[mc4wp_form id="13358"]
<script>(function() { window.mc4wp = window.mc4wp || { listeners: [], forms: { on: function(evt, cb) { window.mc4wp.listeners.push( { event : evt, callback: cb } ); } } } })(); </script><!-- Mailchimp for WordPress v4.8.7 - https://wordpress.org/plugins/mailchimp-for-wp/ --><form id="mc4wp-form-2" class="mc4wp-form mc4wp-form-13358 mc4wp-form-basic mc4wp-ajax" method="post" data-id="13358" data-name="optin_en_optinmonster" ><div class="mc4wp-form-fields"><fieldset> <input id="email_mc4wp" class="" name="EMAIL" placeholder="enter your email address here" required="" type="EMAIL" > <input type="hidden" class="newsletter-mail" name="newsletter-mail" id="email_newsletter"> <input name="MMERGE7" value="optinmonster" type="hidden"> <input name="MMERGE9" value=en_US type="hidden"> <input name="MMERGE8" value={country} type="hidden"> <input name="MMERGE10" value=66.249.70.6 type="hidden"> <input value="OK" type="submit" class="om-trigger-conversion" onClick="write_email();" > <br><input id="terms_optin" name="_mc4wp_agree_to_terms" value="1" required="" type="checkbox"><label for="terms_optin">Yes, I confirm that I am over 16 years old and I want to receive information from IOMA on new products and services. </label></fieldset> <script type="text/javascript"> function write_email(){ var email1 = document.getElementById('email_mc4wp').value; var a = document.getElementById('email_newsletter'); a.value = email1; } </script> </div><label style="display: none !important;">Leave this field empty if you're human: <input type="text" name="_mc4wp_honeypot" value="" tabindex="-1" autocomplete="off" /></label><input type="hidden" name="_mc4wp_timestamp" value="1686359460" /><input type="hidden" name="_mc4wp_form_id" value="13358" /><input type="hidden" name="_mc4wp_form_element_id" value="mc4wp-form-2" /><div class="mc4wp-response"></div></form><!-- / Mailchimp for WordPress Plugin -->
