usaassistanceguide.com
Open in
urlscan Pro
2606:4700:20::ac43:4a31
Public Scan
Submitted URL: http://selectivebroadcastletterto-witnesstoday.info/
Effective URL: https://usaassistanceguide.com/sign-up/
Submission: On February 21 via api from US — Scanned from US
Effective URL: https://usaassistanceguide.com/sign-up/
Submission: On February 21 via api from US — Scanned from US
Form analysis
1 forms found in the DOMPOST
<form id="forminator-module-1233" class="forminator-ui forminator-custom-form forminator-custom-form-1233 forminator-design--default forminator_ajax" method="post" data-forminator-render="0" data-form-id="1233" data-design="default" data-grid="open"
style="" data-uid="63f47050b72d2" novalidate="novalidate">
<div class="forminator-response-message forminator-error" aria-hidden="true"></div>
<div class="forminator-row">
<div id="text-1" class="forminator-col forminator-col-12 ">
<div class="forminator-field"><label for="forminator-field-text-1_63f47050b72d2" class="forminator-label">First Name <span class="forminator-required">*</span></label><input type="text" name="text-1" value="" placeholder=""
id="forminator-field-text-1_63f47050b72d2" class="forminator-input forminator-name--field" data-required="1"></div>
</div>
</div>
<div class="forminator-row">
<div id="email-1" class="forminator-col forminator-col-12 ">
<div class="forminator-field"><label for="forminator-field-email-1_63f47050b72d2" class="forminator-label">Your Email <span class="forminator-required">*</span></label><input type="email" name="email-1" value="" placeholder=""
id="forminator-field-email-1_63f47050b72d2" class="forminator-input forminator-email--field" data-required="1" aria-required="true"></div>
</div>
</div>
<div class="forminator-row">
<div id="gdprcheckbox-1" class="forminator-col forminator-col-12 ">
<div class="forminator-field"><label for="forminator-field-gdprcheckbox-1_63f47050b72d2" class="forminator-label">Required <span class="forminator-required">*</span></label><label for="forminator-field-gdprcheckbox-1_63f47050b72d2"
class="forminator-checkbox"><input type="checkbox" name="gdprcheckbox-1" value="true" id="forminator-field-gdprcheckbox-1_63f47050b72d2" data-required="true" aria-required="true"><span class="forminator-checkbox-box"
aria-hidden="true"></span><span class="forminator-checkbox-label">
<p data-pm-slice="1 1 []">I agree that I am a U.S. resident, I am at least 18 years old, and I agree to the <a href="https://usaassistanceguide.com/terms-conditions/">Terms and Conditions</a>
and <a href="https://usaassistanceguide.com/privacy-policy/">Privacy Policy</a>.</p>
</span></label></div>
</div>
</div>
<div class="forminator-row">
<div id="checkbox-2" class="forminator-col forminator-col-12 ">
<div role="group" class="forminator-field" aria-labelledby="forminator-checkbox-group-63f47050b72d2-label"><label for="forminator-field-checkbox-2-1-63f47050b72d2" class="forminator-checkbox"
title=" I understand by submitting my email address that I will receive daily email from USA Assistance Guide until I unsubscribe."><input type="checkbox" name="checkbox-2[]"
value="i-understand-by-submitting-my-email-address-that-i-will-receive-daily-email-from-usa-assistance-guide-until-i-unsubscribe" id="forminator-field-checkbox-2-1-63f47050b72d2" data-calculation="0"
aria-describedby="forminator-field-checkbox-2-63f47050b72d2-description"><span class="forminator-checkbox-box" aria-hidden="true"></span><span class="forminator-checkbox-label"> I understand by submitting my email address that I will
receive daily email from USA Assistance Guide until I unsubscribe.</span></label></div>
</div>
</div>
<div class="forminator-row forminator-hidden"><input type="hidden" id="hidden-1_63f47050b72d2" name="hidden-1" value="2001:550:1d05:1::9"></div>
<div class="forminator-row forminator-hidden"><input type="hidden" id="hidden-2_63f47050b72d2" name="hidden-2" value="Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/110.0.5481.100 Safari/537.36"></div>
<div class="forminator-row">
<div id="captcha-1" class="forminator-col forminator-col-12 ">
<div class="forminator-g-recaptcha recaptcha-invisible" data-theme="light" data-badge="inline" data-sitekey="6LdvjswZAAAAAC2BGKhSY_StoN9UWkJz-n-_Uvt7" data-size="invisible" style="transform: scale(1); transform-origin: 0px 0px;">
<div class="grecaptcha-badge" data-style="inline" style="width: 256px; height: 60px; box-shadow: gray 0px 0px 5px; z-index: 99;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LdvjswZAAAAAC2BGKhSY_StoN9UWkJz-n-_Uvt7&co=aHR0cHM6Ly91c2Fhc3Npc3RhbmNlZ3VpZGUuY29tOjQ0Mw..&hl=en&v=O4xzMiFqEvA4YhWjk5t8Xuas&theme=light&size=invisible&badge=inline&cb=em20207xkftk"
width="256" height="60" role="presentation" name="a-i1q0hyrj47mq" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response" aria-hidden="true" aria-label="do not use" aria-readonly="true"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
</div>
</div><input type="hidden" name="referer_url" value="">
<div class="forminator-row forminator-row-last">
<div class="forminator-col">
<div class="forminator-field"><button class="forminator-button forminator-button-submit">Send</button></div>
</div>
</div><input type="hidden" id="forminator_nonce" name="forminator_nonce" value="e09b01da67"><input type="hidden" name="_wp_http_referer" value="/sign-up/"><input type="hidden" name="form_id" value="1233"><input type="hidden" name="page_id"
value="1234"><input type="hidden" name="form_type" value=""><input type="hidden" name="current_url" value="https://usaassistanceguide.com/sign-up/"><input type="hidden" name="render_id" value="0"><input type="hidden" name="action"
value="forminator_submit_form_custom-forms">
</form>
Text Content
Skip to content Open toolbar Accessibility Accessibility * Increase TextIncrease Text * Decrease TextDecrease Text * GrayscaleGrayscale * High ContrastHigh Contrast * Negative ContrastNegative Contrast * Light BackgroundLight Background * Links UnderlineLinks Underline * Readable FontReadable Font * Reset Reset * Home * Search Charities * Do I Qualify? * Disaster Assistance * Government Assistance * Sign Up * Covid Relief * Home * Search Charities * Do I Qualify? * Disaster Assistance * Government Assistance * Sign Up * Covid Relief Search Charities SIGN UP NOW IS YOUR CHANCE, GET EXCLUSSIVE OFFERS AND OPPORTUNITIES FOR HELP DIRECTLY TO YOUR INBOX. First Name * Your Email * Required * I agree that I am a U.S. resident, I am at least 18 years old, and I agree to the Terms and Conditions and Privacy Policy. I understand by submitting my email address that I will receive daily email from USA Assistance Guide until I unsubscribe. Send Recommended for you Recommended by Skip Ads by Privacy Policy | Data Policy | How It works | Terms & Conditions | Unsubscribe | Accessible View | Do Not Sell or Share My Information | Privacy Notice | Copyright © 2023 C4R Media Corp.