www.biggestmorningtea.com.au
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54.252.37.158
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URL:
https://www.biggestmorningtea.com.au/register/biggest-morning-tea-nsw/member?utm_source=edm&utm_medium=email&utm_campaign=nsw_ABMT&ut...
Submission: On May 24 via manual from NL — Scanned from AU
Submission: On May 24 via manual from NL — Scanned from AU
Form analysis 4 forms found in the DOM
/sponsor
<form class="navbar-form" action="/sponsor">
<div class="input-group">
<input type="text" name="kw" id="header_kw" placeholder="Find a friend" class="form-control" aria-label="Find a friend">
<span class="btn input-group-btn">
<button type="submit" class="btn btn-primary" aria-label="Search"><i class="fa fa-search"></i></button>
</span>
</div>
</form>/sponsor
<form class="navbar-form" action="/sponsor">
<div class="input-group">
<input type="text" name="kw" id="header_kw" placeholder="Find a friend" class="form-control" aria-label="Find a friend">
<span class="btn input-group-btn">
<button type="submit" class="btn btn-primary" aria-label="Search"><i class="fa fa-search"></i></button>
</span>
</div>
</form>POST https://www.biggestmorningtea.com.au/register/personaldetails/biggest-morning-tea-nsw/member
<form id="RegisterLoginForm" class="form-horizontal funraisin-form" action="https://www.biggestmorningtea.com.au/register/personaldetails/biggest-morning-tea-nsw/member" method="post" novalidate="novalidate">
<input type="hidden" name="login" value="Y">
<input type="hidden" name="CSRFToken" value="9cd43d1e4fcc06ff94072d973fe5bfb5">
<input type="text" name="botrap" value="" style="display:none;">
<section class="section mt10">
<div class="container">
<h3 class="text-center">Already have an Account with us?</h3>
<p class="text-center"> If you have an account with us already please login below. </p>
<div class="row">
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Email Address</label>
<div class="col-sm-12">
<input class="form-control" type="text" name="login_email" id="login_email_address">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Password</label>
<div class="col-sm-12 input-group mb-3 pl15">
<input class="form-control" type="password" name="login_pass" id="login_pass" autocomplete="off">
<span class="input-group-addon" onclick="password_show_hide3();" style="cursor: pointer;"><span
class="input-group-text"><i class="fas fa-eye" id="show_eye3" aria-hidden="true" style="display: block;"></i><i class="fas fa-eye-slash" id="hide_eye3" aria-hidden="true" style="display: none;"></i></span></span>
</div>
</div>
</div>
</div>
<div class="form-group">
<div class="text-center">
<button type="submit" class="btn btn-primary btn-xl"><span>Login</span></button>
</div>
</div>
<div class="form-group">
<div class="text-center">
<a href="/login/nopass" class="lightbox">Forgotten your password?</a>
</div>
</div>
</div>
</section>
</form>POST https://www.biggestmorningtea.com.au/register/personaldetails/biggest-morning-tea-nsw/member
<form action="https://www.biggestmorningtea.com.au/register/personaldetails/biggest-morning-tea-nsw/member" method="post" id="RegistrationForm" class="funraisin-form form-horizontal" novalidate="novalidate">
<input type="hidden" name="mandatory" value="m_fname,m_lname,m_email,m_email{email},m_address_street,m_address_suburb,m_address_pcode,m_address_country">
<input type="hidden" name="m_photo" id="m_photo" value="">
<input type="hidden" name="m_coverphoto" id="m_coverphoto" value="">
<input type="hidden" name="cropitimage" id="cropitimage" value="">
<input type="hidden" name="cropitcoverimage" id="cropitcoverimage" value="">
<input type="hidden" name="orgcropitimage" id="orgcropitimage" value="">
<input type="hidden" name="CSRFToken" value="9cd43d1e4fcc06ff94072d973fe5bfb5">
<input type="hidden" name="register" value="Y">
<input type="text" name="botrap" value="" style="display:none;">
<input type="hidden" name="join_team_id" id="join_team_id" value="">
<input type="hidden" name="join_org_id" id="join_org_id" value="">
<section class="section">
<div class="container" style="border-bottom:none!important">
<h3 class="text-center">Personal Details</h3>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">First Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" autocomplete="given-name" name="m_fname" id="m_fname" value="" maxlength="50">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Last Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" autocomplete="family-name" name="m_lname" id="m_lname" value="" maxlength="50">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Email Address *</label>
<div class="col-sm-12">
<input type="text" class="form-control" autocomplete="email" name="m_email" id="m_email" value="">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Password *</label>
<div class="col-sm-12 input-group mb-3 pl15">
<input type="password" class="form-control" name="m_pass" id="m_pass" value="" autocomplete="off">
<span class="input-group-addon" onclick="password_show_hide();" style="cursor: pointer;"><span
class="input-group-text"><i class="fas fa-eye" id="show_eye" aria-hidden="true" style="display: block;"></i><i class="fas fa-eye-slash" id="hide_eye" aria-hidden="true" style="display: none;"></i></span></span>
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Phone *</label>
<div class="col-sm-12">
<input type="text" class="form-control phone-group" name="m_phone_home" id="m_phone_home" value="">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Date of birth *</label>
<div class="col-sm-3 pr0">
<input type="text" class="form-control" name="m_dob_d" id="m_dob_d" value="" placeholder="dd" minlength="2" maxlength="2" autocomplete="bday-day">
</div>
<div class="col-sm-3 pr0">
<input type="text" class="form-control" name="m_dob_m" id="m_dob_m" value="" placeholder="mm" minlength="2" maxlength="2" autocomplete="bday-month">
</div>
<div class="col-sm-5 pr0">
<input type="text" class="form-control" name="m_dob_y" id="m_dob_y" value="" placeholder="yyyy" minlength="4" maxlength="4" autocomplete="bday-year">
</div>
</div>
</div>
<div class="clear"></div>
</div>
<div class="container addressdetails" style="border-top:none!important">
<h3 class="text-center">Postal Address *</h3>
<div class="form-group ">
<div class="col-sm-8 position-relative">
<input type="text" class="form-control" name="kw_address" id="kw_address" value="" placeholder="Please enter your street address" autocomplete="noprefill">
<div class="loqate-marker position-relative"></div>
</div>
<div class="col-sm-4">
<a href="javascript:;" class="expand-address">(enter address manually)</a>
</div>
<div class="clear"></div>
<div class="col-sm-12 position-relative">
<div id="kw_postcode_results" class="height-300 position-absolute hidden p20 mt10"></div>
</div>
<div class="clear"></div>
<div class="loqate-container" style="width: 100%; position: absolute; display: none;">
<div class="loqate-item loqate-item-template">
<span class="loqate-icon loqate-icon-marker"></span><span class="loqate-item-query"></span>
</div>
</div>
</div>
<div class="clear"></div>
<div class="row address-expand hidden">
<div class="col-md-12">
<p style="color: red;">Please check that the below address is correct, and ensure to include your organisation or school's name, if applicable.</p>
</div>
<div class="col-md-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Organisation or School Name</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="customfield[company_name]" id="company_name" value="" placeholder="">
</div>
</div>
</div>
</div>
<div class="form-group row address-expand hidden">
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Address Line 1 <small>*</small></label>
<div class="col-sm-12">
<input type="text" class="form-control" name="m_address_street" id="m_address_street" value="" data-geo="route" placeholder="Street address, P.O. box" autocomplete="address-line1">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Address Line 2 (opt)</label>
<div class="col-sm-12">
<input class="form-control" type="text" name="m_address_2" id="m_address_2" value="" placeholder="Apartment, suite, unit, building, floor etc" autocomplete="address-line2">
</div>
</div>
</div>
</div>
<div class="form-group row address-expand hidden">
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Town/Suburb <small>*</small></label>
<div class="col-sm-12">
<input type="text" class="form-control" name="m_address_suburb" id="m_address_suburb" value="" data-geo="locality">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Postcode <small>*</small></label>
<div class="col-sm-6">
<input type="text" class="form-control" name="m_address_pcode" id="m_address_pcode" value="" data-geo="postal_code" autocomplete="postal-code">
</div>
</div>
</div>
</div>
<div class="form-group row address-expand hidden">
<div class="col-md-6">
<div class="form-group addressstate_field">
<label class="col-sm-12 pt10 pb5">State*</label>
<div class="col-sm-12">
<!--<input class="form-control" type="text" name="m_address_state" id="m_address_state" value="" data-geo="administrative_area_level_1_short" />-->
<div class="btn-group bootstrap-select form-control ui-autocomplete-input"><button type="button" class="dropdown-toggle bs-placeholder form-control" data-toggle="dropdown" role="button" data-id="m_address_state"
title="Nothing selected"><span class="filter-option pull-left">Nothing selected</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" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text"></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">ACT</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">NSW</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">NT</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">QLD</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">SA</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">TAS</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">VIC</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">WA</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">Other</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
</ul>
</div><select class="form-control selectpicker ui-autocomplete-input" name="m_address_state" id="m_address_state" autocomplete="off" tabindex="-98">
<option value="" selected="selected"></option>
<option value="ACT">ACT</option>
<option value="NSW">NSW</option>
<option value="NT">NT</option>
<option value="QLD">QLD</option>
<option value="SA">SA</option>
<option value="TAS">TAS</option>
<option value="VIC">VIC</option>
<option value="WA">WA</option>
<option value="Other">Other</option>
</select>
</div>
</div>
</div>
</div>
<div class="col-md-6 countryinput_field">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Country*</label>
<div class="col-sm-12">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="m_address_country" title="United States"><span
class="filter-option pull-left">United States</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">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><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" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><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="m_address_country" id="m_address_country" class="form-control selectpicker" autocomplete="country" required="" 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>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="North Korea">North Korea</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine, State of">Palestine, State of</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Réunion">Réunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena">Saint Helena</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Saint-Martin (France)">Saint-Martin (France)</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch part)">Sint Maarten (Dutch part)</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Korea">South Korea</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="The Netherlands">The Netherlands</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States" selected="selected">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican">Vatican</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Vietnam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (U.S.)">Virgin Islands (U.S.)</option>
<option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
<option value="Åland Islands">Åland Islands</option>
</select>
</div>
</div>
</div>
</div>
</div>
</div>
</section>
<section class="section">
</section>
<!-- New -->
<!-- Age Validation for Parent Guardian section - ONLY VALID FOR NSW EVENTS -->
<!-- Added by Ben 06-02-2023 -->
<section class="section guardian_details hidden">
<div class="container">
<div class="row">
<h3 class="text-center">Parent / Guardian Details</h3>
<p class="ml30 mr30">Fundraisers under 15 require parent/guardian consent. Please provide this below, or call us on 1300 65 65 85 if you have any questions.</p>
<div class="col-md-12 mt10">
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12" for="">Parent / Guardian First Name * </label>
<div class="col-sm-12">
<input type="text" class="form-control col-sm-12" name="customfield[guardian_fname]" id="guardian_fname" value="">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12" for="">Parent / Guardian Last Name * </label>
<div class="col-sm-12">
<input type="text" class="form-control col-sm-12" name="customfield[guardian_lname]" id="guardian_lname" value="">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12" for="">Parent / Guardian Phone * </label>
<div class="col-sm-12">
<input type="text" class="form-control col-sm-12" name="customfield[guardian_phone]" id="guardian_phone" value="">
</div>
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<label class="col-sm-12" for="">Parent / Guardian Email * </label>
<div class="col-sm-12">
<input type="text" class="form-control col-sm-12" name="customfield[guardian_email]" id="guardian_email" value="">
</div>
</div>
</div>
</div>
</div>
</div>
</section>
<script>
$(function() {
$("#m_dob_y, #m_dob_m, #m_dob_d").change(function() {
var year = $("#m_dob_y").val();
var month = $("#m_dob_m").val()
var day = $("#m_dob_d").val();
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var dateString = year + '-' + month + '-' + day;
var date = new Date(dateString);
//Get current date
var currentDate = new Date();
//Get difference between user input and current date in milliseconds
var dateDiff = currentDate.getTime() - date.getTime();
//Convert milliseconds to year
var ageDate = new Date(dateDiff);
//Get the absolute value of below operation
var age = Math.abs(ageDate.getUTCFullYear() - 1970);
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return age >= 15;
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// Call the change function on page load
$("#m_dob_y").change();
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<!-- End New -->
<section class="section">
<div class="container">
<input type="hidden" name="form_key" value="7CC724">
<div class="lump-form form-horizontal" id="DIV71">
<div class="row">
<div class="col-md-12 ">
<h3 class="mb20" style="text-align: center;">Terms and Conditions</h3>
</div>
<div class="col-md-12 up-to-date-check hidden">
<div class="form-group">
<div class="col-sm-12">
<span class="checkbox-item"><input type="checkbox" class="option_789" name="option[789][]" value="Y" style="width:20px;">
<div class="display-inline-block pl5" style="width:calc(100% - 35px);vertical-align:middle;">
<p class="m0">Yes, keep me up-to-date with information from Cancer Council.</p>
</div>
</span>
</div>
</div>
</div>
<!--
<script>
$(document).ready(function(){
$( ".option_790" ).rules( "add", {
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<div class="form-group">
<div class="col-sm-12">
<span class="checkbox-item"><input type="checkbox" class="option_790" required="" name="option[790][]" value="Y" style="width:20px;">
<div class="display-inline-block pl5" style="width:calc(100% - 35px);vertical-align:middle;">
<p class="m0">Yes, I have read Cancer Council’s<span> </span><span style="text-decoration: underline;"><a href="/privacy-policy" target="_blank" rel="noopener noreferrer">privacy policy</a></span> and agree to the <span
style="text-decoration: underline;"><a href="/terms-and-conditions" target="_blank" rel="noopener noreferrer">Terms and Conditions</a></span>*</p>
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<div class="text-center">
<button type="submit" class="btn btn-primary btn-xl"><span>Next Step</span></button>
</div>
</form>Text Content
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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 PARENT / GUARDIAN DETAILS Fundraisers under 15 require parent/guardian consent. Please provide this below, or call us on 1300 65 65 85 if you have any questions. Parent / Guardian First Name * Parent / Guardian Last Name * Parent / Guardian Phone * Parent / Guardian Email * TERMS AND CONDITIONS Yes, keep me up-to-date with information from Cancer Council. Yes, I have read Cancer Council’s privacy policy and agree to the Terms and Conditions* Next Step * Register Now * About Cancer Council * Gallery * Recipes * Host resources * Your impact * Donate * Bank your funds -------------------------------------------------------------------------------- Cancer Council acknowledges the traditional custodians of the land on which we live and work. We pay our respects to the elders past and present and extend that respect to all other Aboriginal and Torres Strait Islander peoples. Cancer Council is registered with the Australian Taxation Office as an Income tax Exempt Charity. All donations over $2 are tax deductible. 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