medwave.staffingreferrals.com Open in urlscan Pro
2606:4700:10::6816:20f4  Public Scan

Form analysis
1 forms found in the DOM

POST /join/creese1

<form method="post" action="/join/creese1" id="the_form" class="flex flex-col justify-between">
  <div class="px-4">
    <div class="max-w-md mx-auto px-1">
      <h1 class="text-2xl leading-tight text-black font-medium mb-3 ">Refer friends. Earn rewards.</h1>
      <h2 class="text-lg leading-tight text-black font-light mb-3 ">Give friends up to a $250 bonus. Get up to $500 when they meet the requirements for MedWave Healthcare Staffing.</h2>
      <div class="mb-2 mt-3"><label class="block text-base font-normal text-black " style="font-size: 14px; color: rgb(17, 17, 17);">Your Email Address</label>
        <div><input type="text" name="user[email]" required="" class="focus:ring-blue-500 focus:border-blue-500 block w-full h-12 text-base py-2 px-3 border border-gray-300 rounded " placeholder="john@smith.com"
            pattern="[a-zA-Z0-9._%+-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,5}$" title="john@smith.com" autocapitalize="none" value=""></div>
      </div>
      <div class="mb-2 mt-3"><label class="block text-base font-normal text-black " style="font-size: 14px; color: rgb(17, 17, 17);">Your First Name</label>
        <div><input type="text" name="user[first_name]" required="" class="focus:ring-blue-500 focus:border-blue-500 block w-full h-12 text-base py-2 px-3 border border-gray-300 rounded-md " placeholder="John" autocomplete="off" autocapitalize="none"
            value=""></div>
      </div>
      <div class="mb-2 mt-3"><label class="block text-base font-normal text-black " style="font-size: 14px; color: rgb(17, 17, 17);">Your Last Name</label>
        <div><input type="text" name="user[last_name]" class="focus:ring-blue-500 focus:border-blue-500 block w-full h-12 text-base py-2 px-3 border border-gray-300 rounded-md " placeholder="Smith" autocomplete="off" autocapitalize="none" value="">
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          STARTED</button></div>
      <div>
        <div class="text-center text-gray-500 mb-4">Or</div>
        <a href="/google/join" target="_self" class=" w-full  whitespace-nowrap text-lg flex items-center justify-center px-6 py-3 h-11 border text-base font-normal hover:no-underline rounded focus:ring focus:ring-blue-400 undefined border-gray-300 bg-white text-blue-700 "><span class="google-icon mr-2"></span><span class="text-gray-700 text-lg font-medium">Join Using Google</span></a>
      </div>
      <div class="text-center mt-3">or <a href="https://medwave.staffingreferrals.com/meet/creese1" class="text-blue-700">Meet your recruiter</a></div>
    </div>
    <div class="pt-6 text-center"><a href="#" class="text-xs text-gray-400 underline">View referral program details</a></div><input type="hidden" name="authenticity_token"
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    </div>
  </div>
</form>

Text Content

Carrie Reese
Director of Recruitment

creese@medwavehealthcarestaffing.com
(716) 708-4151


REFER FRIENDS. EARN REWARDS.


GIVE FRIENDS UP TO A $250 BONUS. GET UP TO $500 WHEN THEY MEET THE REQUIREMENTS
FOR MEDWAVE HEALTHCARE STAFFING.

Your Email Address

Your First Name

Your Last Name

GET STARTED
Or
Join Using Google
or Meet your recruiter
View referral program details