tickets.hogarth.us Open in urlscan Pro
108.36.70.81  Public Scan

Form analysis
1 forms found in the DOM

POST

<form method="post">
  <fieldset>
    <legend>Request for Raffle Tickets</legend>
    <div class="row">
      <div class="col-sm-4">
        <div class="mb-3">
          <label for="first_name" class="form-label">First Name</label>
          <input type="text" class="form-control" maxlength="60" required="" name="first_name" id="first_name" autofocus="">
        </div>
      </div>
      <div class="col-sm-4">
        <div class="mb-3">
          <label for="last_name" class="form-label">Last Name</label>
          <input type="text" class="form-control" maxlength="60" required="" name="last_name" id="last_name" autofocus="">
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-8">
        <div class="mb-3">
          <label for="address1" class="form-label">Address Line 1</label>
          <input type="text" class="form-control" maxlength="50" required="" name="address1" id="address1">
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-8">
        <div class="mb-3">
          <label for="address2" class="form-label">Address Line 2</label>
          <input type="text" class="form-control" maxlength="50" name="address2" id="address2">
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="mb-3">
          <label for="address1" class="form-label">City</label>
          <input type="text" class="form-control" maxlength="30" required="" name="city" id="city">
        </div>
      </div>
      <div class="col-sm-2">
        <div class="mb-3">
          <label for="address1" class="form-label">State</label>
          <select class="form-select" maxlength="30" required="" name="state" id="state">
            <option disabled="" selected="" value=""></option>
            <option value="AK">AK</option>
            <option value="AL">AL</option>
            <option value="AL">AL</option>
            <option value="AR">AR</option>
            <option value="AZ">AZ</option>
            <option value="CA">CA</option>
            <option value="CO">CO</option>
            <option value="CT">CT</option>
            <option value="DC">DC</option>
            <option value="DE">DE</option>
            <option value="FL">FL</option>
            <option value="GA">GA</option>
            <option value="HI">HI</option>
            <option value="IA">IA</option>
            <option value="ID">ID</option>
            <option value="IL">IL</option>
            <option value="IN">IN</option>
            <option value="KS">KS</option>
            <option value="KY">KY</option>
            <option value="LA">LA</option>
            <option value="MA">MA</option>
            <option value="MD">MD</option>
            <option value="ME">ME</option>
            <option value="MI">MI</option>
            <option value="MN">MN</option>
            <option value="MO">MO</option>
            <option value="MS">MS</option>
            <option value="MT">MT</option>
            <option value="NC">NC</option>
            <option value="ND">ND</option>
            <option value="NE">NE</option>
            <option value="NH">NH</option>
            <option value="NJ">NJ</option>
            <option value="NM">NM</option>
            <option value="NV">NV</option>
            <option value="NY">NY</option>
            <option value="OH">OH</option>
            <option value="OK">OK</option>
            <option value="OR">OR</option>
            <option value="PA">PA</option>
            <option value="PR">PR</option>
            <option value="RI">RI</option>
            <option value="SC">SC</option>
            <option value="SD">SD</option>
            <option value="TN">TN</option>
            <option value="TX">TX</option>
            <option value="UT">UT</option>
            <option value="VA">VA</option>
            <option value="VT">VT</option>
            <option value="WA">WA</option>
            <option value="WI">WI</option>
            <option value="WV">WV</option>
            <option value="WY">WY</option>
          </select>
        </div>
      </div>
      <div class="col-sm-3">
        <div class="mb-3">
          <label for="address1" class="form-label">ZIP</label>
          <input type="text" class="form-control" maxlength="10" required="" name="zip" id="zip">
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="mb-3">
          <label for="phone" class="form-label">Phone Number</label>
          <input type="tel" class="form-control" name="phone" id="phone" required="" placeholder="111-555-1212" pattern="[0-9]{3}-[0-9]{3}-[0-9]{4}">
        </div>
      </div>
      <div class="col-sm-5">
        <div class="mb-3">
          <label for="email" class="form-label">Email Address</label>
          <input type="email" class="form-control" maxlength="50" id="email" required="" name="email">
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-3">
        <div class="mb-3">
          <label for="number-tickets" class="form-label">Number of Tickets</label>
          <input type="number" class="form-control" required="" id="number-tickets" min="0" max="1000" name="number_tickets">
        </div>
      </div>
    </div>
    <div class="row">
      <div class="col-sm-8">
        <div class="mb-3">
          <label for="comments" class="form-label">Comments</label>
          <textarea rows="4" cols="45" id="comments" name="comments"></textarea>
        </div>
      </div>
    </div>
    <button type="submit" name="submit" id="submit" class="btn btn-primary btn-lg">Request Tickets</button>
  </fieldset>
</form>

Text Content

TICKET TEST SITE

Request for Raffle Tickets
First Name
Last Name
Address Line 1
Address Line 2
City
State AK AL AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN
MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV
WY
ZIP
Phone Number
Email Address
Number of Tickets
Comments
Request Tickets