<form class="petpack-newsletter-subscribe newsletter-subscribe-5fe462ef12104b0104f09b39aed547b5"method="POST" action="https://petpack.com.au/newsletter-subscribe/5fe462ef12104b0104f09b39aed547b5"> <!-- [et_pb_line_break_holder] --> <label class="firstname"><span><strong>First Name:</strong></span><input class="firstname" type="text" name="Name" placeholder="Your First Name" /></label><!-- [et_pb_line_break_holder] --> <label class="surname"><span><strong>Surname:</strong></span><input class="surname" type="text" name="Surname" placeholder="Your Surname" /></label><!-- [et_pb_line_break_holder] --> <label class="email"><span><strong>Email:</strong></span><input class="email" type="text" name="Email" placeholder="Your Email Address" /></label><!-- [et_pb_line_break_holder] --> <label class="confirm"><span><strong>Confirm Email:</strong></span><input class="confirm" type="text" name="Confirm_Email" placeholder="Confirm Your Email" /></label><!-- [et_pb_line_break_holder] --> <input class="submit" type="submit" value="Subscribe" /><!-- [et_pb_line_break_holder] --></form><!-- [et_pb_line_break_holder] -->