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1 forms found in the DOM

POST

<form action="" id="preferences_form" method="POST" role="form" class="form-horizontal" novalidate="novalidate">
  <input type="hidden" name="$fields" value="EmailInterests,EmailFrequency">
  <input type="hidden" name="$list_fields" value="EmailInterests">
  <!-- <input type="hidden" name="$unsubscribed_url" value="/p/preferences_updated" /> -->
  <!-- <input type="hidden" name="$updated_profile_url" value="/p/preferences_updated" /> -->
  <!--<p class="required-fields">
               <span>*</span> Required Information
               </p>-->
  <div class="form-group">
    <label for="email" class="col-sm-3 control-label">Email Address<span class="required" aria-required="true">*</span></label>
    <div class="col-sm-9">
      <input type="email" class="form-control" id="email" name="$email" value="support@mokoiaca.org.nz">
    </div>
  </div>
  <div class="form-group">
    <label for="first_name" class="col-sm-3 control-label">First Name</label>
    <div class="col-sm-9">
      <input type="text" class="form-control" id="first_name" name="$first_name" value="paula">
    </div>
  </div>
  <div class="form-group">
    <label for="last_name" class="col-sm-3 control-label">Last Name</label>
    <div class="col-sm-9">
      <input type="text" class="form-control" id="last_name" name="$last_name" value="">
    </div>
  </div>
  <div class="form-group">
    <label for="interests" class="col-sm-3 control-label">Interests</label>
    <div class="col-sm-9">
      <div class="checkbox">
        <label>
          <input type="checkbox" name="EmailInterests" value="Monday Parenting Tips"> Monday Parenting Tips </label>
      </div>
      <div class="checkbox">
        <label>
          <input type="checkbox" name="EmailInterests" value="Friday Weekly Printables"> Friday Weekly Printables </label>
      </div>
      <div class="checkbox">
        <label>
          <input type="checkbox" name="EmailInterests" value="Resources for Ages 4-10"> Resources for Ages 4-10 </label>
      </div>
      <div class="checkbox">
        <label>
          <input type="checkbox" name="EmailInterests" value="Resources for Ages 11+"> Resources for Ages 11+ </label>
      </div>
    </div>
  </div>
  <div class="checkbox">
    <label>
      <input type="checkbox" name="$unsubscribe" value="true">
      <span class="text">Unsubscribe me from all emails.</span>
    </label>
  </div>
  <div class="clearfix form-actions">
    <div class="pull-right">
      <button type="submit" class="btn btn-default btn-primary">Update Preferences</button>
    </div>
  </div>
</form>

Text Content

EMAIL PREFERENCES

Email Address*

First Name

Last Name

Interests
Monday Parenting Tips
Friday Weekly Printables
Resources for Ages 4-10
Resources for Ages 11+
Unsubscribe me from all emails.
Update Preferences

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