services.everestfuneral.com
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Submitted URL: https://www.everestfuneral.com/voya
Effective URL: https://services.everestfuneral.com/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4...
Submission Tags: falconsandbox
Submission: On March 14 via api from US — Scanned from DE
Effective URL: https://services.everestfuneral.com/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4...
Submission Tags: falconsandbox
Submission: On March 14 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST ./Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044
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<!--
*********************************************************************
* Copyright 2010, Everest Funeral Package, LLC. All rights reserved
*
* An unpublished work created in 2010. This work is a trade secret
* and unauthorized use or copying is prohibited.
*********************************************************************
-->
<script type="text/javascript">
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$('#GoMobileDialog').dialog('open');
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<div class="container-fluid">
<div class="container">
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<div class="text-start">
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</a>
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</li>
<li>
<a id="PageHeader_Language_Switch_USES" customparameter="switch-language-es" href="javascript:__doPostBack('ctl00$PageHeader$Language_Switch_USES','')">Español</a>
</li>
</ul>
</div>
</div>
<div class="d-inline-block position-relative me-4 btn-menu-services">
<a class="open-popmenu" href="#">
<img class="img-top-link" src="/wwwroot/uploads/icon-top-link.png">
</a>
<div class="popmenu services">
<div class="arrow"></div>
<ul>
<li>
<a href="/Common/EverestHome?lang=en-US" target="_blank">Everest Funeral Concierge</a>
</li>
<li>
<a customparameter="everest_tools" href="javascript:__doPostBack('ctl00$PageHeader$ctl00','')">All Everest Tools</a>
</li>
<li id="PageHeader_lnkTenzing">
<a customparameter="tenzing" href="javascript:__doPostBack('ctl00$PageHeader$ctl04','')">Tenzing
<sup>TM</sup>
</a>
</li>
<li id="PageHeader_lnkEpoq">
<a customparameter="willprep" href="javascript:__doPostBack('ctl00$PageHeader$ctl05','')">Will Prep</a>
</li>
<li>
<a customparameter="planning_tools" href="javascript:__doPostBack('ctl00$PageHeader$ctl01','')">Planning Tools</a>
</li>
<li>
<a customparameter="pricefinder" href="javascript:__doPostBack('ctl00$PageHeader$ctl02','')"> PriceFinder
<sup>SM</sup>
</a>
</li>
<li>
<a customparameter="resource" href="javascript:__doPostBack('ctl00$PageHeader$ctl03','')">Resources</a>
</li>
</ul>
</div>
</div>
</div>
</div>
</header>
<div id="PageHeader_OldHeaderDiv">
<div class="header">
<div class="headerLanguages">
<div class="headerLanguagesTable">
<div class="headerLanguagesRow">
<div class="headerLanguagesCell"><input type="image" name="ctl00$PageHeader$imgUSEN" id="PageHeader_imgUSEN" src="../../common/images/usa.gif" alt="United States Flag"
onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$PageHeader$imgUSEN", "", false, "", "/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=en-US", false, false))">
</div>
<div class="headerLanguagesCell headerLanguagesLink">
<a id="PageHeader_lnkUSEN" class="on" href="/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=en-US">U.S. English</a></div>
<div class="headerLanguagesCell"><input type="image" name="ctl00$PageHeader$imgUSES" id="PageHeader_imgUSES" src="../../common/images/usa.gif" alt="United States Flag"
onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$PageHeader$imgUSES", "", false, "", "/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=es-US", false, false))">
</div>
<div class="headerLanguagesCell headerLanguagesLink"><a id="PageHeader_lnkUSES" href="/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=es-US">U.S. Español</a></div>
<div class="headerLanguagesCell"><input type="image" name="ctl00$PageHeader$imgCAEN" id="PageHeader_imgCAEN" src="../../common/images/canada.gif" alt="Canadian Flag"
onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$PageHeader$imgCAEN", "", false, "", "/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=en-CA", false, false))">
</div>
<div class="headerLanguagesCell headerLanguagesLink"><a id="PageHeader_lnkCAEN" href="/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=en-CA">Canada English</a></div>
<div class="headerLanguagesCell"><input type="image" name="ctl00$PageHeader$imgCAFR" id="PageHeader_imgCAFR" src="../../common/images/canada.gif" alt="Canadian Flag"
onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$PageHeader$imgCAFR", "", false, "", "/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=fr-CA", false, false))">
</div>
<div class="headerLanguagesCell headerLanguagesLink"><a id="PageHeader_lnkCAFR" href="/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&lang=fr-CA">Canada Français</a></div>
</div>
</div>
<div class="clearDiv"></div>
</div>
<div class="oldHeaderUserName">
</div>
<div class="headerTable headerLink">
<div class="headerLeftTable">
<div class="headerRow">
<div class="headerCell headerProfile">
</div>
</div>
</div>
<div class="headerRightTable">
<div class="headerRow">
<div class="headerCell headerFAQs">
<a id="PageHeader_lnkFAQs" href="https://everestfuneral.com/faq/">FAQs</a>
</div>
<div class="headerCell headerContactUs">
<a id="PageHeader_lnkContactUs" href="https://everestfuneral.com/faq/">Contact & Inquiries</a>
</div>
<div class="headerCell headerPhone">
<div class="headerPhoneTable">
<div class="headerPhoneRow">
<div class="headerPhoneCell">
<div class="phoneTable">
<div class="phoneRow">
<div class="phoneCell phoneImage"><img src="/common/images/phone.gif" alt="Phone"></div>
<div class="phoneCell">1-800-913-8318</div>
</div>
</div>
</div>
<div class="headerPhoneCell" style="border-left: 1px solid #E5B561;">
<div class="phoneTable">
<div class="phoneRow">
<div class="phoneCell phoneOutsideUSCA">Outside U.S. and Canada</div>
</div>
<div class="phoneRow">
<div class="phoneCell">011-1-905-754-1922</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="headerCell headerLogon">
<a id="PageHeader_LoginStatus2" href="javascript:__doPostBack('ctl00$PageHeader$LoginStatus2$ctl02','')">Log On</a>
</div>
</div>
</div>
<div class="clearDiv"></div>
</div>
<div class="headerLogoEverestContainer" style="display: none;">
<img src="/common/images/everestLogo.png" alt="Everest" style="float: left; margin-left: 50%;">
</div>
<div><img src="/common/images/goldBar.jpg" alt="gold rule" class="goldBar" style="display: none; height: 7px; width: 100%;"></div>
<div class="tabNav">
<ul>
<li id="PageHeader_lnkLIHome"><a id="PageHeader_lnkHome" href="https://everestfuneral.com/">Home</a></li>
<li id="PageHeader_lnkLICompanyOverview"><a id="PageHeader_lnkCompanyOverview" href="https://everestfuneral.com/about/">About Everest</a></li>
<li id="PageHeader_lnkLIServices"><a id="PageHeader_lnkServices" href="https://everestfuneral.com/services/">Services</a></li>
<li id="PageHeader_lnkLIPriceFinder"><a id="PageHeader_lnkPriceFinder" href="https://services.everestfuneral.com/PriceFinderFuneralPlanning/PriceFinderSearch.aspx?lang=en-US">PriceFinder<span class="serviceMark">SM</span></a></li>
<li id="PageHeader_lnkLIPlanningTools"><a id="PageHeader_lnkPlanningTools" href="https://services.everestfuneral.com/PriceFinderFuneralPlanning/MyPlanningTools.aspx?lang=en-US">Planning Tools</a></li>
<li id="PageHeader_lnkLIClientStories"><a id="PageHeader_lnkClientStories" href="https://everestfuneral.com/testimonials/">Client Stories</a></li>
<li id="PageHeader_lnkLIDigitalIdentityArchive"></li>
</ul>
</div>
</div>
</div>
<div id="PageHeader_HeaderDiv" style="display: none;">
<!-- Added by El Paso Team 4/2/2014 Loading gif image to style transitions -->
<div id="loading" style="display: none;">
<img id="loading-image" src="/common/images/loading_image.gif" alt="Loading...">
</div>
<div>
<div class="headerMenu">
<div class="hambMenu" onclick="mainMenu();"></div>
<div id="mainMenuClick" class="menuOptions" style="display: none;">
<div class="closeMenuOptions" onclick="mainMenu();"><img src="/common/images/closeMenu.png"></div>
<ul class="listOptions">
<li>
<a id="MyInformationLink" href="/PriceFinderFuneralPlanning/Tenzing/MyInformation.aspx">
My Information
</a>
</li>
<li>
<a id="MyProfileLink" href="/PriceFinderFuneralPlanning/users/MyProfile.aspx?z=1">
My Profile
</a>
</li>
<li>
<a id="LearnMoreLink" href="#" onclick="OpenDialog('LearnMoreLink3Dialog'); mainMenu(); return true;">
FAQs
</a>
</li>
<li>
<a id="EverestLink" href="/PriceFinderFuneralPlanning/MyPlanningTools.aspx">
Everest
</a>
</li>
</ul>
</div>
</div>
<img id="PageHeader_HeaderLogoImage" title="Everest" class="headerLogo" src="../../common/images/everestLogo.png" alt="Everest">
<div id="myInfoText" class="myInfoPhone" style="display: none;">My Information</div>
<div class="headerLink loginStatus">
<a id="PageHeader_LoginStatus1" href="javascript:__doPostBack('ctl00$PageHeader$LoginStatus1$ctl02','')">Log On</a>
</div>
<div class="clearDiv"></div>
</div>
<div id="textMobile" style="display:none!important"> Securely Manage Your Information </div>
<div><img src="/common/images/goldBar.jpg" width="100%" height="7" alt="gold rule" class="goldBar"></div>
<div id="textTablet" class="secureHeader" style="display:none!important"> Securely Manage Your Information </div>
<span id="headerUserNameBootstrap" class="headerUserName">
</span>
</div>
<div id="GoMobileDialog" title="Go Mobile with Tenzing" style="display: none; overflow: hidden;">
<div class="DialogContent Dialog450">
<div style="color: #333333; font-size: 1.5em; padding: 10px 10px 0 10px;"> Step 1. Go to this URL on your Mobile Device: </div>
<div style="font-size: 1.2em; padding: 10px 10px 0 20px;">
<a href="/GoMobile/" style="overflow-wrap: break-word; width:85%">everestfuneral.com/GoMobile</a>
</div>
<div style="color: #333333; font-size: 1.5em; padding: 30px 10px 0 10px;"> Step 2. Bookmark Tenzing </div>
<div style="padding: 5px 10px 0 10px;"> The first time you access Tenzing with your mobile device, you will be guided to create a bookmark icon so you can just click and come back! </div>
<div style="padding: 30px 10px 0 10px;">
<img src="/common/images/security_big.png" alt="Security Tip">
</div>
<div style="color: #333333; font-size: 1.5em; padding: 5px 10px 0 10px;"> Security Tip </div>
<div style="padding: 5px 10px 0 10px;"> Always log in to keep your information secure. <u>Never</u> allow your device to save your ID and password. </div>
</div>
<div class="DialogButtons">
<input type="submit" name="ctl00$PageHeader$CloseMobileDialogButton" value="Close" onclick="javascript:return CloseGoMobileDialog(this);" id="PageHeader_CloseMobileDialogButton" class="TenzingSmallCancelButton"
style="width: 100px;background-color: #005CB9; color:white">
</div>
</div>
<!-- PAGE HEADER ENDS -->
<!-- MAIN PAGE TABLE BEGIN -->
<div id="wrap-body">
<div id="container" class="shadow-2-strong">
<a name="PageTop"></a>
<input type="hidden" name="ctl00$MyInformationHidden" id="MyInformationHidden" value="My Information">
<input type="hidden" name="ctl00$MyProfileHidden" id="MyProfileHidden" value="My Profile">
<!-- PAGE CONTENT BEGINS -->
<script type="text/javascript">
//<![CDATA[
Sys.WebForms.PageRequestManager._initialize('ctl00$ContentPlaceHolder1$LoginScriptManager', 'theForm', [], [], [], 90, 'ctl00');
//]]>
</script>
<!--
***************************************************************************************
Added by El Paso Team 1/22/2014
Bookmark add to home Libraries import
***************************************************************************************
-->
<script type="text/javascript">
$(function() {
OnWindowResize();
$(window).resize(OnWindowResize);
if (checkDevice()) {
$('#PageHeader_LoginStatus1').css('color', 'transparent');
$('#ContentPlaceHolder1_Login1_UserName').attr('placeholder', 'Email Address');
$('#ContentPlaceHolder1_Login1_Password').attr('placeholder', 'Password');
$('#ContentPlaceHolder1_TenzingLogin_UserName').attr('placeholder', 'Email Address');
$('#ContentPlaceHolder1_TenzingLogin_Password').attr('placeholder', 'Password');
}
});
var OnWindowResize = function() {
if ($(window).width() > 1152) {
$('#ContentPlaceHolder1_TenzingLogin_UserName').attr('placeholder', '');
$('#ContentPlaceHolder1_TenzingLogin_Password').attr('placeholder', '');
} else {
$('#ContentPlaceHolder1_TenzingLogin_UserName').attr('placeholder', 'Email Address');
$('#ContentPlaceHolder1_TenzingLogin_Password').attr('placeholder', 'Password');
}
return false;
}
function checkDevice() {
var isAndroid = navigator.userAgent.toLowerCase().indexOf("android");
var isiPhone = navigator.userAgent.toLowerCase().indexOf("iphone");
var isiPad = navigator.userAgent.toLowerCase().indexOf("ipad");
var isiPod = navigator.userAgent.toLowerCase().indexOf("ipod");
var isWindows = ((navigator.platform.toLowerCase().indexOf("win") !== -1) && (navigator.userAgent.toLowerCase().indexOf("touch") !== -1));
if (isAndroid > -1 || isiPhone > -1 || isiPad > -1 || isiPod > -1) {
return true;
}
if (isWindows) {
$('.TenzingFAQsBlue').css('font-size', '14px');
return true;
}
return false;
}
</script>
<!--
*********************************************************************
* Copyright 2010, Everest Funeral Package, LLC. All rights reserved
*
* An unpublished work created in 2006. This work is a trade secret
* and unauthorized use or copying is prohibited.
*********************************************************************
-->
<img src="/common/images/TenzingServices.png" id="img3" style="display:none; width:inherit; margin-bottom:10px;">
<div id="ContentPlaceHolder1_LoginDiv" class="data100">
<table id="logInDesktop" class="displayNonePhone displayNoneTablet" border="0" cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td>
<!--<h1>Log on</h1>-->
<div id="ContentPlaceHolder1_HeaderPanel">
<div class="container-fluid">
<div class="row">
<div class="col-9 px-0 py-0 pt-4">
<b><i>Welcome to Everest Funeral Planning and Concierge Service offered through Voya<span class="serviceMark">TM</span> Employee Benefits.</i></b><br><br>
<p>As an Insured through a ReliaStar Life Insurance Company, you and your covered family members are entitled to all of the Funeral Planning Tools and Concierge Services offered by Everest.</p>
<p>To begin, Please create your personal user account. If you have questions or need immediate assistance, please call an Everest Advisor toll-free 1-800-913-8318.</p>
</div>
<div class="col-3"><img id="ContentPlaceHolder1_imgLogoImage" src="../../common/images/Voya.png"></div>
</div>
</div>
<div style="float: left; width: 700px;">
<table class="tableNothing">
<tbody>
<tr>
<td> </td>
</tr>
<tr>
<td></td>
</tr>
<tr>
<td> </td>
</tr>
<tr>
<td> </td>
</tr>
</tbody>
</table>
</div>
<div style="float: right; width: 280px;">
<table class="tableNothing">
<tbody>
<tr>
<td></td>
</tr>
</tbody>
</table>
</div>
</div>
</td>
</tr>
</tbody>
</table>
<!-- Munda cor meum ac labia mea, omnipotens Deus, qui labia Isaiae Prophetae calculo mundasti ignito: ita me tua grata miseratione dignare mundare, ut sanctum Evangelium tuum digne valeam nuntiare. Per Christum Dominum nostrum. -->
<!-- Cleanse my heart and my lips, O Almighty God, Who cleansed the lips of the Prophet Isaias with a burning coal. In Thy gracious mercy deign so to purify me that I may worthily proclaim Thy holy Gospel. Through Christ our Lord. -->
<table border="0" cellpadding="0" cellspacing="0" width="100%"> <!-- Table contains both existing and new user login boxes -->
<tbody>
<tr>
<td valign="top" width="45%" height="230px" align="left" id="ExistingUserTable">
<div id="ExistingUserTableInfo" class="displayNonePhone displayNoneTablet">
<h6>Existing User</h6><br> If you are an existing Everest client and have a User Account,<br>
<strong>Log On</strong> now.<br> <br>
<span class="labelmed">Required fields are marked with an asterisk</span> (<span class="required">*</span>).
</div>
<table id="ContentPlaceHolder1_Login1" cellspacing="0" cellpadding="0" style="border-collapse:collapse;">
<tbody>
<tr>
<td>
<div id="ContentPlaceHolder1_Login1_panelLogin" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ContentPlaceHolder1_Login1_LoginButton')">
<table border="0" cellpadding="0" cellspacing="0" width="100%" class="tableNothing">
<tbody>
<tr>
<td align="left"><span class="fpt_error">
</span></td>
</tr>
<tr>
<td align="left">
<div id="ContentPlaceHolder1_Login1_ValidationSummary1" class="message" style="color:#B90000;display:none;">
</div>
</td>
</tr>
</tbody>
</table>
<table id="grayBackground" border="0" cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td class="hiddenLabels displayNonePhone displayNoneTablet" width="35%" align="right"><label for="ContentPlaceHolder1_Login1_UserName" id="ContentPlaceHolder1_Login1_UserNameLabel">Email Address:</label></td>
<td width="5%" class="required">*</td>
<td class="inputEmailMobile" width="60%" align="left"><input name="ctl00$ContentPlaceHolder1$Login1$UserName" type="text" maxlength="256" id="ContentPlaceHolder1_Login1_UserName" class="form-control">
<div class="required_Image displayBlockPhone displayNoneTablet" style="margin: -49px 10px 0px 10px; display:none; position: absolute;"><img src="/common/images/TenzingRequired.png" alt="Required" title="Required">
</div>
<div class="required_Image_tablet displayNonePhone displayBlockTablet" style="margin: -45px 10px 0px -5px; display:none; position: absolute;"><img src="/common/images/TenzingRequired.png" alt="Required"
title="Required"></div>
<span id="ContentPlaceHolder1_Login1_UserNameRequired" title="Email Address is required." style="color:#B90000;display:none;">*</span>
<span id="ContentPlaceHolder1_Login1_EmailValidator" title="Please enter a valid Email Address (e.g., name@domain.com)" style="color:#B90000;display:none;">*</span>
</td>
</tr>
<tr>
<td class="tdspace2" colspan="3"></td>
</tr>
<tr>
<td class="hiddenLabels displayNonePhone displayNoneTablet" align="right"><label for="ContentPlaceHolder1_Login1_Password" id="ContentPlaceHolder1_Login1_PasswordLabel">Password:</label></td>
<td class="required">*</td>
<td class="inputEmailMobile" align="left"><input name="ctl00$ContentPlaceHolder1$Login1$Password" type="password" maxlength="128" id="ContentPlaceHolder1_Login1_Password" class="form-control">
<div class="required_Image displayBlockPhone" style="margin: -49px 10px 0px 10px; display:none; position: absolute;"><img src="/common/images/TenzingRequired.png" alt="Required" title="Required"></div>
<div class="required_Image_tablet displayNonePhone displayBlockTablet" style="margin: -45px 10px 0px -5px; display:none; position: absolute;"><img src="/common/images/TenzingRequired.png" alt="Required"
title="Required"></div>
<span id="ContentPlaceHolder1_Login1_PasswordRequired" title="Password is required." style="color:#B90000;display:none;">*</span>
</td>
</tr>
<tr>
<td id="spacerColumn" class="displayNonePhone displayNoneTablet" colspan="2"> </td>
<td align="left" style="position:absolute">
<a id="ContentPlaceHolder1_Login1_ForgotPasswordLink" class="link" href="https://services.everestfuneral.com/PriceFinderFuneralPlanning/account/PasswordRecovery.aspx?lang=en-US">Forgot password?</a>
</td>
<td id="spacerTablet" class="displayNonePhone" style="display:none" colspan="2"> </td>
</tr>
<tr>
<td colspan="2"></td>
<td><input type="submit" name="ctl00$ContentPlaceHolder1$Login1$LoginButton" value="Log On"
onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ContentPlaceHolder1$Login1$LoginButton", "", true, "Login1", "", false, false))"
id="ContentPlaceHolder1_Login1_LoginButton" class="btn ActionButton btn-primary btn-lg"></td>
</tr>
</tbody>
</table>
<div id="noUserText" class="displayBlockPhone" style="display:none">Not yet a user?
<a id="ContentPlaceHolder1_Login1_CreateProfile1Link" href="/pricefinderfuneralplanning/account/Login.aspx?partner=Voya&partnerID=7a4c8f4d-a51c-4c60-8869-ee4c75a3e044&nr=1">Create your profile here</a>
</div>
<div id="securityTextTablet" class="displayBlockPhone" style="display:none"><img src="/common/images/security_big.png"><a> Security</a></div>
</div>
</td>
</tr>
</tbody>
</table>
</td>
<td width="10%" id="spaceTable"></td>
<td valign="top" width="45%" align="left" id="NewUserTable" class="displayNonePhone displayNoneTablet">
<h6>New User</h6><br> If this is your first time using Everest's online planning tools, create an account now.<br> <br>
<span class="labelmed">Required fields are marked with an asterisk</span> (<span class="required">*</span>). <div id="ContentPlaceHolder1_pnlNewUser"
onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ContentPlaceHolder1_EnrollButton')" style="margin-right:15px;">
<table border="0" cellpadding="0" cellspacing="0" width="100%" class="tableNothing">
<tbody>
<tr>
<td align="left"><span class="fpt_error"></span></td>
</tr>
<tr>
<td align="left">
<div id="ContentPlaceHolder1_vsEmailEnrollment" class="message" style="color:#B90000;display:none;">
</div>
</td>
</tr>
</tbody>
</table>
<table border="0" cellpadding="0" cellspacing="0" width="100%">
<tbody>
<tr>
<td width="30%" align="right"><label for="ContentPlaceHolder1_txtEmailAddress" id="ContentPlaceHolder1_lblEmailAddress">Email Address:</label></td>
<td width="5%" class="required">*</td>
<td width="65%" align="left"><input name="ctl00$ContentPlaceHolder1$txtEmailAddress" type="text" maxlength="256" id="ContentPlaceHolder1_txtEmailAddress" class="form-control"><label for="ContentPlaceHolder1_txtEmailAddress"
id="ContentPlaceHolder1_lblAtEdsDotCom" class="fmlabelbluebold"></label>
<span id="ContentPlaceHolder1_EmailAddressRequired" title="Email Address is required." style="color:#B90000;display:none;">*</span>
<span id="ContentPlaceHolder1_EmailAddressValidator" title="Please enter a valid Email Address (e.g., name@domain.com)" style="color:#B90000;display:none;">*</span>
</td>
</tr>
<tr>
<td colspan="3"></td>
</tr>
<tr id="ContentPlaceHolder1_rowEmployerName">
<td align="right"><span id="ContentPlaceHolder1_lblEmployerName">Employer Name:</span></td>
<td class="required">*</td>
<td align="left"><input name="ctl00$ContentPlaceHolder1$txtEmployerName" type="text" maxlength="50" id="ContentPlaceHolder1_txtEmployerName" class="form-control" style="width:250px;">
<span id="ContentPlaceHolder1_EmployerNameReqVal" title="Employer Name is required." style="color:#B90000;display:none;">*</span>
<span id="ContentPlaceHolder1_EmployerNameRegExVal" title="Employer Name has invalid characters." style="display:none;">
<img src="/common/images/error.gif" alt="error" width="17" height="17">
</span>
</td>
</tr>
<tr>
<td colspan="2"></td>
<td><input type="submit" name="ctl00$ContentPlaceHolder1$EnrollButton" value="Log On"
onclick="return ReCaptchaExecuteValid();WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ContentPlaceHolder1$EnrollButton", "", true, "EmailEnrollment", "", false, false))"
id="ContentPlaceHolder1_EnrollButton" class="btn ActionButton btn-primary btn-lg"></td>
</tr>
<tr>
<td colspan="3">
<div id="ContentPlaceHolder1_ReCaptchaDiv" class="RecaptchaBox">
<span id="ContentPlaceHolder1_ReCaptchaControl">
<script src="https://www.google.com/recaptcha/api.js?hl=en" async="" defer=""></script>
<script type="text/javascript">
function ReCaptchaExecute() {
grecaptcha.execute();
return false;
}
</script>
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