optin form

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<div background-color="none;" border="0px solid #ffcc00" style="margin: 10px 10px 10px 10px; width=" class="optin" id="optin">
<form name="ARGWA" method="post" action="http://www.prosocialroi.com/index.php">
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                            <div align="center"> I'll show you how to quickly list your business FREE!<br />
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                            <span style="font-size: 13pt; color: #000000;"><span style="font-family: Tahoma;"><strong><span style="text-decoration: underline;"><span style="color: #ff0000;">FREE!</span></span> </strong> &quot;Dominate Page #1 in SERPS&quot;</span></span></div>
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</form>
<div align="center"><span style="font-family: Tahoma; font-size: x-small;">Fill in your details for instant access! </span></div>
<div><strong>Name:</strong> <input type="text" name="" style="width: 200px; margin-bottom: 2px; font-size: 16px; color: #333333; padding: 3px; text-indent: 50px;" id="argwa_name" /><strong><br />
Email:</strong> <input type="text" name="email" style="width: 200px; margin-bottom: 2px; font-size: 16px; color: #333333; padding: 3px; text-indent: 50px;" id="argwa_email" /> <center> <input type="submit" value="Get On Page #1 Now" name="Add" onmouseout="this.className='btn'" onmouseover="this.className='btn btnhov'" onclick="return gwaCheckForm1(this.form)" class="btn" /></center></div>
<div style="font-size: 12px; color: #999999; margin: 10px 0pt;"><span style="color: #000000;"><em>Your <a href="www.leaveyourmark.org/privacy-policy">Privacy</a> is Always Respected!</em></span></div>
<span style="font-size: 13pt; color: #000;"> </span> <span style="font-size: 13pt; color: #000;"> </span> <span style="font-size: 13pt; color: #000;"> </span> <span style="font-size: 13pt; color: #000;"> </span> <input type="hidden" value="s_add" name="act" /> <input type="hidden" value="1" name="listid" />  </div>
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