www.jcbins-demo.com Open in urlscan Pro
65.74.175.75  Public Scan

Submitted URL: http://jcbins-demo.com/
Effective URL: https://www.jcbins-demo.com/
Submission: On August 10 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST /#wpcf7-f147-o1

<form action="/#wpcf7-f147-o1" method="post" class="wpcf7-form init" aria-label="Contact form" novalidate="novalidate" data-status="init">
  <div style="display: none;">
    <input type="hidden" name="_wpcf7" value="147">
    <input type="hidden" name="_wpcf7_version" value="5.7.7">
    <input type="hidden" name="_wpcf7_locale" value="en_US">
    <input type="hidden" name="_wpcf7_unit_tag" value="wpcf7-f147-o1">
    <input type="hidden" name="_wpcf7_container_post" value="0">
    <input type="hidden" name="_wpcf7_posted_data_hash" value="">
    <input type="hidden" name="_wpcf7_recaptcha_response" value="HFZmwydRUVDCtac1wHSEYWSQZ3bX9RVz5uZy9sKBw8CQZmYRd8NUtEDS9uJzYSJhF1GS0kAh9BT1kJYSYhBF90PhJlPF0MJkNEaTwSZGMlGFEmOTcqSWYQNgQHFh9BAh8wDCk5IH4vQkRifnd8XGMvVk9ObE0VZwcIZjd1dRJlDCws">
  </div>
  <div class="modal-header">
    <div data-dismiss="modal" aria-label="Close">
      <p><em class="fa fa-times-circle"></em>
      </p>
    </div>
    <h1 class="modal-title">Request A Demo </h1>
    <p>Let us show you the difference of working with JCB. Give us a few details about yourself and we'll be in touch. </p>
  </div>
  <div class="modal-body">
    <p><label for="name_field" class="lbl">Name</label><span class="wpcf7-form-control-wrap" data-name="your-name"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control" id="name_field" aria-required="true"
          aria-invalid="false" value="" type="text" name="your-name"></span><br>
      <label for="email_field" class="lbl">Email</label><span class="wpcf7-form-control-wrap" data-name="your-email"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email form-control"
          id="email_field" aria-required="true" aria-invalid="false" value="" type="email" name="your-email"></span><br>
      <label for="phone_field" class="lbl">Phone</label><span class="wpcf7-form-control-wrap" data-name="your-phone"><input size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required form-control" id="phone_field" aria-required="true"
          aria-invalid="false" value="" type="text" name="your-phone"></span><br>
      <label for="message_field" class="lbl">Message</label><span class="wpcf7-form-control-wrap" data-name="your-message"><textarea cols="40" rows="10" class="wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required form-control"
          id="message_field" aria-required="true" aria-invalid="false" name="your-message"></textarea></span><br>
      <br>
      <label for="leaveitalone" style="visibility:hidden;">Leave it Alone</label><span id="wpcf7-64d54affc813b-wrapper" class="wpcf7-form-control-wrap leaveitalone-wrap" style="display:none !important; visibility:hidden !important;"><input
          id="leaveitalone" class="wpcf7-form-control wpcf7-text" type="text" name="leaveitalone" value="" size="40" tabindex="-1" autocomplete="new-password" aria-label="Please leave this field empty."></span><br>
      <input class="wpcf7-form-control has-spinner wpcf7-submit btn btn-green btn-round btn-xl" type="submit" value="Submit"><span class="wpcf7-spinner"></span>
    </p>
  </div>
  <div class="wpcf7-response-output" aria-hidden="true"></div>
</form>

Text Content

Skip to content
Open toolbar Accessibility Tools

Accessibility Tools

 * 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
 * Admins
 * Students
 * Our Services
 * About

 * Home
 * Students
 * Admins
 * Our Services
 * About

 * Home
 * Students
 * Admins
 * Our Services
 * About


REDEFINING STUDENT INSURANCE

Use the search and we’ll direct you to your student portal.


STUDENTS, FIND YOUR SCHOOL

Use the search and we’ll direct you to your student portal.



Select school year
Select a plan

View My School Portal
ERROR: You must complete all fields.






STUDENT PORTAL

Click Here


ADMINISTRATOR PORTAL

Click Here
©2023 JCB Insurance Solution, a Gallagher Company

Terms of Use
Privacy Policy

©2023 JCB Insurance Solution, a Gallagher Company



REQUEST A DEMO

Let us show you the difference of working with JCB. Give us a few details about
yourself and we'll be in touch.

Name
Email
Phone
Message

Leave it Alone




Notifications





1
 * Start Again

Hello there!
Let me know if there is anything I can help.

Today


--------------------------------------------------------------------------------

New Messages


Charlie  a few seconds ago
Hi, my name is Charlie! How can I help?
Enrollment
General
Login
Waiver

by Freshworks


1