Add New Row Edit ElementClone ElementAdvanced Element OptionsMoveRemove Element Please complete this form to set up your newsletter template. [headline style="1" font_size="32" font_font="Open%20Sans" font_color="%231c7dbf" font_spacing="-2" align="left"]Please complete this form to set up your newsletter template.[/headline] Edit ElementClone ElementAdvanced Element OptionsMoveRemove Element — SPACER — [vertical_spacing height="20"] Edit ElementClone ElementAdvanced Element OptionsMoveRemove Element [custom_html] Thank you for your order! Please complete as much of this form as you can. We realize that it looks like we are asking for duplicate information. Please bear with us! It will help us get it right the first time! If you have any questions, please call us at 877-976-6368, then press 2 for support. Account Login Info First Name * Last Name * Email address you signed up with * Choose a secure password (8 character minimum) * Do you want us to send your Email Newsletter out Automatically each month? * Please select one1st8th14thDon't auto-send Auto-sending can be done once your contacts have been uploaded. I accept the terms and conditions of using Ready To Go Newsletters. * To read the terms and conditions, right click on the link below and open in a new tab: Ready To Go Newsletters Terms of Service Template Setup Details Use this section to tell us what information you want included in your newsletter each month. You don't need to fill out all these fields - just the ones you want to use. Newsletter title. Max. 20 characters. Use "News You Can Use" or your own preference. * Brought to you by... * This is space at the top of the newsletter for a line that says "Brought to you by [your name]". What do you want here? Company name you want associated with your newsletters * Contact information throughout newsletter Main phone number you want associated with your newsletters (format: 555-555-5555) * Additional Phone (please use this format 555-555-5555) Fax (please use this format 555-555-5555): Email address you want associated with your newsletters. * PLEASE NOTE: If you plan on sending e-newsletters, we cannot accept Yahoo, AOL, or iCloud email addresses due to their policies about bulk emails. License Number (if required) If you would like a second person in your newsletter, please include their name, contact details, and any other information. Office Address Included on Newsletter Address (first line) * Suite, P.O. Box, etc. City * State/Province * Zip/Postal Code * Country * SPAM Law Compliance Requirement The law requires that all email newsletters include a mailing address. Your office address will automatically be added at the foot of your newsletters. Website & Links Website: Facebook: Twitter: LinkedIn: Instagram: YouTube: Permission to send electronic messages To comply with our terms and conditions, we need to be sure you have permission to send email newsletters to your database. (This is also best practice). If you don't plan to send emails, just write "not emailing" in these fields. How did you obtain your list of email contacts? * How do you confirm that you have permission to send marketing emails to them? * Submit Once you click 'Submit', you'll be prompted to upload your headshot, logo and any other images on the next page. [/custom_html] [custom_html]<style type="text/css"><br /> .beta-base .preheader, .beta-base .header, .beta-base .sidebar, .beta-base .body, .beta-base .footer, #mainContent {<br /> text-align: start;<br /> }<br /> .beta-base .preheader, .beta-base .header, .beta-base .body, .beta-base .sidebar, .beta-base .leftSidebar, .beta-base .rightSidebar, .beta-base .footer {<br /> margin: 0;<br /> padding: 0;<br /> border: none;<br /> white-space: normal;<br /> line-height: normal;<br /> }<br /> .beta-base .title, .beta-base .subtitle, .beta-base .text, .beta-base img {<br /> margin: 0;<br /> padding: 0;<br /> background: none;<br /> border: none;<br /> white-space: normal;<br /> line-height: normal;<br /> }<br /> .beta-base .bodyContainer td.preheader{<br /> padding: 10px 0;<br /> }<br /> .beta-base .bodyContainer td.header {<br /> padding: 0;<br /> height: 30px;<br /> }<br /> .beta-base .bodyContainer td.body, .beta-base .bodyContainer td.footer,<br /> .beta-base .bodyContainer td.sidebar, .beta-base .bodyContainer td.leftSidebar, .beta-base .bodyContainer td.rightSidebar {<br /> padding: 20px;<br /> }<br /> .beta-base .bodyContainer td.header p, .beta-base .bodyContainer td.preheader p, .beta-base .bodyContainer td.body p,<br /> .beta-base .bodyContainer td.footer p, .beta-base .bodyContainer td.sidebar p,<br /> .beta-base .bodyContainer td.leftSidebar p, .beta-base .bodyContainer td.rightSidebar p {<br /> margin: 0;<br /> color: inherit;<br /> }<br /> .beta-base .bodyContainer td.header div.title, .beta-base .bodyContainer td.preheader div.title, .beta-base .bodyContainer td.body div.title,<br /> .beta-base .bodyContainer td.footer div.title, .beta-base .bodyContainer td.sidebar div.title,<br /> .beta-base .bodyContainer td.leftSidebar div.title, .beta-base .bodyContainer td.rightSidebar div.title,<br /> .beta-base .bodyContainer td.header div.subtitle, .beta-base .bodyContainer td.preheader div.subtitle, .beta-base .bodyContainer td.body div.subtitle,<br /> .beta-base .bodyContainer td.footer div.subtitle, .beta-base .bodyContainer td.sidebar div.subtitle,<br /> .beta-base .bodyContainer td.leftSidebar div.subtitle, .beta-base .bodyContainer td.rightSidebar div.subtitle,<br /> .beta-base .bodyContainer td.header div.text, .beta-base .bodyContainer td.preheader div.text, .beta-base .bodyContainer td.body div.text, .beta-base .bodyContainer td.body div.text div,<br /> .beta-base .bodyContainer td.footer div.text, .beta-base .bodyContainer td.sidebar div.text,<br /> .beta-base .bodyContainer td.leftSidebar div.text, .beta-base .bodyContainer td.rightSidebar div.text {<br /> overflow: auto;<br /> }<br /> .beta-base .optout {<br /> margin-bottom: 10px;<br /> margin-top: 10px;<br /> }<br /> div.infusion-captcha {<br /> width: 220px;<br /> padding: 10px;<br /> }<br /> div.infusion-captcha input, div.infusion-captcha select, div.infusion-captcha textarea {<br /> width: 95%;<br /> display: inline-block;<br /> vertical-align: middle;<br /> }<br /> table.infusion-field-container td.infusion-field-input-container input[type='text'],<br /> table.infusion-field-container td.infusion-field-input-container input[type='password'],<br /> table.infusion-field-container td.infusion-field-input-container textarea {<br /> width: 98%; /* must be 98% to make the snippet-menu line up due to border width */<br /> margin: 0;<br /> }<br /> table.infusion-field-container td.infusion-field-input-container select {<br /> width: 101%;<br /> *width: 102%; /* this one for IE */<br /> margin: 0;<br /> }<br /> table.infusion-field-container td.infusion-field-label-container {<br /> padding-right: 5px;<br /> max-width: 200px;<br /> }<br /> td.header .image-snippet img {<br /> vertical-align: bottom;<br /> }<br /> #webformErrors {<br /> color: #990000;<br /> font-size: 14px;<br /> }<br /> html, body {<br /> margin: 0;<br /> padding: 0;<br /> height: 100%;<br /> }<br /> .infusion-form {<br /> margin: 0;<br /> height: 100%;<br /> }<br /> .infusion-option {<br /> display: block;<br /> text-align: left;<br /> }<br /> </style><style type="text/css"><br /> .beta-font-b h1, .beta-font-b h2, .beta-font-b h3, .beta-font-b h4, .beta-font-b h5, .beta-font-b h6 {<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b h1 {font-size: 24px;}<br /> .beta-font-b h2 {font-size: 20px;}<br /> .beta-font-b h3 {font-size: 14px;}<br /> .beta-font-b h4 {font-size: 12px;}<br /> .beta-font-b h5 {font-size: 10px;}<br /> .beta-font-b h6 {font-size: 8px;}<br /> .beta-font-b address {font-style: italic;}<br /> .beta-font-b pre {font-family: Courier New, monospace;}<br /> .beta-font-b .title, .beta-font-b .title p {<br /> font-size: 20px;<br /> font-weight: bold;<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b .subtitle, .beta-font-b .subtitle p {<br /> font-size: 11px;<br /> font-weight: normal;<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b .text, .beta-font-b p {<br /> font-size: 12px;<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b .preheader .text, .beta-font-b .preheader .text p {<br /> font-size: 11px;<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b .footer a {<br /> font-size: 11px;<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b .footer .text {<br /> font-size: 10px;<br /> font-family: verdana,sans-serif;<br /> }<br /> .beta-font-b .sidebar .title, .beta-font-b .leftSidebar .title, .beta-font-b .rightSidebar .title {<br /> font-size: 15px;<br /> font-weight: bold;<br /> font-family: arial,sans-serif;<br /> }<br /> .beta-font-b .sidebar .subtitle, .beta-font-b .leftSidebar .subtitle, .beta-font-b .rightSidebar .subtitle {<br /> font-size: 12px;<br /> font-family: arial, sans-serif;<br /> }<br /> .beta-font-b .sidebar .text, .beta-font-b .sidebar .text p, .beta-font-b .leftSidebar .text, .beta-font-b .rightSidebar .text {<br /> font-size: 11px;<br /> font-family: arial, sans-serif;<br /> }<br /> .infusion-field-label-container {<br /> font-size: 14px;<br /> font-family: arial,sans-serif;<br /> }<br /> .infusion-field-input-container {<br /> color: #000000;<br /> font-size: 12px;<br /> }<br /> .infusion-option label {<br /> color: #000000;<br /> font-size: 14px;<br /> font-family: arial,sans-serif;<br /> }<br /> </style><style type="text/css"><br /> .simple .background {<br /> background-color: #FFFFFF;<br /> }<br /> .simple .body {<br /> background-color: #FFFFFF;<br /> }<br /> .simple a {<br /> color: #0645AD;<br /> }<br /> .simple .text {<br /> color: #000000;<br /> }<br /> .simple .background .preheader a {<br /> color: #0645AD;<br /> }<br /> .simple .background .preheader .text {<br /> color: #1A242E;<br /> }<br /> .simple .header {<br /> background-color: #FFFFFF;<br /> }<br /> .simple .title {<br /> color: #1A242E;<br /> }<br /> .simple .subtitle {<br /> color: #000000;<br /> }<br /> .simple .sidebar .title {<br /> color: #000000;<br /> }<br /> .simple .leftSidebar .title {<br /> color: #000000;<br /> }<br /> .simple .rightSidebar .title {<br /> color: #000000;<br /> }<br /> .simple .sidebar .subtitle {<br /> color: #000000;<br /> }<br /> .simple .leftSidebar .subtitle {<br /> color: #000000;<br /> }<br /> .simple .rightSidebar .subtitle {<br /> color: #000000;<br /> }<br /> .simple .footer {<br /> background-color: #FFFFFF;<br /> }<br /> .simple .footer a {<br /> color: #0645AD;<br /> }<br /> .simple .footer .text {<br /> color: #000000;<br /> }<br /> .simple .infusion-field-label-container {<br /> color: #000000;<br /> font-size: 14px;<br /> font-family: arial, sans-serif;<br /> }<br /> .simple .infusion-field-input-container {<br /> color: #000000;<br /> font-size: 12px;<br /> }<br /> .simple .infusion-option label {<br /> color: #000000;<br /> font-size: 14px;<br /> font-family: arial, sans-serif;<br /> }<br /> .simple .webFormBodyContainer{<br /> border-style:Hidden;<br /> border-color:#000000;<br /> border-width:0px;<br /> }<br /> .simple .sidebar {<br /> background-color: #FFFFFF;<br /> }<br /> .simple .leftSidebar {<br /> background-color: #FFFFFF;<br /> }<br /> .simple .rightSidebar {<br /> background-color: #FFFFFF;<br /> }<br /> </style><style type="text/css"><br /> .infusion-field-label-container {<br /> text-align:Left;<br /> }<br /> .infusion-field-input-container {<br /> width:200px;<br /> }<br /> .infusion-field-label-container {<br /> vertical-align:Middle;<br /> }<br /> .bodyContainer {<br /> width:425px;<br /> }<br /> </style><script src="https://readytogo.infusionsoft.app/app/webTracking/getTrackingCode?b=1.70.0.119516" type="text/javascript"><br /> </script><br /> <div class="text" id="webformErrors" name="errorContent"><br /> </div><br /> <form accept-charset="UTF-8" action="https://readytogo.infusionsoft.com/app/form/process/e76ba227ae25a33d823bd07a3582b815" class="infusion-form" id="inf_form_e76ba227ae25a33d823bd07a3582b815" method="POST" name="RTGN-<br /> Setup Form" onsubmit="submitWebForm()"><br /> <script type="text/javascript"><br /> function submitWebForm() {<br /> var form = document.forms[0];<br /> var resolution = document.createElement('input');<br /> resolution.setAttribute('id', 'screenResolution');<br /> resolution.setAttribute('type', 'hidden');<br /> resolution.setAttribute('name', 'screenResolution');<br /> var resolutionString = screen.width + 'x' + screen.height;<br /> resolution.setAttribute('value', resolutionString);<br /> form.appendChild(resolution);<br /> var pluginString = '';<br /> if (window.ActiveXObject) {<br /> var activeXNames = {'AcroPDF.PDF':'Adobe Reader',<br /> 'ShockwaveFlash.ShockwaveFlash':'Flash',<br /> 'QuickTime.QuickTime':'Quick Time',<br /> 'SWCtl':'Shockwave',<br /> 'WMPLayer.OCX':'Windows Media Player',<br /> 'AgControl.AgControl':'Silverlight'};<br /> var plugin = null;<br /> for (var activeKey in activeXNames) {<br /> try {<br /> plugin = null;<br /> plugin = new ActiveXObject(activeKey);<br /> } catch (e) {<br /> // do nothing, the plugin is not installed<br /> }<br /> pluginString += activeXNames[activeKey] + ',';<br /> }<br /> var realPlayerNames = ['rmockx.RealPlayer G2 Control',<br /> 'rmocx.RealPlayer G2 Control.1',<br /> 'RealPlayer.RealPlayer(tm) ActiveX Control (32-bit)',<br /> 'RealVideo.RealVideo(tm) ActiveX Control (32-bit)',<br /> 'RealPlayer'];<br /> for (var index = 0; index < realPlayerNames.length; index++) {<br /> try {<br /> plugin = new ActiveXObject(realPlayerNames[index]);<br /> } catch (e) {<br /> continue;<br /> }<br /> if (plugin) {<br /> break;<br /> }<br /> }<br /> if (plugin) {<br /> pluginString += 'RealPlayer,';<br /> }<br /> } else {<br /> for (var i = 0; i < navigator.plugins.length; i++) {<br /> pluginString += navigator.plugins[i].name + ',';<br /> }<br /> }<br /> pluginString = pluginString.substring(0, pluginString.lastIndexOf(','));<br /> var plugins = document.createElement('input');<br /> plugins.setAttribute('id', 'pluginList');<br /> plugins.setAttribute('type', 'hidden');<br /> plugins.setAttribute('name', 'pluginList');<br /> plugins.setAttribute('value', pluginString);<br /> form.appendChild(plugins);<br /> var java = navigator.javaEnabled();<br /> var javaEnabled = document.createElement('input');<br /> javaEnabled.setAttribute('id', 'javaEnabled');<br /> javaEnabled.setAttribute('type', 'hidden');<br /> javaEnabled.setAttribute('name', 'javaEnabled');<br /> javaEnabled.setAttribute('value', java);<br /> form.appendChild(javaEnabled);<br /> jQuery('.infusion-submit button').attr('disabled', true);<br /> }<br /> </script><input name="inf_form_xid" type="hidden" value="e76ba227ae25a33d823bd07a3582b815" /><input name="inf_form_name" type="hidden" value="RTGN-<br /> Setup Form" /><input name="infusionsoft_version" type="hidden" value="1.70.0.119516" /><br /> <div class="simple beta-base beta-font-b" id="mainContent" style="height:100%"><br /> <table cellpadding="10" cellspacing="0" class="background" style="width: 100%; height: 100%"><tbody><tr><td align="center" valign="top"><br /> <table bgcolor="#FFFFFF" cellpadding="20" cellspacing="0" class="bodyContainer webFormBodyContainer" width="100%"><tbody><tr><td bgcolor="#FFFFFF" class="body" sectionid="body" valign="top"><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <h2 class="sectionHeading"><br /> Thank you for your order!<br /> </h2><br /> <span style="font-size: 10pt;">Please complete as much of this form as you can.</span><br /> <p class="sectionHeading"><br /> </p><br /> <p><br /> <span style="font-size: 10pt;"><strong>We realize that it looks like we are asking for duplicate information. Please bear with us! It will help us get it right the first time!</strong></span><br /> </p><br /> <p class="sectionHeading"><br /> </p><br /> <p><br /> <span style="font-size: 10pt;">If you have any questions, please call us at 877-976-6368, then press 2 for support.</span><br /> </p><br /> <p><br /> <br /> </p><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <div><br /> <div class="title" style="text-align:left"><br /> <div class="title" contentid="title" style="text-align: left;"><br /> <div><br /> Account Login Info<br /> </div><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_field_FirstName">First Name *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_field_FirstName" name="inf_field_FirstName" placeholder="First Name *" type="text" /><br /> </td></tr><tr><td class="infusion-field-label-container"><br /> <label for="inf_field_LastName">Last Name *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_field_LastName" name="inf_field_LastName" placeholder="Last Name *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_field_Email">Email address you signed up with *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_field_Email" name="inf_field_Email" placeholder="Email address you signed up with *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_i4wpassword">Choose a secure password (8 character minimum) *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_i4wpassword" name="inf_custom_i4wpassword" placeholder="Choose a secure password (8 character minimum) *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_SendNewsletterAutomatically">Do you want us to send your Email Newsletter out Automatically each month? *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <div class="infusion-field-input-container"><br /> <select id="inf_custom_SendNewsletterAutomatically" name="inf_custom_SendNewsletterAutomatically"><option value="">Please select one</option><option value="1st">1st</option><option value="8th">8th</option><option value="14th">14th</option><option value="Don't auto-send">Don't auto-send</option></select><br /> </div><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <em><span style="font-size: 10pt;">Auto-sending can be done once your contacts have been uploaded.</span></em><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-input-container" style="width:200px;"><br /> <span class="infusion-option"><input id="inf_option_IacceptthetermsandconditionsofusingReadyToGoNewsletters" name="inf_option_IacceptthetermsandconditionsofusingReadyToGoNewsletters" style="margin-right:3px;" type="checkbox" value="5639" /><label for="inf_option_IacceptthetermsandconditionsofusingReadyToGoNewsletters">I accept the terms and conditions of using Ready To Go Newsletters. *</label></span><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <span style="font-size: 10pt;">To read the terms and conditions, right click on the link below and open in a new tab:</span><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div><br /> <font face="arial" font="font" size="2"><a href="https://readytogonewsletters.com/terms-of-service/" shape="rect" target="_blank"> Ready To Go Newsletters Terms of Service </a></font><br /> </div><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <div><br /> <div class="title" style="text-align:left"><br /> <div class="title" contentid="title" style="text-align: left;"><br /> <div><br /> Template Setup Details<br /> </div><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <p><br /> <span style="font-size: 10pt;">Use this section to tell us what information you want included in your newsletter each month.</span><br /> </p><br /> <p><br /> <span style="font-size: 10pt;"> </span><br /> </p><br /> <p><br /> <span style="text-decoration: underline; font-size: 10pt;">You don't need to fill out all these fields - just the ones you want to use.</span><br /> </p><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <div class="authoring-image image-snippet" contentid="image"><br /> <div class="authoring-image image-snippet" contentid="image"><br /> <div class="imageSnippet-alignDiv"><br /> <img align="bottom" alt="Header Image" border="0" class="simage" height="103" src="https://d1yoaun8syyxxt.cloudfront.net/readytogo-d3e9c570-d0b1-44e0-b644-915f6b220382-v2" style="margin-left: 0px; margin-right: 0px;" title="Header Image" width="484" /><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtitleA">Newsletter title. Max. 20 characters. Use "News You Can Use" or your own preference. *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtitleA" name="inf_custom_VRCtitleA" placeholder="Newsletter title. Max. 20 characters. Use "News You Can Use" or your own preference. *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCbrought">Brought to you by... *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCbrought" name="inf_custom_VRCbrought" placeholder="Brought to you by... *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <span style="font-size: 10pt;"><em>This is space at the top of the newsletter for a line that says "Brought to you by [your name]". What do you want here?</em></span><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:10px; line-height:10px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatecompany">Company name you want associated with your newsletters *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatecompany" name="inf_custom_VRCtemplatecompany" placeholder="Company name you want associated with your newsletters *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div><br /> <div class="title" style="text-align:left"><br /> <div class="title" contentid="title" style="text-align: left;"><br /> <div><br /> <h2 class="sectionHeading"><br /> Contact information throughout newsletter<br /> </h2><br /> </div><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatebestphone">Main phone number you want associated with your newsletters (format: 555-555-5555) *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatebestphone" name="inf_custom_VRCtemplatebestphone" placeholder="Main phone number you want associated with your newsletters (format: 555-555-5555) *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div style="height:10px; line-height:10px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatephonecell">Additional Phone (please use this format 555-555-5555)</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatephonecell" name="inf_custom_VRCtemplatephonecell" placeholder="Additional Phone (please use this format 555-555-5555)" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatefax">Fax (please use this format 555-555-5555):</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatefax" name="inf_custom_VRCtemplatefax" placeholder="Fax (please use this format 555-555-5555):" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatebestemail">Email address you want associated with your newsletters. *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatebestemail" name="inf_custom_VRCtemplatebestemail" placeholder="Email address you want associated with your newsletters. *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div style="height:10px; line-height:10px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <span style=""><strong>PLEASE NOTE: If you plan on sending e-newsletters, we cannot accept Yahoo, AOL, or iCloud email addresses due to their policies about bulk emails. </strong></span><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatelicense">License Number (if required)</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatelicense" name="inf_custom_VRCtemplatelicense" placeholder="License Number (if required)" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtopleft">If you would like a second person in your newsletter, please include their name, contact details, and any other information.</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <textarea cols="24" id="inf_custom_VRCtopleft" name="inf_custom_VRCtopleft" placeholder="If you would like a second person in your newsletter, please include their name, contact details, and any other information." rows="5"></textarea><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <div><br /> <div class="title" style="text-align:left"><br /> <div class="title" contentid="title" style="text-align: left;"><br /> <div><br /> Office Address Included on Newsletter<br /> </div><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplateaddress1">Address (first line) *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplateaddress1" name="inf_custom_VRCtemplateaddress1" placeholder="Address (first line) *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplateaddress2">Suite, P.O. Box, etc.</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplateaddress2" name="inf_custom_VRCtemplateaddress2" placeholder="Suite, P.O. Box, etc." type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatecity">City *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatecity" name="inf_custom_VRCtemplatecity" placeholder="City *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatestate">State/Province *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatestate" name="inf_custom_VRCtemplatestate" placeholder="State/Province *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatezip">Zip/Postal Code *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatezip" name="inf_custom_VRCtemplatezip" placeholder="Zip/Postal Code *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCmailingcountry">Country *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCmailingcountry" name="inf_custom_VRCmailingcountry" placeholder="Country *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <h2 class="sectionHeading"><br /> <span style="font-size: 12pt;">SPAM Law Compliance Requirement</span><br /> </h2><br /> <p><br /> <span style="font-size: 10pt;">The law requires that all email newsletters include a mailing address. Your office address will automatically be added at the foot of your newsletters.</span><br /> </p><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:10px; line-height:10px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <div><br /> <div class="title" style="text-align:left"><br /> <div class="title" contentid="title" style="text-align: left;"><br /> <div><br /> Website & Links<br /> </div><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:20px"><br /> <div style="height:10px;border-bottom:1px solid #CCCCCC"><br /> <br /> </div><br /> <div style="height:10px;"><br /> <br /> </div><br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatewebsite">Website:</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatewebsite" name="inf_custom_VRCtemplatewebsite" placeholder="Website:" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatefacebook">Facebook:</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatefacebook" name="inf_custom_VRCtemplatefacebook" placeholder="Facebook:" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatetwitter">Twitter:</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatetwitter" name="inf_custom_VRCtemplatetwitter" placeholder="Twitter:" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatelinkedin">LinkedIn:</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatelinkedin" name="inf_custom_VRCtemplatelinkedin" placeholder="LinkedIn:" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplalewebsite1">Instagram:</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplalewebsite1" name="inf_custom_VRCtemplalewebsite1" placeholder="Instagram:" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_VRCtemplatetitlebackground">YouTube:</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_VRCtemplatetitlebackground" name="inf_custom_VRCtemplatetitlebackground" placeholder="YouTube:" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <h2 class="sectionHeading"><br /> Permission to send electronic messages<br /> </h2><br /> <p><br /> <span style="font-size: 10pt;">To comply with our terms and conditions, we need to be sure you have permission to send email newsletters to your database. (This is also best practice). If you don't plan to send emails, just write "not emailing" in these fields.</span><br /> </p><br /> </div><br /> </div><br /> </div><br /> </div><br /> <div><br /> <div style="height:10px; line-height:10px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_permissionconfirmation">How did you obtain your list of email contacts? *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <textarea cols="24" id="inf_custom_permissionconfirmation" name="inf_custom_permissionconfirmation" placeholder="How did you obtain your list of email contacts? *" rows="5"></textarea><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <table class="infusion-field-container" style="width:100%;"><tbody><tr><td class="infusion-field-label-container"><br /> <label for="inf_custom_permissionlastsent">How do you confirm that you have permission to send marketing emails to them? *</label><br /> </td><td class="infusion-field-input-container" style="width:200px;"><br /> <input class="infusion-field-input" id="inf_custom_permissionlastsent" name="inf_custom_permissionlastsent" placeholder="How do you confirm that you have permission to send marketing emails to them? *" type="text" /><br /> </td></tr></tbody></table><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <div class="infusion-submit" style="text-align:center;"><br /> <button style="width:200px; height:30px; background-color:#6FC41A; color:#FFFFF0; font-size:14px; font-family:Helvetica; border-color:#000000; border-style:Solid; border-width:1px; -moz-border-radius:3px;border-radius:3px;" type="submit" value="Submit">Submit</button><br /> </div><br /> </div><br /> <div><br /> <div style="height:15px; line-height:15px;"><br /> <br /> </div><br /> </div><br /> <div><br /> <div class="text"><br /> <div class="text" contentid="paragraph"><br /> <div><br /> <div style="text-align: center;"><br /> <span style="">Once you click 'Submit', you'll be prompted to upload your headshot, </span><br /> </div><br /> <div style="text-align: center;"><br /> <span style=""></span><span style="">logo and any other images on the next page.</span><br /> </div><br /> </div><br /> </div><br /> </div><br /> </div><br /> </td></tr></tbody></table><br /> </td></tr></tbody></table><br /> </div><br /> </form><br /> <script type="text/javascript" src="https://readytogo.infusionsoft.app/app/webTracking/getTrackingCode"></script><br /> <script type="text/javascript" src="https://readytogo.infusionsoft.com/app/timezone/timezoneInputJs?xid=e76ba227ae25a33d823bd07a3582b815"></script>[/custom_html] Edit ElementClone ElementAdvanced Element OptionsMoveRemove Element -- SPACER -- [vertical_spacing height="20"] Add Element
