"Full Name" name="member[first_name]" required>
          <input type="email" name="member[email]" placeholder="Email" required>
          <input type="text" name="member[postcode]" placeholder="Zip Code">
          <input type="tel" name="member[phone_number]" placeholder="Phone (optional)">
          <input type="hidden" name="member[country]" value="US">
          <input class="hidden" type="checkbox" checked="checked" name="hp_enabled">
          <input class="hidden" type="checkbox" name="hp_disabled">