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zing.jewelersmutual.com Open in urlscan Pro
2620:1ec:46::45  Public Scan

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Submitted URL: https://u17862350.ct.sendgrid.net/ls/click?upn=ox3oeVgZ2V7n2jRI99YAl5eB00-2FltRLfQzU5B52kD8G-2FhfmJkEqMgRNjIpIuLie9opPZig2lmCV0TBB...
Effective URL: https://zing.jewelersmutual.com/register/invite/E073ED2121F8308A9EBC82C6868032C9
Submission: On December 06 via manual from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form _ngcontent-zing-c181="" novalidate="" autocomplete="off" class="form-container ng-invalid ng-star-inserted ng-touched ng-dirty">
  <div _ngcontent-zing-c181="" class="details-form">
    <div _ngcontent-zing-c181="" class="row">
      <div _ngcontent-zing-c181="" class="col-12 heading-20-bold-primary mb-1"> Personal Details </div>
      <div _ngcontent-zing-c181="" class="col-12 heading-12-light-onyx mb-5"> Enter information below to begin creating your account. </div>
    </div>
    <div _ngcontent-zing-c181="" class="row">
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="firstName">First Name</label><input _ngcontent-zing-c181="" formcontrolname="firstName" type="text" id="firstName" placeholder="Enter First Name"
          class="form-control ng-touched ng-dirty ng-valid"><!----></div>
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="lastName">Last Name</label><input _ngcontent-zing-c181="" formcontrolname="lastName" type="text" id="lastName" placeholder="Enter Last Name"
          class="form-control ng-touched ng-dirty ng-valid"><!----></div>
    </div>
    <div _ngcontent-zing-c181="" class="row">
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="middleName">Middle Name</label><input _ngcontent-zing-c181="" formcontrolname="middleName" type="text" id="middleName" placeholder="Enter Middle Name"
          class="form-control ng-valid ng-touched ng-dirty"><!----></div>
    </div>
    <div _ngcontent-zing-c181="" class="row">
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="email">Email Address</label><input _ngcontent-zing-c181="" formcontrolname="email" type="text" id="email" placeholder="Enter Email Address"
          list="autocompleteOff" class="form-control ng-touched ng-dirty ng-valid" autocomplete="new-password"><!----></div>
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="phone">Mobile Number</label>
        <div _ngcontent-zing-c181="" class="input-group prepend"><label _ngcontent-zing-c181="" for="country-code" class="input-group-prepend mb-0"><select _ngcontent-zing-c181="" formcontrolname="countryCode" id="country-code"
              class="custom-select ng-valid ng-touched ng-dirty">
              <option _ngcontent-zing-c181="" selected="" value="+1">+1 </option>
            </select></label><input _ngcontent-zing-c181="" formcontrolname="phone" type="text" id="phone" class="form-control ng-valid ng-touched ng-dirty" placeholder="Mobile Number"></div><!---->
      </div>
    </div>
    <div _ngcontent-zing-c181="" class="row">
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="companyName">Legal Company Name</label><input _ngcontent-zing-c181="" formcontrolname="companyName" type="text" autocomplete="new-business-name"
          id="companyName" placeholder="Enter Company Name" class="form-control ng-touched ng-dirty" disabled=""><!----></div>
      <div _ngcontent-zing-c181="" class="col-lg-6 form-group"><label _ngcontent-zing-c181="" for="companyPhone">Company Phone Number</label>
        <div _ngcontent-zing-c181="" class="input-group prepend"><label _ngcontent-zing-c181="" for="country-code" class="input-group-prepend mb-0"><select _ngcontent-zing-c181="" formcontrolname="companyCountryCode" id="company-country-code"
              class="custom-select ng-touched ng-dirty" disabled="">
              <option _ngcontent-zing-c181="" selected="" value="+1">+1 </option>
            </select></label><input _ngcontent-zing-c181="" formcontrolname="companyPhone" type="text" id="companyPhone" class="form-control ng-touched ng-dirty" placeholder="Phone Number" disabled=""></div><!---->
      </div>
    </div>
    <div _ngcontent-zing-c181=""><z-address-details _ngcontent-zing-c181="" _nghost-zing-c178="">
        <div _ngcontent-zing-c178="" class="z-address-form position-relative ng-invalid ng-touched ng-dirty"><!----><!----><!---->
          <div _ngcontent-zing-c178="" class="row">
            <fieldset _ngcontent-zing-c178="" class="col-lg-6 form-group"><label _ngcontent-zing-c178="" for="addressLine1">Address Line 1 </label>
              <div _ngcontent-zing-c178="" class="fw-container"><input _ngcontent-zing-c178="" forbiddenwords="" formcontrolname="addressLine1" type="text" id="addressLine1" placeholder="Enter Address" autocomplete="new-address-addressLine1"
                  class="form-control ng-touched ng-dirty" disabled=""></div><!----><i _ngcontent-zing-c178="" id="addressLine1Icon" class="mdi mdi-alert text-red float-right warning-icon d-none"></i>
            </fieldset>
            <fieldset _ngcontent-zing-c178="" class="col-lg-6 form-group ng-star-inserted"><label _ngcontent-zing-c178="" for="addressLine2">Address Line 2</label>
              <div _ngcontent-zing-c178="" class="fw-container"><input _ngcontent-zing-c178="" forbiddenwords="" formcontrolname="addressLine2" type="text" id="addressLine2" placeholder="Enter Address" autocomplete="new-address-addressLine2"
                  class="form-control ng-touched ng-dirty" disabled=""></div><!----><i _ngcontent-zing-c178="" id="addressLine2Icon" class="mdi mdi-alert text-red float-right warning-icon d-none"></i>
            </fieldset><!---->
          </div>
          <div _ngcontent-zing-c178="" class="row">
            <fieldset _ngcontent-zing-c178="" class="col-lg-6 form-group"><label _ngcontent-zing-c178="" for="city">City</label><input _ngcontent-zing-c178="" formcontrolname="city" type="text" id="city" placeholder="Enter City"
                autocomplete="new-address-city" class="form-control ng-touched ng-dirty" disabled=""><!----></fieldset>
            <fieldset _ngcontent-zing-c178="" class="col-lg-6 form-group ng-star-inserted"><!----><label _ngcontent-zing-c178="" for="country" class="ng-star-inserted">Country</label><!----><select _ngcontent-zing-c178="" formcontrolname="country"
                id="country" class="custom-select ng-star-inserted ng-touched ng-dirty" disabled="">
                <option _ngcontent-zing-c178="" value="" selected="" disabled="" hidden="">Select Country</option>
                <option _ngcontent-zing-c178="" value="USA" class="ng-star-inserted">USA</option>
                <option _ngcontent-zing-c178="" value="CAN" class="ng-star-inserted">Canada</option><!---->
              </select><!----><!----><!----></fieldset><!---->
            <fieldset _ngcontent-zing-c178="" class="col-lg-6 form-group"><!----><label _ngcontent-zing-c178="" for="state" class="ng-star-inserted">State/Province</label><!----><select _ngcontent-zing-c178="" formcontrolname="stateCode" id="state"
                autocomplete="new-address-state" class="custom-select ng-touched ng-dirty ng-star-inserted" disabled="">
                <option _ngcontent-zing-c178="" value="" selected="" disabled="" hidden="" class="ng-star-inserted">Select State/Province</option><!---->
                <option _ngcontent-zing-c178="" value="AL" class="ng-star-inserted">Alabama</option>
                <option _ngcontent-zing-c178="" value="AK" class="ng-star-inserted">Alaska</option>
                <option _ngcontent-zing-c178="" value="AS" class="ng-star-inserted">American Samoa</option>
                <option _ngcontent-zing-c178="" value="AZ" class="ng-star-inserted">Arizona</option>
                <option _ngcontent-zing-c178="" value="AR" class="ng-star-inserted">Arkansas</option>
                <option _ngcontent-zing-c178="" value="CA" class="ng-star-inserted">California</option>
                <option _ngcontent-zing-c178="" value="CO" class="ng-star-inserted">Colorado</option>
                <option _ngcontent-zing-c178="" value="CT" class="ng-star-inserted">Connecticut</option>
                <option _ngcontent-zing-c178="" value="DE" class="ng-star-inserted">Delaware</option>
                <option _ngcontent-zing-c178="" value="DC" class="ng-star-inserted">District Of Columbia</option>
                <option _ngcontent-zing-c178="" value="FM" class="ng-star-inserted">Federated States Of Micronesia</option>
                <option _ngcontent-zing-c178="" value="FL" class="ng-star-inserted">Florida</option>
                <option _ngcontent-zing-c178="" value="GA" class="ng-star-inserted">Georgia</option>
                <option _ngcontent-zing-c178="" value="GU" class="ng-star-inserted">Guam</option>
                <option _ngcontent-zing-c178="" value="HI" class="ng-star-inserted">Hawaii</option>
                <option _ngcontent-zing-c178="" value="ID" class="ng-star-inserted">Idaho</option>
                <option _ngcontent-zing-c178="" value="IL" class="ng-star-inserted">Illinois</option>
                <option _ngcontent-zing-c178="" value="IN" class="ng-star-inserted">Indiana</option>
                <option _ngcontent-zing-c178="" value="IA" class="ng-star-inserted">Iowa</option>
                <option _ngcontent-zing-c178="" value="KS" class="ng-star-inserted">Kansas</option>
                <option _ngcontent-zing-c178="" value="KY" class="ng-star-inserted">Kentucky</option>
                <option _ngcontent-zing-c178="" value="LA" class="ng-star-inserted">Louisiana</option>
                <option _ngcontent-zing-c178="" value="ME" class="ng-star-inserted">Maine</option>
                <option _ngcontent-zing-c178="" value="MH" class="ng-star-inserted">Marshall Islands</option>
                <option _ngcontent-zing-c178="" value="MD" class="ng-star-inserted">Maryland</option>
                <option _ngcontent-zing-c178="" value="MA" class="ng-star-inserted">Massachusetts</option>
                <option _ngcontent-zing-c178="" value="MI" class="ng-star-inserted">Michigan</option>
                <option _ngcontent-zing-c178="" value="MN" class="ng-star-inserted">Minnesota</option>
                <option _ngcontent-zing-c178="" value="MS" class="ng-star-inserted">Mississippi</option>
                <option _ngcontent-zing-c178="" value="MO" class="ng-star-inserted">Missouri</option>
                <option _ngcontent-zing-c178="" value="MT" class="ng-star-inserted">Montana</option>
                <option _ngcontent-zing-c178="" value="NE" class="ng-star-inserted">Nebraska</option>
                <option _ngcontent-zing-c178="" value="NV" class="ng-star-inserted">Nevada</option>
                <option _ngcontent-zing-c178="" value="NH" class="ng-star-inserted">New Hampshire</option>
                <option _ngcontent-zing-c178="" value="NJ" class="ng-star-inserted">New Jersey</option>
                <option _ngcontent-zing-c178="" value="NM" class="ng-star-inserted">New Mexico</option>
                <option _ngcontent-zing-c178="" value="NY" class="ng-star-inserted">New York</option>
                <option _ngcontent-zing-c178="" value="NC" class="ng-star-inserted">North Carolina</option>
                <option _ngcontent-zing-c178="" value="ND" class="ng-star-inserted">North Dakota</option>
                <option _ngcontent-zing-c178="" value="MP" class="ng-star-inserted">Northern Mariana Islands</option>
                <option _ngcontent-zing-c178="" value="OH" class="ng-star-inserted">Ohio</option>
                <option _ngcontent-zing-c178="" value="OK" class="ng-star-inserted">Oklahoma</option>
                <option _ngcontent-zing-c178="" value="OR" class="ng-star-inserted">Oregon</option>
                <option _ngcontent-zing-c178="" value="PW" class="ng-star-inserted">Palau</option>
                <option _ngcontent-zing-c178="" value="PA" class="ng-star-inserted">Pennsylvania</option>
                <option _ngcontent-zing-c178="" value="PR" class="ng-star-inserted">Puerto Rico</option>
                <option _ngcontent-zing-c178="" value="RI" class="ng-star-inserted">Rhode Island</option>
                <option _ngcontent-zing-c178="" value="SC" class="ng-star-inserted">South Carolina</option>
                <option _ngcontent-zing-c178="" value="SD" class="ng-star-inserted">South Dakota</option>
                <option _ngcontent-zing-c178="" value="TN" class="ng-star-inserted">Tennessee</option>
                <option _ngcontent-zing-c178="" value="TX" class="ng-star-inserted">Texas</option>
                <option _ngcontent-zing-c178="" value="UT" class="ng-star-inserted">Utah</option>
                <option _ngcontent-zing-c178="" value="VT" class="ng-star-inserted">Vermont</option>
                <option _ngcontent-zing-c178="" value="VI" class="ng-star-inserted">Virgin Islands</option>
                <option _ngcontent-zing-c178="" value="VA" class="ng-star-inserted">Virginia</option>
                <option _ngcontent-zing-c178="" value="WA" class="ng-star-inserted">Washington</option>
                <option _ngcontent-zing-c178="" value="WV" class="ng-star-inserted">West Virginia</option>
                <option _ngcontent-zing-c178="" value="WI" class="ng-star-inserted">Wisconsin</option>
                <option _ngcontent-zing-c178="" value="WY" class="ng-star-inserted">Wyoming</option><!---->
              </select><!----><!----><!----><!----></fieldset>
            <fieldset _ngcontent-zing-c178="" class="col-lg-6 form-group"><label _ngcontent-zing-c178="" for="zipcode">Postal Code</label><input _ngcontent-zing-c178="" formcontrolname="zipCode" type="text" id="zipcode"
                placeholder="Enter Postal Code" autocomplete="new-address-postal" class="form-control ng-touched ng-dirty" disabled=""><!----><!----><!----></fieldset>
          </div>
        </div><z-spinner _ngcontent-zing-c178="" _nghost-zing-c106=""><!----></z-spinner>
      </z-address-details></div>
    <div _ngcontent-zing-c181="" class="custom-control custom-checkbox my-3 participant-agreement-consent"><input _ngcontent-zing-c181="" type="checkbox" id="participant-agreement-consent" class="custom-control-input"><label _ngcontent-zing-c181=""
        for="participant-agreement-consent" class="custom-control-label zing-blue"><span _ngcontent-zing-c181=""><strong> By checking this box, you are accepting the terms and conditions of the</strong>
        </span><a _ngcontent-zing-c181="" target="blank" id="participant-agreement" href="/legal/participant-agreement"> Participant Agreement. </a></label></div>
    <div _ngcontent-zing-c181="" class="custom-control custom-checkbox my-3 email-consent"><input _ngcontent-zing-c181="" type="checkbox" id="email-consent" class="custom-control-input"><label _ngcontent-zing-c181="" for="email-consent"
        class="custom-control-label zing-blue"><span _ngcontent-zing-c181=""><strong>Yes, I consent to receive news, updates or promotions from Jewelers Mutual Group.</strong> I understand that I can unsubscribe at any time. Please refer to
          our</span><a _ngcontent-zing-c181="" target="blank" id="privacy-policy" href="https://www.jewelersmutual.com/privacy-policy"> Privacy Policy </a> for more details. </label></div><button _ngcontent-zing-c181="" type="submit"
      id="personalDetailsContinue" class="btn-md btn-zing-blue mt-2 :disabled{cursor:not-allowed}" disabled=""> Continue </button>
  </div>
</form>

Text Content

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Personal Details
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First Name
Last Name
Middle Name
Email Address
Mobile Number
+1
Legal Company Name
Company Phone Number
+1
Address Line 1

Address Line 2

CityCountrySelect CountryUSACanadaState/ProvinceSelect
State/ProvinceAlabamaAlaskaAmerican
SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of
ColumbiaFederated States Of
MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall
IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana
IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth
CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin
IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingPostal Code
By checking this box, you are accepting the terms and conditions of the
Participant Agreement.
Yes, I consent to receive news, updates or promotions from Jewelers Mutual
Group. I understand that I can unsubscribe at any time. Please refer to our
Privacy Policy for more details.
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