totalcustomers.com Open in urlscan Pro
163.47.72.161  Public Scan

Form analysis
1 forms found in the DOM

Name: get_touch_form — POST

<form name="get_touch_form" id="get_touch_form" method="post">
  <input type="hidden" name="act" value="get_touch">
  <table border="0" cellpadding="1" cellspacing="1" width="100%" style="background-color: #00cc99;align:center;vertical-align: top;" id="get_touch_tabs">
    <tbody>
      <tr>
        <td width="100%" colspan="5">&nbsp;</td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="48%">
          <div style="width:100%;"><b style="font-size:15px;">I am Interested in:</b>
            <label for="get_touch_product_enquiry"></label>
            <select name="get_touch_product_enquiry" id="get_touch_product_enquiry" style="width:100% !important;">
              <option value="Total Customer">Total Customer</option>
            </select>
          </div>
        </td>
        <td width="2%"></td>
        <td width="48%"></td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="100%" colspan="5" class="error_clsss"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="48%">
          <div style="width:100%;"><b style="font-size:15px;">Company Name:</b>
            <label for="get_touch_company_name"></label>
            <input type="text" name="get_touch_company_name" id="get_touch_company_name" style="width:100% !important;">
          </div>
        </td>
        <td width="2%"></td>
        <td width="48%">
          <div style="width:100%;"><b style="font-size:15px;">Full Name:</b>
            <label for="get_touch_owner_name"></label>
            <input type="text" name="get_touch_owner_name" id="get_touch_owner_name" style="width:100% !important;">
          </div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="48%">
          <div id="get_touch_form_get_touch_company_name_errorloc" class="error_strings"></div>
        </td>
        <td width="2%"></td>
        <td width="48%">
          <div id="get_touch_form_get_touch_owner_name_errorloc" class="error_strings"></div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="48%">
          <div style="width:100%;"><b style="font-size:15px;">Website:</b>
            <label for="get_touch_domain"></label>
            <input type="text" name="get_touch_domain" id="get_touch_domain" style="width:100% !important;">
          </div>
        </td>
        <td width="2%"></td>
        <td width="48%">
          <div style="width:100%;"><b style="font-size:15px;">Email Address:</b>
            <label for="get_touch_email"></label>
            <input type="text" name="get_touch_email" id="get_touch_email" style="width:100% !important;">
          </div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="48%">
          <div id="get_touch_form_get_touch_domain_errorloc" class="error_strings"></div>
        </td>
        <td width="2%"></td>
        <td width="48%">
          <div id="get_touch_form_get_touch_email_errorloc" class="error_strings"></div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="98%" colspan="3">
          <div style="width:100%;"><b style="font-size:15px;">Your Message or Question:</b>
            <label for="get_touch_message"></label>
            <textarea name="get_touch_message" id="get_touch_message" rows="5" style="width:100% !important;"></textarea>
          </div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="98%" colspan="3">
          <div id="get_touch_form_get_touch_message_errorloc" class="error_strings"></div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="1%"></td>
        <td width="98%" colspan="3">
          <div style="width:100%;float: left;">
            <input type="submit" value="Submit Question" id="btn_get_touch" name="btn_get_touch" class="btn btn-primary">
          </div>
        </td>
        <td width="1%"></td>
      </tr>
      <tr>
        <td width="100%" colspan="5">&nbsp;</td>
      </tr>
    </tbody>
  </table>
</form>

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