<form class="infusion-form" accept-charset="UTF-8" action="https://beliefcloset.infusionsoft.com/app/form/process/fce61116f5a9a85d3022cf39699950ce" method="POST"><input type="hidden" name="inf_form_xid" value="fce61116f5a9a85d3022cf39699950ce" />
<input type="hidden" name="inf_form_name" value="CYB Newsletter Sign Up" />
<input type="hidden" name="infusionsoft_version" value="1.29.11.21" />
<div class="infusion-field"><label for="inf_field_FirstName">First Name *</label>
<input class="infusion-field-input-container" id="inf_field_FirstName" type="text" name="inf_field_FirstName" /></div>
<div class="infusion-field"><label for="inf_field_Email">Email *</label>
<input class="infusion-field-input-container" id="inf_field_Email" type="text" name="inf_field_Email" /></div>
<div class="infusion-submit"><input type="submit" value="Submit" /></div>
</form>