www.feedback.alsanea.com Open in urlscan Pro
198.12.245.166  Public Scan

Form analysis
1 forms found in the DOM

POST sales_compliant.php

<form class="contact100-form validate-form" method="post" action="sales_compliant.php">
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="name" placeholder="Customer Name">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-user m-b-2"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="phone" placeholder="Customer Phone">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-phone-handset"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="email" class="input100" type="text" name="email" placeholder="Customer Email">
    <span class="focus-input100"></span>
    <label class="label-input100" for="email">
      <span class="lnr lnr-envelope m-b-5"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <textarea id="message" class="input100" name="address" placeholder="Customer Address"></textarea>
    <span class="focus-input100"></span>
    <label class="label-input100 rs1" for="message">
      <span class="lnr lnr-apartment"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="co_name" placeholder="Contact Name">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-user m-b-2"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="co_position" placeholder="Contact Position">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-briefcase"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="po_no" placeholder="Customer PO #">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-book"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="invoice_no" placeholder="Invoice #">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-paperclip"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="product_code" placeholder="Product Code">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-tag"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="name" class="input100" type="text" name="description" placeholder="Product Description">
    <span class="focus-input100"></span>
    <label class="label-input100" for="name">
      <span class="lnr lnr-keyboard"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <textarea id="message" class="input100" name="details" placeholder="Feedback Details"></textarea>
    <span class="focus-input100"></span>
    <label class="label-input100 rs1" for="message">
      <span class="lnr lnr-keyboard"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <input id="email" class="input100" type="date" name="date" placeholder="Complaint Date">
    <span class="focus-input100"></span>
    <label class="label-input100" for="email">
      <span class="lnr lnr-calendar-full"></span>
    </label>
  </div>
  <div class="wrap-input100 validate-input">
    <span class="focus-input100"></span>
    <div class="g-recaptcha" data-sitekey="6Lfvf0oUAAAAAPywsouWvKnJfXZrYhQXjtB4aM6q">
      <div style="width: 304px; height: 78px;">
        <div><iframe title="reCAPTCHA"
            src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6Lfvf0oUAAAAAPywsouWvKnJfXZrYhQXjtB4aM6q&amp;co=aHR0cHM6Ly93d3cuZmVlZGJhY2suYWxzYW5lYS5jb206NDQz&amp;hl=de&amp;v=qljbK_DTcvY1PzbR7IG69z1r&amp;size=normal&amp;cb=vib1rloic0lp"
            width="304" height="78" role="presentation" name="a-z34ehobtizvm" frameborder="0" scrolling="no" sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe>
        </div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
          style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
      </div><iframe style="display: none;"></iframe>
    </div><br><br>
  </div>
  <div class="container-contact100-form-btn">
    <button class="contact100-form-btn"> Send Now </button>
  </div>
</form>

Text Content

Corporate Website


CUSTOMER FEEDBACK




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