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<!-- Begin MailChimp Signup Form --> <link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css"> <style type="text/css"> #mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; } /* Add your own MailChimp form style overrides in your site stylesheet or in this style block. We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */ </style> <div id="mc_embed_signup"> <form action="//eleqtron.us13.list-manage.com/subscribe/post?u=11f183c390036c1512803630c&id=9b41b2551d" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate> <div id="mc_embed_signup_scroll"> <div class="indicates-required"><span class="asterisk">*</span> required field</div> <div class="mc-field-group"> <label for="mce-COMPANY">Company<span class="asterisk">*</span> </label> <input type="text" value="" name="COMPANY" class="required" id="mce-COMPANY"> </div> <div class="mc-field-group"> <label for="mce-FNAME">First name<span class="asterisk">*</span> </label> <input type="text" value="" name="FNAME" class="required" id="mce-FNAME"> </div> <div class="mc-field-group"> <label for="mce-MMERGE4">Insertion</label> <input type="text" value="" name="MMERGE4" class="" id="mce-MMERGE4"> </div> <div class="mc-field-group"> <label for="mce-LNAME">Last name<span class="asterisk">*</span> </label> <input type="text" value="" name="LNAME" class="required" id="mce-LNAME"> </div> <div class="mc-field-group"> <label for="mce-EMAIL">E-mailaddress <span class="asterisk">*</span> </label> <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL"> </div> <div id="mce-responses" class="clear"> <div class="response" id="mce-error-response" style="display:none"></div> <div class="response" id="mce-success-response" style="display:none"></div> </div> <!-- real people should not fill this in and expect good things - do not remove this or risk form bot signups--> <div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_11f183c390036c1512803630c_9b41b2551d" tabindex="-1" value=""></div> <div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div> </div> </form> </div> <!--End mc_embed_signup-->