www.resultshq.com.au
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52.65.42.112
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URL:
https://www.resultshq.com.au/Account/VerifyAccount/caa34751-c9fe-4065-a003-574011855bc9
Submission: On September 27 via manual from AU — Scanned from DE
Submission: On September 27 via manual from AU — Scanned from DE
Form analysis 1 forms found in the DOM
POST /Account/AcceptAccountRequest
<form method="post" action="/Account/AcceptAccountRequest" id="accountRequestForm" novalidate="novalidate">
<input type="hidden" name="hdnAccountRequest" value="caa34751-c9fe-4065-a003-574011855bc9">
<p>You will be required to enter a password for your account while accepting.</p>
<div class="row">
<div class="col-md-6">
<label>Password</label>
<input type="password" name="tbAccountPasswordOne" id="tbAccountPasswordOne" class="form-control">
</div>
<div class="col-md-6">
<label>Confirm Password</label>
<input type="password" name="tbAccountPasswordTwo" id="tbAccountPasswordTwo" class="form-control">
</div>
</div>
<p class="mt20"><b>Subscription Options</b><i class="glyphicon glyphicon-info-sign" style="cursor:pointer; float:right; margin-top:10px;" data-toggle="modal" data-target="#subOptionsModal"></i></p>
<div class="row">
<div class="col-md-6">
<label>Mailing</label>
<select name="ddlMailing" class="form-control">
<option value="true" selected="">YES</option>
<option value="false">NO</option>
</select>
<label>Marketing</label>
<select name="ddlMarketing" class="form-control">
<option value="true">YES</option>
<option value="false" selected="">NO</option>
</select>
</div>
<div class="col-md-6">
<label>Announcement</label>
<select name="ddlAnnouncement" class="form-control">
<option value="true" selected="">YES</option>
<option value="false">NO</option>
</select>
<label>Emergency</label>
<select name="ddlEmergency" class="form-control">
<option value="true" selected="">YES</option>
<option value="false">NO</option>
</select>
</div>
</div>
<p class="mt20"><b>Review your details</b></p>
<div class="row">
<div class="col-md-12">
<label>Find your address</label>
<div class="input-group">
<span class="input-group-addon" id="basic-addon1"><i class="glyphicon glyphicon-search"></i></span>
<input type="text" class="form-control pac-target-input" id="autocomplete" placeholder="" onfocus="geolocate()" autocomplete="off">
</div>
</div>
</div>
<div class="row formBlock-content">
<div class="col-md-6">
<div class="form-group">
<label for="" class="control-label">Phone</label>
<input class="form-control" id="tbPhone" name="tbPhone" value="0421597275">
</div>
<div class="form-group">
<label for="" class="control-label">Unit Number</label>
<input class="form-control" id="subpremise" name="tbUnitNumber" value="">
</div>
<div class="form-group">
<label for="" class="control-label">Street Number</label>
<input class="form-control" id="street_number" name="tbStreetNumber" value="26">
</div>
<div class="form-group">
<label for="" class="control-label">Street</label>
<input class="form-control" id="route" name="tbStreet" value="Gleneagles Road">
</div>
<div class="form-group">
<label for="" class="control-label">City</label>
<input class="form-control" id="locality" name="tbCity" value="Mount Osmond">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label for="" class="control-label">State</label>
<input class="form-control" id="administrative_area_level_1" name="tbState" value="SA">
</div>
<div class="form-group">
<label for="" class="control-label">Postcode</label>
<input class="form-control" id="postal_code" name="tbPostcode" value="5064">
</div>
<div class="form-group">
<label for="" class="control-label">Country</label>
<input class="form-control" id="country" name="tbCountry" value="Australia">
</div>
<div class="form-group">
<label for="" class="control-label">Timezone</label>
<select name="ddlTimezone" class="form-control col-md-9">
<option value="-11_(UTC-11:00) GMT-11:00">(UTC-11:00) GMT-11:00</option>
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