industrialmedia.dragonforms.com
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204.180.130.190
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Submitted URL: https://im.omeclk.com/portal/wts/ugmcmS6hmDaq3A6dyVm63DjMfaf7yMmLP~1mOtmvo7|qFk5o7fDx9rp3a
Effective URL: https://industrialmedia.dragonforms.com/loading.do?__lt-lid=60c39243a58c1814c50bef12&utm_source=Industrial+Media&utm_medium=email&utm_ca...
Submission: On May 05 via api from US — Scanned from DE
Effective URL: https://industrialmedia.dragonforms.com/loading.do?__lt-lid=60c39243a58c1814c50bef12&utm_source=Industrial+Media&utm_medium=email&utm_ca...
Submission: On May 05 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST saveNewSubscription.do;jsessionid=7972775C7CD99D2D471D516D9F7BC002;jsessionid=7972775C7CD99D2D471D516D9F7BC002
<form method="post" accept-charset="utf-8" action="saveNewSubscription.do;jsessionid=7972775C7CD99D2D471D516D9F7BC002;jsessionid=7972775C7CD99D2D471D516D9F7BC002" id="standardForm"><input type="hidden" name="14" id="14" value="1"><input type="hidden"
id="dragonjsessionid" name="dragonjsessionid" value="7972775C7CD99D2D471D516D9F7BC002"><input type="hidden" id="shippingaddresscountry" name="shippingaddresscountry" value="7">
<div class="container">
<div class="sixteen columns">
<div class="header"><img src="https://hostedcontent.dragonforms.com/hosted/images/dragon/12267/86.jpg" alt="MBT_logo"></div>
</div>
<nav class="drgNav nav" style="display: none;"><select>
<option selected="selected" value="">Go to...</option>
</select></nav>
<div>
<span class="validation">
<ul></ul>
</span>
</div>
<div class="sixteen columns">
<div class="content1">
<hr>
</div>
</div>
<div class="eleven columns">
<div class="content2"><span class="spancp712 drg-element-type-product drg-element-sub-type-type-2">
<p id="pp712" class="drg-element-type-product drg-element-sub-type-type-2"><span class="questionlabel ">MBT Today </span></p>
<ul>
<li class="licrp712_1 lier2817_1 "><input name="opt2817" type="radio" value="1" id="optid712_1"><span class="radiolabel"><label for="optid712_1">Yes</label></span></li>
<li class="licrp712_2 lier2817_2 "><input name="opt2817" type="radio" value="2" id="optid712_2"><span class="radiolabel"><label for="optid712_2">No</label></span></li>
</ul>
</span>
<hr><span class="spancp722 drg-element-type-product drg-element-sub-type-type-2">
<p id="pp722" class="drg-element-type-product drg-element-sub-type-type-2"><span class="questionlabel ">MBT Product Showcase </span></p>
<ul>
<li class="licrp722_1 lier2819_1 "><input name="opt2819" type="radio" value="1" id="optid722_1"><span class="radiolabel"><label for="optid722_1">Yes</label></span></li>
<li class="licrp722_2 lier2819_2 "><input name="opt2819" type="radio" value="2" id="optid722_2"><span class="radiolabel"><label for="optid722_2">No</label></span></li>
</ul>
</span>
<hr><span class="spanc85 drg-element-type-demographic drg-element-sub-type-type-1">
<p id="p85" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><label for="id85"><strong>Please fill in the ONE category which best describes your business (Check only
one):</strong></label> </span><select name="demo2828" id="id85">
<option value="">Select...</option>
<option value="429">Additive Manufacturing</option>
<option value="430">Aerospace</option>
<option value="431">Automation</option>
<option value="432">Automotive</option>
<option value="433">Chemicals</option>
<option value="434">Contract Manufacturing</option>
<option value="435">CPG</option>
<option value="436">Electrical & Electronics</option>
<option value="437">Energy & Power</option>
<option value="438">Food & Beverage</option>
<option value="439">Government & Military</option>
<option value="440">Industrial & Commercial Equipment</option>
<option value="441">Industrial & Commercial Machinery</option>
<option value="442">Instrumentation</option>
<option value="443">Material Handling</option>
<option value="444">Materials, inc. Rubber & Plastics</option>
<option value="445">Metal Fabrication</option>
<option value="446">MRO</option>
<option value="447">Off Road</option>
<option value="448">Packaging</option>
<option value="449">Pharma & Medical</option>
<option value="450">Retail/Distribution</option>
<option value="451">Services, inc. Training</option>
<option value="452">Software</option>
<option value="453">Supply Chain</option>
<option value="454">Technology & Communications</option>
<option value="455">Textiles</option>
<option value="456">Wood & Paper</option>
</select></p>
</span><span class="spanc86 drg-element-type-demographic drg-element-sub-type-type-1">
<p id="p86" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><label for="id86"><strong>Please fill in the ONE category which best describes your job title (Check only
one):</strong></label> </span><select name="demo2831" id="id86">
<option value="">Select...</option>
<option value="457">Administration</option>
<option value="458">Executive Management</option>
<option value="459">Finance</option>
<option value="460">IT</option>
<option value="461">Maintenance, Operations, Management</option>
<option value="462">Product Development</option>
<option value="463">Purchasing</option>
<option value="465">Safety</option>
<option value="466">Sales</option>
<option value="467">Supply Chain</option>
</select></p>
</span><span class="spanc84 drg-element-type-demographic drg-element-sub-type-type-1">
<p id="p84" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><label for="id84"><strong>What is the total number of employees at this location?</strong></label> </span><select name="demo2829"
id="id84">
<option value="">Select...</option>
<option value="422">Less than 10</option>
<option value="423">10 to 50 Employees</option>
<option value="424">50 to 100 Employees</option>
<option value="425">100 to 500 Employees</option>
<option value="426">500 to 1000 Employees</option>
<option value="427">1000 to 5000 Employees</option>
<option value="428">Over 5000 Employees</option>
</select></p>
</span><span class="spanc83 drg-element-type-demographic drg-element-sub-type-type-1">
<p id="p83" class="drg-element-type-demographic drg-element-sub-type-type-1"><span class="questionlabel "><label for="id83"><strong>What is the annual revenue at your company?</strong></label> </span><select name="demo2830" id="id83">
<option value="">Select...</option>
<option value="415">Less than $5M</option>
<option value="416">$5M to $50M</option>
<option value="417">$50M to $200M</option>
<option value="418">$200M to $500M</option>
<option value="419">$500M to $1B</option>
<option value="420">$1B to $5B</option>
<option value="421">Over $5B</option>
</select></p>
</span>
</div>
</div>
<div class="five columns">
<div class="content3">
<p id="p13" class="drg-element-type-standard-field drg-element-sub-type-fieldname-EMAILADDR addresslabel"><span class="questionlabel "><label for="id13">Email Address <font color="red">*</font></label> </span><input
class="drg-field-address-normal" name="demo2820" type="text" value="" id="id13" maxlength="50" size="50"></p>
<p id="p28" class="drg-element-type-standard-field drg-element-sub-type-fieldname-EMAILADDRC addresslabel"><span class="questionlabel "><label for="id28">Confirm Email Address <font color="red">*</font></label> </span><input
class="drg-field-address-normal" name="demo2821" type="text" value="" id="id28" maxlength="50" size="50"></p>
<p id="p1" class="drg-element-type-standard-field drg-element-sub-type-fieldname-FIRSTNAME addresslabel"><span class="questionlabel "><label for="id1">First Name <font color="red">*</font></label> </span><input
class="drg-field-address-normal" name="demo2822" type="text" value="" id="id1" maxlength="40" size="40"></p>
<p id="p2" class="drg-element-type-standard-field drg-element-sub-type-fieldname-LASTNAME addresslabel"><span class="questionlabel "><label for="id2">Last Name <font color="red">*</font></label> </span><input class="drg-field-address-normal"
name="demo2823" type="text" value="" id="id2" maxlength="40" size="40"></p>
<p id="p3" class="drg-element-type-standard-field drg-element-sub-type-fieldname-COMPANY addresslabel"><span class="questionlabel "><label for="id3">Company Name</label> </span><input class="drg-field-address-normal" name="demo2824"
type="text" value="" id="id3" maxlength="40" size="40"></p>
<p id="p11" class="drg-element-type-standard-field drg-element-sub-type-fieldname-PHONE addresslabel"><span class="questionlabel "><label for="id11">Phone Number</label> </span><input class="drg-field-address-normal" name="demo2825"
type="text" value="" id="id11" maxlength="32" size="32"></p>
<div id="cstmsubmit"><input type="submit" value="Submit" id="custombtn"></div>
</div>
</div>
<div class="sixteen columns">
<div class="footer">
<hr>
</div>
</div>
</div>
<input type="hidden" name="transactionKey" value="dragon-hpci-ba28ff7a3f504781863495c481b2f358"><input type="hidden" name="dragon_pagenumber" value="1"><input type="hidden" id="originalUrlParams"
value="__lt-lid=60c39243a58c1814c50bef12&utm_source=Industrial+Media&utm_medium=email&utm_campaign=05052022&utm_term=IMCD220429010&omedasite=mbt_signup">
</form>
Text Content
Go to... -------------------------------------------------------------------------------- MBT Today * Yes * No -------------------------------------------------------------------------------- MBT Product Showcase * Yes * No -------------------------------------------------------------------------------- Please fill in the ONE category which best describes your business (Check only one): Select...Additive ManufacturingAerospaceAutomationAutomotiveChemicalsContract ManufacturingCPGElectrical & ElectronicsEnergy & PowerFood & BeverageGovernment & MilitaryIndustrial & Commercial EquipmentIndustrial & Commercial MachineryInstrumentationMaterial HandlingMaterials, inc. Rubber & PlasticsMetal FabricationMROOff RoadPackagingPharma & MedicalRetail/DistributionServices, inc. TrainingSoftwareSupply ChainTechnology & CommunicationsTextilesWood & Paper Please fill in the ONE category which best describes your job title (Check only one): Select...AdministrationExecutive ManagementFinanceITMaintenance, Operations, ManagementProduct DevelopmentPurchasingSafetySalesSupply Chain What is the total number of employees at this location? Select...Less than 1010 to 50 Employees50 to 100 Employees100 to 500 Employees500 to 1000 Employees1000 to 5000 EmployeesOver 5000 Employees What is the annual revenue at your company? Select...Less than $5M$5M to $50M$50M to $200M$200M to $500M$500M to $1B$1B to $5BOver $5B Email Address * Confirm Email Address * First Name * Last Name * Company Name Phone Number -------------------------------------------------------------------------------- <%-- the gray background --%> Yes No