conblackndeckerpuoivinceresamsung.mediamilano.it Open in urlscan Pro
212.35.195.219 Public Scan

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URL:
https://conblackndeckerpuoivinceresamsung.mediamilano.it/
Submission: On July 15 via api (July 15th 2024, 6:35:08 am UTC) from US — Scanned from IT

Form analysis
1 forms found in the DOM

POST https://contestdewalt.mpromo.it/includes/user_insert_html.php

<form class="row g-3 needs-validation" method="post" action="https://contestdewalt.mpromo.it/includes/user_insert_html.php" id="form-wrap" novalidate="">
  <p>Partecipa al concorso compilando il form, i campi contrassegnati da asterisco sono obbligatori.</p>
  <!-- customer_id -->
  <fieldset class="row align-items-center">
    <label class="form-label" for="customer_id">User ID from your system (should not be shown on the form page)</label>
    <input placeholder="ID cliente" readonly="" type="text" class="form-control" id="customer_id" name="customer_id" value="123456abcdefg" required="">
  </fieldset>
  <!-- first row starts -->
  <fieldset class="row align-items-center">
    <!-- name -->
    <div class="col-md-4 form-group">
      <label class="form-label" for="first_name">Nome // Name*</label>
      <input placeholder="Nome" type="text" class="form-control" id="first_name" name="first_name" required="">
      <script>
        setInputFilter(document.getElementById("first_name"), function(value) {
          return /^[-A-Za-zòàèéùìæøås\s]*$/.test(value);
        }, "Solo lettere");
      </script>
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un nome valido </div>
    </div>
    <!-- surname -->
    <div class="col-md-4 form-group">
      <label for="last_name">Cognome // Surname*</label>
      <input placeholder="Cognome" type="text" class="form-control" id="last_name" name="last_name" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un cognome valido </div>
      <script>
        setInputFilter(document.getElementById("last_name"), function(value) {
          return /^[-A-Za-zòàèéùìæøås\s]+)*$/.test(value);
        }, "Solo lettere");
      </script>
    </div>
    <!-- birthday -->
    <div class="col-md-4 form-group" id="birth-wrap">
      <label class="form-label" for="birth-wrap-selector">Data di nascita // Date of birth*</label>
      <div id="birth-wrap-selector" style="display:flex">
        <select name="birth_day" class="form-select form-select-md" aria-label=".form-select-sm example">
          <option value="ND">Giorno // Day</option>
          <option value="ND" 01="">01</option>
          <option value="ND" 02="">02</option>
          <option value="ND" 03="">03</option>
          <option value="ND" 04="">04</option>
          <option value="ND" 05="">05</option>
          <option value="ND" 06="">06</option>
          <option value="ND" 07="">07</option>
          <option value="ND" 08="">08</option>
          <option value="ND" 09="">09</option>
          <option 10="" value="ND">10</option>
          <option 11="" value="ND">11</option>
          <option 12="" value="ND">12</option>
          <option 13="" value="ND">13</option>
          <option 14="" value="ND">14</option>
          <option 15="" value="ND">15</option>
          <option 16="" value="ND">16</option>
          <option 17="" value="ND">17</option>
          <option 18="" value="ND">18</option>
          <option 19="" value="ND">19</option>
          <option 20="" value="ND">20</option>
          <option 21="" value="ND">21</option>
          <option 22="" value="ND">22</option>
          <option 23="" value="ND">23</option>
          <option 24="" value="ND">24</option>
          <option 25="" value="ND">25</option>
          <option 26="" value="ND">26</option>
          <option 27="" value="ND">27</option>
          <option 28="" value="ND">28</option>
          <option 29="" value="ND">29</option>
          <option 30="" value="ND">30</option>
          <option 31="" value="ND">31</option>
        </select>
        <p>/</p>
        <select name="birth_month" class="form-select form-select-md" aria-label=".form-select-sm example">
          <option value="ND">Mese // Month</option>
          <option value="ND" 01="">01</option>
          <option value="ND" 02="">02</option>
          <option value="ND" 03="">03</option>
          <option value="ND" 04="">04</option>
          <option value="ND" 05="">05</option>
          <option value="ND" 06="">06</option>
          <option value="ND" 07="">07</option>
          <option value="ND" 08="">08</option>
          <option value="ND" 09="">09</option>
          <option 10="" value="ND">10</option>
          <option 11="" value="ND">11</option>
          <option 12="" value="ND">12</option>
        </select>
        <p>/</p>
        <select name="birth_year" class="form-select form-select-md" aria-label=".form-select-sm example">
          <option value="ND">Anno // Year</option>
          <option>2006</option>
          <option>2005</option>
          <option>2004</option>
          <option>2003</option>
          <option>2002</option>
          <option>2001</option>
          <option>2000</option>
          <option>1999</option>
          <option>1998</option>
          <option>1997</option>
          <option>1996</option>
          <option>1995</option>
          <option>1994</option>
          <option>1993</option>
          <option>1992</option>
          <option>1991</option>
          <option>1990</option>
          <option>1989</option>
          <option>1988</option>
          <option>1987</option>
          <option>1986</option>
          <option>1985</option>
          <option>1984</option>
          <option>1983</option>
          <option>1982</option>
          <option>1981</option>
          <option>1980</option>
          <option>1979</option>
          <option>1978</option>
          <option>1977</option>
          <option>1976</option>
          <option>1975</option>
          <option>1974</option>
          <option>1973</option>
          <option>1972</option>
          <option>1971</option>
          <option>1970</option>
          <option>1969</option>
          <option>1968</option>
          <option>1967</option>
          <option>1966</option>
          <option>1965</option>
          <option>1964</option>
          <option>1963</option>
          <option>1962</option>
          <option>1961</option>
          <option>1960</option>
          <option>1959</option>
          <option>1958</option>
          <option>1957</option>
          <option>1956</option>
          <option>1955</option>
          <option>1954</option>
          <option>1953</option>
          <option>1952</option>
          <option>1951</option>
          <option>1950</option>
          <option>1949</option>
          <option>1948</option>
          <option>1947</option>
          <option>1946</option>
          <option>1945</option>
          <option>1944</option>
          <option>1943</option>
          <option>1942</option>
          <option>1941</option>
          <option>1940</option>
          <option>1939</option>
          <option>1938</option>
          <option>1937</option>
          <option>1936</option>
          <option>1935</option>
          <option>1934</option>
          <option>1933</option>
          <option>1932</option>
          <option>1931</option>
          <option>1930</option>
          <option>1929</option>
          <option>1928</option>
          <option>1927</option>
          <option>1926</option>
          <option>1925</option>
          <option>1924</option>
          <option>1923</option>
          <option>1922</option>
          <option>1921</option>
          <option>1920</option>
        </select>
      </div>
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci una data valida </div>
    </div>
  </fieldset>
  <!-- first row ends, second row starts -->
  <fieldset class="row align-items-center">
    <!-- street -->
    <div class="col-md-4 form-group">
      <label class="form-label" for="address">Via // Address*</label>
      <input placeholder="Indirizzo" type="text" class="form-control" id="address" name="address" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un indirizzo valido </div>
      <script>
        setInputFilter(document.getElementById("address"), function(value) {
          return /^[-A-Za-zòàèéùìæøås\d\s]*$/.test(value);
        }, "Solo lettere e numeri");
      </script>
    </div>
    <!-- house number -->
    <div class="col-md-2 form-group">
      <label class="form-label" for="house_nr">Nr civico // House number*</label>
      <input placeholder="Civico" maxlength="6" type="text" class="form-control" id="house_nr" name="house_nr" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un numero civico valido </div>
      <script>
        setInputFilter(document.getElementById("house_nr"), function(value) {
          return /^[\w*\/]*$/g.test(value);
        }, 'Solo numeri, lettere e slash ("/")');
      </script>
    </div>
    <!-- postal code -->
    <div class="col-md-2 form-group">
      <label class="form-label" for="cap">Cap // Postal code*</label>
      <input placeholder="CAP" minlength="5" maxlength="5" type="text" class="form-control" id="cap" name="cap" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un CAP valido </div>
      <script>
        setInputFilter(document.getElementById("cap"), function(value) {
          return /^\d*$/g.test(value);
        }, "Solo numeri");
      </script>
    </div>
    <!-- town -->
    <div class="col-md-2 form-group">
      <label class="form-label" for="city">Città // City*</label>
      <input placeholder="Città" type="text" class="form-control" id="city" name="city" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un comune valido </div>
      <script>
        setInputFilter(document.getElementById("city"), function(value) {
          return /^[-A-Za-zòàèéùìæøås\s]*$/.test(value);
        }, "Solo lettere");
      </script>
    </div>
    <!-- county -->
    <div class="col-md-2 form-group">
      <label class="form-label" for="county">Provincia // County*</label>
      <select id="county" name="county" class="form-select form-select-md" aria-label=".form-select-sm example" required="">
        <option value="N/D">Seleziona una provincia</option>
        <option value="AG">Agrigento</option>
        <option value="AL">Alessandria</option>
        <option value="AN">Ancona</option>
        <option value="AO">Aosta</option>
        <option value="AR">Arezzo</option>
        <option value="AP">Ascoli Piceno</option>
        <option value="AT">Asti</option>
        <option value="AV">Avellino</option>
        <option value="BA">Bari</option>
        <option value="BT">Barletta-Andria-Trani</option>
        <option value="BL">Belluno</option>
        <option value="BN">Benevento</option>
        <option value="BG">Bergamo</option>
        <option value="BI">Biella</option>
        <option value="BO">Bologna</option>
        <option value="BZ">Bolzano</option>
        <option value="BS">Brescia</option>
        <option value="BR">Brindisi</option>
        <option value="CA">Cagliari</option>
        <option value="CL">Caltanissetta</option>
        <option value="CB">Campobasso</option>
        <option value="CE">Caserta</option>
        <option value="CT">Catania</option>
        <option value="CZ">Catanzaro</option>
        <option value="CH">Chieti</option>
        <option value="CO">Como</option>
        <option value="CS">Cosenza</option>
        <option value="CR">Cremona</option>
        <option value="KR">Crotone</option>
        <option value="CN">Cuneo</option>
        <option value="EN">Enna</option>
        <option value="FM">Fermo</option>
        <option value="FE">Ferrara</option>
        <option value="FI">Firenze</option>
        <option value="FG">Foggia</option>
        <option value="FC">Forlì-Cesena</option>
        <option value="FR">Frosinone</option>
        <option value="GE">Genova</option>
        <option value="GO">Gorizia</option>
        <option value="GR">Grosseto</option>
        <option value="IM">Imperia</option>
        <option value="IS">Isernia</option>
        <option value="SP">La Spezia</option>
        <option value="AQ">L'Aquila</option>
        <option value="LT">Latina</option>
        <option value="LE">Lecce</option>
        <option value="LC">Lecco</option>
        <option value="LI">Livorno</option>
        <option value="LO">Lodi</option>
        <option value="LU">Lucca</option>
        <option value="MC">Macerata</option>
        <option value="MN">Mantova</option>
        <option value="MS">Massa-Carrara</option>
        <option value="MT">Matera</option>
        <option value="ME">Messina</option>
        <option value="MI">Milano</option>
        <option value="MO">Modena</option>
        <option value="MB">Monza e Brianza</option>
        <option value="NA">Napoli</option>
        <option value="NO">Novara</option>
        <option value="NU">Nuoro</option>
        <option value="OR">Oristano</option>
        <option value="PD">Padova</option>
        <option value="PA">Palermo</option>
        <option value="PR">Parma</option>
        <option value="PV">Pavia</option>
        <option value="PG">Perugia</option>
        <option value="PU">Pesaro e Urbino</option>
        <option value="PE">Pescara</option>
        <option value="PC">Piacenza</option>
        <option value="PI">Pisa</option>
        <option value="PT">Pistoia</option>
        <option value="PN">Pordenone</option>
        <option value="PZ">Potenza</option>
        <option value="PO">Prato</option>
        <option value="RG">Ragusa</option>
        <option value="RA">Ravenna</option>
        <option value="RC">Reggio Calabria</option>
        <option value="RE">Reggio Emilia</option>
        <option value="RI">Rieti</option>
        <option value="RN">Rimini</option>
        <option value="RM">Roma</option>
        <option value="RO">Rovigo</option>
        <option value="SA">Salerno</option>
        <option value="SS">Sassari</option>
        <option value="SV">Savona</option>
        <option value="SI">Siena</option>
        <option value="SR">Siracusa</option>
        <option value="SO">Sondrio</option>
        <option value="SU">Sud Sardegna</option>
        <option value="TA">Taranto</option>
        <option value="TE">Teramo</option>
        <option value="TR">Terni</option>
        <option value="TO">Torino</option>
        <option value="TP">Trapani</option>
        <option value="TN">Trento</option>
        <option value="TV">Treviso</option>
        <option value="TS">Trieste</option>
        <option value="UD">Udine</option>
        <option value="VA">Varese</option>
        <option value="VE">Venezia</option>
        <option value="VB">Verbano-Cusio-Ossola</option>
        <option value="VC">Vercelli</option>
        <option value="VR">Verona</option>
        <option value="VV">Vibo Valentia</option>
        <option value="VI">Vicenza</option>
        <option value="VT">Viterbo</option>
      </select>
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci una provincia valida </div>
    </div>
    <!-- third row ends -->
  </fieldset>
  <!-- second row ends, third row starts -->
  <fieldset class="row align-items-center">
    <!-- phone number -->
    <div class="col-md-4 form-group">
      <label class="form-label" for="phone">Numero di telefono // Phone number*</label>
      <input placeholder="Telefono" minlength="5" maxlength="13" type="tel" class="form-control" id="phone" name="phone" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un numero di telefono valido </div>
      <script>
        setInputFilter(document.getElementById("phone"), function(value) {
          return /^\d*$/.test(value);
        }, "Solo cifre");
      </script>
    </div>
    <!-- email address -->
    <div class="col-md-4 form-group">
      <label class="form-label" for="email1">E-mail // E-mail address*</label>
      <input placeholder="E-mail" type="email" class="form-control" id="email1" name="email1" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un indirizzo email valido </div>
      <script>
        setInputFilter(document.getElementById("email1"), function(value) {
          return /^(?:[a-zA-Z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-zA-Z0-9!#$%&'*+\/=?^_`{|}~-]+)*|"(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21\x23-\x5b\x5d-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])*")@(?:(?:[a-zA-Z0-9](?:[a-zA-Z0-9-]*[a-zA-Z0-9])?\.)+[a-zA-Z0-9](?:[a-zA-Z0-9-]*[a-zA-Z0-9])?|\[(?:(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9]))\.){3}(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9])|[a-zA-Z0-9-]*[a-zA-Z0-9]:(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21-\x5a\x53-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])+)\])$/
          g.test(value);
        }, "Carattere non consentito");
      </script>
    </div>
    <!-- confirm your email address -->
    <div class="col-md-4 form-group">
      <label class="form-label" for="email">Conferma e-mail // E-mail addres confirmation*</label>
      <input placeholder="Conferma la tua e-mail" type="email" class="form-control" id="email" name="email" required="">
      <div class="valid-feedback">
      </div>
      <div class="invalid-feedback">Inserisci un indirizzo email valido </div>
      <script>
        setInputFilter(document.getElementById("email"), function(value) {
          return /^(?:[a-zA-Z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-zA-Z0-9!#$%&'*+\/=?^_`{|}~-]+)*|"(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21\x23-\x5b\x5d-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])*")@(?:(?:[a-zA-Z0-9](?:[a-zA-Z0-9-]*[a-zA-Z0-9])?\.)+[a-zA-Z0-9](?:[a-zA-Z0-9-]*[a-zA-Z0-9])?|\[(?:(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9]))\.){3}(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9])|[a-zA-Z0-9-]*[a-zA-Z0-9]:(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21-\x5a\x53-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])+)\])$/
          g.test(value);
        }, "Carattere non consentito");
      </script>
    </div>
  </fieldset>
  <!-- third row ends, fourth row starts.. -->
  <fieldset class="row row-wrap justify-content-start">
    <!-- fifth row starts -->
    <div class="row align-items-end text-start purchased-wrap-sub">
      <!-- purchased product -->
      <div class="col-md-4 form-group" id="purchased-input-wrap">
        <label class="form-label" for="purchased-input">Digita il codice del purchased DEWALT acquistato. Se non lo trovi, digita 'Altro' // Purchased product*</label>
        <input name="item" placeholder="Prodotto acquistato" class="form-control purchased" id="purchased-input" type="text">
        <ol style="position:absolute" id="rendered-list"></ol>
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Inserisci un prodotto valido </div>
      </div>
      <!-- vendor -->
      <div class="col-md-4 form-group">
        <label class="form-label" for="vendor">Nome del rivenditore dove hai effettuato l'acquisto // Vendor Name*</label>
        <input placeholder="Rivenditore" maxlength="40" type="text" class="form-control purchased" id="vendor" name="vendor">
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Inserisci un punto vendita valido </div>
        <script>
          setInputFilter(document.getElementById("vendor"), function(value) {
            return /^\w*\s?\w*\s?\w*\s?\w*$/g.test(value);
          }, "Solo lettere e numeri");
        </script>
      </div>
      <!-- ticket number -->
      <div class="col-md-4 form-group">
        <label class="form-label" for="receipt_nr-input">Numero dello scontrino // Ticket number*</label>
        <input maxlength="30" placeholder="Numero scontrino" type="text" class="purchased form-control" id="receipt_nr-input" name="receipt_nr">
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Inserisci un numero di scontrino valido </div>
        <script>
          setInputFilter(document.getElementById("receipt_nr-input"), function(value) {
            return /^\w*$/.test(value);
          }, "Solo lettere e numeri");
        </script>
      </div>
    </div>
    <!-- fifth row ends, sixth row starts -->
    <div class="row align-items-end justify-content-center purchased-wrap-sub">
      <!-- amount of the purchase -->
      <div class="col-md-4 form-group row justify-content-center">
        <label class="form-label" for="amount">Importo totale in € della spesa // Amount of the purchase*</label>
        <div id="amount-wrap" class="w-50 d-flex align-items-end">
          <input required="" placeholder="Importo" type="text" class="purchased form-control" id="amount-input" name="amount_euro">
          <p>,</p>
          <select class="purchased w-75 form-select form-select-md" name="amount_cent">
            <option>00</option>
            <option value="ND">01</option>
            <option value="ND" 01="">01</option>
            <option value="ND" 02="">02</option>
            <option value="ND" 03="">03</option>
            <option value="ND" 04="">04</option>
            <option value="ND" 05="">05</option>
            <option value="ND" 06="">06</option>
            <option value="ND" 07="">07</option>
            <option value="ND" 08="">08</option>
            <option value="ND" 09="">09</option>
            <option 10="" value="ND">10</option>
            <option 11="" value="ND">11</option>
            <option 12="" value="ND">12</option>
            <option 13="" value="ND">13</option>
            <option 14="" value="ND">14</option>
            <option 15="" value="ND">15</option>
            <option 16="" value="ND">16</option>
            <option 17="" value="ND">17</option>
            <option 18="" value="ND">18</option>
            <option 19="" value="ND">19</option>
            <option 20="" value="ND">20</option>
            <option 21="" value="ND">21</option>
            <option 22="" value="ND">22</option>
            <option 23="" value="ND">23</option>
            <option 24="" value="ND">24</option>
            <option 25="" value="ND">25</option>
            <option 26="" value="ND">26</option>
            <option 27="" value="ND">27</option>
            <option 28="" value="ND">28</option>
            <option 29="" value="ND">29</option>
            <option 30="" value="ND">30</option>
            <option 31="" value="ND">31</option>
            <option 32="" value="ND">32</option>
            <option 33="" value="ND">33</option>
            <option 34="" value="ND">34</option>
            <option 35="" value="ND">35</option>
            <option 36="" value="ND">36</option>
            <option 37="" value="ND">37</option>
            <option 38="" value="ND">38</option>
            <option 39="" value="ND">39</option>
            <option 40="" value="ND">40</option>
            <option 41="" value="ND">41</option>
            <option 42="" value="ND">42</option>
            <option 43="" value="ND">43</option>
            <option 44="" value="ND">44</option>
            <option 45="" value="ND">45</option>
            <option 46="" value="ND">46</option>
            <option 47="" value="ND">47</option>
            <option 48="" value="ND">48</option>
            <option 49="" value="ND">49</option>
            <option 50="" value="ND">50</option>
            <option 51="" value="ND">51</option>
            <option 52="" value="ND">52</option>
            <option 53="" value="ND">53</option>
            <option 54="" value="ND">54</option>
            <option 55="" value="ND">55</option>
            <option 56="" value="ND">56</option>
            <option 57="" value="ND">57</option>
            <option 58="" value="ND">58</option>
            <option 59="" value="ND">59</option>
            <option 60="" value="ND">60</option>
            <option 61="" value="ND">61</option>
            <option 62="" value="ND">62</option>
            <option 63="" value="ND">63</option>
            <option 64="" value="ND">64</option>
            <option 65="" value="ND">65</option>
            <option 66="" value="ND">66</option>
            <option 67="" value="ND">67</option>
            <option 68="" value="ND">68</option>
            <option 69="" value="ND">69</option>
            <option 70="" value="ND">70</option>
            <option 71="" value="ND">71</option>
            <option 72="" value="ND">72</option>
            <option 73="" value="ND">73</option>
            <option 74="" value="ND">74</option>
            <option 75="" value="ND">75</option>
            <option 76="" value="ND">76</option>
            <option 77="" value="ND">77</option>
            <option 78="" value="ND">78</option>
            <option 79="" value="ND">79</option>
            <option 80="" value="ND">80</option>
            <option 81="" value="ND">81</option>
            <option 82="" value="ND">82</option>
            <option 83="" value="ND">83</option>
            <option 84="" value="ND">84</option>
            <option 85="" value="ND">85</option>
            <option 86="" value="ND">86</option>
            <option 87="" value="ND">87</option>
            <option 88="" value="ND">88</option>
            <option 89="" value="ND">89</option>
            <option 90="" value="ND">90</option>
            <option 91="" value="ND">91</option>
            <option 92="" value="ND">92</option>
            <option 93="" value="ND">93</option>
            <option 94="" value="ND">94</option>
            <option 95="" value="ND">95</option>
            <option 96="" value="ND">96</option>
            <option 97="" value="ND">97</option>
            <option 98="" value="ND">98</option>
            <option 99="" value="ND">99</option>
          </select>
        </div>
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Inserisci un importo valido </div>
        <script>
          setInputFilter(document.getElementById("amount-input"), function(value) {
            return /^\d*$/.test(value);
          }, "Solo cifre");
        </script>
      </div>
      <!-- purchase dd/mm/yyyy -->
      <div class="col-md-4 form-group" id="purchase-date">
        <label class="form-label" for="purchase-date">Data di acquisto // Date of purchase*</label>
        <div class="form-inline" style="display:flex">
          <select name="purchase_day" class="purchased form-select form-select-md" aria-label=".form-select form-select-md">
            <option value="ND">Giorno // Day</option>
            <option value="ND" 01="">01</option>
            <option value="ND" 02="">02</option>
            <option value="ND" 03="">03</option>
            <option value="ND" 04="">04</option>
            <option value="ND" 05="">05</option>
            <option value="ND" 06="">06</option>
            <option value="ND" 07="">07</option>
            <option value="ND" 08="">08</option>
            <option value="ND" 09="">09</option>
            <option 10="" value="ND">10</option>
            <option 11="" value="ND">11</option>
            <option 12="" value="ND">12</option>
            <option 13="" value="ND">13</option>
            <option 14="" value="ND">14</option>
            <option 15="" value="ND">15</option>
            <option 16="" value="ND">16</option>
            <option 17="" value="ND">17</option>
            <option 18="" value="ND">18</option>
            <option 19="" value="ND">19</option>
            <option 20="" value="ND">20</option>
            <option 21="" value="ND">21</option>
            <option 22="" value="ND">22</option>
            <option 23="" value="ND">23</option>
            <option 24="" value="ND">24</option>
            <option 25="" value="ND">25</option>
            <option 26="" value="ND">26</option>
            <option 27="" value="ND">27</option>
            <option 28="" value="ND">28</option>
            <option 29="" value="ND">29</option>
            <option 30="" value="ND">30</option>
            <option 31="" value="ND">31</option>
          </select>
          <select name="purchase_month" class="purchased form-select form-select-md" aria-label=".form-select form-select-md">
            <option value="ND">Mese // Month</option>
            <option>04</option>
            <option>05</option>
          </select>
          <select name="purchase_month" class="purchased form-select form-select-md" aria-label=".form-select form-select-md">
            <option value="ND">Anno // Year</option>
            <option>2024</option>
          </select>
          <div class="valid-feedback">
          </div>
          <div class="invalid-feedback">Inserisci una data valida </div>
        </div>
      </div>
      <!-- purchase hh:mm -->
      <div class="col-md-4 form-group justify-content-center" id="purchase-hm">
        <label style="text-align: left" class="form-label" for="purchase-hm">Ora di acquisto // Hour and minutes*</label>
        <div class="d-flex justify-content-end">
          <select name="purchase_hour" class="purchased form-select form-select-md w-25" aria-label=".form-select-sm">
            <option value="ND">Ora // Hour</option>
            <option value="ND" 01="">01</option>
            <option value="ND" 02="">02</option>
            <option value="ND" 03="">03</option>
            <option value="ND" 04="">04</option>
            <option value="ND" 05="">05</option>
            <option value="ND" 06="">06</option>
            <option value="ND" 07="">07</option>
            <option value="ND" 08="">08</option>
            <option value="ND" 09="">09</option>
            <option 10="" value="ND">10</option>
            <option 11="" value="ND">11</option>
            <option 12="" value="ND">12</option>
            <option 13="" value="ND">13</option>
            <option 14="" value="ND">14</option>
            <option 15="" value="ND">15</option>
            <option 16="" value="ND">16</option>
            <option 17="" value="ND">17</option>
            <option 18="" value="ND">18</option>
            <option 19="" value="ND">19</option>
            <option 20="" value="ND">20</option>
            <option 21="" value="ND">21</option>
            <option 22="" value="ND">22</option>
            <option 23="" value="ND">23</option>
          </select>
          <p>:</p>
          <select name="purchase_minute" class="purchased form-select form-select-md w-25" aria-label=".form-select-sm">
            <option value="ND">Minuti // Minutes</option>
            <option value="ND" 01="">01</option>
            <option value="ND" 02="">02</option>
            <option value="ND" 03="">03</option>
            <option value="ND" 04="">04</option>
            <option value="ND" 05="">05</option>
            <option value="ND" 06="">06</option>
            <option value="ND" 07="">07</option>
            <option value="ND" 08="">08</option>
            <option value="ND" 09="">09</option>
            <option 10="" value="ND">10</option>
            <option 11="" value="ND">11</option>
            <option 12="" value="ND">12</option>
            <option 13="" value="ND">13</option>
            <option 14="" value="ND">14</option>
            <option 15="" value="ND">15</option>
            <option 16="" value="ND">16</option>
            <option 17="" value="ND">17</option>
            <option 18="" value="ND">18</option>
            <option 19="" value="ND">19</option>
            <option 20="" value="ND">20</option>
            <option 21="" value="ND">21</option>
            <option 22="" value="ND">22</option>
            <option 23="" value="ND">23</option>
            <option 24="" value="ND">24</option>
            <option 25="" value="ND">25</option>
            <option 26="" value="ND">26</option>
            <option 27="" value="ND">27</option>
            <option 28="" value="ND">28</option>
            <option 29="" value="ND">29</option>
            <option 30="" value="ND">30</option>
            <option 31="" value="ND">31</option>
            <option 32="" value="ND">32</option>
            <option 33="" value="ND">33</option>
            <option 34="" value="ND">34</option>
            <option 35="" value="ND">35</option>
            <option 36="" value="ND">36</option>
            <option 37="" value="ND">37</option>
            <option 38="" value="ND">38</option>
            <option 39="" value="ND">39</option>
            <option 40="" value="ND">40</option>
            <option 41="" value="ND">41</option>
            <option 42="" value="ND">42</option>
            <option 43="" value="ND">43</option>
            <option 44="" value="ND">44</option>
            <option 45="" value="ND">45</option>
            <option 46="" value="ND">46</option>
            <option 47="" value="ND">47</option>
            <option 48="" value="ND">48</option>
            <option 49="" value="ND">49</option>
            <option 50="" value="ND">50</option>
            <option 51="" value="ND">51</option>
            <option 52="" value="ND">52</option>
            <option 53="" value="ND">53</option>
            <option 54="" value="ND">54</option>
            <option 55="" value="ND">55</option>
            <option 56="" value="ND">56</option>
            <option 57="" value="ND">57</option>
            <option 58="" value="ND">58</option>
            <option 59="" value="ND">59</option>
          </select>
          <div class="valid-feedback">
          </div>
          <div class="invalid-feedback">Inserisci un nome valido </div>
        </div>
      </div>
    </div>
    <!-- upload the purchase receipt and product barcode -->
    <div class="row d-flex justify-content-between align-items-end purchased-wrap-sub">
      <!-- purchase receipt -->
      <div class="col-md-5 form-group">
        <label class="form-label" for="file">Carica la ricevuta di acquisto // Upload the purchase receipt*</label>
        <input type="file" class="purchased form-control" id="file" name="file">
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Inserisci un file valido </div>
      </div>
      <!-- product barcode -->
      <div class="col-md-6 form-group">
        <label class="form-label" for="barcode-input">In caso di scontrino senza descrizione specifica, carica la foto del codice a barre del prodotto acquistato // In case of generic description on the proof of purchase, pls upload an image of the
          product bar code*</label>
        <input type="file" class="form-control" id="barcode-input" name="barcode">
      </div>
    </div>
  </fieldset>
  <!-- fourth row ends, fifth row starts -->
  <fieldset class="row row-wrap justify-content-start">
    <!-- survey -->
    <div style="padding-bottom:4vh">
      <label class="form-label" for="survey">Come hai saputo della promozione? // How did you hear about the promo?*</label>
      <select id="survey" class="purchased form-select form-select-md w-25" name="survey">
        <option value="N/D">Scegli un'opzione // Chose an option</option>
        <option>Web</option>
        <option>Social Media</option>
        <option>Email</option>
        <option>Rivenditore // Vendor</option>
      </select>
    </div>
    <!-- eighth row ends -->
  </fieldset>
  <!-- fifth row ends, sixth row starts -->
  <fieldset class="row row-wrap justify-content-start">
    <!-- t & c -->
    <div class="flex-column">
      <div class=" form-check form-switch">
        <label class="form-label" for="tc"> Ho letto e accetto il <a target="_blank" href="https://dewaltwinyourseat.mpromo.it/assets/files/Regolamento_conc_Stanley_BD_DW_McLaren_55-24_v.3_DEF.pdf">regolamento</a> del concorso. // T&amp;C *</label>
        <input required="" class="purchased form-check-input" type="checkbox" id="tc" name="tc">
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Per partecipare al concorso devi accettarne il regolamento </div>
      </div>
      <!-- privacy -->
      <div class="form-check form-switch">
        <label class="form-label" for="privacy">Ho letto e accetto l'<a target="”_blank”" href="https://dewaltwinyourseat.mpromo.it/assets/files/Informativa_Privacy_concorso_McLaren_Win_your_seat_2024_for_web.pdf">informativa sulla privacy</a>. //
          Privacy document*</label>
        <input required="" class="form-check-input" type="checkbox" id="privacy" name="privacy">
        <div class="valid-feedback">
        </div>
        <div class="invalid-feedback">Per partecipare al concorso devi accettare l'informativa sulla privacy </div>
      </div>
      <!-- commercial e-mail -->
      <div class="col-md-4 form-group text-nowrap">
        <label class="form-label" for="mailing_list">Desidero ricevere via e-mail le promozioni esclusive, le novità e le ultime informazioni sui prodotti DEWALT // I agree to receive commercial e-mails*</label>
        <div id="mailing_list">
          <div class="form-check">
            <input required="" class="form-check-input" type="radio" name="mailing_list" id="mailing_list1" value="y">
            <label class="form-check-label" for="mailing_list1"> Acconsento // Agree </label>
          </div>
          <div class="form-check">
            <input required="" class="form-check-input" type="radio" name="mailing_list" id="mailing_list2" value="n">
            <label class="form-check-label" for="mailing_list2"> Non acconsento // Disagree </label>
          </div>
          <div class="valid-feedback">
          </div>
          <div class="invalid-feedback">Per partecipare al concorso devi scegliere un'opzione </div>
        </div>
      </div>
    </div>
  </fieldset>
  <!-- seventh row ends, eigthth row starts (submit button) -->
  <div class="row">
    <div class="col-md-4 form-group"></div>
    <input class=" col-md-4 form-group text-nowrap btn btn-primary" id="submit" type="submit" value="Partecipa // Send">
    <div class="col-md-4 form-group"></div>
  </div>
  <!-- scripts -->
  <script src=" https://cdn.jsdelivr.net/npm/bootstrap@5.0.2/dist/js/bootstrap.min.js"></script>
  <script src="https://cdn.jsdelivr.net/npm/@popperjs/core@2.9.2/dist/umd/popper.min.js"></script>
  <script integrity="sha384-d4ZMd8jj3R6L3GIdPqSjVjrGdD1RB4QwQ8WO3Ici/pJq11cMY/DUpGnmLT5ez5k1" crossorigin="anonymous"></script>
  <script src="assets/js/formValidator.js"></script>
  <script src="assets/js/selectProducts.js"></script>
</form>

Text Content

Partecipa al concorso compilando il form, i campi contrassegnati da asterisco
sono obbligatori.

User ID from your system (should not be shown on the form page)
Nome // Name*

Inserisci un nome valido
Cognome // Surname*

Inserisci un cognome valido
Data di nascita // Date of birth*
Giorno // Day01020304050607080910111213141516171819202122232425262728293031

/

Mese // Month010203040506070809101112

/

Anno // Year
200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Inserisci una data valida
Via // Address*

Inserisci un indirizzo valido
Nr civico // House number*

Inserisci un numero civico valido
Cap // Postal code*

Inserisci un CAP valido
Città // City*

Inserisci un comune valido
Provincia // County* Seleziona una provincia Agrigento Alessandria Ancona Aosta
Arezzo Ascoli Piceno Asti Avellino Bari Barletta-Andria-Trani Belluno Benevento
Bergamo Biella Bologna Bolzano Brescia Brindisi Cagliari Caltanissetta
Campobasso Caserta Catania Catanzaro Chieti Como Cosenza Cremona Crotone Cuneo
Enna Fermo Ferrara Firenze Foggia Forlì-Cesena Frosinone Genova Gorizia Grosseto
Imperia Isernia La Spezia L'Aquila Latina Lecce Lecco Livorno Lodi Lucca
Macerata Mantova Massa-Carrara Matera Messina Milano Modena Monza e Brianza
Napoli Novara Nuoro Oristano Padova Palermo Parma Pavia Perugia Pesaro e Urbino
Pescara Piacenza Pisa Pistoia Pordenone Potenza Prato Ragusa Ravenna Reggio
Calabria Reggio Emilia Rieti Rimini Roma Rovigo Salerno Sassari Savona Siena
Siracusa Sondrio Sud Sardegna Taranto Teramo Terni Torino Trapani Trento Treviso
Trieste Udine Varese Venezia Verbano-Cusio-Ossola Vercelli Verona Vibo Valentia
Vicenza Viterbo

Inserisci una provincia valida
Numero di telefono // Phone number*

Inserisci un numero di telefono valido
E-mail // E-mail address*

Inserisci un indirizzo email valido
Conferma e-mail // E-mail addres confirmation*

Inserisci un indirizzo email valido
Digita il codice del purchased DEWALT acquistato. Se non lo trovi, digita
'Altro' // Purchased product*

Inserisci un prodotto valido
Nome del rivenditore dove hai effettuato l'acquisto // Vendor Name*

Inserisci un punto vendita valido
Numero dello scontrino // Ticket number*

Inserisci un numero di scontrino valido
Importo totale in € della spesa // Amount of the purchase*

,

00
01010203040506070809101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899

Inserisci un importo valido
Data di acquisto // Date of purchase*
Giorno // Day01020304050607080910111213141516171819202122232425262728293031 Mese
// Month 04 05 Anno // Year 2024

Inserisci una data valida
Ora di acquisto // Hour and minutes*
Ora // Hour0102030405060708091011121314151617181920212223

:

Minuti //
Minutes0102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859

Inserisci un nome valido
Carica la ricevuta di acquisto // Upload the purchase receipt*

Inserisci un file valido
In caso di scontrino senza descrizione specifica, carica la foto del codice a
barre del prodotto acquistato // In case of generic description on the proof of
purchase, pls upload an image of the product bar code*
Come hai saputo della promozione? // How did you hear about the promo?* Scegli
un'opzione // Chose an option Web Social Media Email Rivenditore // Vendor
Ho letto e accetto il regolamento del concorso. // T&C *

Per partecipare al concorso devi accettarne il regolamento
Ho letto e accetto l'informativa sulla privacy. // Privacy document*

Per partecipare al concorso devi accettare l'informativa sulla privacy
Desidero ricevere via e-mail le promozioni esclusive, le novità e le ultime
informazioni sui prodotti DEWALT // I agree to receive commercial e-mails*
Acconsento // Agree
Non acconsento // Disagree

Per partecipare al concorso devi scegliere un'opzione

conblackndeckerpuoivinceresamsung.mediamilano.it Open in urlscan Pro 212.35.195.219 Public Scan

Form analysis 1 forms found in the DOM

POST https://contestdewalt.mpromo.it/includes/user_insert_html.php

Text Content

conblackndeckerpuoivinceresamsung.mediamilano.it Open in urlscan Pro
212.35.195.219 Public Scan

Form analysis
1 forms found in the DOM