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Server: Microsoft-IIS/8.5
System: Windows NT YDAWBH120 6.3 build 9600 (Windows Server 2012 R2 Standard Edition) AMD64
User: tentjecom_web (0)
PHP: 7.4.14
Disabled: NONE
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File: D:/HostingSpaces/SBogers93/fitale.nl/app/views/layouts/partials/mailChimp.blade.php
<div class="mail-chimp-row" id="nieuwsbrief">

    <h2>Volg het laatste nieuws</h2>
    <p>Schrijf je in voor de nieuwsbrief</p>

    <!-- Begin MailChimp Signup Form -->
    <div id="mc_embed_signup">
        <form action="https://fitale.us14.list-manage.com/subscribe/post?u=712549879ba33129fa92f147c&amp;id=885cb7626a"
              method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate"
              target="_blank" novalidate>
            <div id="mc_embed_signup_scroll">

                <div class="field-multiple">
                    <div class="mc-field-group">
                        <label for="mce-FNAME">Voornaam </label>
                        <input type="text" value="" name="FNAME" class="" id="mce-FNAME">
                    </div>
                    <div class="mc-field-group">
                        <label for="mce-LNAME">Achternaam </label>
                        <input type="text" value="" name="LNAME" class="" id="mce-LNAME">
                    </div>
                    <div class="clear"></div>
                </div>
                <div class="mc-field-group">
                    <label for="mce-MMERGE3">Bedrijfsnaam </label>
                    <input type="text" value="" name="MMERGE3" class="" id="mce-MMERGE3">
                </div>
                <div class="mc-field-group size1of2">
                    <label for="mce-MMERGE4-month">Birthday </label>
                    <div class="datefield">
                        <span class="subfield dayfield"><input class="birthday " type="text" pattern="[0-9]*" value=""
                                                               placeholder="DD" size="2" maxlength="2"
                                                               name="MMERGE4[day]" id="mce-MMERGE4-day"></span> /
                        <span class="subfield monthfield"><input class="birthday " type="text" pattern="[0-9]*" value=""
                                                                 placeholder="MM" size="2" maxlength="2"
                                                                 name="MMERGE4[month]" id="mce-MMERGE4-month"></span>
                        <span class="small-meta nowrap">( dag / maand )</span>
                    </div>
                </div>
                <div class="mc-field-group">
                    <label for="mce-EMAIL">E-mailadres <span class="asterisk">*</span>
                    </label>
                    <input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
                </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_712549879ba33129fa92f147c_74596973b8"
                                                                                          tabindex="-1" value=""></div>
                <div class="clear">
                    <input type="submit" value="Aanmelden" name="subscribe" id="mc-embedded-subscribe"
                           class="button">
                </div>
            </div>
        </form>
    </div>

    <!--End mc_embed_signup-->

</div>