<code><div><div><h2 id=”o-form-title”>Mail List Subscription Form</h2><p id=”o-form-description”>Please fill in and submit the form below to subscribe to our mailing list.</p></div><form action=”http://www.imnicamail.com/v4/subscribe.php&#8221; method=”post” accept-charset=”UTF-8″><div><label for=”FormValue_EmailAddress”>Email Address</label><input name=”FormValue_Fields[EmailAddress]” value=”” id=”FormValue_EmailAddress” type=”text”></div><div><label for=”FormValue_CustomField7823″>First Name</label><input name=”FormValue_Fields[CustomField7823]” value=”” id=”FormValue_CustomField7823″ type=”text”></div><div><label for=”FormValue_CustomField7824″>Last Name</label><input name=”FormValue_Fields[CustomField7824]” value=”” id=”FormValue_CustomField7824″ type=”text”></div><input name=”FormButton_Subscribe” value=”Subscribe” id=”FormButton_Subscribe” type=”submit”><input name=”FormValue_ListID” value=”6992″ type=”hidden”><input name=”FormValue_Command” value=”Subscriber.Add” id=”FormValue_Command” type=”hidden”></form><style type=”text/css” media=”screen”>.o-form{background-color:#fff;border:1px solid #f2f2f2;}
.o-form form{margin:0px;padding:0px;}
.o-form .o-form-header{background-color:#f2f2f2;padding:9px;}
.o-form h2{font-family:Arial,sans-serif;font-size:18px;line-height:27px;margin:0px;padding:0px;}
.o-form p{font-family:Arial,sans-serif;font-size:12px;line-height:18px;margin:0px;padding:0px;}
.o-form .o-form-row{margin-top:9px;padding:0 9px;}
.o-form .o-form-row label{font-family:Arial,sans-serif;font-size:12px;display:block;font-weight:bold;}
.o-form input[type=”submit”]{margin:20px 9px 18px 9px;}
</style></div></code>

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