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siazik-ortala.kemdikbud.go.id Open in urlscan Pro
118.98.229.107  Public Scan

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URL: https://siazik-ortala.kemdikbud.go.id/survey/97fd45ba-af8e-11ee-8f59-005056af1431
Submission: On January 31 via manual from ID — Scanned from DE

Form analysis 1 forms found in the DOM

POST https://siazik-ortala.kemdikbud.go.id/survey/lanjut

<form class="login100-form validate-form" enctype="multipart/form-data" action="https://siazik-ortala.kemdikbud.go.id/survey/lanjut" method="post">
  <input type="hidden" name="_token" value="0Y9g3iJx7gRZS1G7vsv63Fit67qoRqwOpgNeo6kK"> <input type="hidden" name="_method" value="POST"> <span class="login90-form-title">
    <center><br>Selamat datang di survey ZI - WBK<br>
      <strong>Kementerian Pendidikan, Kebudayaan, Riset, dan Teknologi</strong>
    </center>
  </span>
  <div style="margin-top: 2em">
    <center><small>Silakan isi kolom di bawah ini untuk melanjutkan survey:</small></center>
  </div>
  <div class="wrap-input100 validate-input" data-bs-validate="Kolom nama harap diisi">
    <input class="input100" type="text" name="nama" placeholder="Masukkan nama Anda" required="">
    <span class="focus-input100"></span>
    <span class="symbol-input100">
      <i class="icon icon-user" aria-hidden="true"></i>
    </span>
  </div>
  <div class="wrap-input100 validate-input" data-bs-validate="Kolom email harap diisi: ex@abc.xyz">
    <input class="input100" type="email" name="email" placeholder="Masukkan email Anda" required="">
    <span class="focus-input100"></span>
    <span class="symbol-input100">
      <i class="zmdi zmdi-email" aria-hidden="true"></i>
    </span>
  </div>
  <div class="wrap-input100 validate-input" data-bs-validate="Kolom nomor whatsapp harap diisi: 08xxxxx">
    <input class="input100" type="number" name="whatsapp" minlength="10" placeholder="Nomor Whatstapp 08xxxxx" required="">
    <span class="focus-input100"></span>
    <span class="symbol-input100">
      <i class="zmdi zmdi-whatsapp" aria-hidden="true"></i>
    </span>
  </div>
  <div class="container-login100-form-btn">
    <button class="login100-form-btn btn-primary">Lanjutkan ke survey</button>
  </div>
  <input type="hidden" name="id_survey_link" value="97fd4ae2-af8e-11ee-8927-005056af1431">
</form>

Text Content

Selamat datang di survey ZI - WBK
Kementerian Pendidikan, Kebudayaan, Riset, dan Teknologi
Silakan isi kolom di bawah ini untuk melanjutkan survey:



Lanjutkan ke survey

Mohon untuk melakukan pengisian melalui
perangkat komputer dan tidak dianjurkan
melalui HP/Tab atau piranti lainnya.
Selengkapnya di https://s.id/survei-siazik