www.citivelocity.com Open in urlscan Pro
2a02:26f0:6c00:1ad::ca3  Public Scan

Form analysis
1 forms found in the DOM

Name: mncustomform — POST /cvr/eppublic/ccm-media/web?c=75ha&d=1h&h=3ovt4blo698b8054blk3gmdfh&i=i&iw=1&p=H559540974&s=wp&sn=am&sw=6h&wp=6h

<form action="/cvr/eppublic/ccm-media/web?c=75ha&amp;d=1h&amp;h=3ovt4blo698b8054blk3gmdfh&amp;i=i&amp;iw=1&amp;p=H559540974&amp;s=wp&amp;sn=am&amp;sw=6h&amp;wp=6h" method="POST" mnwzscope="wiz0" name="mncustomform"
  onsubmit="mn_before_submitform('wiz0')">
  <input type="hidden" autocomplete="off" name="__mn_form_tpk209" id="__mn_form_tpk209" value="true">
  <input type="hidden" autocomplete="off" name="refererFormPage" id="refererFormPage" value="209">
  <input type="hidden" autocomplete="off" name="__mn_form_currentcontent209" id="__mn_form_currentcontent209" value="342">
  <input type="hidden" autocomplete="off" name="__mn_form_currentforward209" id="__mn_form_currentforward209" value="forwardashtml">
  <input type="hidden" autocomplete="off" name="_mn_var" id="_mn_var" value="0">
  <input type="hidden" autocomplete="off" name="_mn_spd" id="_mn_spd" value="49">
  <input type="hidden" autocomplete="off" name="_mn_idmsg" id="_mn_idmsg" value="0">
  <div class="pagecontainer">
    <div id="_mn_form_ctrl_1390_container">
      <h1>Forward this newsletter</h1>
    </div>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1390', '_mn_form_ctrl_1390_container', '_mn_form_ctrl_1390', false, 'true', 45, '');
    </script>
    <div id="_mn_form_ctrl_1393_container"> The message is about to be sent by e-mail. <br>Enter the recipient's address, your name and e-mail so they can recognise you. <br>Entered address will not be saved on any database. </div>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1393', '_mn_form_ctrl_1393_container', '_mn_form_ctrl_1393', false, 'true', 45, '');
    </script>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1394', '_mn_form_ctrl_1394_container', '_mn_form_ctrl_1394', false, 'true', 37, '');
    </script>
    <p class="formfield"><label>E-mail of recipient 1</label><input name="_mn_form_ctrl_1395" style="" id="_mn_form_ctrl_1395" type="text" value=""></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1395', '_mn_form_ctrl_1395_container', '_mn_form_ctrl_1395', false, 'true', 30, 'emailofrecipient1');
    </script>
    <p class="formfield"><label>E-mail of recipient 2</label><input name="_mn_form_ctrl_1396" style="" id="_mn_form_ctrl_1396" type="text" value=""></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1396', '_mn_form_ctrl_1396_container', '_mn_form_ctrl_1396', false, 'true', 30, 'emailofrecipient2');
    </script>
    <p class="formfield"><label>E-mail of recipient 3</label><input name="_mn_form_ctrl_1397" style="" id="_mn_form_ctrl_1397" type="text" value=""></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1397', '_mn_form_ctrl_1397_container', '_mn_form_ctrl_1397', false, 'true', 30, 'emailofrecipient3');
    </script>
    <p class="formfield"><label>E-mail of recipient 4</label><input name="_mn_form_ctrl_1398" style="" id="_mn_form_ctrl_1398" type="text" value=""></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1398', '_mn_form_ctrl_1398_container', '_mn_form_ctrl_1398', false, 'true', 30, 'emailofrecipient4');
    </script>
    <p class="formfield"><label>E-mail of recipient 5</label><input name="_mn_form_ctrl_1399" style="" id="_mn_form_ctrl_1399" type="text" value=""></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1399', '_mn_form_ctrl_1399_container', '_mn_form_ctrl_1399', false, 'true', 30, 'emailofrecipient5');
    </script>
    <p class="formfield"><label>Your Name</label><input name="_mn_form_ctrl_1400" style="" id="_mn_form_ctrl_1400" type="text" value=""></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1400', '_mn_form_ctrl_1400_container', '_mn_form_ctrl_1400', false, 'true', 30, 'yourname');
    </script>
    <p class="formfield"><label>Your e-mail address</label><input name="_mn_form_ctrl_1401" style="" id="_mn_form_ctrl_1401" type="text" value="teresa.turnbull@ubs.com"></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1401', '_mn_form_ctrl_1401_container', '_mn_form_ctrl_1401', false, 'true', 30, 'youremail');
    </script>
    <p class="formfield"><label>Comment</label><textarea name="_mn_form_ctrl_1402" style="" id="_mn_form_ctrl_1402" rows="5" cols="20"></textarea></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1402', '_mn_form_ctrl_1402_container', '_mn_form_ctrl_1402', false, 'true', 32, 'comment');
    </script>
    <p class="captcha"><label>Type the characters you see below:</label><input name="_mn_form_ctrl_1403" type="text" style="" id="_mn_form_ctrl_1403" value=""><img id="_mn_form_ctrl_1403_img"
        src="/cvr/eppublic/ccm-media/captcha.jpg?type=0&amp;seed=b075669e-4083-4dd5-b8b4-242b59efd252&amp;idc=18&amp;tpk=209&amp;w=100&amp;h=45&amp;fore=%23000000&amp;back=%23FFFFFF" class="captcha"></p>
    <input type="hidden" name="_mn_form_ctrl_1403_seed" value="b075669e-4083-4dd5-b8b4-242b59efd252">
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1403', '_mn_form_ctrl_1403_container', '_mn_form_ctrl_1403', false, 'true', 40, '');
    </script>
    <p class="submit"><input name="_mn_form_ctrl_1404" type="submit" style="" id="_mn_form_ctrl_1404" value="Send" mn-submit="true" mn-submit-type="normal"></p>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1404', '_mn_form_ctrl_1404_container', '_mn_form_ctrl_1404', false, 'true', 36, '');
    </script>
    <div class="surveyNavbar">
    </div>
    <div id="_mn_form_ctrl_1392_container"></div>
    <script type="text/javascript">
      mn_register_form_control('wiz0', '_mn_form_ctrl_1392', '_mn_form_ctrl_1392_container', '_mn_form_ctrl_1392', false, 'true', 45, '');
    </script>
  </div>
  <script type="text/javascript">
    mn_setcustomerid('wiz0', '18');
  </script>
  <script type="text/javascript">
    mn_prepare_form_control_behaviour_sources('wiz0');
  </script><textarea style="display:none" name="_mn_refpageparams_209" id="_mn_refpageparams_209"></textarea>
  <script>
    window.mnf.getFormElementById('wiz0', '_mn_refpageparams_209').val(JSON.stringify(window.mnf.scope('wiz0').mnurl));
  </script>
  <script type="text/javascript">
    mn_handle_keypress_form_submit("wiz0", "true", "_mn_form_ctrl_1404")
  </script>
</form>

Text Content

FORWARD THIS NEWSLETTER

The message is about to be sent by e-mail.
Enter the recipient's address, your name and e-mail so they can recognise you.
Entered address will not be saved on any database.

E-mail of recipient 1

E-mail of recipient 2

E-mail of recipient 3

E-mail of recipient 4

E-mail of recipient 5

Your Name

Your e-mail address

Comment

Type the characters you see below: