!-- begin subscription_form_widget.tmpl --
form action=httpbfastclub.comcgi-bindadamail.cgi method=post accept-charset=UTF-8 id=subscription_form
input type=hidden name=flavor id=ddm_flavor value=subscribe
div class=row
div class=small-12 columns
input
type=hidden
name=list
id=ddm_list
value=isalumnilist1
div class=row
div class=large-4 medium-4 columns
label
class=medium-text-right
for=ddm_email
Email Address
label
div
div class=large-8 medium-8 columns
input
type=email
name=email
id=ddm_email
value=
required=required
placeholder=user@example.com (required)
div
div
div id=ddm_subscriber_fields
div class=row
div class=large-4 medium-4 columns
label
class=medium-text-right
for=ddm_subscribername_real
Your Real Name
label
div
div class=large-8 medium-8 columns
input
type=text
name=subscribername_real
id=ddm_subscribername_real
value=
placeholder=
div
div
div class=row
div class=large-4 medium-4 columns
label
class=medium-text-right
for=ddm_subscribername_nick
Name You like us to call you by
label
div
div class=large-8 medium-8 columns
input
type=text
name=subscribername_nick
id=ddm_subscribername_nick
value=
placeholder=
div
div
div class=row
div class=large-4 medium-4 columns
label
class=medium-text-right
for=ddm_courseattended
Course Attended
label
div
div class=large-8 medium-8 columns
input
type=text
name=courseattended
id=ddm_courseattended
value=
placeholder=
div
div
div class=row
div class=large-4 medium-4 columns
label
class=medium-text-right
for=ddm_courseattendedyear
Year Attended Course
label
div
div class=large-8 medium-8 columns
input
type=text
name=courseattendedyear
id=ddm_courseattendedyear
value=
placeholder=
div
div
div class=row
div class=large-4 medium-4 columns
label
class=medium-text-right
for=ddm_remarks
Anything you like to tell us (Optional)
label
div
div class=large-8 medium-8 columns
input
type=text
name=remarks
id=ddm_remarks
value=
placeholder=
div
div
div
div class=row
div class=large-4 medium-4 columns
div
div class=large-8 medium-8 columns
input
type=submit
value=Subscribe
class=button success expand
id=ddm_subscribe_button
div
div
div
div
form
!-- end subscription_form_widget.tmpl --
