Update Your Profile Info

<link href="https://cdnjs.cloudflare.com/ajax/libs/pikaday/1.5.1/css/pikaday.min.css" rel="stylesheet" type="text/css"/><!-- [et_pb_line_break_holder] --><link href="https://cdnjs.cloudflare.com/ajax/libs/pikaday/1.5.1/css/pikaday.min.css" rel="stylesheet" type="text/css"/><!-- [et_pb_line_break_holder] --><div class="et_pb_contact"><!-- [et_pb_line_break_holder] --> <form id="inf_form_631ff00c79bb326bf2bc5a8125ebe561" class="infusion-form et_pb_contact_form clearfix" accept-charset="UTF-8" action="https://education.infusionsoft.com/app/form/process/631ff00c79bb326bf2bc5a8125ebe561" method="POST"><input name="inf_form_xid" type="hidden" value="631ff00c79bb326bf2bc5a8125ebe561"/><!-- [et_pb_line_break_holder] --> <input name="inf_form_name" type="hidden" value="Web Form submitted"/><!-- [et_pb_line_break_holder] --> <input name="infusionsoft_version" type="hidden" value="1.70.0.57987"/><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half"><!-- [et_pb_line_break_holder] --> <label for="inf_field_FirstName" class="et_pb_contact_form_label">First Name *</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_FirstName" class="infusion-field-input" name="inf_field_FirstName" type="text" value="[memb_contact fields=FirstName]" placeholder="First Name *"/></p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <label for="inf_field_LastName" class="et_pb_contact_form_label">Last Name *</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_LastName" class="infusion-field-input" name="inf_field_LastName" type="text" value="[memb_contact fields=LastName]" placeholder="Last Name *"/></p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <label for="inf_field_Company" class="et_pb_contact_form_label">Company</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_Company" class="infusion-field-input" name="inf_field_Company" type="text" value="[memb_contact fields=Company]" placeholder="Company"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <div class="et_pb_contact_field et_pb_contact_field_half" style="margin-bottom: 3%; padding: 0 0 0 3%;"><!-- [et_pb_line_break_holder] --> <label for="inf_field_Birthday" class="et_pb_contact_form_label">Birthday</label><!-- [et_pb_line_break_holder] --> <div class="infusion-calendar-wrapper"><!-- [et_pb_line_break_holder] --> <script src="https://cdnjs.cloudflare.com/ajax/libs/moment.js/2.17.0/moment.min.js" type="text/javascript"></script><!-- [et_pb_line_break_holder] --> <script src="https://cdnjs.cloudflare.com/ajax/libs/pikaday/1.5.1/pikaday.min.js" type="text/javascript"></script><!-- [et_pb_line_break_holder] --> <p><input id="inf_field_Birthday" class="infusion-field-input-container infusion-date-input" name="inf_field_Birthday" size="10px" type="text" value="[memb_contact fields=Birthday]" placeholder="Birthday" style="width: 90%" /></p><!-- [et_pb_line_break_holder] --> <div class="cal-popup" style="margin: -32px 0 0 90%;"><!-- [et_pb_line_break_holder] --> <svg height="24" id="inf_field_Birthday_img" viewbox="0 0 28 28" width="24"><!-- [et_pb_line_break_holder] --> <path d="M7 10H12V15H7M19 19H5V8H19M19 3H18V1H16V3H8V1H6V3H5C3.9 3 3 3.9 3 5V19A2 2 0 0 0 5 21H19A2 2 0 0 0 21 19V5A2 2 0 0 0 19 3Z"><!-- [et_pb_line_break_holder] --> </path><!-- [et_pb_line_break_holder] --> </svg><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div id="inf_field_Birthday_calContainer" class="pikaday-container"></div><!-- [et_pb_line_break_holder] --> <script><!-- [et_pb_line_break_holder] --> var inf_field_BirthdayDatePicker = new Pikaday( {<!-- [et_pb_line_break_holder] --> container: document.getElementById( 'inf_field_Birthday_calContainer' ),<!-- [et_pb_line_break_holder] --> field: document.getElementById( 'inf_field_Birthday' ),<!-- [et_pb_line_break_holder] --> format: 'MM-DD-YYYY',<!-- [et_pb_line_break_holder] --> yearRange: '100',<!-- [et_pb_line_break_holder] --> maxYear: '2018'<!-- [et_pb_line_break_holder] --> } );<!-- [et_pb_line_break_holder] --> var inf_field_BirthdayIcon = document.getElementById( 'inf_field_Birthday_img' );<!-- [et_pb_line_break_holder] --> inf_field_BirthdayIcon.addEventListener( 'click', function () {<!-- [et_pb_line_break_holder] --> inf_field_BirthdayDatePicker.show();<!-- [et_pb_line_break_holder] --> } );<!-- [et_pb_line_break_holder] --> </script><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div class="et_pb_contact_field et_pb_contact_field_half et_pb_contact_field_last" style="margin-bottom: 3%; padding: 0 0 0 3%;"><!-- [et_pb_line_break_holder] --> <label for="inf_field_Anniversary" class="et_pb_contact_form_label">Anniversary</label><!-- [et_pb_line_break_holder] --> <div class="infusion-calendar-wrapper"><!-- [et_pb_line_break_holder] --> <p><input id="inf_field_Anniversary" class="infusion-field-input-container infusion-date-input" name="inf_field_Anniversary" size="10px" type="text" value="[memb_contact fields=Anniversary]" placeholder="Anniversary" style="width: 90%" /></p><!-- [et_pb_line_break_holder] --> <div class="cal-popup" style="margin: -32px 0 0 90%;"><!-- [et_pb_line_break_holder] --> <svg height="24" id="inf_field_Anniversary_img" viewbox="0 0 28 28" width="24"><!-- [et_pb_line_break_holder] --> <path d="M7 10H12V15H7M19 19H5V8H19M19 3H18V1H16V3H8V1H6V3H5C3.9 3 3 3.9 3 5V19A2 2 0 0 0 5 21H19A2 2 0 0 0 21 19V5A2 2 0 0 0 19 3Z"><!-- [et_pb_line_break_holder] --> </path><!-- [et_pb_line_break_holder] --> </svg><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <div id="inf_field_Anniversary_calContainer" class="pikaday-container"></div><!-- [et_pb_line_break_holder] --> <script><!-- [et_pb_line_break_holder] --> var inf_field_AnniversaryDatePicker = new Pikaday( {<!-- [et_pb_line_break_holder] --> container: document.getElementById( 'inf_field_Anniversary_calContainer' ),<!-- [et_pb_line_break_holder] --> field: document.getElementById( 'inf_field_Anniversary' ),<!-- [et_pb_line_break_holder] --> format: 'MM-DD-YYYY'<!-- [et_pb_line_break_holder] --> } );<!-- [et_pb_line_break_holder] --> var inf_field_AnniversaryIcon = document.getElementById( 'inf_field_Anniversary_img' );<!-- [et_pb_line_break_holder] --> inf_field_AnniversaryIcon.addEventListener( 'click', function () {<!-- [et_pb_line_break_holder] --> inf_field_AnniversaryDatePicker.show();<!-- [et_pb_line_break_holder] --> } );<!-- [et_pb_line_break_holder] --> </script><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half"><!-- [et_pb_line_break_holder] --> <label for="inf_field_Address2Street1">Mailing Address</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_Address2Street1" class="infusion-field-input" name="inf_field_Address2Street1" type="text" value="[memb_contact fields=Address2Street1]" placeholder="Mailing Address"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <label for="inf_field_City2">City</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_City2" class="infusion-field-input" name="inf_field_City2" type="text" value="[memb_contact fields=City2]" placeholder="City"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half"><!-- [et_pb_line_break_holder] --> <label for="inf_field_State2">State</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_State2" class="infusion-field-input" name="inf_field_State2" type="text" value="[memb_contact fields=State2]" placeholder="State"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <label for="inf_field_PostalCode2">Zip</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_PostalCode2" class="infusion-field-input" name="inf_field_PostalCode2" type="text" value="[memb_contact fields=PostalCode2]" placeholder="Zip"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half"><!-- [et_pb_line_break_holder] --> <label for="inf_field_Phone1">Cell Phone</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_Phone1" class="infusion-field-input" name="inf_field_Phone1" type="text" value="[memb_contact fields=Phone1]" placeholder="Cell Phone"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <p class="et_pb_contact_field et_pb_contact_field_half et_pb_contact_field_last"><!-- [et_pb_line_break_holder] --> <label for="inf_field_Phone2">Office Phone</label><!-- [et_pb_line_break_holder] --> <input id="inf_field_Phone2" class="infusion-field-input" name="inf_field_Phone2" type="text" value="[memb_contact fields=Phone2]" placeholder="Office Phone"/><!-- [et_pb_line_break_holder] --> </p><!-- [et_pb_line_break_holder] --> <input name="inf_field_Email" type="hidden" value="[memb_contact fields=Email]"/><!-- [et_pb_line_break_holder] --> <div class="et_contact_bottom_container"><!-- [et_pb_line_break_holder] --> <div class="et_pb_contact_right"><!-- [et_pb_line_break_holder] --> <p class="clearfix"><button id="recaptcha_631ff00c79bb326bf2bc5a8125ebe561" class="infusion-recaptcha et_pb_contact_submit et_pb_button" type="submit">Submit</button></p><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </div><!-- [et_pb_line_break_holder] --> </form><!-- [et_pb_line_break_holder] --></div><!-- [et_pb_line_break_holder] --><script type="text/javascript" src="https://education.infusionsoft.com/app/webTracking/getTrackingCode"></script><!-- [et_pb_line_break_holder] --><script type="text/javascript" src="https://education.infusionsoft.com/resources/external/recaptcha/production/recaptcha.js?b=1.70.0.57987"></script><!-- [et_pb_line_break_holder] --><script src="https://www.google.com/recaptcha/api.js?onload=onloadInfusionRecaptchaCallback&render=explicit" async="async" defer="defer"></script><!-- [et_pb_line_break_holder] --><script type="text/javascript" src="https://education.infusionsoft.com/app/timezone/timezoneInputJs?xid=631ff00c79bb326bf2bc5a8125ebe561"></script><!-- [et_pb_line_break_holder] --><script><!-- [et_pb_line_break_holder] --> jQuery( function ( $ ) {<!-- [et_pb_line_break_holder] --> function pad( num, size ) {<!-- [et_pb_line_break_holder] --> var s = num + "";<!-- [et_pb_line_break_holder] --> while ( s.length < size ) s = "0" + s;<!-- [et_pb_line_break_holder] --> return s;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --><!-- [et_pb_line_break_holder] --> if ( $( '#inf_field_Birthday' ).val().indexOf( 'T' ) ) {<!-- [et_pb_line_break_holder] --> var BDd = $( '#inf_field_Birthday' ).val();<!-- [et_pb_line_break_holder] --> var rtnBDd = BDd.substring( 4, 6 ) + '-' + BDd.substring( 6, 8 ) + '-' + BDd.substring( 0, 4 );<!-- [et_pb_line_break_holder] --> $( '#inf_field_Birthday' ).val( rtnBDd );<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> if ( $( '#inf_field_Anniversary' ).val().indexOf( 'T' ) ) {<!-- [et_pb_line_break_holder] --> var BDd2 = $( '#inf_field_Anniversary' ).val();<!-- [et_pb_line_break_holder] --> var rtnBDd2 = BDd2.substring( 4, 6 ) + '-' + BDd2.substring( 6, 8 ) + '-' + BDd2.substring( 0, 4 );<!-- [et_pb_line_break_holder] --> $( '#inf_field_Anniversary' ).val( rtnBDd2 );<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> } );<!-- [et_pb_line_break_holder] --></script><!-- [et_pb_line_break_holder] --><style><!-- [et_pb_line_break_holder] --> .entry-content table.pika-table {<!-- [et_pb_line_break_holder] --> width: auto;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --> .entry-content .pika-table tr td, .entry-content .pika-table thead th, .entry-content .pika-table tr th {<!-- [et_pb_line_break_holder] --> padding: 0px !important;<!-- [et_pb_line_break_holder] --> }<!-- [et_pb_line_break_holder] --></style>