premio-bremgarten.ch Open in urlscan Pro
83.137.169.88 Public Scan

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Submitted URL:
https://premio-bremgarten.ch/
Effective URL:
https://premio-bremgarten.ch/de
Submission: On February 15 via api (February 15th 2024, 2:27:26 am UTC) from CH — Scanned from CH

Form analysis
3 forms found in the DOM

POST /de

<form class="webform-client-form webform-client-form-731 honeypot-timestamp-js honeypot-timestamp-processed webform-conditional-processed" action="/de" method="post" id="webform-client-form-731" accept-charset="UTF-8">
  <div>
    <div class="modal-body">
      <div class="form-item webform-component webform-component-hidden webform-component--haendler form-item form-item-submitted-haendler form-type-hidden" style="display: none"><input type="hidden" name="submitted[haendler]" value="532">
      </div>
      <div class="row">
        <div class="col-md-2">
          <div class="form-item webform-component webform-component-select webform-component--anrede form-group form-item form-item-submitted-anrede form-type-select form-group"> <label class="control-label" for="edit-submitted-anrede">Anrede</label>
            <select class="form-control form-select" id="edit-submitted-anrede" name="submitted[anrede]">
              <option value="" selected="selected">- Keine -</option>
              <option value="m">Herr</option>
              <option value="f">Frau</option>
            </select>
          </div>
        </div>
        <div class="col-md-5">
          <div class="form-item webform-component webform-component-textfield webform-component--vorname form-group form-item form-item-submitted-vorname form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-vorname">Vorname <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-vorname" name="submitted[vorname]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-5">
          <div class="form-item webform-component webform-component-textfield webform-component--nachname form-group form-item form-item-submitted-nachname form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-nachname">Nachname <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-nachname" name="submitted[nachname]" value="" size="60" maxlength="128">
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textfield webform-component--strasse---nr form-group form-item form-item-submitted-strasse__-nr form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-strasse-nr">Strasse / Nr</label>
            <input class="form-control form-text" type="text" id="edit-submitted-strasse-nr" name="submitted[strasse___nr]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-textfield webform-component--plz form-group form-item form-item-submitted-plz form-type-textfield form-group"> <label class="control-label" for="edit-submitted-plz">PLZ</label>
            <input class="form-control form-text" type="text" id="edit-submitted-plz" name="submitted[plz]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-8">
          <div class="form-item webform-component webform-component-textfield webform-component--ort form-group form-item form-item-submitted-ort form-type-textfield form-group"> <label class="control-label" for="edit-submitted-ort">Ort</label>
            <input class="form-control form-text" type="text" id="edit-submitted-ort" name="submitted[ort]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-textfield webform-component--telefon form-group form-item form-item-submitted-telefon form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-telefon">Telefon <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-telefon" name="submitted[telefon]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-email webform-component--e-mail form-group form-item form-item-submitted-e-mail form-type-webform-email form-group"> <label class="control-label" for="edit-submitted-e-mail">E-Mail
              <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="email form-control form-text form-email required" type="email" id="edit-submitted-e-mail" name="submitted[e_mail]" size="60">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-select webform-component--hersteller form-group form-item form-item-submitted-hersteller form-type-select form-group"> <label class="control-label"
              for="edit-submitted-hersteller">Hersteller</label>
            <select class="form-control form-select" id="edit-submitted-hersteller" name="submitted[hersteller]">
              <option value="" selected="selected">- Alle -</option>
              <option value="GOODYEAR">Goodyear</option>
              <option value="DUNLOP">Dunlop</option>
              <option value="FULDA">Fulda</option>
              <option value="SAVA">Sava</option>
              <option value="DEBICA">Debica</option>
              <option value="APOLLO">Apollo</option>
              <option value="ATLAS">Atlas</option>
              <option value="AVON">Avon</option>
              <option value="BARUM">Barum</option>
              <option value="BF GOODRICH">BF Goodrich</option>
              <option value="BRIDGESTONE">Bridgestone</option>
              <option value="CONTINENTAL">Continental</option>
              <option value="COOPER">Cooper</option>
              <option value="FALKEN">Falken</option>
              <option value="FIRESTONE">Firestone</option>
              <option value="GT RADIAL">GT Radial</option>
              <option value="HANKOOK">Hankook</option>
              <option value="KLEBER">Kleber</option>
              <option value="KORMORAN">Kormoran</option>
              <option value="KUMHO">Kumho</option>
              <option value="MATADOR">Matador</option>
              <option value="MAXXIS">Maxxis</option>
              <option value="MICHELIN">Michelin</option>
              <option value="NEXEN">Nexen</option>
              <option value="NOKIAN">Nokian</option>
              <option value="PIRELLI">Pirelli</option>
              <option value="SEMPERIT">Semperit</option>
              <option value="SYRON">Syron</option>
              <option value="TOYO">Toyo</option>
              <option value="TIGAR">Tigar</option>
              <option value="UNIROYAL">Uniroyal</option>
              <option value="VREDESTEIN">Vredestein</option>
              <option value="WINDPOWER">Windpower</option>
              <option value="YOKOHAMA">Yokohama</option>
            </select>
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-select webform-component--reifentyp form-group form-item form-item-submitted-reifentyp form-type-select form-group"> <label class="control-label"
              for="edit-submitted-reifentyp">Reifentyp <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <select required="required" class="form-control form-select required" id="edit-submitted-reifentyp" name="submitted[reifentyp]">
              <option value="" selected="selected">- Auswählen -</option>
              <option value="summer">Sommerreifen</option>
              <option value="winter">Winterreifen</option>
              <option value="allseason">Ganzjahresreifen</option>
            </select>
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-select webform-component--breite form-group form-item form-item-submitted-breite form-type-select form-group"> <label class="control-label" for="edit-submitted-breite">Breite <span
                class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <select required="required" class="form-control form-select required" id="edit-submitted-breite" name="submitted[breite]">
              <option value="125">125</option>
              <option value="135">135</option>
              <option value="140">140</option>
              <option value="145">145</option>
              <option value="155">155</option>
              <option value="165">165</option>
              <option value="175">175</option>
              <option value="185">185</option>
              <option value="195">195</option>
              <option value="205" selected="selected">205</option>
              <option value="215">215</option>
              <option value="225">225</option>
              <option value="235">235</option>
              <option value="245">245</option>
              <option value="255">255</option>
              <option value="265">265</option>
              <option value="275">275</option>
              <option value="285">285</option>
              <option value="295">295</option>
              <option value="305">305</option>
              <option value="315">315</option>
              <option value="325">325</option>
              <option value="335">335</option>
              <option value="345">345</option>
              <option value="355">355</option>
            </select>
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-select webform-component--hoehe form-group form-item form-item-submitted-hoehe form-type-select form-group"> <label class="control-label" for="edit-submitted-hoehe">Höhe <span
                class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <select required="required" class="form-control form-select required" id="edit-submitted-hoehe" name="submitted[hoehe]">
              <option value="9_5">9,5</option>
              <option value="10_5">10,5</option>
              <option value="20">20</option>
              <option value="25">25</option>
              <option value="30">30</option>
              <option value="35">35</option>
              <option value="40">40</option>
              <option value="45">45</option>
              <option value="50">50</option>
              <option value="55" selected="selected">55</option>
              <option value="60">60</option>
              <option value="65">65</option>
              <option value="70">70</option>
              <option value="75">75</option>
              <option value="80">80</option>
              <option value="82">82</option>
              <option value="85">85</option>
            </select>
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-select webform-component--zoll form-group form-item form-item-submitted-zoll form-type-select form-group"> <label class="control-label" for="edit-submitted-zoll">Zoll <span
                class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <select required="required" class="form-control form-select required" id="edit-submitted-zoll" name="submitted[zoll]">
              <option value="13">13</option>
              <option value="14">14</option>
              <option value="15">15</option>
              <option value="16" selected="selected">16</option>
              <option value="17">17</option>
              <option value="18">18</option>
              <option value="19">19</option>
              <option value="20">20</option>
              <option value="21">21</option>
              <option value="22">22</option>
              <option value="23">23</option>
              <option value="24">24</option>
              <option value="26">26</option>
            </select>
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-number webform-component--anzahl-reifen form-group form-item form-item-submitted-anzahl-reifen form-type-select form-group"> <label class="control-label"
              for="edit-submitted-anzahl-reifen">Anzahl Reifen <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <select required="required" class="form-control form-select required" id="edit-submitted-anzahl-reifen" name="submitted[anzahl_reifen]">
              <option value="1">1</option>
              <option value="2">2</option>
              <option value="3">3</option>
              <option value="4" selected="selected">4</option>
            </select>
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-select webform-component--preiskategorie form-group form-item form-item-submitted-preiskategorie form-type-select form-group"> <label class="control-label"
              for="edit-submitted-preiskategorie">Preiskategorie</label>
            <select class="form-control form-select" id="edit-submitted-preiskategorie" name="submitted[preiskategorie]">
              <option value="" selected="selected">- Egal -</option>
              <option value="premium">Premium</option>
              <option value="budget">Budget</option>
            </select>
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-checkboxes webform-component--runflat form-group form-item form-item-submitted-runflat form-type-checkboxes form-group"> <label class="control-label"
              for="edit-submitted-runflat">Runflat</label>
            <div id="edit-submitted-runflat" class="form-checkboxes">
              <div class="form-item form-item-submitted-runflat-yes form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-runflat-1"><input type="checkbox" id="edit-submitted-runflat-1" name="submitted[runflat][yes]"
                    value="yes" class="form-checkbox">Ja</label>
              </div>
            </div>
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textarea webform-component--anmerkung form-group form-item form-item-submitted-anmerkung form-type-textarea form-group"> <label class="control-label"
              for="edit-submitted-anmerkung">Anmerkung</label>
            <div class="form-textarea-wrapper resizable textarea-processed resizable-textarea"><textarea class="form-control form-textarea" id="edit-submitted-anmerkung" name="submitted[anmerkung]" cols="60" rows="5"></textarea>
              <div class="grippie"></div>
            </div>
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-checkboxes webform-component--datenschutz form-group form-item form-item-submitted-datenschutz form-type-checkboxes form-group">
            <div id="edit-submitted-datenschutz" class="form-checkboxes">
              <div class="form-item form-item-submitted-datenschutz-datenschutz form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-datenschutz-1"><input required="required" type="checkbox" id="edit-submitted-datenschutz-1"
                    name="submitted[datenschutz][datenschutz]" value="datenschutz" class="form-checkbox">Ich habe die Hinweise zum <a target="_blank" href="https://premio-bremgarten.ch/de/datenschutz">Datenschutz</a> gelesen.*</label>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="modal-footer">
      <button type="button" class="btn btn-secondary" data-dismiss="modal">Abbrechen</button>
      <div class="form-actions"><button class="webform-submit button-primary btn btn-primary form-submit" type="submit" name="op" value="Absenden"><span class="icon fa fa-" aria-hidden="true"></span> Absenden</button>
      </div>
      <div class="form-item webform-component webform-component-checkboxes webform-component--vip-kunde form-group form-item form-item-submitted-vip-kunde form-type-checkboxes form-group webform-conditional-hidden" style="display: none;"> <label
          class="control-label" for="edit-submitted-vip-kunde">VIP-Kunde</label>
        <div id="edit-submitted-vip-kunde" class="form-checkboxes">
          <div class="form-item form-item-submitted-vip-kunde-yes form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-vip-kunde-1"><input type="checkbox" id="edit-submitted-vip-kunde-1" name="submitted[vip_kunde][yes]"
                value="yes" class="form-checkbox webform-conditional-disabled" disabled="">Ja</label>
          </div>
        </div>
      </div>
      <div class="form-item webform-component webform-component-select webform-component--fahrzeugtyp form-group form-item form-item-submitted-fahrzeugtyp form-type-select form-group webform-conditional-hidden" style="display: none;"> <label
          class="control-label" for="edit-submitted-fahrzeugtyp">Fahrzeugtyp <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
        <select required="required" class="form-control form-select required webform-conditional-disabled" id="edit-submitted-fahrzeugtyp" name="submitted[fahrzeugtyp]" disabled="">
          <option value="pkw" selected="selected">Personenwagen</option>
          <option value="jeep">Geländewagen</option>
          <option value="delivery">Lieferwagen</option>
          <option value="lkw">Lastwagen</option>
        </select>
      </div><input type="hidden" name="details[sid]">
      <input type="hidden" name="details[page_num]" value="1">
      <input type="hidden" name="details[page_count]" value="1">
      <input type="hidden" name="details[finished]" value="0">
      <input type="hidden" name="form_build_id" value="form-cTbmiu26gsYCIIbSzsqVvaXhshdxzm7Qhuwd9xamk0Q">
      <input type="hidden" name="form_id" value="webform_client_form_731">
      <input type="hidden" name="honeypot_time" value="no_js_available">
      <div class="homepage-textfield">
        <div class="form-item form-item-homepage form-type-textfield form-group"> <label class="control-label" for="edit-homepage">Bitte dieses Feld leer lassen</label>
          <input autocomplete="off" class="form-control form-text" type="text" id="edit-homepage" name="homepage" value="" size="20" maxlength="128">
        </div>
      </div>
    </div>
  </div>
</form>

POST /de

<form class="webform-client-form webform-client-form-705 honeypot-timestamp-js honeypot-timestamp-processed" action="/de" method="post" id="webform-client-form-705" accept-charset="UTF-8">
  <div>
    <div class="modal-body">
      <div class="row">
        <div class="col-md-2">
          <div class="form-item webform-component webform-component-select webform-component--anrede form-group form-item form-item-submitted-anrede form-type-select form-group"> <label class="control-label"
              for="edit-submitted-anrede--2">Anrede</label>
            <select class="form-control form-select" id="edit-submitted-anrede--2" name="submitted[anrede]">
              <option value="" selected="selected">- Keine -</option>
              <option value="m">Herr</option>
              <option value="f">Frau</option>
            </select>
          </div>
        </div>
        <div class="col-md-5">
          <div class="form-item webform-component webform-component-textfield webform-component--vorname form-group form-item form-item-submitted-vorname form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-vorname--2">Vorname <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-vorname--2" name="submitted[vorname]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-5">
          <div class="form-item webform-component webform-component-textfield webform-component--nachname form-group form-item form-item-submitted-nachname form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-nachname--2">Nachname <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-nachname--2" name="submitted[nachname]" value="" size="60" maxlength="128">
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textfield webform-component--strasse---nr form-group form-item form-item-submitted-strasse__-nr form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-strasse-nr--2">Strasse / Nr</label>
            <input class="form-control form-text" type="text" id="edit-submitted-strasse-nr--2" name="submitted[strasse___nr]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-textfield webform-component--plz form-group form-item form-item-submitted-plz form-type-textfield form-group"> <label class="control-label" for="edit-submitted-plz--2">PLZ</label>
            <input class="form-control form-text" type="text" id="edit-submitted-plz--2" name="submitted[plz]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-8">
          <div class="form-item webform-component webform-component-textfield webform-component--ort form-group form-item form-item-submitted-ort form-type-textfield form-group"> <label class="control-label" for="edit-submitted-ort--2">Ort</label>
            <input class="form-control form-text" type="text" id="edit-submitted-ort--2" name="submitted[ort]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-textfield webform-component--telefon form-group form-item form-item-submitted-telefon form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-telefon--2">Telefon <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-telefon--2" name="submitted[telefon]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-email webform-component--e-mail form-group form-item form-item-submitted-e-mail form-type-webform-email form-group"> <label class="control-label"
              for="edit-submitted-e-mail--2">E-Mail <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="email form-control form-text form-email required" type="email" id="edit-submitted-e-mail--2" name="submitted[e_mail]" size="60">
          </div>
        </div>
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textfield webform-component--ihr-anliegen form-group form-item form-item-submitted-ihr-anliegen form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-ihr-anliegen">Ihr Anliegen <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-ihr-anliegen" name="submitted[ihr_anliegen]" value="" size="60" maxlength="128">
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textarea webform-component--ihre-nachricht form-group form-item form-item-submitted-ihre-nachricht form-type-textarea form-group"> <label class="control-label"
              for="edit-submitted-ihre-nachricht">Ihre Nachricht <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <div class="form-textarea-wrapper resizable textarea-processed resizable-textarea"><textarea required="required" class="form-control form-textarea required" id="edit-submitted-ihre-nachricht" name="submitted[ihre_nachricht]" cols="60"
                rows="5"></textarea>
              <div class="grippie"></div>
            </div>
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-checkboxes webform-component--datenschutz form-group form-item form-item-submitted-datenschutz form-type-checkboxes form-group">
            <div id="edit-submitted-datenschutz--2" class="form-checkboxes">
              <div class="form-item form-item-submitted-datenschutz-datenschutz form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-datenschutz--2-1"><input required="required" type="checkbox"
                    id="edit-submitted-datenschutz--2-1" name="submitted[datenschutz][datenschutz]" value="datenschutz" class="form-checkbox">Ich habe die Hinweise zum
                  <a target="_blank" href="https://premio-bremgarten.ch/de/datenschutz">Datenschutz</a> gelesen.*</label>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="modal-footer">
      <button type="button" class="btn btn-secondary" data-dismiss="modal">Abbrechen</button>
      <div class="form-actions"><button class="webform-submit button-primary btn btn-primary form-submit" type="submit" name="op" value="Absenden"><span class="icon fa fa-" aria-hidden="true"></span> Absenden</button>
      </div> <input type="hidden" name="details[sid]">
      <input type="hidden" name="details[page_num]" value="1">
      <input type="hidden" name="details[page_count]" value="1">
      <input type="hidden" name="details[finished]" value="0">
      <input type="hidden" name="form_build_id" value="form-zCelp5tQH2r3xZ0sbsHRx8KeOzNKIVRAW7wwMCfH-NE">
      <input type="hidden" name="form_id" value="webform_client_form_705">
      <input type="hidden" name="honeypot_time" value="no_js_available">
      <div class="homepage-textfield">
        <div class="form-item form-item-homepage form-type-textfield form-group"> <label class="control-label" for="edit-homepage--2">Bitte dieses Feld leer lassen</label>
          <input autocomplete="off" class="form-control form-text" type="text" id="edit-homepage--2" name="homepage" value="" size="20" maxlength="128">
        </div>
      </div>
    </div>
  </div>
</form>

POST /de

<form class="webform-client-form webform-client-form-706 honeypot-timestamp-js honeypot-timestamp-processed webform-conditional-processed" action="/de" method="post" id="webform-client-form-706" accept-charset="UTF-8">
  <div>
    <div class="modal-body">
      <div class="row">
        <div class="col-md-2">
          <div class="form-item webform-component webform-component-select webform-component--anrede form-group form-item form-item-submitted-anrede form-type-select form-group"> <label class="control-label"
              for="edit-submitted-anrede--3">Anrede</label>
            <select class="form-control form-select" id="edit-submitted-anrede--3" name="submitted[anrede]">
              <option value="" selected="selected">- Keine -</option>
              <option value="m">Herr</option>
              <option value="f">Frau</option>
            </select>
          </div>
        </div>
        <div class="col-md-5">
          <div class="form-item webform-component webform-component-textfield webform-component--vorname form-group form-item form-item-submitted-vorname form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-vorname--3">Vorname <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-vorname--3" name="submitted[vorname]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-5">
          <div class="form-item webform-component webform-component-textfield webform-component--nachname form-group form-item form-item-submitted-nachname form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-nachname--3">Nachname <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-nachname--3" name="submitted[nachname]" value="" size="60" maxlength="128">
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textfield webform-component--strasse---nr form-group form-item form-item-submitted-strasse__-nr form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-strasse-nr--3">Strasse / Nr</label>
            <input class="form-control form-text" type="text" id="edit-submitted-strasse-nr--3" name="submitted[strasse___nr]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-4">
          <div class="form-item webform-component webform-component-textfield webform-component--plz form-group form-item form-item-submitted-plz form-type-textfield form-group"> <label class="control-label" for="edit-submitted-plz--3">PLZ</label>
            <input class="form-control form-text" type="text" id="edit-submitted-plz--3" name="submitted[plz]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-8">
          <div class="form-item webform-component webform-component-textfield webform-component--ort form-group form-item form-item-submitted-ort form-type-textfield form-group"> <label class="control-label" for="edit-submitted-ort--3">Ort</label>
            <input class="form-control form-text" type="text" id="edit-submitted-ort--3" name="submitted[ort]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-textfield webform-component--telefon form-group form-item form-item-submitted-telefon form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-telefon--3">Telefon <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-telefon--3" name="submitted[telefon]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-email webform-component--e-mail form-group form-item form-item-submitted-e-mail form-type-webform-email form-group"> <label class="control-label"
              for="edit-submitted-e-mail--3">E-Mail <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="email form-control form-text form-email required" type="email" id="edit-submitted-e-mail--3" name="submitted[e_mail]" size="60">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-select webform-component--leistung form-group form-item form-item-submitted-leistung form-type-select form-group"> <label class="control-label" for="edit-submitted-leistung">Leistung
              <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <select required="required" class="form-control form-select required ajax-processed" id="edit-submitted-leistung" name="submitted[leistung]">
              <option value="" selected="selected">- Auswählen -</option>
              <option value="1005">Radwechsel + Wuchten</option>
              <option value="1008">Radwechsel + Wuchten + Wäsche</option>
              <option value="1009">Achsvermessung</option>
              <option value="1010">Ummontage</option>
              <option value="1011">Reifenreparatur</option>
              <option value="1012">Sonstiges</option>
            </select>
          </div>
        </div>
        <div class="col-md-6">
        </div>
        <div class="col-md-6">
          <div id="wrapper-date">
            <div class="form-item webform-component webform-component-textfield webform-component--datum form-group form-item form-item-submitted-datum form-type-textfield form-disabled form-group"> <label class="control-label"
                for="edit-submitted-datum">Datum</label>
              <input disabled="disabled" class="form-control form-text ajax-processed picker__input" type="text" id="edit-submitted-datum" name="" value="" size="60" maxlength="128" readonly="" aria-haspopup="true" aria-expanded="false"
                aria-readonly="false" aria-owns="edit-submitted-datum_root">
              <div class="picker" id="edit-submitted-datum_root" aria-hidden="true">
                <div class="picker__holder" tabindex="-1">
                  <div class="picker__frame">
                    <div class="picker__wrap">
                      <div class="picker__box">
                        <div class="picker__header">
                          <div class="picker__month">Februar</div>
                          <div class="picker__year">2024</div>
                          <div class="picker__nav--prev picker__nav--disabled" data-nav="-1" role="button" aria-controls="edit-submitted-datum_table" title="Previous month"> </div>
                          <div class="picker__nav--next" data-nav="1" role="button" aria-controls="edit-submitted-datum_table" title="Next month"> </div>
                        </div>
                        <table class="picker__table" id="edit-submitted-datum_table" role="grid" aria-controls="edit-submitted-datum" aria-readonly="true">
                          <thead>
                            <tr>
                              <th class="picker__weekday" scope="col" title="Montag">Mo</th>
                              <th class="picker__weekday" scope="col" title="Dienstag">Di</th>
                              <th class="picker__weekday" scope="col" title="Mittwoch">Mi</th>
                              <th class="picker__weekday" scope="col" title="Donnerstag">Do</th>
                              <th class="picker__weekday" scope="col" title="Freitag">Fr</th>
                              <th class="picker__weekday" scope="col" title="Samstag">Sa</th>
                              <th class="picker__weekday" scope="col" title="Sonntag">So</th>
                            </tr>
                          </thead>
                          <tbody>
                            <tr>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1706482800000" role="gridcell" aria-label="29.1.2024" aria-disabled="true">29</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1706569200000" role="gridcell" aria-label="30.1.2024" aria-disabled="true">30</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1706655600000" role="gridcell" aria-label="31.1.2024" aria-disabled="true">31</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1706742000000" role="gridcell" aria-label="1.2.2024" aria-disabled="true">1</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1706828400000" role="gridcell" aria-label="2.2.2024" aria-disabled="true">2</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1706914800000" role="gridcell" aria-label="3.2.2024" aria-disabled="true">3</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707001200000" role="gridcell" aria-label="4.2.2024" aria-disabled="true">4</div>
                              </td>
                            </tr>
                            <tr>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707087600000" role="gridcell" aria-label="5.2.2024" aria-disabled="true">5</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707174000000" role="gridcell" aria-label="6.2.2024" aria-disabled="true">6</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707260400000" role="gridcell" aria-label="7.2.2024" aria-disabled="true">7</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707346800000" role="gridcell" aria-label="8.2.2024" aria-disabled="true">8</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707433200000" role="gridcell" aria-label="9.2.2024" aria-disabled="true">9</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707519600000" role="gridcell" aria-label="10.2.2024" aria-disabled="true">10</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707606000000" role="gridcell" aria-label="11.2.2024" aria-disabled="true">11</div>
                              </td>
                            </tr>
                            <tr>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707692400000" role="gridcell" aria-label="12.2.2024" aria-disabled="true">12</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707778800000" role="gridcell" aria-label="13.2.2024" aria-disabled="true">13</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1707865200000" role="gridcell" aria-label="14.2.2024" aria-disabled="true">14</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--today picker__day--highlighted picker__day--noappointment" data-pick="1707951600000" role="gridcell" aria-label="15.2.2024" aria-activedescendant="true"
                                  title="Ggf. sind keine Termine für diesen Tag verfügbar.">15</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708038000000" role="gridcell" aria-label="16.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">16</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708124400000" role="gridcell" aria-label="17.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">17</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1708210800000" role="gridcell" aria-label="18.2.2024" aria-disabled="true">18</div>
                              </td>
                            </tr>
                            <tr>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708297200000" role="gridcell" aria-label="19.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">19</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708383600000" role="gridcell" aria-label="20.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">20</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708470000000" role="gridcell" aria-label="21.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">21</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708556400000" role="gridcell" aria-label="22.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">22</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708642800000" role="gridcell" aria-label="23.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">23</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708729200000" role="gridcell" aria-label="24.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">24</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1708815600000" role="gridcell" aria-label="25.2.2024" aria-disabled="true">25</div>
                              </td>
                            </tr>
                            <tr>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708902000000" role="gridcell" aria-label="26.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">26</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1708988400000" role="gridcell" aria-label="27.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">27</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1709074800000" role="gridcell" aria-label="28.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">28</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--infocus picker__day--noappointment" data-pick="1709161200000" role="gridcell" aria-label="29.2.2024" title="Ggf. sind keine Termine für diesen Tag verfügbar.">29</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709247600000" role="gridcell" aria-label="1.3.2024">1</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709334000000" role="gridcell" aria-label="2.3.2024">2</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1709420400000" role="gridcell" aria-label="3.3.2024" aria-disabled="true">3</div>
                              </td>
                            </tr>
                            <tr>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709506800000" role="gridcell" aria-label="4.3.2024">4</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709593200000" role="gridcell" aria-label="5.3.2024">5</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709679600000" role="gridcell" aria-label="6.3.2024">6</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709766000000" role="gridcell" aria-label="7.3.2024">7</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709852400000" role="gridcell" aria-label="8.3.2024">8</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus" data-pick="1709938800000" role="gridcell" aria-label="9.3.2024">9</div>
                              </td>
                              <td role="presentation">
                                <div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1710025200000" role="gridcell" aria-label="10.3.2024" aria-disabled="true">10</div>
                              </td>
                            </tr>
                          </tbody>
                        </table>
                        <div class="picker__footer"><button class="picker__button--today" type="button" data-pick="1707951600000" disabled="" aria-controls="edit-submitted-datum">Heute</button><button class="picker__button--clear" type="button"
                            data-clear="1" disabled="" aria-controls="edit-submitted-datum">Löschen</button><button class="picker__button--close" type="button" data-close="true" disabled="" aria-controls="edit-submitted-datum">Schließen</button>
                        </div>
                      </div>
                    </div>
                  </div>
                </div>
              </div><input type="hidden" name="submitted[datum]">
            </div>
          </div>
        </div>
        <div class="col-md-6">
          <div id="wrapper-time">
            <div class="form-item webform-component webform-component-select webform-component--uhrzeit form-group form-item form-item-submitted-uhrzeit form-type-select form-disabled form-group"> <label class="control-label"
                for="edit-submitted-uhrzeit">Uhrzeit</label>
              <select disabled="disabled" class="form-control form-select" id="edit-submitted-uhrzeit" name="submitted[uhrzeit]">
                <option value="no">Bitte wählen Sie zunächst ein Datum aus</option>
              </select>
            </div>
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-textfield webform-component--kfz-kennzeichen form-group form-item form-item-submitted-kfz-kennzeichen form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-kfz-kennzeichen">KFZ-Kennzeichen <span class="form-required" title="Diese Angabe wird benötigt.">*</span></label>
            <input required="required" class="form-control form-text required" type="text" id="edit-submitted-kfz-kennzeichen" name="submitted[kfz_kennzeichen]" value="" size="60" maxlength="128">
          </div>
        </div>
        <div class="col-md-6">
          <div class="form-item webform-component webform-component-textfield webform-component--einlagerungsnummer form-group form-item form-item-submitted-einlagerungsnummer form-type-textfield form-group"> <label class="control-label"
              for="edit-submitted-einlagerungsnummer">Einlagerungsnummer</label>
            <input class="form-control form-text" type="text" id="edit-submitted-einlagerungsnummer" name="submitted[einlagerungsnummer]" value="" size="60" maxlength="128">
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-textarea webform-component--anmerkung form-group form-item form-item-submitted-anmerkung form-type-textarea form-group"> <label class="control-label"
              for="edit-submitted-anmerkung--2">Anmerkung</label>
            <div class="form-textarea-wrapper resizable textarea-processed resizable-textarea"><textarea class="form-control form-textarea" id="edit-submitted-anmerkung--2" name="submitted[anmerkung]" cols="60" rows="5"></textarea>
              <div class="grippie"></div>
            </div>
          </div>
        </div>
      </div>
      <div class="row mt-3">
        <div class="col-md-12">
          <div class="form-item webform-component webform-component-checkboxes webform-component--datenschutz form-group form-item form-item-submitted-datenschutz form-type-checkboxes form-group">
            <div id="edit-submitted-datenschutz--3" class="form-checkboxes">
              <div class="form-item form-item-submitted-datenschutz-datenschutz form-type-checkbox checkbox"> <label class="control-label" for="edit-submitted-datenschutz--3-1"><input required="required" type="checkbox"
                    id="edit-submitted-datenschutz--3-1" name="submitted[datenschutz][datenschutz]" value="datenschutz" class="form-checkbox">Ich habe die Hinweise zum
                  <a target="_blank" href="https://premio-bremgarten.ch/de/datenschutz">Datenschutz</a> gelesen.*</label>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="modal-footer">
      <button type="button" class="btn btn-secondary" data-dismiss="modal">Abbrechen</button>
      <div class="form-actions"><button class="webform-submit button-primary btn btn-primary form-submit ajax-processed" type="submit" id="edit-submit--3" name="op" value="Absenden"><span class="icon fa fa-" aria-hidden="true"></span>
          Absenden</button>
      </div>
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          <input autocomplete="off" class="form-control form-text" type="text" id="edit-homepage--3" name="homepage" value="" size="20" maxlength="128">
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</form>

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Februar
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premio-bremgarten.ch Open in urlscan Pro 83.137.169.88 Public Scan

Form analysis 3 forms found in the DOM

POST /de

POST /de

POST /de

Text Content

premio-bremgarten.ch Open in urlscan Pro
83.137.169.88 Public Scan

Form analysis
3 forms found in the DOM