www.valet.co.za Open in urlscan Pro
41.203.18.73  Public Scan

Form analysis
1 forms found in the DOM

Name: emf-form — POST http://www.emailmeform.com/builder/form/MJEuw4V0a3Gcgn2L3b70

<form id="emf-form" target="_self" class="leftLabel" enctype="multipart/form-data" method="post" action="http://www.emailmeform.com/builder/form/MJEuw4V0a3Gcgn2L3b70" name="emf-form">
  <div id="emf-form-instruction" class="emf-head-widget">
    <div id="emf-form-title" class="emf-bold"> Contact Us </div>
    <div id="emf-form-description"></div>
  </div>
  <ul>
    <li id="emf-li-0" class="emf-li-field emf-field-select data_container" style="text-align:left">
      <label class="emf-label-desc" for="element_0">Title: <span>*</span></label>
      <div class="emf-div-field">
        <select id="element_0" name="element_0" class="validate[required]">
          <option value="" selected="selected"> Please select </option>
          <option value="Mr"> Mr </option>
          <option value="Mrs"> Mrs </option>
          <option value="Ms"> Ms </option>
          <option value="Dr"> Dr </option>
          <option value="Prof"> Prof </option>
          <option value="Hon"> Hon </option>
        </select>
      </div>
      <div class="emf-clear"></div>
    </li>
    <li id="emf-li-1" class="emf-li-field emf-field-text data_container" style="text-align:left">
      <label class="emf-label-desc" for="element_1">Name: <span>*</span></label>
      <div class="emf-div-field">
        <input id="element_1" name="element_1" value="" size="30" type="text" class="validate[required]">
      </div>
      <div class="emf-clear"></div>
    </li>
    <li id="emf-li-2" class="emf-li-field emf-field-text data_container" style="text-align:left">
      <label class="emf-label-desc" for="element_2">Surname: <span>*</span></label>
      <div class="emf-div-field">
        <input id="element_2" name="element_2" value="" size="30" type="text" class="validate[required]">
      </div>
      <div class="emf-clear"></div>
    </li>
    <li id="emf-li-3" class="emf-li-field emf-field-email data_container" style="text-align:left">
      <label class="emf-label-desc" for="element_3">Email: <span>*</span></label>
      <div class="emf-div-field">
        <input id="element_3" name="element_3" class="validate[required,custom[email]]" value="" size="30" type="text">
      </div>
      <div class="emf-clear"></div>
    </li>
    <li id="emf-li-4" class="emf-li-field emf-field-text data_container" style="text-align:left">
      <label class="emf-label-desc" for="element_4">Contact No: <span>*</span></label>
      <div class="emf-div-field">
        <input id="element_4" name="element_4" value="" size="30" type="text" class="validate[required]">
      </div>
      <div class="emf-clear"></div>
    </li>
    <li id="emf-li-5" class="emf-li-field emf-field-textarea data_container" style="text-align:left">
      <label class="emf-label-desc" for="element_5">Message: <span>*</span></label>
      <div class="emf-div-field">
        <textarea id="element_5" name="element_5" cols="45" rows="10" class="validate[required]"></textarea>
      </div>
      <div class="emf-clear"></div>
    </li>
    <li id="emf-li-post-button" class="left">
      <input value="Submit" type="submit" onmouseover="return true;">
    </li>
  </ul><input name="element_counts" value="6" type="hidden"> <input name="embed" value="forms" type="hidden">
  <div style="margin-top:18px;text-align:center">
    <script type="text/javascript">
      //<![CDATA[
      generate_css_for_emf_ad();
      //]]>
    </script>
  </div>
</form>

Text Content

 * Home
 * How to use Katanga
 * Services & Rates
 * Make a Booking
 * Our Gallery
 * Find Us
 * Contact Us



Contact Us

 * Title: *
   Please select Mr Mrs Ms Dr Prof Hon
   
 * Name: *
   
   
 * Surname: *
   
   
 * Email: *
   
   
 * Contact No: *
   
   
 * Message: *
   
   
 * 








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