app.fictiv.com Open in urlscan Pro
18.173.154.122  Public Scan

Submitted URL: http://pages.fictiv.com/u/ODUyLVdHUi03MTYAAAGMlxbLsNhmcBZo5-r3k11EEWbJDqhGY9hBRWEOgbQg4T4_EfMLnTGmb9uuh_We5WO48kY70Uc=
Effective URL: https://app.fictiv.com/signup?utm_source=marketo&utm_medium=email&utm_campaign=global_em_footer&utm_content=quote&mkt_t...
Submission: On June 27 via api from GB — Scanned from GB

Form analysis 1 forms found in the DOM

<form autocomplete="on" class="ant-form ant-form-horizontal signupForm--nQyEV" style="width: 100%;">
  <div class="mobileColBox--jwFJ7 displayFlex--q7zS4" data-id="mobileColBox-displayFlex" style="justify-content: space-between;">
    <div class="formItemsBox--B2hR9 displayFlex--q7zS4" data-id="formItemsBox-displayFlex"><span class="x4" data-id="x">First name</span>
      <div class="ant-row ant-form-item" style="row-gap: 0px;">
        <div class="ant-col ant-form-item-control">
          <div class="ant-form-item-control-input">
            <div class="ant-form-item-control-input-content"><input placeholder="First name" data-test-target="first-name" type="text" id="first-name" class="ant-input" value=""></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formItemsBox--B2hR9 displayFlex--q7zS4" data-id="formItemsBox-displayFlex"><span class="x4" data-id="x">Last name</span>
      <div class="ant-row ant-form-item" style="row-gap: 0px;">
        <div class="ant-col ant-form-item-control">
          <div class="ant-form-item-control-input">
            <div class="ant-form-item-control-input-content"><input placeholder="Last name" data-test-target="last-name" type="text" id="last-name" class="ant-input" value=""></div>
          </div>
        </div>
      </div>
    </div>
  </div><span class="x4" data-id="x">Company</span>
  <div class="ant-row ant-form-item" style="row-gap: 0px;">
    <div class="ant-col ant-form-item-control">
      <div class="ant-form-item-control-input">
        <div class="ant-form-item-control-input-content"><input placeholder="Company name" data-test-target="company" type="text" id="company" class="ant-input" value=""></div>
      </div>
    </div>
  </div><span class="x4" data-id="x">Company email</span>
  <div class="ant-row ant-form-item" style="row-gap: 0px;">
    <div class="ant-col ant-form-item-control">
      <div class="ant-form-item-control-input">
        <div class="ant-form-item-control-input-content"><input type="email" placeholder="name@company.com" data-test-target="email" id="email" class="ant-input" value=""></div>
      </div>
      <div class="ant-form-item-extra"><span class="x7 x8" data-id="x-x">Use your company email address to unlock additional features and support from our team.</span></div>
    </div>
  </div><span class="x4" data-id="x">Create password</span>
  <div class="ant-row ant-form-item ant-form-item-with-help" style="row-gap: 0px;">
    <div class="ant-col ant-form-item-control">
      <div class="ant-form-item-control-input">
        <div class="ant-form-item-control-input-content"><input type="password" placeholder="Enter strong password here" data-test-target="password" id="password" class="ant-input"></div>
      </div>
      <div class="ant-form-item-explain ant-form-item-explain-connected">
        <div role="alert" class="" style="">
          <div class="x9 xa displayFlex--q7zS4 col--jQgi4" data-id="x-x-displayFlex-col"><span class="x7 x8" data-id="x-x"> Password must be between 12-64 characters</span></div>
        </div>
      </div>
    </div>
  </div>
  <div class="mobileColBox--jwFJ7 displayFlex--q7zS4" data-id="mobileColBox-displayFlex" style="justify-content: space-between;">
    <div class="formItemsBox--B2hR9 displayFlex--q7zS4" data-id="formItemsBox-displayFlex"><span class="x4" data-id="x">Phone number</span>
      <div class="ant-row ant-form-item" style="row-gap: 0px;">
        <div class="ant-col ant-form-item-control">
          <div class="ant-form-item-control-input">
            <div class="ant-form-item-control-input-content"><input placeholder="(123) 456-7890" data-test-target="phone-number" type="text" id="phone-number" class="ant-input" value=""></div>
          </div>
        </div>
      </div>
    </div>
    <div class="formItemsBox--B2hR9 displayFlex--q7zS4" data-id="formItemsBox-displayFlex"><span class="x4" data-id="x">Location</span>
      <div class="ant-row ant-form-item" style="row-gap: 0px;">
        <div class="ant-col ant-form-item-control">
          <div class="ant-form-item-control-input">
            <div class="ant-form-item-control-input-content">
              <div class="ant-select ant-select-single ant-select-show-arrow ant-select-show-search" data-test-target="location" style="width: 100%;">
                <div class="ant-select-selector"><span class="ant-select-selection-search"><input id="location" autocomplete="off" type="search" class="ant-select-selection-search-input" role="combobox" aria-haspopup="listbox"
                      aria-owns="location_list" aria-autocomplete="list" aria-controls="location_list" aria-activedescendant="location_list_0" value=""></span><span class="ant-select-selection-item"></span></div><span class="ant-select-arrow"
                  unselectable="on" aria-hidden="true" style="user-select: none;"><span role="img" aria-label="down" class="anticon anticon-down ant-select-suffix"><svg viewBox="64 64 896 896" focusable="false" data-icon="down" width="1em"
                      height="1em" fill="currentColor" aria-hidden="true">
                      <path d="M884 256h-75c-5.1 0-9.9 2.5-12.9 6.6L512 654.2 227.9 262.6c-3-4.1-7.8-6.6-12.9-6.6h-75c-6.5 0-10.3 7.4-6.5 12.7l352.6 486.1c12.8 17.6 39 17.6 51.7 0l352.6-486.1c3.9-5.3.1-12.7-6.4-12.7z"></path>
                    </svg></span></span>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="xb x9 displayFlex--q7zS4 justifyContentCenter--E7je6" data-id="x-x-displayFlex-justifyContentCenter"><button name="create-account" placement="sign-up" data-test-target="sign-up-create-account" data-placement="sign-up"
      data-name="create-account" rel="" type="submit" class="ant-btn ant-btn-primary ant-btn-lg guide-sign-up-create-account"><span>Get Instant Quote</span></button></div>
  <div class="displayFlex--q7zS4" data-id="displayFlex" style="visibility: hidden;"><select id="state" name="state" style="margin-left: 20px;">
      <option value="AL">Alabama</option>
      <option value="AK">Alaska</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="FL">Florida</option>
      <option value="GA">Georgia</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="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="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>
</form>

Text Content

Custom Manufactured Parts Done Right
First name

Last name

Company

Company email
Use your company email address to unlock additional features and support from
our team.
Create password
Password must be between 12-64 characters
Phone number

Location

Get Instant Quote
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of
ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth
DakotaOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth
DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
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