<form action="https://app.cyberimpact.com/optin" method="post" accept-charset="utf-8" class="form_infolettre"><!-- [et_pb_line_break_holder] --> <fieldset><!-- [et_pb_line_break_holder] --> <legend></legend><!-- [et_pb_line_break_holder] --> <div><!-- [et_pb_line_break_holder] --> <label for="ci_firstname">Prénom<span class="form_oblig">*</span></label><!-- [et_pb_line_break_holder] --> <input type="text" id="ci_firstname" name="ci_firstname" maxlength="255" /><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div><!-- [et_pb_line_break_holder] --> <label for="ci_lastname">Nom<span class="form_oblig">*</span></label><!-- [et_pb_line_break_holder] --> <input type="text" id="ci_lastname" name="ci_lastname" maxlength="255" /><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div><!-- [et_pb_line_break_holder] --> <label for="ci_company">Entreprise (Optionnel)</label><!-- [et_pb_line_break_holder] --> <input type="text" id="ci_company" name="ci_company" maxlength="255" /><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div><!-- [et_pb_line_break_holder] --> <label for="ci_email">Courriel<span class="form_oblig">*</span></label><!-- [et_pb_line_break_holder] --> <input type="text" id="ci_email" name="ci_email" maxlength="255" /><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div style="display:block; visibility:hidden; height:1px;"><!-- [et_pb_line_break_holder] --> <input style="display:none;" type="text" id="ci_verification" name="ci_verification" /><!-- [et_pb_line_break_holder] --> <input type="hidden" id="ci_groups" name="ci_groups" value="3" /><!-- [et_pb_line_break_holder] --> <input type="hidden" id="ci_account" name="ci_account" value="ed988c3b-88c7-4ed4-b16d-761d6f85fb08" /><!-- [et_pb_line_break_holder] --> <input type="hidden" id="ci_language" name="ci_language" value="fr_ca" /><!-- [et_pb_line_break_holder] --><input type="hidden" id="ci_sent_url" name="ci_sent_url" value="https://serviceauxentreprises.cfpml.qc.ca/inscription-envoyee/" /><!-- [et_pb_line_break_holder] --><input type="hidden" id="ci_error_url" name="ci_error_url" value="https://serviceauxentreprises.cfpml.qc.ca/erreur-inscription-infolettre/" /><!-- [et_pb_line_break_holder] --><input type="hidden" id="ci_confirm_url" name="ci_confirm_url" value="https://serviceauxentreprises.cfpml.qc.ca/confirmations/" /><!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <input type="submit" value="Envoyer" /><!-- [et_pb_line_break_holder] --> </fieldset><!-- [et_pb_line_break_holder] --></form><!-- [et_pb_line_break_holder] -->