login.athastechnology.com Open in urlscan Pro
144.76.3.17  Public Scan

Form analysis
1 forms found in the DOM

POST https://login.athastechnology.com/forms/ticket?styled=1&with_logo=1

<form action="https://login.athastechnology.com/forms/ticket?styled=1&amp;with_logo=1" id="ticketForm" class="disable-on-submit" method="post" accept-charset="utf-8" novalidate="novalidate">
  <input type="hidden" name="csrf_token_name" value="17359f355725cf86ce93acb599375d72">
  <div class="form-group" app-field-wrapper="subject"><label for="subject" class="control-label">Subject</label><input type="text" id="subject" name="subject" class="form-control" required="true" value=""></div>
  <div class="row">
    <div class="col-md-6">
      <div class="form-group" app-field-wrapper="name"><label for="name" class="control-label">Your name</label><input type="text" id="name" name="name" class="form-control" required="true" value=""></div>
    </div>
    <div class="col-md-6">
      <div class="form-group" app-field-wrapper="email"><label for="email" class="control-label">Email Address</label><input type="email" id="email" name="email" class="form-control" required="true" value=""></div>
    </div>
  </div>
  <div class="">
    <div class="select-placeholder form-group" app-field-wrapper="department"><label for="department" class="control-label">Department</label>
      <div class="dropdown bootstrap-select bs3" style="width: 100%;"><select id="department" name="department" class="selectpicker" required="true" data-width="100%" data-none-selected-text="None selected" data-live-search="true" tabindex="-98">
          <option value=""></option>
          <option value="1">Support</option>
          <option value="2">Hr-Admin</option>
          <option value="3">Sales</option>
          <option value="5">Purchase</option>
        </select><button type="button" class="btn dropdown-toggle btn-default bs-placeholder" data-toggle="dropdown" role="combobox" aria-owns="bs-select-1" aria-haspopup="listbox" aria-expanded="false" data-id="department" title="None selected">
          <div class="filter-option">
            <div class="filter-option-inner">
              <div class="filter-option-inner-inner">None selected</div>
            </div>
          </div><span class="bs-caret"><span class="caret"></span></span>
        </button>
        <div class="dropdown-menu open">
          <div class="bs-searchbox"><input type="search" class="form-control" autocomplete="off" role="combobox" aria-label="Search" aria-controls="bs-select-1" aria-autocomplete="list"></div>
          <div class="inner open" role="listbox" id="bs-select-1" tabindex="-1">
            <ul class="dropdown-menu inner " role="presentation"></ul>
          </div>
        </div>
      </div>
    </div>
  </div>
  <div class="select-placeholder form-group" app-field-wrapper="priority"><label for="priority" class="control-label">Priority</label>
    <div class="dropdown bootstrap-select bs3" style="width: 100%;"><select id="priority" name="priority" class="selectpicker" required="true" data-width="100%" data-none-selected-text="None selected" data-live-search="true" tabindex="-98">
        <option value=""></option>
        <option value="1">Low</option>
        <option value="2" selected="">Medium</option>
        <option value="3">High</option>
      </select><button type="button" class="btn dropdown-toggle btn-default" data-toggle="dropdown" role="combobox" aria-owns="bs-select-2" aria-haspopup="listbox" aria-expanded="false" data-id="priority" title="Medium">
        <div class="filter-option">
          <div class="filter-option-inner">
            <div class="filter-option-inner-inner">Medium</div>
          </div>
        </div><span class="bs-caret"><span class="caret"></span></span>
      </button>
      <div class="dropdown-menu open">
        <div class="bs-searchbox"><input type="search" class="form-control" autocomplete="off" role="combobox" aria-label="Search" aria-controls="bs-select-2" aria-autocomplete="list"></div>
        <div class="inner open" role="listbox" id="bs-select-2" tabindex="-1">
          <ul class="dropdown-menu inner " role="presentation"></ul>
        </div>
      </div>
    </div>
  </div>
  <div class="form-group" app-field-wrapper="message"><label for="message" class="control-label">Message</label><textarea id="message" name="message" class="form-control" required="true" rows="8"></textarea></div>
  <div class="attachments">
    <div class="row attachment form-group">
      <div class="col-md-6 col-md-offset-3">
        <label for="attachment" class="control-label">Attachments</label>
        <div class="input-group">
          <input type="file" extension="jpg,png,pdf,doc,zip,rar" filesize="134217728" class="form-control" name="attachments[]"
            accept=".jpg,.png,.pdf,.doc,.zip,.rar,image/jpeg,image/png,application/pdf,application/msword,application/x-zip,application/x-rar">
          <span class="input-group-btn">
            <button class="btn btn-primary add_more_attachments" data-max="4" type="button"><i class="fa fa-plus"></i></button>
          </span>
        </div>
      </div>
    </div>
  </div>
  <div class="clearfix"></div>
  <div class="text-center submit-btn-wrapper">
    <button class="btn btn-success" id="form_submit" type="submit">
      <i class="fa fa-spinner fa-spin hide" style="margin-right: 5px;">
                            </i>Submit </button>
  </div>
</form>

Text Content

Subject
Your name
Email Address
Department
SupportHr-AdminSalesPurchase
None selected

Priority
LowMediumHigh
Medium

Message
Attachments


Submit