Form Test


<script>window.jQuery || document.write('<script src="https://app.kartra.com/js/jquery-1.11.3.min.js"><\/script>')</script>
<script src="https://app.kartra.com/resources/js/analytics/Zko4b9r8"></script>
<script src="https://app.kartra.com/resources/js/optin_fill_in?optin=q0O4rlD5T2Za"></script>
<script>
<script src="https://app.kartra.com/optin/q0O4rlD5T2Za"></script>

<form method="post" action="https://app.kartra.com/process/add_lead/q0O4rlD5T2Za" target="_top" class="form_class_q0O4rlD5T2Za optin_form_for_video js_kartra_trackable_object" data-kt-type="optin" data-kt-value="q0O4rlD5T2Za" data-kt-owner="Zko4b9r8" accept-charset="UTF-8">
	
		
	<input type="text" class="js_kartra_santitation" data-santitation-type="name" placeholder="First name..." name="first_name" value="" >







	<input type="text" class="js_kartra_santitation" data-santitation-type="name" placeholder="Last name..." name="last_name" value="" >







	<input type="text" class="js_kartra_santitation" data-santitation-type="email" placeholder="Email address..." name="email" value="" >









    

          
   
	<button class='submit_button_c74d97b01eae257e44aa9d5bade97baf'
        
            onclick="var element = this;
            element.form.submit();
            element.setAttribute('disabled', true);
            setTimeout(function(){
                element.removeAttribute('disabled');
            }, 1000);"
         type="submit" >

		Submit
	</button>

    


	
</form>