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Submitted URL: https://app.go.informamail01.com/e/er?s=1346786309&lid=170264&elqTrackId=c005c24a565544269ca01db785bf87e0&EM=cdonivan%40riverside...
Effective URL: https://pen.dragonforms.com/loading.do?PK=NE219Y&EM=cdonivan%40riversidesheriff.org&omedasite=PEN6094_Rgnew
Submission: On September 30 via api from US — Scanned from DE
Effective URL: https://pen.dragonforms.com/loading.do?PK=NE219Y&EM=cdonivan%40riversidesheriff.org&omedasite=PEN6094_Rgnew
Submission: On September 30 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST saveNewSubscription.do;jsessionid=35FD89B914313704D048989D89F57999
<form method="post" accept-charset="utf-8" action="saveNewSubscription.do;jsessionid=35FD89B914313704D048989D89F57999" id="standardForm"><input type="hidden" name="14" id="14" value="1"><input type="hidden" id="dragonjsessionid"
name="dragonjsessionid" value="35FD89B914313704D048989D89F57999"><input type="hidden" id="shippingaddresscountry" name="shippingaddresscountry" value="7">
<header class="row borderleft borderright">
<div class="twelvecol headertop">
</div>
</header>
<header class="row borderleft borderright borderbottom">
<div class="twelvecol">
<span class="logo">
<!-- OMNITURE CODE PART 1 -->
<!-- Demandbase Code -->
<script src="https://cdn.omeda.com/hosted/images/dragon/12278/5542.js" type="text/javascript"></script>
<!-- DO NOT REPLACE -->
<script type="text/javascript" src="https://api.demandbase.com/api/v2/ip.json?token=b155ec5d50b5dcb41662f36b4d10a6f7702c87e6&callback=dbase_parse"></script>
<!-- End Demandbase Code -->
<!-- SiteCatalyst code H.23.2. for Hallmark forms -->
<script language="JavaScript" type="text/javascript" src="https://cdn.omeda.com/hosted/images/dragon/12278/8818.js"></script>
<!-- omniture/s_code.js -->
<!-- END OMNITURE 1 -->
<img src="https://link.p0.com/1x1c.dyn?p=344DFA04C" width="0" height="0">
<img src="https://hostedcontent.dragonforms.com/hosted/images/dragon/12278/2992.png" alt="Wealth_Management_LargeLogo">
</span>
</div>
</header>
<section class="row contentbg borderleft borderright">
<div class="twelvecol">
<section class="content1">
<h2>New Magazine Subscription</h2>
<style>
.breadcrumb {
list-style: none;
overflow: hidden;
font: 12px Helvetica, Arial, Sans-Serif;
background: #2dcff6;
display: block;
min-width: 500px;
height: 30px;
margin: 10px 0;
}
.breadcrumb li {
float: left;
max-width: 100%;
height: auto;
}
.breadcrumb li:first-child .crumbitem {
padding-left: 10px;
}
.breadcrumb li .crumbitem {
color: #fff;
text-decoration: none;
padding: 8px 0 8px 45px;
background: #2dcff6;
position: relative;
display: block;
float: left;
}
.breadcrumb li .crumbitem:after {
content: " ";
display: block;
width: 0;
height: 0;
border-top: 50px solid transparent;
/* Go big on the size, and let overflow hide */
border-bottom: 50px solid transparent;
border-left: 30px solid #2dcff6;
position: absolute;
top: 50%;
margin-top: -50px;
left: 100%;
z-index: 5;
}
.breadcrumb li.zoetic .crumbitem {
background: #1794c1 !important;
color: #2dcff6;
z-index: 5;
}
.breadcrumb li.zoetic .crumbitem:after {
border-left-color: #1794c1 !important;
}
/*.breadcrumb li.level-1 .crumbitem { padding-left: 10px; }
.breadcrumb li.level-2 .crumbitem { background: #2dcff6; }
.breadcrumb li.level-2 .crumbitem:after { border-left-color: #2dcff6; }
.breadcrumb li.level-3 .crumbitem { background: #2dcff6; }
.breadcrumb li.level-3 .crumbitem:after { border-left-color: #2dcff6; }*/
.current {
color: #fff !important;
}
</style>
<ul class="breadcrumb">
<li class="zoetic">
<div class="crumbitem current">1. Contact Information</div>
</li>
<li class="">
<div class="crumbitem">2. Credentials Checklist</div>
</li>
<li class="">
<div class="crumbitem">3. Customize Subscription</div>
</li>
</ul> *Required items.
</section>
</div>
</section>
<section class="row contentbg borderleft borderright">
<div class="twelvecol">
<section class="validation">
<ul></ul>
</section>
</div>
</section>
<section class="row contentbg borderleft borderright">
<div class="sixcol">
<section class="content2"><span class="spanc112 drg-element-type-standard-field drg-element-sub-type-fieldname-REQUESTED_VERSION">
<p id="p112" class="drg-element-type-standard-field drg-element-sub-type-fieldname-REQUESTED_VERSION"><span class="questionlabel ">* <big><big>Would you like to receive Wealth Management magazine?</big></big> </span></p>
<ul>
<li class="licr112_998 lier141061_998 "><input name="demo141061" type="radio" value="998" id="id112_998" [-checked141061_r998-]=""><span class="radiolabel"><label for="id112_998">Yes, the print version</label></span></li>
<li class="licr112_999 lier141061_999 "><input name="demo141061" type="radio" value="999" id="id112_999" [-checked141061_r999-]=""><span class="radiolabel"><label for="id112_999">Yes, the digital version</label></span></li>
<li class="licr112_1003 lier141061_1003 "><input name="demo141061" type="radio" value="1003" id="id112_1003" [-checked141061_r1003-]=""><span class="radiolabel"><label for="id112_1003">No, thank you</label></span></li>
</ul>
</span>
<p id="p13" class="drg-element-type-standard-field drg-element-sub-type-fieldname-EMAILADDR addresslabel"><span class="questionlabel "><label for="id13">* E-mail Address</label> </span><input class="drg-field-address-normal" name="demo141062"
type="text" value="cdonivan@riversidesheriff.org" id="id13" maxlength="50" size="50"></p>
<p id="p28" class="drg-element-type-standard-field drg-element-sub-type-fieldname-EMAILADDRC addresslabel"><span class="questionlabel "><label for="id28">* Confirm E-mail Address</label> </span><input class="drg-field-address-normal"
name="demo141063" type="text" value="" id="id28" maxlength="50" size="50"></p>
<p id="p1" class="drg-element-type-standard-field drg-element-sub-type-fieldname-FIRSTNAME addresslabel"><span class="questionlabel "><label for="id1">* First Name</label> </span><input class="drg-field-address-normal" name="demo141064"
type="text" value="" id="id1" maxlength="40" size="40"></p>
<p id="p2" class="drg-element-type-standard-field drg-element-sub-type-fieldname-LASTNAME addresslabel"><span class="questionlabel "><label for="id2">* Last Name</label> </span><input class="drg-field-address-normal" name="demo141065"
type="text" value="" id="id2" maxlength="40" size="40"></p><input name="demo141066" type="hidden" value="NE219Y" id="demo141066">
</section>
</div>
<div class="sixcol last">
<section class="content3">
<p id="p10" class="drg-element-type-standard-field drg-element-sub-type-fieldname-TITLE addresslabel"><span class="questionlabel "><label for="id10">* Title</label> </span><input class="drg-field-address-normal" name="demo141067" type="text"
value="" id="id10" maxlength="40" size="40"></p>
<p id="p3" class="drg-element-type-standard-field drg-element-sub-type-fieldname-COMPANY addresslabel"><span class="questionlabel "><label for="id3">* Company Name</label> </span><input class="drg-field-address-normal" name="demo141068"
type="text" value="" id="id3" maxlength="40" size="40"></p>
<p id="p5" class="drg-element-type-standard-field drg-element-sub-type-fieldname-DEPARTMENT addresslabel"><span class="questionlabel "><label for="id5">Dept/Mail Stop</label> </span><input class="drg-field-address-normal" name="demo141069"
type="text" value="" id="id5" maxlength="255" size="255"></p>
<p id="p4" class="drg-element-type-standard-field drg-element-sub-type-fieldname-ADDRESS addresslabel"><span class="questionlabel "><label for="id4">* Street Address</label> </span><input class="drg-field-address-normal" name="demo141070"
type="text" value="" id="id4" maxlength="255" size="255"></p>
<p id="p6" class="drg-element-type-standard-field drg-element-sub-type-fieldname-CITY addresslabel"><span class="questionlabel "><label for="id6">* City</label> </span><input class="drg-field-address-normal" name="demo141071" type="text"
value="" id="id6" maxlength="100" size="100"></p><span class="spanc8 drg-element-type-standard-field drg-element-sub-type-fieldname-STATE">
<p id="p8" class="drg-element-type-standard-field drg-element-sub-type-fieldname-STATE addresslabel"><span class="questionlabel "><label for="id8">State / Prov</label> </span><select name="demo141072" id="id8">
<option value="">Select One</option>
<option value="1" [-selected141072_r1-]="">ALABAMA</option>
<option value="2" [-selected141072_r2-]="">ALASKA</option>
<option value="3" [-selected141072_r3-]="">ARIZONA</option>
<option value="4" [-selected141072_r4-]="">ARKANSAS</option>
<option value="5" [-selected141072_r5-]="">CALIFORNIA</option>
<option value="6" [-selected141072_r6-]="">COLORADO</option>
<option value="7" [-selected141072_r7-]="">CONNECTICUT</option>
<option value="8" [-selected141072_r8-]="">DELAWARE</option>
<option value="9" [-selected141072_r9-]="">DISTRICT OF COLUMBIA</option>
<option value="10" [-selected141072_r10-]="">FLORIDA</option>
<option value="11" [-selected141072_r11-]="">GEORGIA</option>
<option value="12" [-selected141072_r12-]="">HAWAII</option>
<option value="13" [-selected141072_r13-]="">IDAHO</option>
<option value="14" [-selected141072_r14-]="">ILLINOIS</option>
<option value="15" [-selected141072_r15-]="">INDIANA</option>
<option value="16" [-selected141072_r16-]="">IOWA</option>
<option value="17" [-selected141072_r17-]="">KANSAS</option>
<option value="18" [-selected141072_r18-]="">KENTUCKY</option>
<option value="19" [-selected141072_r19-]="">LOUISIANA</option>
<option value="20" [-selected141072_r20-]="">MAINE</option>
<option value="21" [-selected141072_r21-]="">MARYLAND</option>
<option value="22" [-selected141072_r22-]="">MASSACHUSETTS</option>
<option value="23" [-selected141072_r23-]="">MICHIGAN</option>
<option value="24" [-selected141072_r24-]="">MINNESOTA</option>
<option value="25" [-selected141072_r25-]="">MISSISSIPPI</option>
<option value="26" [-selected141072_r26-]="">MISSOURI</option>
<option value="27" [-selected141072_r27-]="">MONTANA</option>
<option value="28" [-selected141072_r28-]="">NEBRASKA</option>
<option value="29" [-selected141072_r29-]="">NEVADA</option>
<option value="30" [-selected141072_r30-]="">NEW HAMPSHIRE</option>
<option value="31" [-selected141072_r31-]="">NEW JERSEY</option>
<option value="32" [-selected141072_r32-]="">NEW MEXICO</option>
<option value="33" [-selected141072_r33-]="">NEW YORK</option>
<option value="34" [-selected141072_r34-]="">NORTH CAROLINA</option>
<option value="35" [-selected141072_r35-]="">NORTH DAKOTA</option>
<option value="36" [-selected141072_r36-]="">OHIO</option>
<option value="37" [-selected141072_r37-]="">OKLAHOMA</option>
<option value="38" [-selected141072_r38-]="">OREGON</option>
<option value="39" [-selected141072_r39-]="">PENNSYLVANIA</option>
<option value="40" [-selected141072_r40-]="">RHODE ISLAND</option>
<option value="41" [-selected141072_r41-]="">SOUTH CAROLINA</option>
<option value="42" [-selected141072_r42-]="">SOUTH DAKOTA</option>
<option value="43" [-selected141072_r43-]="">TENNESSEE</option>
<option value="44" [-selected141072_r44-]="">TEXAS</option>
<option value="45" [-selected141072_r45-]="">UTAH</option>
<option value="46" [-selected141072_r46-]="">VERMONT</option>
<option value="47" [-selected141072_r47-]="">VIRGIN ISLANDS</option>
<option value="48" [-selected141072_r48-]="">VIRGINIA</option>
<option value="49" [-selected141072_r49-]="">WASHINGTON</option>
<option value="50" [-selected141072_r50-]="">WEST VIRGINIA</option>
<option value="51" [-selected141072_r51-]="">WISCONSIN</option>
<option value="52" [-selected141072_r52-]="">WYOMING</option>
<option value="53" [-selected141072_r53-]="">American Samoa</option>
<option value="54" [-selected141072_r54-]="">Guam</option>
<option value="56" [-selected141072_r56-]="">Micronesia (Federated States of)</option>
<option value="58" [-selected141072_r58-]="">Puerto Rico</option>
<option value="59" [-selected141072_r59-]="">U.S. Minor Outlying Islands</option>
<option value="60" [-selected141072_r60-]="">NORTHERN MARIANA ISLANDS</option>
<option value="61" [-selected141072_r61-]="">Armed Forces Africa</option>
<option value="62" [-selected141072_r62-]="">Armed Forces Americas AA (except Canada)</option>
<option value="63" [-selected141072_r63-]="">Armed Forces Canada</option>
<option value="64" [-selected141072_r64-]="">Armed Forces Europe AE</option>
<option value="65" [-selected141072_r65-]="">Armed Forces Middle East AE</option>
<option value="66" [-selected141072_r66-]="">Armed Forces Pacific AP</option>
<option value="67" [-selected141072_r67-]="">ALBERTA</option>
<option value="68" [-selected141072_r68-]="">NOVA SCOTIA</option>
<option value="69" [-selected141072_r69-]="">BRITISH COLUMBIA</option>
<option value="70" [-selected141072_r70-]="">ONTARIO</option>
<option value="71" [-selected141072_r71-]="">MANITOBA</option>
<option value="72" [-selected141072_r72-]="">PRINCE EDWARD ISLAND</option>
<option value="73" [-selected141072_r73-]="">NEW BRUNSWICK</option>
<option value="74" [-selected141072_r74-]="">QUEBEC</option>
<option value="75" [-selected141072_r75-]="">NEWFOUNDLAND</option>
<option value="76" [-selected141072_r76-]="">SASKATCHEWAN</option>
<option value="77" [-selected141072_r77-]="">NORTHWEST TERRITORIES</option>
<option value="78" [-selected141072_r78-]="">YUKON TERRITORY</option>
<option value="79" [-selected141072_r79-]="">NUNAVUT</option>
</select></p>
</span>
<p id="p9" class="drg-element-type-standard-field drg-element-sub-type-fieldname-ZIP addresslabel"><span class="questionlabel "><label for="id9">Zip/Postal Code</label> </span><input class="drg-field-address-normal" name="demo141073"
type="text" value="" id="id9" maxlength="9" size="9"></p><span class="spanc7 drg-element-type-standard-field drg-element-sub-type-fieldname-COUNTRY">
<p id="p7" class="drg-element-type-standard-field drg-element-sub-type-fieldname-COUNTRY addresslabel"><span class="questionlabel "><label for="id7">* Country</label> </span><select name="demo141074" id="id7">
<option value="">Select One</option>
<option value="80">UNITED STATES</option>
<option value="81">CANADA</option>
<option value="84">AFGHANISTAN</option>
<option value="86">ALBANIA</option>
<option value="87">ALGERIA</option>
<option value="89">ANDORRA</option>
<option value="90">ANGOLA</option>
<option value="91">ANGUILLA</option>
<option value="350">ANTARCTICA</option>
<option value="92">ANTIGUA</option>
<option value="93">ARGENTINA</option>
<option value="94">ARMENIA</option>
<option value="95">ARUBA</option>
<option value="96">ASCENSION IS</option>
<option value="97">AUSTRALIA</option>
<option value="98">AUSTRIA</option>
<option value="99">AZERBAIJAN</option>
<option value="101">BAHAMAS</option>
<option value="102">BAHRAIN</option>
<option value="103">BANGLADESH</option>
<option value="104">BARBADOS</option>
<option value="106">BELARUS</option>
<option value="108">BELGIUM</option>
<option value="109">BELIZE</option>
<option value="110">BENIN</option>
<option value="111">BERMUDA</option>
<option value="112">BHUTAN</option>
<option value="113">BOLIVIA</option>
<option value="115">BOSNIA-HERZEGOVINA</option>
<option value="116">BOTSWANA</option>
<option value="117">BRAZIL</option>
<option value="351">BRITISH INDIAN OCEAN TERRITORY</option>
<option value="118">BRITISH VIRGIN IS</option>
<option value="120">BRUNEI</option>
<option value="121">BULGARIA</option>
<option value="122">BURKINA FASO</option>
<option value="123">BURUNDI</option>
<option value="124">CAMBODIA</option>
<option value="125">CAMEROON</option>
<option value="127">CAPE VERDE ISLANDS</option>
<option value="128">CAYMAN ISLANDS</option>
<option value="129">CENTRAL AFRICAN REP</option>
<option value="130">CHAD</option>
<option value="134">CHILE</option>
<option value="135">CHINA</option>
<option value="136">COCO ISLAND</option>
<option value="137">COLOMBIA</option>
<option value="138">COMOROS</option>
<option value="139">CONGO</option>
<option value="141">COOK ISLANDS</option>
<option value="142">COSTA RICA</option>
<option value="143">CROATIA</option>
<option value="145">CYPRUS</option>
<option value="146">CZECH REPUBLIC</option>
<option value="147">DENMARK</option>
<option value="148">DJIBOUTI</option>
<option value="149">DOMINICA</option>
<option value="150">DOMINICAN REPUBLIC</option>
<option value="151">EAST TIMOR</option>
<option value="152">ECUADOR</option>
<option value="153">EGYPT</option>
<option value="154">EL SALVADOR</option>
<option value="156">ERITREA</option>
<option value="157">ESTONIA</option>
<option value="158">ETHIOPIA</option>
<option value="159">FAEROE ISLANDS</option>
<option value="160">FALKLAND ISLANDS</option>
<option value="161">FIJI</option>
<option value="162">FINLAND</option>
<option value="163">FRANCE</option>
<option value="164">FRENCH GUIANA</option>
<option value="165">FRENCH POLYNESIA</option>
<option value="168">GABON</option>
<option value="169">GAMBIA</option>
<option value="171">GEORGIA</option>
<option value="172">GERMANY</option>
<option value="173">GHANA</option>
<option value="174">GIBRALTAR</option>
<option value="176">GREECE</option>
<option value="177">GREENLAND</option>
<option value="178">GRENADA</option>
<option value="179">GUADELOUPE</option>
<option value="180">GUATEMALA</option>
<option value="181">GUERNSEY</option>
<option value="182">GUINEA</option>
<option value="183">GUYANA</option>
<option value="184">HAITI</option>
<option value="185">HONDURAS</option>
<option value="186">HONG KONG</option>
<option value="187">HUNGARY</option>
<option value="188">ICELAND</option>
<option value="189">INDIA</option>
<option value="190">INDONESIA</option>
<option value="192">IRAQ</option>
<option value="193">IRELAND</option>
<option value="194">ISLE OF MAN</option>
<option value="195">ISRAEL</option>
<option value="196">ITALY</option>
<option value="197">IVORY COAST</option>
<option value="198">JAMAICA</option>
<option value="199">JAPAN</option>
<option value="200">JORDAN</option>
<option value="201">KAZAKHSTAN</option>
<option value="202">KENYA</option>
<option value="204">KIRIBATI</option>
<option value="206">KUWAIT</option>
<option value="207">KYRGYZSTAN</option>
<option value="208">LAOS</option>
<option value="209">LATVIA</option>
<option value="210">LEBANON</option>
<option value="211">LESOTHO</option>
<option value="212">LIBERIA</option>
<option value="213">LIBYA</option>
<option value="214">LIECHTENSTEIN</option>
<option value="215">LITHUANIA</option>
<option value="216">LUXEMBOURG</option>
<option value="217">MACAO</option>
<option value="218">MACEDONIA</option>
<option value="219">MADAGASCAR</option>
<option value="221">MALAWI</option>
<option value="222">MALAYSIA</option>
<option value="223">MALDIVES</option>
<option value="224">MALI</option>
<option value="225">MALTA</option>
<option value="226">MARSHALL ISLANDS</option>
<option value="227">MARTINIQUE</option>
<option value="228">MAURITANIA</option>
<option value="229">MAURITIUS</option>
<option value="230">MAYOTTE</option>
<option value="231">MEXICO</option>
<option value="232">MICRONESIA</option>
<option value="233">MOLDOVA</option>
<option value="235">MONACO</option>
<option value="236">MONGOLIA</option>
<option value="237">MONTENEGRO</option>
<option value="238">MONTSERRAT</option>
<option value="239">MOROCCO</option>
<option value="240">MOZAMBIQUE</option>
<option value="241">MYANMAR</option>
<option value="242">NAMIBIA</option>
<option value="243">NAURU</option>
<option value="244">NEPAL</option>
<option value="245">NETHERLAND ANTILLES</option>
<option value="246">NETHERLANDS</option>
<option value="248">NEW CALEDONIA</option>
<option value="249">NEW GUINEA</option>
<option value="250">NEW ZEALAND</option>
<option value="251">NICARAGUA</option>
<option value="252">NIGER</option>
<option value="253">NIGERIA</option>
<option value="256">NORWAY</option>
<option value="257">OMAN</option>
<option value="259">PAKISTAN</option>
<option value="260">PALAU</option>
<option value="261">PALESTINE</option>
<option value="262">PANAMA</option>
<option value="264">PARAGUAY</option>
<option value="265">PERU</option>
<option value="266">PHILIPPINES</option>
<option value="268">PITCAIRN IS</option>
<option value="269">POLAND</option>
<option value="270">PORTUGAL</option>
<option value="271">QATAR</option>
<option value="272">REUNION</option>
<option value="273">ROMANIA</option>
<option value="274">RUSSIA</option>
<option value="275">RWANDA</option>
<option value="276">SAN MARINO</option>
<option value="277">SAO TOME E PRINCIPE</option>
<option value="279">SAUDI ARABIA</option>
<option value="281">SENEGAL</option>
<option value="282">SERBIA</option>
<option value="283">SEYCHELLES</option>
<option value="284">SIERRA LEONE</option>
<option value="285">SINGAPORE</option>
<option value="286">SLOVAK REPUBLIC</option>
<option value="287">SLOVENIA</option>
<option value="288">SOLOMON ISLANDS</option>
<option value="289">SOMALIA</option>
<option value="290">SOUTH AFRICA</option>
<option value="291">SOUTH KOREA</option>
<option value="292">SPAIN</option>
<option value="293">SRI LANKA</option>
<option value="294">ST CROIX</option>
<option value="295">ST KITTS</option>
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