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HTML CODE

<!-- AWeber Web Form Generator 3.0.1 -->
<style type="text/css">
#af-form-2035809592 .af-body .af-textWrap{width:98%;display:block;float:none;}
#af-form-2035809592 .af-body .privacyPolicy{color:#CCCCCC;font-size:11px;font-family:Verdana, sans-serif;}
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#af-form-2035809592 select,#af-form-2035809592 label,#af-form-2035809592 optgroup,#af-form-2035809592 option{padding:0;}
#af-form-2035809592 table{border-collapse:collapse;border-spacing:0;}
#af-form-2035809592 ul,#af-form-2035809592 ol{list-style-image:none;list-style-position:outside;list-style-type:disc;padding-left:40px;}
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#af-form-2035809592{display:block;}
#af-form-2035809592{overflow:hidden;}
.af-body .af-textWrap{text-align:left;}
.af-body input.image{border:none!important;}
.af-body input.submit,.af-body input.image,.af-form .af-element input.button{float:none!important;}
.af-body input.text{width:100%;float:none;padding:2px!important;}
.af-body.af-standards input.submit{padding:4px 12px;}
.af-clear{clear:both;}
.af-element label{text-align:left;display:block;float:left;}
.af-element{padding-bottom:5px;padding-top:5px;}
.af-footer{margin-bottom:0;margin-top:0;padding:10px;}
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.lbl-right .af-element label{text-align:right;}
body {
}

</style>
<form method="post" class="af-form-wrapper" accept-charset="UTF-8" action="https://www.aweber.com/scripts/addlead.pl" >
<div style="display: none;">
<input type="hidden" name="meta_web_form_id" value="2035809592" />
<input type="hidden" name="meta_split_id" value="" />
<input type="hidden" name="listname" value="awlist4905803" />
<input type="hidden" name="redirect" value="https://www.aweber.com/thankyou.htm?m=default" id="redirect_c24109debe9ae67804e4c41c8a6079e5" />

<input type="hidden" name="meta_adtracking" value="FREE_Bottle_Signup_Form" />
<input type="hidden" name="meta_message" value="1" />
<input type="hidden" name="meta_required" value="name,email" />

<input type="hidden" name="meta_tooltip" value="" />
</div>
<div id="af-form-2035809592" class="af-form"><div id="af-body-2035809592" class="af-body af-standards">
<div class="af-element">
<label class="previewLabel" for="awf_field-100123960">Full Name: </label>
<div class="af-textWrap">
<input id="awf_field-100123960" type="text" name="name" class="text" value="" onfocus=" if (this.value == '') { this.value = ''; }" onblur="if (this.value == '') { this.value='';} " tabindex="500" />
</div>
<div class="af-clear"></div></div>
<div class="af-element">
<label class="previewLabel" for="awf_field-100123961">Email: </label>
<div class="af-textWrap"><input class="text" id="awf_field-100123961" type="text" name="email" value="" tabindex="501" onfocus=" if (this.value == '') { this.value = ''; }" onblur="if (this.value == '') { this.value='';} " />
</div><div class="af-clear"></div>
</div>
<div class="af-element buttonContainer">
<input name="submit" class="submit" type="submit" value="Get My FREE BOTTLE" tabindex="502" />
<div class="af-clear"></div>
</div>
<div class="af-element privacyPolicy" style="text-align: center"><p>We respect your <a title="Privacy Policy" href="https://www.aweber.com/permission.htm" target="_blank" rel="nofollow">email privacy</a></p>
<div class="af-clear"></div>
</div>
<div class="af-element poweredBy" style="text-align: center; font-size: 9px;"><p><a href="https://www.aweber.com" title="AWeber Email Marketing" target="_blank" rel="nofollow">Powered by AWeber Email Marketing</a></p>
<div class="af-clear"></div>
</div>
</div>
<div id="af-footer-2035809592" class="af-footer"><div class="bodyText"><p>&nbsp;</p></div></div>
</div>
<div style="display: none;"><img src="https://forms.aweber.com/form/displays.htm?id=TAzMrBwMnKycTA==" alt="" /></div>
</form>
<script type="text/javascript">
// Special handling for facebook iOS since it cannot open new windows
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document.getElementById('af-form-2035809592').parentElement.removeAttribute('target');
}
})();
</script><script type="text/javascript">
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document.getElementById("af-footer-2035809592").className = "af-footer af-quirksMode";
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})();
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<!-- /AWeber Web Form Generator 3.0.1 -->

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