multiple-list-sub-unsub.html

<form action="http://cl.exct.net/subscribe.aspx" name="subscribeForm" method="post">
  <input type="hidden" name="thx" value="https://sfmctest-clas3.ws.asu.edu/content/test-web-collect-success" />
  <input type="hidden" name="err" value="https://sfmctest-clas3.ws.asu.edu/content/test-web-collect-error" />
  <input type="hidden" name="usub" value="https://sfmctest-clas3.ws.asu.edu/content/test-web-collect-success" />
  <input type="hidden" name="MID" value="7201485" />
  <input name="ASU College of Liberal Arts and Sciences" type="hidden" value="TRUE" />

  <div class="form-group">
    <label for="firstNameInput">First Name</label>
    <input class="form-control" id="firstNameInput" placeholder="First Name" name="First Name">
  </div>

  <div class="form-group">
    <label for="lastNameInput">Last Name</label>
    <input class="form-control" id="lastNameInput" placeholder="Last Name" name="Last Name">
  </div>

  <div class="form-group">
    <label for="emailAddressInput">Email Address</label>
    <input type="email" class="form-control" id="emailAddressInput" placeholder="Email Address" name="Email Address">
  </div>  

  <div class="checkbox">
    <label>
      <input type="checkbox" name=lid value="14735">Gabe Secondary Test List - 27983
    </label>
  </div>

  <div class="checkbox">
    <label>
      <input type="checkbox" name=lid value="15043">Gabe Tertiary Test List - 27983
    </label>
  </div>

  <div class="radio">
    <label>
      <input type="radio" name="SubAction" id="optionsRadios1" value="sub" checked>
      Subscribe
    </label>
  </div>
  <div class="radio">
    <label>
      <input type="radio" name="SubAction" id="optionsRadios2" value="unsub">
      Unsubscribe
    </label>
  </div>

  <button type="submit" class="form-submit btn btn-primary">Submit</button>

</form>