obform.verzeo.in
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15.206.189.182
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URL:
https://obform.verzeo.in/pre-registration/d0gxw0rprcs4nfwgfpk6
Submission: On October 25 via manual from IN — Scanned from DE
Submission: On October 25 via manual from IN — Scanned from DE
Form analysis
1 forms found in the DOMPOST /pre-order-summary
<form action="/pre-order-summary" method="post" onsubmit="return closesub()" autocomplete="off">
<div>
<input type="text" name="name" id="name" placeholder="Name" required="">
</div>
<div style="position: relative;">
<!-- <span style="position: absolute;font-size: 18px; color: black;top: 19px;left: 0;">+91-</span> -->
<input type="tel" name="phone" id="phone" placeholder="Phone" maxlength="10" required="">
</div>
<div>
<input type="email" name="email" id="email" placeholder="Email" required="">
</div>
<input type="hidden" name="link" value="d0gxw0rprcs4nfwgfpk6">
<div>
<button type="submit" id="submit">Register</button>
</div>
</form>
Text Content
Programs Sign In REGISTRATION Please fill in your details some error some success Register