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<html xmlns="http://www.w3.org/1999/xhtml">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge" />
<meta property="fb:app_id" content="105047196722" />
<meta property="fb:page_id" content="23797290954" />
<meta name="format-detection" content="telephone=no" />
<meta name="viewport" content="width=919" />
<title>Payment Method</title>
</head>
<body>
<form id="frmEditPaymentMethod" name="frmEditPaymentMethod" method="post" action="https://www.qvc.com/webapp/wcs/stores/servlet/NPOOrderAddPaymentMethods">
<input type="hidden" name="csrfToken" value="M1E1cTBwME9saUVZaU9iNUdJVnZqSm9JQThHM3gwSUt0elROSE9oSDJaST0=" />
<input type="hidden" name="ccId" value="" />
<input type="hidden" name="payMethodExpireMonth" value="" />
<input type="hidden" name="payMethodExpireYear" value="" />
<input type="hidden" name="ccDtime" value="" />
<input type="hidden" name="payMethodNewCard" value="N" />
<input type="hidden" name="payMethodExpiryEdited" value="N" />
<input type="hidden" name="payMethodCVV" value="" />
<input type="hidden" name="orderId" value="476661567" />
<input type="hidden" name="langId" value="-1" />
<input type="hidden" name="catalogId" value="10151" />
<input type="hidden" name="storeId" value="10251" />
<input type="hidden" name="dummydata" value="" />
<input type="hidden" id="currentPaymentMethod" name="currentPaymentMethod" value="VI" />
<input type="hidden" name="checkoutStep" value="3" />
<input type="hidden" name="fromPaymentPage" value="Y" />
<input type="hidden" name="URL" value="" />
<input type="hidden" id="addAnotherGC" name="addAnotherGC" value="N" />
<input type="hidden" name="BMLFilePath" id="BMLFilePath" value="https://www.qvc.com/wcsstore/US/content/html/popups/BillMeLaterTermsandConditions.html" />
<div id="divEasyPayOptions">
<fieldset>
<ul>
<li>
<input type="radio" value="Z" id="rb1PaymentsItem_1" name="rbItemEasyPayOption_1"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: 4 Easy Pays of $39.74 parseable name: rbItemEasyPayOption_1 field signature: 915844214 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<label for="rb1PaymentsItem_1">4 Easy Pays of $39.74</label>
</li>
<li>
<input type="radio" value="N" id="rb2PaymentsItem_1" name="rbItemEasyPayOption_1"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: 1 payment of $158.96 parseable name: rbItemEasyPayOption_1 field signature: 915844214 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<label for="rb2PaymentsItem_1">1 payment of $158.96</label>
</li>
</ul>
<input type="hidden" name="hItemEasyPayOptionPayMthd_1" id="hItemEasyPayOptionPayMthd_1" value="QVAXCBDCSIMCVIBL " />
<input type="hidden" name="orderItemId_1" id="orderItemId_1" value="660521668" />
</fieldset>
</div>
<div id="divNewPaymentMethod">
<input id="ccId_1" type="hidden" name="ccId_1" value="" />
<table id="tblNewPaymentMethod" border="0" cellspacing="0" cellpadding="0" width="100%" summary="Payment methods available for Checkout">
<tbody>
<tr id="trBillMeLaterRow-1">
<td>
<input type="radio" name="rbNewPaymentMethod" id="rbBillLater" value="rbBillLater"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: PayPal Credit parseable name: rbNewPaymentMethod field signature: 95492298 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<label for="rbBillLater">PayPal Credit</label>
</td>
</tr>
<tr id="trBillMeLaterRow-2">
<td colspan="5">
<div id="divBillMeLater">
<fieldset>
<label id="lblPrimaryPhone" for="txtPrimaryPhone">Home Phone:</label>
<input id="txtPrimaryPhone" type="tel" name="txtPrimaryPhone" autocomplete="off" autocorrect="off" value="" maxlength="14" size="14"
title="overall type: PHONE_HOME_CITY_AND_NUMBER server type: PHONE_HOME_CITY_AND_NUMBER heuristic type: PHONE_HOME_WHOLE_NUMBER label: Home Phone: parseable name: txtPrimaryPhone field signature: 918983855 form signature: 12190733459375771907"
autofill-prediction="PHONE_HOME_CITY_AND_NUMBER"
/>
</fieldset>
<fieldset>
<label id="lblEmailAddress" for="txtEmailAddress">Email Address:</label>
<input id="txtEmailAddress" type="email" name="txtEmailAddress" autocomplete="on" autocorrect="off" value=""
title="overall type: EMAIL_ADDRESS server type: EMAIL_ADDRESS heuristic type: EMAIL_ADDRESS label: Email Address: parseable name: txtEmailAddress field signature: 653947670 form signature: 12190733459375771907"
autofill-prediction="EMAIL_ADDRESS"
/>
</fieldset>
<fieldset>
<label id="lblSsn" for="txtSsn">Social Security Number:</label>XXX-XX-<input id="txtSsn" type="text" pattern="[0-9]*" autocomplete="off" autocorrect="off" maxlength="4" size="4" name="txtLast4SSN" value=""
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Social Security Number: parseable name: txtLast4SSN field signature: 598258955 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
</fieldset>
<fieldset>
<label id="lblDateOfBirthMonth" for="selDobMonth">Date of Birth:</label>
<select id="selDobMonth" name="dobMonth" size="1"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Date of Birth: parseable name: dobMonth field signature: 3916402925 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
>
<option value="month" selected="selected">Month</option>
<option value="01">January</option>
<option value="02">February</option>
<option value="03">March</option>
<option value="04">April</option>
<option value="05">May</option>
<option value="06">June</option>
<option value="07">July</option>
<option value="08">August</option>
<option value="09">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select>
<label id="lblDateOfBirthDay" for="selDobDay">Day of Birth:</label>
<select id="selDobDay" name="dobDay" size="1"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Day of Birth: parseable name: dobDay field signature: 4127787517 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
>
<option value="day" selected="selected">Day</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 value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<label id="lblDateOfBirthYear" for="selDobYear">Year of Birth:</label>
<select id="selDobYear" name="dobYear" size="1"
title="overall type: COMPANY_NAME server type: COMPANY_NAME heuristic type: UNKNOWN_TYPE label: Year of Birth: parseable name: dobYear field signature: 3750696607 form signature: 12190733459375771907"
autofill-prediction="COMPANY_NAME"
>
<option value="year" selected="selected">Year</option>
<option value="1927">1927</option>
<option value="1928">1928</option>
<option value="1929">1929</option>
<option value="1930">1930</option>
<option value="1931">1931</option>
<option value="1932">1932</option>
<option value="1933">1933</option>
<option value="1934">1934</option>
<option value="1935">1935</option>
<option value="1936">1936</option>
<option value="1937">1937</option>
<option value="1938">1938</option>
<option value="1939">1939</option>
<option value="1940">1940</option>
<option value="1941">1941</option>
<option value="1942">1942</option>
<option value="1943">1943</option>
<option value="1944">1944</option>
<option value="1945">1945</option>
<option value="1946">1946</option>
<option value="1947">1947</option>
<option value="1948">1948</option>
<option value="1949">1949</option>
<option value="1950">1950</option>
<option value="1951">1951</option>
<option value="1952">1952</option>
<option value="1953">1953</option>
<option value="1954">1954</option>
<option value="1955">1955</option>
<option value="1956">1956</option>
<option value="1957">1957</option>
<option value="1958">1958</option>
<option value="1959">1959</option>
<option value="1960">1960</option>
<option value="1961">1961</option>
<option value="1962">1962</option>
<option value="1963">1963</option>
<option value="1964">1964</option>
<option value="1965">1965</option>
<option value="1966">1966</option>
<option value="1967">1967</option>
<option value="1968">1968</option>
<option value="1969">1969</option>
<option value="1970">1970</option>
<option value="1971">1971</option>
<option value="1972">1972</option>
<option value="1973">1973</option>
<option value="1974">1974</option>
<option value="1975">1975</option>
<option value="1976">1976</option>
<option value="1977">1977</option>
<option value="1978">1978</option>
<option value="1979">1979</option>
<option value="1980">1980</option>
<option value="1981">1981</option>
<option value="1982">1982</option>
<option value="1983">1983</option>
<option value="1984">1984</option>
<option value="1985">1985</option>
<option value="1986">1986</option>
<option value="1987">1987</option>
<option value="1988">1988</option>
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
<option value="1997">1997</option>
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
<option value="2001">2001</option>
<option value="2002">2002</option>
<option value="2003">2003</option>
<option value="2004">2004</option>
<option value="2005">2005</option>
<option value="2006">2006</option>
<option value="2007">2007</option>
<option value="2008">2008</option>
<option value="2009">2009</option>
<option value="2010">2010</option>
<option value="2011">2011</option>
<option value="2012">2012</option>
<option value="2013">2013</option>
<option value="2014">2014</option>
<option value="2015">2015</option>
<option value="2016">2016</option>
<option value="2017">2017</option>
</select>
</fieldset>
<div id="monetate_selectorHTML_b234e9d_0">
<div>
<label for="cbBillMeLaterElectronicConsent" id="lblBillMeLaterElectronicConsent"> <input id="cbBillMeLaterElectronicConsent" name="bmlAcceptTerms" type="checkbox" />
</label>
</div>
</div>
</div>
<div id="BMLScroll">
<input name="bmlAcceptTermsTemp" id="cbBillMeLaterElectronicConsentTemp" type="checkbox"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Note: After scrolling, please remain at the bottom of the Terms and Conditions section to continue. parseable name: bmlAcceptTermsTemp field signature: 1379157860 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<label for="cbBillMeLaterElectronicConsent" id="lblBillMeLaterElectronicConsent"> <input name="bmlAcceptTerms" id="cbBillMeLaterElectronicConsent" type="checkbox"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Note: After scrolling, please remain at the bottom of the Terms and Conditions section to continue. parseable name: bmlAcceptTerms field signature: 4275106371 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
</label>
</div>
</td>
</tr>
<tr id="trEnterNewCard-1">
<td colspan="5">
<input type="radio" name="rbNewPaymentMethod" id="rbNewCard" value="rbNewCard" checked="checked"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Enter New Card parseable name: rbNewPaymentMethod field signature: 95492298 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<label for="rbNewCard"> Enter New Card</label>
</td>
</tr>
<tr id="trEnterNewCard-2">
<td colspan="5">
<div id="divEnterNewCard">
<fieldset>
<label id="lblNewCardType" for="selNewCardType">Type</label>
<select name="NewCardType" id="selNewCardType" size="1"
title="overall type: CREDIT_CARD_TYPE server type: CREDIT_CARD_TYPE heuristic type: CREDIT_CARD_TYPE label: Type parseable name: NewCardType field signature: 3035337803 form signature: 12190733459375771907"
autofill-prediction="CREDIT_CARD_TYPE"
>
<option value="AX">American Express</option>
<option value="CB">Carte Blanc</option>
<option value="DC">Diners Club</option>
<option value="SI">Discover</option>
<option value="MC">MasterCard</option>
<option value="QV">QCard</option>
<option value="VI" selected="selected">Visa</option>
</select>
<label id="lblNewCardNumber" for="txtNewCardNumber">Number:</label>
<input id="txtNewCardNumber" name="NewCardNumber" type="text" maxlength="20" size="21" autocomplete="off" autocorrect="off" value="" pattern="[0-9]*"
title="overall type: CREDIT_CARD_NUMBER server type: CREDIT_CARD_NUMBER heuristic type: CREDIT_CARD_NUMBER label: Number: parseable name: NewCardNumber field signature: 2370218454 form signature: 12190733459375771907"
autofill-prediction="CREDIT_CARD_NUMBER"
/>
<input id="hidNewLastCC" name="hidNewLastCC" type="hidden" value="" />
<fieldset id="fldExpireDateNewCard">
<label id="lblNewCard" for="selNewCard">Expiration Date:</label>
<select name="selNewCard" id="selNewCard" size="1"
title="overall type: CREDIT_CARD_EXP_DATE_4_DIGIT_YEAR server type: NO_SERVER_DATA heuristic type: CREDIT_CARD_EXP_DATE_4_DIGIT_YEAR label: Expiration Date: parseable name: selNewCard field signature: 2308816317 form signature: 12190733459375771907"
autofill-prediction="CREDIT_CARD_EXP_DATE_4_DIGIT_YEAR"
>
<option value="03/2017" selected="selected">03/2017</option>
<option value="04/2017">04/2017</option>
<option value="05/2017">05/2017</option>
<option value="06/2017">06/2017</option>
<option value="07/2017">07/2017</option>
<option value="08/2017">08/2017</option>
<option value="09/2017">09/2017</option>
<option value="10/2017">10/2017</option>
<option value="11/2017">11/2017</option>
<option value="12/2017">12/2017</option>
<option value="01/2018">01/2018</option>
<option value="02/2018">02/2018</option>
<option value="03/2018">03/2018</option>
<option value="04/2018">04/2018</option>
<option value="05/2018">05/2018</option>
<option value="06/2018">06/2018</option>
<option value="07/2018">07/2018</option>
<option value="08/2018">08/2018</option>
<option value="09/2018">09/2018</option>
<option value="10/2018">10/2018</option>
<option value="11/2018">11/2018</option>
<option value="12/2018">12/2018</option>
<option value="01/2019">01/2019</option>
<option value="02/2019">02/2019</option>
<option value="03/2019">03/2019</option>
<option value="04/2019">04/2019</option>
<option value="05/2019">05/2019</option>
<option value="06/2019">06/2019</option>
<option value="07/2019">07/2019</option>
<option value="08/2019">08/2019</option>
<option value="09/2019">09/2019</option>
<option value="10/2019">10/2019</option>
<option value="11/2019">11/2019</option>
<option value="12/2019">12/2019</option>
<option value="01/2020">01/2020</option>
<option value="02/2020">02/2020</option>
<option value="03/2020">03/2020</option>
<option value="04/2020">04/2020</option>
<option value="05/2020">05/2020</option>
<option value="06/2020">06/2020</option>
<option value="07/2020">07/2020</option>
<option value="08/2020">08/2020</option>
<option value="09/2020">09/2020</option>
<option value="10/2020">10/2020</option>
<option value="11/2020">11/2020</option>
<option value="12/2020">12/2020</option>
<option value="01/2021">01/2021</option>
<option value="02/2021">02/2021</option>
<option value="03/2021">03/2021</option>
<option value="04/2021">04/2021</option>
<option value="05/2021">05/2021</option>
<option value="06/2021">06/2021</option>
<option value="07/2021">07/2021</option>
<option value="08/2021">08/2021</option>
<option value="09/2021">09/2021</option>
<option value="10/2021">10/2021</option>
<option value="11/2021">11/2021</option>
<option value="12/2021">12/2021</option>
<option value="01/2022">01/2022</option>
<option value="02/2022">02/2022</option>
<option value="03/2022">03/2022</option>
<option value="04/2022">04/2022</option>
<option value="05/2022">05/2022</option>
<option value="06/2022">06/2022</option>
<option value="07/2022">07/2022</option>
<option value="08/2022">08/2022</option>
<option value="09/2022">09/2022</option>
<option value="10/2022">10/2022</option>
<option value="11/2022">11/2022</option>
<option value="12/2022">12/2022</option>
<option value="01/2023">01/2023</option>
<option value="02/2023">02/2023</option>
<option value="03/2023">03/2023</option>
<option value="04/2023">04/2023</option>
<option value="05/2023">05/2023</option>
<option value="06/2023">06/2023</option>
<option value="07/2023">07/2023</option>
<option value="08/2023">08/2023</option>
<option value="09/2023">09/2023</option>
<option value="10/2023">10/2023</option>
<option value="11/2023">11/2023</option>
<option value="12/2023">12/2023</option>
<option value="01/2024">01/2024</option>
<option value="02/2024">02/2024</option>
<option value="03/2024">03/2024</option>
<option value="04/2024">04/2024</option>
<option value="05/2024">05/2024</option>
<option value="06/2024">06/2024</option>
<option value="07/2024">07/2024</option>
<option value="08/2024">08/2024</option>
<option value="09/2024">09/2024</option>
<option value="10/2024">10/2024</option>
<option value="11/2024">11/2024</option>
<option value="12/2024">12/2024</option>
<option value="01/2025">01/2025</option>
<option value="02/2025">02/2025</option>
<option value="03/2025">03/2025</option>
<option value="04/2025">04/2025</option>
<option value="05/2025">05/2025</option>
<option value="06/2025">06/2025</option>
<option value="07/2025">07/2025</option>
<option value="08/2025">08/2025</option>
<option value="09/2025">09/2025</option>
<option value="10/2025">10/2025</option>
<option value="11/2025">11/2025</option>
<option value="12/2025">12/2025</option>
<option value="01/2026">01/2026</option>
<option value="02/2026">02/2026</option>
<option value="03/2026">03/2026</option>
<option value="04/2026">04/2026</option>
<option value="05/2026">05/2026</option>
<option value="06/2026">06/2026</option>
<option value="07/2026">07/2026</option>
<option value="08/2026">08/2026</option>
<option value="09/2026">09/2026</option>
<option value="10/2026">10/2026</option>
<option value="11/2026">11/2026</option>
<option value="12/2026">12/2026</option>
<option value="01/2027">01/2027</option>
<option value="02/2027">02/2027</option>
<option value="03/2027">03/2027</option>
<option value="04/2027">04/2027</option>
<option value="05/2027">05/2027</option>
<option value="06/2027">06/2027</option>
<option value="07/2027">07/2027</option>
<option value="08/2027">08/2027</option>
<option value="09/2027">09/2027</option>
<option value="10/2027">10/2027</option>
<option value="11/2027">11/2027</option>
<option value="12/2027">12/2027</option>
</select>
</fieldset>
</fieldset>
<fieldset id="fldSecurityCodeNewCard">
<div id="fldSecurityCode">
<label for="txtSecurityCode">Security Code:</label> <input id="txtSecurityCode" name="SecurityCode" type="text" pattern="[0-9]*" maxlength="5" size="5" value=""
title="overall type: CREDIT_CARD_VERIFICATION_CODE server type: NO_SERVER_DATA heuristic type: CREDIT_CARD_VERIFICATION_CODE label: Security Code: parseable name: SecurityCode field signature: 4107652875 form signature: 12190733459375771907"
autofill-prediction="CREDIT_CARD_VERIFICATION_CODE"
/>
</div>
</fieldset>
<div id="divQButton">
<span>
<input type="button" id="btnQCard" value="Add My QCard" />
<span>Add My QCard</span>
</span>
<input type="hidden" id="addMyQCard" name="addMyQCard" value="false" />
<input type="hidden" id="isNPO" name="isNPO" value="true" />
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
<div id="divQvcGiftCardsMethod">
<div>
<div id="divGiftCardPaymentOption">
<input type="checkbox" name="cbGiftCard" id="cbGiftCard"
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Use a Gift Card parseable name: cbGiftCard field signature: 2461714937 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<label for="cbGiftCard">Use a Gift Card</label>
<div id="divQvcGiftCardEntry">
<fieldset>
<label for="txtQvcGiftCardNumber">Card Number:</label>
<input id="txtQvcGiftCardNumber" name="txtQvcGiftCardNumber" type="tel" autocomplete="off" autocorrect="off" maxlength="19" size="19" value=""
title="overall type: CREDIT_CARD_NUMBER server type: CREDIT_CARD_NUMBER heuristic type: CREDIT_CARD_NUMBER label: Card Number: parseable name: txtQvcGiftCardNumber field signature: 375442765 form signature: 12190733459375771907"
autofill-prediction="CREDIT_CARD_NUMBER"
/>
<label for="txtQvcGiftCardSecurityIdNumber">Security ID Number:</label>
<input id="txtQvcGiftCardSecurityIdNumber" name="txtQvcGiftCardSecurityIdNumber" type="text" autocomplete="off" autocorrect="off" maxlength="12" size="19" value=""
title="overall type: UNKNOWN_TYPE server type: NO_SERVER_DATA heuristic type: UNKNOWN_TYPE label: Security ID Number: parseable name: txtQvcGiftCardSecurityIdNumber field signature: 383370886 form signature: 12190733459375771907"
autofill-prediction="UNKNOWN_TYPE"
/>
<span>
<input type="button" id="btnQvcGiftCardEnterAnotherCard" name="btnQvcGiftCardEnterAnotherCard" value="Enter Another Card" />
<span>Enter Another Card</span>
</span>
<br />
</fieldset>
</div>
</div>
</div>
</div>
<div id="monetate_selectorHTML_c937b2dd_0">
<div id="mainVoucherCodeDiv">
<input id="txtQvcApplyCodeNumber" name="txtQvcApplyCodeNumber" type="text" autocomplete="off" autocorrect="off" maxlength="25" size="19" value="" />
<input type="button" id="btnApplyCode" value="Apply Code" />
</div>
</div>
<div id="divButtons">
<span>
<input type="button" id="btnSubmitChanges" value="Continue Checkout" />
<span>Continue Checkout</span>
</span>
<span>
<span>Continue Checkout</span>
<input type="button" id="btnQCard2" value="Continue Checkout" />
</span>
<span>
<input type="button" id="btnReturnToOrder" value="EDIT SHOPPING CART" />
<span>Edit Shopping cart</span>
</span>
</div>
</form>
<form id="captureFormFooter" method="post" name="captureFormFooter">
<div id="divEmailFormFooter">
<label for="emailAddress1Footer">Get sneak previews of special offers and upcoming events delivered to your inbox.</label>
<span id="emailAddressErrorFooter">*</span>
<input id="emailAddress1Footer" type="text" value="Enter email" />
<input id="emailAddress2Footer" type="text" value="Confirm email" />
<input id="signUpFooter" type="submit" value="Sign Up" />
<span id="disclaimerTextFooter">*You're signing up to receive QVC promotional email.</span>
</div>
</form>
</body>
</html>
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