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2606:4700:4400::6812:298a  Public Scan

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URL: https://www.emiratesislamic.ae/eng/contact-us/
Submission: On October 25 via api from AE — Scanned from DE

Form analysis 2 forms found in the DOM

Name: frm_search — POST ##

<form name="frm_search" method="post" id="frm_search" action="##">
  <i class="fa fa-search fa-lg search-input-icon" id="search_icon" style="float: right;position: absolute;top: 30%;right: 26px; cursor:pointer"></i>
  <input type="text" id="txt_search" class="form-control input-lg" value="" placeholder="Search here" style="width:100%" aria-label="search here" data-uw-rm-form="fx">
</form>

POST 

<form role="form" action="" method="post" id="applynow_form">
  <div class="row">
    <div class="col-12 col-lg-6">
      <div class="form-group">
        <label class="control-label" for="selectbasic">Nature of Enquiry<em>*</em> </label>
        <select name="laNatureEnquiry" id="laNatureEnquiry" class="form-control input-lg" aria-label="nature of enquiry*" data-uw-rm-form="fx">
          <option value="" selected="selected">-Select-</option>
          <option value="Products and Services">Interested in a product</option>
          <option value="Complaints">Complaints</option>
          <option value="Appreciation">Appreciation</option>
          <option value="Suggestion">Suggestion</option>
        </select>
      </div>
    </div>
  </div>
  <div class="row div_firstlastname" style="display:none;">
    <div class="col-12 col-sm-6">
      <div class="form-group">
        <input name="firstname" type="text" placeholder="First Name *" class="form-control input-lg" onkeypress="return isSpeKey(event)" maxlength="50" id="firstname" value="" autocomplete="off" aria-label="first name *" data-uw-rm-form="fx">
      </div>
    </div>
    <div class="col-12 col-sm-6">
      <div class="control-group">
        <input class="form-control input-lg" name="lastName" placeholder="Last Name *" type="text" onkeypress="return isSpeKey(event)" maxlength="50" id="lastName" value="" autocomplete="off" aria-label="last name *" data-uw-rm-form="fx">
      </div>
    </div>
  </div>
  <div class="row div_fullname" style="display:block;">
    <div class="col-12">
      <div class="form-group">
        <input name="fullname" type="text" placeholder="Tell us your name *" class="form-control input-lg" onkeypress="return isSpeKey(event)" maxlength="50" id="fullname" value="" autocomplete="off" aria-label="tell us your name *"
          data-uw-rm-form="fx">
      </div>
    </div>
    <div class="col-xs-6 col-md-6 ">
      <div class="control-group">
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-12 col-md-6 ">
      <div class="form-group">
        <input name="mobile" type="text" placeholder="Mobile Number *" maxlength="14" onkeypress="return isNumberKey(event)" class="form-control input-lg" id="mobile" value="" autocomplete="off" aria-label="mobile number *" data-uw-rm-form="fx">
      </div>
    </div>
    <div class="col-12 col-md-6 ">
      <div class="form-group">
        <input type="text" name="email" placeholder="Email *" class="form-control input-lg" id="email" value="" autocomplete="off" aria-label="email *" data-uw-rm-form="fx">
      </div>
    </div>
  </div>
  <div class="row div_suggestion" style="display:none;">
    <div class="col-12 col-md-6">
      <div class="form-group">
        <label class="radio control-label d-block"><b>Existing Customer<em>*</em></b></label>
        <label class="radio-inline mb-0">
          <input name="existingcust" type="radio" class="existingcust" value="Yes" autocomplete="off" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="nfx">Yes </label>
        <label class="radio-inline mb-0">
          <input name="existingcust" type="radio" value="No" class="existingcust" autocomplete="off" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="nfx">No </label>
      </div>
    </div>
    <div class="col-12 col-md-6 existing_yes" style="display:none;">
      <div class="form-group">
        <label class="control-label" for="textinput">Account Number (optional)</label>
        <input name="accountnumber" type="text" class="form-control input-lg" onkeypress="return isNumberKey(event)" maxlength="50" value="" autocomplete="off" aria-label="account number (optional)" data-uw-rm-form="fx">
      </div>
    </div>
  </div>
  <div class="div_appreciation" style="display:none;">
    <div class="control-group">
      <div class="form-group">
        <label class="radio control-label d-block"><b>Assisted by<em>*</em></b></label>
        <label class="radio-inline">
          <input name="assistedby" type="radio" class="assistedby" value="Branch Staff" autocomplete="off" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="nfx">Branch Staff </label>
        <label class="radio-inline">
          <input name="assistedby" type="radio" value="Call Center" class="assistedby" autocomplete="off" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="nfx">Call Center </label>
        <label class="radio-inline">
          <input name="assistedby" type="radio" value="Department" class="assistedby" autocomplete="off" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="nfx">Department </label>
        <label class="radio-inline">
          <input name="assistedby" type="radio" value="I don't remember" class="assistedby" autocomplete="off" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="nfx">I don't remember </label>
      </div>
    </div>
    <div class="row astd_callcenter" style="display:none;">
      <div class="col-12 col-md-6 ">
        <div class="form-group">
          <label class="control-label d-block" for="textinput">Call Center Representative Name</label>
          <input name="astd_callcenter" type="text" class="form-control input-lg" onkeypress="return isSpeKey(event)" maxlength="50" value="" autocomplete="off" aria-label="call center representative name" data-uw-rm-form="fx">
        </div>
      </div>
    </div>
    <div class="row astd_staff" style="display:none;">
      <div class="col-12 col-md-6 ">
        <div class="form-group">
          <label class="control-label" for="textinput">Branch Staff Name</label>
          <input name="astd_staff" type="text" class="form-control input-lg" onkeypress="return isSpeKey(event)" maxlength="50" value="" autocomplete="off" aria-label="branch staff name" data-uw-rm-form="fx">
        </div>
      </div>
    </div>
    <div class="row astd_department" style="display:none;">
      <div class="col-12 col-md-6 ">
        <div class="form-group">
          <label class="control-label" for="textinput">Department Name</label>
          <input name="astd_department" type="text" class="form-control input-lg" onkeypress="return isSpeKey(event)" maxlength="50" value="" autocomplete="off" aria-label="department name" data-uw-rm-form="fx">
        </div>
      </div>
    </div>
  </div>
  <div class="row div_emirate" style="display:block;">
    <div class="col-12 col-md-6 ">
      <div class="form-group">
        <label class="control-label" for="selectbasic">Emirate<em>*</em></label>
        <select name="laEmirate" id="laEmirate" class="form-control input-lg" aria-label="emirate*" data-uw-rm-form="fx">
          <option value="">Select Emirate *</option>
          <option>Abu Dhabi</option>
          <option>Ajman </option>
          <option>Dubai </option>
          <option>Fujairah </option>
          <option>Ras Al Khaimah</option>
          <option>Sharjah</option>
          <option>Umm Al Qwain </option>
        </select>
      </div>
    </div>
  </div>
  <div class="form-group">
    <div class="controls">
      <textarea name="laComments" id="laComments" placeholder="Write us a message *" rows="4" cols="20" class="form-control input-lg comments" onkeypress="return isCommets(event)" maxlength="500" aria-label="write us a message *"
        data-uw-rm-form="fx"></textarea>
      <span class="fine">(Maximum length is 500 characters)</span>
    </div>
  </div>
  <div id="recaptcha-demo" class="g-recaptcha" data-sitekey="6LcCoz8UAAAAAIv2eI9xzdE3AX5REwoBVZNmDXO4" data-callback="onSuccess" data-bind="submitForm">
    <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-wp94mx1tuf3u" frameborder="0" scrolling="no"
          sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"
          src="https://www.google.com/recaptcha/api2/anchor?ar=1&amp;k=6LcCoz8UAAAAAIv2eI9xzdE3AX5REwoBVZNmDXO4&amp;co=aHR0cHM6Ly93d3cuZW1pcmF0ZXNpc2xhbWljLmFlOjQ0Mw..&amp;hl=de&amp;v=vm_YDiq1BiI3a8zfbIPZjtF2&amp;size=invisible&amp;cb=ttvj6pda0xw0"></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;" aria-label="placeholder" data-uw-placeholder-aria-label="placeholder" data-uw-rm-form="fx"></textarea>
    </div><iframe style="display: none;" data-uw-rm-iframe="un"></iframe>
  </div>
  <div class="row">
    <div class="col-xs-6 col-md-6">
      <input type="hidden" name="submitForm" value="submitForm">
      <a href="javascript:void()" onclick="document.getElementById('submitForm').style.display='none';" class="btn btn-orange btn-block btn-lg submit-btn" name="submitForm" id="submitForm" data-uw-rm-kbnav="click">Submit</a>
    </div>
  </div>
</form>

Text Content

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 * LOCATE
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Please do not report any lost or stolen cards through this channel.

Nature of Enquiry* -Select- Interested in a product Complaints Appreciation
Suggestion



Existing Customer* Yes No
Account Number (optional)
Assisted by* Branch Staff Call Center Department I don't remember
Call Center Representative Name
Branch Staff Name
Department Name
Emirate* Select Emirate * Abu Dhabi Ajman Dubai Fujairah Ras Al Khaimah Sharjah
Umm Al Qwain
(Maximum length is 500 characters)

Submit

CALL US ON

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SWIFT ADDRESS

MEBLAEAD

EMAIL US AT

Customercareunit@emiratesislamic.ae

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800 111 22

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+971 (4) 3160080

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