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<div class="et_pb_contact"><!-- [et_pb_line_break_holder] --><form action="https://app.getresponse.com/add_subscriber.html" class="et_pb_contact_form clearfix" accept-charset="utf-8" method="post"><!-- [et_pb_line_break_holder] --> <!-- Nombre --><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_0 et_pb_contact_field_half"><!-- [et_pb_line_break_holder] --> <input type="text" name="name" class="input" placeholder="Nombre"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_1 et_pb_contact_field_half et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <input name="custom_company" class="input" type="text" value="" placeholder="Empresa"><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <!-- Campo email (requerido) --><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_2 et_pb_contact_field_half"><!-- [et_pb_line_break_holder] --> <input type="text" name="email" class="input" placeholder="Email"><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_3 et_pb_contact_field_half et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <input name="custom_phone" class="input" type="text" value="" placeholder="Teléfono (+34)"><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_4 et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <textarea name="custom_comment" class="et_pb_contact_message input" placeholder="Comentario"></textarea><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <!-- Token de lista --><!-- [et_pb_line_break_holder] --> <!-- Obtenga el token en: https://app.getresponse.com/campaign_list.html --><!-- [et_pb_line_break_holder] --> <input type="hidden" name="campaign_token" value="6OeyN" /><!-- [et_pb_line_break_holder] --> <!-- Botón de suscriptor --><!-- [et_pb_line_break_holder] --> <div class="et_contact_bottom_container"><!-- [et_pb_line_break_holder] --> <input type="submit" class="et_pb_contact_submit et_pb_button" value="Enviar"/><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --></form><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] -->