- ID de l'analyse :
- 7ae98dd9-84da-4e88-abaf-bfaf7a3ce754Terminée
- URL soumise :
- https://groupbenefitsplace.com/
- Fin du rapport :
Liens : 0 trouvé(s)
Liens sortants identifiés à partir de la page
Variables JavaScript : 5 trouvée(s)
Les variables JavaScript globales chargées dans l'objet fenêtre d'une page sont des variables déclarées en dehors des fonctions et accessibles depuis n'importe quel endroit du code au sein du champ d'application actuel
| Nom | Type |
|---|---|
| onbeforetoggle | object |
| documentPictureInPicture | object |
| onscrollend | object |
| $ | function |
| jQuery | function |
Messages de journal de console : 1 trouvé(s)
Messages consignés dans la console web
| Type | Catégorie | Enregistrement |
|---|---|---|
| error | network |
|
HTML
Le corps HTML de la page en données brutes
<!DOCTYPE html><html><head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<title>American Employee Services</title>
<style type="text/css">
input:required:invalid, input:focus:invalid {
background-image: url(/images/invalid.png);
background-position: right top;
background-repeat: no-repeat;
}
input:required:valid {
background-image: url(/images/valid.png);
background-position: right top;
background-repeat: no-repeat;
}
</style>
<link href="css/style-ltc.css" rel="stylesheet">
<script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.6.2/jquery.min.js"></script>
<script type="text/javascript" src="js/jquery.maskedinput-1.3.min.js"></script>
<script type="text/javascript" src="js/phonemask.js"></script>
<script type="text/javascript" charset="utf-8">
jQuery(function($) {
$.mask.definitions['~']='[+-]';
$('#date').mask('99/99/9999');
});
</script>
</head>
<body>
<div class="color-border">
</div>
<div id="maincontainer">
<div id="topsection"><img src="images/head.jpg" alt="American Employee Services" align="left" style="width:100%; max-width:750px; height:auto;"></div>
<div style="clear:both;"></div>
<div id="contentwrapper">
<div id="contentcolumn">
<div class="innertube">
<div class="wrapper">
<div id="main" style="padding:0 0 0 0;" class="clearfix">
<!-- Form -->
<form action="quote.php" method="post" enctype="application/x-www-form-urlencoded" id="contact-form">
<input type="hidden" name="s" value="AES">
<input type="hidden" name="a" value="AES">
<h2>Long Term Care Insurance - Information Request</h2>
<h4>Please complete the form below and our representative will contact you.<br> <span style="color:#F00">* indicates required fields</span> </h4>
<div class="form-row">
<div class="column-half">
<label>
<span><h5>*</h5> First Name:</span>
<input placeholder="Please enter your first name" type="text" tabindex="1" name="first_name" data-validate="required" required="" autofocus="">
</label>
</div>
<div class="column-half">
<label>
<span><h5>*</h5> Last Name:</span>
<input placeholder="Please enter your last name" type="text" tabindex="2" name="last_name" data-validate="required" required="">
</label>
</div>
</div>
<div class="form-row">
<div class="column-half">
<label>
<span><h5>*</h5> City:</span>
<input placeholder="Please enter your city" type="text" tabindex="3" name="city" required="">
</label>
</div>
<div class="column-half">
<label>
<span><h5>*</h5> State:</span>
<select name="Market" id="Market" type="select" tabindex="4" required="">
<option value="default">Choose...</option>
<option value="AL">Alabama</option>
<option value="AK">Alaska</option>
<option value="AZ">Arizona</option>
<option value="AR">Arkansas</option>
<option value="CA">California</option>
<option value="CO">Colorado</option>
<option value="CT">Connecticut</option>
<option value="DE">Delaware</option>
<option value="DC">District Of Columbia</option>
<option value="FL">Florida</option>
<option value="GA">Georgia</option>
<option value="HI">Hawaii</option>
<option value="ID">Idaho</option>
<option value="IL">Illinois</option>
<option value="IN">Indiana</option>
<option value="IA">Iowa</option>
<option value="KS">Kansas</option>
<option value="KY">Kentucky</option>
<option value="LA">Louisiana</option>
<option value="ME">Maine</option>
<option value="MD">Maryland</option>
<option value="MA">Massachusetts</option>
<option value="MI">Michigan</option>
<option value="MN">Minnesota</option>
<option value="MS">Mississippi</option>
<option value="MO">Missouri</option>
<option value="MT">Montana</option>
<option value="NE">Nebraska</option>
<option value="NV">Nevada</option>
<option value="NH">New Hampshire</option>
<option value="NJ">New Jersey</option>
<option value="NM">New Mexico</option>
<option value="NY">New York</option>
<option value="NC">North Carolina</option>
<option value="ND">North Dakota</option>
<option value="OH">Ohio</option>
<option value="OK">Oklahoma</option>
<option value="OR">Oregon</option>
<option value="PA">Pennsylvania</option>
<option value="RI">Rhode Island</option>
<option value="SC">South Carolina</option>
<option value="SD">South Dakota</option>
<option value="TN">Tennessee</option>
<option value="TX">Texas</option>
<option value="UT">Utah</option>
<option value="VT">Vermont</option>
<option value="VA">Virginia</option>
<option value="WA">Washington</option>
<option value="WV">West Virginia</option>
<option value="WI">Wisconsin</option>
<option value="WY">Wyoming</option>
</select>
</label>
</div>
</div>
<div style="clear:both;"></div>
<div class="form-row">
<div class="column-half">
<label>
<span><h5>*</h5> Zip Code:</span>
<input placeholder="Please enter your zip" type="text" tabindex="5" name="zip" required="">
</label>
</div>
<div class="column-half">
<label>
<span><h5>*</h5> Age of Insured:</span>
<input placeholder="Please enter age" type="text" tabindex="6" name="age" required="">
</label>
</div>
</div>
<div style="clear:both;"></div>
<div class="form-row">
<div class="column-half">
<label>
<span><h5>*</h5> Email Address:</span>
<input placeholder="Please enter your email" type="email" tabindex="7" name="email" required="">
</label>
</div>
<div class="column-half">
<label>
<span><h5>*</h5>
Cell Phone:</span>
<input id="txtPhoneNumber" name="FancyPhoneNumber" tabindex="8" placeholder="(XXX) XXX-XXXX" type="text" required="">
</label>
</div>
</div>
<input id="txtHiddenPhoneNumber" name="PhoneNumber" type="hidden" value="">
<div>
<button name="submit" type="submit" id="contact-submit">Send</button>
</div>
</form>
<!-- /Form -->
</div>
</div>
<script src="js/scripts.js"></script>
</div>
</div>
</div>
<div id="footer">
<p><strong>AES - American Employee Services</strong></p>
<p>953 Pavilion Street Suite #3 Cincinnati, OH 45202 </p>
<p>Tol Free: 866-242-6940 | <a href="http://www.americaneducational.us/email.html">Unsubscribe your Email</a></p>
</div>
</div>
</body></html>