document.write('<script language="javascript" type="text/javascript"> function validateForm_6638b6a8c4cc9665710447(form){var email=form["Email"].value; var reg_exp = /[0-9a-z]([-_.+0-9a-z])*@[0-9a-zñáéíóúÇçãõ]([-.]?[0-9a-zñáéíóúÇçãõ])*\.[a-z]{2,7}/i; testSuccess = reg_exp.test(email); if(!testSuccess){ alert("El campo Dirección de email es obligatorio y debe contener una dirección de correo válida"); return false;}  return true;}; </script> <style type="text/css"> .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1{  background: #E9E9E9;  font-family: Georgia, "Times New Roman", Times, serif;  font-size: 14px;  color: #2E1818;  margin-top: 5px;  margin-right: 5px;  margin-bottom: 5px;  padding-top: 10px;  padding-right: 20px;  padding-bottom: 10px;  padding-left: 20px;  width: 900px;  -webkit-box-sizing: border-box;  -moz-box-sizing: border-box;  box-sizing: border-box; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 label{  display: block;  font-family: Georgia, "Times New Roman", Times, serif;  font-size: 14px;  padding-top: 3px;  padding-right: 7px;  padding-bottom: 3px; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingPrivacyLink{  text-decoration: underline;  font-weight: normal;  font-size: 14px;  font-family: Georgia, "Times New Roman", Times, serif; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingFormTitle{  font-weight: bold;  font-size: 14px;  font-family: Georgia, "Times New Roman", Times, serif; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingFormDescription{  font-weight: normal;  font-size: 14px;  font-family: Georgia, "Times New Roman", Times, serif; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 input.emailMarketingSubscriptionTextField, .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 select.emailMarketingSubscriptionSelectField, .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 textarea.emailMarketingSubscriptionTextareaField{  border: medium none;  border-radius: 3px;  font-family: Georgia, "Times New Roman", Times, serif;  font-size: 14px;  color: #777777;  margin-bottom: 7px;  padding-top: 5px;  padding-right: 10px;  padding-bottom: 5px;  padding-left: 10px;  width: 100%;  resize: none;  -moz-box-sizing: border-box;  -o-box-sizing: border-box;  -webkit-box-sizing: border-box;  -ms-box-sizing: border-box;  box-sizing: border-box;  -o-box-shadow: 1px 1px 1px rgba(0, 0, 0, 0.2) inset, 0 0 3px rgba(0, 0, 0, 0.2) inset;  -ms-box-shadow: 1px 1px 1px rgba(0, 0, 0, 0.2) inset, 0 0 3px rgba(0, 0, 0, 0.2) inset;  -wekbit-box-shadow: 1px 1px 1px rgba(0, 0, 0, 0.2) inset, 0 0 3px rgba(0, 0, 0, 0.2) inset;  -moz-box-shadow: 1px 1px 1px rgba(0, 0, 0, 0.2) inset, 0 0 3px rgba(0, 0, 0, 0.2) inset;  box-shadow: 1px 1px 1px rgba(0, 0, 0, 0.2) inset, 0 0 3px rgba(0, 0, 0, 0.2) inset; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .submitButton{  font-family: Georgia, "Times New Roman", Times, serif;  font-size: 14px;  cursor: pointer; } .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingSubscriptionMonthDayEnvolpe{  width: 100%;} .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingSubscriptionMonthDayEnvolpe td:first-child{  width:60%;} .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingSubscriptionMonthDayEnvolpe td + td{  padding-left:10px;} .emailMarketingSubscriptionFormContainer.formID_subscriptionForm-60181-1 .emailMarketingSubscriptionMonthDayEnvolpe .emailMarketingSubscriptionMonthDayEnvolpe-subLabel label{  font-size: .7em;  color: #2E1818;} </style> <div class="emailMarketingSubscriptionFormContainer formID_subscriptionForm-60181-1"> <form name="emailMarketingSubscription" method="post" action="http://app.envialosimple.com/form/subscribe" onsubmit="return validateForm_6638b6a8c4cc9665710447(this);"> <input type="hidden" name="FormID" value="1" /> <input type="hidden" name="AdministratorID" value="60181" /> <input type="hidden" name="isFacebook" value="0" /> <label class="emailMarketingFormTitle">Solicitud de credencial PAGO FÁCIL </label><br /> <p class="emailMarketingFormDescription">Completando la siguiente información, te contactaremos para que accedas a una credencial que te permita hacer una donación a Fe y Alegría Argentina </p> <label for="Email">Dirección de email </label><input type="text" class="emailMarketingSubscriptionTextField" id="Email" name="Email" value="" /><br /> <label for="CustomField1">Nombre</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField1" id="CustomField1" value="" /><br/> <label for="CustomField2">Apellido</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField2" id="CustomField2" value="" /><br/> <label for="CustomField10">Teléfono</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField10" id="CustomField10" value="" /><br/> <label for="CustomField5">Calle</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField5" id="CustomField5" value="" /><br/> <label for="CustomField6">CP</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField6" id="CustomField6" value="" /><br/> <label for="CustomField7">Localidad</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField7" id="CustomField7" value="" /><br/> <label for="CustomField8">Provincia</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField8" id="CustomField8" value="" /><br/> <label for="CustomField9">País</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField9" id="CustomField9" value="" /><br/> <label for="CustomField15">Fecha de Nacimiento</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField15" id="CustomField15" value="" /><br/> <label for="CustomField11">¿Cómo supiste de FE y ALEGRÍA?</label><input type="text" class="emailMarketingSubscriptionTextField" name="CustomField11" id="CustomField11" value="" /><br/> <br /><input type="submit" name="Subscribe" value="Enviar" class="submitButton" /> </form> </div>')