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<form action="//josephinegracepuppycouture.us13.list-manage.com/subscribe/post?u=9af3052b1291bcce9d46514e3&id=13e5260a3c" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
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<h2>Subscribe to our mailing list</h2>
<div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
<div class="mc-field-group">
<label for="mce-EMAIL">Email Address <span class="asterisk">*</span>
</label>
<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
</div>
<div class="mc-field-group">
<label for="mce-FNAME">First Name <span class="asterisk">*</span>
</label>
<input type="text" value="" name="FNAME" class="required" id="mce-FNAME">
</div>
<div class="mc-field-group">
<label for="mce-LNAME">Last Name <span class="asterisk">*</span>
</label>
<input type="text" value="" name="LNAME" class="required" id="mce-LNAME">
</div>
<div class="mc-field-group">
<label for="mce-CITY">City <span class="asterisk">*</span>
</label>
<input type="text" value="" name="CITY" class="required" id="mce-CITY">
</div>
<div class="mc-field-group">
<label for="mce-STATE">State <span class="asterisk">*</span>
</label>
<input type="text" value="" name="STATE" class="required" id="mce-STATE">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PHONE">Phone Number </label>
<input type="text" name="PHONE" class="" value="" id="mce-PHONE">
</div>
<div class="mc-field-group">
<label for="mce-PUPNAME1">Pup's Name (1) </label>
<input type="text" value="" name="PUPNAME1" class="" id="mce-PUPNAME1">
</div>
<div class="mc-field-group">
<label for="mce-PUPBREED1">Pup's Breed (1) </label>
<input type="text" value="" name="PUPBREED1" class="" id="mce-PUPBREED1">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PUPBDAY1-month">Pup's Birthday (1) </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="PUPBDAY1[month]" id="mce-PUPBDAY1-month"></span> / <span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="PUPBDAY1[day]" id="mce-PUPBDAY1-day"></span>
<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div><div class="mc-field-group">
<label for="mce-PUPNAME2">Pup's Name (2) </label>
<input type="text" value="" name="PUPNAME2" class="" id="mce-PUPNAME2">
</div>
<div class="mc-field-group">
<label for="mce-PUPBREED2">Pup's Breed (2) </label>
<input type="text" value="" name="PUPBREED2" class="" id="mce-PUPBREED2">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PUPBDAY2-month">Pup's Birthday (2) </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="PUPBDAY2[month]" id="mce-PUPBDAY2-month"></span> / <span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="PUPBDAY2[day]" id="mce-PUPBDAY2-day"></span>
<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div><div class="mc-field-group">
<label for="mce-PUPNAME3">Pup's Name (3) </label>
<input type="text" value="" name="PUPNAME3" class="" id="mce-PUPNAME3">
</div>
<div class="mc-field-group">
<label for="mce-PUPBREED3">Pup's Breed (3) </label>
<input type="text" value="" name="PUPBREED3" class="" id="mce-PUPBREED3">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PUPBDAY3-month">Pup's Birthday (3) </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="PUPBDAY3[month]" id="mce-PUPBDAY3-month"></span> /
<span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="PUPBDAY3[day]" id="mce-PUPBDAY3-day"></span>
<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div><div class="mc-field-group input-group">
<strong>Email Format </strong>
<ul><li><input type="radio" value="html" name="EMAILTYPE" id="mce-EMAILTYPE-0"><label for="mce-EMAILTYPE-0">html</label></li>
<li><input type="radio" value="text" name="EMAILTYPE" id="mce-EMAILTYPE-1"><label for="mce-EMAILTYPE-1">text</label></li>
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<div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
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</form>
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<script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[0]='EMAIL';ftypes[0]='email';fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[4]='CITY';ftypes[4]='text';fnames[3]='STATE';ftypes[3]='text';fnames[11]='PHONE';ftypes[11]='phone';fnames[5]='PUPNAME1';ftypes[5]='text';fnames[6]='PUPBREED1';ftypes[6]='text';fnames[12]='PUPBDAY1';ftypes[12]='birthday';fnames[7]='PUPNAME2';ftypes[7]='text';fnames[8]='PUPBREED2';ftypes[8]='text';fnames[13]='PUPBDAY2';ftypes[13]='birthday';fnames[9]='PUPNAME3';ftypes[9]='text';fnames[10]='PUPBREED3';ftypes[10]='text';fnames[14]='PUPBDAY3';ftypes[14]='birthday';}(jQuery));var $mcj = jQuery.noConflict(true);</script>
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<link href="//cdn-images.mailchimp.com/embedcode/classic-10_7.css" rel="stylesheet" type="text/css">
<style type="text/css">
#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }
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<form action="//josephinegracepuppycouture.us13.list-manage.com/subscribe/post?u=9af3052b1291bcce9d46514e3&id=13e5260a3c" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
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<h2>Subscribe to our mailing list</h2>
<div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
<div class="mc-field-group">
<label for="mce-EMAIL">Email Address <span class="asterisk">*</span>
</label>
<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
</div>
<div class="mc-field-group">
<label for="mce-FNAME">First Name <span class="asterisk">*</span>
</label>
<input type="text" value="" name="FNAME" class="required" id="mce-FNAME">
</div>
<div class="mc-field-group">
<label for="mce-LNAME">Last Name <span class="asterisk">*</span>
</label>
<input type="text" value="" name="LNAME" class="required" id="mce-LNAME">
</div>
<div class="mc-field-group">
<label for="mce-CITY">City <span class="asterisk">*</span>
</label>
<input type="text" value="" name="CITY" class="required" id="mce-CITY">
</div>
<div class="mc-field-group">
<label for="mce-STATE">State <span class="asterisk">*</span>
</label>
<input type="text" value="" name="STATE" class="required" id="mce-STATE">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PHONE">Phone Number </label>
<input type="text" name="PHONE" class="" value="" id="mce-PHONE">
</div>
<div class="mc-field-group">
<label for="mce-PUPNAME1">Pup's Name (1) </label>
<input type="text" value="" name="PUPNAME1" class="" id="mce-PUPNAME1">
</div>
<div class="mc-field-group">
<label for="mce-PUPBREED1">Pup's Breed (1) </label>
<input type="text" value="" name="PUPBREED1" class="" id="mce-PUPBREED1">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PUPBDAY1-month">Pup's Birthday (1) </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="PUPBDAY1[month]" id="mce-PUPBDAY1-month"></span> / <span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="PUPBDAY1[day]" id="mce-PUPBDAY1-day"></span>
<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div><div class="mc-field-group">
<label for="mce-PUPNAME2">Pup's Name (2) </label>
<input type="text" value="" name="PUPNAME2" class="" id="mce-PUPNAME2">
</div>
<div class="mc-field-group">
<label for="mce-PUPBREED2">Pup's Breed (2) </label>
<input type="text" value="" name="PUPBREED2" class="" id="mce-PUPBREED2">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PUPBDAY2-month">Pup's Birthday (2) </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="PUPBDAY2[month]" id="mce-PUPBDAY2-month"></span> / <span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="DD" size="2" maxlength="2" name="PUPBDAY2[day]" id="mce-PUPBDAY2-day"></span>
<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div><div class="mc-field-group">
<label for="mce-PUPNAME3">Pup's Name (3) </label>
<input type="text" value="" name="PUPNAME3" class="" id="mce-PUPNAME3">
</div>
<div class="mc-field-group">
<label for="mce-PUPBREED3">Pup's Breed (3) </label>
<input type="text" value="" name="PUPBREED3" class="" id="mce-PUPBREED3">
</div>
<div class="mc-field-group size1of2">
<label for="mce-PUPBDAY3-month">Pup's Birthday (3) </label>
<div class="datefield">
<span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value="" placeholder="MM" size="2" maxlength="2" name="PUPBDAY3[month]" id="mce-PUPBDAY3-month"></span> /
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<span class="small-meta nowrap">( mm / dd )</span>
</div>
</div><div class="mc-field-group input-group">
<strong>Email Format </strong>
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<li><input type="radio" value="text" name="EMAILTYPE" id="mce-EMAILTYPE-1"><label for="mce-EMAILTYPE-1">text</label></li>
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<div class="response" id="mce-error-response" style="display:none"></div>
<div class="response" id="mce-success-response" style="display:none"></div>
</div> <!-- real people should not fill this in and expect good things - do not remove this or risk form bot signups-->
<div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_9af3052b1291bcce9d46514e3_13e5260a3c" tabindex="-1" value=""></div>
<div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
</div>
</form>
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<script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[0]='EMAIL';ftypes[0]='email';fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[4]='CITY';ftypes[4]='text';fnames[3]='STATE';ftypes[3]='text';fnames[11]='PHONE';ftypes[11]='phone';fnames[5]='PUPNAME1';ftypes[5]='text';fnames[6]='PUPBREED1';ftypes[6]='text';fnames[12]='PUPBDAY1';ftypes[12]='birthday';fnames[7]='PUPNAME2';ftypes[7]='text';fnames[8]='PUPBREED2';ftypes[8]='text';fnames[13]='PUPBDAY2';ftypes[13]='birthday';fnames[9]='PUPNAME3';ftypes[9]='text';fnames[10]='PUPBREED3';ftypes[10]='text';fnames[14]='PUPBDAY3';ftypes[14]='birthday';}(jQuery));var $mcj = jQuery.noConflict(true);</script>
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