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prizezappy.com Open in urlscan Pro
2001:4860:4802:38::15  Public Scan

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Submitted URL: https://prizezappy.com/
Effective URL: https://prizezappy.com/journey?s=4eedff5f-97c0-4556-a8f8-6219601dbfba
Submission: On June 13 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST 

<form method="post" class="max-w-md">
  <div class="bg-white p-5">
    <div class="mb-3">
      <label for="first_name" class="block mb-1 font-bold text-black">First Name</label>
      <input type="text" id="first_name" name="first_name" value="" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
    </div>
    <div class="mb-3">
      <label for="last_name" class="block mb-1 font-bold text-black">Last Name</label>
      <input type="text" id="last_name" name="last_name" value="" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
    </div>
    <div class="mb-3">
      <label for="email" class="block mb-1 font-bold text-black">Email Address</label>
      <input type="email" id="email" name="email" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
      <span class="consent-language block mb-2 text-xs text-black">By clicking Continue below, I agree to receive email from MyAmericanPrizes and affiliated brands that may be of interest to me. I also agree to the Terms &amp; Conditions (including
        mandatory arbitration), Privacy Policy, and site visit recordation by TrustedForm and Jornaya.</span>
      <input type="hidden" name="email_consent_text"
        value="By clicking Continue below, I agree to receive email from MyAmericanPrizes and affiliated brands that may be of interest to me. I also agree to the Terms &amp; Conditions (including mandatory arbitration), Privacy Policy, and site visit recordation by TrustedForm and Jornaya.">
      <input type="checkbox" name="email_consent" checked="" style="display:none">
    </div>
    <div class="mb-3">
      <label for="date_of_birth" class="block mb-1 font-bold text-black">Date of Birth</label>
      <input type="date" id="date_of_birth" name="date_of_birth" required="" max="2024-06-13" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
    </div>
    <div class="mb-3">
      <label for="gender" class="block mb-1 font-bold text-black">Gender</label>
      <select id="gender" name="gender" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
        <option value="">Select</option>
        <option value="male">Male</option>
        <option value="female">Female</option>
        <option value="other">Other</option>
      </select>
    </div>
    <div class="mb-3">
      <label for="address" class="block mb-1 font-bold text-black">Address</label>
      <input type="text" id="address" name="address" value="" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
    </div>
    <div class="mb-3">
      <label for="zip" class="block mb-1 font-bold text-black">Zip Code</label>
      <input type="text" id="zip" name="zip" required="" pattern="^\d{5}$" title="Enter a valid 5-digit ZIP code" value="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
    </div>
    <div class="flex mb-3">
      <div class="mr-2 flex-grow">
        <label for="city" class="block mb-1 font-bold text-black">City</label>
        <input type="text" id="city" name="city" value="" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
      </div>
      <div class="flex-grow">
        <label for="state" class="block mb-1 font-bold text-black">State</label>
        <select id="state" name="state" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
          <option value="" selected="">Select State</option>
          <option value="AL">Alabama</option>
          <option value="AK">Alaska</option>
          <option value="AZ">Arizona</option>
          <option value="AR">Arkansas</option>
          <option value="CA">California</option>
          <option value="CO">Colorado</option>
          <option value="CT">Connecticut</option>
          <option value="DE">Delaware</option>
          <option value="FL">Florida</option>
          <option value="GA">Georgia</option>
          <option value="HI">Hawaii</option>
          <option value="ID">Idaho</option>
          <option value="IL">Illinois</option>
          <option value="IN">Indiana</option>
          <option value="IA">Iowa</option>
          <option value="KS">Kansas</option>
          <option value="KY">Kentucky</option>
          <option value="LA">Louisiana</option>
          <option value="ME">Maine</option>
          <option value="MD">Maryland</option>
          <option value="MA">Massachusetts</option>
          <option value="MI">Michigan</option>
          <option value="MN">Minnesota</option>
          <option value="MS">Mississippi</option>
          <option value="MO">Missouri</option>
          <option value="MT">Montana</option>
          <option value="NE">Nebraska</option>
          <option value="NV">Nevada</option>
          <option value="NH">New Hampshire</option>
          <option value="NJ">New Jersey</option>
          <option value="NM">New Mexico</option>
          <option value="NY">New York</option>
          <option value="NC">North Carolina</option>
          <option value="ND">North Dakota</option>
          <option value="OH">Ohio</option>
          <option value="OK">Oklahoma</option>
          <option value="OR">Oregon</option>
          <option value="PA">Pennsylvania</option>
          <option value="RI">Rhode Island</option>
          <option value="SC">South Carolina</option>
          <option value="SD">South Dakota</option>
          <option value="TN">Tennessee</option>
          <option value="TX">Texas</option>
          <option value="UT">Utah</option>
          <option value="VT">Vermont</option>
          <option value="VA">Virginia</option>
          <option value="WA">Washington</option>
          <option value="WV">West Virginia</option>
          <option value="WI">Wisconsin</option>
          <option value="WY">Wyoming</option>
        </select>
      </div>
    </div>
    <div class="mb-3">
      <label for="phone" class="block mb-1 font-bold text-black">Phone #</label>
      <input type="tel" id="phone" name="phone" value="" required="" class="w-full p-2 mb-2 border border-gray-300 rounded box-border text-black">
      <input type="checkbox" name="phone_consent" class="h-4 w-4">
      <span class="consent-language block mb-2 text-xs text-black">
        <input type="hidden" id="leadid_tcpa_disclosure" name="chktcpa" checked="">
        <label for="leadid_tcpa_disclosure">[Kevin will provide]</label>
      </span>
      <input type="hidden" name="phone_consent_text" value="[Kevin will provide]">
      <input id="leadid_token" name="universal_leadid" type="hidden" value="2E235429-098E-9DFE-C25C-68BF8ACABB57">
    </div>
    <input type="submit" value="Submit" class="w-full p-2 bg-blue-800 text-white rounded cursor-pointer hover:bg-blue-900">
  </div>
  <input type="hidden" name="xxTrustedFormCertUrl" value="https://cert.trustedform.com/a69f5413cd30bbc9b1a6dedf6c75dfcb7cfe89d3" id="xxTrustedFormCertUrl_0"><input type="hidden" name="xxTrustedFormToken"
    value="https://cert.trustedform.com/a69f5413cd30bbc9b1a6dedf6c75dfcb7cfe89d3" id="xxTrustedFormToken_0"><input type="hidden" name="xxTrustedFormPingUrl"
    value="https://ping.trustedform.com/0.e8aeBGdymkj5Nuxg8zmVrh8bvTGXDYm2EdmXmlDsXn5_g_tSXJ6mPTETCfagfk0Nbz45QxaX.sbC1ynd6So5aJ9iMqv15_A.vNEng_j7Y-8RwbwKPtEeyw" id="xxTrustedFormPingUrl_0">
</form>

Text Content

$750 Cash
Giveaway
First Name
Last Name
Email Address By clicking Continue below, I agree to receive email from
MyAmericanPrizes and affiliated brands that may be of interest to me. I also
agree to the Terms & Conditions (including mandatory arbitration), Privacy
Policy, and site visit recordation by TrustedForm and Jornaya.
Date of Birth
Gender Select Male Female Other
Address
Zip Code
City
State Select State Alabama Alaska Arizona Arkansas California Colorado
Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas
Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi
Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York
North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South
Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West
Virginia Wisconsin Wyoming
Phone # [Kevin will provide]


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