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Submission: On June 16 via api from US — Scanned from NL
Submission: On June 16 via api from US — Scanned from NL
Form analysis 1 forms found in the DOM
POST /#gf_1
<form method="post" enctype="multipart/form-data" id="gform_1" action="/#gf_1">
<div id="gf_page_steps_1" class="gf_page_steps">
<div id="gf_step_1_1" class="gf_step gf_step_active gf_step_first"><span class="gf_step_number">1</span><span class="gf_step_label">Personal Details</span></div>
<div id="gf_step_1_2" class="gf_step gf_step_last gf_step_next gf_step_pending"><span class="gf_step_number">2</span><span class="gf_step_label">Vehicle Details</span></div>
</div>
<div class="gform_body gform-body">
<div id="gform_page_1_1" class="gform_page">
<div class="gform_page_fields">
<div id="gform_fields_1" class="gform_fields top_label form_sublabel_below description_below">
<fieldset id="field_1_1" class="gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible">
<legend class="gfield_label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name" id="input_1_1">
<span id="input_1_1_3_container" class="name_first">
<input type="text" name="input_1.3" id="input_1_1_3" value="" aria-label="First name" aria-required="true">
<label for="input_1_1_3">First</label>
</span>
<span id="input_1_1_6_container" class="name_last">
<input type="text" name="input_1.6" id="input_1_1_6" value="" aria-label="Last name" aria-required="true">
<label for="input_1_1_6">Last</label>
</span>
</div>
</fieldset>
<div id="field_1_2" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_2">Phone<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_2" id="input_1_2" type="text" value="" class="large" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_1_3" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_3">Email<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_3" id="input_1_3" type="text" value="" class="large" aria-required="true" aria-invalid="false">
</div>
</div>
</div>
</div>
<div class="gform_page_footer top_label">
<input type="button" id="gform_next_button_1_4" class="gform_next_button button" value="Continue" onclick="jQuery("#gform_target_page_number_1").val("2"); jQuery("#gform_1").trigger("submit",[true]); "
onkeypress="if( event.keyCode == 13 ){ jQuery("#gform_target_page_number_1").val("2"); jQuery("#gform_1").trigger("submit",[true]); } ">
</div>
</div>
<div id="gform_page_1_2" class="gform_page" style="display:none;">
<div class="gform_page_fields">
<div id="gform_fields_1_2" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_1_27" class="gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"><br></div>
<div id="field_1_12" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h3 class="gsection_title">Vehicle Details</h3>
</div>
<div id="field_1_5" class="gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_5">Make<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_5" id="input_1_5" type="text" value="" class="large" placeholder="Toyota" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_1_8" class="gfield gfield--width-third gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_8">Model<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_8" id="input_1_8" type="text" value="" class="large" placeholder="Camry" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_1_11" class="gfield gfield--width-third field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_11">Year</label>
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_1_11" type="text" value="" class="large" aria-invalid="false"> </div>
</div>
<div id="field_1_34" class="gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"><br></div>
<div id="field_1_35" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h3 class="gsection_title">Vehicle License</h3>
<div class="gsection_description" id="gfield_description_1_35">Please input your vehicle details correctly. See sample
<a style="font-weight: 600;" target="_blank" href="https://drive.google.com/file/d/1hFvg2JyAT1ELC9Bh_PAbF1LN4oJm8boJ/view?usp=drive_link">here</a></div>
</div>
<div id="field_1_42" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_42">Expiry Date<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date">
<input name="input_42" id="input_1_42" type="text" value="" class="datepicker dmy datepicker_no_icon gdatepicker-no-icon hasDatepicker initialized" placeholder="dd/mm/yyyy" aria-describedby="input_1_42_date_format" aria-invalid="false"
aria-required="true">
<span id="input_1_42_date_format" class="screen-reader-text">DD slash MM slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_1_42" class="gform_hidden" value="https://remindly.net/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</div>
<div id="field_1_19" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_19">Frequency of Renewal</label>
<div class="ginput_container ginput_container_select"><select name="input_19" id="input_1_19" class="large gfield_select" aria-invalid="false">
<option value="Monthly">Monthly</option>
<option value="Half Yearly">Half Yearly</option>
<option value="Yearly">Yearly</option>
</select></div>
</div>
<div id="field_1_28" class="gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"><br></div>
<div id="field_1_20" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h3 class="gsection_title">Insurance</h3>
<div class="gsection_description" id="gfield_description_1_20">Please input your vehicle details correctly. See sample
<a style="font-weight: 600;" target="_blank" href="https://drive.google.com/file/d/1hFvg2JyAT1ELC9Bh_PAbF1LN4oJm8boJ/view?usp=drive_link">here</a></div>
</div>
<div id="field_1_41" class="gfield gfield--width-half gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_41">Expiry Date<span
class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date">
<input name="input_41" id="input_1_41" type="text" value="" class="datepicker dmy datepicker_no_icon gdatepicker-no-icon hasDatepicker initialized" placeholder="dd/mm/yyyy" aria-describedby="input_1_41_date_format" aria-invalid="false"
aria-required="true">
<span id="input_1_41_date_format" class="screen-reader-text">DD slash MM slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_1_41" class="gform_hidden" value="https://remindly.net/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</div>
<div id="field_1_36" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_36">Frequency of Renewal</label>
<div class="ginput_container ginput_container_select"><select name="input_36" id="input_1_36" class="large gfield_select" aria-invalid="false">
<option value="Monthly">Monthly</option>
<option value="Half Yearly">Half Yearly</option>
<option value="Yearly">Yearly</option>
</select></div>
</div>
<div id="field_1_29" class="gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"><br></div>
<div id="field_1_23" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h3 class="gsection_title">Road Worthiness</h3>
<div class="gsection_description" id="gfield_description_1_23">Please input your vehicle details correctly. See sample
<a style="font-weight: 600;" target="_blank" href="https://drive.google.com/file/d/1hFvg2JyAT1ELC9Bh_PAbF1LN4oJm8boJ/view?usp=drive_link">here</a></div>
</div>
<div id="field_1_40" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_40">Expiry Date</label>
<div class="ginput_container ginput_container_date">
<input name="input_40" id="input_1_40" type="text" value="" class="datepicker dmy datepicker_no_icon gdatepicker-no-icon hasDatepicker initialized" placeholder="dd/mm/yyyy" aria-describedby="input_1_40_date_format" aria-invalid="false">
<span id="input_1_40_date_format" class="screen-reader-text">DD slash MM slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_1_40" class="gform_hidden" value="https://remindly.net/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</div>
<div id="field_1_37" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_37">Frequency of Renewal</label>
<div class="ginput_container ginput_container_select"><select name="input_37" id="input_1_37" class="large gfield_select" aria-invalid="false">
<option value="Monthly">Monthly</option>
<option value="Half Yearly">Half Yearly</option>
<option value="Yearly">Yearly</option>
</select></div>
</div>
<div id="field_1_30" class="gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"><br></div>
<div id="field_1_31" class="gfield gsection field_sublabel_below field_description_below gfield_visibility_visible">
<h3 class="gsection_title">Driver's license</h3>
<div class="gsection_description" id="gfield_description_1_31">Please input your vehicle details correctly. See sample
<a style="font-weight: 600;" target="_blank" href="https://drive.google.com/file/d/1hFvg2JyAT1ELC9Bh_PAbF1LN4oJm8boJ/view?usp=sharing">here</a></div>
</div>
<div id="field_1_32" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_32">Expiry Date</label>
<div class="ginput_container ginput_container_date">
<input name="input_32" id="input_1_32" type="text" value="" class="datepicker dmy datepicker_no_icon gdatepicker-no-icon hasDatepicker initialized" placeholder="dd/mm/yyyy" aria-describedby="input_1_32_date_format" aria-invalid="false">
<span id="input_1_32_date_format" class="screen-reader-text">DD slash MM slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_1_32" class="gform_hidden" value="https://remindly.net/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</div>
<div id="field_1_38" class="gfield gfield--width-half field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_38">Frequency of Renewal</label>
<div class="ginput_container ginput_container_select"><select name="input_38" id="input_1_38" class="large gfield_select" aria-invalid="false">
<option value="Monthly">Monthly</option>
<option value="Half Yearly">Half Yearly</option>
<option value="Yearly">Yearly</option>
</select></div>
</div>
<div id="field_1_45" class="gfield gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"></div>
<div id="field_1_47" class="gfield gfield--width-full field_sublabel_below field_description_below gfield_visibility_visible"><label class="gfield_label" for="input_1_47">How Did You Hear About Us</label>
<div class="ginput_container ginput_container_text"><input name="input_47" id="input_1_47" type="text" value="" class="large" aria-invalid="false"> </div>
</div>
<div id="field_1_43" class="gfield field_sublabel_below field_description_below hidden_label gfield_visibility_visible"><label class="gfield_label" for="input_1_43">CAPTCHA</label>
<div id="input_1_43" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6LdTPospAAAAAFh_EOTTr0ShXTtZU2Bmbj26B4VJ" data-theme="light" data-tabindex="-1" data-size="invisible" data-badge="bottomright">
<div class="grecaptcha-badge" data-style="bottomright"
style="width: 256px; height: 60px; display: block; transition: right 0.3s ease 0s; position: fixed; bottom: 14px; right: -186px; box-shadow: gray 0px 0px 5px; border-radius: 2px; overflow: hidden;">
<div class="grecaptcha-logo"><iframe title="reCAPTCHA" width="256" height="60" role="presentation" name="a-nzg9tklmnry5" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LdTPospAAAAAFh_EOTTr0ShXTtZU2Bmbj26B4VJ&co=aHR0cHM6Ly9yZW1pbmRseS5uZXQ6NDQz&hl=en&v=TqxSU0dsOd2Q9IbI7CpFnJLD&theme=light&size=invisible&badge=bottomright&cb=ykigheemdrbd"
tabindex="-1"></iframe></div>
<div class="grecaptcha-error"></div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
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 id="field_1_44" class="gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible"></div>
</div>
</div>
<div class="gform_page_footer top_label"><input type="submit" id="gform_previous_button_1" class="gform_previous_button button" value="Previous"
onclick="if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; jQuery("#gform_1").trigger("submit",[true]); }"> <input type="submit"
id="gform_submit_button_1" class="gform_button button" value="Submit" onclick="if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_1"]){return false;} window["gf_submitting_1"]=true; jQuery("#gform_1").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_1" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="1">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_1" value="WyJbXSIsIjliODEzNDY1OWE4MDkwMDUyMDcxODAxZDYyMTgyMmE3Il0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_1" id="gform_target_page_number_1" value="2">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_1" id="gform_source_page_number_1" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</div>
</div>
</form>Text Content
* How it works Sign up Sign up Never Miss a Renewal Deadline Again Get timely reminders for your vehicle license, insurance, road worthiness, and driver’s license renewals SIGN UP NOW How it works SIGN UP FOR FREE Register for FREE using your name, phone number, and email address for personalized reminders. REGISTER YOUR CAR DETAILS Accurately submit your vehicle details, we’ll manage the rest for hassle-free reminders and updates. GET REMINDED EASILY Get emails and text messages 30 days, 7 days, 3 days and on the day of expiration of each vehicle document. Sign up below 1Personal Details 2Vehicle Details Name* First Last Phone* Email* VEHICLE DETAILS Make* Model* Year VEHICLE LICENSE Please input your vehicle details correctly. See sample here Expiry Date* DD slash MM slash YYYY Frequency of Renewal MonthlyHalf YearlyYearly INSURANCE Please input your vehicle details correctly. See sample here Expiry Date* DD slash MM slash YYYY Frequency of Renewal MonthlyHalf YearlyYearly ROAD WORTHINESS Please input your vehicle details correctly. See sample here Expiry Date DD slash MM slash YYYY Frequency of Renewal MonthlyHalf YearlyYearly DRIVER'S LICENSE Please input your vehicle details correctly. See sample here Expiry Date DD slash MM slash YYYY Frequency of Renewal MonthlyHalf YearlyYearly How Did You Hear About Us CAPTCHA If you have any questions about renewing your documents or need assistance, please get in touch with us. +234 812 836 0875 support@remindly.net Home Blog Privacy Policy Terms of Service © 2024 Remindly. All rights reserved Built by DONCEPT Chat Now Notifications