pmb.ubm.ac.id Open in urlscan Pro
43.243.143.101  Public Scan

Form analysis
2 forms found in the DOM

POST ?module=Login

<form id="frmInlineLogin" action="?module=Login" method="post">
  <table>
    <tbody>
      <tr>
        <td>Username</td>
        <td>Password</td>
        <td>&nbsp;</td>
      </tr>
      <tr>
        <td><input type="text" name="usr" size="15" value=""></td>
        <td><input type="password" name="pwd" size="15" value=""></td>
        <td><input type="submit" name="inlineLogin" value="Log In"></td>
      </tr>
    </tbody>
  </table>
</form>

POST

<form id="frmEntry" action="" method="post">
  <input type="hidden" name="submitData" value="submitData">
  <fieldset id="fMain">
    <legend>Form Pendaftaran</legend>
    <p class="fieldsetRemark"> Silahkan melengkapi formulir berikut ini. Kemudian klik tombol <b>Beli</b> untuk melanjutkan. </p>
    <table>
      <tbody>
        <tr>
          <td>E-mail *</td>
          <td>:</td>
          <td>
            <input type="text" name="email" class="textfield" maxlength="50" size="35" value="" id="parentemail">
            <input type="hidden" name="msgEmail">
          </td>
        </tr>
        <tr>
          <td>Nama Lengkap *</td>
          <td>:</td>
          <td>
            <input type="text" name="name" class="textfield" maxlength="100" size="50" value="">
            <input type="hidden" name="msgName">
          </td>
        </tr>
        <tr>
          <td>HP *</td>
          <td>:</td>
          <td>
            <input type="text" name="hp" class="textfield" maxlength="15" size="15" value=""> &nbsp;&nbsp;&nbsp; No. Telepon : <input type="text" name="phone" class="textfield" maxlength="15" size="15" value="">
            <input type="hidden" name="msgHp">
            <input type="hidden" name="msgPhone">
          </td>
        </tr>
        <tr>
          <td>Asal Sekolah *</td>
          <td>:</td>
          <td>
            <input type="text" name="asalSekolah" class="textfield" maxlength="100" size="35" value="">
            <input type="hidden" name="msgAsalSekolah">
          </td>
        </tr>
        <tr>
          <td>Kota Asal Sekolah *</td>
          <td>:</td>
          <td>
            <input type="text" name="asalSekolahKota" class="textfield" maxlength="100" size="25" value="">
            <input type="hidden" name="msgAsalSekolahKota">
          </td>
        </tr>
        <tr>
          <td>Angkatan Perkuliahan *</td>
          <td>:</td>
          <td>
            <select name="intake" class="list">
              <option value="">- Pilih -</option>
              <option value="2024"> 2024 </option>
              <option value="2025"> 2025 </option>
            </select>
            <input type="hidden" name="msgIntake">
          </td>
        </tr>
        <tr>
          <td>Jumlah Formulir *</td>
          <td>:</td>
          <td>
            <span class="ui-spinner ui-widget ui-widget-content ui-corner-all"><input id="txtJmlFormulir" type="text" name="jmlFormulir" class="textfield ui-spinner-input" maxlength="2" size="1" value="1" aria-valuenow="1" autocomplete="off"
                role="spinbutton" aria-valuemin="1"
                aria-valuemax="10"><a class="ui-spinner-button ui-spinner-up ui-corner-tr ui-button ui-widget ui-state-default ui-button-text-only" tabindex="-1" role="button" aria-disabled="false"><span class="ui-button-text"><span class="ui-icon ui-icon-triangle-1-n">▲</span></span></a><a class="ui-spinner-button ui-spinner-down ui-corner-br ui-button ui-widget ui-state-default ui-button-text-only" tabindex="-1" role="button" aria-disabled="false"><span class="ui-button-text"><span class="ui-icon ui-icon-triangle-1-s">▼</span></span></a></span>
            <input type="hidden" name="msgJmlFormulir"> (max=10)
          </td>
        </tr>
        <tr>
          <td>&nbsp;</td>
          <td>&nbsp;</td>
          <td>
            <div class="g-recaptcha" data-sitekey="6LfxdDUUAAAAAGe4sFpKObYu3TV4oquinM917W3B">
              <div style="width: 304px; height: 78px;">
                <div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-mfkc35mg75h" frameborder="0" scrolling="no"
                    sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
                    src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LfxdDUUAAAAAGe4sFpKObYu3TV4oquinM917W3B&amp;co=aHR0cHM6Ly9wbWIudWJtLmFjLmlkOjQ0Mw..&amp;hl=de&amp;v=yiNW3R9jkyLVP5-EEZLDzUtA&amp;size=normal&amp;cb=u7i9728wszg1"></iframe>
                </div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
                  style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
              </div><iframe style="display: none;"></iframe>
            </div>
            <input type="hidden" name="msgCaptcha">
          </td>
        </tr>
        <tr>
          <td>&nbsp;</td>
          <td>&nbsp;</td>
          <td>&nbsp;</td>
        </tr>
        <tr>
          <td>&nbsp;</td>
          <td>&nbsp;</td>
          <td>
            <input id="btnSubmit" type="button" name="submit" value="Beli">
          </td>
        </tr>
      </tbody>
    </table>
  </fieldset>
</form>

Text Content

Sistem Pendaftaran Online
Universitas Bunda Mulia

Username Password  





SELAMAT DATANG


Bagi Anda yang belum memiliki username dan password, silahkan melakukan
pembelian formulir terlebih dahulu pada kolom di sebelah kanan.

Sistem pendaftaran online ini, hanya berlaku untuk pendaftaran calon mahasiswa
Universitas Bunda Mulia jenjang pendidikan sarjana.


Informasi & pertanyaan hubungi :
Call Center : (021) 6929090 Ext. 1230
Email : pmb@ubm.ac.id


Pembelian Formulir >>>
Form Pendaftaran

Silahkan melengkapi formulir berikut ini. Kemudian klik tombol Beli untuk
melanjutkan.

E-mail * : Nama Lengkap * : HP * :     No. Telepon : Asal Sekolah * : Kota Asal
Sekolah * : Angkatan Perkuliahan * : - Pilih - 2024 2025 Jumlah Formulir * : ▲▼
(max=10)    

         







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