<form class=»simple_form form form-vertical» id=»new_subscriber» action=»https://miasesordetesis.ipzmarketing.com/f/-6Waf3AMOr4″ accept-charset=»UTF-8″ method=»post»>
<div class=»form-group string optional subscriber_name»><label class=»control-label string optional» for=»subscriber_name»>Nombre</label><input class=»form-control string optional» type=»text» name=»subscriber[name]» id=»subscriber_name» /></div>
<div class=»form-group email required subscriber_email»><label class=»control-label email required» for=»subscriber_email»><abbr title=»Requerido»> </abbr> Email</label><input class=»form-control string email required» required=»required» aria-required=»true» type=»email» name=»subscriber[email]» id=»subscriber_email» /></div>
<div class=»image-block-wrapper» style=»text-align: center»>
<img alt=»» width=»850″ height=»1230″ src=»https://assets.ipzmarketing.com/data/063e4cf46ace3ea79d54a4cbf2c51db0f1bc4c48/media_files/1/original/Gancho_2_-_850.jpg» />
</div>
<div class=»image-block-wrapper» style=»text-align: center»>
<img alt=»» width=»850″ height=»1134″ src=»https://assets.ipzmarketing.com/data/063e4cf46ace3ea79d54a4cbf2c51db0f1bc4c48/media_files/2/original/Gancho_3_-%C2%B4850.jpg» />
</div>
<div class=»submit-wrapper»>
<input type=»submit» name=»commit» value=»Enviar» class=»btn btn-primary» data-disable-with=»Procesando» />
</div>
</form>