djmart.id Open in urlscan Pro
103.250.10.249  Public Scan

URL: https://djmart.id/
Submission: On June 24 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

Name: form

<form name="form" ng-submit="submitForm()" enctype="multipart/form-data" class="ng-pristine ng-invalid ng-invalid-required">
  <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="c_member" ng-model="applicant.c_member" readonly="" autocomplete="off">
  <div class="form-group input-group">
    <div class="input-group-prepend">
      <span class="input-group-text"><i class="fas fa-user"></i></span>
    </div>
    <input type="text" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" id="full_name" ng-model="applicant.full_name" placeholder="Nama Lengkap" required="">
  </div>
  <div class="form-group input-group">
    <div class="input-group-prepend">
      <span class="input-group-text"><i class="fab fa-whatsapp"></i></span>
    </div>
    <input type="text" class="form-control ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" id="phone_number" ng-model="applicant.phone_number" phone-number-prefix="" placeholder="No. Whatsapp" required="">
    <div ng-show="form.phone_number.$error.specialChars" class="text-danger ng-hide">No special characters allowed.</div>
    <div ng-show="form.phone_number.$error.phoneNumberLength" class="text-danger ng-hide">Nomor WhatsApp harus antara 10 hingga 15 angka.</div>
  </div>
  <div ng-init="hideAllExceptNameAndPhone()">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="email" ng-model="applicant.email" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="place_of_birth" ng-model="applicant.place_of_birth" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="date_of_birth" ng-model="applicant.date_of_birth" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="gender" ng-model="applicant.gender" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="marital_status" ng-model="applicant.marital_status" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="highest_education" ng-model="applicant.highest_education" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="job_experience" ng-model="applicant.job_experience" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="province" ng-model="applicant.province" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="province_id" ng-model="applicant.province_id" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="district" ng-model="applicant.district" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="regency_id" ng-model="applicant.regency_id" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="sub_district" ng-model="applicant.sub_district" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="district_id" ng-model="applicant.district_id" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="village" ng-model="applicant.village" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="rt" ng-model="applicant.rt" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="rw" ng-model="applicant.rw" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="address" ng-model="applicant.address" autocomplete="off">
    <input type="hidden" class="form-control" id="doc_lamaran" file-model="applicant.doc_lamaran" autocomplete="off">
    <input type="hidden" class="form-control" id="doc_cv" file-model="applicant.doc_cv" autocomplete="off">
    <input type="hidden" class="form-control" id="fc_ijazah" file-model="applicant.fc_ijazah" autocomplete="off">
    <input type="hidden" class="form-control" id="fc_ktp" file-model="applicant.fc_ktp" autocomplete="off">
    <input type="hidden" class="form-control" id="fc_kk" file-model="applicant.fc_kk" autocomplete="off">
    <input type="hidden" class="form-control" id="fc_skck" file-model="applicant.fc_skck" autocomplete="off">
    <input type="hidden" class="form-control" id="fc_ak" file-model="applicant.fc_ak" autocomplete="off">
    <input type="hidden" class="form-control" id="image1" file-model="applicant.image1" autocomplete="off">
    <input type="hidden" class="form-control" id="image2" file-model="applicant.image2" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="c_agency" ng-model="applicant.c_agency" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="c_rw" ng-model="applicant.c_rw" autocomplete="off">
    <input type="hidden" class="form-control ng-pristine ng-untouched ng-valid ng-empty" id="c_village" ng-model="applicant.c_village" autocomplete="off">
  </div>
  <div class="text-center">
    <button type="submit" class="btn btn-primary">Daftar Sekarang</button>
  </div>
</form>

Text Content

PENDAFTARAN MEMBER

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

No special characters allowed.
Nomor WhatsApp harus antara 10 hingga 15 angka.

Daftar Sekarang

DJ MART © 2024