<form id=“{{urid}}_form” action=“__api__/mailchimp” method=“post” onsubmit=“event.preventDefault()”>

<input type="hidden" name="listid" value="{{options.listid}}" />

<div class="form-group">
        <input type="text" name="email" data-validation="required email" class="form-control" placeholder="{{locale_str_system_email}}">
</div>
<div class="form-group">
        <input type="text" name="firstname" data-validation="required" class="form-control" placeholder="{{locale_str_users_firstname}}">
</div>
<div class="form-group">
        <input type="text" name="lastname" data-validation="required" class="form-control" placeholder="{{locale_str_users_lastname}}">
</div>

<button type="submit" class="btn btn-primary" data-loading-text='{{locale_str_system_sending}}' data-complete-text='{{locale_str_system_success}}'>
        {{locale_str_system_send}}
</button>

</form>

<div id=“{{urid}}_success” class=“hidden alert alert-success”>

{{locale_str_mailchimp_success}}

</div>

<script type=“application/javascript”>

(function() {

        "use strict";

        var $form = $("#{{urid}}_form");

        $form.submit(function (event) {
                event.preventDefault();
                $(".alert", $form).remove();
                if (!Validator.validateForm($form[0])) {
                        return false;
                }
                var $btn = $(".btn-primary", $form);
                $form.attr("method", "post");
                $form.attr("action", "__api__/mailchimp");

                $btn.button("loading");
                $form.ajaxSubmit({
                        success: function () {
                                $btn.button("complete").addClass("btn-success disabled");
                                $form.remove();
                                $("#{{urid}}_success").removeClass("hidden");
                        },
                        error: function (e) {
                                var message = e.responseJSON.error.message;
                                if (message.indexOf("already a list member") > 0) {
                                        message = "{{locale_str_mailchimp_already_list_member}}";
                                }
                                $form.prepend($("<div class='alert alert-danger'>" + message + "</div>"));
                                $btn.button('reset');
                        }
                });
                return false;
        });

})(jQuery);

</script>