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Form analysis
2 forms found in the DOM

POST mailtop.php

<form class="contact centradorework1" action="mailtop.php" method="post">
  <div class="row mt-3  ">
    <div class="col-12 col-lg-4  d-flex flex-column  mb-3 mb-lg-0 text-left">
      <label for="firstname" class="newline ">Full Name</label>
      <input type="text" name="firstname" id="firstname" placeholder="Full Name">
    </div>
    <div class="col-12 col-lg-4 d-flex flex-column mb-3 mb-lg-0 text-left">
      <label for="Telephone" class="newline">Mobile Phone Number</label>
      <input type="text" name="telephone" id="telephone" placeholder="Telephone">
    </div>
    <div class=" col-12 col-lg-4   d-flex mb-3  mt-3 mt-md-4 contactoboton2">
      <button type="submit" name="submit" class="btn btn-primary contactbottom" style="background-color: #00AAFF;">Contact Us </button>
    </div>
  </div>
</form>

POST mail.php

<form class="contact col formularioclase  mt-3" action="mail.php" method="post">
  <div class="col-12 d-flex flex-column   flex-md-row formularioclase mb-md-3 ">
    <div class="col d-flex flex-column  formularioclase mr-4  ">
      <label for="firstname" class="newline ">First Name</label>
      <input type="text" name="firstname" id="firstname1" placeholder="First Name">
    </div>
    <div class="col d-flex flex-column  formularioclase ">
      <label for="lastname" class="newline ">Last Name</label>
      <input type="text" name="lastname" id="lastname" placeholder="Last Name">
    </div>
  </div>
  <div class="col-12 d-flex flex-column flex-md-row formularioclase ">
    <div class="col d-flex flex-column  formularioclase mr-4">
      <label for="mail" class="newline ">Email</label>
      <input type="text" name="mail" id="mail" placeholder="Email">
    </div>
    <div class="col d-flex flex-column  formularioclase mb-md-3   ">
      <label for="Telephone" class="newline">Mobile Phone Number</label>
      <input type="text" name="telephone" id="telephone1" placeholder="Phone Number">
    </div>
  </div>
  <div class=" col-12 d-flex justify-content-center arreglobotondeabajo mb-5 mt-3 formularioclase">
    <button type="submit" name="submit" class="btn btn-primary contactbottom" style="background-color: #00AAFF;">Get in Touch </button>
  </div>
</form>

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ABOUT US



Insurance Consultants International is a Florida Blue agency that started in
2011 with just 3 agents. At the very start of the agency, we only sold Florida
Blue Individual products but through time, we began to realize that we wanted to
expand that and create opportunities to reach more people.

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