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Form analysis
1 forms found in the DOM

POST /landing/postdata.php

<form class="form animate-form" id="form1" method="POST" action="/landing/postdata.php" novalidate="novalidate">
  <div class="row">
    <div class="col-md-10 col-md-offset-1 col-sm-10 col-sm-offset-1 text-center sm-center " style="text-align: center">
      <h2 class=" sm-center" style="color: #1162af;text-transform: uppercase;padding-bottom: 13px;padding-top: 13px;font-weight: bold;font-size: 20px;margin: 0;"> Mon devis téléphonique sur mesure </h2>
    </div>
  </div>
  <div class="form-group has-feedback">
    <label class="control-label sr-only" for="societe">Société *</label>
    <div class="input-group-addon">
      <div class="glyphicon glyphicon-briefcase"></div>
    </div>
    <input class="form-control" id="societe" name="raison_sociale" placeholder="Votre société *" type="text" minlength="2" required="" aria-required="true">
    <span class="glyphicon glyphicon-ok form-control-feedback"></span>
  </div>
  <div class="form-group has-feedback">
    <label class="control-label sr-only" for="nom">Contact *</label>
    <div class="input-group-addon">
      <div class="glyphicon glyphicon-user"></div>
    </div>
    <input class="form-control" id="nom" name="nom_et_prénom" placeholder="Vos nom &amp; prénom *" type="text" minlength="2" required="" aria-required="true">
    <span class="glyphicon glyphicon-ok form-control-feedback"></span>
  </div>
  <div class="form-group has-feedback">
    <label class="control-label sr-only" for="tel">Téléphone *</label>
    <div class="input-group-addon">
      <div class="glyphicon glyphicon-earphone"></div>
    </div>
    <input class="form-control" id="tel" name="téléphone" placeholder="N° de téléphone (fixe ou mobile) *" type="text" required="" aria-required="true">
    <span class="glyphicon glyphicon-ok form-control-feedback"></span>
  </div>
  <div class="form-group has-feedback">
    <label class="control-label sr-only" for="email">Adresse email *</label>
    <div class="input-group-addon">
      <div class="glyphicon glyphicon-envelope"></div>
    </div>
    <input class="form-control" id="email" name="email" placeholder="Votre adresse email *" type="email" required="" aria-required="true">
    <span class="glyphicon glyphicon-ok form-control-feedback"></span>
  </div>
  <div class="form-group has-feedback">
    <label class="control-label sr-only" for="demande">Demande * :</label>
    <div class="input-group-addon">
      <div class="glyphicon glyphicon-pencil "></div>
    </div>
    <select class="form-control" name="projet" id="demande" required="" aria-required="true" style="color: #a7a9ac">
      <option value="" disabled="" selected="" hidden="">Demande *</option>
      <option value="Urgent">Projet Urgent</option>
      <option value="Non Urgent">Projet Non Urgent</option>
    </select>
    <span class="glyphicon glyphicon-ok form-control-feedback"></span>
  </div>
  <div class="form-group has-feedback">
    <p class="text-left">* Champs obligatoires</p>
  </div>
  <div class="form-group submit">
    <input class="btn btn-lg" type="submit" value="POURSUIVRE">
  </div>
  <input type="hidden" name="kit_formulaire" value="bgactu">
  <input type="hidden" name="form_platform" value="email">
  <input type="hidden" name="form_key" value="002b4b6a4326">
  <input type="hidden" name="form_identifier" value="email">
</form>

Text Content

MON DEVIS TÉLÉPHONIQUE SUR MESURE

Société *

Contact *

Téléphone *

Adresse email *

Demande * :

Demande * Projet Urgent Projet Non Urgent

* Champs obligatoires