<form action='http://madmimi.com/signups/subscribe/2868' method='post'><input type="hidden" name="phpMyAdmin" value="bdaad78886db80c8a84610c7f57cb3f2" />
<div><label for='signup_name'>Name</label><br /><input id='signup_name' name='signup[name]' type='text' /><br />
<label for='signup_email'>Email</label><br /><input id='signup_email' name='signup[email]' type='text' /><br /><input name='commit' type='submit' value='Sign Up' /></div>
</form>