yotsuba-milkchristmas-cpiga843g.shuttlerock-form.com Open in urlscan Pro
63.32.161.232  Public Scan

URL: https://yotsuba-milkchristmas-cpiga843g.shuttlerock-form.com/
Submission: On January 15 via api from US — Scanned from US

Form analysis 1 forms found in the DOM

POST /confirm

<form id="form" class="h-adr" novalidate="novalidate" action="/confirm" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="oaZ3Oa34mtLcuviengx56r8Lwd3EjzPNBXn6bi4uz_AJJ1bORPS90t7pyO4c-8sXjLXX0VY7TBBzPyVnVFq-8w"
    autocomplete="off">
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_da0ab93c-fe65-4e62-aada-b6d5526e950c">お名前</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="da0ab93c-fe65-4e62-aada-b6d5526e950c" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_da0ab93c-fe65-4e62-aada-b6d5526e950c" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_443eb6d5-4266-4d1d-b2c6-734096b1d3df">郵便番号</span><span class="text-danger">*</span><br><small>(ハイフンなしでご記入ください)</small></div>
    <div class="col-sm-9 position-relative"><input value="443eb6d5-4266-4d1d-b2c6-734096b1d3df" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_443eb6d5-4266-4d1d-b2c6-734096b1d3df" class="form-control" placeholder="" required="required" maxlength="8" size="8" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_86de2630-87d1-4634-b6c6-529a3ddfed65">都道府県</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="86de2630-87d1-4634-b6c6-529a3ddfed65" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_86de2630-87d1-4634-b6c6-529a3ddfed65" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_42f133bd-f7d3-4de4-90e2-19b797ab3d71">市区町村</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="42f133bd-f7d3-4de4-90e2-19b797ab3d71" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_42f133bd-f7d3-4de4-90e2-19b797ab3d71" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_d9588254-60c0-4bb6-adf4-e585e19439f8">番地</span><span class="text-danger">*</span></div>
    <div class="col-sm-9 position-relative"><input value="d9588254-60c0-4bb6-adf4-e585e19439f8" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_d9588254-60c0-4bb6-adf4-e585e19439f8" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_0472107d-43f9-4646-b227-6071381bca8d">建物名・部屋番号</span></div>
    <div class="col-sm-9 position-relative"><input value="0472107d-43f9-4646-b227-6071381bca8d" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
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  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_50ffc198-a66f-415f-a248-bf5e153d5071">お電話番号</span><span class="text-danger">*</span><br><small>(ハイフンなしでご記入ください)</small></div>
    <div class="col-sm-9 position-relative"><input value="50ffc198-a66f-415f-a248-bf5e153d5071" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_50ffc198-a66f-415f-a248-bf5e153d5071" class="form-control" placeholder="" required="required" maxlength="11" size="11" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="row py-3 border-bottom">
    <div class="col-sm-3 text-start"><span class="fw-bold" id="label_field_ffe0b817-326a-4203-bc41-144b970cd595">Xユーザー名</span><span class="text-danger">*</span><br><small>(@は含まずご記入ください)</small></div>
    <div class="col-sm-9 position-relative"><input value="ffe0b817-326a-4203-bc41-144b970cd595" autocomplete="off" type="hidden" name="response[responses_fields_attributes[][field_id]]" id="response_responses_fields_attributes[][field_id]"><input
        id="field_ffe0b817-326a-4203-bc41-144b970cd595" class="form-control" placeholder="" required="required" maxlength="1024" size="1024" type="text" name="response[responses_fields_attributes[][value]]"></div>
  </div>
  <div class="terms ql-editor card mt-4 p-3 overflow-auto">
    <p>【プレゼント内容】</p>
    <p>よつ葉製品セット</p>
    <p>・よつ葉パンにおいしいはちみつ&amp;バター</p>
    <p>・よつ葉パンにおいしい発酵バター</p>
    <p>・よつ葉北海道十勝 大人のカマンベール&amp;ブルー</p>
    <p>・よつ葉北海道十勝 クリームチーズ&amp;いちご</p>
    <p>・よつ葉のバターミルクパンケーキミックス</p>
  </div>
  <div class="my-5 form-check d-flex justify-content-center">
    <div class="terms-checkbox"><label class="form-check"><input name="response[confirmation_term]" type="hidden" value="0" autocomplete="off"><input class="form-check-input" type="checkbox" value="1" name="response[confirmation_term]"
          id="response_confirmation_term">同意する</label>
      <div class="invalid-tooltip"></div>
    </div>
  </div>
  <div class="text-center"><input type="submit" name="commit" value="確認する" class="btn btn-dark px-5 py-3 rounded-pill" data-disable-with="確認する"></div>
</form>

Text Content

平素より、よつ葉乳業製品をご愛顧いただきまして誠にありがとうございます。

さて、先日ご参加くださいました「よつ葉のクリスマス2023 #ミルクでクリスマス プレゼントキャンペーン」について

厳正なる抽選を行った結果、「よつ葉製品セット」が当選されましたのでお知らせいたします。

つきましては、お届け先【お名前、ご住所、ユーザー名、郵便番号、電話番号】をお知らせくださいますようお願い申し上げます。

お名前*

郵便番号*
(ハイフンなしでご記入ください)

都道府県*

市区町村*

番地*

建物名・部屋番号

お電話番号*
(ハイフンなしでご記入ください)

Xユーザー名*
(@は含まずご記入ください)


【プレゼント内容】

よつ葉製品セット

・よつ葉パンにおいしいはちみつ&バター

・よつ葉パンにおいしい発酵バター

・よつ葉北海道十勝 大人のカマンベール&ブルー

・よつ葉北海道十勝 クリームチーズ&いちご

・よつ葉のバターミルクパンケーキミックス

同意する