<!DOCTYPE html>
<html>
<head>
<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta name="viewport" content="width=device-width, initial-scale=1" />
</head>
<body class="dlv-content-wrapper">
<style type="text/css">
table.email-cell-group {
border-collapse: collapse;
width: 100%;
table-layout: fixed;
}
table.dragndrop div.field-label {
font-weight: bold;
}
table.dragndrop div.field-label.required:after,
table.dragndrop div.editor-form-field span.required:after, .editor-form-field.required:after {
content: " *";
color: Red;
}
table.dragndrop .editor-email-button {
text-align: center;
margin: auto;
box-sizing: border-box;
cursor: pointer;
text-decoration: none;
display: inline-flex;
justify-content: center;
align-items: center;
font-size: inherit;
font-family: inherit;
}
table.dragndrop img.img100 {
max-width: 100% !important;
height: auto !important;
width: auto !important;
}
@media screen and (max-width: 540px) {
table.dragndrop td.td100, table.email-cell-group.responsive > tbody > tr > td {
display: block !important;
width: 100% !important;
box-sizing: border-box !important;
}
table.dragndrop > colgroup, table.dragndrop > colgroup > col,
table.email-cell-group.responsive > colgroup, table.email-cell-group.responsive > colgroup > col {
display: none !important;
}
}
table.table100 { /*border: 1px solid rgb(233, 233, 233);*/ margin: 0px auto; padding: 25px 30px 30px 25px; max-width: 1200px; }
table.table100 > tr > td, table.table100 > tbody > tr > td { font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; font-size: 14px; color: rgb(136, 136, 136); }
table.table100 a { color: rgb(28, 38, 116); }
table.table100 h3 { font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; }
table.table100 h2 { font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; }
table.table100 h1 { font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; }
div.editor-email-button { color: rgb(28, 38, 116); }
.editor-email-button { background-color: rgb(28, 38, 116); width: 50%; border-radius: 6px; padding: 25px; }
</style>
<script language="javascript" type="text/javascript" src="https://editor.ne16.com/Subscribe/Subscribe.js"></script>
<form action="https://editor.ne16.com/Subscribe/Subscribe.ashx" method="POST" class="editor-dragndrop-form">
<script type="text/javascript" src="https://www.google.com/recaptcha/api.js?render=explicit" async defer></script>
<html><head></head><body><table class="dragndrop table100" border="0" cellspacing="0" cellpadding="0">
<tbody data-role="sortable">
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="width: 100%; text-align: left; vertical-align: top; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; padding-top: 10px; padding-right: 0; padding-bottom: 10px; border-width: 0; border-style: none">
<div class="editor-form-field">
<div class="field-label required">Email Address</div>
<input type="textbox" name="emailaddr_" required="" class="demographic fieldInput">
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="width: 100%; text-align: left; vertical-align: top; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; padding-top: 10px; padding-bottom: 10px">
<div class="editor-form-field">
<div class="field-label required">First Name</div>
<input type="textbox" name="FirstName_" required="" class="demographic fieldInput">
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="width: 100%; text-align: left; vertical-align: top; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; padding-top: 10px; padding-bottom: 10px">
<div class="editor-form-field">
<div class="field-label required">Last Name</div>
<input type="textbox" name="LastName_" required="" class="demographic fieldInput">
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="text-align: left; vertical-align: top; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; font-size: 16px; width: 100%; padding-top: 10px; padding-bottom: 10px; padding-left: 15px">
<div class="editor-form-field">
<div class="field-label required">Fund</div>
<select name="text1_" class="demographic fieldInput" required="">
<option value="PERF Hybrid">PERF Hybrid</option>
<option value="My Choice Plan">My Choice Plan</option>
<option value="TRF">TRF</option>
<option value="Judges' Retirement System">Judges' Retirement System</option>
<option value="PARF">PARF</option>
<option value="Excise">Excise</option>
<option value="77 Fund">77 Fund</option>
</select>
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="width: 100%; text-align: left; vertical-align: top; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; padding-top: 10px; padding-bottom: 10px; padding-left: 15px">
<div class="editor-form-field">
<div class="field-label">Employer</div>
<input name="company_" class="demographic fieldInput" type="textbox">
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="text-align: left; vertical-align: top; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; width: 100%; padding-top: 10px; padding-bottom: 11px; padding-left: 15px">
<div class="editor-form-field">
<div class="field-label">City</div>
<input type="textbox" name="addresscity_" class="demographic fieldInput">
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="text-align: left; vertical-align: top; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; width: 100%; padding-top: 10px; padding-bottom: 10px; padding-left: 15px">
<div class="editor-form-field">
<div class="field-label">Zip</div>
<input type="textbox" name="addresszip_" class="demographic fieldInput">
</div>
</td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="width: 100%; text-align: left; vertical-align: top; padding: 20px 0 20px 15px; font-size: 16px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; line-height: 2">
<div class="editor-form-categories">
<div>
<label>
<input type="checkbox" name="category" value="PERF Hybrid Plan (Subscribe Form)"><span>PERF Hybrid Plan Quarterly Member Emails</span></label>
</div>
<div>
<label>
<input type="checkbox" name="category" value="TRF Member (Subscribe Form)"><span>TRF Hybrid Plan Quarterly Member Emails</span></label>
</div>
<div>
<label>
<input type="checkbox" name="category" value="LEDC Members"><span>Legislators' Plan Quarterly Member Emails</span></label>
</div>
<div>
<label>
<input type="checkbox" name="category" value="My Choice Retirement Savings Plan (Subscribe Form)"><span>My Choice Plan Quarterly Member Emails</span></label>
</div>
<div>
<label>
<input type="checkbox" name="category" value="Retiree (Subscribe Form)"><span>Retiree Quarterly Emails (All Funds)</span></label>
</div>
<div>
<label>
<input type="checkbox" name="category" value="Mar 2020 COVID message working members"><span>Working Member Weekly Updates During National Health Concerns</span></label>
</div>
<div>
<label>
<input type="checkbox" name="category" value="Mar 2020 COVID message Retirees"><span>Retired Member Weekly Updates During National Health Concerns</span></label>
</div>
</div>
</td>
</tr>
<tr>
<td colspan="2" data-role="droptarget" class="td100" style="width: 33.3333%">
<table width="100%" style="table-layout:fixed;" class="recaptchaTable"><tr><td><div class="g-recaptcha" data-sitekey="6LcOrCUTAAAAAF9zoknqkfFQS1TYoVJO_0kXzsZx"></div></td></tr></table>
</td>
<td colspan="4" data-role="droptarget" class="td100" style="width: 66.6667%"></td>
</tr>
<tr>
<td colspan="6" data-role="droptarget" class="td100" style="text-align: center; vertical-align: middle; width: 100%; padding-top: 20px; font-family: "Lucida Sans Unicode", "Lucida Grande", sans-serif; font-weight: bold; font-size: 22px; color: rgba(255, 255, 255, 1); padding-bottom: 20px">
<button class="editor-email-button" style="background-color:#1C2674;padding:25px;width:50%;color:#FFFFFF;border-radius:40px;float:center;" data-type="save" data-href="http://www.in.gov/inprs/3026.htm" data-target="_blank" target="_blank" type="submit" name="save" value="http://www.in.gov/inprs/3026.htm" target="_blank">Sign me up!</button>
</td>
</tr>
</tbody>
</table>
<input name="demographics" value="emailaddr_ FirstName_ LastName_ text1_ company_ addresscity_ addresszip_ Source_" type="hidden">
<input type="hidden" class="hidden" name="category" value="Form Signup">
<input type="hidden" class="hidden demographic" name="Source_" value="Subscribe Form">
<input type="hidden" name="confirm" value=""></body></html>
<input type="hidden" name="list" value="indianapublicretirement" />
<input type="hidden" id="DlvListID" value="1002603" />
<input type="hidden" id="DlvWebFormID" value="a811ad38-9acb-4733-b550-566e2ab21c2b" />
<input type="hidden" id="DlvStyleType" value="Classic" />
<input type="hidden" name="DlvFormType" id="DlvFormType" value="Subscribe" />
</form>
</body>
</html>
