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<form align='center' action="https://member.mailingboss.com/index.php/lists/wp9355noeeebe/subscribe" method="post" accept-charset="utf-8" target="_blank">
<div class="form-group">
    <label>Imię <span class="required">*</span></label></br>
	<input type="text" class="form-control" name="IMIE" placeholder="" value="" required />
</div>
<div class="form-group">
    <label>E-mail <span class="required">*</span></label>
	</br><input type="text" class="form-control" name="EMAIL" placeholder="" value="" required />
</div>
<div class="form-group">
    <label>Numer telefonu <span class="required">*</span></label>
	</br><input type="text" class="form-control" name="TELEFON" placeholder="" value="" required />
</div>
<div class="form-group">
    <label>Polityka prywatności <span class="required">*</span></label>
	</br><input type="checkbox" name="GDPR[]" value="tak"  />tak <br />
</div>

    <div class="clearfix"><!-- --></div>
    <div class="actions">
    <button type="submit" class="btn btn-primary btn-submit">Zarejestruj</button>
    </div>
    <div class="clearfix"><!-- --></div>
</form>