Membership

<form method="post" action="" class="aaamembership_form aaa-form-null" enctype="multipart/form-data"><input type="hidden" name="container_id" value=""><input type="hidden" name="form_id" value="6887"><input type="hidden" name="form_domain" value="coldbrew-tea.myshopify.com"><input type="hidden" name="" value="Thank You!" class="success_msg"><input type="hidden" name="" value="" class="aaa_thankyoupageurl"><div class=""><h1 type="h1" class="header" name="" id="" style="color: rgb(0, 0, 0);">test plan - SGD0.01 </h1></div><div class=""><hr type="hr" class="aaadivider" name="" id=""> </div><div class=""><h3 type="h3" class="header" name="" id="" style="color: rgb(0, 0, 0);">Subscribe and get benefits</h3></div><div class="membership-text form-group field-first-name"><label for="first-name" class="membership-text-label" style="color: rgb(0, 0, 0);">First Name <span class="required">*</span> </label> <input type="text" required="" class="form-control" name="first-name" id="first-name" aria-required="true"></div><div class="membership-text form-group field-last-name"><label for="last-name" class="membership-text-label" style="color: rgb(0, 0, 0);">Last Name <span class="required">*</span> </label> <input type="text" required="" class="form-control" name="last-name" id="last-name" aria-required="true"></div><div class="membership-email form-group field-replyemail"><label for="replyemail" class="membership-email-label" style="color: rgb(0, 0, 0);">Email Address <span class="required">*</span> </label> <input type="email" required="" class="form-control" name="replyemail" id="replyemail" aria-required="true"></div><div class="membership-number form-group field-aaa-customer-phone-number"><label for="aaa-customer-phone-number" class="membership-number-label" style="color: rgb(0, 0, 0);">Phone Number  </label> <input type="number" class="form-control aaa-customer-phone-number-class" name="aaa-customer-phone-number" id="aaa-customer-phone-number"><input type="text" name="aaa-customer-phone-number-country" class="aaa-customer-phone-number-country" placeholder="country code(+1)" value="" style="width: 49% !important;float: left;margin-left: 1%;"></div><div class="membership-password form-group field-customer-password"><label for="customer-password" class="membership-password-label" style="color: rgb(0, 0, 0);">Password <span class="required">*</span> </label> <input type="password" required="" class="form-control" name="customer-password" id="customer-password" aria-required="true"></div><div class="card-number form-group field-card-number"><label for="card-number" class="card-number" style="color: rgb(0, 0, 0);">Card Number <span class="required">*</span> </label><input type="number" required="" class="form-control removearrow" name="card-number" id="cardnumber" aria-required="true"></div><div class="expiry-month-year form-group field-expiry-month-year field-first-name"><label for="expiry-month-year" class="expiry-month-year" style="color: rgb(0, 0, 0);">Expiry Month <span class="required">*</span> </label><select name="expiryMonth" id="expiryMonth" class="expirymonthyearselectBox expirymonthonly"><option value="01">01</option><option value="02">02</option><option value="03">03</option><option value="04">04</option><option value="05">05</option><option value="06">06</option><option value="07">07</option><option value="08">08</option><option value="09">09</option><option value="10">10</option><option value="11">11</option><option value="12">12</option></select></div><div class="form-group field-last-name"><label for="expiry-month-year" class="expiry-month-year" style="color: rgb(0, 0, 0);">Expiry Year <span class="required">*</span> </label><select name="expiryYear" id="expiryYear" class="expirymonthyearselectBox"><option value="2020">2020</option><option value="2021">2021</option><option value="2022">2022</option><option value="2023">2023</option><option value="2024">2024</option><option value="2025">2025</option><option value="2026">2026</option><option value="2027">2027</option><option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option><option value="2031">2031</option></select></div><div class="cvv-number form-group field-cvv-number"><label for="cvv-number" class="cvv-number" style="color: rgb(0, 0, 0);"> CVV <span class="required">*</span> </label><input type="password" required="" class="form-control removearrow" name="cvv-number" id="cvvnumber" aria-required="true"></div><div class="membership-submit form-group field-button-1497336985158"><button type="submit" class="button-input btn btn-primary" name="button-1497336985158" style="primary" id="button-1497336985158">Subscribe Now</button></div></form><style type="text/css">.aaamembership_form .membership-submit button { background-color: #000000  !important; }.aaamembership_form .membership-submit button { color: #FFFFFF  !important; }.aaamembership_form .membership-submit button { font-size: 14px !important; }</style><style>.aaamembership_form input[type="text"], .aaamembership_form input[type="search"], .aaamembership_form input[type="password"], .aaamembership_form input[type="email"], .aaamembership_form input[type="file"], .aaamembership_form input[type="number"], .aaamembership_form input[type="tel"], .aaamembership_form textarea, .aaamembership_form select { width: 100% !important; margin: 0;border: 1px solid #ccc; }</style>