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  1. <form accept-charset="UTF-8" action="https://portaltogenius.infusionsoft.com/app/form/process/aec0a44635a9752ab83ed3e5346d8d4b" class="infusion-form" id="inf_form_aec0a44635a9752ab83ed3e5346d8d4b" method="POST">
  2.     <input name="inf_form_xid" type="hidden" value="aec0a44635a9752ab83ed3e5346d8d4b" />
  3.     <input name="inf_form_name" type="hidden" value="Facilitator Interest Form" />
  4.     <input name="infusionsoft_version" type="hidden" value="1.70.0.72808" />
  5.     <div class="infusion-field">
  6.         <label for="inf_field_FirstName">First Name *</label>
  7.         <input class="infusion-field-input" id="inf_field_FirstName" name="inf_field_FirstName" placeholder="First Name *" type="text" />
  8.     </div>
  9.     <div class="infusion-field">
  10.         <label for="inf_field_LastName">Last Name *</label>
  11.         <input class="infusion-field-input" id="inf_field_LastName" name="inf_field_LastName" placeholder="Last Name *" type="text" />
  12.     </div>
  13.     <div class="infusion-field">
  14.         <label for="inf_field_Email">Email *</label>
  15.         <input class="infusion-field-input" id="inf_field_Email" name="inf_field_Email" placeholder="Email *" type="text" />
  16.     </div>
  17.     <div>
  18.         <div>&nbsp;</div>
  19.     </div>
  20.     <div class="infusion-field">
  21.         <span class="infusion-option">
  22.             <input id="inf_option_IagreetothetermsofyourPrivacyPolicy" name="inf_option_IagreetothetermsofyourPrivacyPolicy" type="checkbox" value="17780" />
  23.             <label for="inf_option_IagreetothetermsofyourPrivacyPolicy">I agree to the terms of your Privacy Policy *</label>
  24.         </span>
  25.     </div>
  26.     <div>
  27.         <div>&nbsp;</div>
  28.     </div>
  29.     <div>
  30.         <div class="text">
  31.                     <div class="text" contentid="paragraph">
  32.                         <div>View <a href="http://www.thoughtsalive.com/privacy-policy/" nottracked="true" shape="rect">Privacy Policy</a>
  33.                         </div>
  34.                     </div>
  35.         </div>
  36.     </div>
  37.     <div>
  38.         <div>&nbsp;</div>
  39.     </div>
  40.     <div class="infusion-submit">
  41.         <button class="infusion-recaptcha" id="recaptcha_aec0a44635a9752ab83ed3e5346d8d4b" type="submit">Add me to the Facilitator Interest List</button>
  42.     </div>
  43. </form>
  44. <script type="text/javascript" src="https://portaltogenius.infusionsoft.com/app/webTracking/getTrackingCode"></script>
  45. <script type="text/javascript" src="https://portaltogenius.infusionsoft.com/resources/external/recaptcha/production/recaptcha.js?b=1.70.0.72808"></script>
  46. <script src="https://www.google.com/recaptcha/api.js?onload=onloadInfusionRecaptchaCallback&render=explicit" async="async" defer="defer"></script>
  47. <script type="text/javascript" src="https://portaltogenius.infusionsoft.com/app/timezone/timezoneInputJs?xid=aec0a44635a9752ab83ed3e5346d8d4b"></script>
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