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<form class="description" style="padding:3px;text-align:center; border:none 0;" action="https://my.sendinblue.com/users/subscribe/" method="post" onsubmit="return false">
<input type="hidden" name="hdn_email_txt" id="hdn_email_txt" value="">
<input type="hidden" name="js_id" id="js_id" value="2g1oi">
<input type="hidden" name="primary_type" id="primary_type" value="email">
<div class="sib-container rounded ui-sortable" style="border-radius: 4px; position: relative; margin: 0px; text-align: left; background: rgb(252, 252, 252) none repeat scroll 0% 0%; padding: 40px 20px 20px; border-width: 0px !important; border-color: transparent !important;">
<input type="hidden" name="req_hid" id="req_hid" value="~PRENOM~interestList~NOM~Captcha~CONSENT" style="font-size: 32px;">
<div class="header" style="padding: 0px 20px;">
<h1 class="title editable" data-editfield="newsletter_name" style="font-weight: normal; text-align: left; font-size: 39px; margin-bottom: 2px; padding: 0px; margin-top: 0px; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(35, 57, 105);" contenteditable="true">SIGN UP AND RECEIVE OUR LATEST NEWS</h1>
<h3 id="company-name" style="font-weight: normal; text-align: left; font-size: 25px; margin-bottom: 12px; padding: 0px; margin-top: 0px; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52);" contenteditable="true"><br></h3>
</div>
<div class="description editable" data-editfield="newsletter_description" style="padding: 0px 20px 15px; border-bottom: 1px solid rgb(204, 204, 204); font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52); font-size: 17px;" contenteditable="true">Subscribe to our newsletter to receive news from the field and learn more about our actions, partnerships and initiatives.</div>
<div class="view-messages" style=" margin:5px 0;"> </div>
<!-- an email as primary -->
<div class="primary-group email-group forms-builder-group ui-sortable" style="">
<div class="row" style="padding: 10px 20px; font-size: 17px; position: relative; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52);"><div class="lbl-tinyltr" style="clear:both; float:none;" contenteditable="true">Your first name<red style="color:#ff0000;">*</red></div> <input type="text" name="PRENOM" id="PRENOM" value="" style="padding: 10px 2%; width: 90%; min-width: auto;"> <div class="clear" style="clear:both;"></div> <div class="hidden-btns"> <a class="btn move" href="#"><i class="fa fa-arrows"></i></a><br> <a class="btn btn-danger delete" href="#"><i class="fa fa-trash-o fa-inverse"></i></a> </div> </div><div class="row" style="padding: 10px 20px; font-size: 17px; position: relative; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52); left: 0px; top: 0px;"><div class="lbl-tinyltr" style="clear:both; float:none;" contenteditable="true">Your last name<red style="color:#ff0000;">*</red></div> <input type="text" name="NOM" id="NOM" value="" style="padding: 10px 2%; width: 90%; min-width: auto;"> <div class="clear" style="clear:both;"></div> <div class="hidden-btns"> <a class="btn move" href="#"><i class="fa fa-arrows"></i></a><br> <a class="btn btn-danger delete" href="#"><i class="fa fa-trash-o fa-inverse"></i></a> </div> </div><div class="row mandatory-email" style="padding: 10px 20px; position: relative; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52); font-size: 17px; left: 0px; top: 0px;">
<div class="lbl-tinyltr" style="clear: both; float: none; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif;" contenteditable="true">Your email <red style="color:#ff0000;">*</red></div>
<input type="text" name="email" id="email" value="" style="padding: 10px 2%; width: 90%; min-width: auto;">
<div style="clear:both;"></div>
<div class="hidden-btns">
<a class="btn move" href="#"><i class="fa fa-arrows"></i></a><br>
<!--<a class="btn btn-danger delete" href="#"><i class="fa fa-trash-o fa-inverse"></i></a>-->
</div>
</div><div class="row" style="padding: 10px 20px; font-size: 17px; position: relative; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52);"> <div class="lbl-tinyltr" style="clear:both; float:none;" contenteditable="true"><div>When subscribing to the ACTED newsletter<red style="color:#ff0000;">*</red></div><div><red style="color:#ff0000;"><br></red></div></div><div class="lbl-tinyltr" style="clear:both; float:none;"><input type="radio" id="CONSENT1" value="1" name="CONSENT" style="font-size: 32px;"> I agree to receive information from the charity, and for my personal data to be processed for this end</div> <div class="clear" style="clear:both;"></div> <div class="hidden-btns"> <a href="#" class="btn move"><i class="fa fa-arrows"></i></a><br> <a href="#" class="btn btn-danger delete"><i class="fa fa-trash-o fa-inverse"></i></a> </div> </div></div>
<div class="captcha forms-builder-group" style=""><div class="row" style="font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52); font-size: 17px; padding: 10px 20px;"><div id="gcaptcha" style="transform: scale(1); margin-left: 0px;"></div></div></div>
<!-- end of primary -->
<div class="byline" style="font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52); font-weight: bold; font-size: 16px; text-align: center; display: block;">
<button class="button editable " type="submit" data-editfield="subscribe" style="font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(255, 255, 255); background: rgb(5, 5, 5) none repeat scroll 0% 0%; display: inline-block; white-space: nowrap; min-height: 40px; margin: 0px 5px 0px 0px; padding: 0px 22px; text-decoration: none; text-transform: uppercase; text-align: center; font-weight: bold; font-style: normal; font-size: 17px; cursor: pointer; border: 0px none; border-radius: 4px; vertical-align: top; height: auto; line-height: 150%;" contenteditable="true">SIGN UP</button></div>
<div style="clear:both;"></div>
<div class="row forms-builder-group" style="padding: 10px 20px; font-size: 17px; position: relative; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: rgb(52, 52, 52);"><div class="lbl-tinyltr" id="sib_gdpr" style="clear:both; float:none; word-wrap: break-word;" contenteditable="true"><div><br></div><div>Your email will only be used to send you our newsletter and other relevant information about ACTED. You may unsubscribe at any moment by clicking on the unsubscribe button at the bottom of all our emails.</div></div> <div class="clear" style="clear:both;"></div> <div class="hidden-btns"> <a class="btn move" href="#"><i class="fa fa-arrows"></i></a><br> <a class="btn btn-danger delete" href="#"><i class="fa fa-trash-o fa-inverse"></i></a> </div> </div></div>
</form>
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