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Subscription Page

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<div id="mc_embed_signup">
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<div id="mc_embed_signup_scroll">
<h2>Subscribe to our mailing list</h2>
<div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
<div class="mc-field-group">
<label for="mce-EMAIL">Email Address <span class="asterisk">*</span>
</label>
<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
</div>
<div class="mc-field-group">
<label for="mce-FNAME">First Name </label>
<input type="text" value="" name="FNAME" class="" id="mce-FNAME">
</div>
<div class="mc-field-group">
<label for="mce-LNAME">Last Name </label>
<input type="text" value="" name="LNAME" class="" id="mce-LNAME">
</div>
<div class="mc-field-group">
<label for="mce-MMERGE3">Untitled </label>
<select name="MMERGE3" class="" id="mce-MMERGE3">
<option value=""></option>
<option value="First Choice">First Choice</option>
<option value="Second Choice">Second Choice</option>
<option value="Third Choice">Third Choice</option>

</select>
</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-->
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<div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
</div>
</form>
</div>
<script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[0]='EMAIL';ftypes[0]='email';fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[3]='MMERGE3';ftypes[3]='dropdown';}(jQuery));var $mcj = jQuery.noConflict(true);</script>
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