my December payroll
Begin Enrollment
Powered by FormstackCreate your own form ›