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[wpforms id="8315" title="false" description="false"]
<div class="wpforms-container wpforms-container-full" id="wpforms-8315"><form id="wpforms-form-8315" class="wpforms-validate wpforms-form" data-formid="8315" method="post" enctype="multipart/form-data" action="/birthday/" data-token="d0fad2e4c635ff6d6f3c940ed3dfdd97"><noscript class="wpforms-error-noscript">Please enable JavaScript in your browser to complete this form.</noscript><div class="wpforms-field-container"><div id="wpforms-8315-field_1-container" class="wpforms-field wpforms-field-name" data-field-id="1"><label class="wpforms-field-label" for="wpforms-8315-field_1">Name <span class="wpforms-required-label">*</span></label><div class="wpforms-field-row wpforms-field-large"><div class="wpforms-field-row-block wpforms-first wpforms-one-half"><input type="text" id="wpforms-8315-field_1" class="wpforms-field-name-first wpforms-field-required" name="wpforms[fields][1][first]" required><label for="wpforms-8315-field_1" class="wpforms-field-sublabel after ">First</label></div><div 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name="wpforms[fields][4]" required></div><div id="wpforms-8315-field_9-container" class="wpforms-field wpforms-field-date-time" data-field-id="9"><label class="wpforms-field-label" for="wpforms-8315-field_9">Birthday <span class="wpforms-required-label">*</span></label><select name="wpforms[fields][9][date][m]" id="wpforms-field_9-month" class="wpforms-field-date-time-date-month wpforms-field-required" required><option value="" class="placeholder" selected disabled>MM</option><option value="1" >1</option><option value="2" >2</option><option value="3" >3</option><option value="4" >4</option><option value="5" >5</option><option value="6" >6</option><option value="7" >7</option><option value="8" >8</option><option value="9" >9</option><option value="10" >10</option><option value="11" >11</option><option value="12" >12</option></select><span class="wpforms-field-date-time-date-sep">/</span><select name="wpforms[fields][9][date][d]" id="wpforms-field_9-day" class="wpforms-field-date-time-date-day wpforms-field-required" required><option value="" class="placeholder" selected disabled>DD</option><option value="1" >1</option><option value="2" >2</option><option value="3" >3</option><option value="4" >4</option><option value="5" >5</option><option value="6" >6</option><option value="7" >7</option><option value="8" >8</option><option value="9" >9</option><option value="10" >10</option><option value="11" >11</option><option value="12" >12</option><option value="13" >13</option><option value="14" >14</option><option value="15" >15</option><option value="16" >16</option><option value="17" >17</option><option value="18" >18</option><option value="19" >19</option><option value="20" >20</option><option value="21" >21</option><option value="22" >22</option><option value="23" >23</option><option value="24" >24</option><option value="25" >25</option><option value="26" >26</option><option value="27" >27</option><option value="28" >28</option><option 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>1975</option><option value="1974" >1974</option><option value="1973" >1973</option><option value="1972" >1972</option><option value="1971" >1971</option><option value="1970" >1970</option><option value="1969" >1969</option><option value="1968" >1968</option><option value="1967" >1967</option><option value="1966" >1966</option><option value="1965" >1965</option><option value="1964" >1964</option><option value="1963" >1963</option><option value="1962" >1962</option><option value="1961" >1961</option><option value="1960" >1960</option><option value="1959" >1959</option><option value="1958" >1958</option><option value="1957" >1957</option><option value="1956" >1956</option><option value="1955" >1955</option><option value="1954" >1954</option><option value="1953" >1953</option><option value="1952" >1952</option><option value="1951" >1951</option><option value="1950" >1950</option><option value="1949" >1949</option><option value="1948" >1948</option><option value="1947" >1947</option><option value="1946" >1946</option><option value="1945" >1945</option><option value="1944" >1944</option><option value="1943" >1943</option><option value="1942" >1942</option><option value="1941" >1941</option><option value="1940" >1940</option><option value="1939" >1939</option><option value="1938" >1938</option><option value="1937" >1937</option><option value="1936" >1936</option><option value="1935" >1935</option><option value="1934" >1934</option><option value="1933" >1933</option><option value="1932" >1932</option><option value="1931" >1931</option><option value="1930" >1930</option><option value="1929" >1929</option><option value="1928" >1928</option><option value="1927" >1927</option><option value="1926" >1926</option><option value="1925" >1925</option><option value="1924" >1924</option><option value="1923" >1923</option><option value="1922" >1922</option><option value="1921" >1921</option><option value="1920" >1920</option></select></div><div id="wpforms-8315-field_6-container" class="wpforms-field wpforms-field-hidden" data-field-id="6"><input type="hidden" id="wpforms-8315-field_6" name="wpforms[fields][6]" value="https://nationaltoday.com/birthday"></div><div id="wpforms-8315-field_8-container" class="wpforms-field wpforms-field-hidden" data-field-id="8"><input type="hidden" id="wpforms-8315-field_8" name="wpforms[fields][8]" value="2021-10-18 16:37:39"></div><div id="wpforms-8315-field_10-container" class="wpforms-field wpforms-field-hidden" data-field-id="10"><input type="hidden" id="wpforms-8315-field_10" name="wpforms[fields][10]" value="wpforms"></div></div><div class="wpforms-field wpforms-field-hp"><label for="wpforms-8315-field-hp" class="wpforms-field-label">Comment</label><input type="text" name="wpforms[hp]" id="wpforms-8315-field-hp" class="wpforms-field-medium"></div><div class="wpforms-submit-container" ><input type="hidden" name="wpforms[id]" value="8315"><input type="hidden" name="wpforms[author]" value="0"><button type="submit" name="wpforms[submit]" class="wpforms-submit om-trigger-conversion" id="wpforms-submit-8315" value="wpforms-submit" aria-live="assertive" >Submit</button></div></form></div> <!-- .wpforms-container -->
