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prod.gskm.cloud.opentext.com Open in urlscan Pro
149.235.1.111  Public Scan

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URL: https://prod.gskm.cloud.opentext.com/home/gsk/com/gsk/html/RegistrationFormGSKApproverTask.html?instanceId=005056A8-4C35-A1EC-A9A8-BB...
Submission: On March 21 via manual from US — Scanned from GB

Form analysis 1 forms found in the DOM

<form class="registration-form" onsubmit="return false;">
  <h1>Your Details</h1>
  <div class="row">
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="firstname">*First Name</label>
        <input type="text" class="form-control firstname" id="firstname" disabled="">
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="lastname">*Last Name</label>
        <input type="text" class="form-control lastname" id="lastname" disabled="">
      </div>
    </div>
  </div>
  <div class="row">
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="category">*Category</label>
        <select class="form-control category" id="category" disabled="">
          <option value="">Please Select a value</option>
          <option value="Drive Profit Brands">Drive Profit Brands</option>
          <option value="Multi Category">Multi Category</option>
          <option value="No Therapeutic Area">No Therapeutic Area</option>
          <option value="Oral Health">Oral Health</option>
          <option value="Pain Relief">Pain Relief</option>
          <option value="Respiratory Skin Health">Respiratory Skin Health</option>
          <option value="Wellness">Wellness</option>
        </select>
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="email">*Email</label>
        <input type="text" class="form-control email" id="email" disabled="">
      </div>
    </div>
  </div>
  <div class="row">
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="brand">*Brand</label>
        <select class="form-control brand" id="brand" multiple="" disabled="" style="height:306px">
          <option value="Sensodyne">Sensodyne</option>
        </select>
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="country">*Country</label>
        <select class="form-control country" id="country" disabled="">
          <option value="">Please Select a value</option>
          <option value="Albania">Albania</option>
          <option value="Algeria">Algeria</option>
          <option value="Antigua">Antigua</option>
          <option value="Argentina">Argentina</option>
          <option value="Australia">Australia</option>
          <option value="Austria">Austria</option>
          <option value="Bahamas">Bahamas</option>
          <option value="Bahrain">Bahrain</option>
          <option value="Bangladesh">Bangladesh</option>
          <option value="Barbados">Barbados</option>
          <option value="Barbuda">Barbuda</option>
          <option value="Belarus">Belarus</option>
          <option value="Belgium">Belgium</option>
          <option value="Belize">Belize</option>
          <option value="BNL and Nordics">BNL and Nordics</option>
          <option value="Bolivia">Bolivia</option>
          <option value="Bosnia">Bosnia</option>
          <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
          <option value="Brazil">Brazil</option>
          <option value="Bulgaria">Bulgaria</option>
          <option value="Cambodia">Cambodia</option>
          <option value="Canada">Canada</option>
          <option value="Caricom">Caricom</option>
          <option value="Central Eastern Europe">Central Eastern Europe</option>
          <option value="Chile">Chile</option>
          <option value="China">China</option>
          <option value="Colombia">Colombia</option>
          <option value="Costa Rica">Costa Rica</option>
          <option value="Croatia">Croatia</option>
          <option value="Cyprus">Cyprus</option>
          <option value="Czech Republic">Czech Republic</option>
          <option value="DACH">DACH</option>
          <option value="Denmark">Denmark</option>
          <option value="Dominica">Dominica</option>
          <option value="Dominican Republic">Dominican Republic</option>
          <option value="East and West Africa">East and West Africa</option>
          <option value="Ecuador">Ecuador</option>
          <option value="Egypt">Egypt</option>
          <option value="El Salvador">El Salvador</option>
          <option value="Estonia">Estonia</option>
          <option value="Eswatini">Eswatini</option>
          <option value="Ethiopia">Ethiopia</option>
          <option value="Finland">Finland</option>
          <option value="France">France</option>
          <option value="French Africa">French Africa</option>
          <option value="Georgia">Georgia</option>
          <option value="Germany">Germany</option>
          <option value="Ghana">Ghana</option>
          <option value="Global">Global</option>
          <option value="Greece">Greece</option>
          <option value="Grenada">Grenada</option>
          <option value="Guatemala">Guatemala</option>
          <option value="Gulf and North East">Gulf and North East</option>
          <option value="Guyana">Guyana</option>
          <option value="Haiti">Haiti</option>
          <option value="Honduras">Honduras</option>
          <option value="Hong Kong">Hong Kong</option>
          <option value="Hungary">Hungary</option>
          <option value="Iceland">Iceland</option>
          <option value="India">India</option>
          <option value="Indonesia">Indonesia</option>
          <option value="Ireland">Ireland</option>
          <option value="Israel">Israel</option>
          <option value="Italy">Italy</option>
          <option value="Jamaica">Jamaica</option>
          <option value="Japan">Japan</option>
          <option value="Jordan">Jordan</option>
          <option value="Kazakhstan">Kazakhstan</option>
          <option value="Kenya">Kenya</option>
          <option value="Korea">Korea</option>
          <option value="Kuwait">Kuwait</option>
          <option value="Latvia">Latvia</option>
          <option value="Lebanon">Lebanon</option>
          <option value="Lesotho">Lesotho</option>
          <option value="Libya">Libya</option>
          <option value="Lithuania">Lithuania</option>
          <option value="Luxembourg">Luxembourg</option>
          <option value="Macedonia (North)">Macedonia (North)</option>
          <option value="Madagascar">Madagascar</option>
          <option value="Malaysia">Malaysia</option>
          <option value="Malta">Malta</option>
          <option value="Mauritius">Mauritius</option>
          <option value="Mexico">Mexico</option>
          <option value="Moldova">Moldova</option>
          <option value="Montserrat">Montserrat</option>
          <option value="Morocco">Morocco</option>
          <option value="Namibia">Namibia</option>
          <option value="Netherlands">Netherlands</option>
          <option value="New Zealand">New Zealand</option>
          <option value="Nicaragua">Nicaragua</option>
          <option value="Nigeria">Nigeria</option>
          <option value="Nordic">Nordic</option>
          <option value="Norway">Norway</option>
          <option value="Oman">Oman</option>
          <option value="Pakistan">Pakistan</option>
          <option value="Panama">Panama</option>
          <option value="Paraguay">Paraguay</option>
          <option value="Peru">Peru</option>
          <option value="Philippines">Philippines</option>
          <option value="Poland">Poland</option>
          <option value="Portugal">Portugal</option>
          <option value="Puerto rico">Puerto Rico</option>
          <option value="Qatar">Qatar</option>
          <option value="Romania">Romania</option>
          <option value="Russia">Russia</option>
          <option value="Saint Kitts &amp; nevis">Saint Kitts &amp; nevis</option>
          <option value="Saint Lucia">Saint Lucia</option>
          <option value="Saint Vincent">Saint Vincent</option>
          <option value="Saudi Arabia">Saudi Arabia</option>
          <option value="Scandinavia">Scandinavia</option>
          <option value="Serbia">Serbia</option>
          <option value="Seychelles">Seychelles</option>
          <option value="Singapore">Singapore</option>
          <option value="Slovakia">Slovakia</option>
          <option value="Slovenia">Slovenia</option>
          <option value="South Africa">South Africa</option>
          <option value="South and Southern Africa">South and Southern Africa</option>
          <option value="Spain">Spain</option>
          <option value="Sri Lanka">Sri Lanka</option>
          <option value="Suriname">Suriname</option>
          <option value="Sweden">Sweden</option>
          <option value="Switzerland">Switzerland</option>
          <option value="Taiwan">Taiwan</option>
          <option value="Thailand">Thailand</option>
          <option value="Trinidad">Trinidad</option>
          <option value="Trinidad and Tobago">Trinidad and Tobago</option>
          <option value="Tunisia">Tunisia</option>
          <option value="Turkey">Turkey</option>
          <option value="Uganda">Uganda</option>
          <option value="Ukraine">Ukraine</option>
          <option value="United Arab Emirates">United Arab Emirates</option>
          <option value="United Kingdom">United Kingdom</option>
          <option value="United States">United States</option>
          <option value="Uruguay">Uruguay</option>
          <option value="Uzbekistan">Uzbekistan</option>
          <option value="Venezuela">Venezuela</option>
          <option value="Vietnam">Vietnam</option>
          <option value="Zambia">Zambia</option>
        </select>
      </div>
    </div>
    <div class="full-width half-width-sm" style="display: none;">
      <div class="form-group">
        <label for="agency">*Agency/Company</label>
        <input type="text" class="form-control agency" id="agency" disabled="">
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group" style="border-bottom:0px">
        <label class="form-control">*Access Type</label>
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group" style="border-bottom:0px">
        <input type="radio" class="form-control agencyType" id="agencyType1" name="agencyType" value="GSK Brand Manager Access (View/Download/Upload/Edit)" disabled="">
        <label for="agencyType1">GSK Brand Manager Access (View/Download/Upload/Edit)</label>
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group">
        <input type="radio" class="form-control agencyType" id="agencyType2" name="agencyType" value="Standard GSK Access (View/Download excluding Supplemental Files)" disabled="">
        <label for="agencyType2">Standard GSK Access (View/Download excluding Supplemental Files)</label>
      </div>
    </div>
    <div class="full-width half-width-sm" style="display: none;">
      <div class="form-group" style="border-bottom:0px">
        <input type="radio" class="form-control agencyType" id="agencyType3" name="agencyType" value="Agency Access (View/Download/Upload/Edit)" disabled="">
        <label for="agencyType3">Agency Access (View/Download/Upload/Edit)</label>
      </div>
    </div>
    <div class="full-width half-width-sm" style="display: none;">
      <div class="form-group">
        <input type="radio" class="form-control agencyType" id="agencyType5" name="agencyType" value="Standard Access  (View/Download excluding Supplemental Files)" disabled="">
        <label for="agencyType5">Standard Access (View/Download excluding Supplemental Files)</label>
      </div>
    </div>
    <div class="full-width half-width-sm">
      <div class="form-group">
        <label for="gskContact">*Your GSK Approver</label>
        <input type="text" class="form-control" id="gskContact" disabled="">
      </div>
    </div>
  </div>
  <div class="row">
    <div class="full-width">
      <div class="form-group textarea-wrap">
        <label for="comments"> GSK Approver Comments <img src="../images/Tooltip_icon.png" class="tooltip-icon">
          <div class="tooltip">Please enter here any reasons for rejection</div>
        </label>
        <textarea id="comments"></textarea>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="full-width text-right mt-20">
      <button type="submit" id="accept" class="btn btn-primary">APPROVED</button>
      <button type="submit" id="reject" class="btn btn-primary">REJECTED</button>
    </div>
  </div>
</form>

Text Content

USER REGISTRATION FORM


YOUR DETAILS

*First Name
*Last Name
*Category Please Select a value Drive Profit BrandsMulti CategoryNo Therapeutic
AreaOral HealthPain ReliefRespiratory Skin HealthWellness
*Email
*Brand Sensodyne
*Country Please Select a value
AlbaniaAlgeriaAntiguaArgentinaAustraliaAustriaBahamasBahrainBangladeshBarbadosBarbudaBelarusBelgiumBelizeBNL
and NordicsBoliviaBosniaBosnia and
HerzegovinaBrazilBulgariaCambodiaCanadaCaricomCentral Eastern
EuropeChileChinaColombiaCosta RicaCroatiaCyprusCzech
RepublicDACHDenmarkDominicaDominican RepublicEast and West AfricaEcuadorEgyptEl
SalvadorEstoniaEswatiniEthiopiaFinlandFranceFrench
AfricaGeorgiaGermanyGhanaGlobalGreeceGrenadaGuatemalaGulf and North
EastGuyanaHaitiHondurasHong
KongHungaryIcelandIndiaIndonesiaIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKoreaKuwaitLatviaLebanonLesothoLibyaLithuaniaLuxembourgMacedonia
(North)MadagascarMalaysiaMaltaMauritiusMexicoMoldovaMontserratMoroccoNamibiaNetherlandsNew
ZealandNicaraguaNigeriaNordicNorwayOmanPakistanPanamaParaguayPeruPhilippinesPolandPortugalPuerto
RicoQatarRomaniaRussiaSaint Kitts & nevisSaint LuciaSaint VincentSaudi
ArabiaScandinaviaSerbiaSeychellesSingaporeSlovakiaSloveniaSouth AfricaSouth and
Southern AfricaSpainSri
LankaSurinameSwedenSwitzerlandTaiwanThailandTrinidadTrinidad and
TobagoTunisiaTurkeyUgandaUkraineUnited Arab EmiratesUnited KingdomUnited
StatesUruguayUzbekistanVenezuelaVietnamZambia
*Agency/Company
*Access Type
GSK Brand Manager Access (View/Download/Upload/Edit)
Standard GSK Access (View/Download excluding Supplemental Files)
Agency Access (View/Download/Upload/Edit)
Standard Access (View/Download excluding Supplemental Files)
*Your GSK Approver
GSK Approver Comments
Please enter here any reasons for rejection
APPROVED REJECTED



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