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<!DOCTYPE html>    <html dir="ltr" lang="en">  <head> <title>WITNESS</title> <meta http-equiv="Content-Type" content="text/html; charset=utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta name="description" content="WITNESS Email Forms"> <meta name="keywords" content="WITNESS"> <script src="//ajax.googleapis.com/ajax/libs/dojo/1.8/dojo/dojo.js"></script> <script type="text/javascript"> require([ "dojo/query", "dojo/dom", "dojo/dom-geometry", "dojo/dom-class", "dojo/dom-style", "dojo/dom-construct", "dijit/focus", "dojo/parser", "dijit/form/DateTextBox", "dojo/NodeList-traverse", "dojo/domReady!" ], function(query, dom, domGeom, domClass, domStyle, domConstruct, focusUtil, parser){ // Move the focused-field class to the field-group that contains the focused input. var handle = focusUtil.watch("curNode", function(name, oldValue, newValue){ var parent = query(newValue).closest('.field-group'); if(!domClass.contains(parent, "focused-field")) { query('.focused-field').removeClass('focused-field'); parent.addClass('focused-field'); } }); // Add error class to parent wrapper and only show error borders on empty fields in addresses query('.feedback.error').closest('.field-group').addClass('error'); query('.addressfield input:text[value=""]').addClass('empty'); // Focus first input of birthdayfield or phonefield-us when parent wrapper is clicked query('div.subfields').on("click", function(e){ var firstInput = query('input', e.target)[0]; focusUtil.focus(firstInput); }); // Use native checkboxes and radio buttons outside the app dojo.query(".radio input, .checkbox input").removeAttr("data-dojo-type"); // Render DateTextBoxes parser.parse(); query('form').on("submit",function(e){ var invalidDate = dojo.query('.dijitTextBoxError'); if(invalidDate.length){ query('.dijitDateTextBox ~ .feedback.error').forEach(domConstruct.destroy); invalidDate.forEach(function(node) { domConstruct.place('<div class="feedback error"><div class="errorText">Please enter a valid date</div></div>', node, 'after'); }); e.preventDefault(); } else if (window.bmak) { // Bot manager telemetry data window.bmak.form_submit(); } }); }); </script> <script src='https://www.google.com/recaptcha/api.js' async defer></script> <style type="text/css">/* Forms */ label { display:block; width:auto; margin-top:8px; font-weight:bold; } .mergeRow { padding:0 0 6px 0 !important; clear:both; } .field-group { position:relative; margin:3px 0 12px 0; overflow:hidden; background:transparent !important; } .mergeRow-radio .field-group, .mergeRow-interests-checkboxes .field-group {margin-bottom:6px;} input, textarea, select { display:block; margin:0; padding:10px; background:#fff; width:100%; border:2px solid #d0d0d0 !important; border-radius:3px; -webkit-appearance: none; } .field-group input, select, textarea, .dijitInputField { font-size: 14px; } .field-group.error > input, .field-group.error > select, .field-group.error .addressfield input.empty, .field-group.error .birthdayfield, .field-group.error .subfields, .field-group.error .datefield .dijitInputInner, .datefield .dijitTextBoxError .dijitInputInner, .field-group.error textarea { border-color:#e85c41 !important; } textarea { font:14px/18px 'Helvetica', Arial, sans-serif; width:100%; height:150px; overflow:auto; } select { background:#fff url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat right -295px; background:#fff url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat right -295px, -webkit-gradient(linear, left top, left bottom, from(#fff), to(#f1f1f1)); background:#fff url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat right -295px, -webkit-linear-gradient(top, #fff, #f1f1f1); background:#fff url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat right -295px, -ms-linear-gradient(top, #fff, #f1f1f1); background:#fff url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat right -295px, linear-gradient(to bottom, #fff, #f1f1f1); } html[dir="rtl"] select {background-position:14px -295px;} /* Firefox always displays native select arrow button, so hide the background image arrow. */ @-moz-document url-prefix() { select { padding: 8px; background-position: -99px 0 !important; -moz-appearance: none; } } input:focus, textarea:focus, select:focus, .focused-field .subfields { border-color:#5d5d5d !important; outline:none; } /* Prevent Chrome's autofill yellow box shadow */ input:-webkit-autofill { -webkit-box-shadow: 0 0 0 1000px white inset !important; } .field-help { display:block; font-weight:normal; position:static; float:none; clear:both; margin:0; padding:0; max-height:0; overflow:hidden; -webkit-transition: all .25s; -moz-transition: all .25s; -ms-transition: all .25s; transition: all .25s; } .focused-field .field-help, input:focus + .field-help { display:block; padding:10px 0; max-height:100px; } .field-help .help { min-height:16px; text-decoration: none; } /* Error container */ .feedback { padding:10px 0; line-height:16px; font-size:14px; } .feedback br {display:none;} .feedback div { font:14px/20px 'Helvetica', Arial, sans-serif !important; padding:0 !important; margin:0 !important; } .indicates-required {text-align:right;} .indicates-required span { font-size:150%; font-weight:bold; display:inline !important; } .formstatus { margin-bottom:12px; font-size:18px; } .alert { background:#e4f3d4; border:2px solid #5ca000; font-size:14px; color:#4e7e0e !important; margin:10px 0; padding:10px; } /* Groups, checkboxes, radio buttons */ ul.interestgroup_field, ul.interestgroup_field li, ul.unsub-options, ul.unsub-options li, .interestgroup_row { display:block; padding:0; margin:0; list-style:none; } label.checkbox, label.radio { font-weight:normal; position:relative; line-height:24px; } .checkbox input, .radio input { width:auto !important; display:inline-block; margin-right:5px; padding:0; border:none; background-color:transparent; } /* Address blocks */ .addressfield span {display:block; margin:3px 0 15px 0;} .addressfield label {display:none;} .cityfield {width:35%; float:left; padding-right:12px;} .statefield {width:30%; float:left; padding-right:12px;} .zipfield {width:35%; float:left;} .countryfield {clear:both;} /* Date picker */ .dijitCalendarPopup {position:absolute;} .dijitComboBox.dijitDateTextBox .dijitArrowButtonContainer { cursor:pointer; position:absolute; top:3px; right:2px; background:url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat 10px -235px; height:34px; width:42px; opacity:.5; padding:0 5px; } .dijitComboBox.dijitDateTextBox .dijitArrowButtonContainer input {visibility:hidden;} .dijitComboBox.dijitDateTextBox .dijitArrowButtonContainer:hover {opacity:1;} .dijitValidationContainer {display:none;} /* Input placeholder color */ .dijitPlaceHolder {position:absolute; top:10px; left:10px; color:#ababab !important; font-weight:normal;} ::-webkit-input-placeholder {color:#ababab;} :-moz-placeholder {color:#ababab; opacity:1;} ::-moz-placeholder {color:#ababab; opacity:1;} :-ms-input-placeholder {color:#ababab;} html[dir="rtl"] .dijitComboBox.dijitDateTextBox .dijitArrowButtonContainer {left:6px; right:auto;} html[dir="rtl"] .dijitPlaceHolder {left:auto; right:10px;} /* Birthday & US phone field */ .subfields { display:block; margin:0; padding:8px 10px; background:#fff; width:100%; border:2px solid #d0d0d0; border-radius:3px; color:#d0d0d0 } .subfields input { display:inline-block; margin:0; padding:0; width:2.5em; border:none !important; text-align:center; } .subfields label {display:none;} .phonedetail2 input {width:3.4em;} .birthdayfield input {width:1.7em;} /* Forward to friend */ .captcha { float:left; width:320px; margin-right:20px; min-height:150px; } .captcha input {display:inline;} /* Archive list */ #archive-list { display:block; margin:15px 0; padding:0; border-top:1px solid #eee; } #archive-list li { display:block; list-style:none; margin:0; padding:6px 10px; border-bottom:1px solid #eee; } .borderbox, .field-help, input, textarea, select { -moz-box-sizing: border-box; -webkit-box-sizing: border-box; box-sizing: border-box; } .field-shift { left: -9999px; position: absolute; } html[dir="rtl"] .field-shift { right: -9999px; left: auto; } /* Image replacement for checkbox and radio buttons. */ /* Placing in @media block forces browsers that don't support :checked to fall back to native inputs. */ @media only screen { .mergeRow-radio .field-group, .mergeRow-interests-checkboxes .field-group {margin:0 -6px 11px -6px;} .checkbox, .radio { margin:9px 0 0 0; padding:0; } /* Position and hide the real checkboxes and radio buttons */ .checkbox input, .radio input { position:absolute; width:24px; height:24px; overflow:hidden; margin:0; padding:0; outline:0; opacity:0; } .checkbox input + span, .radio input + span { display:block; border-radius:3px; padding:6px 6px 6px 38px; } .checkbox:hover span, .checkbox input:focus + span, .radio:hover span, .radio input:focus + span { background:rgba(0,0,0,.05); } /* Insert a pseudo element inside each label with a background sprite. */ .checkbox input + span:before, .radio input + span:before { display:block; position:absolute; top:6px; left:6px; width:24px; height:24px; background:url('https://cdn-images.mailchimp.com/product/icons/signup-sprite.png') no-repeat; content:" "; vertical-align:top; } /* Position the background sprite based on state of checkbox/radio. */ .radio input:focus + span:before { background-position:0 -30px; } .radio input:checked + span:before { background-position:0 -60px; } .radio input:checked:focus + span:before { background-position:-0 -90px; } .checkbox input + span:before { background-position:0 -120px; } .checkbox input:focus + span:before { background-position:0 -150px; } .checkbox input:checked + span:before { background-position:0 -180px; } .checkbox input:checked:focus + span:before { background-position:0 -210px; } /* Right-to-left checkbox/radio modifications */ html[dir="rtl"] .checkbox input + span:before, html[dir="rtl"] .radio input + span:before {left:auto; right:0;} html[dir="rtl"] .checkbox input + span, html[dir="rtl"] .radio input + span {padding:6px 38px 6px 6px;} } /* Use high-res sprite for retina displays */ @media (-webkit-min-device-pixel-ratio: 1.5),(min-resolution: 1.5dppx) { .checkbox input + span:before, .radio input + span:before, .calendar-icon { background-image:url('https://cdn-images.mailchimp.com/product/icons/signup-sprite-2x.png'); background-size: 24px; } } /* IE6 and 7 overrides */ .ie-lte7 .field-group input, .ie-lte7 .subfields {width:535px;} .ie-lte7 .cityfield input {width:170px;} .ie-lte7 .statefield input {width:121px;} .ie-lte7 .zipfield input {width:170px;} .ie-lte7 .subfields input {width:40px;} .ie-lte7 .hidden-from-view {display:none;} .ie-lte7 select { display:inline-block; width:560px; } /* IE doesn't support input placeholders until v10, show labels on addresses */ .ie-lte7 .addressfield label, .ie-lte9 .addressfield label {display:block; font-weight:normal; font-size:14px;} /* Dijit styles for date picker */ .dijitPopup .dijitReset{margin:0;border:0;padding:0;font:inherit;line-height:normal;color:inherit;font-family:"Helvetica Neue",Helvetica,Arial,Verdana,sans-serif} .dijitPopup .dj_a11y .dijitReset{-moz-appearance:none;} .dijitPopup .dijitInline{display:inline-block;border:0;padding:0;vertical-align:middle} .dijitPopup .dijitInline{display:inline-table;box-sizing:content-box;-moz-box-sizing:content-box} .dijitPopup .dijitHidden{display:none !important} .dijitPopup .dijitVisible{display:block !important;position:relative;} .dijitPopup .dijitInputContainer{overflow:hidden;float:none !important;position:relative} .dijitPopup .dj_ie .dijitSelect input, .dijitPopup .dj_ie input.dijitTextBox, .dijitPopup .dj_ie .dijitTextBox input{font-size:100%} .dijitPopup .dijitSelect .dijitButtonText{float:left;vertical-align:top} .dijitPopup .dijitSelect{padding:0 !important;} .dijitPopup .dijitTextBox .dijitSpinnerButtonContainer, .dijitPopup .dijitTextBox .dijitArrowButtonContainer, .dijitPopup .dijitValidationTextBox .dijitValidationContainer{float:right;text-align:center} .dijitPopup .dijitSelect input.dijitInputField, .dijitPopup .dijitTextBox input.dijitInputField{padding-left:0 !important;padding-right:0 !important} .dijitPopup .dijitValidationTextBox .dijitValidationContainer{display:none} .dijitPopup .dijitTeeny{font-size:1px;line-height:1px} .dijitPopup .dijitOffScreen{position:absolute !important;left:50% !important;top:-10000px !important} .dijitPopup .dijitPositionOnly{padding:0 !important;border:0 !important;background-color:transparent !important;background-image:none !important;height:auto !important;width:auto !important} .dijitPopup .dijitNonPositionOnly{float:none !important;position:static !important;margin:0 0 0 0 !important;vertical-align:middle !important} .dijitPopup .dijitBackgroundIframe{position:absolute;left:0;top:0;width:100%;height:100%;z-index:-1;border:0;padding:0;margin:0} .dijitPopup .dijitDisplayNone{display:none !important} .dijitPopup .dijitContainer{overflow:hidden;} .dijitPopup{position:absolute;background-color:transparent;margin:0;border:0;padding:0} .dijitPopup{-webkit-box-shadow:0 6px 6px 1px rgba(0, 0, 0, 0.1);box-shadow:0 6px 6px 1px rgba(0, 0, 0, 0.1);border-radius:6px} @media screen and (max-width:40em){ .dijitPopup{width:96% !important;left:50% !important;margin:0 auto 0 -48%} } .dijitPopup .dijitMenuTable{width:100% !important} .dijitMenu{border:1px solid #000;background-color:#fff} .dijitMenuTable{border-collapse:collapse;border-width:0;background-color:#fff} .dj_webkit .dijitMenuTable td[colspan="2"]{border-right:hidden} .dijitMenuItem{text-align:left;white-space:nowrap;padding:.1em .2em;cursor:pointer} .dijitMenuItem:focus{outline:none} .dijitMenuItemIcon, .dijitMenuExpand{background-repeat:no-repeat} .dijitMenuItemDisabled *{opacity:.5;cursor:default} .dj_ie .dj_a11y .dijitMenuItemDisabled, .dj_ie .dj_a11y .dijitMenuItemDisabled *, .dj_ie .dijitMenuItemDisabled *{color:#808080;filter:alpha(opacity=35)} .dijitMenuItemLabel{position:relative;vertical-align:middle} .dj_a11y .dijitMenuItemSelected{border:1px dotted #000 !important;} .dj_ff3 .dj_a11y .dijitMenuItem td{padding:0 !important;background:none !important} .dj_a11y .dijitMenuItemSelected .dijitMenuItemLabel{border-width:1px;border-style:solid} .dj_ie8 .dj_a11y .dijitMenuItemLabel{position:static} .dijitMenuExpandA11y{display:none} .dj_a11y .dijitMenuExpandA11y{display:inline} .dijitMenuSeparator td{border:0;padding:0} .dijitMenuSeparatorTop{height:50%;margin:0;margin-top:3px;font-size:1px} .dijitMenuSeparatorBottom{height:50%;margin:0;margin-bottom:3px;font-size:1px} .dijitCheckedMenuItemIconChar{vertical-align:middle;visibility:hidden} .dijitCheckedMenuItemChecked .dijitCheckedMenuItemIconChar{visibility:visible} .dj_a11y .dijitCheckedMenuItemIconChar{display:inline !important} .dj_a11y .dijitCheckedMenuItemIcon{display:none} .dj_ie .dj_a11y .dijitMenuBar .dijitMenuItem{margin:0} .dijitCalendarContainer{width:auto;} .dijitCalendarContainer th, .dijitCalendarContainer td{padding:0;vertical-align:middle} .dijitCalendarYearLabel{white-space:nowrap;} .dijitCalendarNextYear{margin:0 0 0 .55em} .dijitCalendarPreviousYear{margin:0 .55em 0 0} .dijitCalendarIncrementControl{vertical-align:middle} .dijitCalendarIncrementControl, .dijitCalendarDateTemplate, .dijitCalendarMonthLabel, .dijitCalendarPreviousYear, .dijitCalendarNextYear{cursor:pointer} .dijitCalendarDisabledDate{color:#808080;text-decoration:line-through;cursor:default} .dijitSpacer{position:relative;height:1px;overflow:hidden;visibility:hidden} .dijitCalendarMonthMenu .dijitCalendarMonthLabel{text-align:center} .dijitCalendar{border:solid 1px #cfcfcf;background-color:#fff;text-align:center;padding:18px;border-radius:6px;border-collapse:separate} .dijitCalendar img{border:none} .dijitCalendarMonthContainer th{text-align:center;vertical-align:middle} .dijitCalendarMonthLabel{color:#595959;font-size:.9375em;font-weight:bold;padding:6px 12px} .dijitA11ySideArrow{display:none} .dijitCalendarArrow{cursor:pointer;border:1px solid transparent;position:relative;} .dijitCalendarArrow img {display:none;} .dijitCalendarArrow:hover{background-color:#f2f2f2;border-color:#d0d0d0} .dijitCalendarArrow:after{content:" "; width:0; height:0; border:6px solid transparent; border-left:6px solid #333; display:block; position:absolute; top:25%; left:45%} .dijitCalendarArrow:first-child:before{content:" "; width:0; height:0; border:6px solid transparent; border-right:6px solid #333; display:block; position:absolute; top:25%; left:45%} .dijitCalendarArrow:first-child:after{border:none;} .dijitCalendarCurrentDate {background:#eee;} .dijitCalendarDayLabelTemplate{text-align:center;font-weight:bold;padding:8px 12px} .dijitCalendarDayLabel{font-weight:bold;font-size:.9375em;text-align:center;color:#595959} .dijitCalendarDateTemplate{border-bottom:0 none;font-size:.9375em;font-weight:500;letter-spacing:.05em;text-align:center;color:#595959} .dijitCalendarPreviousMonth, .dijitCalendarNextMonth{border-bottom:0 none} .dijitCalendarDateTemplate .dijitCalendarDateLabel{text-decoration:none;display:block;padding:6px 10px;border:1px solid transparent;-webkit-transition-property:background-color,border;-ms-transition-property:background-color,border;transition-property:background-color,border;-webkit-transition-duration:.35s;-ms-transition-duration:.35s;transition-duration:.35s} .dijitCalendarPreviousMonth .dijitCalendarDateLabel, .dijitCalendarNextMonth .dijitCalendarDateLabel{color:#ababab;border-color:#fff;} .dijitCalendarYearContainer{vertical-align:middle} .dijitCalendarYearControl{padding:1px 2px 2px 2px} .dijitCalendarYearLabel{padding:8px 0 0;margin:0;font-size:.9375em} .dijitCalendarYearLabel span{vertical-align:middle} .dijitCalendarSelectedYear{padding:0 6px;font-size:.9375em;color:#52bad5} .dijitCalendarNextYear, .dijitCalendarPreviousYear{font-size:.9375em;border:1px solid transparent;padding:6px 12px} .dijitCalendarHoveredDate .dijitCalendarDateLabel, .dijitCalendarEnabledDate:hover .dijitCalendarDateLabel{background-color:#b1e0ec;border:solid 1px #52bad5;color:#595959;-webkit-transition-duration:.2s;-ms-transition-duration:.2s;transition-duration:.2s} .dijitCalendarNextYearHover, .dijitCalendarNextYear:hover, .dijitCalendarPreviousYearHover, .dijitCalendarPreviousYear:hover{color:#595959;background-color:#f2f2f2;border-color:#d0d0d0} .dijitCalendarNextYearActive, .dijitCalendarNextYear:active .dijitCalendarPreviousYearActive, .dijitCalendarPreviousYear:active{background-color:#c7c7c7} .dijitCalendarActiveDate .dijitCalendarDateLabel, .dijitCalendarEnabledDate:active .dijitCalendarDateLabel{border:solid 1px #fff;-webkit-transition-duration:.1s;-ms-transition-duration:.1s;transition-duration:.1s} .dijitCalendarSelectedDate .dijitCalendarDateLabel{color:#595959;background-color:#b1e0ec;border:solid 1px #52bad5} .dijitCalendarDisabledDate .dijitCalendarDateLabel{color:#808080;text-decoration:line-through} .dijitCalendar .dijitDropDownButton{margin:0;background-color:transparent} .dijitCalendar .dijitDropDownButtonHover .dijitButtonNode, .dijitCalendar .dijitDropDownButton:hover .dijitButtonNode{background-color:transparent;border:0 none} .dijitCalendarMonthMenu{border-color:#ababab;background-color:#fff;text-align:center;background-image:none} .dijitCalendarMonthMenu .dijitCalendarMonthLabel{border-top:solid 1px transparent;border-bottom:solid 1px transparent} .dijitCalendarMonthMenu .dijitCalendarMonthLabelHover, .dijitCalendarMonthMenu .dijitCalendarMonthLabel:hover{background-color:#b1e0ec;border-color:#52bad5;border-width:1px 0} .dijitTooltip{display:none !important;} </style><style type="text/css"> body{ font:14px/20px 'Helvetica', Arial, sans-serif; margin:0; padding:75px 0 0 0; text-align:center; -webkit-text-size-adjust:none; } p{ padding:0 0 10px 0; } h1 img{ max-width:100%; height:auto !important; vertical-align:bottom; } h2{ font-size:22px; line-height:28px; margin:0 0 12px 0; } h3{ margin:0 0 12px 0; } .headerBar{ background:none; padding:0; border:none; } .wrapper{ width:600px; margin:0 auto 10px auto; text-align:left; } input.formEmailButton{ border:none !important; } .formEmailButton{ display:inline-block; font-weight:500; font-size:16px; line-height:42px; font-family:'Helvetica', Arial, sans-serif; width:auto; white-space:nowrap; height:42px; margin:12px 5px 12px 0; padding:0 22px; text-decoration:none; text-align:center; cursor:pointer; border:0; border-radius:3px; vertical-align:top; } .formEmailButton span{ display:inline; font-family:'Helvetica', Arial, sans-serif; text-decoration:none; font-weight:500; font-style:normal; font-size:16px; line-height:42px; cursor:pointer; border:none; } .rounded6{ border-radius:6px; } .poweredWrapper{ padding:20px 0; width:560px; margin:0 auto; } .poweredBy{ display:block; } span.or{ display:inline-block; height:32px; line-height:32px; padding:0 5px; margin:5px 5px 0 0; } .clear{ clear:both; } .profile-list{ display:block; margin:15px 20px; padding:0; list-style:none; border-top:1px solid #eee; } .profile-list li{ display:block; margin:0; padding:5px 0; border-bottom:1px solid #eee; } html[dir=rtl] .wrapper,html[dir=rtl] .container,html[dir=rtl] label{ text-align:right !important; } html[dir=rtl] ul.interestgroup_field label{ padding:0; } html[dir=rtl] ul.interestgroup_field input{ margin-left:5px; } html[dir=rtl] .hidden-from-view{ right:-5000px; left:auto; } body,#bodyTable{ background-color:#eeeeee; } h1{ font-size:28px; line-height:110%; margin-bottom:30px; margin-top:0; padding:0; } #templateContainer{ background-color:none; } 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opacity 0.2s ease-in-out 0s; } .unsubscribe-sms-only .button:hover{ background-color:#006570; } .unsubscribe-sms-only .disabled{ cursor:not-allowed; } </style></head> <body> <div class="wrapper rounded6" id="templateContainer"> <h1 class="masthead">WITNESS América Latina y el Caribe</h1> <div id="templateBody" class="bodyContent rounded6"> <div id="subscribeFormWelcome"><span style="font-size:15px"><strong><span style="background-color:rgb(255, 255, 255); font-family:arial,sans-serif">¡Suscríbete! Recibe en tu correo recursos, casos y noticias. Sigamos aprendiendo y fortalezcamos el uso de video para el cambio en la región.</span></strong></span> </div> <div class="indicates-required"><span class="asterisk">*</span> indica que es obligatorio</div> <form action="https://witness.us3.list-manage.com/subscribe/post" method="POST"> <input type="hidden" name="u" value="22622883108b9dd9ae857a057"> <input type="hidden" name="id" value="953f30ef66">  <div class="field-shift" aria-label="Please leave the following three fields empty" aria-hidden="true"> <label for="b_name">Name: </label> <input type="text" name="b_name" tabindex="-1" value="" placeholder="Freddie" id="b_name"> <label for="b_email">Email: </label> <input type="email" name="b_email" tabindex="-1" value="" placeholder="youremail@gmail.com" id="b_email"> <label for="b_comment">Comment: </label> <textarea name="b_comment" tabindex="-1" placeholder="Please comment" id="b_comment"></textarea> </div> <div id="mergeTable" class="mergeTable"> <div class="mergeRow dojoDndItem mergeRow-email" id="mergeRow-0"> <label for="MERGE0">Correo Electr贸nico <span class="req asterisk">*</span></label> <div class="field-group"> <input type="email" autocapitalize="off" autocorrect="off" name="MERGE0" id="MERGE0" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-1"> <label for="MERGE1">Nombre</label> <div class="field-group"> <input type="text" name="MERGE1" id="MERGE1" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-2"> <label for="MERGE2">Apellido</label> <div class="field-group"> <input type="text" name="MERGE2" id="MERGE2" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-text" id="mergeRow-3"> <label for="MERGE3">Organizaci贸n</label> <div class="field-group"> <input type="text" name="MERGE3" id="MERGE3" size="25" value=""> </div> </div> <div class="mergeRow dojoDndItem mergeRow-dropdown" id="mergeRow-4"> <label for="MERGE4">Pa铆s</label> <div class="field-group"> <select class="select-small" id="MERGE4" name="MERGE4"><option value="United States of America">United States of America</option><option value="Aaland Islands">Aaland Islands</option><option value="Afghanistan">Afghanistan</option><option value="Albania">Albania</option><option value="Algeria">Algeria</option><option value="American Samoa">American Samoa</option><option value="Andorra">Andorra</option><option value="Angola">Angola</option><option value="Anguilla">Anguilla</option><option value="Antarctica">Antarctica</option><option value="Antigua And Barbuda">Antigua And Barbuda</option><option value="Argentina">Argentina</option><option value="Armenia">Armenia</option><option value="Aruba">Aruba</option><option value="Australia">Australia</option><option value="Austria">Austria</option><option value="Azerbaijan">Azerbaijan</option><option value="Bahamas">Bahamas</option><option value="Bahrain">Bahrain</option><option value="Bangladesh">Bangladesh</option><option value="Barbados">Barbados</option><option value="Belarus">Belarus</option><option value="Belgium">Belgium</option><option value="Belize">Belize</option><option value="Benin">Benin</option><option value="Bermuda">Bermuda</option><option value="Bhutan">Bhutan</option><option value="Bolivia">Bolivia</option><option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option><option value="Botswana">Botswana</option><option value="Bouvet Island">Bouvet Island</option><option value="Brazil">Brazil</option><option value="British Indian Ocean Territory">British Indian Ocean Territory</option><option value="Brunei Darussalam">Brunei Darussalam</option><option value="Bulgaria">Bulgaria</option><option value="Burkina Faso">Burkina Faso</option><option value="Burundi">Burundi</option><option value="Cambodia">Cambodia</option><option value="Cameroon">Cameroon</option><option value="Canada">Canada</option><option value="Cape Verde">Cape Verde</option><option value="Cayman Islands">Cayman Islands</option><option value="Central African Republic">Central African Republic</option><option value="Chad">Chad</option><option value="Chile">Chile</option><option value="China">China</option><option value="Christmas Island">Christmas Island</option><option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option><option value="Colombia">Colombia</option><option value="Comoros">Comoros</option><option value="Congo">Congo</option><option value="Cook Islands">Cook Islands</option><option value="Costa Rica">Costa Rica</option><option value="Cote D'Ivoire">Cote D'Ivoire</option><option value="Croatia">Croatia</option><option value="Cuba">Cuba</option><option value="Curacao">Curacao</option><option value="Cyprus">Cyprus</option><option value="Czech Republic">Czech Republic</option><option value="Democratic Republic of the Congo">Democratic Republic of the Congo</option><option value="Denmark">Denmark</option><option value="Djibouti">Djibouti</option><option value="Dominica">Dominica</option><option value="Dominican Republic">Dominican Republic</option><option value="East Timor">East Timor</option><option value="Ecuador">Ecuador</option><option value="Egypt">Egypt</option><option value="El Salvador">El Salvador</option><option value="Equatorial Guinea">Equatorial Guinea</option><option value="Eritrea">Eritrea</option><option value="Estonia">Estonia</option><option value="Ethiopia">Ethiopia</option><option value="Falkland Islands">Falkland Islands</option><option value="Faroe Islands">Faroe Islands</option><option value="Fiji">Fiji</option><option value="Finland">Finland</option><option value="France">France</option><option value="French Guiana">French Guiana</option><option value="French Polynesia">French Polynesia</option><option value="French Southern Territories">French Southern Territories</option><option value="Gabon">Gabon</option><option value="Gambia">Gambia</option><option value="Georgia">Georgia</option><option value="Germany">Germany</option><option value="Ghana">Ghana</option><option value="Gibraltar">Gibraltar</option><option value="Greece">Greece</option><option value="Greenland">Greenland</option><option value="Grenada">Grenada</option><option value="Guadeloupe">Guadeloupe</option><option value="Guam">Guam</option><option value="Guatemala">Guatemala</option><option value="Guernsey">Guernsey</option><option value="Guinea">Guinea</option><option value="Guinea-Bissau">Guinea-Bissau</option><option value="Guyana">Guyana</option><option value="Haiti">Haiti</option><option value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option><option value="Honduras">Honduras</option><option value="Hong Kong">Hong Kong</option><option value="Hungary">Hungary</option><option value="Iceland">Iceland</option><option value="India">India</option><option value="Indonesia">Indonesia</option><option value="Iran">Iran</option><option value="Iraq">Iraq</option><option value="Ireland">Ireland</option><option value="Isle of Man">Isle of Man</option><option value="Israel">Israel</option><option value="Italy">Italy</option><option value="Jamaica">Jamaica</option><option value="Japan">Japan</option><option value="Jersey (Channel Islands)">Jersey (Channel Islands)</option><option value="Jordan">Jordan</option><option value="Kazakhstan">Kazakhstan</option><option value="Kenya">Kenya</option><option value="Kiribati">Kiribati</option><option value="Kuwait">Kuwait</option><option value="Kyrgyzstan">Kyrgyzstan</option><option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option><option value="Latvia">Latvia</option><option value="Lebanon">Lebanon</option><option value="Lesotho">Lesotho</option><option value="Liberia">Liberia</option><option value="Libya">Libya</option><option value="Liechtenstein">Liechtenstein</option><option value="Lithuania">Lithuania</option><option value="Luxembourg">Luxembourg</option><option value="Macau">Macau</option><option value="Macedonia">Macedonia</option><option value="Madagascar">Madagascar</option><option value="Malawi">Malawi</option><option value="Malaysia">Malaysia</option><option value="Maldives">Maldives</option><option value="Mali">Mali</option><option value="Malta">Malta</option><option value="Marshall Islands">Marshall Islands</option><option value="Martinique">Martinique</option><option value="Mauritania">Mauritania</option><option value="Mauritius">Mauritius</option><option value="Mayotte">Mayotte</option><option value="Mexico">Mexico</option><option value="Micronesia, Federated States of">Micronesia, Federated States of</option><option value="Moldova, Republic of">Moldova, Republic of</option><option value="Monaco">Monaco</option><option value="Mongolia">Mongolia</option><option value="Montenegro">Montenegro</option><option value="Montserrat">Montserrat</option><option value="Morocco">Morocco</option><option value="Mozambique">Mozambique</option><option value="Myanmar">Myanmar</option><option value="Namibia">Namibia</option><option value="Nauru">Nauru</option><option value="Nepal">Nepal</option><option value="Netherlands">Netherlands</option><option value="Netherlands Antilles">Netherlands Antilles</option><option value="New Caledonia">New Caledonia</option><option value="New Zealand">New Zealand</option><option value="Nicaragua">Nicaragua</option><option value="Niger">Niger</option><option value="Nigeria">Nigeria</option><option value="Niue">Niue</option><option value="Norfolk Island">Norfolk Island</option><option value="North Korea">North Korea</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Palestine">Palestine</option><option value="Panama">Panama</option><option value="Papua New Guinea">Papua New Guinea</option><option value="Paraguay">Paraguay</option><option value="Peru">Peru</option><option value="Philippines">Philippines</option><option value="Pitcairn">Pitcairn</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Republic of Kosovo">Republic of Kosovo</option><option value="Reunion">Reunion</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option><option value="Saint Lucia">Saint Lucia</option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option><option value="Samoa (Independent)">Samoa (Independent)</option><option value="San Marino">San Marino</option><option value="Sao Tome and Principe">Sao Tome and Principe</option><option value="Saudi Arabia">Saudi Arabia</option><option value="Senegal">Senegal</option><option value="Serbia">Serbia</option><option value="Seychelles">Seychelles</option><option value="Sierra Leone">Sierra Leone</option><option value="Singapore">Singapore</option><option value="Sint Maarten">Sint Maarten</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="South Africa">South Africa</option><option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option><option value="South Korea">South Korea</option><option value="South Sudan">South Sudan</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="St. Helena">St. Helena</option><option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option><option value="Swaziland">Swaziland</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="Taiwan">Taiwan</option><option value="Tajikistan">Tajikistan</option><option value="Tanzania">Tanzania</option><option value="Thailand">Thailand</option><option value="Togo">Togo</option><option value="Tokelau">Tokelau</option><option value="Tonga">Tonga</option><option value="Trinidad and Tobago">Trinidad and Tobago</option><option value="Tunisia">Tunisia</option><option value="Turkey">Turkey</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks & Caicos Islands">Turks & Caicos Islands</option><option value="Turks and Caicos Islands">Turks and Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</option><option value="United Arab Emirates">United Arab Emirates</option><option value="United Kingdom">United Kingdom</option><option value="Uruguay">Uruguay</option><option value="USA Minor Outlying Islands">USA Minor Outlying Islands</option><option value="Uzbekistan">Uzbekistan</option><option value="Vanuatu">Vanuatu</option><option value="Vatican City State (Holy See)">Vatican City State (Holy See)</option><option value="Venezuela">Venezuela</option><option value="Vietnam">Vietnam</option><option value="Virgin Islands (British)">Virgin Islands (British)</option><option value="Virgin Islands (U.S.)">Virgin Islands (U.S.)</option><option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option></select> </div> </div> <div class="mergeRow-emailFormat"> <label>Formato preferido</label> <div class="field-group groups"> <div class="interestgroup_field radio-group"> <label class="radio" for="EMAILTYPE_HTML"><input type="radio" name="EMAILTYPE" id="EMAILTYPE_HTML" value="html" checked><span>HTML</span></label> <label class="radio" for="EMAILTYPE_TEXT"><input type="radio" name="EMAILTYPE" id="EMAILTYPE_TEXT" value="text" ><span>Texto</span></label> </div> </div> </div> <div id="mergeRow-gdpr" class="mergeRow gdpr-mergeRow"> <div class="gdpr-content"> <label id="gdpr-label"> Permisos de promoci贸n </label> <p id="gdpr-description">En WITNESS, usaremos la informaci贸n que nos proporciones en este formulario para enviarte actualizaciones. Por favor, confirma que est谩s de acuerdo en recibir:</p> <div><ul class="interestgroup_field checkbox-group"> <li class="!margin-bottom--lv2"> <label class="checkbox" for="gdpr_37"><input type="checkbox" data-dojo-type="dijit/form/CheckBox" id="gdpr_37" name="gdpr[37]" value="Y" } class="av-checkbox"><span>Bolet铆n electr贸nico</span> </label> </li> </ul> </div> <p id="gdpr-legal">Puede cambiar de opini贸n en cualquier momento haciendo clic en el enlace desuscribir que hay en el pie de p谩gina de cualquier correo electr贸nico que reciba de nuestra parte, o poni茅ndose en contacto con nosotros al engage@witness.org. Trataremos su informaci贸n con respeto. Para obtener m谩s informaci贸n acerca de nuestras pr谩cticas de privacidad, visite nuestro sitio web. Al hacer clic a continuaci贸n, acepta que podamos procesar su informaci贸n de acuerdo con estos t茅rminos.</p> </div> <div class="gdpr-footer"> <a href="https://www.mailchimp.com/gdpr" target="_blank"><img src="https://cdn-images.mailchimp.com/icons/mailchimp-gdpr.svg" alt="GDPR"></a> <p>We use Mailchimp as our marketing platform. By clicking below to subscribe, you acknowledge that your information will be transferred to Mailchimp for processing. <a href="https://mailchimp.com/legal/terms" target="_blank">Learn more</a> about Mailchimp's privacy practices.</p> </div> </div> </div> <div class="submit_container clear"> <input type="submit" class="formEmailButton" name="submit" value="Suscribirse"> </div> <input type="hidden" name="ht" value="7f62427de20ac82374aad92f7893289b5262b2be:MTczMjM5ODI3Ny42MTM2"> <input type="hidden" name="mc_signupsource" value="hosted"> </form> </div> </div> <script type="text/javascript" src="/B61y7VNGj3l1dVURV5PCQoeN/iuuabccpJGrJum/R3weTgo7RAE/SjF/nPWcELyU"></script></body> </html>