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  • Profile Image

    SSL problem

    Asked by rickeb on April 15, 2012 at 07:28 PM

    The page with my jotform application says something about the application is not secure when using Browsers Iron, Chrome, Camino and Safari. When using Firefox and OmniWeb it seems secure. This is the page:

    https://regalservice.com/Application.html

     https://regalservice.com/Home.html and https://regalservice.com/Thanks.html always come up secure in all Browsers. What are these Browsers seeing in my application that is not secure?

    Page URL:
    https://regalservice.com/Application.html

    Screenshot
  • Profile Image

    Answered by jeanettebmz on April 15, 2012 at 07:54 PM

    Make sure the form's code is embedded using the secure method into your .js file, since Chrome as well as Safari, have detected that something inside the page's code is not secure

    Jeanette

     

     

  • Profile Image

    Answered by rickeb on April 15, 2012 at 08:06 PM

    I did that, heres the code for the iWeb widget:

     

    <script src="https://secure.jotform.com/min/g=jotform?3.0.3169" type="text/javascript"></script>

    <script type="text/javascript">

       JotForm.init(function(){

          JotForm.initCaptcha('input_66');

          JotForm.description('input_13', 'What\'s the best number to reach you at?');

          $('input_12').hint('ex: myname@example.com');

       });

    </script>

    <link target="_blank" href="https://secure.jotform.com/min/g=formCss?3.0.3169" rel="nofollow noopener" rel="stylesheet" type="text/css" />

    <style type="text/css">

        .form-label{

            width:150px !important;

        }

        .form-label-left{

            width:150px !important;

        }

        .form-line{

            padding:10px;

        }

        .form-label-right{

            width:150px !important;

        }

        .form-all{

            width:677px;

            background:transparent;

            color:#000000 !important;

            font-family:'Verdana';

            font-size:12px;

        }

    </style>

     

    <form class="jotform-form" action="https://secure.jotform.com/submit.php" method="post" name="form_3465841261" id="3465841261" accept-charset="utf-8">

      <input type="hidden" name="formID" value="3465841261" />

      <div class="form-all">

        <ul class="form-section">

          <li class="form-line" id="id_65">

            <div id="cid_65" class="form-input-wide">

              <div style="text-align:center;">

                <img alt="" class="form-image" border="0" src="//www.jotform.net/uploads/rickeb/form_files/crown(address)copper(trim).png" height="158" width="299" />

              </div>

            </div>

          </li>

          <li class="form-line" id="id_77">

            <div id="cid_77" class="form-input-wide">

              <div id="text_77" class="form-html">

                <p>

                  <br />

                  <br />

                  <strong>

                    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Interested in a driving career with Employee Owned, Asset Based Regal Service?

                  </strong>

                  <br />

                  <strong>

                    &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; We are currently looking for drivers who live in the following areas:

                  </strong>

                  <br />

                  &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;

                  <em>

                    <strong>

                      &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &bull;

                    </strong>

                    Northwestern&nbsp; Pennsylvania

                  </em>

                  <br />

                  <em>

                    <strong>

                      &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &bull;

                    </strong>

                    Western New York

                  </em>

                  <br />

                  <em>

                    <strong>

                      &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &bull;

                    </strong>

                    Eastern Ohio

                  </em>

                  <br />

                  <em>

                    <strong>

                      &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp; &bull;

                    </strong>

                    The Baltimore MD and Indianapolis IN area

                  </em>

                </p>

              </div>

            </div>

          </li>

          <li id="cid_10" class="form-input-wide">

            <div class="form-header-group">

              <h2 id="header_10" class="form-header">

                Driver's Application for Employment

              </h2>

              <div id="subHeader_10" class="form-subHeader">

                Please complete the form below to apply for a Driver's Position with The Regal Service Company

              </div>

            </div>

          </li>

          <li class="form-line" id="id_66">

            <label class="form-label-left" id="label_66" for="input_66">

              Enter the message as it's shown to prevent spam submissions:<span class="form-required">*</span>

            </label>

            <div id="cid_66" class="form-input">

              <div class="form-captcha">

                <label for="input_66"> <img alt="Captcha - Reload if it's not displayed" id="input_66_captcha" class="form-captcha-image" style="background:url(https://secure.jotform.com/images/loader-big.gif) no-repeat center;" src="https://secure.jotform.com/images/blank.gif" width="150" height="41" /> </label>

                <div style="white-space:nowrap;">

                  <input type="text" id="input_66" class="form-textbox validate[required]" name="captcha" style="width:130px;" />

                  <img src="https://secure.jotform.com/images/reload.png" alt="Reload" align="absmiddle" style="cursor:pointer" onclick="JotForm.reloadCaptcha('input_66');" />

                  <input type="hidden" name="captcha_id" id="input_66_captcha_id" value="0" />

                </div>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_16">

            <div id="cid_16" class="form-input-wide">

              <div id="text_16" class="form-html">

                <p>

                  &nbsp;&nbsp; In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.

                </p>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_11">

            <label class="form-label-left" id="label_11" for="input_11">

              Full Name<span class="form-required">*</span>

            </label>

            <div id="cid_11" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q11_fullName[first]" id="first_11" />

                <label class="form-sub-label" for="first_11" id="sublabel_first"> First Name </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q11_fullName[last]" id="last_11" />

                <label class="form-sub-label" for="last_11" id="sublabel_last"> Last Name </label></span>

            </div>

          </li>

          <li class="form-line" id="id_64">

            <label class="form-label-left" id="label_64" for="input_64">

              Address<span class="form-required">*</span>

            </label>

            <div id="cid_64" class="form-input">

              <table summary="" class="form-address-table" border="0" cellpadding="0" cellspacing="0">

                <tr>

                  <td colspan="2"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-line" type="text" name="q64_address64[addr_line1]" id="input_64_addr_line1" />

                      <label class="form-sub-label" for="input_64_addr_line1" id="sublabel_addr_line1"> Street Address </label></span>

                  </td>

                </tr>

                <tr>

                  <td colspan="2"><span class="form-sub-label-container"><input class="form-textbox form-address-line" type="text" name="q64_address64[addr_line2]" id="input_64_addr_line2" size="46" />

                      <label class="form-sub-label" for="input_64_addr_line2" id="sublabel_addr_line2"> Street Address Line 2 </label></span>

                  </td>

                </tr>

                <tr>

                  <td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-city" type="text" name="q64_address64[city]" id="input_64_city" size="21" />

                      <label class="form-sub-label" for="input_64_city" id="sublabel_city"> City </label></span>

                  </td>

                  <td><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-state" type="text" name="q64_address64[state]" id="input_64_state" size="22" />

                      <label class="form-sub-label" for="input_64_state" id="sublabel_state"> State / Province </label></span>

                  </td>

                </tr>

                <tr>

                  <td width="50%"><span class="form-sub-label-container"><input class="form-textbox validate[required] form-address-postal" type="text" name="q64_address64[postal]" id="input_64_postal" size="10" />

                      <label class="form-sub-label" for="input_64_postal" id="sublabel_postal"> Postal / Zip Code </label></span>

                  </td>

                  <td><span class="form-sub-label-container"><select class="form-dropdown validate[required] form-address-country" name="q64_address64[country]" id="input_64_country">

                        <option selected> Please Select </option>

                        <option value="United States"> United States </option>

                        <option value="Abkhazia"> Abkhazia </option>

                        <option value="Afghanistan"> Afghanistan </option>

                        <option value="Albania"> Albania </option>

                        <option value="Algeria"> Algeria </option>

                        <option value="American Samoa"> American Samoa </option>

                        <option value="Andorra"> Andorra </option>

                        <option value="Angola"> Angola </option>

                        <option value="Anguilla"> Anguilla </option>

                        <option value="Antigua and Barbuda"> Antigua and Barbuda </option>

                        <option value="Argentina"> Argentina </option>

                        <option value="Armenia"> Armenia </option>

                        <option value="Aruba"> Aruba </option>

                        <option value="Australia"> Australia </option>

                        <option value="Austria"> Austria </option>

                        <option value="Azerbaijan"> Azerbaijan </option>

                        <option value="The Bahamas"> The Bahamas </option>

                        <option value="Bahrain"> Bahrain </option>

                        <option value="Bangladesh"> Bangladesh </option>

                        <option value="Barbados"> Barbados </option>

                        <option value="Belarus"> Belarus </option>

                        <option value="Belgium"> Belgium </option>

                        <option value="Belize"> Belize </option>

                        <option value="Benin"> Benin </option>

                        <option value="Bermuda"> Bermuda </option>

                        <option value="Bhutan"> Bhutan </option>

                        <option value="Bolivia"> Bolivia </option>

                        <option value="Bosnia and Herzegovina"> Bosnia and Herzegovina </option>

                        <option value="Botswana"> Botswana </option>

                        <option value="Brazil"> Brazil </option>

                        <option value="Brunei"> Brunei </option>

                        <option value="Bulgaria"> Bulgaria </option>

                        <option value="Burkina Faso"> Burkina Faso </option>

                        <option value="Burundi"> Burundi </option>

                        <option value="Cambodia"> Cambodia </option>

                        <option value="Cameroon"> Cameroon </option>

                        <option value="Canada"> Canada </option>

                        <option value="Cape Verde"> Cape Verde </option>

                        <option value="Cayman Islands"> Cayman Islands </option>

                        <option value="Central African Republic"> Central African Republic </option>

                        <option value="Chad"> Chad </option>

                        <option value="Chile"> Chile </option>

                        <option value="People's Republic of China"> People's Republic of China </option>

                        <option value="Republic of China"> Republic of China </option>

                        <option value="Christmas Island"> Christmas Island </option>

                        <option value="Cocos (Keeling) Islands"> Cocos (Keeling) Islands </option>

                        <option value="Colombia"> Colombia </option>

                        <option value="Comoros"> Comoros </option>

                        <option value="Congo"> Congo </option>

                        <option value="Cook Islands"> Cook Islands </option>

                        <option value="Costa Rica"> Costa Rica </option>

                        <option value="Cote d'Ivoire"> Cote d'Ivoire </option>

                        <option value="Croatia"> Croatia </option>

                        <option value="Cuba"> Cuba </option>

                        <option value="Cyprus"> Cyprus </option>

                        <option value="Czech Republic"> Czech Republic </option>

                        <option value="Denmark"> Denmark </option>

                        <option value="Djibouti"> Djibouti </option>

                        <option value="Dominica"> Dominica </option>

                        <option value="Dominican Republic"> Dominican Republic </option>

                        <option value="Ecuador"> Ecuador </option>

                        <option value="Egypt"> Egypt </option>

                        <option value="El Salvador"> El Salvador </option>

                        <option value="Equatorial Guinea"> Equatorial Guinea </option>

                        <option value="Eritrea"> Eritrea </option>

                        <option value="Estonia"> Estonia </option>

                        <option value="Ethiopia"> Ethiopia </option>

                        <option value="Falkland Islands"> Falkland Islands </option>

                        <option value="Faroe Islands"> Faroe Islands </option>

                        <option value="Fiji"> Fiji </option>

                        <option value="Finland"> Finland </option>

                        <option value="France"> France </option>

                        <option value="French Polynesia"> French Polynesia </option>

                        <option value="Gabon"> Gabon </option>

                        <option value="The Gambia"> The Gambia </option>

                        <option value="Georgia"> Georgia </option>

                        <option value="Germany"> Germany </option>

                        <option value="Ghana"> Ghana </option>

                        <option value="Gibraltar"> Gibraltar </option>

                        <option value="Greece"> Greece </option>

                        <option value="Greenland"> Greenland </option>

                        <option value="Grenada"> Grenada </option>

                        <option value="Guadeloupe"> Guadeloupe </option>

                        <option value="Guam"> Guam </option>

                        <option value="Guatemala"> Guatemala </option>

                        <option value="Guernsey"> Guernsey </option>

                        <option value="Guinea"> Guinea </option>

                        <option value="Guinea-Bissau"> Guinea-Bissau </option>

                        <option value="Guyana"> Guyana </option>

                        <option value="Haiti"> Haiti </option>

                        <option value="Honduras"> Honduras </option>

                        <option value="Hong Kong"> Hong Kong </option>

                        <option value="Hungary"> Hungary </option>

                        <option value="Iceland"> Iceland </option>

                        <option value="India"> India </option>

                        <option value="Indonesia"> Indonesia </option>

                        <option value="Iran"> Iran </option>

                        <option value="Iraq"> Iraq </option>

                        <option value="Ireland"> Ireland </option>

                        <option value="Israel"> Israel </option>

                        <option value="Italy"> Italy </option>

                        <option value="Jamaica"> Jamaica </option>

                        <option value="Japan"> Japan </option>

                        <option value="Jersey"> Jersey </option>

                        <option value="Jordan"> Jordan </option>

                        <option value="Kazakhstan"> Kazakhstan </option>

                        <option value="Kenya"> Kenya </option>

                        <option value="Kiribati"> Kiribati </option>

                        <option value="North Korea"> North Korea </option>

                        <option value="South Korea"> South Korea </option>

                        <option value="Kosovo"> Kosovo </option>

                        <option value="Kuwait"> Kuwait </option>

                        <option value="Kyrgyzstan"> Kyrgyzstan </option>

                        <option value="Laos"> Laos </option>

                        <option value="Latvia"> Latvia </option>

                        <option value="Lebanon"> Lebanon </option>

                        <option value="Lesotho"> Lesotho </option>

                        <option value="Liberia"> Liberia </option>

                        <option value="Libya"> Libya </option>

                        <option value="Liechtenstein"> Liechtenstein </option>

                        <option value="Lithuania"> Lithuania </option>

                        <option value="Luxembourg"> Luxembourg </option>

                        <option value="Macau"> Macau </option>

                        <option value="Macedonia"> Macedonia </option>

                        <option value="Madagascar"> Madagascar </option>

                        <option value="Malawi"> Malawi </option>

                        <option value="Malaysia"> Malaysia </option>

                        <option value="Maldives"> Maldives </option>

                        <option value="Mali"> Mali </option>

                        <option value="Malta"> Malta </option>

                        <option value="Marshall Islands"> Marshall Islands </option>

                        <option value="Martinique"> Martinique </option>

                        <option value="Mauritania"> Mauritania </option>

                        <option value="Mauritius"> Mauritius </option>

                        <option value="Mayotte"> Mayotte </option>

                        <option value="Mexico"> Mexico </option>

                        <option value="Micronesia"> Micronesia </option>

                        <option value="Moldova"> Moldova </option>

                        <option value="Monaco"> Monaco </option>

                        <option value="Mongolia"> Mongolia </option>

                        <option value="Montenegro"> Montenegro </option>

                        <option value="Montserrat"> Montserrat </option>

                        <option value="Morocco"> Morocco </option>

                        <option value="Mozambique"> Mozambique </option>

                        <option value="Myanmar"> Myanmar </option>

                        <option value="Nagorno-Karabakh"> Nagorno-Karabakh </option>

                        <option value="Namibia"> Namibia </option>

                        <option value="Nauru"> Nauru </option>

                        <option value="Nepal"> Nepal </option>

                        <option value="Netherlands"> Netherlands </option>

                        <option value="Netherlands Antilles"> Netherlands Antilles </option>

                        <option value="New Caledonia"> New Caledonia </option>

                        <option value="New Zealand"> New Zealand </option>

                        <option value="Nicaragua"> Nicaragua </option>

                        <option value="Niger"> Niger </option>

                        <option value="Nigeria"> Nigeria </option>

                        <option value="Niue"> Niue </option>

                        <option value="Norfolk Island"> Norfolk Island </option>

                        <option value="Turkish Republic of Northern Cyprus"> Turkish Republic of Northern Cyprus </option>

                        <option value="Northern Mariana"> Northern Mariana </option>

                        <option value="Norway"> Norway </option>

                        <option value="Oman"> Oman </option>

                        <option value="Pakistan"> Pakistan </option>

                        <option value="Palau"> Palau </option>

                        <option value="Palestine"> Palestine </option>

                        <option value="Panama"> Panama </option>

                        <option value="Papua New Guinea"> Papua New Guinea </option>

                        <option value="Paraguay"> Paraguay </option>

                        <option value="Peru"> Peru </option>

                        <option value="Philippines"> Philippines </option>

                        <option value="Pitcairn Islands"> Pitcairn Islands </option>

                        <option value="Poland"> Poland </option>

                        <option value="Portugal"> Portugal </option>

                        <option value="Puerto Rico"> Puerto Rico </option>

                        <option value="Qatar"> Qatar </option>

                        <option value="Romania"> Romania </option>

                        <option value="Russia"> Russia </option>

                        <option value="Rwanda"> Rwanda </option>

                        <option value="Saint Barthelemy"> Saint Barthelemy </option>

                        <option value="Saint Helena"> Saint Helena </option>

                        <option value="Saint Kitts and Nevis"> Saint Kitts and Nevis </option>

                        <option value="Saint Lucia"> Saint Lucia </option>

                        <option value="Saint Martin"> Saint Martin </option>

                        <option value="Saint Pierre and Miquelon"> Saint Pierre and Miquelon </option>

                        <option value="Saint Vincent and the Grenadines"> Saint Vincent and the Grenadines </option>

                        <option value="Samoa"> Samoa </option>

                        <option value="San Marino"> San Marino </option>

                        <option value="Sao Tome and Principe"> Sao Tome and Principe </option>

                        <option value="Saudi Arabia"> Saudi Arabia </option>

                        <option value="Senegal"> Senegal </option>

                        <option value="Serbia"> Serbia </option>

                        <option value="Seychelles"> Seychelles </option>

                        <option value="Sierra Leone"> Sierra Leone </option>

                        <option value="Singapore"> Singapore </option>

                        <option value="Slovakia"> Slovakia </option>

                        <option value="Slovenia"> Slovenia </option>

                        <option value="Solomon Islands"> Solomon Islands </option>

                        <option value="Somalia"> Somalia </option>

                        <option value="Somaliland"> Somaliland </option>

                        <option value="South Africa"> South Africa </option>

                        <option value="South Ossetia"> South Ossetia </option>

                        <option value="Spain"> Spain </option>

                        <option value="Sri Lanka"> Sri Lanka </option>

                        <option value="Sudan"> Sudan </option>

                        <option value="Suriname"> Suriname </option>

                        <option value="Svalbard"> Svalbard </option>

                        <option value="Swaziland"> Swaziland </option>

                        <option value="Sweden"> Sweden </option>

                        <option value="Switzerland"> Switzerland </option>

                        <option value="Syria"> Syria </option>

                        <option value="Taiwan"> Taiwan </option>

                        <option value="Tajikistan"> Tajikistan </option>

                        <option value="Tanzania"> Tanzania </option>

                        <option value="Thailand"> Thailand </option>

                        <option value="Timor-Leste"> Timor-Leste </option>

                        <option value="Togo"> Togo </option>

                        <option value="Tokelau"> Tokelau </option>

                        <option value="Tonga"> Tonga </option>

                        <option value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie </option>

                        <option value="Trinidad and Tobago"> Trinidad and Tobago </option>

                        <option value="Tristan da Cunha"> Tristan da Cunha </option>

                        <option value="Tunisia"> Tunisia </option>

                        <option value="Turkey"> Turkey </option>

                        <option value="Turkmenistan"> Turkmenistan </option>

                        <option value="Turks and Caicos Islands"> Turks and Caicos Islands </option>

                        <option value="Tuvalu"> Tuvalu </option>

                        <option value="Uganda"> Uganda </option>

                        <option value="Ukraine"> Ukraine </option>

                        <option value="United Arab Emirates"> United Arab Emirates </option>

                        <option value="United Kingdom"> United Kingdom </option>

                        <option value="Uruguay"> Uruguay </option>

                        <option value="Uzbekistan"> Uzbekistan </option>

                        <option value="Vanuatu"> Vanuatu </option>

                        <option value="Vatican City"> Vatican City </option>

                        <option value="Venezuela"> Venezuela </option>

                        <option value="Vietnam"> Vietnam </option>

                        <option value="British Virgin Islands"> British Virgin Islands </option>

                        <option value="US Virgin Islands"> US Virgin Islands </option>

                        <option value="Wallis and Futuna"> Wallis and Futuna </option>

                        <option value="Western Sahara"> Western Sahara </option>

                        <option value="Yemen"> Yemen </option>

                        <option value="Zambia"> Zambia </option>

                        <option value="Zimbabwe"> Zimbabwe </option>

                        <option value="other"> Other </option>

                      </select>

                      <label class="form-sub-label" for="input_64_country" id="sublabel_country"> Country </label></span>

                  </td>

                </tr>

              </table>

            </div>

          </li>

          <li class="form-line" id="id_19">

            <label class="form-label-left" id="label_19" for="input_19">

              Birth Date<span class="form-required">*</span>

            </label>

            <div id="cid_19" class="form-input"><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q19_birthDate[month]" id="input_19_month">

                  <option>  </option>

                  <option value="January"> January </option>

                  <option value="February"> February </option>

                  <option value="March"> March </option>

                  <option value="April"> April </option>

                  <option value="May"> May </option>

                  <option value="June"> June </option>

                  <option value="July"> July </option>

                  <option value="August"> August </option>

                  <option value="September"> September </option>

                  <option value="October"> October </option>

                  <option value="November"> November </option>

                  <option value="December"> December </option>

                </select>

                <label class="form-sub-label" for="input_19_month" id="sublabel_month"> Month </label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q19_birthDate[day]" id="input_19_day">

                  <option>  </option>

                  <option value="1"> 1 </option>

                  <option value="2"> 2 </option>

                  <option value="3"> 3 </option>

                  <option value="4"> 4 </option>

                  <option value="5"> 5 </option>

                  <option value="6"> 6 </option>

                  <option value="7"> 7 </option>

                  <option value="8"> 8 </option>

                  <option value="9"> 9 </option>

                  <option value="10"> 10 </option>

                  <option value="11"> 11 </option>

                  <option value="12"> 12 </option>

                  <option value="13"> 13 </option>

                  <option value="14"> 14 </option>

                  <option value="15"> 15 </option>

                  <option value="16"> 16 </option>

                  <option value="17"> 17 </option>

                  <option value="18"> 18 </option>

                  <option value="19"> 19 </option>

                  <option value="20"> 20 </option>

                  <option value="21"> 21 </option>

                  <option value="22"> 22 </option>

                  <option value="23"> 23 </option>

                  <option value="24"> 24 </option>

                  <option value="25"> 25 </option>

                  <option value="26"> 26 </option>

                  <option value="27"> 27 </option>

                  <option value="28"> 28 </option>

                  <option value="29"> 29 </option>

                  <option value="30"> 30 </option>

                  <option value="31"> 31 </option>

                </select>

                <label class="form-sub-label" for="input_19_day" id="sublabel_day"> Day </label></span><span class="form-sub-label-container"><select class="form-dropdown validate[required]" name="q19_birthDate[year]" id="input_19_year">

                  <option>  </option>

                  <option value="2016"> 2016 </option>

                  <option value="2015"> 2015 </option>

                  <option value="2014"> 2014 </option>

                  <option value="2013"> 2013 </option>

                  <option value="2012"> 2012 </option>

                  <option value="2011"> 2011 </option>

                  <option value="2010"> 2010 </option>

                  <option value="2009"> 2009 </option>

                  <option value="2008"> 2008 </option>

                  <option value="2007"> 2007 </option>

                  <option value="2006"> 2006 </option>

                  <option value="2005"> 2005 </option>

                  <option value="2004"> 2004 </option>

                  <option value="2003"> 2003 </option>

                  <option value="2002"> 2002 </option>

                  <option value="2001"> 2001 </option>

                  <option value="2000"> 2000 </option>

                  <option value="1999"> 1999 </option>

                  <option value="1998"> 1998 </option>

                  <option value="1997"> 1997 </option>

                  <option value="1996"> 1996 </option>

                  <option value="1995"> 1995 </option>

                  <option value="1994"> 1994 </option>

                  <option value="1993"> 1993 </option>

                  <option value="1992"> 1992 </option>

                  <option value="1991"> 1991 </option>

                  <option value="1990"> 1990 </option>

                  <option value="1989"> 1989 </option>

                  <option value="1988"> 1988 </option>

                  <option value="1987"> 1987 </option>

                  <option value="1986"> 1986 </option>

                  <option value="1985"> 1985 </option>

                  <option value="1984"> 1984 </option>

                  <option value="1983"> 1983 </option>

                  <option value="1982"> 1982 </option>

                  <option value="1981"> 1981 </option>

                  <option value="1980"> 1980 </option>

                  <option value="1979"> 1979 </option>

                  <option value="1978"> 1978 </option>

                  <option value="1977"> 1977 </option>

                  <option value="1976"> 1976 </option>

                  <option value="1975"> 1975 </option>

                  <option value="1974"> 1974 </option>

                  <option value="1973"> 1973 </option>

                  <option value="1972"> 1972 </option>

                  <option value="1971"> 1971 </option>

                  <option value="1970"> 1970 </option>

                  <option value="1969"> 1969 </option>

                  <option value="1968"> 1968 </option>

                  <option value="1967"> 1967 </option>

                  <option value="1966"> 1966 </option>

                  <option value="1965"> 1965 </option>

                  <option value="1964"> 1964 </option>

                  <option value="1963"> 1963 </option>

                  <option value="1962"> 1962 </option>

                  <option value="1961"> 1961 </option>

                  <option value="1960"> 1960 </option>

                  <option value="1959"> 1959 </option>

                  <option value="1958"> 1958 </option>

                  <option value="1957"> 1957 </option>

                  <option value="1956"> 1956 </option>

                  <option value="1955"> 1955 </option>

                  <option value="1954"> 1954 </option>

                  <option value="1953"> 1953 </option>

                  <option value="1952"> 1952 </option>

                  <option value="1951"> 1951 </option>

                  <option value="1950"> 1950 </option>

                  <option value="1949"> 1949 </option>

                  <option value="1948"> 1948 </option>

                  <option value="1947"> 1947 </option>

                  <option value="1946"> 1946 </option>

                  <option value="1945"> 1945 </option>

                  <option value="1944"> 1944 </option>

                  <option value="1943"> 1943 </option>

                  <option value="1942"> 1942 </option>

                  <option value="1941"> 1941 </option>

                  <option value="1940"> 1940 </option>

                  <option value="1939"> 1939 </option>

                  <option value="1938"> 1938 </option>

                  <option value="1937"> 1937 </option>

                  <option value="1936"> 1936 </option>

                  <option value="1935"> 1935 </option>

                  <option value="1934"> 1934 </option>

                  <option value="1933"> 1933 </option>

                  <option value="1932"> 1932 </option>

                  <option value="1931"> 1931 </option>

                  <option value="1930"> 1930 </option>

                  <option value="1929"> 1929 </option>

                  <option value="1928"> 1928 </option>

                  <option value="1927"> 1927 </option>

                  <option value="1926"> 1926 </option>

                  <option value="1925"> 1925 </option>

                  <option value="1924"> 1924 </option>

                  <option value="1923"> 1923 </option>

                  <option value="1922"> 1922 </option>

                  <option value="1921"> 1921 </option>

                  <option value="1920"> 1920 </option>

                </select>

                <label class="form-sub-label" for="input_19_year" id="sublabel_year"> Year </label></span>

            </div>

          </li>

          <li class="form-line" id="id_17">

            <label class="form-label-left" id="label_17" for="input_17">

              Social Security #<span class="form-required">*</span>

            </label>

            <div id="cid_17" class="form-input">

              <input type="text" class="form-textbox validate[required]" id="input_17" name="q17_socialSecurity17" size="20" />

            </div>

          </li>

          <li class="form-line" id="id_67">

            <label class="form-label-left" id="label_67" for="input_67">

              Driver's License #<span class="form-required">*</span>

            </label>

            <div id="cid_67" class="form-input">

              <input type="text" class="form-textbox validate[required]" id="input_67" name="q67_driversLicense67" size="20" />

            </div>

          </li>

          <li class="form-line" id="id_68">

            <label class="form-label-left" id="label_68" for="input_68">

              License Class & State<span class="form-required">*</span>

            </label>

            <div id="cid_68" class="form-input">

              <input type="text" class="form-textbox validate[required]" id="input_68" name="q68_licenseClass" size="20" />

            </div>

          </li>

          <li class="form-line" id="id_13">

            <label class="form-label-left" id="label_13" for="input_13">

              Phone<span class="form-required">*</span>

            </label>

            <div id="cid_13" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q13_phone13[area]" id="input_13_area" size="3">

                -

                <label class="form-sub-label" for="input_13_area" id="sublabel_area"> Area Code </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="tel" name="q13_phone13[phone]" id="input_13_phone" size="8">

                <label class="form-sub-label" for="input_13_phone" id="sublabel_phone"> Phone Number </label></span>

            </div>

          </li>

          <li class="form-line" id="id_12">

            <label class="form-label-left" id="label_12" for="input_12"> E-mail </label>

            <div id="cid_12" class="form-input">

              <input type="email" class="form-textbox validate[Email]" id="input_12" name="q12_email" size="20" />

            </div>

          </li>

          <li class="form-line" id="id_5">

            <label class="form-label-left" id="label_5" for="input_5"> Applying for Position: </label>

            <div id="cid_5" class="form-input">

              <input type="text" class="form-textbox" id="input_5" name="q5_Applying_for_Position_" size="30" />

            </div>

          </li>

          <li class="form-line" id="id_6">

            <label class="form-label-left" id="label_6" for="input_6"> When can you start? </label>

            <div id="cid_6" class="form-input">

              <input type="text" class="form-textbox" id="input_6" name="q6_When_can_you_start_" size="10" />

            </div>

          </li>

          <li class="form-line" id="id_15">

            <div id="cid_15" class="form-input-wide">

              <div id="text_15" class="form-html">

                <p>

                  <strong>

                    TO BE READ & STIPULATED TO BY APPLICANT

                  </strong>

                  <br />

                  &nbsp;&nbsp; I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only If and after a conditional offer of employment has been extended.)

                  <br />

                  &nbsp;&nbsp; I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

                  <br />

                  &nbsp;&nbsp; In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.

                  <br />

                  &nbsp;&nbsp; I understand that information I provide regarding current andlor previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

                  <br />

                  &nbsp;&nbsp;

                  <strong>

                    &bull;

                  </strong>

                  Review information provided by previous employers;

                  <br />

                  &nbsp;&nbsp;

                  <strong>

                    &bull;

                  </strong>

                  Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and

                  <br />

                  &nbsp;&nbsp;

                  <strong>

                    &bull;

                  </strong>

                  Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

                </p>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_63">

            <label class="form-label-left" id="label_63" for="input_63">

              Full Name<span class="form-required">*</span>

            </label>

            <div id="cid_63" class="form-input"><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q63_fullName63[first]" id="first_63" />

                <label class="form-sub-label" for="first_63" id="sublabel_first"> First Name </label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q63_fullName63[last]" id="last_63" />

                <label class="form-sub-label" for="last_63" id="sublabel_last"> Last Name </label></span>

            </div>

          </li>

          <li class="form-line" id="id_26">

            <label class="form-label-left" id="label_26" for="input_26">

              I Agree:<span class="form-required">*</span>

            </label>

            <div id="cid_26" class="form-input">

              <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_26_0" name="q26_iAgree26" value="Yes" />

                  <label for="input_26_0"> Yes </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio validate[required]" id="input_26_1" name="q26_iAgree26" value="No" />

                  <label for="input_26_1"> No </label></span><span class="clearfix"></span>

              </div>

            </div>

          </li>

          <li id="cid_21" class="form-input-wide">

            <div class="form-header-group">

              <h3 id="header_21" class="form-header">

                List your addresses of residency for the past 3 years:

              </h3>

            </div>

          </li>

          <li class="form-line" id="id_20">

            <label class="form-label-left" id="label_20" for="input_20"> Current Address: </label>

            <div id="cid_20" class="form-input">

              <textarea id="input_20" class="form-textarea" name="q20_currentAddress20" cols="40" rows="6"></textarea>

            </div>

          </li>

          <li class="form-line" id="id_23">

            <label class="form-label-left" id="label_23" for="input_23"> How Long Here: </label>

            <div id="cid_23" class="form-input">

              <input type="text" class="form-textbox" id="input_23" name="q23_howLong" size="20" />

            </div>

          </li>

          <li class="form-line" id="id_22">

            <label class="form-label-left" id="label_22" for="input_22"> Previous Address: </label>

            <div id="cid_22" class="form-input">

              <textarea id="input_22" class="form-textarea" name="q22_previousAddress" cols="40" rows="6"></textarea>

            </div>

          </li>

          <li class="form-line" id="id_24">

            <label class="form-label-left" id="label_24" for="input_24"> How Long Here: </label>

            <div id="cid_24" class="form-input">

              <input type="text" class="form-textbox" id="input_24" name="q24_howLong24" size="20" />

            </div>

          </li>

          <li class="form-line" id="id_25">

            <label class="form-label-left" id="label_25" for="input_25"> Do you have the Legal Right to work in the United States? </label>

            <div id="cid_25" class="form-input">

              <div class="form-single-column"><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox" id="input_25_0" name="q25_doYou[]" value="Yes" />

                  <label for="input_25_0"> Yes </label></span><span class="clearfix"></span><span class="form-checkbox-item" style="clear:left;"><input type="checkbox" class="form-checkbox" id="input_25_1" name="q25_doYou[]" value="No" />

                  <label for="input_25_1"> No </label></span><span class="clearfix"></span>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_27">

            <label class="form-label-left" id="label_27" for="input_27"> Have you worked for Regal Service before? </label>

            <div id="cid_27" class="form-input">

              <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_27_0" name="q27_haveYou" value="Yes" />

                  <label for="input_27_0"> Yes </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_27_1" name="q27_haveYou" value="No" />

                  <label for="input_27_1"> No </label></span><span class="clearfix"></span>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_28">

            <label class="form-label-left" id="label_28" for="input_28"> If so, when and for how long? Reason for leaving? </label>

            <div id="cid_28" class="form-input">

              <textarea id="input_28" class="form-textarea" name="q28_ifSo" cols="40" rows="6"></textarea>

            </div>

          </li>

          <li class="form-line" id="id_29">

            <label class="form-label-left" id="label_29" for="input_29"> Do you have a job now? </label>

            <div id="cid_29" class="form-input">

              <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_29_0" name="q29_doYou29" value="Yes" />

                  <label for="input_29_0"> Yes </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_29_1" name="q29_doYou29" value="No" />

                  <label for="input_29_1"> No </label></span><span class="clearfix"></span>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_30">

            <label class="form-label-left" id="label_30" for="input_30"> If so, employer name and how long you've been there? </label>

            <div id="cid_30" class="form-input">

              <textarea id="input_30" class="form-textarea" name="q30_ifSo30" cols="40" rows="6"></textarea>

            </div>

          </li>

          <li class="form-line" id="id_31">

            <label class="form-label-left" id="label_31" for="input_31"> Have you ever been Bonded? </label>

            <div id="cid_31" class="form-input">

              <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_31_0" name="q31_haveYou31" value="Yes" />

                  <label for="input_31_0"> Yes </label></span><span class="clearfix"></span><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_31_1" name="q31_haveYou31" value="No" />

                  <label for="input_31_1"> No </label></span><span class="clearfix"></span>

              </div>

            </div>

          </li>

          <li class="form-line" id="id_32">

            <label class="form-label-left" id="label_32" for="input_32"> Have you ever been convicted of a Felony? </label>

            <div id="cid_32" class="form-input">

              <div class="form-single-column"><span class="form-radio-item" style="clear:left;"><input type="radio" class="form-radio" id="input_32_0" name="q32_haveYou32" value="Yes" />

                  <label for="input_32_0"> Yes </label></span><span clas

  • Profile Image

    Answered by jeanettebmz on April 15, 2012 at 08:30 PM

    Hi , I found a bug in the iWeb widget code

     

    you will need to set it , this way:

    https://secure.jotform.net/uploads/rickeb/form_files/crown(address)copper(trim).png

     

    Make sure to de-bug the rest of the code so if you find something similar, add the "s" and replace  www by secure

    Jeanette


  • Profile Image

    Answered by rickeb on April 16, 2012 at 09:02 AM

    Thanks jeanettebmz, that one tweak fixed it.

     

    Rick