www.roswalt.com Open in urlscan Pro
68.178.149.158  Public Scan

Form analysis
1 forms found in the DOM

Name: contact — POST

<form name="contact" method="post" action="" id="reqcall" novalidate="novalidate">
  <div class="js-form-content ui-light-background modal__content modal__content--height containerHeight container-v-modal-callback">
    <div class="js-modal-content containerHeight-form">
      <div class="modal__header group group--nav is-hidden--md-up mb-2">
        <div class="modal__header__back modal__header__back--left">
          <a class="btn btn--square btn--accent btn--xs-static btn-outline js-modal-close" aria-label="Back">
                        <svg><rect x="0.5" y="0.5" rx="1" width="1" height="1"></rect><rect x="0.5" y="0.5" rx="1" width="1" height="1"></rect></svg>

                    <span class="btn__content">
                        <svg class="icon icon-back" width="20" height="20" aria-hidden="true"><use xlink:href="assets/images/icons.svg?v=1632914791#back"></use></svg>
                    </span>
                </a>
        </div>
      </div>
      <div class="modal-form callback-modal">
        <h3 class="text-crop textColorAccent modal-form__title callback-modal__title">
          <span>Request <br>callback</span>
          <span class="decoTitle decoTitle--center decoTitle--above-text">
            <span class="decoTitle__sizer">
              <span class="decoTitle__text textcolor-text fontstyle"> a </span>
            </span>
          </span>
        </h3>
        <div class="error-message js-form-error-message is-hidden"></div>
        <div class="form-group">
          <div class="form-control form-control--input form-control--full form-control--float" data-plugin="inputState">
            <input type="text" id="contact_name" name="contact[name]" required="required" data-msg-required="please enter your name" placeholder="Your name">
            <label class="form-label required" for="contact_name">Your name</label>
          </div>
        </div>
        <div class="form-group">
          <div class="form-control form-control--input form-control--full form-control--float" data-plugin="inputState">
            <input type="email" id="email" name="email" required="required" data-msg-required="please enter your name" placeholder="Your name">
            <label class="form-label required" for="email">Your email</label>
          </div>
        </div>
        <div class="form-group">
          <div class="form-control form-control--input form-control--full form-control--float" data-plugin="inputState">
            <input type="tel" id="contact_phone" name="contact[phone]" required="required" data-msg-required="please enter your phone number" placeholder="Phone">
            <label class="form-label required" for="contact_phone">Phone</label>
          </div>
        </div>
        <div class="form-group w-7:md w-6:xl">
          <label class="form-control form-control-checkbox" for="callback-form-agreement">
            <input id="callback-form-agreement" name="agreement" type="checkbox" data-msg-required="This field is required" required="" checked="">
            <span class="form-control-checkbox__icon"></span>
            <span class="form-control-checkbox__label text--color-small"> I accept <a href="/en/legal" target="_blank">the terms</a> for processing <br>personal data </span>
          </label>
        </div>
        <div class="form-footer text-center" id="reqmsg" style="display: none;">
          <label class="form-control form-control-checkbox" for="callback-form-agreement">
            <span class="form-control-checkbox__label text--color-small" style="color: green;font-size: 15px;"> Submitted Successfully, </span>
          </label>
        </div>
        <div class="form-footer text-center">
          <button type="button" class="btn btn--primary btn--modal btn--square" aria-label="Request <br/>callback" id="reqbtn">
            <span class="btn__content">
              <svg class="icon icon-btn-arrow-right" width="22" height="22" aria-hidden="true">
                <use xlink:href="assets/images/icons.svg?v=1632914791#btn-arrow-right"></use>
              </svg>
            </span>
          </button>
        </div>
      </div>
    </div>
  </div>
</form>

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+91 75 07 07 07 07 info@roswalt.com



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  903, Naman Centre, C-31, G Block, Bandra Kurla Complex,
Bandra East, Mumbai, Maharashtra 400051



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REQUEST
CALLBACK A


Your name
Your email
Phone
I accept the terms for processing
personal data
Submitted Successfully,