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Form analysis
1 forms found in the DOM

Name: prospect_form1 — POST ajax.php?method=new_prospect

<form method="post" action="ajax.php?method=new_prospect" name="prospect_form1" accept-charset="utf-8" enctype="application/x-www-form-urlencoded;charset=utf-8" class="new-form" id="theForm" novalidate="novalidate">
  <div class="row">
    <div class="col pr-0">
      <div class="form-group">
        <input name="firstName" type="text" placeholder="First Name " value="" class="form-control form-control-xs required" data-error-message="Please enter your first name!">
      </div>
    </div>
    <div class="col">
      <div class="form-group">
        <input name="lastName" type="text" placeholder="Last Name " value="" class="form-control form-control-xs required" data-error-message="Please enter your last name!">
      </div>
    </div>
  </div>
  <div class="form-group">
    <input name="email" type="email" placeholder="Email Address" value="" pattern="" class="form-control form-control-xs required" data-error-message="Please enter a valid email id!">
  </div>
  <div class="form-group">
    <input name="phone" type="tel" placeholder="Phone Number" value="" class="form-control form-control-xs required" data-error-message="Please enter a valid contact number!" data-min-length="10" data-max-length="10"
      onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g,'');" maxlength="10" minlength="10">
  </div>
  <div class="form-group">
    <input type="text" class="form-control form-control-xs required" name="shippingAddress1" placeholder="Address" data-error-message="Please enter your address!">
  </div>
  <div class="form-group">
    <input type="text" class="form-control form-control-xs required" id="city" name="shippingCity" value="" placeholder="City" data-error-message="Please enter your city!">
  </div>
  <div class="form-group" style="display: none;">
    <select name="shippingCountry" id="shippingCountry" class="required form-control valid all-fields no-error" data-selected="US" data-error-message="Please select your country!" style="display:none;">
      <option value="US">United States</option>
    </select>
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  <div class="form-group">
    <select name="shippingState" type="text" class="form-control form-control-xs required" data-field="state" data-group="1" id="shippingState" data-default="" data-error-message="Please select your state!" readonly="readonly">
      <option value="" selected="selected">Select State</option>
      <option value="AL">Alabama</option>
      <option value="AK">Alaska</option>
      <option value="AS">American Samoa</option>
      <option value="AZ">Arizona</option>
      <option value="AR">Arkansas</option>
      <option value="AE">Armed Forces Middle East</option>
      <option value="AA">Armed Forces Americas</option>
      <option value="AP">Armed Forces Pacific</option>
      <option value="CA">California</option>
      <option value="CO">Colorado</option>
      <option value="CT">Connecticut</option>
      <option value="DE">Delaware</option>
      <option value="DC">District of Columbia</option>
      <option value="FM">Federated States of Micronesia</option>
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      <option value="HI">Hawaii</option>
      <option value="ID">Idaho</option>
      <option value="IL">Illinois</option>
      <option value="IN">Indiana</option>
      <option value="IA">Iowa</option>
      <option value="KS">Kansas</option>
      <option value="KY">Kentucky</option>
      <option value="LA">Louisiana</option>
      <option value="ME">Maine</option>
      <option value="MD">Maryland</option>
      <option value="MA">Massachusetts</option>
      <option value="MI">Michigan</option>
      <option value="MN">Minnesota</option>
      <option value="MS">Mississippi</option>
      <option value="MO">Missouri</option>
      <option value="MT">Montana</option>
      <option value="NE">Nebraska</option>
      <option value="NV">Nevada</option>
      <option value="NH">New Hampshire</option>
      <option value="NJ">New Jersey</option>
      <option value="NM">New Mexico</option>
      <option value="NY">New York</option>
      <option value="NC">North Carolina</option>
      <option value="ND">North Dakota</option>
      <option value="MP">Northern Mariana Islands</option>
      <option value="OH">Ohio</option>
      <option value="OK">Oklahoma</option>
      <option value="OR">Oregon</option>
      <option value="PA">Pennsylvania</option>
      <option value="PR">Puerto Rico</option>
      <option value="MH">Republic of Marshall Islands</option>
      <option value="RI">Rhode Island</option>
      <option value="SC">South Carolina</option>
      <option value="SD">South Dakota</option>
      <option value="TN">Tennessee</option>
      <option value="TX">Texas</option>
      <option value="UT">Utah</option>
      <option value="VT">Vermont</option>
      <option value="VI">Virgin Islands of the U.S.</option>
      <option value="VA">Virginia</option>
      <option value="WA">Washington</option>
      <option value="WV">West Virginia</option>
      <option value="WY">Wyoming</option>
    </select>
  </div>
  <div class="form-group">
    <input type="tel" class="form-control form-control-xs required" id="zip" name="shippingZip" placeholder="Zip code" maxlength="5" data-min-length="5" data-max-length="5" onkeyup="javascript: this.value = this.value.replace(/[^0-9]/g,'');"
      data-error-message="Please enter a valid Zip code!">
  </div>
  <div class="form-group"><button type="submit" id="submit-button" name="reg" class="btn btn-lg btn-success btn-block text-uppercase btnsubmit" disabled="">Continue</button></div>
  <div id="i4mqow"> </div>
  <p id="loading-indicator" style="display:none;">Processing...</p>
</form>

Text Content

SPECIAL OFFER

Today's Offer Mixed Tools
Attention, this offer expires in:
04:28


MIXED TOOLS



--------------------------------------------------------------------------------


 * - Meets or exceeds ASME specifications.
 * - Durable black chrome plating provides improved rust resistance and
   corrosion.
 * - Designed with easy to read laser-etched markings.
 * - Set includes 183 pieces.
 * - Lifetime Exchange Warranty.


FILL OUT YOUR DETAILS:

Color:

United States
Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces Middle
EastArmed Forces AmericasArmed Forces
PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States
of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana
IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRepublic of Marshall
IslandsRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin
Islands of the U.S.VirginiaWashingtonWest VirginiaWyoming

Continue


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MIXED TOOLS

Features Professional Grade Black Chrome Socket Set contains a spinner driver
handle, hex keys, wrenches, spark plug sockets, Torx bit sockets, deep sockets,
extension bars, and bit drivers Includes 72-Tooth Pear Head quick release button
and reversible mechanism 1/4", 3/8" and 1/2" ratchets Durable black chrome
plating provides improved rust resistance and corrosion Designed with easy to
read laser etched markings Meets or exceeds ASME specifications Set includes 183
pieces Lifetime Exchange Warranty This product carries a no time limit warranty
against defects in workmanship and materials. Canada agrees to have any
defective product replaced free of charge. This product is not guaranteed
against wear or breakage due to misuse and/or abuse.




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