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[/et_pb_image][/et_pb_column][et_pb_column type=”1_2″][et_pb_code global_parent=”2278″ admin_label=”Code”]<!– Begin MailChimp Signup Form –> <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; } /* Add your own MailChimp form style overrides in your site stylesheet or in this style block. We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */ </style> <div id=”mc_embed_signup”> <form action=”https://flemingwatson.us15.list-manage.com/subscribe/post?u=f0b5dde876b579a3e2c8ebf7b&amp;id=79b2ab749e” method=”post” id=”mc-embedded-subscribe-form” name=”mc-embedded-subscribe-form” class=”validate” target=”_blank” novalidate> <div id=”mc_embed_signup_scroll”> <h2>Download Your Guide: <i>The Five Big Questions</i></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 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-AGE”>Your Age </label> <select name=”AGE” class=”” id=”mce-AGE”> <option value=””></option> <option value=”45-50″>45-50</option> <option value=”50-55″>50-55</option> <option value=”55-60″>55-60</option> <option value=”60-65″>60-65</option> <option value=”65-70″>65-70</option> <option value=”70+”>70+</option> </select> </div> <div class=”mc-field-group”> <label for=”mce-WHENRET”>When Do You Hope to Retire? </label> <select name=”WHENRET” class=”” id=”mce-WHENRET”> <option value=””></option> <option value=”More than 10 Years”>More than 10 Years</option> <option value=”5-10 Years”>5-10 Years</option> <option value=”3-5 Years”>3-5 Years</option> <option value=”1-3 Years”>1-3 Years</option> <option value=”In The Next 12 Months”>In The Next 12 Months</option> <option value=”Already Retired”>Already Retired</option> </select> </div> <div id=”mce-responses” class=”clear”> <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_f0b5dde876b579a3e2c8ebf7b_79b2ab749e” tabindex=”-1″ value=””></div> <div class=”clear”><input type=”submit” value=”Get My Free Guide” name=”subscribe” id=”mc-embedded-subscribe” class=”button”></div> </div> </form> </div> <!–End mc_embed_signup–>[/et_pb_code][/et_pb_column][/et_pb_row][/et_pb_section]