#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }
/* Add your own Mailchimp form style overrides in your site stylesheet or in this style block.
We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */

* indicates required

(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]=’ADDRESS’;ftypes[3]=’address’;fnames[4]=’PHONE’;ftypes[4]=’phone’;fnames[5]=’BIRTHDAY’;ftypes[5]=’birthday’;fnames[6]=’MMERGE6′;ftypes[6]=’text’;}(jQuery));var $mcj = jQuery.noConflict(true);

What you’ll get

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat.