Error from Hubspot Form API Submission on Nursing Request Information Form (NursingRequestInformation.php)

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REQUEST ID: 4f76db835eae398c IP ADDRESS: 50.62.176.123

Gateway time-out

The web server reported a gateway time-out error.


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Status Code:504
CURL Error:
DATA:degree=LPN%2FLVN+to+ASN+Bridge+%28RN%29&please_select_your_license_=LPN%2FLVN&firstname=zena&lastname=davis&phone=870-779-1330&alternate_phone_=903-824-4079&email=zenajld%40aol.com&how_did_you_find_us_=Search+Engine&state=AR&zip=71854&lead_status=New+Lead&lifecyclestage=lead&hs_context=%7B%22hutk%22%3A%221daeb543a27a5599fc9b9b5122a248c1%22%2C%22ipAddress%22%3A%22162.71.241.12%22%2C%22pageUrl%22%3A%22https%3A%5C%2F%5C%2Fwww.achievetestprep.com%5C%2Frequest-more-information-RN-bridge-program%3F__hssc%3D107512029.2.1563309069913%26__hstc%3D107512029.1daeb543a27a5599fc9b9b5122a248c1.1563309069912.1563309069912.1563309069912.1%26__hsfp%3D3556510710%26hsCtaTracking%3D08767bb8-04cf-4f53-be09-762bb9949714%257C665f1fef-ab44-4e00-b107-f9e49bc01929%22%2C%22pageName%22%3A%22Request+More+Information+%7C+RN+Bridge+Program+%7C+Achieve+Test+Prep%22%2C%22pageId%22%3A%227715426260%22%7D&general_program_of_interest=RN+Bridge+%28ASN+or+BSN%29
162.71.241.12
Texarkana, Texas 75501
Form Title: Nursing Request Information
File Name: NursingRequestInformation.php
Session ID: ltibmue7df4rs87a3tjgjknkj2
Form ID: e594e1e65866c47461c7f929cf9bd946
Key: eyJBIjoib2owbWVzIiwiQiI6IjRiNGl4MjAiLCJDIjoiOTF2MHQiLCJEIjoiMXJwODViYSIsIkUiOiJyNHBpY3AiLCJGIjoiMWxscXY1eSJ9
Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/75.0.3770.100 Safari/537.36
PHP_SELF: /forms/Views/NursingRequestInformation.php
SERVER_ADDR: 23.229.210.163
SERVER_NAME: www2.achievetestprep.com
SERVER_SOFTWARE: Apache
SERVER_PROTOCOL: HTTP/2.0
REQUEST_METHOD: POST
REQUEST_TIME: 1563310344
REQUEST_TIME_FLOAT: 1563310344.2837
DOCUMENT_ROOT: /home/atphosting/public_html/achievetestprep.com
HTTP_ACCEPT: */*
HTTP_ACCEPT_ENCODING: gzip, deflate, br
HTTP_ACCEPT_LANGUAGE: en-US,en;q=0.9
HTTP_HOST: www2.achievetestprep.com
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HTTP_USER_AGENT: Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/75.0.3770.100 Safari/537.36
HTTPS: on
REMOTE_ADDR: 162.71.241.12
REMOTE_PORT: 47096
SCRIPT_FILENAME: /home/atphosting/public_html/achievetestprep.com/forms/Views/NursingRequestInformation.php
SERVER_ADMIN: webmaster@www2.achievetestprep.com
SERVER_PORT: 443
SCRIPT_NAME: /forms/Views/NursingRequestInformation.php
REQUEST_URI: /forms/Views/NursingRequestInformation.php
Array ( [degree] => Array ( [label] => Degree of Interest: [column] => 1 [required] => 1 [req_dependant] => None [type] => select [options] => Array ( [LPN/LVN to ASN Bridge (RN)] => LPN/LVN to ASN Bridge (RN) [LPN to BSN Bridge (RN)] => LPN to BSN Bridge (RN) [LPN to Nurse Practitioner] => LPN to Nurse Practitioner [RN or BSN Bridge] => RN or BSN Bridge [RN to BSN] => RN to BSN [Paramedic to RN] => Paramedic to RN [Paramedic to BSN (flight nurse)] => Paramedic to BSN (flight nurse) [EMT to RN] => EMT to RN [Respiratory Therapist to RN] => Respiratory Therapist to RN [Fire & Emergency Management] => Fire & Emergency Management [Fire Science] => Fire Science [Physician Assistant] => Physician Assistant [Respiratory Therapy] => Respiratory Therapy [Nursing - Full RN Program (not an LPN/LVN)] => Nursing - General Degree [Nursing - CNA to RN] => CNA to RN [Nursing - Medical Assistant to RN] => Medical Asst to RN [Healthcare Administration] => Healthcare Administration [Healthcare Management] => Healthcare Management [Other] => Other ) [sf_lead_field] => Initial_Program_of_Interest__c [sf_instructor_field] => [hs_field] => degree [note] => [valid] => 1 [post] => 1br126 [value] => LPN/LVN to ASN Bridge (RN) ) [license] => Array ( [label] => Please select your license. [column] => 1 [required] => 1 [req_dependant] => None [type] => select [options] => Array ( [CNA/CMA] => CNA/CMA [EMT] => EMT [LPN/LVN] => LPN/LVN [Paramedic] => Paramedic [Physician's Assistant] => Physician's Assistant [RN] => RN [Respiratory Therapist] => RT [None of the above] => None ) [sf_lead_field] => License__c [sf_instructor_field] => License__c [hs_field] => please_select_your_license_ [note] => [valid] => 1 [post] => 1br127 [value] => LPN/LVN ) [fname] => Array ( [label] => First Name: [column] => 1 [required] => 1 [req_dependant] => None [type] => text [size] => 25 [sf_lead_field] => First_Name__c [hs_field] => firstname [valid] => 1 [post] => 1br128 [value] => zena ) [lname] => Array ( [label] => Last Name: [column] => 1 [required] => 1 [req_dependant] => None [type] => text [size] => 25 [sf_lead_field] => Name [hs_field] => lastname [valid] => 1 [post] => 1br129 [value] => davis ) [phone] => Array ( [label] => Phone: [column] => 1 [required] => 1 [req_dependant] => none [type] => phone [size] => 25 [sf_lead_field] => Mobile_Primary__c [hs_field] => phone [note] => [valid] => 1 [post] => 1br130 [value] => 870-779-1330 ) [aphone] => Array ( [label] => Alternate Phone: [column] => 1 [required] => [req_dependant] => none [type] => phone [size] => 25 [sf_lead_field] => Home_Phone__c [hs_field] => alternate_phone_ [note] => [valid] => 1 [post] => 1br131 [value] => 903-824-4079 ) [email] => Array ( [label] => Email: [column] => 1 [required] => 1 [req_dependant] => None [type] => email [size] => 25 [sf_lead_field] => Email__c [hs_field] => email [valid] => 1 [post] => 1br132 [value] => zenajld@aol.com ) [find] => Array ( [label] => How did you find us? [column] => 1 [required] => 1 [req_dependant] => None [type] => select [options] => Array ( [Advanced Career Fair] => Advanced Career Fair [Blog/Forum] => Blog/Forum [Email] => Email [Facebook] => Facebook [LinkedIn] => LinkedIn [Online Job Board] => Other Online Job Board [Received postcard in the mail] => Postcard [Received letter in the mail (not postcard)] => Letter - in mail [Referred by Achieve Student] => Referral - Student [Referred by Someone at Work] => Referral - Nursing Home/Work [Referred by Other] => Referral - Unknown person [Search Engine] => Search Engine [Other] => Other/Unknown ) [sf_lead_field] => Lead_Source__c [sf_instructor_field] => [hs_field] => how_did_you_find_us_ [note] => [valid] => 1 [post] => 1br133 [value] => Search Engine ) [state] => Array ( [label] => State/Province [column] => 1 [required] => 1 [req_dependant] => None [type] => select [sf_lead_field] => State__c [hs_field] => state [options] => Array ( [Alabama] => AL [Alaska] => AK [Arizona] => AZ [Arkansas] => AR [California] => CA [Colorado] => CO [Connecticut] => CT [Delaware] => DE [District of Columbia] => DC [Florida] => FL [Georgia] => GA [Hawaii] => HI [Idaho] => ID [Illinois] => IL [Indiana] => IN [Iowa] => IA [Kansas] => KS [Kentucky] => KY [Louisiana] => LA [Maine] => ME [Maryland] => MD [Massachusetts] => MA [Michigan] => MI [Minnesota] => MN [Mississippi] => MS [Missouri] => MO [Montana] => MT [Nebraska] => NE [Nevada] => NV [New Hampshire] => NH [New Jersey] => NJ [New Mexico] => NM [New York] => NY [North Carolina] => NC [North Dakota] => ND [Ohio] => OH [Oklahoma] => OK [Oregon] => OR [Pennsylvania] => PA [Rhode Island] => RI [South Carolina] => SC [South Dakota] => SD [Tennessee] => TN [Texas] => TX [Utah] => UT [Vermont] => VT [Virginia] => VA [Washington] => WA [West Virginia] => WV [Wisconsin] => WI [Wyoming] => WY ) [valid] => 1 [post] => 1br134 [value] => AR ) [zip] => Array ( [label] => Zip Code [column] => 1 [required] => 1 [req_dependant] => None [type] => zip [sf_lead_field] => Zip_Code__c [hs_field] => zip [valid] => 1 [post] => 1br135 [value] => 71854 ) [comments] => Array ( [label] => Comments or questions: [column] => [required] => [req_dependant] => None [type] => textarea [sf_lead_field] => Web_Form_Comments__c [hs_field] => message [note] => [valid] => 1 [post] => 1br136 [value] => ) )