crisiscoordinator.talentlms.com Open in urlscan Pro
34.236.22.110 Public Scan

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Submitted URL:
https://bps.certify.crisiscoordinator.com/
Effective URL:
https://crisiscoordinator.talentlms.com/
Submission Tags: phishingrod
Submission: On June 20 via api (June 20th 2024, 12:28:29 pm UTC) from DE — Scanned from DE

Form analysis
3 forms found in the DOM

Name: login_form — POST https://crisiscoordinator.talentlms.com/index

<form name="login_form" method="post" action="https://crisiscoordinator.talentlms.com/index" class="tl-form form-horizontal" id="tl-cms-login-form"><input type="hidden" name="_track_login_form" value="1718886502" class="" id="1063615380"><input
    type="hidden" name="_redirect_" value="" class="" id="_redirect_"><input type="hidden" name="_loginToken" value="6c6163c1aea0fe2da83d68d49c2fc155" class="" id="_loginToken"><input type="hidden" name="course-id" value="0"
    class="tl-catalog-course-id" id="course-id"><input type="hidden" name="category-id" value="0" class="tl-catalog-category-id" id="category-id"><input type="hidden" name="group-id" value="0" class="tl-catalog-group-id" id="group-id"><input
    type="hidden" name="catalog-get-subscription" value="0" class="tl-catalog-get-subscription" id="catalog-get-subscription"><input type="hidden" name="login-referrer" value="" class="" id="login-referrer"><input type="hidden"
    name="redirection_path" value="" class="" id="1845989622">
  <div class="spacer"></div>
  <div class="spacer">
    <div class="control-group ">
      <label> Username or email </label>
      <div class="controls">
        <input type="text" name="login" value="" class="" id="tl-shared-username" placeholder="" autocomplete="on" tabindex=""> <span class="help-block">
        </span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label> Password </label>
      <div class="controls">
        <input type="password" name="password" value="" class=" tl-form-password-field" id="763597366" placeholder="" autocomplete="off" tabindex=""> <span class="help-block">
        </span>
      </div>
    </div>
  </div>
  <div class="spacer spacer--x2">
    <div class="control-group">
      <input type="submit" name="submit" value="Login" class="btn btn-primary btn-large" id="520113040" data-loading-text="Logging in..." tabindex="">
    </div>
  </div>
  <div class="spacer spacer--x2">
    <div class="control-group">
      <div class="text-center"> Forgot your <a href="javascript:void(0)" class="link-color" data-select-state="auth_form_view:forgot_password">password</a>? </div>
    </div>
  </div>
</form>

Name: form — POST https://crisiscoordinator.talentlms.com/index

<form name="form" method="post" action="https://crisiscoordinator.talentlms.com/index" class="tl-form form-horizontal hide" id="tl-cms-forgot-password-form"><input type="hidden" name="_track_form" value="1718886502" class="" id="231588724"><input
    type="hidden" name="_redirect_" value="" class="" id="_redirect_">
  <div class="spacer"></div>
  <div class="spacer">
    <h3 class="tl-auth-form_title">Reset password</h3>
    <p>Enter your username or email address and we'll email you instructions on how to reset your password</p>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <div class="controls">
        <input type="text" name="username" value="" class="" id="1381585520" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex=""> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer--x2">
    <div class="control-group">
      <input type="submit" name="submit_login" value="Send" class="btn btn-primary btn-large" id="1664635724" autocomplete="off" data-loading-text="Processing..." tabindex="">
    </div>
  </div>
  <div class="spacer"></div>
  <div class="spacer spacer--x2 text-center">
    <a class="link-color" href="javascript:void(0)" data-select-state="auth_form_view:login">
					Log in				</a> with your credentials
  </div>
</form>

Name: signup_form — POST https://crisiscoordinator.talentlms.com/index

<form name="signup_form" method="post" action="https://crisiscoordinator.talentlms.com/index" class="tl-form form-horizontal" id="tl-cms-signup-form"><input type="hidden" name="_track_signup_form" value="1718886502" class="" id="1977295718"><input
    type="hidden" name="_redirect_" value="" class="" id="_redirect_"><input type="hidden" name="course-id" value="0" class="tl-catalog-course-id" id="course-id"><input type="hidden" name="category-id" value="0" class="tl-catalog-category-id"
    id="category-id"><input type="hidden" name="group-id" value="0" class="tl-catalog-group-id" id="group-id"><input type="hidden" name="catalog-get-subscription" value="0" class="tl-catalog-get-subscription" id="catalog-get-subscription"><input
    type="hidden" name="signup-referrer" value="" class="" id="signup-referrer"><input type="hidden" name="session_data" value="" class="" id="session_data">
  <div class="spacer"></div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="tl-shared-first-name">First name</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="name" value="" class="" id="tl-shared-first-name" placeholder="e.g. John" autocomplete="on" tabindex="" data-provide="limit" data-counter="#counter-tl-shared-first-name"
            data-maxchars="50"><span class="add-on" id="counter-tl-shared-first-name"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1867162101">Last name</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="surname" value="" class="" id="1867162101" placeholder="e.g. Doe" autocomplete="on" tabindex="" data-provide="limit" data-counter="#counter-1867162101" data-maxchars="50"><span
            class="add-on" id="counter-1867162101"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1670129379">Email address</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="email" value="" class="" id="1670129379" placeholder="e.g. jdoe@example.com" autocomplete="on" tabindex="" data-provide="limit" data-counter="#counter-1670129379"
            data-maxchars="150"><span class="add-on" id="counter-1670129379"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1066951437">Username</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="login" value="" class="" id="1066951437" placeholder="e.g. jdoe" autocomplete="on" tabindex="" data-provide="limit" data-counter="#counter-1066951437" data-maxchars="150"><span
            class="add-on" id="counter-1066951437"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer ">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="911262034">Password</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="password" name="password" value="" class="" id="911262034" placeholder="" autocomplete="off" tabindex="" data-provide="limit" data-counter="#counter-911262034" data-maxchars="30"><span
            class="add-on" id="counter-911262034"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <hr>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1957980619">Your Insurer/Insurance Pool</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_18" value="" class="" id="1957980619" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1957980619" data-maxchars="150"><span class="add-on" id="counter-1957980619"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="s2id_autogen1">OrganIzation Type / Affiliation</label>
      <div class="controls">
        <div class="select2-container tl-select2" id="s2id_1133076448" style="width: 220px;">
          <a href="javascript:void(0)" onclick="return false;" class="select2-choice" tabindex="-1">   <span class="select2-chosen">Select an option...</span><abbr class="select2-search-choice-close"></abbr>   <span class="select2-arrow"><b></b></span></a><input
            class="select2-focusser select2-offscreen" type="text" id="s2id_autogen1" tabindex="">
          <div class="select2-drop select2-display-none select2-with-searchbox">
            <div class="select2-search"> <input type="text" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false" class="select2-input"> </div>
            <ul class="select2-results"> </ul>
          </div>
        </div><select name="custom_field_1" class="tl-select2 select2-offscreen" id="1133076448" tabindex="-1">
          <option value="" selected="">Select an option...</option>
          <option value="ASSOCIATION - SCHOOL (GISA)">ASSOCIATION - SCHOOL (GISA)</option>
          <option value="INSURANCE POOL - COUNTY (ACCG)">INSURANCE POOL - COUNTY (ACCG)</option>
          <option value="INSURANCE POOL - CITY/MUNICIPAL (GMA)">INSURANCE POOL - CITY/MUNICIPAL (GMA)</option>
          <option value="INSURANCE POOL - LGRMS">INSURANCE POOL - LGRMS</option>
          <option value="PILOT / DEMO">PILOT / DEMO</option>
          <option value="OTHER - INSURANCE POOL">OTHER - INSURANCE POOL</option>
          <option value="OTHER - INSURER">OTHER - INSURER</option>
          <option value="OTHER - NOT LISTED">OTHER - NOT LISTED</option>
        </select> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label" for="887378012">If OTHER affiliation - please describe</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_19" value="" class="" id="887378012" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-887378012" data-maxchars="150"><span class="add-on" id="counter-887378012"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="2075905311">Organization Name / Company</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_2" value="" class="" id="2075905311" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-2075905311" data-maxchars="150"><span class="add-on" id="counter-2075905311"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1888045003">Position Title</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_3" value="" class="" id="1888045003" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1888045003" data-maxchars="150"><span class="add-on" id="counter-1888045003"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="883110237">Phone Number</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_4" value="" class="" id="883110237" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-883110237" data-maxchars="150"><span class="add-on" id="counter-883110237"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label" for="1699770241">Street 1</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_7" value="" class="" id="1699770241" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1699770241" data-maxchars="150"><span class="add-on" id="counter-1699770241"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label" for="1992872005">Street 2</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_8" value="" class="" id="1992872005" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1992872005" data-maxchars="150"><span class="add-on" id="counter-1992872005"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label" for="587301311">City</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_9" value="" class="" id="587301311" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-587301311" data-maxchars="150"><span class="add-on" id="counter-587301311"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label" for="1461200883">County</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_10" value="" class="" id="1461200883" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1461200883" data-maxchars="150"><span class="add-on" id="counter-1461200883"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1544915541">State</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_11" value="" class="" id="1544915541" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1544915541" data-maxchars="150"><span class="add-on" id="counter-1544915541"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="674302512">Zip Code</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_12" value="" class="" id="674302512" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-674302512" data-maxchars="150"><span class="add-on" id="counter-674302512"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label" for="289451097">Country</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_13" value="" class="" id="289451097" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-289451097" data-maxchars="150"><span class="add-on" id="counter-289451097"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1823554884">Supervisor Name</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_5" value="" class="" id="1823554884" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1823554884" data-maxchars="150"><span class="add-on" id="counter-1823554884"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <label class="control-label tl-mandatory-label" for="1564048309">Supervisor Email</label>
      <div class="controls">
        <div class="input-append tl-countdown"><input type="text" name="custom_field_6" value="" class="" id="1564048309" placeholder="" autocomplete="off" data-lpignore="true" data-form-type="other" tabindex="" data-provide="limit"
            data-counter="#counter-1564048309" data-maxchars="150"><span class="add-on" id="counter-1564048309"></span></div> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <div class="controls">
        <input type="checkbox" name="custom_field_14" checked="" class="" id="1054655741" tabindex=""> <label class="control-label" for="1054655741">Before continuing, you must respond to a confirmation email.</label> <span class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer">
    <div class="control-group ">
      <div class="controls">
        <input type="checkbox" name="custom_field_15" checked="" class="" id="1104857988" tabindex=""> <label class="control-label" for="1104857988">If you don't see the email in your inbox, check your junk/spam folders!</label> <span
          class="help-block"></span>
      </div>
    </div>
  </div>
  <div class="spacer--x2">
    <div class="control-group">
      <input type="submit" name="submit" value="Create account" class="btn btn-primary btn-large" id="179291430" autocomplete="off" data-loading-text="Processing..." tabindex="">
    </div>
  </div>
  <div class="spacer"></div>
</form>

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Your Insurer/Insurance Pool

OrganIzation Type / Affiliation
Select an option...

Select an option...ASSOCIATION - SCHOOL (GISA)INSURANCE POOL - COUNTY
(ACCG)INSURANCE POOL - CITY/MUNICIPAL (GMA)INSURANCE POOL - LGRMSPILOT /
DEMOOTHER - INSURANCE POOLOTHER - INSUREROTHER - NOT LISTED
If OTHER affiliation - please describe

Organization Name / Company

Position Title

Phone Number

Street 1

Street 2

City

County

State

Zip Code

Country

Supervisor Name

Supervisor Email

Before continuing, you must respond to a confirmation email.
If you don't see the email in your inbox, check your junk/spam folders!



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