tickets.netdynamix.co.za Open in urlscan Pro
95.216.32.179  Public Scan

Form analysis
1 forms found in the DOM

POST

<form role="form" method="post" id="reused_form">
  <div class="form-group">
    <label for="name"> Name:</label>
    <input type="text" class="form-control" id="name" name="name" required="" maxlength="50">
  </div>
  <div class="form-group">
    <label for="station"> Radio Station Name:</label>
    <input type="text" class="form-control" id="station" name="station" required="" maxlength="50">
  </div>
  <div class="form-group">
    <label for="email"> Email:</label>
    <input type="email" class="form-control" id="email" name="email" required="" maxlength="50">
  </div>
  <div class="form-group">
    <label for="name"> Message:</label>
    <textarea class="form-control" type="textarea" name="message" id="message" placeholder="Your Message Here" maxlength="6000" rows="7"></textarea>
  </div>
  <div class="row" style="margin-bottom:30px;">
    <div class="col-sm-5">
      <img src="captcha.php" id="captcha_image">
      <br>
      <a id="captcha_reload" href="#">reload</a>
    </div>
    <div class="col-sm-6">
      <label for="email">Enter the code from the image here:</label>
      <input type="text" class="form-control" required="" id="captcha" name="captcha">
    </div>
  </div>
  <button type="submit" class="btn btn-lg btn-success pull-right" id="btnContactUs">Send →</button>
</form>

Text Content

STREAMING SUPPORT CONTACT PAGE

Send your message in the form below and we will get back to you as soon as
possible.

Name:
Radio Station Name:
Email:
Message:

reload
Enter the code from the image here:
Send →


SENT YOUR MESSAGE SUCCESSFULLY!


ERROR

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