<div class=”sec1inner”>
<div class=”contentWrap” style=”position:relative;”>
<div class=”lft-content”>
<div class=”logo s1-logo”> </div>
<img src=”./assets/images/top-tagline.png” width=”565″ height=”50″ alt=”” class=”s1-tagline”>
<img src=”/bnewv4//image.php?AFFID=DLX&C1=216041&C2=ABG&C3=253917998&click_id=253917998″ alt=”alt-logo” style=”display:none;”>
<p class=”s1hding”>
Medical Strength Male Enhancement
</p>
<p class=”s1hding2″>
Get Maximum<br>
<span>Sexual Benefits</span>
</p>
<div class=”doctor”>
<img src=”./assets/images/s1no-pres.png” width=”504″ height=”88″ alt=”” class=”s1no-pres”>
</div>
<img src=”./assets/images/arrow.png” width=”534″ height=”106″ alt=”” class=”s1-arrow”>
<div class=”topImageContainer”>
<div class=”bottle left device-desktop-page-index-flow-me-v2-step-1-img-1″> </div>
<div class=”bottle right device-desktop-page-index-flow-me-v2-step-1-img-2″> </div>
</div>
<img src=”./assets/images/us-seal.png” width=”173″ height=”173″ alt=”” class=”s1seal”>
<ul class=”s1list”>
<li>
<span>Bigger & Long-Lasting Erections *</span><br>
Maximum pleasure & intensified orgasms
</li>
<li>
<span>Surge In Sex Drive & Energy *</span><br>
Ramps up stamina & staying power
</li>
<li>
<span>Increased Sexual Confidence *</span><br>
Experience vitality & peak performance
</li>
</ul>
<img src=”./assets/images/as-seen.png” width=”467″ height=”44″ alt=”” class=”as-seen”>
</div>
<div class=”rgt-frm”>
<!– start form –>
<div class=”frm-top”>
<img src=”./assets/images/frm-top.png” width=”307″ height=”134″ alt=””>
</div>
<div class=”form-position”>
<form class=”form123″ id=”theForm” method=”POST” action=”https://buyprimevxl.com/bnewv4/api/create_prospect.php” onsubmit=”return validate_optin_form()”>
<input type=”hidden” id=”campaign_id” name=”campaign_id” value=”146″ class=”no-error”>
<input type=”hidden” name=”notes” value=”” class=”has-error”>
<input type=”hidden” name=”country” id=”country” value=”US” class=”no-error”>
<input type=”hidden” name=”AFFID” value=”DLX” class=”no-error”><input type=”hidden” name=”C1″ value=”216041″ class=”no-error”><input type=”hidden” name=”C2″ value=”ABG” class=”no-error”><input type=”hidden” name=”C3″ value=”253917998″ class=”no-error”><input type=”hidden” name=”CLICK_ID” value=”253917998″ class=”no-error”> <!– <input type=”hidden” name=”action” value=”prospect”> –>
<div class=”fields”>
<div class=”field-first_name frm-element input left”>
<label>First Name: </label>
<input type=”text” class=”form-control required has-error” data-placement=”auto left” placeholder=”First Name*” name=”fields_fname” id=”fields_fname” value=””>
<div class=”spacer clear”></div>
</div>
<div class=”field-last_name frm-element input left”>
<label>Last Name: </label>
<input type=”text” class=”form-control required has-error” data-placement=”auto left” placeholder=”Last Name*” name=”fields_lname” id=”fields_lname” value=””>
<div class=”spacer clear”></div>
</div>
<div class=”field-email frm-element input left”>
<label>Email: </label>
<input type=”email” class=”form-control required has-error” data-placement=”auto left” name=”fields_email” id=”fields_email” placeholder=”Email*” title=”Email” value=””>
<div class=”spacer clear”></div>
</div>
<div class=”field-phone frm-element input left”>
<label>Phone: </label>
<input type=”tel” class=”form-control required has-error” data-placement=”auto left” placeholder=”Phone Number*” id=”fields_phone” name=”fields_phone” maxlength=”14″ data-validation-regexp=”^(\+\d{1,2}\s)?\(?\d{3}\)?[\s.-]\d{3}[\s.-]\d{4}$” value=””>
<div class=”spacer clear”></div>
</div>
<div class=”field-country frm-element input left” style=”display: none;”>
<label>Country: </label>
<select name=”country” class=”form-control no-error” required=”” id=”country” data-group=”1″ data-state=”state” data-field=”country” data-validation=”required”>
<option value=”US” data-states=”{"AL":"Alabama","AK":"Alaska","AZ":"Arizona","AR":"Arkansas","CA":"California","CO":"Colorado","CT":"Connecticut","DE":"Delaware","FL":"Florida","GA":"Georgia","HI":"Hawaii","ID":"Idaho","IL":"Illinois","IN":"Indiana","IA":"Iowa","KS":"Kansas","KY":"Kentucky","LA":"Lousiana","ME":"Maine","MD":"Maryland","MA":"Massachusetts","MI":"Michigan","MN":"Minnesota","MS":"Mississippi","MO":"Missouri","MT":"Montana","NE":"Nebraska","NV":"Nevada","NH":"New Hampshire","NJ":"New Jersey","NM":"New Mexico","NY":"New York","NC":"North Carolina","ND":"North Dakota","OH":"Ohio","OK":"Oklahoma","OR":"Oregon","PA":"Pennsylvania","RI":"Rhode Island","SC":"South Carolina","SD":"South Dakota","TN":"Tennessee","TX":"Texas","UT":"Utah","VT":"Vermont","VA":"Virginia","WA":"Washington","WV":"West Virginia","WI":"Wisconsin","WY":"Wyoming","DC":"Washington, DC"}”>
United States
</option>
</select>
<div class=”spacer clear”></div>
</div>
<div class=”field-address frm-element input left”>
<label>Address: </label>
<input type=”text” class=”form-control required has-error” data-placement=”auto left” placeholder=”Address*” name=”fields_address1″ id=”fields_address1″ value=””>
<div class=”spacer clear”></div>
</div>
<div class=”field-address_2 frm-element input left”>
<label>Apt: </label>
<input type=”text” class=”form-control has-error” data-placement=”auto left” placeholder=”Apt/Unit” title=”Apt/Unit” name=”fields_address2″ id=”fields_address2″>
<div class=”spacer clear”></div>
</div>
<div class=”field-city frm-element input left”>
<label>City: </label>
<input type=”text” class=”form-control required has-error” data-placement=”auto left” placeholder=”City*” name=”fields_city” id=”fields_city” value=””>
<div class=”spacer clear”></div>
</div>
<div class=”field-state frm-element input left”>
<label>State: </label>
<select name=”fields_state” id=”fields_state” class=”form-control required no-error” data-selected=”” data-error-message=”State is required”>
<option required=”” onclick=””>Select State</option>
<option value=”AL”>Alabama (AL)</option>
<option value=”AK”>Alaska (AK)</option>
<option value=”AZ”>Arizona (AZ)</option>
<option value=”AR”>Arkansas (AR)</option>
<option value=”CA”>California (CA)</option>
<option value=”CO”>Colorado (CO)</option>
<option value=”CT”>Connecticut (CT)</option>
<option value=”DE”>Delaware (DE)</option>
<option value=”DC”>District of Columbia (DC)</option>
<option value=”FL”>Florida (FL)</option>
<option value=”GA”>Georgia (GA)</option>
<option value=”HI”>Hawaii (HI)</option>
<option value=”ID”>Idaho (ID)</option>
<option value=”IL”>Illinois (IL)</option>
<option value=”IN”>Indiana (IN)</option>
<option value=”IA” selected=”selected”>Iowa (IA)</option>
<option value=”KS”>Kansas (KS)</option>
<option value=”KY”>Kentucky (KY)</option>
<option value=”LA”>Louisiana (LA)</option>
<option value=”ME”>Maine (ME)</option>
<option value=”MD”>Maryland (MD)</option>
<option value=”MA”>Massachusetts (MA)</option>
<option value=”MI”>Michigan (MI)</option>
<option value=”MN”>Minnesota (MN)</option>
<option value=”MS”>Mississippi (MS)</option>
<option value=”MO”>Missouri (MO)</option>
<option value=”MT”>Montana (MT)</option>
<option value=”NE”>Nebraska (NE)</option>
<option value=”NV”>Nevada (NV)</option>
<option value=”NH”>New Hampshire (NH)</option>
<option value=”NJ”>New Jersey (NJ)</option>
<option value=”NM”>New Mexico (NM)</option>
<option value=”NY”>New York (NY)</option>
<option value=”NC”>North Carolina (NC)</option>
<option value=”ND”>North Dakota (ND)</option>
<option value=”OH”>Ohio (OH)</option>
<option value=”OK”>Oklahoma (OK)</option>
<option value=”OR”>Oregon (OR)</option>
<option value=”PA”>Pennsylvania (PA)</option>
<option value=”RI”>Rhode Island (RI)</option>
<option value=”SC”>South Carolina (SC)</option>
<option value=”SD”>South Dakota (SD)</option>
<option value=”TN”>Tennessee (TN)</option>
<option value=”TX”>Texas (TX)</option>
<option value=”UT”>Utah (UT)</option>
<option value=”VT”>Vermont (VT)</option>
<option value=”VA”>Virginia (VA)</option>
<option value=”WA”>Washington (WA)</option>
<option value=”WV”>West Virginia (WV)</option>
<option value=”WI”>Wisconsin (WI)</option>
<option value=”WY”>Wyoming (WY)</option>
</select>
<div class=”spacer clear”></div>
</div>
<div class=”field-zip frm-element input left”>
<label>Zip Code: </label>
<input type=”text” class=”form-control required has-error” data-placement=”auto left” placeholder=”Zip Code*” name=”fields_zip” id=”fields_zip” value=”” onkeyup=”javascript: this.value = this.value.replace(/[^0-9]/g, ”);” maxlength=”5″>
<div class=”spacer clear”></div>
</div>
<div class=”clear”></div>
<div class=”frm-btm”>
<img src=”./assets/images/lock.png” width=”199″ height=”10″ alt=”” class=”lock”>
<input type=”image” src=”./assets/images/submit-btn.png” alt=”RUSH MY BOTTLE” class=”submit pulse has-error”> <img src=”./assets/images/frm-btm.png” width=”164″ height=”39″ alt=”” class=”security”>
</div>
<div class=”clear”></div>
</div>
</form>
</div>
<!– end form –>
</div>
</div>
</div>