secure.ngpvan.com Open in urlscan Pro
45.60.33.183  Public Scan

Form analysis
1 forms found in the DOM

POST

<form class="clearfix" method="post" novalidate="" action="" accept-charset="utf-8" autocomplete="on">
  <div class="at-markup FastAction" id="NVSignupForm883613-FastAction">
    <div class="fastaction-block">
      <div class="fastAction clearfix">
        <p>
          <span class="fa-cta">
            <a href="#fastaction-login" class="profile-link" aria-label="FastAction">
          <img class="profile-link-fa-image" src="//d3rse9xjbp8270.cloudfront.net/assets/images/fast-action.svg"> 
        </a>
            <span><a href="https://fastaction.ngpvan.com##whats-this" class="circle" id="fastaction-whatsthis" data-popup="true" data-popup-width="515" data-popup-height="540" target="_blank">?</a></span>
          </span>
          <span class="fa-lead"> Take future action with a single click.<br>
            <a href="#fastaction-login" class="call-modal" id="fastaction-widget-login">Log in</a>&nbsp;or&nbsp;<a href="#fastaction-signup" class="call-modal" id="fastaction-widget-signup">Sign up</a>&nbsp;for <i>Fast</i><b>Action</b>
          </span>
        </p>
      </div>
    </div>
  </div>
  <div data-name="undefined" data-subview="submit_view" data-subview-index="1"></div>
  <fieldset class="at-fieldset ContactInformation" id="NVSignupForm883613-ContactInformation">
    <legend class="at-legend">Contact Information</legend>
    <div class="at-fields">
      <div class="at-row at-row-solo PostalCode"><label class="at-text   PostalCode" id="NVSignupForm883613-ContactInformation-PostalCode">Postal Code<input type="tel" autocomplete="postal-code" x-autocompletetype="postal-code"
            pattern="^\d{5}([\-]\d{4})?$" required="" title="Postal Code (required)" name="PostalCode" value="" maxlength="10">
        </label></div>
      <div class="at-row EmailAddress MobilePhone"><label class="at-text   EmailAddress" id="NVSignupForm883613-ContactInformation-EmailAddress">Email<input type="email" autocomplete="email" x-autocompletetype="email"
            pattern="^([\w!#$%&amp;'*+\-\/=?\^`\{\|\}~]+\.)*[\w!#$%&amp;'*+\-\/=?\^`\{\|\}~]+@((((([a-zA-Z0-9]{1}[a-zA-Z0-9\-]{0,62}[a-zA-Z0-9]{1})|[a-zA-Z])\.)+[a-zA-Z]{2,62})|(\d{1,3}\.){3}\d{1,3}(:\d{1,5})?)$" required="" title="Email (required)"
            name="EmailAddress" value="" maxlength="100" placeholder="email@email.com">
        </label><label class="at-text   MobilePhone" id="NVSignupForm883613-ContactInformation-MobilePhone">Mobile Phone <small>(Optional)</small>
          <div class="intl-tel-input iti iti--allow-dropdown">
            <div class="iti__flag-container">
              <div class="iti__selected-flag" role="combobox" aria-controls="iti-0__country-listbox" aria-owns="iti-0__country-listbox" aria-expanded="false" tabindex="0" title="United States: +1" aria-activedescendant="iti-0__item-us-preferred">
                <div class="iti__flag iti__us"></div>
                <div class="iti__arrow"></div>
              </div>
            </div><input type="tel" class="intl-phone-MobilePhone" name="MobilePhone" title="Mobile Phone" data-intl-tel-input-id="0">
          </div>
        </label></div>
      <div class="at-row at-row-solo YesSignMeUpForUpdatesForBinder"><input id="YesSignMeUpForUpdatesForBinder_Value" type="hidden" name="YesSignMeUpForUpdatesForBinder.Value" value="true"></div>
      <div class="at-row at-row-solo at-row-full UpdateMyProfile at-mode-person-only">
        <div class="at-markup UpdateMyProfile at-mode-person-only" id="NVSignupForm883613-ContactInformation-UpdateMyProfile">
          <div class="updateMyProfileSection" style=""><label style="display:inline;"><input type="checkbox" name="updateMyProfile" checked="checked"><span><span class="text">Remember me so that I can use <i>Fast</i><b>Action</b> next
                  time.</span></span></label></div>
        </div>
      </div>
      <div class="at-row "><label class="at-text   PersonalUrl" id="NVSignupForm883613-ContactInformation-PersonalUrl"> <small>(Optional)</small><input type="text" autocomplete="on" false="" title="" name="PersonalUrl" value="" maxlength="">
        </label></div>
      <div class="at-row ">
        <div class="at-markup TrackingPixel" id="NVSignupForm883613-ContactInformation-TrackingPixel" style="display: none;"><img alt=""
            src="https://secure.ngpvan.com/v1/Track/S1Twf4tZ7EKJY0pfxDr7Qw2?formSessionId=aa40e326-749c-4f33-aa1d-433216bd5e55&amp;bName=chrome&amp;dType=desktop&amp;formVersion=7/18/2023 4:55:09 PM|8/23/2023 7:00:26 PM&amp;fUrl=aHR0cHM6Ly9zZWN1cmUubmdwdmFuLmNvbS9TMVR3ZjR0WjdFS0pZMHBmeERyN1F3Mg%3D%3D&amp;fRef="
            style="display:none"></div>
      </div>
    </div>
  </fieldset>
  <div class="at-form-submit clearfix">
    <input type="submit" value="Submit" class="at-submit btn-at btn-at-primary">
  </div>
</form>

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