signup.suburbanacademy.ng Open in urlscan Pro
41.73.0.43  Public Scan

Form analysis
1 forms found in the DOM

POST success.html

<form action="success.html" method="POST">
  <div class="form-row">
    <div class="form-group">
      <label for="firstName">First Name (required)</label>
      <input type="text" id="firstName" name="firstName" required="">
    </div>
    <div class="form-group">
      <label for="lastName">Last Name (required)</label>
      <input type="text" id="lastName" name="lastName" required="">
    </div>
  </div>
  <div class="form-row">
    <div class="form-group">
      <label for="dob">Date of Birth (required)</label>
      <input type="date" id="dob" name="dob" required="">
    </div>
    <div class="form-group">
      <label for="email">Email Address (required)</label>
      <input type="email" id="email" name="email" required="">
    </div>
  </div>
  <div class="form-row">
    <div class="form-group">
      <label for="phone">Phone Number (required)</label>
      <input type="tel" id="phone" name="phone" required="">
    </div>
    <div class="form-group">
      <label for="state">State of Residence (required)</label>
      <input type="text" id="state" name="state" required="">
    </div>
  </div>
  <div class="form-group">
    <label for="educationStatus">Education Status (required)</label>
    <select id="educationStatus" name="educationStatus" required="">
      <option value="in-school">In school</option>
      <option value="out-of-school">Out of school</option>
      <option value="university-graduate">University graduate</option>
    </select>
  </div>
  <div class="form-group">
    <label for="institutionName">Institution Name (optional)</label>
    <input type="text" id="institutionName" name="institutionName">
  </div>
  <div class="form-group">
    <label for="courses">Course(s) of Interest</label>
    <div class="checkbox-group">
      <input type="checkbox" id="uiux" name="courses" value="UI/UX">
      <label for="uiux">UI/UX</label>
      <input type="checkbox" id="cloudComputing" name="courses" value="Cloud Computing">
      <label for="cloudComputing">Cloud Computing</label>
      <input type="checkbox" id="webDevelopment" name="courses" value="Web Development">
      <label for="webDevelopment">Web Development</label>
      <input type="checkbox" id="softwareEngineering" name="courses" value="Software Engineering">
      <label for="softwareEngineering">Software Engineering</label>
    </div>
  </div>
  <div class="form-group">
    <label for="referralSource">How did you hear about Suburban Academy? (required)</label>
    <select id="referralSource" name="referralSource" required="">
      <option value="LinkedIn">LinkedIn</option>
      <option value="Instagram">Instagram</option>
      <option value="Facebook">Facebook</option>
      <option value="Twitter">Twitter</option>
      <option value="Email">Email</option>
      <option value="Website">Website</option>
      <option value="Friend/Family">Friend/Family</option>
      <option value="Event">Event</option>
    </select>
  </div>
  <button type="submit">Sign Up</button>
</form>

Text Content

Registration


JOIN SUBURBAN ACADEMY

Empowering Your Future

First Name (required)
Last Name (required)
Date of Birth (required)
Email Address (required)
Phone Number (required)
State of Residence (required)
Education Status (required) In school Out of school University graduate
Institution Name (optional)
Course(s) of Interest
UI/UX Cloud Computing Web Development Software Engineering
How did you hear about Suburban Academy? (required) LinkedIn Instagram Facebook
Twitter Email Website Friend/Family Event
Sign Up