<form method=post name="subscribeform" action=”https://newsletter.fjreitzinstrumentalmusic.us/?p=subscribe&id=1″>
<input type="hidden" name="formtoken" value="19ebe60baf0b60ef7cfb37536fb38459" />
<table border=0>
<tr>
<td>
<div class="required"> Email</div>

   </td>
   <td class="attributeinput">
   <input type=text name=email value="" size="40">
   <script language="Javascript" type="text/javascript">addFieldToCheck("email","Email");</script>

   </td>
   </tr>
   <tr>
   <td>
   <div class="required">Confirm your email address</div>
   </td>
   <td class="attributeinput">
   <input type=text name=emailconfirm value="" size="40">

   <script language="Javascript" type="text/javascript">
   addFieldToCheck("emailconfirm","Confirm your email address");
   </script>

   </td>
   </tr>
   <tr>
   <td colspan=2>
   <span class="attributeinput">
   <input type=checkbox name="htmlemail" value="1"  />
   </span>
   <span class="attributename">I prefer to receive emails in HTML format
   </span>
   </td>
   </tr>
   </table>
   <input type="hidden" name="list[4]" value="signup">
   <input type="hidden" name="listname[4]" value="Mailing List 3"/>
   <div style="display:none">
   <input type="text" name="VerificationCodeX" value="" size="20">
   </div>

   <p>
   <input type=submit name="subscribe" value="Subscribe to the Selected Newsletters" onClick="return checkform();">
   </p>
   </form>