visitor.srm-medias.com Open in urlscan Pro
2606:4700:3030::6815:1738  Public Scan

Form analysis
1 forms found in the DOM

https://visitor.srm-medias.com/visitor-checkin

<form class="form w-100 fv-plugins-bootstrap5 fv-plugins-framework" novalidate="novalidate" id="kt_sign_up_form" data-kt-redirect-url="https://visitor.srm-medias.com/visitor-checkin" action="https://visitor.srm-medias.com/visitor-checkin">
  <input type="hidden" name="_token" value="UiF9J6r0aTXXGEJ9FbSG1fYes5Mwftc25CJm6WOh" autocomplete="off"> <!--begin::Heading-->
  <div class="text-center mb-11">
    <!--begin::Title-->
    <h1 class="text-gray-900 fw-bolder mb-3"> Visitor Check In </h1>
    <!--end::Title-->
    <!--begin::Subtitle-->
    <div class="text-gray-500 fw-semibold fs-6"> Please fill the form below </div>
    <!--end::Subtitle--->
  </div>
  <!--begin::Heading-->
  <!--begin::Input group--->
  <div class="fv-row mb-8 fv-plugins-icon-container">
    <!--begin::Name-->
    <input type="text" placeholder="First name *" name="first_name" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Name-->
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback"></div>
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8 fv-plugins-icon-container">
    <!--begin::Name-->
    <input type="text" placeholder="Last name *" name="last_name" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Name-->
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback"></div>
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8 fv-plugins-icon-container">
    <!--begin::Email-->
    <input type="text" placeholder="Email *" name="email" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Email-->
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback">
      <div class="email message d-none" data-field="email" data-validator="notEmpty"></div>
    </div>
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback"></div>
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8 fv-plugins-icon-container">
    <!--begin::Email-->
    <input type="text" placeholder="ID/Passport number *" name="id_passport" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Email-->
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback"></div>
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8 fv-plugins-icon-container">
    <!--begin::Email-->
    <input type="text" placeholder="Mobile number *" name="mobile" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Email-->
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback"></div>
  </div>
  <div class="mb-8">
    <select name="building" id="building" class="form-select form-control form-control-lg bg-transparent select2-hidden-accessible" data-control="select2" data-hide-search="true" data-placeholder="Select a building *"
      data-select2-id="select2-data-building" tabindex="-1" aria-hidden="true" data-kt-initialized="1">
      <option data-select2-id="select2-data-2-oetl"></option>
      <option value="1">Prishtinë</option>
      <option value="2">Lipjan</option>
      <option value="3">Vushtrri</option>
    </select><span class="select2 select2-container select2-container--bootstrap5" dir="ltr" data-select2-id="select2-data-1-pk8r" style="width: 100%;"><span class="selection"><span
          class="select2-selection select2-selection--single form-select form-control form-control-lg bg-transparent" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="0" aria-disabled="false"
          aria-labelledby="select2-building-container" aria-controls="select2-building-container"><span class="select2-selection__rendered" id="select2-building-container" role="textbox" aria-readonly="true" title="Select a building *"><span
              class="select2-selection__placeholder">Select a building *</span></span><span class="select2-selection__arrow" role="presentation"><b role="presentation"></b></span></span></span><span class="dropdown-wrapper"
        aria-hidden="true"></span></span>
    <div class="fv-plugins-message-container fv-plugins-message-container--enabled invalid-feedback">
      <div class="building message d-none" data-field="building" data-validator="notEmpty"></div>
    </div>
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8">
    <!--begin::Email-->
    <input type="text" placeholder="Department" name="department" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Email-->
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8">
    <!--begin::Email-->
    <input type="text" placeholder="Reason for visiting" name="visit_reason" autocomplete="off" class="form-control form-control-lg bg-transparent">
    <!--end::Email-->
  </div>
  <div class="fv-row mb-8">
    <label style="font-size: 16px; font-weight: 500; color: lightgray">Signature</label>
    <div id="sig" class="kbw-signature">
      <textarea id="signature64" name="signature" style="display: none"></textarea>
      <canvas width="433" height="148">Your browser doesn't support signing</canvas>
    </div>
    <p style="clear: both;">
      <button id="clear" class="btn btn-info btn-sm">Clear</button>
    </p>
  </div>
  <!--begin::Input group--->
  <div class="fv-row mb-8">
    <label> By checking in, you acknowledge that you have read, understood, and agree to the terms of the <a href="#" data-bs-toggle="modal" data-bs-target="#kt_modal_scrollable_1">Non-Disclosure Agreement (NDA)</a> and
      <a href="#" data-bs-toggle="modal" data-bs-target="#kt_modal_scrollable_2">Statement of Consent for Video Surveillance</a> provided. You confirm that you accept the confidentiality obligations and other terms set forth in the NDA. </label>
  </div>
  <!--begin::Submit button-->
  <div class="d-grid mb-5">
    <button type="submit" id="kt_sign_up_submit" class="btn btn-primary">
      <!--begin::Indicator label-->
      <span class="indicator-label"> Check In </span>
      <!--end::Indicator label-->
      <!--begin::Indicator progress-->
      <span class="indicator-progress">Please wait... <span class="spinner-border spinner-border-sm align-middle ms-2"></span></span>
      <!--end::Indicator progress-->
    </button>
  </div>
  <!--end::Submit button-->
  <!--begin::Sign up-->
  <div class="text-gray-500 text-center fw-semibold fs-6"> Goto <a href="https://visitor.srm-medias.com/login" class="link-primary">
                Sign In            </a> page </div>
  <!--end::Sign up-->
</form>

Text Content

English Albanian German English Language



VISITOR CHECK IN

Please fill the form below





Prishtinë Lipjan Vushtrri Select a building *



Signature
Your browser doesn't support signing

Clear

By checking in, you acknowledge that you have read, understood, and agree to the
terms of the Non-Disclosure Agreement (NDA) and Statement of Consent for Video
Surveillance provided. You confirm that you accept the confidentiality
obligations and other terms set forth in the NDA.
Check In Please wait...
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VISITOR NON-DISCLOSURE AGREEMENT (NDA)


 1. I may be given access to confidential information belonging to (the
    “Company”) through my relationship with Company or as a result of my access
    to Company’s premises.
 2. I understand and acknowledge that Company’s trade secrets consist of
    information and materials that are valuable and not generally known by
    Company’s competitors, including:
     * Any and all information concerning Company’s current, future or proposed
       products, including, but not limited to, computer code, drawings,
       specifications, notebook entries, technical notes and graphs, computer
       printouts, technical memoranda and correspondence, product development
       agreements and related agreements.
     * Information and materials relating to Company’s purchasing, accounting,
       and marketing; including, but not limited to, marketing plans, sales
       data, unpublished promotional material, cost and pricing information and
       customer lists.
     * Information and materials during the interview process regarding the work
       environment, recruitment methodology, clients, terms of the employment
       contract such as: personnel, project, salary, bonuses, schedule, etc.
     * Information of the type described above which Company obtained from
       another party and which Company treats as confidential, whether or not
       owned or developed by Company.
     * Other:

 3. In consideration of being admitted to Company’s facilities, I will hold in
    the strictest confidence any trade secrets or confidential information that
    is disclosed to me. I will not remove any document, equipment or other
    materials from the premises without the Company's written permission. I will
    not photograph or otherwise record any information to which I may have
    access during my visit.
 4. This Agreement is binding on me, my heirs, executors, administrators and
    assigns and inures to the benefit of Company, its successors, and assigns.
 5. This Agreement constitutes the entire understanding between Company and me
    with respect to its subject matter. It supersedes all earlier
    representations and understandings, whether oral or written.

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STATEMENT OF CONSENT FOR VIDEO SURVEILLANCE




STATEMENT OF CONSENT FOR VIDEO SURVEILLANCE IN OPERATING SPACES

between/among:

PALET/PARTIES:

1.´´FLINE SH.p.k., a company established and registered in Vushtrri in
accordance with the laws of the Republic of Kosovo, with the business
registration number 811849316, based in Vushtrri, Xhon Buzuku Street no. 36,
represented by Faton Orlishta.

and:

The following agreement about video surveillance is done in accordance with the
protection of data:

The following video surveillance agreement is made in accordance with data
protection:

The surveillance cameras provided aim to avoid the following risks for the
company and its employees:

Allowed reasons will Were property protection and the data by theft. Permitted
reasons would be protection of property and data from theft.

On the other hand, filming is not allowed in places that are considered part of
the more personal sphere of life. This includes: bathrooms, break rooms.

Video recordings expressly not used about labor registration but management of
inputs-outputs within operative space.

Video recordings are not expressly used to record working hours

I fully accept the video surveillance as described in this document.

Close