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www.solutionfun.info Open in urlscan Pro
18.165.61.36  Public Scan

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URL: https://www.solutionfun.info/landingpage/4bcb0b04-d120-4eb8-bc11-70f1009a6714/HIRgjh_JWwawr6IrWSvmAJRB0BIWGG0So0m0XKPo44k
Submission: On December 23 via manual from ID — Scanned from DE

Form analysis 1 forms found in the DOM

POST /landingpages/79dd26ef-dc22-4776-8ac3-29493a051716/HIRgjh_JWwawr6IrWSvmAJRB0BIWGG0So0m0XKPo44k

<form action="/landingpages/79dd26ef-dc22-4776-8ac3-29493a051716/HIRgjh_JWwawr6IrWSvmAJRB0BIWGG0So0m0XKPo44k" data-direct-to="" id="disable_form" method="POST"
  style="width: 800px; margin-left: auto; margin-right: auto; margin-top: 10; border: solid; border-width: 0px; padding: 1%;">
  <table style="width: 100%; height: 360.734px;">
    <thead>
      <tr style="height: 24.45px;">
        <th colspan="2" style="height: 24.45px; width: 100.002%; text-align: left;"><span style="font-size: 18pt;">Donasi Sekarang:</span><span style="font-size: 28pt;"><br></span></th>
      </tr>
    </thead>
    <tbody>
      <tr style="height: 29.1167px;">
        <td style="height: 29.1167px; width: 17.0715%;">Nama</td>
        <td style="height: 29.1167px; width: 82.9307%;"><input class="form-control" name="nama" required="" style="width: 100%;" type="text"></td>
      </tr>
      <tr style="height: 29.1167px;">
        <td style="height: 29.1167px; width: 17.0715%;">NIK</td>
        <td style="height: 29.1167px; width: 82.9307%;"><input class="form-control" name="nik" required="" style="width: 100%;" type="text"></td>
      </tr>
      <tr style="height: 29.1167px;">
        <td style="height: 29.1167px; width: 17.0715%;">No. Handphone</td>
        <td style="height: 29.1167px; width: 82.9307%;"><input class="form-control" name="hp" required="" style="width: 100%;" type="text"></td>
      </tr>
      <tr style="height: 29.1167px;">
        <td style="height: 29.1167px; width: 17.0715%;">Email</td>
        <td style="height: 29.1167px; width: 82.9307%;"><input class="form-control" name="email" required="" style="width: 100%;" type="text"></td>
      </tr>
      <tr style="height: 29.1167px;">
        <td style="height: 29.1167px; width: 17.0715%;">Jumlah Donasi</td>
        <td style="height: 29.1167px; width: 82.9307%;"><select id="donasi" name="donasi">
            <option value="sepuluh">Rp10.000</option>
            <option value="duapuluh">Rp20.000</option>
            <option value="limapuluh">Rp50.000</option>
            <option value="seratus">Rp100.000</option>
          </select></td>
      </tr>
      <tr style="height: 29.1167px;">
        <td style="height: 29.1167px; width: 17.0715%;">E-Wallet</td>
        <td style="height: 29.1167px; width: 82.9307%;"><select id="wallet" name="wallet">
            <option value="link">LinkAja</option>
            <option value="opo">OVO</option>
            <option value="gope">Gopay</option>
            <option value="anda">Dana</option>
          </select></td>
      </tr>
      <tr style="height: 24.45px;">
        <th colspan="2" style="height: 24.45px; width: 100.002%; text-align: left;"><span style="color: #7e8c8d; font-size: 8pt;"><label for="cek1">*) Anda akan terhubung ke layar pembayaran</label></span></th>
      </tr>
    </tbody>
    <tfoot>
      <tr style="height: 24.45px;">
        <th colspan="2" style="height: 24.45px; width: 100.002%; text-align: center;"><input class="btn btn-primary" data-i18n="" data-i18nattr_value="Submit" style="color: white; background-color: #da336b; font-weight: bold;" type="submit"
            value="Donasi Sekarang"></th>
      </tr>
    </tfoot>
  </table>
</form>

Text Content

Ulurkan Tangan Kita untuk Anak yang Kurang Beruntung di Indonesia
Donasi terkumpul Rp60.435.134


Donasi Sekarang:
NamaNIKNo. HandphoneEmailJumlah
DonasiRp10.000Rp20.000Rp50.000Rp100.000E-WalletLinkAjaOVOGopayDana*) Anda akan
terhubung ke layar pembayaran