mg

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Marianna

<form accept-charset="UTF-8" action="https://mail.andrzejfesnak.pl/subscribe.php" method="POST"><div id="sqm-liveform" data-enhance="false" style="border-width: 10px 3px; border-radius: 5px; background: rgb(242, 242, 242); border-color: rgb(0, 0, 0); color: rgb(0, 0, 0); padding: 20px; border-style: solid;">  

                  <div class="sqm-description" style="margin-bottom: 20px; width: 100%; float: none; padding-right: 0px; display: none;">

                    przykładowy opis                  </div>

                  <div class="sqm-form" style="float: none; width: 100%;">

                    <div class="sqm-fields" style="float: none;"><div class="sqm-form-group" style="margin: 10px 0px; display: block;"><label for="sqm-femail" style="width: inherit;">Adres e-mail</label><input type="text" name="email" class="form-control sqm-textinput" id="sqm-femail" value="" data-placeholder="Adres e-mail" placeholder="Adres e-mail" onblur="this.style.backgroundColor = '#ffffff'; this.style.color = '#000000'; this.style.borderColor = '#3f51b5'; " onfocus="this.style.backgroundColor = '#d7d7d7'; this.style.color = '#3f51b5'; this.style.borderColor = '#ffffff'; " style="background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); border-color: rgb(63, 81, 181); width: 100%; display: block;"></div><div class="sqm-form-group" style="margin: 10px 0px; display: block;"><label for="sqm-ffname" style="width: inherit;">Imię</label><input type="text" name="fname" class="form-control sqm-textinput" id="sqm-ffname" value="" data-placeholder="Imię" placeholder="Imię" onblur="this.style.backgroundColor = '#ffffff'; this.style.color = '#000000'; this.style.borderColor = '#3f51b5'; " onfocus="this.style.backgroundColor = '#d7d7d7'; this.style.color = '#3f51b5'; this.style.borderColor = '#ffffff'; " style="background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); border-color: rgb(63, 81, 181); width: 100%; display: block;"></div><div class="sqm-form-group" style="margin: 10px 0px; display: block;"><label for="sqm-flname" style="width: inherit;">Nazwisko</label><input type="text" name="lname" class="form-control sqm-textinput" id="sqm-flname" value="" data-placeholder="Nazwisko" placeholder="Nazwisko" onblur="this.style.backgroundColor = '#ffffff'; this.style.color = '#000000'; this.style.borderColor = '#3f51b5'; " onfocus="this.style.backgroundColor = '#d7d7d7'; this.style.color = '#3f51b5'; this.style.borderColor = '#ffffff'; " style="background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); border-color: rgb(63, 81, 181); width: 100%; display: block;"></div><div class="sqm-form-group" style="margin: 10px 0px; display: block;"><label for="sqm-fphone" style="width: inherit;">Telefon</label><input type="text" name="phone" class="form-control sqm-textinput" id="sqm-fphone" value="" data-placeholder="Telefon" placeholder="Telefon" onblur="this.style.backgroundColor = '#ffffff'; this.style.color = '#000000'; this.style.borderColor = '#3f51b5'; " onfocus="this.style.backgroundColor = '#d7d7d7'; this.style.color = '#3f51b5'; this.style.borderColor = '#ffffff'; " style="background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); border-color: rgb(63, 81, 181); width: 100%; display: block;"></div><div class="sqm-form-group" style="margin: 10px 0px; display: block;"><label for="sqm-f20" style="width: inherit;">Kto zaprosił (imię i nazwisko)</label><input type="text" name="fields[20]" class="form-control sqm-textinput" id="sqm-f20" value="" data-placeholder="Kto zaprosił (imię i nazwisko)" placeholder="Kto zaprosił (imię i nazwisko)" onblur="this.style.backgroundColor = '#ffffff'; this.style.color = '#000000'; this.style.borderColor = '#3f51b5'; " onfocus="this.style.backgroundColor = '#d7d7d7'; this.style.color = '#3f51b5'; this.style.borderColor = '#ffffff'; " style="background-color: rgb(255, 255, 255); color: rgb(0, 0, 0); border-color: rgb(63, 81, 181); width: 100%; display: block;"></div></div>

                    <div id="sqm-coregister" style="display: none;">

                      <h5 id="sqm-coregister-text">Zapisz mnie również na poniższe listy:</h5>

                    </div>

                    <div id="sqm-submit-box" style="width: 100%; text-align: left; float: none;"><div id="sqm-submit1" class="sqm-form-group form-group" style="margin: 10px 0px; text-align: left; display: block;"><input type="submit" class="sqm-submit" id="sqm-submit" value="Zapisz się" style="border-style: solid; background: rgb(63, 81, 181); color: rgb(255, 255, 255); border-color: rgb(102, 181, 240); border-width: 0px 0px 4px; border-radius: 3px; padding: 7px 25px; margin: 0px; font-size: 16px;" onmouseover="this.style.backgroundColor = '#98c8eb';" onmouseout="this.style.backgroundColor = '#3f51b5';"></div>

                       

                    </div>

                  </div>

                  <div style="clear: both;"></div>

                </div><input type="hidden" name="mlid" value="139" />

<input type="hidden" name="req" value="email:fname:lname:phone" />

<input type="hidden" name="token" value="b296ce0a8c1652d6fee33f20fe55943cf1e963af" />

<input type="hidden" name="coregister" value="" />


</form>

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