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<div id= »mlb2-3936301″ class= »ml-form-embedContainer ml-subscribe-form ml-subscribe-form-3936301″>
<div class= »ml-form-align-center »>
<div class= »ml-form-embedWrapper embedForm »>
<div class= »ml-form-embedHeader »>
<img src= »https://bucket.mlcdn.com/a/3082/3082549/images/b1e3b0c407bc9349468fc9d94f6a0d054caa5d9a.png » border= »0″ style= »display:block »>
<style>
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</div>
<div class= »ml-form-embedBody ml-form-embedBodyDefault row-form »>
<div class= »ml-form-embedContent » style= » »>
<h4>Formulaire d’inscription</h4>
<p>Il nous faut votre adresse Email pour pouvoir vous adresser le dossier de demande pour avoir un mentor.</p>
</div>
<form class= »ml-block-form » action= »https://static.mailerlite.com/webforms/submit/r4b1y7″ data-code= »r4b1y7″ method= »post » target= »_blank »>
<div class= »ml-form-formContent »>
<div class= »ml-form-fieldRow ml-last-item »>
<div class= »ml-field-group ml-field-email ml-validate-email ml-validate-required »>
<input aria-label= »email » aria-required= »true » type= »email » class= »form-control » data-inputmask= » » name= »fields[email] » placeholder= »Email » autocomplete= »email »>
</div>
</div>
</div>
<div class= »ml-form-embedPermissions » style= » »>
<div class= »ml-form-embedPermissionsContent default privacy-policy »>
<p>Un Email pour valider votre adresse va vous être envoyé.&nbsp;Vous pourrez vous désinscrire à tous moments à l’avenir.&nbsp;</p>
</div>
</div>
<div class= »ml-form-checkboxRow ml-validate-required »>
<label class= »checkbox »> <input type= »checkbox »> <div class= »label-description »> <p>Bouton à cocher pour valider cette demande.</p> </div> </label>
</div>
<div class= »ml-form-recaptcha ml-validate-required » style= »float:left »>
<style type= »text/css »>
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</style>
<script src= »https://www.google.com/recaptcha/api.js »></script>
<div class= »g-recaptcha » data-sitekey= »6Lf1KHQUAAAAAFNKEX1hdSWCS3mRMv4FlFaNslaD »></div>
</div>
<input type= »hidden » name= »ml-submit » value= »1″>
<div class= »ml-form-embedSubmit »>
<button type= »submit » class= »primary »>Valider</button>
<button disabled= »disabled » style= »display:none » type= »button » class= »loading »> <div class= »ml-form-embedSubmitLoad »></div> <span class= »sr-only »>Loading…</span> </button>
</div>
<input type= »hidden » name= »anticsrf » value= »true »>
</form>
</div>
<div class= »ml-form-successBody row-success » style= »display:none »>
<div class= »ml-form-successContent »>
<h4>C’est bien noté !</h4>
<p>Nous avons bien pris en compte votre demande.</p>
</div>
</div>
</div>
</div>
</div>
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<img src= »https://track.mailerlite.com/webforms/o/3936301/r4b1y7?v1618920218″ width= »1″ height= »1″ style= »max-width:1px;max-height:1px;visibility:hidden;padding:0;margin:0;display:block » alt= ». » border= »0″>
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