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<div id="mc_embed_signup">
<form action="https://stecklergrassfed.us12.list-manage.com/subscribe/post?u=2e2fa16f2e2e534c10305129e&id=a9126a6bcc" method="post" id="mc-embedded-subscribe-form" name="mc-embedded-subscribe-form" class="validate" target="_blank" novalidate>
<div id="mc_embed_signup_scroll">
<h2>Subscribe</h2>
<div class="indicates-required"><span class="asterisk">*</span> indicates required</div>
<div class="mc-field-group">
<label for="mce-EMAIL">Email Address <span class="asterisk">*</span>
</label>
<input type="email" value="" name="EMAIL" class="required email" id="mce-EMAIL">
</div>
<div class="mc-field-group">
<label for="mce-FNAME">First Name </label>
<input type="text" value="" name="FNAME" class="" id="mce-FNAME">
</div>
<div class="mc-field-group">
<label for="mce-LNAME">Last Name </label>
<input type="text" value="" name="LNAME" class="" id="mce-LNAME">
</div>
<div class="mc-field-group">
<label for="mce-MMERGE3">Zip Code </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 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="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="small-meta nowrap">( mm / dd )</span>
</div>
</div> <div id="mce-responses" class="clear">
<div class="response" id="mce-error-response" style="display:none"></div>
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<div style="position: absolute; left: -5000px;" aria-hidden="true"><input type="text" name="b_2e2fa16f2e2e534c10305129e_a9126a6bcc" tabindex="-1" value=""></div>
<div class="clear"><input type="submit" value="Subscribe" name="subscribe" id="mc-embedded-subscribe" class="button"></div>
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</form>
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<script type='text/javascript' src='//s3.amazonaws.com/downloads.mailchimp.com/js/mc-validate.js'></script><script type='text/javascript'>(function($) {window.fnames = new Array(); window.ftypes = new Array();fnames[0]='EMAIL';ftypes[0]='email';fnames[1]='FNAME';ftypes[1]='text';fnames[2]='LNAME';ftypes[2]='text';fnames[3]='MMERGE3';ftypes[3]='zip';fnames[4]='MMERGE4';ftypes[4]='birthday';}(jQuery));var $mcj = jQuery.noConflict(true);</script>
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