www.citeline.com Open in urlscan Pro
2606:4700::6812:13aa  Public Scan

Form analysis
1 forms found in the DOM

Name: citelinemarketingsitecoreform — POST /citeline-api/Forms/EloquaFormSubmitV2

<form id="fasttrack" data-form-validation="" method="post" class="form form--dark elq-form fasttrack elq-form-fasttrack" name="citelinemarketingsitecoreform" action="/citeline-api/Forms/EloquaFormSubmitV2"
  data-form-error-message="Oops there was an error!" data-form-ok-message="Message submitted." data-form-redirect-message="We will redirect you shortly." onsubmit="return handleFastTrackFormSubmit(event, this)">
  <input name="__RequestVerificationToken" type="hidden" value="Ls2oDKI5guBI60UaIYFMDeLiDOk7kQOYI2eCEUcWSIO92Jp8-kIYyZwZ-F-FAu6E-Dq1rQ1CGjuzcjz-tnc7XD37xxM5txJT411Zy_xeuEI1">
  <input value="citelinemarketingsitecoreform" type="hidden" name="elqFormName">
  <input type="hidden" name="formSettingsId" value="8c5940f6-0e39-404b-bc73-1fc040fc5f71">
  <div class="form--dark form__header">
    <h3 class="form__title"></h3>
    <div class="form__copy">
    </div>
  </div>
  <div class="form__input form__input--50">
    <label for="firstName"> First Name <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <input value="" data-regex="^.{0,30}$" data-regex-message="Maximum 30 characters are allowed." data-visible-field="" id="firstName" name="firstName" type="text" data-required-error-message="Please enter your First Name." maxlength="30"
        data-required="">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div class="form__input form__input--50">
    <label for="lastName"> Last Name <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <input value="" data-regex="^.{0,30}$" data-regex-message="Maximum 30 characters are allowed." data-visible-field="" id="lastName" name="lastName" type="text" data-required-error-message="Please enter your Last Name." maxlength="30"
        data-required="">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div class="form__input">
    <label for="company" class="label-position top "> Company <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <input value="" data-regex="^.{0,30}$" data-regex-message="Maximum 30 characters are allowed." data-visible-field="" id="company" name="company" type="text" data-required-error-message="Please enter your Company." maxlength="30"
        data-required="">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div class="form__input">
    <label for="department1" class="label-position top "> Department </label>
    <div class="form__input-wrapper">
      <input value="" data-regex="^.{0,30}$" data-regex-message="Maximum 30 characters are allowed." data-visible-field="" id="department1" name="department1" type="text" data-required-error-message="Please enter your Department." maxlength="30">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div class="form__input">
    <label for="title"> Job Title <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <input value="" data-regex="^.{0,30}$" data-regex-message="Maximum 30 characters are allowed." data-visible-field="" id="title" name="title" type="text" data-required-error-message="Please enter your Job Title." maxlength="30" data-required="">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div class="form__input">
    <label for="emailAddress"> Business Email Address <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <input value=""
        data-regex="(?:[a-z0-9!#$%&amp;'*+/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&amp;'*+/=?^_`{|}~-]+)*|&quot;(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21\x23-\x5b\x5d-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])*&quot;)@(?:(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?|\[(?:(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9]))\.){3}(?:(2(5[0-5]|[0-4][0-9])|1[0-9][0-9]|[1-9]?[0-9])|[a-z0-9-]*[a-z0-9]:(?:[\x01-\x08\x0b\x0c\x0e-\x1f\x21-\x5a\x53-\x7f]|\\[\x01-\x09\x0b\x0c\x0e-\x7f])+)\])"
        data-regex-message="Please enter a valid email address." data-visible-field="" id="emailAddress" name="emailAddress" type="text" data-required-error-message="Please enter your Business Email Address."
        data-valid-email-message="Please enter a valid email address." data-required="">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div class="form__input-dropdown">
    <label for="country" class="label-position top "> Country <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <select data-country-selector="" data-regex="" data-regex-message="Field value is incorrect" data-visible-field="" id="country" data-required-error-message="Please enter your Country." name="country" data-required="">
        <option value="">Please select</option>
        <option value="Afghanistan" data-compliant="False"> Afghanistan </option>
        <option value="Aland Islands" data-compliant="False"> Aland Islands </option>
        <option value="Albania" data-compliant="False"> Albania </option>
        <option value="Algeria" data-compliant="False"> Algeria </option>
        <option value="American Samoa" data-compliant="False"> American Samoa </option>
        <option value="Andorra" data-compliant="False"> Andorra </option>
        <option value="Angola" data-compliant="False"> Angola </option>
        <option value="Anguilla" data-compliant="False"> Anguilla </option>
        <option value="Antarctica" data-compliant="False"> Antarctica </option>
        <option value="Antigua and Barbuda" data-compliant="False"> Antigua and Barbuda </option>
        <option value="Argentina" data-compliant="False"> Argentina </option>
        <option value="Armenia" data-compliant="False"> Armenia </option>
        <option value="Aruba" data-compliant="False"> Aruba </option>
        <option value="Australia" data-compliant="False"> Australia </option>
        <option value="Austria" data-compliant="True"> Austria </option>
        <option value="Azerbaijan" data-compliant="False"> Azerbaijan </option>
        <option value="Bahamas" data-compliant="False"> Bahamas </option>
        <option value="Bahrain" data-compliant="False"> Bahrain </option>
        <option value="Bangladesh" data-compliant="False"> Bangladesh </option>
        <option value="Barbados" data-compliant="False"> Barbados </option>
        <option value="Belarus" data-compliant="False"> Belarus </option>
        <option value="Belgium" data-compliant="True"> Belgium </option>
        <option value="Belize" data-compliant="False"> Belize </option>
        <option value="Benin" data-compliant="False"> Benin </option>
        <option value="Bermuda" data-compliant="False"> Bermuda </option>
        <option value="Bhutan" data-compliant="False"> Bhutan </option>
        <option value="Bolivia" data-compliant="False"> Bolivia </option>
        <option value="Bosnia and Herzegovina" data-compliant="False"> Bosnia and Herzegovina </option>
        <option value="Botswana" data-compliant="False"> Botswana </option>
        <option value="Bouvet Island" data-compliant="False"> Bouvet Island </option>
        <option value="Brazil" data-compliant="False"> Brazil </option>
        <option value="Brit/Indian Ocean Terr." data-compliant="False"> Brit/Indian Ocean Terr. </option>
        <option value="Brunei Darussalam" data-compliant="False"> Brunei Darussalam </option>
        <option value="Bulgaria" data-compliant="True"> Bulgaria </option>
        <option value="Burkina Faso" data-compliant="False"> Burkina Faso </option>
        <option value="Burundi" data-compliant="False"> Burundi </option>
        <option value="Cambodia" data-compliant="False"> Cambodia </option>
        <option value="Cameroon" data-compliant="False"> Cameroon </option>
        <option value="Canada" data-compliant="True"> Canada </option>
        <option value="Cape Verde" data-compliant="False"> Cape Verde </option>
        <option value="Cayman Islands" data-compliant="False"> Cayman Islands </option>
        <option value="Central African Republic" data-compliant="False"> Central African Republic </option>
        <option value="Chad" data-compliant="False"> Chad </option>
        <option value="Chile" data-compliant="False"> Chile </option>
        <option value="China" data-compliant="True"> China </option>
        <option value="Christmas Island" data-compliant="False"> Christmas Island </option>
        <option value="Cocos (Keeling) Islands" data-compliant="False"> Cocos (Keeling) Islands </option>
        <option value="Colombia" data-compliant="False"> Colombia </option>
        <option value="Comoros" data-compliant="False"> Comoros </option>
        <option value="Congo" data-compliant="False"> Congo </option>
        <option value="Congo, The Dem. Republic Of" data-compliant="False"> Congo, The Dem. Republic Of </option>
        <option value="Cook Islands" data-compliant="False"> Cook Islands </option>
        <option value="Costa Rica" data-compliant="False"> Costa Rica </option>
        <option value="Côte d'Ivoire" data-compliant="False"> Côte d'Ivoire </option>
        <option value="Croatia" data-compliant="False"> Croatia </option>
        <option value="Cuba" data-compliant="False"> Cuba </option>
        <option value="Cyprus" data-compliant="True"> Cyprus </option>
        <option value="Czech Republic" data-compliant="True"> Czech Republic </option>
        <option value="Denmark" data-compliant="True"> Denmark </option>
        <option value="Djibouti" data-compliant="False"> Djibouti </option>
        <option value="Dominica" data-compliant="False"> Dominica </option>
        <option value="Dominican Republic" data-compliant="False"> Dominican Republic </option>
        <option value="Ecuador" data-compliant="False"> Ecuador </option>
        <option value="Egypt" data-compliant="False"> Egypt </option>
        <option value="El Salvador" data-compliant="False"> El Salvador </option>
        <option value="Equatorial Guinea" data-compliant="False"> Equatorial Guinea </option>
        <option value="Eritrea" data-compliant="False"> Eritrea </option>
        <option value="Estonia" data-compliant="False"> Estonia </option>
        <option value="Ethiopia" data-compliant="False"> Ethiopia </option>
        <option value="Falkland Islands" data-compliant="False"> Falkland Islands </option>
        <option value="Faroe Islands" data-compliant="False"> Faroe Islands </option>
        <option value="Fiji" data-compliant="False"> Fiji </option>
        <option value="Finland" data-compliant="False"> Finland </option>
        <option value="France" data-compliant="False"> France </option>
        <option value="French Guiana" data-compliant="False"> French Guiana </option>
        <option value="French Polynesia" data-compliant="False"> French Polynesia </option>
        <option value="French Southern Terr." data-compliant="False"> French Southern Terr. </option>
        <option value="Gabon" data-compliant="False"> Gabon </option>
        <option value="Gambia" data-compliant="False"> Gambia </option>
        <option value="Georgia" data-compliant="False"> Georgia </option>
        <option value="Germany" data-compliant="True"> Germany </option>
        <option value="Ghana" data-compliant="False"> Ghana </option>
        <option value="Gibraltar" data-compliant="False"> Gibraltar </option>
        <option value="Greece" data-compliant="True"> Greece </option>
        <option value="Greenland" data-compliant="False"> Greenland </option>
        <option value="Grenada" data-compliant="False"> Grenada </option>
        <option value="Guadeloupe" data-compliant="False"> Guadeloupe </option>
        <option value="Guam" data-compliant="False"> Guam </option>
        <option value="Guatemala" data-compliant="False"> Guatemala </option>
        <option value="Guinea" data-compliant="False"> Guinea </option>
        <option value="Guinea-Bissau" data-compliant="False"> Guinea-Bissau </option>
        <option value="Guyana" data-compliant="False"> Guyana </option>
        <option value="Haiti" data-compliant="False"> Haiti </option>
        <option value="Heard/McDonald Isls." data-compliant="False"> Heard/McDonald Isls. </option>
        <option value="Honduras" data-compliant="False"> Honduras </option>
        <option value="Hong Kong" data-compliant="False"> Hong Kong </option>
        <option value="Hungary" data-compliant="False"> Hungary </option>
        <option value="Iceland" data-compliant="False"> Iceland </option>
        <option value="India" data-compliant="False"> India </option>
        <option value="Indonesia" data-compliant="True"> Indonesia </option>
        <option value="Iran" data-compliant="False"> Iran </option>
        <option value="Iraq" data-compliant="False"> Iraq </option>
        <option value="Ireland" data-compliant="False"> Ireland </option>
        <option value="Israel" data-compliant="False"> Israel </option>
        <option value="Italy" data-compliant="True"> Italy </option>
        <option value="Jamaica" data-compliant="False"> Jamaica </option>
        <option value="Japan" data-compliant="True"> Japan </option>
        <option value="Jordan" data-compliant="False"> Jordan </option>
        <option value="Kazakhstan" data-compliant="False"> Kazakhstan </option>
        <option value="Kenya" data-compliant="False"> Kenya </option>
        <option value="Kiribati" data-compliant="False"> Kiribati </option>
        <option value="Korea (North)" data-compliant="False"> Korea (North) </option>
        <option value="Korea (South)" data-compliant="True"> Korea (South) </option>
        <option value="Kuwait" data-compliant="False"> Kuwait </option>
        <option value="Kyrgyzstan" data-compliant="False"> Kyrgyzstan </option>
        <option value="Laos" data-compliant="False"> Laos </option>
        <option value="Latvia" data-compliant="False"> Latvia </option>
        <option value="Lebanon" data-compliant="False"> Lebanon </option>
        <option value="Lesotho" data-compliant="False"> Lesotho </option>
        <option value="Liberia" data-compliant="False"> Liberia </option>
        <option value="Libya" data-compliant="False"> Libya </option>
        <option value="Liechtenstein" data-compliant="False"> Liechtenstein </option>
        <option value="Lithuania" data-compliant="True"> Lithuania </option>
        <option value="Luxembourg" data-compliant="False"> Luxembourg </option>
        <option value="Macau" data-compliant="False"> Macau </option>
        <option value="Macedonia" data-compliant="False"> Macedonia </option>
        <option value="Madagascar" data-compliant="False"> Madagascar </option>
        <option value="Malawi" data-compliant="False"> Malawi </option>
        <option value="Malaysia" data-compliant="False"> Malaysia </option>
        <option value="Maldives" data-compliant="False"> Maldives </option>
        <option value="Mali" data-compliant="False"> Mali </option>
        <option value="Malta" data-compliant="True"> Malta </option>
        <option value="Marshall Islands" data-compliant="False"> Marshall Islands </option>
        <option value="Martinique" data-compliant="False"> Martinique </option>
        <option value="Mauritania" data-compliant="False"> Mauritania </option>
        <option value="Mauritius" data-compliant="False"> Mauritius </option>
        <option value="Mayotte" data-compliant="False"> Mayotte </option>
        <option value="Mexico" data-compliant="False"> Mexico </option>
        <option value="Micronesia" data-compliant="False"> Micronesia </option>
        <option value="Moldova" data-compliant="False"> Moldova </option>
        <option value="Monaco" data-compliant="False"> Monaco </option>
        <option value="Mongolia" data-compliant="False"> Mongolia </option>
        <option value="Montserrat" data-compliant="False"> Montserrat </option>
        <option value="Morocco" data-compliant="False"> Morocco </option>
        <option value="Mozambique" data-compliant="False"> Mozambique </option>
        <option value="Myanmar" data-compliant="False"> Myanmar </option>
        <option value="N. Mariana Isls." data-compliant="False"> N. Mariana Isls. </option>
        <option value="Namibia" data-compliant="False"> Namibia </option>
        <option value="Nauru" data-compliant="False"> Nauru </option>
        <option value="Nepal" data-compliant="False"> Nepal </option>
        <option value="Netherlands" data-compliant="True"> Netherlands </option>
        <option value="Netherlands Antilles" data-compliant="False"> Netherlands Antilles </option>
        <option value="New Caledonia" data-compliant="False"> New Caledonia </option>
        <option value="New Zealand" data-compliant="False"> New Zealand </option>
        <option value="Nicaragua" data-compliant="False"> Nicaragua </option>
        <option value="Niger" data-compliant="False"> Niger </option>
        <option value="Nigeria" data-compliant="False"> Nigeria </option>
        <option value="Niue" data-compliant="False"> Niue </option>
        <option value="Norfolk Island" data-compliant="False"> Norfolk Island </option>
        <option value="Norway" data-compliant="False"> Norway </option>
        <option value="Oman" data-compliant="False"> Oman </option>
        <option value="Pakistan" data-compliant="False"> Pakistan </option>
        <option value="Palau" data-compliant="False"> Palau </option>
        <option value="Palestinian Territory, Occupied" data-compliant="False"> Palestinian Territory, Occupied </option>
        <option value="Panama" data-compliant="False"> Panama </option>
        <option value="Papua New Guinea" data-compliant="False"> Papua New Guinea </option>
        <option value="Paraguay" data-compliant="False"> Paraguay </option>
        <option value="Peru" data-compliant="False"> Peru </option>
        <option value="Philippines" data-compliant="True"> Philippines </option>
        <option value="Pitcairn" data-compliant="False"> Pitcairn </option>
        <option value="Poland" data-compliant="True"> Poland </option>
        <option value="Portugal" data-compliant="False"> Portugal </option>
        <option value="Puerto Rico" data-compliant="False"> Puerto Rico </option>
        <option value="Qatar" data-compliant="False"> Qatar </option>
        <option value="Reunion" data-compliant="False"> Reunion </option>
        <option value="Romania" data-compliant="False"> Romania </option>
        <option value="Russian Federation" data-compliant="False"> Russian Federation </option>
        <option value="Rwanda" data-compliant="False"> Rwanda </option>
        <option value="Saint Helena" data-compliant="False"> Saint Helena </option>
        <option value="Saint Kitts and Nevis" data-compliant="False"> Saint Kitts and Nevis </option>
        <option value="Saint Lucia" data-compliant="False"> Saint Lucia </option>
        <option value="Samoa" data-compliant="False"> Samoa </option>
        <option value="San Marino" data-compliant="False"> San Marino </option>
        <option value="Sao Tome/Principe" data-compliant="False"> Sao Tome/Principe </option>
        <option value="Saudi Arabia" data-compliant="False"> Saudi Arabia </option>
        <option value="Senegal" data-compliant="False"> Senegal </option>
        <option value="Serbia and Montenegro" data-compliant="False"> Serbia and Montenegro </option>
        <option value="Seychelles" data-compliant="False"> Seychelles </option>
        <option value="Sierra Leone" data-compliant="False"> Sierra Leone </option>
        <option value="Singapore" data-compliant="True"> Singapore </option>
        <option value="Slovak Republic" data-compliant="False"> Slovak Republic </option>
        <option value="Slovenia" data-compliant="False"> Slovenia </option>
        <option value="Solomon Islands" data-compliant="False"> Solomon Islands </option>
        <option value="Somalia" data-compliant="False"> Somalia </option>
        <option value="South Africa" data-compliant="True"> South Africa </option>
        <option value="Spain" data-compliant="True"> Spain </option>
        <option value="Sri Lanka" data-compliant="False"> Sri Lanka </option>
        <option value="St. Helena" data-compliant="False"> St. Helena </option>
        <option value="St. Pierre and Miquelon" data-compliant="False"> St. Pierre and Miquelon </option>
        <option value="St. Vincent and Grenadines" data-compliant="False"> St. Vincent and Grenadines </option>
        <option value="Sudan" data-compliant="False"> Sudan </option>
        <option value="Suriname" data-compliant="False"> Suriname </option>
        <option value="Svalbard/Jan Mayen Isls." data-compliant="False"> Svalbard/Jan Mayen Isls. </option>
        <option value="Swaziland" data-compliant="False"> Swaziland </option>
        <option value="Sweden" data-compliant="False"> Sweden </option>
        <option value="Switzerland" data-compliant="True"> Switzerland </option>
        <option value="Syria" data-compliant="False"> Syria </option>
        <option value="Taiwan" data-compliant="False"> Taiwan </option>
        <option value="Tajikistan" data-compliant="False"> Tajikistan </option>
        <option value="Tanzania" data-compliant="False"> Tanzania </option>
        <option value="Thailand" data-compliant="False"> Thailand </option>
        <option value="Timor-Leste" data-compliant="False"> Timor-Leste </option>
        <option value="Togo" data-compliant="False"> Togo </option>
        <option value="Tokelau" data-compliant="False"> Tokelau </option>
        <option value="Tonga" data-compliant="False"> Tonga </option>
        <option value="Trinidad and Tobago" data-compliant="False"> Trinidad and Tobago </option>
        <option value="Tunisia" data-compliant="False"> Tunisia </option>
        <option value="Turkey" data-compliant="False"> Turkey </option>
        <option value="Turkmenistan" data-compliant="False"> Turkmenistan </option>
        <option value="Turks/Caicos Isls." data-compliant="False"> Turks/Caicos Isls. </option>
        <option value="Tuvalu" data-compliant="False"> Tuvalu </option>
        <option value="Uganda" data-compliant="False"> Uganda </option>
        <option value="Ukraine" data-compliant="False"> Ukraine </option>
        <option value="United Arab Emirates" data-compliant="False"> United Arab Emirates </option>
        <option value="United Kingdom" data-compliant="False"> United Kingdom </option>
        <option value="United States" data-compliant="False"> United States </option>
        <option value="US Minor Outlying Is." data-compliant="False"> US Minor Outlying Is. </option>
        <option value="Uruguay" data-compliant="False"> Uruguay </option>
        <option value="Uzbekistan" data-compliant="False"> Uzbekistan </option>
        <option value="Vanuatu" data-compliant="False"> Vanuatu </option>
        <option value="Vatican City" data-compliant="False"> Vatican City </option>
        <option value="Venezuela" data-compliant="False"> Venezuela </option>
        <option value="Viet Nam" data-compliant="True"> Viet Nam </option>
        <option value="Virgin Islands (British)" data-compliant="False"> Virgin Islands (British) </option>
        <option value="Virgin Islands (U.S.)" data-compliant="False"> Virgin Islands (U.S.) </option>
        <option value="Wallis/Futuna Isls." data-compliant="False"> Wallis/Futuna Isls. </option>
        <option value="Western Sahara" data-compliant="False"> Western Sahara </option>
        <option value="Yemen" data-compliant="False"> Yemen </option>
        <option value="Zambia" data-compliant="False"> Zambia </option>
        <option value="Zimbabwe" data-compliant="False"> Zimbabwe </option>
      </select>
      <div class="dropdown-icon">
        <svg viewBox="0 0 24 24" class="global-header__chevron icon" fill="none">
          <use xlink:href="/dist/icons/icons.svg#select-arrow"></use>
        </svg>
      </div>
    </div>
  </div>
  <div class="form__input">
    <label for="busPhone"> Business Phone <span class="form-required"> * </span>
    </label>
    <div class="form__input-wrapper">
      <input value="" data-regex="^(\(?\+?[0-9]*\)?)?[0-9_\- \(\)]*$" data-regex-message="Maximum 20 numeric characters are allowed." data-visible-field="" id="busPhone" name="busPhone" type="text"
        data-required-error-message="Please enter your Business Phone." maxlength="20" data-required="">
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div id="" class="form__input">
    <label for="howCanWeHelp"> How Can We Help </label>
    <div class="form__input-wrapper">
      <textarea class="form__input-area" data-regex="^.{0,500}$" data-regex-message="Maximum 500 characters allowed." data-visible-field="" id="howCanWeHelp" name="howCanWeHelp"
        data-required-error-message="Please enter your Form Comments."></textarea>
      <span class="form__input-icon"></span>
    </div>
  </div>
  <div data-opt-out="" class="form__input-wrapper">
    <span class="form__copy"> Citeline may contact you about relevant products, services and content. To opt-out of these communications or to manage what you receive, please visit our
      <a href="https://discover.citeline.com/CommunicationPreferenceCenter" target="_blank" style="color: inherit;">Preference Center</a>.<br> <br>Your information will be used in accordance with our
      <a href="https://www.norstella.com/privacy-notice/" target="_blank" style="color:inherit;">Privacy notice</a>. </span>
  </div>
  <div data-opt-in-checkbox="" hidden="" class="form__checkbox form__hidden">
    <input name="optin" type="checkbox">
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