registration.blackliontires.ca Open in urlscan Pro
23.91.191.14  Public Scan

Form analysis
1 forms found in the DOM

Name: form1 — POST Default.aspx

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    <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="F1788A8B">
    <input type="hidden" name="__VIEWSTATEENCRYPTED" id="__VIEWSTATEENCRYPTED" value="">
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  </div>
  <table width="850" border="0" align="center" cellpadding="5" cellspacing="0" style="margin: 0 auto; position: relative">
    <tbody>
      <tr>
        <td colspan="3">
          <h2> A) Your Contact Information </h2>
        </td>
      </tr>
      <tr>
        <td>
          <label for="dateofpurchase"> Date of Purchase:</label><input name="dateofpurchase" type="text" value="" datatype="d" onfocus="showCalendar('dateofpurchase','mm/dd/y')" onclick="showCalendar('dateofpurchase','mm/dd/y')" id="dateofpurchase"
            autocomplete="off" readonly="readonly" maxlength="12" class="form">
        </td>
        <td>
          <label for="firstname"> First Name:</label><br>
          <input name="firstname" type="text" value="" datatype="s" maxlength="30" class="form">
        </td>
        <td>
          <label for="lastname"> Last Name:</label><br>
          <input name="lastname" type="text" value="" datatype="s" maxlength="30" class="form">
        </td>
      </tr>
      <tr>
        <td colspan="2">
          <label for="address"> Address:</label><br>
          <input name="address" type="text" value="" datatype="s" maxlength="50" class="address">
        </td>
        <td>
          <label for="city"> City:</label><br>
          <input id="city" name="city" type="text" datatype="s" maxlength="50" class="form">
        </td>
      </tr>
      <tr>
        <td>
          <label for="province"> Province:</label><br>
          <select name="province" id="province" datatype="select" errormsg="Please Choose Province.">
            <option selected="selected" value="0">Please Choose Province</option>
            <option value="Alberta">Alberta</option>
            <option value="British Columbia">British Columbia</option>
            <option value="Manitoba">Manitoba</option>
            <option value="New Brunswick">New Brunswick</option>
            <option value="Newfoundland and Labrador">Newfoundland and Labrador</option>
            <option value="Northwest Territories">Northwest Territories</option>
            <option value="Nova Scotia">Nova Scotia</option>
            <option value="Nunavut">Nunavut</option>
            <option value="Ontario">Ontario</option>
            <option value="Prince Edward Island">Prince Edward Island</option>
            <option value="Quebec">Quebec</option>
            <option value="Saskatchewan">Saskatchewan</option>
            <option value="Yukon Territory">Yukon Territory</option>
          </select>
        </td>
        <td>
          <label for="postalcode"> Postal Code:</label><br>
          <input name="postalcode" type="text" value="" maxlength="7" datatype="s" nullmsg="no postal code provided for customer contact information." class="form">
        </td>
        <td>
          <label for="email"> Email:</label><br>
          <input name="email" type="text" value="" datatype="e" nullmsg="Please enter a valid email address." autocomplete="off" maxlength="50" class="form">
        </td>
      </tr>
      <tr>
        <td colspan="3">
          <h2> B) Your Tire Information </h2>
        </td>
      </tr>
      <tr>
        <td width="33%" class="tire-info-cell">
          <p class="label">Tire Size</p>
          <input class="form" type="text" value="" name="tire_size" maxlength="16" datatype="tireSize">
          <p class="example">Example: <span>195/65R15</span></p>
        </td>
        <td width="33%" class="tire-info-cell">
          <p class="label">Tire Line</p>
          <input class="form" type="text" value="" name="tire_line" maxlength="21" datatype="tireLine">
          <p class="example">Example: <span>BH15 CILERRO</span></p>
        </td>
        <td rowspan="8" valign="top">
          <p class="dot-instructions"> The DOT code is the serial code located in the lower sidewall after the word "DOT". The complete DOT code typically contains a group of up to 13 characters (letters and numbers). In the photo below, the DOT code
            is 1KE EFHXLY 2216 – Important: The last four digits indicate the week and year of manufacture. For example, week 22 of the year 2016 </p>
          <p class="dot-sample">
            <a href="imgs/dot-lg.jpg" target="_blank"><img src="imgs/dot_tire.jpg" width="100%"></a>
          </p>
        </td>
      </tr>
      <tr>
        <td width="33%"> DOT Code: </td>
        <td width="33%"> Quantity: </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-1" maxlength="13" datatype="s">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-1" maxlength="2" datatype="n" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-2" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-2" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-3" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-3" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-4" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-4" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-5" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-5" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-6" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-6" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-7" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-7" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td>
          <input class="form" type="text" value="" name="code-8" maxlength="13">
        </td>
        <td>
          <input class="quantity" type="text" value="" name="quantity-8" maxlength="2" datatype="vx" ignore="ignore" errormsg="Quantity value must be number." nullmsg="no quantity associated with DOT number submitted." onkeyup="ChkNumeric(this);">
        </td>
      </tr>
      <tr>
        <td> &nbsp; </td>
        <td> &nbsp; </td>
      </tr>
      <tr>
        <td> &nbsp; </td>
        <td> &nbsp; </td>
      </tr>
      <tr>
        <td colspan="3">
          <h2> C) Dealer Information </h2>
        </td>
      </tr>
      <tr>
        <td>
          <label for="dealer_name"> Dealer Name:</label><br>
          <input name="dealer_name" type="text" value="" datatype="s" maxlength="30" class="form">
        </td>
        <td>
          <label for="dealer_address"> Address:</label><br>
          <input name="dealer_address" type="text" value="" datatype="s" maxlength="50" class="form">
        </td>
        <td>
          <label for="dealer_city"> City:</label><br>
          <input id="dealer_city" name="dealer_city" type="text" datatype="s" maxlength="50" class="form">
        </td>
      </tr>
      <tr>
        <td>
          <label for="dealer_province"> Province:</label><br>
          <select name="dealer_province" id="dealer_province" datatype="select" errormsg="Please Choose Province.">
            <option selected="selected" value="0">Please Choose Province</option>
            <option value="Alberta">Alberta</option>
            <option value="British Columbia">British Columbia</option>
            <option value="Manitoba">Manitoba</option>
            <option value="New Brunswick">New Brunswick</option>
            <option value="Newfoundland and Labrador">Newfoundland and Labrador</option>
            <option value="Northwest Territories">Northwest Territories</option>
            <option value="Nova Scotia">Nova Scotia</option>
            <option value="Nunavut">Nunavut</option>
            <option value="Ontario">Ontario</option>
            <option value="Prince Edward Island">Prince Edward Island</option>
            <option value="Quebec">Quebec</option>
            <option value="Saskatchewan">Saskatchewan</option>
            <option value="Yukon Territory">Yukon Territory</option>
          </select>
        </td>
        <td>
          <label for="dealer_postalcode"> Postal Code:</label><br>
          <input name="dealer_postalcode" type="text" value="" datatype="s" maxlength="7" class="form">
        </td>
        <td> &nbsp; </td>
      </tr>
      <tr>
        <td> &nbsp; </td>
        <td> &nbsp; </td>
        <td> &nbsp; </td>
      </tr>
      <tr>
        <td>
          <input type="submit" name="submit" id="submit" value="Submit Form" style="font-size: 17px;
                    padding: 8px 16px;">
        </td>
        <td> &nbsp; </td>
        <td> &nbsp; </td>
      </tr>
      <tr>
        <td colspan="3">
          <div id="footer">
            <a id="get" href="http://www.blackliontires.ca">
                <img src="imgs/emblem_16x16.png" width="16" alt="Blacklion Tires">Blacklion Tires</a>
          </div>
        </td>
      </tr>
    </tbody>
  </table>
</form>

Text Content

 
français


TIRE REGISTRATION FORM

Dear valued customer,

It is important that you promptly register your Blacklion brand tires after
purchase. This will enable us to contact you in the event of a tire recall.
Blacklion Tires respects your privacy and will not use this information to
contact you for any reason other than in the event of a tire recall.If you have
already submitted a tire registration but wish to inform us of changes to your
contact information, please resubmit this form with your updated information.


A) YOUR CONTACT INFORMATION

Date of Purchase: First Name:
Last Name:
Address:
City:
Province:
Please Choose Province Alberta British Columbia Manitoba New Brunswick
Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario
Prince Edward Island Quebec Saskatchewan Yukon Territory Postal Code:
Email:



B) YOUR TIRE INFORMATION

Tire Size

Example: 195/65R15

Tire Line

Example: BH15 CILERRO

The DOT code is the serial code located in the lower sidewall after the word
"DOT". The complete DOT code typically contains a group of up to 13 characters
(letters and numbers). In the photo below, the DOT code is 1KE EFHXLY 2216 –
Important: The last four digits indicate the week and year of manufacture. For
example, week 22 of the year 2016



DOT Code: Quantity:        


C) DEALER INFORMATION

Dealer Name:
Address:
City:
Province:
Please Choose Province Alberta British Columbia Manitoba New Brunswick
Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario
Prince Edward Island Quebec Saskatchewan Yukon Territory Postal Code:
           
Blacklion Tires


Informationχ