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<input type="text" name="email" id="email" value="" style="position:absolute;border:none;width:1px;height:1px;background-color:rgba(255,255,255,0);" />
<input type="hidden" name="ma_school_id" id="ma_school_id" value="71c992f4-2b4442d6-a382d7b0-23b05ec3" />
<input type="hidden" name="ma_local_time" id="ma_local_time" />
<label for="ma_fullname">Full name</label>
<input type="text" name="ma_fullname" id="ma_fullname" />
<label for="ma_email">Email</label>
<input type="text" name="ma_email" id="ma_email" />
<label for="ma_phone">Mobile</label>
<input type="text" name="ma_phone" id="ma_phone" />
<label for="ma_venue">My closest venue is:</label>
<select name="ma_venue" id="ma_venue" ><option value="2ab2a567-ef42608b-a303ea53-914abaf0">Centar Millenium</option><option value="b800aa58-3406dd66-368a4dd8-213f66c8">Sala OŠ Ž. Z. Izbište</option><option value="920d7cad-917af916-2c9d0991-51888f64">Škola Gudurica</option><option value="35a900dc-e224fb35-39e3a501-c00bd8e1">Sala MZ V Središte</option><option value="1e135cb7-f88ec046-b18239c1-e97e8027">Sala MZ Vlajkovac</option><option value="e23c6bb8-dd2bc680-184dbf0c-de42ab20">Sala doma za decu BC</option><option value="db2b7f90-e3ec926d-d86f3e1e-92bcd3ab">Prodavnica Zagajica</option><option value="19881aee-6d90a57c-7e4a5af3-afaa9a6a">Sala OŠ Potporanj</option></select>
<label for="ma_interests">I'm interested in</label>
<input type="text" name="ma_interests" id="ma_interests" />
<label for="ma_referral">Where did you hear about us?</label>
<select name="ma_referral" id="ma_referral">
<option value="">Select</option>
<option value="Facebook">Facebook</option>
<option value="Twitter">Twitter</option>
<option value="Google+">Google+</option>
<option value="LinkedIn">LinkedIn</option>
<option value="Family">Family</option>
<option value="Friend">Friend</option>
<option value="Magazine">Magazine</option>
<option value="Newspaper">Newspaper</option>
<option value="Television">Television</option>
<option value="Brochure">Brochure</option>
<option value="Leaflet">Leaflet</option>
<option value="Poster">Poster</option>
<option value="Phone Call">Phone Call</option>
<option value="Website">Website</option>
<option value="Word of Mouth">Word of Mouth</option>
<option value="Walk-In">Walk-In</option>
<option value="Other Advertising">Other Advertising</option>
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<input type="submit" name="ma_submit" value="Submit" />
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<p style="text-align:center;font-family:'Verdana';text-align: center;font-size: 12px;"><a href="https://martialytics.com/" style="text-decoration:none;color:#232323;"><img src="https://martialytics.com/img/poweredbyma.png" width="16" height="16" style="display: inline-block;position: relative;top: 3px;margin-right: 4px;" />Powered by Martialytics</a></p>