my.qe2foundation.ca
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Submitted URL: http://qe2covid19response.ca/
Effective URL: https://my.qe2foundation.ca/covid-19-response-fund
Submission: On June 04 via api from BE
Effective URL: https://my.qe2foundation.ca/covid-19-response-fund
Submission: On June 04 via api from BE
Form analysis 1 forms found in the DOM
POST https://my.qe2foundation.ca/processdonation
<form action="https://my.qe2foundation.ca/processdonation" method="post" id="DonationForm" class="form-horizontal " novalidate="novalidate">
<input type="hidden" name="page_id" id="page_id" value="711">
<input type="hidden" name="mandatory" id="mandatory" value="d_fname,d_lname,d_email{email},d_address_street,d_address_country,d_amount{amount},d_receipt">
<input type="hidden" name="d_amount" id="d_amount" value="">
<input type="hidden" name="d_amount_sel" id="d_amount_sel" value="">
<input type="hidden" name="d_fee" id="d_fee">
<input type="hidden" name="initial_amount" id="initial_amount">
<input type="hidden" name="donation_frequency" id="donation_frequency" value="">
<input type="hidden" name="fbuser_id" id="fbuser_id" value="">
<input type="hidden" name="fbuser_pic" id="fbuser_pic" value="">
<input type="hidden" name="d_photo" id="d_photo" value="">
<input type="hidden" name="CSRFToken" value="3307a00a145754b50146750c71d3cc8c">
<input type="hidden" name="stripe_key" id="stripe_key" value="pk_live_W6Y8f0QpH3KN7FmxVt4YsbzP">
<input type="hidden" name="token" id="token" value="">
<input type="hidden" name="payment_intent_id" id="payment_intent_id">
<input type="hidden" name="card_brand" id="card_brand">
<input type="hidden" name="card_country" id="card_country">
<p class="error hidden"></p>
<div class="sidebar-form-toggler-nav" style="max-width:200px;">
<ul id="sidebar-form-toggler" class="text-center list-inline">
<li class="col-md-4"><a href="javascript:;" class="sidebar-form-tab bg-primary" rel="chooseamount" id="chooseamountlink">$</a></li>
<li class="col-md-4"><a href="javascript:;" class="sidebar-form-tab" rel="personaldetails" id="personaldetailslink"><i class="fa fa-user" aria-hidden="true"></i></a></li>
<li class="col-md-4"><a href="javascript:;" class="sidebar-form-tab" rel="paymentdetails" id="paymentdetailslink"><i class="fa fa-credit-card" aria-hidden="true"></i></a></li>
</ul>
<div class="clear"></div>
</div>
<div class="sidebar-form-panel aligncenter active" id="chooseamount">
<h4 class="text-center">Please select a donation amount</h4>
<div class="donationHandlers horizontal">
<div class="col-sm-6 handleHorizontal">
<div class="radio no-image">
<a class="radio-amount" data-rel="25">
<span class="radio-wrap">
<span class="amount-wrap"><span class="amount">$25</span></span>
</span>
</a>
<div class="clear"></div>
</div>
</div>
<div class="col-sm-6 handleHorizontal">
<div class="radio no-image">
<a class="radio-amount" data-rel="50">
<span class="radio-wrap">
<span class="amount-wrap"><span class="amount">$50</span></span>
</span>
</a>
<div class="clear"></div>
</div>
</div>
<div class="col-sm-6 handleHorizontal">
<div class="radio no-image">
<a class="radio-amount" data-rel="75">
<span class="radio-wrap">
<span class="amount-wrap"><span class="amount">$75</span></span>
</span>
</a>
<div class="clear"></div>
</div>
</div>
<div class="col-sm-6 handleHorizontal">
<div class="radio no-image">
<a class="radio-amount" data-rel="100">
<span class="radio-wrap">
<span class="amount-wrap"><span class="amount">$100</span></span>
</span>
</a>
<div class="clear"></div>
</div>
</div>
<div class="clear"></div>
</div><!-- donationHandlers -->
<script>
$('.radio').click(function() {
$('#d_amount,#initial_amount').val($(this).find('.radio-amount').attr('data-rel'));
$('#d_amount_sel').val($(this).find('.radio-amount').attr('data-rel'));
calculateDonation();
positionform();
//showPersonalPanel();
$('#d_amount_free').val('');
$('.radio').removeClass('selected');
$(this).addClass('selected');
$('a[rel="personaldetails"]').addClass('btn-pulse');
setTimeout(function() {
$('a[rel="personaldetails"]').removeClass('btn-pulse')
}, 1000);
return false;
});
</script>
<h4 class="text-center pt10 pb10">Or enter your own</h4>
<div>
<div class="col-sm-2"></div>
<div class="form-group text-center col-sm-8">
<div class="input-group">
<span class="input-group-addon bg-primary"> $ </span>
<input class="form-control" type="text" name="d_amount_free" id="d_amount_free" onfocus="$('#d_amount,#initial_amount').val('');$('input[name=d_amount_sel]').attr('checked',false);" onkeyup="RemoveJunk(this,'nofloat');"
autocomplete="donation-amount" value="">
</div>
</div>
<div class="col-sm-2"></div>
<div class="clear"></div>
</div>
<div class="col-sm-2"></div>
<div class="form-group text-center col-sm-8">
<a href="javascript:;" class="btn btn-tertiary btn-block button-next" rel="personaldetails">Next</a>
</div>
<div class="col-sm-2"></div>
<div class="clear"></div>
</div>
<div class="sidebar-form-panel" id="personaldetails">
<div class="text-center Mandatory toggle-switch form-group">
<div class="col-xs-12">
<label class="bg-primary border-primary col-xs-6 toggle-btn"
onclick="$('#OrganisationInfo').slideUp(300);$('#mandatory').val($('#mandatory').val().replace(',d_organisation',''));$(this).parent().parent().find('label').removeClass('bg-primary border-primary');$(this).addClass('bg-primary border-primary');$('#gift_aid').parent().parent().visibleIn();">
<input type="radio" name="d_receipt" value="personal" checked="checked"> Personal Donation </label>
<label class="col-xs-6 toggle-btn"
onclick="$('#OrganisationInfo').slideDown(300);$('#mandatory').val($('#mandatory').val() +',d_organisation');$(this).parent().parent().find('label').removeClass('bg-primary border-primary');$(this).addClass('bg-primary border-primary');$('#gift_aid').attr('checked',false);$('#gift_aid').parent().parent().visibleOut();">
<input type="radio" name="d_receipt" value="business"> Company Donation </label>
</div>
</div>
<div class="form-group" style="display:none;" id="OrganisationInfo">
<label class="col-sm-12">Organisation Name</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_organisation" id="d_organisation" value="">
</div>
</div>
<div class="col-md-6 p0">
<div class="form-group">
<label class="col-sm-12">First Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_fname" id="d_fname" value="">
</div>
</div>
</div>
<div class="col-md-6 p0">
<div class="form-group">
<label class="col-sm-12">Last Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_lname" id="d_lname" value="">
</div>
</div>
</div>
<div class="col-md-12 p0">
<div class="form-group">
<label class="col-sm-12">Email Address *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_email" id="d_email" value="">
</div>
</div>
</div>
<div class="col-sm-12 p0 Mandatory">
<div class="form-group">
<label class="col-sm-12">Phone *</label>
<div class="col-sm-12">
<input type="tel" class="form-control phone-group" name="d_phone" id="d_phone" value="">
</div>
</div>
</div>
<div class="clear"></div>
<div class="height-20"></div>
<div id="addressdetails">
<div class=" addressdetails address-expand">
<div class="form-group">
<label class="col-xs-12">Address Line 1 *</label>
<div class="col-xs-12">
<input class="form-control" type="text" name="d_address_street" id="d_address_street" value="" data-geo="route" data-stripe="address_line1" autocomplete="address-line1">
</div>
</div>
<div class="form-group">
<label class="col-xs-12">Address Line 2 (opt)</label>
<div class="col-xs-12">
<input class="form-control" type="text" name="d_address_2" id="d_address_2" value="" data-geo="Apartment, suite, unit, building, floor etc" data-stripe="address_line2" autocomplete="address-line2">
</div>
</div>
<div class="form-group">
<label class="col-xs-12">City *</label>
<div class="col-xs-12">
<input type="text" class="form-control" name="d_address_suburb" id="d_address_suburb" value="" data-geo="locality" data-stripe="address_line2">
</div>
</div>
<div class="form-group">
<label class="col-xs-12">Postcode *</label>
<div class="col-xs-12">
<input type="text" class="form-control" name="d_address_pcode" id="d_address_pcode" value="" data-geo="postal_code" data-stripe="address_zip" autocomplete="postal-code">
</div>
</div>
<div class="form-group">
<label class="col-xs-12">Province *</label>
<div class="col-xs-12">
<input class="form-control" type="text" name="d_address_state" id="d_address_state" value="" data-geo="administrative_area_level_1_short" data-stripe="address_state">
</div>
</div>
<div class="form-group">
<label class="col-xs-12">Country *</label>
<div class="col-xs-12">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="d_address_country" title="The Netherlands"><span
class="filter-option pull-left">The Netherlands</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Australia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="2"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Kingdom</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="3">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">---------------------</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Afghanistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Albania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Algeria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="7"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">American Samoa</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Andorra</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Angola</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="10"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Anguilla</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="11"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Antarctica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="12">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Antigua and Barbuda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="13"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Argentina</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="14"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Armenia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="15"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Aruba</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="16"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Australia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="17"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Austria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="18"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Azerbaijan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="19"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bahamas</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="20"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bahrain</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="21"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bangladesh</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="22"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Barbados</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="23"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belarus</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="24"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belgium</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="25"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belize</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="26"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Benin</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="27"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bermuda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="28"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bhutan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="29"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bolivia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="30">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bosnia and Herzegovina</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="31"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Botswana</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="32"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bouvet Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="33"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Brazil</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="34">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">British Indian Ocean Territory</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="35">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Brunei Darussalam</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="36"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bulgaria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="37"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Burkina Faso</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="38"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Burundi</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="39"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cambodia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="40"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cameroon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="41"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Canada</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="42"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cape Verde</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="43">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Caribbean Netherlands </span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="44"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cayman Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="45">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Central African Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="46"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Chad</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="47"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Chile</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="48"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">China</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="49"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Christmas Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="50">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cocos (Keeling) Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="51"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Colombia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="52"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Comoros</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="53"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Congo</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="54">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Congo, Democratic Republic of</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="55"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cook Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="56"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Costa Rica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="57"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Côte d'Ivoire</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="58"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Croatia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="59"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cuba</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="60"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Curaçao</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="61"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cyprus</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="62"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Czech Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="63"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Denmark</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="64"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Djibouti</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="65"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Dominica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="66">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Dominican Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="67"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ecuador</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="68"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Egypt</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="69"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">El Salvador</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="70">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Equatorial Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="71"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Eritrea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="72"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Estonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="73"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ethiopia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="74"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Falkland Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="75"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Faroe Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="76"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Fiji</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="77"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Finland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="78"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">France</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="79"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Guiana</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="80"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Polynesia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="81">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Southern Territories</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="82"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gabon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="83"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gambia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="84"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Georgia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="85"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Germany</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="86"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ghana</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="87"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gibraltar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="88"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Greece</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="89"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Greenland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="90"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Grenada</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="91"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guadeloupe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="92"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guam</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="93"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guatemala</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="94"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guernsey</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="95"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="96"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guinea-Bissau</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="97"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guyana</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="98"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Haiti</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="99">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Heard and McDonald Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="100"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Honduras</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="101"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Hong Kong</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="102"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Hungary</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="103"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iceland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="104"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">India</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="105"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Indonesia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="106"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iran</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="107"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iraq</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="108"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ireland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="109"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Isle of Man</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="110"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Israel</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="111"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Italy</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="112"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jamaica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="113"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Japan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="114"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jersey</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="115"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jordan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="116"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kazakhstan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="117"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kenya</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="118"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kiribati</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="119"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kuwait</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="120"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kyrgyzstan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="121">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lao People's Democratic Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="122"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Latvia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="123"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lebanon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="124"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lesotho</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="125"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Liberia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="126"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Libya</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="127"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Liechtenstein</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="128"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lithuania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="129"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Luxembourg</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="130"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Macau</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="131"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Macedonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="132"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Madagascar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="133"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malawi</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="134"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malaysia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="135"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Maldives</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="136"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mali</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="137"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malta</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="138">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Marshall Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="139"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Martinique</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="140"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mauritania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="141"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mauritius</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="142"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mayotte</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="143"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mexico</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="144">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Micronesia, Federated States of</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="145"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Moldova</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="146"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Monaco</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="147"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mongolia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="148"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Montenegro</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="149"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Montserrat</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="150"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Morocco</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="151"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mozambique</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="152"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Myanmar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="153"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Namibia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="154"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nauru</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="155"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nepal</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="156"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">New Caledonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="157"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">New Zealand</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="158"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nicaragua</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="159"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Niger</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="160"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nigeria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="161"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Niue</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="162"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Norfolk Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="163"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">North Korea</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="164">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Northern Mariana Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="165"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Norway</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="166"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Oman</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="167"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Pakistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="168"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Palau</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="169">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Palestine, State of</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="170"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Panama</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="171">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Papua New Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="172"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Paraguay</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="173"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Peru</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="174"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Philippines</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="175"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Pitcairn</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="176"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Poland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="177"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Portugal</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="178"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Puerto Rico</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="179"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Qatar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="180"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Réunion</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="181"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Romania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="182">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Russian Federation</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="183"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Rwanda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="184">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Barthélemy</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="185"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Helena</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="186">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Kitts and Nevis</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="187"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Lucia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="188">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Vincent and the Grenadines</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="189">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint-Martin (France)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="190"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Samoa</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="191"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">San Marino</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="192">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sao Tome and Principe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="193"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saudi Arabia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="194"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Senegal</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="195"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Serbia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="196"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Seychelles</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="197"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sierra Leone</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="198"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Singapore</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="199">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sint Maarten (Dutch part)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="200"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Slovakia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="201"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Slovenia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="202"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Solomon Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="203"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Somalia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="204"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Africa</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="205">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Georgia and the South Sandwich Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="206"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Korea</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="207"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Sudan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="208"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Spain</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="209"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sri Lanka</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="210">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">St. Pierre and Miquelon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="211"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sudan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="212"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Suriname</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="213">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Svalbard and Jan Mayen Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="214"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Swaziland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="215"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sweden</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="216"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Switzerland</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="217"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Syria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="218"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Taiwan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="219"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tajikistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="220"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tanzania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="221"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Thailand</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="222" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">The Netherlands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="223"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Timor-Leste</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="224"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Togo</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="225"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tokelau</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="226"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tonga</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="227">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Trinidad and Tobago</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="228"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tunisia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="229"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turkey</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="230"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turkmenistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="231">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turks and Caicos Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="232"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tuvalu</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="233"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uganda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="234"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ukraine</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="235">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Arab Emirates</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="236"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Kingdom</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="237"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="238">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States Minor Outlying Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="239"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uruguay</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="240"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uzbekistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="241"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vanuatu</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="242"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vatican</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="243"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Venezuela</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="244"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vietnam</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="245">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Virgin Islands (British)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="246">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Virgin Islands (U.S.)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="247">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Wallis and Futuna Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="248"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Western Sahara</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="249"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Yemen</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="250"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Zambia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="251"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Zimbabwe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="252"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Åland Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
</ul>
</div><select name="d_address_country" id="d_address_country" class="form-control selectpicker" data-stripe="address_country" autocomplete="country" tabindex="-98">
<option value="Australia">Australia</option>
<option value="United States">United States</option>
<option value="United Kingdom">United Kingdom</option>
<option value="">---------------------</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Caribbean Netherlands ">Caribbean Netherlands </option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, Democratic Republic of">Congo, Democratic Republic of</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands">Falkland Islands</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard and McDonald Islands">Heard and McDonald Islands</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macau">Macau</option>
<option value="Macedonia">Macedonia</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
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* home * * Why we need you * Current Priorities * Our Impact * Events & Lottery * Ways To Give Login * DONATE * FUNDRAISE * Login * Why We Need You * Current Priorities * Our Impact * Events & Lottery * Ways To Give QEII COVID-19 RESPONSE FUND Share this page QEII COVID-19 RESPONSE FUND Strong community roots are woven into the fabric of what makes us Atlantic Canadian. When the going gets tough we step up and weather the storm together – protecting and supporting each other. The QEII COVID-19 Response Fund directly supports local response efforts based on immediate and evolving frontline needs amid the COVID-19 pandemic. The curve is flattening in Nova Scotia with certain day surgeries and outpatient clinics being reintroduced at the QEII. As we start to see progress, it is vital that our healthcare teams are prepared to support patients as the situation and future needs evolve. When you support the QEII COVID-19 Response Fund, you help ensure that the QEII is equipped and prepared, regardless of what this pandemic brings our way. Funds raised will help protect patients and staff from exposure and ensure that the right technology and items are in place to care for those affected by the virus. STARTING MAY 28, ALL NEW DONATIONS TO THE QEII’S COVID-19 RESPONSE FUND WILL BE DOUBLED BY THE QEII’S DIVISION OF ORTHOPAEDIC SURGERY UP TO $25,000. -------------------------------------------------------------------------------- IMPACT UPDATES: * April 5, 2020: 1,000 Pulse Oximeters arrive at the QEII for COVID-19 response efforts. Learn more > * May 4, 2020: 40 reseachers received funding through the new Nova Scotia COVID-19 Health Research Coalition. Learn more > -------------------------------------------------------------------------------- EMPOWERING HOME SELF-CARE AND RECOVERY SUPPORT Self-care and recovery at home is an important piece of the COVID-19 response strategy. As patients care for themselves and recover at home, they are in need of items such as; * thermometers * HR and BP machines * telehealth monitoring * portable nebulizer units with mask and tubing * oscillating positive expiratory pressure devices * aerochambers The more we empower patients with the tools they need, the more capacity we build within our healthcare system and the more prepared we are for the future. NOVA SCOTIA COVID-19 HEALTH RESEARCH COALITION In this unprecedented time of local and global uncertainty, there has never been a greater need to conduct medical and health related research to collect real time evidence to inform practice, policy and decision making in this new pandemic environment. The Nova Scotia research community has come together to respond to the COVID-19 global pandemic with a $1.5 million collective investment in COVID-19 focused research. Funds raised through this QEII COVID-19 Response Fund will support the Nova Scotia COVID-19 Health Research Coalition — formed to bring research leaders and foundation partners from across the province together with an ultimate goal of finding a vaccine. Learn more about the Coalition here. ACTIVATING VIRTUAL CARE SOLUTIONS There is an urgent need for e-Mental health treatment options within our province, given the added stress and pressures of the Coronavirus outbreak (COVID-19). We have the opportunity to accelerate the launch of new innovative programs that will help create 24/7 care access for those experiencing common mental health issues. Same-day access programs that incorporate videoconferencing and mobile apps will help close the gap between available practitioners and demand – and offer treatment options individuals can utilize from the comfort and safety of their own homes. The health and safety of QEII staff is of utmost importance everyday – but especially amidst a pandemic. Funds raised will support things such as iPads and virtual doctor visits using technology to connect patients with doctors, nurse practitioners, and pharmacists for both consultative needs and on-site prescriptions. This advanced technology uses thermal imaging and facial recognition to provide patients with a safe, private, and secure consultation with a licensed clinician. SUPPORTING NEEDS IN THE QEII COVID-19 WARDS COVID-19 wards at the QEII are in need of items to care for patients affected by COVID-19. Funds raised will purchase items such as; * electronic stethoscopes * Bluetooth O2 probes * lumify ultrasounds * clinical equipment such as portable ultrasound machines for guided IV insertion and bedside diagnostics This technology provides accurate clinical assessment and diagnostics, without the patient being required to leave their bed. This allows healthcare teams to meet patients at the point-of-care, make a faster diagnosis, and deliver exceptional care whenever it’s needed. BUILDING EFFICIENCIES IN COMMUNICATION AND COLLABORATION To improve efficiencies and abide by social distancing requirements – virtual communication solutions have never been so critical. Funds raised will support digital solutions that allow healthcare professionals to communicate and collaborate in a safe and effective way. The QEII Foundation and QEII Health Sciences Centre are working together to determine frontline needs to combat the COVID-19 pandemic. The items noted above have been communicated as areas of greatest need. This list has the potential to evolve as the response to COVID-19 builds. Funds raised will support a full spectrum of care and be disbursed at the discretion of healthcare teams who are aware of frontline needs. TOGETHER, WE HAVE THE POWER TO CHANGE LIVES. BRING YOUR COMMUNITY TOGETHER WITH A VIRTUAL FUNDRAISER IN SUPPORT OF COVID-19 RESPONSE AT THE QEII. LEARN MORE > $297,320.56 Raised of $500,000 goal * $ * * PLEASE SELECT A DONATION AMOUNT $25 $50 $75 $100 OR ENTER YOUR OWN $ Next Personal Donation Company Donation Organisation Name First Name * Last Name * Email Address * Phone * Address Line 1 * Address Line 2 (opt) City * Postcode * Province * Country * The Netherlands * Australia * United States * United Kingdom * --------------------- * Afghanistan * Albania * Algeria * American Samoa * Andorra * Angola * Anguilla * Antarctica * Antigua and Barbuda * Argentina * Armenia * Aruba * Australia * Austria * Azerbaijan * Bahamas * Bahrain * Bangladesh * Barbados * Belarus * Belgium * Belize * Benin * Bermuda * Bhutan * Bolivia * Bosnia and Herzegovina * Botswana * Bouvet Island * Brazil * British Indian Ocean Territory * Brunei Darussalam * Bulgaria * Burkina Faso * Burundi * Cambodia * Cameroon * Canada * Cape Verde * Caribbean Netherlands * Cayman Islands * Central African Republic * Chad * Chile * China * Christmas Island * Cocos (Keeling) Islands * Colombia * Comoros * Congo * Congo, Democratic Republic of * Cook Islands * Costa Rica * Côte d'Ivoire * Croatia * Cuba * Curaçao * Cyprus * Czech Republic * Denmark * Djibouti * Dominica * Dominican Republic * Ecuador * Egypt * El Salvador * Equatorial Guinea * Eritrea * Estonia * Ethiopia * Falkland Islands * Faroe Islands * Fiji * Finland * France * French Guiana * French Polynesia * French Southern Territories * Gabon * Gambia * Georgia * Germany * Ghana * Gibraltar * Greece * Greenland * Grenada * Guadeloupe * Guam * Guatemala * Guernsey * Guinea * Guinea-Bissau * Guyana * Haiti * Heard and McDonald Islands * Honduras * Hong Kong * Hungary * Iceland * India * Indonesia * Iran * Iraq * Ireland * Isle of Man * Israel * Italy * Jamaica * Japan * Jersey * Jordan * Kazakhstan * Kenya * Kiribati * Kuwait * Kyrgyzstan * Lao People's Democratic Republic * Latvia * Lebanon * Lesotho * Liberia * Libya * Liechtenstein * Lithuania * Luxembourg * Macau * Macedonia * Madagascar * Malawi * Malaysia * Maldives * Mali * Malta * Marshall Islands * Martinique * Mauritania * Mauritius * Mayotte * Mexico * Micronesia, Federated States of * Moldova * Monaco * Mongolia * Montenegro * Montserrat * Morocco * Mozambique * Myanmar * Namibia * Nauru * Nepal * New Caledonia * New Zealand * Nicaragua * Niger * Nigeria * Niue * Norfolk Island * North Korea * Northern Mariana Islands * Norway * Oman * Pakistan * Palau * Palestine, State of * Panama * Papua New Guinea * Paraguay * Peru * Philippines * Pitcairn * Poland * Portugal * Puerto Rico * Qatar * Réunion * Romania * Russian Federation * Rwanda * Saint Barthélemy * Saint Helena * Saint Kitts and Nevis * Saint Lucia * Saint Vincent and the Grenadines * Saint-Martin (France) * Samoa * San Marino * Sao Tome and Principe * Saudi Arabia * Senegal * Serbia * Seychelles * Sierra Leone * Singapore * Sint Maarten (Dutch part) * Slovakia * Slovenia * Solomon Islands * Somalia * South Africa * South Georgia and the South Sandwich Islands * South Korea * South Sudan * Spain * Sri Lanka * St. Pierre and Miquelon * Sudan * Suriname * Svalbard and Jan Mayen Islands * Swaziland * Sweden * Switzerland * Syria * Taiwan * Tajikistan * Tanzania * Thailand * The Netherlands * Timor-Leste * Togo * Tokelau * Tonga * Trinidad and Tobago * Tunisia * Turkey * Turkmenistan * Turks and Caicos Islands * Tuvalu * Uganda * Ukraine * United Arab Emirates * United Kingdom * United States * United States Minor Outlying Islands * Uruguay * Uzbekistan * Vanuatu * Vatican * Venezuela * Vietnam * Virgin Islands (British) * Virgin Islands (U.S.) * Wallis and Futuna Islands * Western Sahara * Yemen * Zambia * Zimbabwe * Åland Islands Australia United States United Kingdom --------------------- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Caribbean Netherlands Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Saint-Martin (France) Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe Åland Islands Leave a Message No Message Name to appear on page Message I'd like to remain anonymous Payment Options Name on Card Card Number Card Expiry CVV Number Donation $ I’d like to add a little extra to help cover transaction fees. This add-on is optional. Donate Now THANK YOU TO THE MANY CHAMPIONS IN OUR COMMUNITY WHO ARE SUPPORTING PATIENTS AND STAFF AT THE QEII. $104 ELIZABETH PARR-JOHNSTON $515 BOB MUSSETT $52 GEORGE SCOBIE Thank You! $5k MICHAEL MURPHY $50 CHARLES D. MAGINLEY My recent experiences have shown me how well you are all doing your job of taking care of Nova Scotians. $78 LINDA BOWSER $1.02k MICHELLE & NINA DAVEY In memory of Robbie Davey & in honour of Dr. Oxner. $26 ANONYMOUS $52 JOHN MCKAY $52 AR KHAN I salute you for your self-less service with a smile 👏 $26 DON & NANCY MACDONALD $52 CHRIS AND ANN PETROPOLIS $26 LINDA THERIAULT $104 DOUG WARD $26 MIKE MACNEIL $104 CARL DEXTER $104 ANONYMOUS $78 CAM AND MIA FUDGE A donation made on behalf of our teachers, as a thank you for all their hard work during this crisis! $26 JOSEPH INNOCENT $360 BRIAN LOCKE I have raised funds by selling refurbished lobster trap chairs .. Nova Scotia has had a difficult spring. This is my attempt at helping. $45 SAWYER BURKE Nova Scotia has done a tremendous job beating Covid 19. It's not just the stay at home order that beat the virus, it was our Health Care Heroes who went to work every day to care for the people who are battling Coronavirus. I can't express enough how grateful I am to have such selfless and driven Health Care Workers in our province. $26 ANONYMOUS $200 GLEN AND SHELLEY MCKENNA $26 KARIN MYERS Thank you for your hard work and sacrifice. You are so appreciated!! $26 LINDA MATTE $26 MARY P. REID $50 ANONYMOUS $250 TURKISH SOCIETY OF NOVA SCOTIA We wish to thank each and every member of the COVID-19 response team for their hard work $1.5k THE BOYD & HOLLY HUNTER FUND AT THE UNITED CHURCH OF CANADA FOUNDATION $10k FRED & ELIZABETH FOUNTAIN $52 SUSAN SHEPHARD $42 STEVE&CECELIA SERNYK $2.2k THE FRONTLINE FUND $26 MBARKA MOHAMED $26 LYNDA M.TYLER thanks and continued prayers for you and your families $52 LYDIA MACKINNON $16 ALLAN MACINNIS Please accept my small donation. As a Senior, I'd like to thank the entire QEII team for your efforts. It is much appreciated! Keep up the stellar work! $260 DIANE GREENOUGH $450 ANONYMOUS $500 DONNA CHAMBERS $50 KELLY & EULA BARNES $104 ART GRIFFIN $1,000 LAKE ECHO & AREA LIONS CLUB The Lake Echo and Area Lions Club salute the efforts of the front-line workers, technicians, cleaning staff and all others in their work against COVID 19. We must all do our part in doing what we can. From housekeeping, truckers keeping the food and medical supplies moving, government officials at all levels to first responders, we thank you. Our donation is a small part in this enormous battle. Keep up the fantastic work. Lake Echo and Area Lions Club - We Serve $50 ENVIE - A VEGAN KITCHEN $343 THE FRONTLINE FUND $2.23k THE FLAG SHOP NOVA SCOTIA Thank you to all our Healthcare Heroes $166 BRIAN LOCKE $52 SCOTT BURKE $2.02k NANCIELLEN DAVIS $104 ANONYMOUS $200 ANONYMOUS Thank you the front line workers! $104 CAROLE REGAN $208 ELISA DAI Thank you to all the frontline workers during this difficult time! $52 BESSIE BOUDREAU $5 ANONYMOUS $52 LINDA ROCKWELL $104 DONALDA KELLY $50 ANONYMOUS $2.5k DARTMOUTH CROSSING We would like to extend our sincere and profound thanks to all frontline teams for their vital work during the COVID-19 pandemic. Thank you for your bravery, hard work and dedication, keeping our communities healthy. $50 NOOR QURESHI Good bless you for all the good you do! $52 WAYNE MOUG $52 WAYNE AND CAROLYN FOLKER We appreciate all you do every day and think of you in these unusual times . $52 ANDREW TANNER $26 RUTH HODGES Thank you for taking such good care of all of us. $75 ANONYMOUS $52 BLAKE FOX $26 LARRY F NARDECCHIA $1.02k JOHANNA JODREY Heartfelt Thankyou $130 MARGARET CLEARY $52 PAT AND ROY SHERWOOD Thank you for all you do. $200 CHRIS MATHERS $52 ANDREW POPLAWSKI $26 ANONYMOUS Thank you and keep safe $52 ANONYMOUS Thank you, heroes!! $52 WAYNE MOSER $40 SAWYER BURKE Thank you Healthcare Heroes! I am 11 years old and I sent in a letter to thank everyone in the assessment centers and on the front lines. Thank you to Ron Clarke for supporting me in my fundraising efforts and I hope to continue to raise more money! $1,000 SENSEA NORDIC SPA Thanks for your great work! $30.95k THE FRONTLINE FUND $104 MJ MCMASTER $100 MATT REEDER $104 CHARLES O'NEIL $156 JOSHUA YOUNG $21 ABDUL K MERCHANT $26 TRISTAN CRANE $75 GREG MORRISON $52 GWEN HALIBURTON $2.5k CLASSY CARDS $104 JOHN LAWTON $1.02k LYDIA BUGDEN $31 ANONYMOUS $50 ROBERT DOHERTY Thank you to all the employees who are putting their lives on the line every day to do their part in treating covd19 patients, testing individuals, and comforting those in need with 811 service. $100 ELLEN CUMMING $100 ANONYMOUS Thank you and stay safe $26 BARRY JOHNSON Thanks for all your efforts during this trying time. $26 ANONYMOUS I hope this little bit helps, thank you so much for all you have done, God bless you. $52 SHARON NICOLLE Heartfelt thanks $40 MARIKA WARREN $31 KEIRA ELLEFSEN $1.02k FARNELL PACKAGING LIMITED $104 SUSAN BAIN Show more #QE2HEALTHHEROES Use the hashtag #QE2HealthHeroes on Instagram or Twitter to have your Thank You message shown here. QEII HEALTH SCIENCES CENTRE FOUNDATION 5657 Spring Garden Road Park Lane Mall, Suite 3005, Halifax, Nova Scotia B3J 3R4 Phone: 902 334 1546 Toll free: 1-888-428-0220 Fax: 902 442 7172 Email:info@qe2foundation.ca * About * Contact * News * Advisors * QEII Staff Portal The Standards Program Trustmark is a mark of Imagine Canada used under license by the QEII Foundation. Charitable Business No: 88646 3496 RR0001 © 2020 QEII Foundation. Privacy Policy QEII HEALTH SCIENCES CENTRE FOUNDATION 5657 Spring Garden Road Park Lane Mall, Suite 3005, Halifax, Nova Scotia B3J 3R4 Phone: 902 334 1546 Toll free: 1-888-428-0220 Fax: 902 442 7172 Email:info@qe2foundation.ca * About * Contact * News * Advisors * QEII Staff Portal Copyright @ 2019 QEII Foundation. All rights reserved. Charitable Business No: 88646 3496 RR0001