<form action=”http://www.getresponse.com/cgi-bin/add.cgi” method=”post” accept-charset=”UTF-8″>
<label for=”subscriber_name”>Name :</label><input id=”subscriber_name” name=”subscriber_name” type=”text” value=”" /><br/>
<label for=”subscriber_email”>Email :</label><input id=”subscriber_email” name=”subscriber_email” type=”text” value=”" /><br/>

<input type=”submit” />
<input type=”hidden” name=”error_url” id=”error_url” value=”"/>
<input type=”hidden” name=”confirmation_url” id=”confirmation_url” value=”http://www.massagetherapybusinessmentor.com/Thanks.html”/>
<input type=”hidden” name=”campaign_name” id=”campaign_name” value=”massagesqueezepage”/>
<input type=”hidden” name=”custom_ref” id=”custom_ref” value=”"/>
</form><script type=”text/javascript”>var el=document.getElementById(“custom_http_referer”);if(el != null){el.value = document.location};</script>