orders.manwardpress.com
Open in
urlscan Pro
192.135.136.193
Public Scan
Submitted URL: https://pro.manwardpress.com/m/1809585?customerNumber=000037052743&campaignId=d5c744f2-0fee-4214-b48c-1dd55017b0ae&r=eml&expe...
Effective URL: https://orders.manwardpress.com/LASTCHANCE39MWLLT/EMWLX6CD/index.htm?pageNumber=2&customerNumber=000037052743&campaignId=d5c744f...
Submission: On April 11 via api from CH — Scanned from DE
Effective URL: https://orders.manwardpress.com/LASTCHANCE39MWLLT/EMWLX6CD/index.htm?pageNumber=2&customerNumber=000037052743&campaignId=d5c744f...
Submission: On April 11 via api from CH — Scanned from DE
Form analysis 2 forms found in the DOM
POST
<form method="post" class="form-horizontal constrained-width center-block">
<fieldset class="step">
<legend class="step__header">Step No. 1: Review Your Subscription</legend>
<script language="javascript">
Namespace('AGORA', {
pricingOptionMap: {},
shippingOptionMap: {},
setPricingOptionIdIfHidden: function(choiceId) {
if (choiceId in AGORA.pricingOptionMap) {
AGORA.setPricingOptionIdSelection(AGORA.pricingOptionMap[choiceId]);
if ($('#__billingEmailAddress__').val() != null && $('#__billingEmailAddress__').val().length != 0) {
AGORA.checkIfPasswordInputRequired();
}
} else {
AGORA.setPricingOptionIdSelection("");
}
AGORA.viewModel.displayAutoRenewPaymentSection();
},
setPricingOptionIdSelection: function(pricingOptionId) {
document.getElementById("__selectedOfferPricingOptionId__").value = pricingOptionId;
if (pricingOptionId != "") {
AGORA.viewModel.selectedOfferPricingOptionId(pricingOptionId);
if (pricingOptionId in AGORA.shippingOptionMap) {
AGORA.viewModel.selectedOfferShippingOptionId(AGORA.shippingOptionMap[pricingOptionId]);
}
}
},
registerPricingOptionId: function(choiceId, pricingOptionId) {
AGORA.pricingOptionMap[choiceId] = pricingOptionId;
},
registerShippingOptionId: function(pricingOptionId, shippingOptionId) {
AGORA.shippingOptionMap[pricingOptionId] = shippingOptionId;
}
});
</script>
<input name="formComponentsMap['offer'].choiceId" type="hidden" value="7849121">
<input id="__selectedOfferPricingOptionId__" name="formComponentsMap['offer'].pricingOptionId" type="hidden" value="7848165">
<div class="choice choice-single">
<label>
<div class="choice__box">
<header class="choice__title">
<h2 class="choice__name"> One-Year Subscription to <cite>Manward Letter</cite> for Just $39 ($79/year after)! </h2>
</header>
<div class="choice__copy">
<!--<p class="text-suppressed"><b>Billing Terms:</b> I agree to pay the price mentioned above for a one-year subscription to this service. I understand that each year, my card on file will be billed automatically at the low rate of just $79 for another year of service, to ensure that I never lose service. If I want to <a href="https://manwardpress.com/contact-us/" target="_blank">cancel my subscription</a> or remove the automatic renewal feature, I can contact the Support Team at any time by <a href="https://manwardpress.com/contact-us/" target="_blank">clicking here</a> or calling 800.682.5210 or 443.353.4263, Monday through Friday from 8 a.m. to 8 p.m. ET. I have read and accepted the <a href="https://manwardpress.com/terms-and-conditions/" target="_blank">Terms & Conditions</a> and <a href="https://manwardpress.com/privacy-policy/" target="_blank">Privacy Policy</a>, which explain how my charge will appear on my credit card statement.</p>-->
<p class="text-suppressed"><b>Refund Policy:</b> Your subscription to <cite>Manward Letter</cite> is completely risk-free for 90 days. If for any reason you decide over the next 90 days that <cite>Manward
Letter</cite> is not right for you, simply call us up. You’ll receive a full, prompt refund of your subscription fee. You can reach our Support Team at 800.682.5210 or 443.353.4263.</p>
<p class="text-suppressed">*Applicable sales tax applies. For more information, please visit <a href="https://manwardpress.com/sales-tax/" target="_blank">https://manwardpress.com/sales-tax/</a>.</p>
</div>
<p class="autorenewMessage">
<strong>The Term</strong> is <strong><span> 12 </span> <span>months</span></strong>.
</p>
<div class="premiumMessage">
<h3 class="premiumMessageTitle">You will also receive:</h3>
<p class="premiumMessageContent"> MWL No Kit/eLetters only </p>
</div>
<table class="priceOption">
<tbody>
<tr>
<td width="18" class="radioCell">
<script language="javascript">
$(function() {
AGORA.setPricingOptionIdSelection(7848165);
});
</script>
</td>
<td width="180">
<span class="label">Price:</span>
<span class="data"> USD $ 39.00 </span>
</td>
</tr>
</tbody>
</table>
<!-- Quantity box -->
<!-- End Quantity box -->
<!-- Shipping Options ----------------------------------------------------------------- -->
<!-- End Shipping Options ----------------------------------------------------------------- -->
</div>
</label>
</div>
</fieldset>
<input name="urlQueryString" id="urlQueryString" type="hidden"
value="pageNumber=2&customerNumber=000037052743&campaignId=d5c744f2-0fee-4214-b48c-1dd55017b0ae&r=eml&experimentId=eb9c777a-85dd-4c7b-8d53-c35c9b9f608f&vid=j_t8lZ&customerId=000037052743-000032200185&utm_campaign=mdded_day-26-last-chance&utm_source=blueshift&utm_medium=email&utm_content=mdded_day-26_mwl-last-chance">
<fieldset class="step">
<legend class="step__header">Step No. 2: Enter Your Name & Email</legend>
<div class="form-notes">
<p class="text-suppressed ta-center">Fields with (*) are mandatory.</p>
</div>
<div class="form-group">
<label class="control-label"> *First Name: </label>
<input name="formComponentsMap['order'].firstName" type="text" value="ALAN" maxlength="20" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> *Last Name: </label>
<input name="formComponentsMap['order'].lastName" type="text" value="KATZ" maxlength="30" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> *Email: </label>
<script type="text/javascript">
$(document).ready(function() {
$('#__billingEmailAddress__').blur(function() {
AGORA.checkIfPasswordInputRequired();
AGORA.checkIfLinkIsEnabled(false);
});
if ($('#__billingEmailAddress__').val()) {
AGORA.checkIfLinkIsEnabled(true);
}
});
Namespace('AGORA', {
getPricingOptionIds: function() {
var selectedOfferPricingOptionId = $('#__selectedOfferPricingOptionId__');
if (selectedOfferPricingOptionId) {
return [selectedOfferPricingOptionId.val()];
}
}
});
Namespace('AGORA', {
checkIfPasswordInputRequired: function() {
if ($('#__billingEmailAddress__').val().length == 0) {
AGORA.onAccountCheckResult(true);
} else {
var pricingOptionIds = AGORA.getPricingOptionIds();
if (pricingOptionIds && pricingOptionIds.length != 0) {
$.getJSON("/__ajax__/accountServices/hasAccountsForAllPricingOptions", {
emailAddress: $('#__billingEmailAddress__').val(),
pricingOptionIds: pricingOptionIds
}, AGORA.onAccountCheckResult);
}
}
},
onAccountCheckResult: function(hasAccountsForAllPricingOptions) {
if (hasAccountsForAllPricingOptions == true) {
$('#__passwordInputSection__').css('display', 'none');
$('#__wasPasswordFieldShown__').val('false');
} else {
$('#__passwordInputSection__').css('display', '');
$('#__wasPasswordFieldShown__').val('true');
}
},
checkIfLinkIsEnabled: function(highlight) {
var pricingOptionIds = AGORA.getPricingOptionIds();
$.ajax({
url: "/LASTCHANCE39MWLLT/EMWLX6CD/generateRetrieveSavedCreditCardsLink",
data: {
emailAddress: $('#__billingEmailAddress__').val(),
pricingOptionIds: pricingOptionIds
},
statusCode: {
400: function() {
$('#lightboxDiv').css('display', 'none');
},
401: function() {
$('#lightboxDiv').css('display', 'none');
},
403: function(event) {
$('#lightboxDiv').css('display', 'none');
AGORA.openLightbox(false);
}
},
success: function(generateRetrieveSavedCreditCardsLink) {
// Clean out creditCards to prevent dupes && flush out any option to prevent delay time between selection and acceptance:
AGORA.creditCards.length = 0;
$('#creditCardSelect option:gt(0)').remove();
var effortType = "OnePageEffort";
if (effortType != "MultiPageEffort") {
$('#creditCardSelect').css('display', 'none');
$('#creditCardElectronicPaymentIdHiddenField').css('display', 'none');
$('#lightboxDiv').css('display', 'block');
$("#popLinkErrorMessage").html('');
if (highlight) {
$('#theLightbox').css('color', 'red');
} else {
$('#theLightbox').css('color', '#428bca');
}
}
}
});
}
});
</script>
<input name="formComponentsMap['order'].emailAddress" type="email" value="ALK1@IX.NETCOM.COM" maxlength="254" id="__billingEmailAddress__" class="form-control" inputmode="email">
</div>
<div data-bind="" class="form-group">
<label class="control-label"> *Retype Email: </label>
<input name="formComponentsMap['order'].confirmEmailAddress" type="email" value="ALK1@IX.NETCOM.COM" maxlength="254" class="form-control" inputmode="email">
</div>
</fieldset>
<fieldset class="step">
<legend class="step__header">Step No. 3: Enter Your Billing Address</legend>
<div class="form-group">
<label class="control-label"> *Address 1: </label>
<input name="formComponentsMap['order'].addressLine1" type="text" value="19580 SAWGRASS CIR APT 2402" maxlength="34" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> Address 2: </label>
<input name="formComponentsMap['order'].addressLine2" type="text" value="" maxlength="34" class="form-control">
</div>
<!-- -->
<div class="form-group">
<label class="control-label"> *City: </label>
<input name="formComponentsMap['order'].city" type="text" value="BOCA RATON" maxlength="35" class="form-control">
</div>
<div id="__stateInputSection__" class="form-group"> <label class="control-label" id="thstate">
<span id="stateRequiredIndicator" style="display: inline;">*</span>State: </label>
<input id="whichStateInput" name="formComponentsMap['order'].whichStateInput" type="hidden" value="dropDown" class="form-control">
<span id="stateSelect" data-bind=""><select name="formComponentsMap['order'].stateId" onchange="AGORA.__onStateChange__($(this).find('option:selected').text());" class="form-control input-sm">
<option value="">Select A State</option>undefined<option value="1">AA - ARMED FORCES</option>
<option value="4">AE - ARMED FORCES</option>
<option value="5">AK - ALASKA</option>
<option value="6">AL - ALABAMA</option>
<option value="7">AP - APO/FPO</option>
<option value="8">AR - ARKANSAS</option>
<option value="9">AS - AMERICAN SAMOA</option>
<option value="10">AZ - ARIZONA</option>
<option value="12">CA - CALIFORNIA</option>
<option value="13">CM - N MARIANA IS.</option>
<option value="14">CO - COLORADO</option>
<option value="15">CT - CONNECTICUT</option>
<option value="17">DC - WASHINGTON D C</option>
<option value="18">DE - DELAWARE</option>
<option value="19" selected="selected">FL - FLORIDA</option>
<option value="20">GA - GEORGIA</option>
<option value="21">GU - GUAM</option>
<option value="22">HI - HAWAII</option>
<option value="24">IA - IOWA</option>
<option value="25">ID - IDAHO</option>
<option value="26">IL - ILLINOIS</option>
<option value="27">IN - INDIANA</option>
<option value="28">KS - KANSAS</option>
<option value="29">KY - KENTUCKY</option>
<option value="30">LA - LOUISIANA</option>
<option value="31">MA - MASSACHUSETTS</option>
<option value="33">MD - MARYLAND</option>
<option value="34">ME - MAINE</option>
<option value="35">MI - MICHIGAN</option>
<option value="36">MN - MINNESOTA</option>
<option value="37">MO - MISSOURI</option>
<option value="39">MP - SAIPAN</option>
<option value="40">MS - MISSISSIPPI</option>
<option value="41">MT - MONTANA</option>
<option value="43">NC - NORTH CAROLINA</option>
<option value="44">ND - NORTH DAKOTA</option>
<option value="45">NE - NEBRASKA</option>
<option value="46">NH - NEW HAMPSHIRE</option>
<option value="47">NJ - NEW JERSEY</option>
<option value="49">NM - NEW MEXICO</option>
<option value="55">NV - NEVADA</option>
<option value="56">NY - NEW YORK</option>
<option value="57">OH - OHIO</option>
<option value="58">OK - OKLAHOMA</option>
<option value="60">OR - OREGON</option>
<option value="61">PA - PENNSYLVANIA</option>
<option value="64">PR - PUERTO RICO</option>
<option value="65">PW - PALAU</option>
<option value="68">RI - RHODE ISLAND</option>
<option value="70">SC - SOUTH CAROLINA</option>
<option value="71">SD - SOUTH DAKOTA</option>
<option value="74">TN - TENNESSEE</option>
<option value="75">TX - TEXAS</option>
<option value="76">UT - UTAH</option>
<option value="77">VA - VIRGINIA</option>
<option value="78">VI - VIRGIN ISLANDS</option>
<option value="80">VT - VERMONT</option>
<option value="82">WA - WASHINGTON</option>
<option value="83">WI - WISCONSIN</option>
<option value="84">WV - WEST VIRGINIA</option>
<option value="85">WY - WYOMING</option>
</select></span>
<input type="text" data-bind="value:AGORA.viewModel.billingStateName, visible: false " class="form-control" style="display: none;">
</div>
<div class="form-group">
<label class="control-label" id="thzipcode">
<span id="postalCodeRequiredIndicator" style="display: inline;">*</span>ZIP/Postal Code: </label>
<input id="__billToZipCode" name="formComponentsMap['order'].postalCode" type="text" value="334343386" maxlength="9" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> *Country: </label>
<script type="text/javascript">
//<![CDATA[
Namespace('AGORA', {
__onCountryChange__: function(countryId, countryName) {
var stateSelect = '';
var whichStateInput = '';
var stateOptionsArray = new Array();
var postalCodeRequiredMap = new Object();
if (countryId != null) {
//gather country iso2 code:
$.ajax({
url: "/LASTCHANCE39MWLLT/EMWLX6CD/getCountryISO2Code",
data: {
countryId: countryId
},
success: function(data) {
AGORA.viewModel.iso2CountryCode(data);
console.log("Country Code is now: " + AGORA.viewModel.iso2CountryCode() + "\nLocale is now: en-" + AGORA.viewModel.iso2CountryCode());
if (window._modoModal) {
window._modoModal.updateModal({
locale: "en-" + data
});
}
},
async: false // Need to make this ajax call synchronous otherwise we will require callbacks!
});
}
AGORA.viewModel.billingCountryId(countryId);
AGORA.viewModel.billingCountryName(countryName);
var stateRequiredIndicator = document.getElementById('stateRequiredIndicator');
var stateInputSection = $('#__stateInputSection__');
var postcodeEverywhereSpan = document.getElementById('__billToPostcodeEverywhereSpan__');
postalCodeRequiredMap["1"] = true;
postalCodeRequiredMap["14"] = true;
postalCodeRequiredMap["38"] = true;
postalCodeRequiredMap["74"] = true;
postalCodeRequiredMap["83"] = true;
postalCodeRequiredMap["99"] = true;
postalCodeRequiredMap["104"] = true;
postalCodeRequiredMap["195"] = true;
postalCodeRequiredMap["82"] = true;
if (postcodeEverywhereSpan && countryId == 82) {
postcodeEverywhereSpan.style.display = 'inline';
} else if (postcodeEverywhereSpan) {
postcodeEverywhereSpan.style.display = 'none';
}
AGORA.__onStateChange__();
stateOptionsArray[1] += '<option value="1" >AA - ARMED FORCES</option>';
stateOptionsArray[38] += '<option value="2" >AB - ALBERTA</option>';
stateOptionsArray[10] += '<option value="124" >ABA - BUENOS AIRES</option>';
stateOptionsArray[30] += '<option value="148" >AC - Acre</option>';
stateOptionsArray[10] += '<option value="125" >ACA - CATAMARCA</option>';
stateOptionsArray[10] += '<option value="126" >ACB - CORDOBA</option>';
stateOptionsArray[10] += '<option value="127" >ACF - CIUDAD AUTO BA</option>';
stateOptionsArray[10] += '<option value="128" >ACH - CHACO</option>';
stateOptionsArray[10] += '<option value="129" >ACR - CORRIENTES</option>';
stateOptionsArray[10] += '<option value="130" >ACT - CHUBUT</option>';
stateOptionsArray[14] += '<option value="3" >ACT - AUS CAPITAL TER</option>';
stateOptionsArray[1] += '<option value="4" >AE - ARMED FORCES</option>';
stateOptionsArray[10] += '<option value="131" >AER - ENTRE RIOS</option>';
stateOptionsArray[10] += '<option value="132" >AFO - FORMOSA</option>';
stateOptionsArray[10] += '<option value="133" >AJY - JUJUY</option>';
stateOptionsArray[1] += '<option value="5" >AK - ALASKA</option>';
stateOptionsArray[1] += '<option value="6" >AL - ALABAMA</option>';
stateOptionsArray[30] += '<option value="149" >AL - Alagoas</option>';
stateOptionsArray[10] += '<option value="134" >ALP - LA PAMPA</option>';
stateOptionsArray[10] += '<option value="135" >ALR - LA RIOJA</option>';
stateOptionsArray[30] += '<option value="150" >AM - Amazonas</option>';
stateOptionsArray[10] += '<option value="136" >AMI - MISIONES</option>';
stateOptionsArray[10] += '<option value="137" >AMZ - MENDOZA</option>';
stateOptionsArray[99] += '<option value="87" >ANDAMAN AND NICOBAR ISLANDS</option>';
stateOptionsArray[10] += '<option value="138" >ANQ - NEUQUEN</option>';
stateOptionsArray[30] += '<option value="151" >AP - Amapá</option>';
stateOptionsArray[99] += '<option value="88" >ANDHRA PRADESH</option>';
stateOptionsArray[1] += '<option value="7" >AP - APO/FPO</option>';
stateOptionsArray[1] += '<option value="8" >AR - ARKANSAS</option>';
stateOptionsArray[99] += '<option value="89" >ARUNACHAL PRADESH</option>';
stateOptionsArray[10] += '<option value="139" >ARN - RÍO NEGRO</option>';
stateOptionsArray[99] += '<option value="90" >ASSAM</option>';
stateOptionsArray[1] += '<option value="9" >AS - AMERICAN SAMOA</option>';
stateOptionsArray[10] += '<option value="140" >ASA - SALTA</option>';
stateOptionsArray[10] += '<option value="141" >ASC - SANTA CRUZ</option>';
stateOptionsArray[10] += '<option value="142" >ASE - SANT DEL ESTERO</option>';
stateOptionsArray[10] += '<option value="143" >ASF - SANTA FE</option>';
stateOptionsArray[10] += '<option value="144" >ASJ - SAN JUAN</option>';
stateOptionsArray[10] += '<option value="145" >ASL - SAN LUIS</option>';
stateOptionsArray[10] += '<option value="146" >ATF - TIERRA DEL FUEG</option>';
stateOptionsArray[10] += '<option value="147" >ATU - TUCUMAN</option>';
stateOptionsArray[1] += '<option value="10" >AZ - ARIZONA</option>';
stateOptionsArray[30] += '<option value="152" >BA - Bahia</option>';
stateOptionsArray[38] += '<option value="11" >BC - BRIT. COLUMBIA</option>';
stateOptionsArray[99] += '<option value="91" >BIHAR</option>';
stateOptionsArray[1] += '<option value="12" >CA - CALIFORNIA</option>';
stateOptionsArray[30] += '<option value="153" >CE - Ceará</option>';
stateOptionsArray[99] += '<option value="92" >CHHATTISGARH</option>';
stateOptionsArray[99] += '<option value="93" >CHANDIGARH</option>';
stateOptionsArray[1] += '<option value="13" >CM - N MARIANA IS.</option>';
stateOptionsArray[1] += '<option value="14" >CO - COLORADO</option>';
stateOptionsArray[1] += '<option value="15" >CT - CONNECTICUT</option>';
stateOptionsArray[1] += '<option value="17" >DC - WASHINGTON D C</option>';
stateOptionsArray[99] += '<option value="94" >DAMAN AND DIU</option>';
stateOptionsArray[1] += '<option value="18" >DE - DELAWARE</option>';
stateOptionsArray[30] += '<option value="154" >DF - Distrito Federal</option>';
stateOptionsArray[99] += '<option value="95" >NEW DELHI</option>';
stateOptionsArray[99] += '<option value="96" >DADRA AND NAGAR HAVELI</option>';
stateOptionsArray[30] += '<option value="155" >ES - Espírito Santo</option>';
AGORA.__onStateChange__('FL - FLORIDA');
stateOptionsArray[1] += '<option value="19" selected="selected" >FL - FLORIDA</option>';
stateOptionsArray[1] += '<option value="20" >GA - GEORGIA</option>';
stateOptionsArray[99] += '<option value="97" >GOA</option>';
stateOptionsArray[99] += '<option value="98" >GUJARAT</option>';
stateOptionsArray[30] += '<option value="156" >GO - Goiás</option>';
stateOptionsArray[1] += '<option value="21" >GU - GUAM</option>';
stateOptionsArray[1] += '<option value="22" >HI - HAWAII</option>';
stateOptionsArray[99] += '<option value="99" >HIMACHAL PRADESH</option>';
stateOptionsArray[99] += '<option value="100" >HARYANA</option>';
stateOptionsArray[1] += '<option value="24" >IA - IOWA</option>';
stateOptionsArray[1] += '<option value="25" >ID - IDAHO</option>';
stateOptionsArray[1] += '<option value="26" >IL - ILLINOIS</option>';
stateOptionsArray[1] += '<option value="27" >IN - INDIANA</option>';
stateOptionsArray[99] += '<option value="101" >JHARKHAND</option>';
stateOptionsArray[99] += '<option value="102" >JAMMU AND KASHMIR</option>';
stateOptionsArray[99] += '<option value="103" >KARNATAKA</option>';
stateOptionsArray[99] += '<option value="104" >KERALA</option>';
stateOptionsArray[1] += '<option value="28" >KS - KANSAS</option>';
stateOptionsArray[1] += '<option value="29" >KY - KENTUCKY</option>';
stateOptionsArray[1] += '<option value="30" >LA - LOUISIANA</option>';
stateOptionsArray[99] += '<option value="105" >LAKSHADWEEP</option>';
stateOptionsArray[30] += '<option value="157" >MA - Maranhão</option>';
stateOptionsArray[1] += '<option value="31" >MA - MASSACHUSETTS</option>';
stateOptionsArray[38] += '<option value="32" >MB - MANITOBA</option>';
stateOptionsArray[1] += '<option value="33" >MD - MARYLAND</option>';
stateOptionsArray[1] += '<option value="34" >ME - MAINE</option>';
stateOptionsArray[30] += '<option value="158" >MG - Minas Gerais</option>';
stateOptionsArray[99] += '<option value="106" >MAHARASHTRA</option>';
stateOptionsArray[1] += '<option value="35" >MI - MICHIGAN</option>';
stateOptionsArray[99] += '<option value="107" >MEGHALAYA</option>';
stateOptionsArray[99] += '<option value="108" >MANIPUR</option>';
stateOptionsArray[1] += '<option value="36" >MN - MINNESOTA</option>';
stateOptionsArray[1] += '<option value="37" >MO - MISSOURI</option>';
stateOptionsArray[38] += '<option value="38" >MP - NORTHERN MARIAN</option>';
stateOptionsArray[1] += '<option value="39" >MP - SAIPAN</option>';
stateOptionsArray[99] += '<option value="109" >MADHYA PRADESH</option>';
stateOptionsArray[30] += '<option value="159" >MS - Mato Grosso do Sul</option>';
stateOptionsArray[1] += '<option value="40" >MS - MISSISSIPPI</option>';
stateOptionsArray[1] += '<option value="41" >MT - MONTANA</option>';
stateOptionsArray[30] += '<option value="160" >MT - Mato Grosso</option>';
stateOptionsArray[99] += '<option value="110" >MIZORAM</option>';
stateOptionsArray[38] += '<option value="42" >NB - NEW BRUNSWICK</option>';
stateOptionsArray[1] += '<option value="43" >NC - NORTH CAROLINA</option>';
stateOptionsArray[1] += '<option value="44" >ND - NORTH DAKOTA</option>';
stateOptionsArray[1] += '<option value="45" >NE - NEBRASKA</option>';
stateOptionsArray[1] += '<option value="46" >NH - NEW HAMPSHIRE</option>';
stateOptionsArray[1] += '<option value="47" >NJ - NEW JERSEY</option>';
stateOptionsArray[38] += '<option value="48" >NL - NEWFOUNDLAND</option>';
stateOptionsArray[99] += '<option value="112" >NAGALAND</option>';
stateOptionsArray[1] += '<option value="49" >NM - NEW MEXICO</option>';
stateOptionsArray[38] += '<option value="50" >NS - NOVA SCOTIA</option>';
stateOptionsArray[14] += '<option value="51" >NSW - NEW SOUTH WALES</option>';
stateOptionsArray[14] += '<option value="52" >NT - NORTHERN TERR</option>';
stateOptionsArray[38] += '<option value="53" >NT - N.W. TERRITORY</option>';
stateOptionsArray[38] += '<option value="54" >NU - NUNAVUT TERR.</option>';
stateOptionsArray[1] += '<option value="55" >NV - NEVADA</option>';
stateOptionsArray[1] += '<option value="56" >NY - NEW YORK</option>';
stateOptionsArray[1] += '<option value="57" >OH - OHIO</option>';
stateOptionsArray[1] += '<option value="58" >OK - OKLAHOMA</option>';
stateOptionsArray[38] += '<option value="59" >ON - ONTARIO</option>';
stateOptionsArray[1] += '<option value="60" >OR - OREGON</option>';
stateOptionsArray[99] += '<option value="113" >ORISSA</option>';
stateOptionsArray[30] += '<option value="161" >PA - Pará</option>';
stateOptionsArray[1] += '<option value="61" >PA - PENNSYLVANIA</option>';
stateOptionsArray[30] += '<option value="162" >PB - Paraíba</option>';
stateOptionsArray[99] += '<option value="114" >PUNJAB</option>';
stateOptionsArray[30] += '<option value="163" >PE - Pernambuco</option>';
stateOptionsArray[38] += '<option value="62" >PE - PR. EDWARD IS.</option>';
stateOptionsArray[30] += '<option value="164" >PI - Piauí</option>';
stateOptionsArray[38] += '<option value="63" >PQ - QUEBEC</option>';
stateOptionsArray[1] += '<option value="64" >PR - PUERTO RICO</option>';
stateOptionsArray[30] += '<option value="165" >PR - Paraná</option>';
stateOptionsArray[1] += '<option value="65" >PW - PALAU</option>';
stateOptionsArray[99] += '<option value="115" >PUDUCHERRY</option>';
stateOptionsArray[38] += '<option value="66" >QC - QUEBEC</option>';
stateOptionsArray[14] += '<option value="67" >QLD - QUEENSLAND</option>';
stateOptionsArray[1] += '<option value="68" >RI - RHODE ISLAND</option>';
stateOptionsArray[99] += '<option value="116" >RAJASTHAN</option>';
stateOptionsArray[30] += '<option value="166" >RJ - Rio de Janeiro</option>';
stateOptionsArray[30] += '<option value="167" >RN - Rio Grande do Norte</option>';
stateOptionsArray[30] += '<option value="168" >RO - Rondônia</option>';
stateOptionsArray[30] += '<option value="169" >RR - Roraima</option>';
stateOptionsArray[30] += '<option value="170" >RS - Rio Grande do Sul</option>';
stateOptionsArray[14] += '<option value="69" >SA - SOUTH AUSTRALIA</option>';
stateOptionsArray[1] += '<option value="70" >SC - SOUTH CAROLINA</option>';
stateOptionsArray[30] += '<option value="171" >SC - Santa Catarina</option>';
stateOptionsArray[1] += '<option value="71" >SD - SOUTH DAKOTA</option>';
stateOptionsArray[30] += '<option value="172" >SE - Sergipe</option>';
stateOptionsArray[99] += '<option value="117" >SIKKIM</option>';
stateOptionsArray[38] += '<option value="72" >SK - SASKATCHEWAN</option>';
stateOptionsArray[30] += '<option value="173" >SP - São Paulo</option>';
stateOptionsArray[14] += '<option value="73" >TAS - TASMANIA</option>';
stateOptionsArray[99] += '<option value="123" >TELANGANA</option>';
stateOptionsArray[1] += '<option value="74" >TN - TENNESSEE</option>';
stateOptionsArray[99] += '<option value="118" >TAMIL NADU</option>';
stateOptionsArray[30] += '<option value="174" >TO - Tocantins</option>';
stateOptionsArray[99] += '<option value="119" >TRIPURA</option>';
stateOptionsArray[1] += '<option value="75" >TX - TEXAS</option>';
stateOptionsArray[99] += '<option value="120" >UTTARAKHAND</option>';
stateOptionsArray[99] += '<option value="121" >UTTAR PRADESH</option>';
stateOptionsArray[1] += '<option value="76" >UT - UTAH</option>';
stateOptionsArray[1] += '<option value="77" >VA - VIRGINIA</option>';
stateOptionsArray[1] += '<option value="78" >VI - VIRGIN ISLANDS</option>';
stateOptionsArray[14] += '<option value="79" >VIC - VICTORIA</option>';
stateOptionsArray[1] += '<option value="80" >VT - VERMONT</option>';
stateOptionsArray[14] += '<option value="81" >WA - WESTERN AUS</option>';
stateOptionsArray[1] += '<option value="82" >WA - WASHINGTON</option>';
stateOptionsArray[99] += '<option value="122" >WEST BENGAL</option>';
stateOptionsArray[1] += '<option value="83" >WI - WISCONSIN</option>';
stateOptionsArray[1] += '<option value="84" >WV - WEST VIRGINIA</option>';
stateOptionsArray[1] += '<option value="85" >WY - WYOMING</option>';
stateOptionsArray[38] += '<option value="86" >YT - YUKON TERR.</option>';
stateOptionsArray[254] = 'UNSUPPORTED';
stateOptionsArray[242] = 'UNSUPPORTED';
stateOptionsArray[253] = 'UNSUPPORTED';
stateOptionsArray[241] = 'UNSUPPORTED';
stateOptionsArray[240] = 'UNSUPPORTED';
stateOptionsArray[244] = 'UNSUPPORTED';
stateOptionsArray[246] = 'UNSUPPORTED';
stateOptionsArray[249] = 'UNSUPPORTED';
stateOptionsArray[247] = 'UNSUPPORTED';
stateOptionsArray[245] = 'UNSUPPORTED';
stateOptionsArray[248] = 'UNSUPPORTED';
stateOptionsArray[250] = 'UNSUPPORTED';
stateOptionsArray[82] = 'UNSUPPORTED';
stateOptionsArray[251] = 'UNSUPPORTED';
stateOptionsArray[252] = 'UNSUPPORTED';
stateOptionsArray[243] = 'UNSUPPORTED';
if (stateOptionsArray[countryId] != undefined && stateOptionsArray[countryId] != 'UNSUPPORTED') {
stateSelect = '<select name="formComponentsMap[\'order\'].stateId" onchange="AGORA.__onStateChange__($(this).find(\'option:selected\').text());" class="form-control input-sm" >' + '<option value="">Select A State</option>' +
stateOptionsArray[countryId] + '</select>';
whichStateInput = 'dropDown';
if (stateRequiredIndicator) stateRequiredIndicator.style.display = 'inline';
stateInputSection.css('display', '');
} else {
AGORA.__onStateChange__('');
stateSelect = '<input name="formComponentsMap[\'order\'].stateName" type="text" value="" data-bind="" onchange="AGORA.__onStateChange__($(this).val());" class="form-control"/>';
whichStateInput = 'textBox';
if (stateRequiredIndicator) stateRequiredIndicator.style.display = 'none';
if (stateOptionsArray[countryId] == 'UNSUPPORTED' && stateInputSection.size() > 0) {
stateInputSection.css('display', 'none');
} else {
stateInputSection.css('display', '');
}
}
var postalCodeRequiredIndicator = document.getElementById('postalCodeRequiredIndicator');
if (postalCodeRequiredMap[countryId] && postalCodeRequiredIndicator) {
postalCodeRequiredIndicator.style.display = 'inline';
} else if (postalCodeRequiredIndicator) {
postalCodeRequiredIndicator.style.display = 'none';
}
if (document.getElementById('stateSelect') != null) {
document.getElementById('stateSelect').innerHTML = stateSelect;
document.getElementById('whichStateInput').value = whichStateInput;
}
if (whichStateInput == 'textBox' && false) {
$('#__stateInputSection__').css('display', 'none');
} else {
$('#__stateInputSection__').css('display', '');
}
// Argentina:
if (document.getElementById('argentinaTaxFieldsBlock') != null) {
if (countryId && countryId != "10") {
document.getElementById('argentinaTaxFieldsBlock').style.display = 'none';
} else {
document.getElementById('argentinaTaxFieldsBlock').style.display = 'block';
}
}
// TaxFields:
var countryIds = ["43", "47", "134", "170", "60"];
if (document.getElementById('taxIdLabel') != null) {
var useTaxIdFields = false;
for (var i = 0; i < countryIds.length; i++) {
if (countryIds[i] == countryId) {
useTaxIdFields = true;
var label = '';
if (countryIds[i] == "43") {
label = "*CI/RUT";
} else if (countryIds[i] == "47") {
label = "*CC";
} else if (countryIds[i] == "134") {
label = "*CURP";
} else if (countryIds[i] == "170") {
label = "*DNI";
} else if (countryIds[i] == "60") {
label = "*CI";
} else {
label = "Tax Id";
}
}
}
if (useTaxIdFields == true) {
document.getElementById('taxIdLabelHidden').value = label;
if (document.getElementById("taxIdLabel") != null) {
var taxIdL = document.getElementById("taxIdLabel");
taxIdL.innerHTML = label;
}
} else if (document.getElementById("taxIdLabel") != null && useTaxIdFields == false) {
var taxIdL = document.getElementById("taxIdLabel");
taxIdL.innerHTML = "Tax Id";
}
}
// Country Tax Id (Brazil/Argentina):
// EU-VAT:
checkIfCountryRequiresEuVat(countryId, "billing");
},
__onStateChange__: function(stateName) {
AGORA.viewModel.billingStateName(stateName);
}
});
//]]>
</script>
<select id="__billingCountrySelect__" name="formComponentsMap['order'].countryId" data-bind="" onchange="AGORA.__onCountryChange__($(this).val(), $(this).find('option:selected').text());" class="form-control input-sm">
<option value="1" selected="selected">UNITED STATES</option>
<option value="3">AFGHANISTAN</option>
<option value="4">ALBANIA</option>
<option value="5">ALGERIA</option>
<option value="6">ANDORRA</option>
<option value="7">ANGOLA</option>
<option value="9">ANGUILLA</option>
<option value="8">ANTARCTICA</option>
<option value="2">ANTIGUA AND BARBUDA</option>
<option value="10">ARGENTINA</option>
<option value="11">ARMENIA</option>
<option value="12">ARUBA</option>
<option value="14">AUSTRALIA</option>
<option value="13">AUSTRIA</option>
<option value="16">AZERBAIDJAN</option>
<option value="24">BAHAMAS</option>
<option value="17">BAHRAIN</option>
<option value="18">BANGLADESH</option>
<option value="19">BARBADOS</option>
<option value="20">BELARUS</option>
<option value="25">BELGIUM</option>
<option value="26">BELIZE</option>
<option value="21">BENIN</option>
<option value="22">BERMUDA</option>
<option value="35">BHUTAN</option>
<option value="27">BOLIVIA</option>
<option value="254">BONAIRE,ST EUST,SABA</option>
<option value="28">BOSNIA-HERZEGOVINA</option>
<option value="29">BOTSWANA</option>
<option value="30">BRAZIL</option>
<option value="100">BRITISH INDIAN OCEAN</option>
<option value="32">BRUNEI DARUSSALAM</option>
<option value="33">BULGARIA</option>
<option value="23">BURKINA FASO</option>
<option value="31">BURUNDI</option>
<option value="36">CAMBODIA</option>
<option value="37">CAMEROON</option>
<option value="38">CANADA</option>
<option value="40">CAPE VERDE</option>
<option value="41">CAYMAN ISLANDS</option>
<option value="39">CENTRAL AFRICAN REPU</option>
<option value="42">CHAD</option>
<option value="43">CHILE</option>
<option value="46">CHINA</option>
<option value="242">CHRISTMAS ISLAND</option>
<option value="253">COCOS (KEELING) ISLA</option>
<option value="47">COLOMBIA</option>
<option value="48">COMOROS</option>
<option value="49">CONGO</option>
<option value="45">COOK ISLANDS</option>
<option value="50">COSTA RICA</option>
<option value="51">CROATIA</option>
<option value="52">CUBA</option>
<option value="241">CURACAO</option>
<option value="53">CYPRUS</option>
<option value="54">CZECH REPUBLIC</option>
<option value="55">DENMARK</option>
<option value="56">DJIBOUTI</option>
<option value="57">DOMINICA</option>
<option value="58">DOMINICAN REPUBLIC</option>
<option value="67">EAST TIMOR</option>
<option value="60">ECUADOR</option>
<option value="62">EGYPT</option>
<option value="63">EL SALVADOR</option>
<option value="61">EQUATIORIAL GUINEA</option>
<option value="64">ERITREA</option>
<option value="65">ESTONIA</option>
<option value="66">ETHIOPIA</option>
<option value="68">FAEROE ISLANDS</option>
<option value="69">FALKLAND ISLANDS</option>
<option value="75">FED STATE MICRONESIA</option>
<option value="71">FIJI</option>
<option value="72">FINLAND</option>
<option value="74">FRANCE</option>
<option value="70">FRENCH GUIANA</option>
<option value="73">FRENCH POLYNESIA</option>
<option value="240">FRENCH SOUTHERN TERR</option>
<option value="77">GABON</option>
<option value="79">GAMBIA</option>
<option value="84">GEORGIA, REPUBLIC OF</option>
<option value="83">GERMANY</option>
<option value="85">GHANA</option>
<option value="86">GIBRALTAR</option>
<option value="88">GREECE</option>
<option value="89">GREENLAND</option>
<option value="87">GRENADA</option>
<option value="78">GUADELOUPE</option>
<option value="90">GUATEMALA</option>
<option value="91">GUINEA</option>
<option value="81">GUINEA BISSAU</option>
<option value="92">GUYANA</option>
<option value="93">HAITI</option>
<option value="244">HEARD AND MC DONALD</option>
<option value="95">HONDURAS</option>
<option value="94">HONG KONG</option>
<option value="96">HUNGARY</option>
<option value="97">ICELAND</option>
<option value="99">INDIA</option>
<option value="98">INDONESIA</option>
<option value="101">IRAN</option>
<option value="103">IRAQ</option>
<option value="102">IRELAND</option>
<option value="104">ISRAEL</option>
<option value="105">ITALY</option>
<option value="106">IVORY COAST</option>
<option value="107">JAMAICA</option>
<option value="108">JAPAN</option>
<option value="109">JORDAN</option>
<option value="110">KAZAKHSTAN</option>
<option value="111">KENYA</option>
<option value="112">KIRIBATI</option>
<option value="113">KOREA</option>
<option value="161">KOREA DEMOCRATIC PE</option>
<option value="114">KUWAIT</option>
<option value="115">KYRGYZSTAN</option>
<option value="116">LAO PEOPLES DEM REP</option>
<option value="117">LATVIA</option>
<option value="119">LEBANON</option>
<option value="122">LESOTHO</option>
<option value="123">LIBERIA</option>
<option value="118">LIBYA(N ARAB JAMAHI)</option>
<option value="124">LIECHTENSTEIN</option>
<option value="125">LITHUANIA</option>
<option value="126">LUXEMBOURG</option>
<option value="127">MACAO</option>
<option value="133">MACEDONIA</option>
<option value="128">MADAGASCAR</option>
<option value="129">MALAWI</option>
<option value="142">MALAYSIA</option>
<option value="140">MALDIVES</option>
<option value="139">MALI</option>
<option value="141">MALTA</option>
<option value="137">MARSHALL ISLANDS</option>
<option value="130">MARTINIQUE</option>
<option value="131">MAURITANIA</option>
<option value="147">MAURITIUS</option>
<option value="132">MAYOTTE</option>
<option value="134">MEXICO</option>
<option value="138">MOLDOVA</option>
<option value="143">MONACO</option>
<option value="135">MONGOLIA</option>
<option value="145">MONTSERRAT</option>
<option value="144">MOROCCO</option>
<option value="146">MOZAMBIQUE</option>
<option value="148">MYANMAR</option>
<option value="149">NAMIBIA</option>
<option value="151">NAURU</option>
<option value="153">NEPAL</option>
<option value="150">NETHERLAND ANTILLES</option>
<option value="154">NETHERLANDS</option>
<option value="152">NEW CALEDONIA</option>
<option value="164">NEW ZEALAND</option>
<option value="158">NICARAGUA</option>
<option value="155">NIGER</option>
<option value="159">NIGERIA</option>
<option value="160">NIUE</option>
<option value="246">NORFOLK ISLAND</option>
<option value="162">NORTHERN MARIANA ISL</option>
<option value="163">NORWAY</option>
<option value="165">OMAN</option>
<option value="166">PAKISTAN</option>
<option value="167">PALAU</option>
<option value="168">PANAMA</option>
<option value="156">PAPUA NEW GUINEA</option>
<option value="169">PARAGUAY</option>
<option value="170">PERU</option>
<option value="171">PHILIPPINES</option>
<option value="172">PITCAIRN ISLANDS</option>
<option value="173">POLAND</option>
<option value="174">PORTUGAL</option>
<option value="175">QATAR</option>
<option value="176">REUNION</option>
<option value="178">ROMANIA</option>
<option value="225">RUSSIAN FEDERATION</option>
<option value="179">RWANDA</option>
<option value="198">SAINT HELENA</option>
<option value="188">SAINT KITTS AND NEVI</option>
<option value="191">SAINT LUCIA</option>
<option value="202">SAINT VINCENT AND GR</option>
<option value="181">SAMOA</option>
<option value="193">SAN MARINO</option>
<option value="197">SAO TOME & PRINCIPE</option>
<option value="182">SAUDI ARABIA</option>
<option value="183">SENEGAL</option>
<option value="236">SERBIA & MONTENEGRO</option>
<option value="185">SEYCHELLES</option>
<option value="186">SIERRA LEONE</option>
<option value="187">SINGAPORE</option>
<option value="249">SINT MAARTEN</option>
<option value="190">SLOVAKIA</option>
<option value="192">SLOVENIA</option>
<option value="189">SOLOMON ISLANDS</option>
<option value="194">SOMALIA</option>
<option value="180">SOUTH AFRICA</option>
<option value="247">SOUTH GEORGIA & THE S. SANDWICH ISL.</option>
<option value="177">SOUTH KOREA</option>
<option value="195">SPAIN</option>
<option value="196">SRI LANKA</option>
<option value="245">ST. MARTIN</option>
<option value="199">ST. PIERRE &MIQUELON</option>
<option value="200">SUDAN</option>
<option value="201">SURINAME</option>
<option value="248">SVALBARD AND JAN MAY</option>
<option value="206">SWAZILAND</option>
<option value="204">SWEDEN</option>
<option value="205">SWITZERLAND</option>
<option value="207">SYRIA</option>
<option value="208">TAIWAN</option>
<option value="209">TAJIKISTAN</option>
<option value="210">TANZANIA</option>
<option value="212">THAILAND</option>
<option value="215">TOGO</option>
<option value="250">TOKELAU</option>
<option value="214">TONGA</option>
<option value="217">TRINIDAD AND TOBAGO</option>
<option value="218">TUNISIA</option>
<option value="219">TURKEY</option>
<option value="213">TURKMENISTAN</option>
<option value="211">TURKS AND CAICOS</option>
<option value="220">TUVALU</option>
<option value="222">UGANDA</option>
<option value="223">UKRAINE</option>
<option value="221">UNITED ARAB EMIRATES</option>
<option value="82">UNITED KINGDOM</option>
<option value="251">UNITED STATES MINOR</option>
<option value="224">URUGUAY</option>
<option value="226">UZBEKISTAN</option>
<option value="227">VANUATU</option>
<option value="228">VATICAN CITY STATE</option>
<option value="229">VENEZUELA</option>
<option value="230">VIETNAM</option>
<option value="231">VIRGIN IS, BRIT</option>
<option value="252">WALLIS AND FUTUNA IS</option>
<option value="243">WESTERN SAHARA</option>
<option value="235">YEMEN</option>
<option value="237">ZAIRE</option>
<option value="238">ZAMBIA</option>
<option value="239">ZIMBABWE</option>
</select>
<input type="text" data-bind="value:AGORA.viewModel.billingCountryName, visible: false " class="form-control" style="display: none;">
<script type="text/javascript">
$(document).ready(function() {
AGORA.__onCountryChange__($('#__billingCountrySelect__').val(), $('#__billingCountrySelect__').find('option:selected').text())
});
</script>
</div>
<div class="form-group">
<label class="control-label"> *Phone: </label>
<input name="formComponentsMap['order'].phoneNumber" type="tel" data-bind="" value="516 484-3007" maxlength="25" class="form-control" inputmode="tel">
</div>
<!-- <div class="form-group">
<label class="control-label">
Fax:
</label>
<input name="formComponentsMap['order'].faxNumber" type="text" data-bind="" value="516 874-3205" maxlength="25" class="form-control" />
</div>
-->
<div id="__passwordInputSection__" class="form-group" style="display:none;"> <label class="control-label"> *Create Password: </label>
<input id="__wasPasswordFieldShown__" name="formComponentsMap['order'].wasPasswordFieldShown" type="hidden" value="false">
<input name="formComponentsMap['order'].password" type="password" value="" maxlength="20" class="form-control">
<p class="password1" style="display: inline-block;
color: #0071BC;
font-size: 15px;
padding: 0;
width: 100%;
max-width: 590px;
line-height: 18px;">*Please create a new password that will be used to access your subscription on ManwardPress.com. Recommended: Use a unique password, and keep it secure for your own records.</p>
</div>
<div class="form-group form-check">
<label>
<input name="formComponentsMap['order'].hasAgreedToBeContactedByAffiliates" type="checkbox" value="true" class="check">
<input type="hidden" name="_formComponentsMap['order'].hasAgreedToBeContactedByAffiliates"> Please check the box if you’d like to receive additional information on ways to enjoy a richer, healthier life from us and our affiliates. </label>
</div>
<div class="form-group form-check">
<label>
<input name="formComponentsMap['order'].hasSameShipToAddress" type="checkbox" value="true" data-bind="click: toggleShippingAddressVisibility" checked="checked" class="check">
<input type="hidden" name="_formComponentsMap['order'].hasSameShipToAddress"> Uncheck to ship to a different address. </label>
</div>
</fieldset>
<div id="shipping_div" data-bind="visible: shippingAddressVisible" style="display: none;">
<div class="shipping-div">
<fieldset class="step">
<legend class="step__header">Enter Your Shipping Information</legend>
<div class="form-group">
<label class="control-label"> *First Name: </label>
<input name="formComponentsMap['order'].shipToFirstName" type="text" value="" maxlength="20" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> *Last Name: </label>
<input name="formComponentsMap['order'].shipToLastName" type="text" value="" maxlength="30" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> *Address 1: </label>
<input name="formComponentsMap['order'].shipToAddressLine1" type="text" value="" maxlength="34" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> Address 2: </label>
<input name="formComponentsMap['order'].shipToAddressLine2" type="text" value="" maxlength="34" class="form-control">
</div>
<!-- -->
<div class="form-group">
<label class="control-label"> *City: </label>
<input name="formComponentsMap['order'].shipToCity" type="text" value="" maxlength="35" class="form-control">
</div>
<div id="__shipToStateInputSection__" class="form-group"> <label class="control-label" id="thstate">
<span id="shipToStateRequiredIndicator" style="display: inline;">*</span>State: </label>
<input id="whichShipToStateInput" name="formComponentsMap['order'].whichShipToStateInput" type="hidden" value="dropDown" class="form-control">
<span id="shipToStateSelect" data-bind=""><select name="formComponentsMap['order'].shipToStateId" onchange="AGORA.__onShippingStateChange__($(this).find('option:selected').text());" class="form-control input-sm">
<option value="">Select A State</option>undefined<option value="1">AA - ARMED FORCES</option>
<option value="4">AE - ARMED FORCES</option>
<option value="5">AK - ALASKA</option>
<option value="6">AL - ALABAMA</option>
<option value="7">AP - APO/FPO</option>
<option value="8">AR - ARKANSAS</option>
<option value="9">AS - AMERICAN SAMOA</option>
<option value="10">AZ - ARIZONA</option>
<option value="12">CA - CALIFORNIA</option>
<option value="13">CM - N MARIANA IS.</option>
<option value="14">CO - COLORADO</option>
<option value="15">CT - CONNECTICUT</option>
<option value="17">DC - WASHINGTON D C</option>
<option value="18">DE - DELAWARE</option>
<option value="19">FL - FLORIDA</option>
<option value="20">GA - GEORGIA</option>
<option value="21">GU - GUAM</option>
<option value="22">HI - HAWAII</option>
<option value="24">IA - IOWA</option>
<option value="25">ID - IDAHO</option>
<option value="26">IL - ILLINOIS</option>
<option value="27">IN - INDIANA</option>
<option value="28">KS - KANSAS</option>
<option value="29">KY - KENTUCKY</option>
<option value="30">LA - LOUISIANA</option>
<option value="31">MA - MASSACHUSETTS</option>
<option value="33">MD - MARYLAND</option>
<option value="34">ME - MAINE</option>
<option value="35">MI - MICHIGAN</option>
<option value="36">MN - MINNESOTA</option>
<option value="37">MO - MISSOURI</option>
<option value="39">MP - SAIPAN</option>
<option value="40">MS - MISSISSIPPI</option>
<option value="41">MT - MONTANA</option>
<option value="43">NC - NORTH CAROLINA</option>
<option value="44">ND - NORTH DAKOTA</option>
<option value="45">NE - NEBRASKA</option>
<option value="46">NH - NEW HAMPSHIRE</option>
<option value="47">NJ - NEW JERSEY</option>
<option value="49">NM - NEW MEXICO</option>
<option value="55">NV - NEVADA</option>
<option value="56">NY - NEW YORK</option>
<option value="57">OH - OHIO</option>
<option value="58">OK - OKLAHOMA</option>
<option value="60">OR - OREGON</option>
<option value="61">PA - PENNSYLVANIA</option>
<option value="64">PR - PUERTO RICO</option>
<option value="65">PW - PALAU</option>
<option value="68">RI - RHODE ISLAND</option>
<option value="70">SC - SOUTH CAROLINA</option>
<option value="71">SD - SOUTH DAKOTA</option>
<option value="74">TN - TENNESSEE</option>
<option value="75">TX - TEXAS</option>
<option value="76">UT - UTAH</option>
<option value="77">VA - VIRGINIA</option>
<option value="78">VI - VIRGIN ISLANDS</option>
<option value="80">VT - VERMONT</option>
<option value="82">WA - WASHINGTON</option>
<option value="83">WI - WISCONSIN</option>
<option value="84">WV - WEST VIRGINIA</option>
<option value="85">WY - WYOMING</option>
</select></span>
<input type="text" data-bind="value:AGORA.viewModel.shippingStateName, visible: false " class="form-control" style="display: none;">
</div>
<div class="form-group">
<label class="control-label" id="thzipcode">
<span id="shipToPostalCodeRequiredIndicator" style="display: inline;">*</span>ZIP/Postal Code: </label>
<input id="__shipToZipCode" name="formComponentsMap['order'].shipToPostalCode" type="text" value="" maxlength="9" class="form-control">
</div>
<div class="form-group">
<label class="control-label"> *Country: </label>
<script type="text/javascript">
//<![CDATA[
Namespace('AGORA', {
__onShippingCountryChange__: function(countryId, countryName) {
var stateSelect = '';
var whichStateInput = '';
var stateOptionsArray = new Array();
var postalCodeRequiredMap = new Object();
if (countryId != null) {
//gather country iso2 code:
$.ajax({
url: "/LASTCHANCE39MWLLT/EMWLX6CD/getCountryISO2Code",
data: {
countryId: countryId
},
success: function(data) {
AGORA.viewModel.iso2CountryCode(data);
console.log("Country Code is now: " + AGORA.viewModel.iso2CountryCode() + "\nLocale is now: en-" + AGORA.viewModel.iso2CountryCode());
if (window._modoModal) {
window._modoModal.updateModal({
locale: "en-" + data
});
}
},
async: false // Need to make this ajax call synchronous otherwise we will require callbacks!
});
}
AGORA.viewModel.shippingCountryId(countryId);
AGORA.viewModel.shippingCountryName(countryName);
var stateRequiredIndicator = document.getElementById('shipToStateRequiredIndicator');
var stateInputSection = $('#__shipToStateInputSection__');
var postcodeEverywhereSpan = document.getElementById('__shipToPostcodeEverywhereSpan__');
postalCodeRequiredMap["1"] = true;
postalCodeRequiredMap["14"] = true;
postalCodeRequiredMap["38"] = true;
postalCodeRequiredMap["74"] = true;
postalCodeRequiredMap["83"] = true;
postalCodeRequiredMap["99"] = true;
postalCodeRequiredMap["104"] = true;
postalCodeRequiredMap["195"] = true;
postalCodeRequiredMap["82"] = true;
if (postcodeEverywhereSpan && countryId == 82) {
postcodeEverywhereSpan.style.display = 'inline';
} else if (postcodeEverywhereSpan) {
postcodeEverywhereSpan.style.display = 'none';
}
AGORA.__onShippingStateChange__();
stateOptionsArray[1] += '<option value="1" >AA - ARMED FORCES</option>';
stateOptionsArray[38] += '<option value="2" >AB - ALBERTA</option>';
stateOptionsArray[10] += '<option value="124" >ABA - BUENOS AIRES</option>';
stateOptionsArray[30] += '<option value="148" >AC - Acre</option>';
stateOptionsArray[10] += '<option value="125" >ACA - CATAMARCA</option>';
stateOptionsArray[10] += '<option value="126" >ACB - CORDOBA</option>';
stateOptionsArray[10] += '<option value="127" >ACF - CIUDAD AUTO BA</option>';
stateOptionsArray[10] += '<option value="128" >ACH - CHACO</option>';
stateOptionsArray[10] += '<option value="129" >ACR - CORRIENTES</option>';
stateOptionsArray[10] += '<option value="130" >ACT - CHUBUT</option>';
stateOptionsArray[14] += '<option value="3" >ACT - AUS CAPITAL TER</option>';
stateOptionsArray[1] += '<option value="4" >AE - ARMED FORCES</option>';
stateOptionsArray[10] += '<option value="131" >AER - ENTRE RIOS</option>';
stateOptionsArray[10] += '<option value="132" >AFO - FORMOSA</option>';
stateOptionsArray[10] += '<option value="133" >AJY - JUJUY</option>';
stateOptionsArray[1] += '<option value="5" >AK - ALASKA</option>';
stateOptionsArray[1] += '<option value="6" >AL - ALABAMA</option>';
stateOptionsArray[30] += '<option value="149" >AL - Alagoas</option>';
stateOptionsArray[10] += '<option value="134" >ALP - LA PAMPA</option>';
stateOptionsArray[10] += '<option value="135" >ALR - LA RIOJA</option>';
stateOptionsArray[30] += '<option value="150" >AM - Amazonas</option>';
stateOptionsArray[10] += '<option value="136" >AMI - MISIONES</option>';
stateOptionsArray[10] += '<option value="137" >AMZ - MENDOZA</option>';
stateOptionsArray[99] += '<option value="87" >ANDAMAN AND NICOBAR ISLANDS</option>';
stateOptionsArray[10] += '<option value="138" >ANQ - NEUQUEN</option>';
stateOptionsArray[30] += '<option value="151" >AP - Amapá</option>';
stateOptionsArray[99] += '<option value="88" >ANDHRA PRADESH</option>';
stateOptionsArray[1] += '<option value="7" >AP - APO/FPO</option>';
stateOptionsArray[1] += '<option value="8" >AR - ARKANSAS</option>';
stateOptionsArray[99] += '<option value="89" >ARUNACHAL PRADESH</option>';
stateOptionsArray[10] += '<option value="139" >ARN - RÍO NEGRO</option>';
stateOptionsArray[99] += '<option value="90" >ASSAM</option>';
stateOptionsArray[1] += '<option value="9" >AS - AMERICAN SAMOA</option>';
stateOptionsArray[10] += '<option value="140" >ASA - SALTA</option>';
stateOptionsArray[10] += '<option value="141" >ASC - SANTA CRUZ</option>';
stateOptionsArray[10] += '<option value="142" >ASE - SANT DEL ESTERO</option>';
stateOptionsArray[10] += '<option value="143" >ASF - SANTA FE</option>';
stateOptionsArray[10] += '<option value="144" >ASJ - SAN JUAN</option>';
stateOptionsArray[10] += '<option value="145" >ASL - SAN LUIS</option>';
stateOptionsArray[10] += '<option value="146" >ATF - TIERRA DEL FUEG</option>';
stateOptionsArray[10] += '<option value="147" >ATU - TUCUMAN</option>';
stateOptionsArray[1] += '<option value="10" >AZ - ARIZONA</option>';
stateOptionsArray[30] += '<option value="152" >BA - Bahia</option>';
stateOptionsArray[38] += '<option value="11" >BC - BRIT. COLUMBIA</option>';
stateOptionsArray[99] += '<option value="91" >BIHAR</option>';
stateOptionsArray[1] += '<option value="12" >CA - CALIFORNIA</option>';
stateOptionsArray[30] += '<option value="153" >CE - Ceará</option>';
stateOptionsArray[99] += '<option value="92" >CHHATTISGARH</option>';
stateOptionsArray[99] += '<option value="93" >CHANDIGARH</option>';
stateOptionsArray[1] += '<option value="13" >CM - N MARIANA IS.</option>';
stateOptionsArray[1] += '<option value="14" >CO - COLORADO</option>';
stateOptionsArray[1] += '<option value="15" >CT - CONNECTICUT</option>';
stateOptionsArray[1] += '<option value="17" >DC - WASHINGTON D C</option>';
stateOptionsArray[99] += '<option value="94" >DAMAN AND DIU</option>';
stateOptionsArray[1] += '<option value="18" >DE - DELAWARE</option>';
stateOptionsArray[30] += '<option value="154" >DF - Distrito Federal</option>';
stateOptionsArray[99] += '<option value="95" >NEW DELHI</option>';
stateOptionsArray[99] += '<option value="96" >DADRA AND NAGAR HAVELI</option>';
stateOptionsArray[30] += '<option value="155" >ES - Espírito Santo</option>';
stateOptionsArray[1] += '<option value="19" >FL - FLORIDA</option>';
stateOptionsArray[1] += '<option value="20" >GA - GEORGIA</option>';
stateOptionsArray[99] += '<option value="97" >GOA</option>';
stateOptionsArray[99] += '<option value="98" >GUJARAT</option>';
stateOptionsArray[30] += '<option value="156" >GO - Goiás</option>';
stateOptionsArray[1] += '<option value="21" >GU - GUAM</option>';
stateOptionsArray[1] += '<option value="22" >HI - HAWAII</option>';
stateOptionsArray[99] += '<option value="99" >HIMACHAL PRADESH</option>';
stateOptionsArray[99] += '<option value="100" >HARYANA</option>';
stateOptionsArray[1] += '<option value="24" >IA - IOWA</option>';
stateOptionsArray[1] += '<option value="25" >ID - IDAHO</option>';
stateOptionsArray[1] += '<option value="26" >IL - ILLINOIS</option>';
stateOptionsArray[1] += '<option value="27" >IN - INDIANA</option>';
stateOptionsArray[99] += '<option value="101" >JHARKHAND</option>';
stateOptionsArray[99] += '<option value="102" >JAMMU AND KASHMIR</option>';
stateOptionsArray[99] += '<option value="103" >KARNATAKA</option>';
stateOptionsArray[99] += '<option value="104" >KERALA</option>';
stateOptionsArray[1] += '<option value="28" >KS - KANSAS</option>';
stateOptionsArray[1] += '<option value="29" >KY - KENTUCKY</option>';
stateOptionsArray[1] += '<option value="30" >LA - LOUISIANA</option>';
stateOptionsArray[99] += '<option value="105" >LAKSHADWEEP</option>';
stateOptionsArray[30] += '<option value="157" >MA - Maranhão</option>';
stateOptionsArray[1] += '<option value="31" >MA - MASSACHUSETTS</option>';
stateOptionsArray[38] += '<option value="32" >MB - MANITOBA</option>';
stateOptionsArray[1] += '<option value="33" >MD - MARYLAND</option>';
stateOptionsArray[1] += '<option value="34" >ME - MAINE</option>';
stateOptionsArray[30] += '<option value="158" >MG - Minas Gerais</option>';
stateOptionsArray[99] += '<option value="106" >MAHARASHTRA</option>';
stateOptionsArray[1] += '<option value="35" >MI - MICHIGAN</option>';
stateOptionsArray[99] += '<option value="107" >MEGHALAYA</option>';
stateOptionsArray[99] += '<option value="108" >MANIPUR</option>';
stateOptionsArray[1] += '<option value="36" >MN - MINNESOTA</option>';
stateOptionsArray[1] += '<option value="37" >MO - MISSOURI</option>';
stateOptionsArray[38] += '<option value="38" >MP - NORTHERN MARIAN</option>';
stateOptionsArray[1] += '<option value="39" >MP - SAIPAN</option>';
stateOptionsArray[99] += '<option value="109" >MADHYA PRADESH</option>';
stateOptionsArray[30] += '<option value="159" >MS - Mato Grosso do Sul</option>';
stateOptionsArray[1] += '<option value="40" >MS - MISSISSIPPI</option>';
stateOptionsArray[1] += '<option value="41" >MT - MONTANA</option>';
stateOptionsArray[30] += '<option value="160" >MT - Mato Grosso</option>';
stateOptionsArray[99] += '<option value="110" >MIZORAM</option>';
stateOptionsArray[38] += '<option value="42" >NB - NEW BRUNSWICK</option>';
stateOptionsArray[1] += '<option value="43" >NC - NORTH CAROLINA</option>';
stateOptionsArray[1] += '<option value="44" >ND - NORTH DAKOTA</option>';
stateOptionsArray[1] += '<option value="45" >NE - NEBRASKA</option>';
stateOptionsArray[1] += '<option value="46" >NH - NEW HAMPSHIRE</option>';
stateOptionsArray[1] += '<option value="47" >NJ - NEW JERSEY</option>';
stateOptionsArray[38] += '<option value="48" >NL - NEWFOUNDLAND</option>';
stateOptionsArray[99] += '<option value="112" >NAGALAND</option>';
stateOptionsArray[1] += '<option value="49" >NM - NEW MEXICO</option>';
stateOptionsArray[38] += '<option value="50" >NS - NOVA SCOTIA</option>';
stateOptionsArray[14] += '<option value="51" >NSW - NEW SOUTH WALES</option>';
stateOptionsArray[14] += '<option value="52" >NT - NORTHERN TERR</option>';
stateOptionsArray[38] += '<option value="53" >NT - N.W. TERRITORY</option>';
stateOptionsArray[38] += '<option value="54" >NU - NUNAVUT TERR.</option>';
stateOptionsArray[1] += '<option value="55" >NV - NEVADA</option>';
stateOptionsArray[1] += '<option value="56" >NY - NEW YORK</option>';
stateOptionsArray[1] += '<option value="57" >OH - OHIO</option>';
stateOptionsArray[1] += '<option value="58" >OK - OKLAHOMA</option>';
stateOptionsArray[38] += '<option value="59" >ON - ONTARIO</option>';
stateOptionsArray[1] += '<option value="60" >OR - OREGON</option>';
stateOptionsArray[99] += '<option value="113" >ORISSA</option>';
stateOptionsArray[30] += '<option value="161" >PA - Pará</option>';
stateOptionsArray[1] += '<option value="61" >PA - PENNSYLVANIA</option>';
stateOptionsArray[30] += '<option value="162" >PB - Paraíba</option>';
stateOptionsArray[99] += '<option value="114" >PUNJAB</option>';
stateOptionsArray[30] += '<option value="163" >PE - Pernambuco</option>';
stateOptionsArray[38] += '<option value="62" >PE - PR. EDWARD IS.</option>';
stateOptionsArray[30] += '<option value="164" >PI - Piauí</option>';
stateOptionsArray[38] += '<option value="63" >PQ - QUEBEC</option>';
stateOptionsArray[1] += '<option value="64" >PR - PUERTO RICO</option>';
stateOptionsArray[30] += '<option value="165" >PR - Paraná</option>';
stateOptionsArray[1] += '<option value="65" >PW - PALAU</option>';
stateOptionsArray[99] += '<option value="115" >PUDUCHERRY</option>';
stateOptionsArray[38] += '<option value="66" >QC - QUEBEC</option>';
stateOptionsArray[14] += '<option value="67" >QLD - QUEENSLAND</option>';
stateOptionsArray[1] += '<option value="68" >RI - RHODE ISLAND</option>';
stateOptionsArray[99] += '<option value="116" >RAJASTHAN</option>';
stateOptionsArray[30] += '<option value="166" >RJ - Rio de Janeiro</option>';
stateOptionsArray[30] += '<option value="167" >RN - Rio Grande do Norte</option>';
stateOptionsArray[30] += '<option value="168" >RO - Rondônia</option>';
stateOptionsArray[30] += '<option value="169" >RR - Roraima</option>';
stateOptionsArray[30] += '<option value="170" >RS - Rio Grande do Sul</option>';
stateOptionsArray[14] += '<option value="69" >SA - SOUTH AUSTRALIA</option>';
stateOptionsArray[1] += '<option value="70" >SC - SOUTH CAROLINA</option>';
stateOptionsArray[30] += '<option value="171" >SC - Santa Catarina</option>';
stateOptionsArray[1] += '<option value="71" >SD - SOUTH DAKOTA</option>';
stateOptionsArray[30] += '<option value="172" >SE - Sergipe</option>';
stateOptionsArray[99] += '<option value="117" >SIKKIM</option>';
stateOptionsArray[38] += '<option value="72" >SK - SASKATCHEWAN</option>';
stateOptionsArray[30] += '<option value="173" >SP - São Paulo</option>';
stateOptionsArray[14] += '<option value="73" >TAS - TASMANIA</option>';
stateOptionsArray[99] += '<option value="123" >TELANGANA</option>';
stateOptionsArray[1] += '<option value="74" >TN - TENNESSEE</option>';
stateOptionsArray[99] += '<option value="118" >TAMIL NADU</option>';
stateOptionsArray[30] += '<option value="174" >TO - Tocantins</option>';
stateOptionsArray[99] += '<option value="119" >TRIPURA</option>';
stateOptionsArray[1] += '<option value="75" >TX - TEXAS</option>';
stateOptionsArray[99] += '<option value="120" >UTTARAKHAND</option>';
stateOptionsArray[99] += '<option value="121" >UTTAR PRADESH</option>';
stateOptionsArray[1] += '<option value="76" >UT - UTAH</option>';
stateOptionsArray[1] += '<option value="77" >VA - VIRGINIA</option>';
stateOptionsArray[1] += '<option value="78" >VI - VIRGIN ISLANDS</option>';
stateOptionsArray[14] += '<option value="79" >VIC - VICTORIA</option>';
stateOptionsArray[1] += '<option value="80" >VT - VERMONT</option>';
stateOptionsArray[14] += '<option value="81" >WA - WESTERN AUS</option>';
stateOptionsArray[1] += '<option value="82" >WA - WASHINGTON</option>';
stateOptionsArray[99] += '<option value="122" >WEST BENGAL</option>';
stateOptionsArray[1] += '<option value="83" >WI - WISCONSIN</option>';
stateOptionsArray[1] += '<option value="84" >WV - WEST VIRGINIA</option>';
stateOptionsArray[1] += '<option value="85" >WY - WYOMING</option>';
stateOptionsArray[38] += '<option value="86" >YT - YUKON TERR.</option>';
stateOptionsArray[254] = 'UNSUPPORTED';
stateOptionsArray[242] = 'UNSUPPORTED';
stateOptionsArray[253] = 'UNSUPPORTED';
stateOptionsArray[241] = 'UNSUPPORTED';
stateOptionsArray[240] = 'UNSUPPORTED';
stateOptionsArray[244] = 'UNSUPPORTED';
stateOptionsArray[246] = 'UNSUPPORTED';
stateOptionsArray[249] = 'UNSUPPORTED';
stateOptionsArray[247] = 'UNSUPPORTED';
stateOptionsArray[245] = 'UNSUPPORTED';
stateOptionsArray[248] = 'UNSUPPORTED';
stateOptionsArray[250] = 'UNSUPPORTED';
stateOptionsArray[82] = 'UNSUPPORTED';
stateOptionsArray[251] = 'UNSUPPORTED';
stateOptionsArray[252] = 'UNSUPPORTED';
stateOptionsArray[243] = 'UNSUPPORTED';
if (stateOptionsArray[countryId] != undefined && stateOptionsArray[countryId] != 'UNSUPPORTED') {
stateSelect = '<select name="formComponentsMap[\'order\'].shipToStateId" onchange="AGORA.__onShippingStateChange__($(this).find(\'option:selected\').text());" class="form-control input-sm" >' +
'<option value="">Select A State</option>' + stateOptionsArray[countryId] + '</select>';
whichStateInput = 'dropDown';
if (stateRequiredIndicator) stateRequiredIndicator.style.display = 'inline';
stateInputSection.css('display', '');
} else {
AGORA.__onShippingStateChange__('');
stateSelect = '<input name="formComponentsMap[\'order\'].shipToStateName" type="text" value="" data-bind="" onchange="AGORA.__onShippingStateChange__($(this).val());" class="form-control"/>';
whichStateInput = 'textBox';
if (stateRequiredIndicator) stateRequiredIndicator.style.display = 'none';
if (stateOptionsArray[countryId] == 'UNSUPPORTED' && stateInputSection.size() > 0) {
stateInputSection.css('display', 'none');
} else {
stateInputSection.css('display', '');
}
}
var postalCodeRequiredIndicator = document.getElementById('shipToPostalCodeRequiredIndicator');
if (postalCodeRequiredMap[countryId] && postalCodeRequiredIndicator) {
postalCodeRequiredIndicator.style.display = 'inline';
} else if (postalCodeRequiredIndicator) {
postalCodeRequiredIndicator.style.display = 'none';
}
if (document.getElementById('shipToStateSelect') != null) {
document.getElementById('shipToStateSelect').innerHTML = stateSelect;
document.getElementById('whichShipToStateInput').value = whichStateInput;
}
// Argentina:
if (document.getElementById('argentinaTaxFieldsBlock') != null) {
if (countryId && countryId != "10") {
document.getElementById('argentinaTaxFieldsBlock').style.display = 'none';
} else {
document.getElementById('argentinaTaxFieldsBlock').style.display = 'block';
}
}
// TaxFields:
var countryIds = ["43", "47", "134", "170", "60"];
if (document.getElementById('taxIdLabel') != null) {
var useTaxIdFields = false;
for (var i = 0; i < countryIds.length; i++) {
if (countryIds[i] == countryId) {
useTaxIdFields = true;
var label = '';
if (countryIds[i] == "43") {
label = "*CI/RUT";
} else if (countryIds[i] == "47") {
label = "*CC";
} else if (countryIds[i] == "134") {
label = "*CURP";
} else if (countryIds[i] == "170") {
label = "*DNI";
} else if (countryIds[i] == "60") {
label = "*CI";
} else {
label = "Tax Id";
}
}
}
if (useTaxIdFields == true) {
document.getElementById('taxIdLabelHidden').value = label;
if (document.getElementById("taxIdLabel") != null) {
var taxIdL = document.getElementById("taxIdLabel");
taxIdL.innerHTML = label;
}
} else if (document.getElementById("taxIdLabel") != null && useTaxIdFields == false) {
var taxIdL = document.getElementById("taxIdLabel");
taxIdL.innerHTML = "Tax Id";
}
}
// Country Tax Id (Brazil/Argentina):
// EU-VAT:
checkIfCountryRequiresEuVat(countryId, "shipping");
},
__onShippingStateChange__: function(stateName) {
AGORA.viewModel.shippingStateName(stateName);
}
});
//]]>
</script>
<select id="__shippingCountrySelect__" name="formComponentsMap['order'].shipToCountryId" data-bind="" onchange="AGORA.__onShippingCountryChange__($(this).val(), $(this).find('option:selected').text());" class="form-control input-sm">
<option value="1" selected="selected">UNITED STATES</option>
<option value="3">AFGHANISTAN</option>
<option value="4">ALBANIA</option>
<option value="5">ALGERIA</option>
<option value="6">ANDORRA</option>
<option value="7">ANGOLA</option>
<option value="9">ANGUILLA</option>
<option value="8">ANTARCTICA</option>
<option value="2">ANTIGUA AND BARBUDA</option>
<option value="10">ARGENTINA</option>
<option value="11">ARMENIA</option>
<option value="12">ARUBA</option>
<option value="14">AUSTRALIA</option>
<option value="13">AUSTRIA</option>
<option value="16">AZERBAIDJAN</option>
<option value="24">BAHAMAS</option>
<option value="17">BAHRAIN</option>
<option value="18">BANGLADESH</option>
<option value="19">BARBADOS</option>
<option value="20">BELARUS</option>
<option value="25">BELGIUM</option>
<option value="26">BELIZE</option>
<option value="21">BENIN</option>
<option value="22">BERMUDA</option>
<option value="35">BHUTAN</option>
<option value="27">BOLIVIA</option>
<option value="254">BONAIRE,ST EUST,SABA</option>
<option value="28">BOSNIA-HERZEGOVINA</option>
<option value="29">BOTSWANA</option>
<option value="30">BRAZIL</option>
<option value="100">BRITISH INDIAN OCEAN</option>
<option value="32">BRUNEI DARUSSALAM</option>
<option value="33">BULGARIA</option>
<option value="23">BURKINA FASO</option>
<option value="31">BURUNDI</option>
<option value="36">CAMBODIA</option>
<option value="37">CAMEROON</option>
<option value="38">CANADA</option>
<option value="40">CAPE VERDE</option>
<option value="41">CAYMAN ISLANDS</option>
<option value="39">CENTRAL AFRICAN REPU</option>
<option value="42">CHAD</option>
<option value="43">CHILE</option>
<option value="46">CHINA</option>
<option value="242">CHRISTMAS ISLAND</option>
<option value="253">COCOS (KEELING) ISLA</option>
<option value="47">COLOMBIA</option>
<option value="48">COMOROS</option>
<option value="49">CONGO</option>
<option value="45">COOK ISLANDS</option>
<option value="50">COSTA RICA</option>
<option value="51">CROATIA</option>
<option value="52">CUBA</option>
<option value="241">CURACAO</option>
<option value="53">CYPRUS</option>
<option value="54">CZECH REPUBLIC</option>
<option value="55">DENMARK</option>
<option value="56">DJIBOUTI</option>
<option value="57">DOMINICA</option>
<option value="58">DOMINICAN REPUBLIC</option>
<option value="67">EAST TIMOR</option>
<option value="60">ECUADOR</option>
<option value="62">EGYPT</option>
<option value="63">EL SALVADOR</option>
<option value="61">EQUATIORIAL GUINEA</option>
<option value="64">ERITREA</option>
<option value="65">ESTONIA</option>
<option value="66">ETHIOPIA</option>
<option value="68">FAEROE ISLANDS</option>
<option value="69">FALKLAND ISLANDS</option>
<option value="75">FED STATE MICRONESIA</option>
<option value="71">FIJI</option>
<option value="72">FINLAND</option>
<option value="74">FRANCE</option>
<option value="70">FRENCH GUIANA</option>
<option value="73">FRENCH POLYNESIA</option>
<option value="240">FRENCH SOUTHERN TERR</option>
<option value="77">GABON</option>
<option value="79">GAMBIA</option>
<option value="84">GEORGIA, REPUBLIC OF</option>
<option value="83">GERMANY</option>
<option value="85">GHANA</option>
<option value="86">GIBRALTAR</option>
<option value="88">GREECE</option>
<option value="89">GREENLAND</option>
<option value="87">GRENADA</option>
<option value="78">GUADELOUPE</option>
<option value="90">GUATEMALA</option>
<option value="91">GUINEA</option>
<option value="81">GUINEA BISSAU</option>
<option value="92">GUYANA</option>
<option value="93">HAITI</option>
<option value="244">HEARD AND MC DONALD</option>
<option value="95">HONDURAS</option>
<option value="94">HONG KONG</option>
<option value="96">HUNGARY</option>
<option value="97">ICELAND</option>
<option value="99">INDIA</option>
<option value="98">INDONESIA</option>
<option value="101">IRAN</option>
<option value="103">IRAQ</option>
<option value="102">IRELAND</option>
<option value="104">ISRAEL</option>
<option value="105">ITALY</option>
<option value="106">IVORY COAST</option>
<option value="107">JAMAICA</option>
<option value="108">JAPAN</option>
<option value="109">JORDAN</option>
<option value="110">KAZAKHSTAN</option>
<option value="111">KENYA</option>
<option value="112">KIRIBATI</option>
<option value="113">KOREA</option>
<option value="161">KOREA DEMOCRATIC PE</option>
<option value="114">KUWAIT</option>
<option value="115">KYRGYZSTAN</option>
<option value="116">LAO PEOPLES DEM REP</option>
<option value="117">LATVIA</option>
<option value="119">LEBANON</option>
<option value="122">LESOTHO</option>
<option value="123">LIBERIA</option>
<option value="118">LIBYA(N ARAB JAMAHI)</option>
<option value="124">LIECHTENSTEIN</option>
<option value="125">LITHUANIA</option>
<option value="126">LUXEMBOURG</option>
<option value="127">MACAO</option>
<option value="133">MACEDONIA</option>
<option value="128">MADAGASCAR</option>
<option value="129">MALAWI</option>
<option value="142">MALAYSIA</option>
<option value="140">MALDIVES</option>
<option value="139">MALI</option>
<option value="141">MALTA</option>
<option value="137">MARSHALL ISLANDS</option>
<option value="130">MARTINIQUE</option>
<option value="131">MAURITANIA</option>
<option value="147">MAURITIUS</option>
<option value="132">MAYOTTE</option>
<option value="134">MEXICO</option>
<option value="138">MOLDOVA</option>
<option value="143">MONACO</option>
<option value="135">MONGOLIA</option>
<option value="145">MONTSERRAT</option>
<option value="144">MOROCCO</option>
<option value="146">MOZAMBIQUE</option>
<option value="148">MYANMAR</option>
<option value="149">NAMIBIA</option>
<option value="151">NAURU</option>
<option value="153">NEPAL</option>
<option value="150">NETHERLAND ANTILLES</option>
<option value="154">NETHERLANDS</option>
<option value="152">NEW CALEDONIA</option>
<option value="164">NEW ZEALAND</option>
<option value="158">NICARAGUA</option>
<option value="155">NIGER</option>
<option value="159">NIGERIA</option>
<option value="160">NIUE</option>
<option value="246">NORFOLK ISLAND</option>
<option value="162">NORTHERN MARIANA ISL</option>
<option value="163">NORWAY</option>
<option value="165">OMAN</option>
<option value="166">PAKISTAN</option>
<option value="167">PALAU</option>
<option value="168">PANAMA</option>
<option value="156">PAPUA NEW GUINEA</option>
<option value="169">PARAGUAY</option>
<option value="170">PERU</option>
<option value="171">PHILIPPINES</option>
<option value="172">PITCAIRN ISLANDS</option>
<option value="173">POLAND</option>
<option value="174">PORTUGAL</option>
<option value="175">QATAR</option>
<option value="176">REUNION</option>
<option value="178">ROMANIA</option>
<option value="225">RUSSIAN FEDERATION</option>
<option value="179">RWANDA</option>
<option value="198">SAINT HELENA</option>
<option value="188">SAINT KITTS AND NEVI</option>
<option value="191">SAINT LUCIA</option>
<option value="202">SAINT VINCENT AND GR</option>
<option value="181">SAMOA</option>
<option value="193">SAN MARINO</option>
<option value="197">SAO TOME & PRINCIPE</option>
<option value="182">SAUDI ARABIA</option>
<option value="183">SENEGAL</option>
<option value="236">SERBIA & MONTENEGRO</option>
<option value="185">SEYCHELLES</option>
<option value="186">SIERRA LEONE</option>
<option value="187">SINGAPORE</option>
<option value="249">SINT MAARTEN</option>
<option value="190">SLOVAKIA</option>
<option value="192">SLOVENIA</option>
<option value="189">SOLOMON ISLANDS</option>
<option value="194">SOMALIA</option>
<option value="180">SOUTH AFRICA</option>
<option value="247">SOUTH GEORGIA & THE S. SANDWICH ISL.</option>
<option value="177">SOUTH KOREA</option>
<option value="195">SPAIN</option>
<option value="196">SRI LANKA</option>
<option value="245">ST. MARTIN</option>
<option value="199">ST. PIERRE &MIQUELON</option>
<option value="200">SUDAN</option>
<option value="201">SURINAME</option>
<option value="248">SVALBARD AND JAN MAY</option>
<option value="206">SWAZILAND</option>
<option value="204">SWEDEN</option>
<option value="205">SWITZERLAND</option>
<option value="207">SYRIA</option>
<option value="208">TAIWAN</option>
<option value="209">TAJIKISTAN</option>
<option value="210">TANZANIA</option>
<option value="212">THAILAND</option>
<option value="215">TOGO</option>
<option value="250">TOKELAU</option>
<option value="214">TONGA</option>
<option value="217">TRINIDAD AND TOBAGO</option>
<option value="218">TUNISIA</option>
<option value="219">TURKEY</option>
<option value="213">TURKMENISTAN</option>
<option value="211">TURKS AND CAICOS</option>
<option value="220">TUVALU</option>
<option value="222">UGANDA</option>
<option value="223">UKRAINE</option>
<option value="221">UNITED ARAB EMIRATES</option>
<option value="82">UNITED KINGDOM</option>
<option value="251">UNITED STATES MINOR</option>
<option value="224">URUGUAY</option>
<option value="226">UZBEKISTAN</option>
<option value="227">VANUATU</option>
<option value="228">VATICAN CITY STATE</option>
<option value="229">VENEZUELA</option>
<option value="230">VIETNAM</option>
<option value="231">VIRGIN IS, BRIT</option>
<option value="252">WALLIS AND FUTUNA IS</option>
<option value="243">WESTERN SAHARA</option>
<option value="235">YEMEN</option>
<option value="237">ZAIRE</option>
<option value="238">ZAMBIA</option>
<option value="239">ZIMBABWE</option>
</select>
<input type="text" data-bind="value:AGORA.viewModel.shippingCountryName, visible: false " class="form-control" style="display: none;">
<script type="text/javascript">
$(document).ready(function() {
AGORA.__onShippingCountryChange__($('#__shippingCountrySelect__').val(), $('#__shippingCountrySelect__').find('option:selected').text())
});
</script>
</div>
<div class="form-group">
<label class="control-label"> Email: </label>
<input name="formComponentsMap['order'].shipToEmailAddress" type="email" value="" maxlength="254" class="form-control" inputmode="email">
</div>
<div data-bind="" class="form-group">
<label class="control-label"> Retype Email: </label>
<input name="formComponentsMap['order'].confirmShipToEmailAddress" type="email" value="" maxlength="254" class="form-control" inputmode="email">
</div>
</fieldset>
</div>
</div>
<div class="paymentFormContainer">
<fieldset class="step">
<legend class="step__header">Step No. 4: Enter Your Payment Information</legend>
<script type="text/javascript">
Namespace('AGORA', {
submitForm: function(isSelfContainedForm, effortPaymentOptionId) {
if (isSelfContainedForm === undefined) {
isSelfContainedForm = false;
}
if (!isSelfContainedForm) {
document.getElementById("formComponentsMap['paymentOption'].effortPaymentOptionId").value = effortPaymentOptionId;
}
window.setTimeout(AGORA.disableSubmit, 1); // Fix to prevent disable from not submitting the form
return true;
},
disableSubmit: function() {
$("input[name=btnPaymentOptionSubmit]").attr("disabled", "disabled").val("Your order is being processed....");
}
});
</script>
<input name="formComponentsMap['paymentOption'].effortPaymentOptionId" id="formComponentsMap['paymentOption'].effortPaymentOptionId" type="hidden" value="">
<div data-bind="visible: isPaymentOptionSupported(7051686)">
<!-- START JAVASCRIPT FOR KOUNT OPTION BLOCK -->
<script type="text/javascript" src="https://ssl.kaptcha.com/collect/sdk?m=171440&s=T2hqXMq-NboWSn"></script>
<script type="text/javascript">
var client = new ka.ClientSDK();
client.autoLoadEvents();
</script>
<!-- END JAVASCRIPT FOR KOUNT OPTION BLOCK -->
<script src="https://images.web-purchases.com/jQuery/jquery.min.js" type="text/javascript"></script>
<script type="text/javascript">
// JavaScript Document
(function($) {
var creditCardTypeListLength = 0;
var creditCardDataArray = [];
var creditCardData1 = {};
creditCardData1 = {
ccId: 1,
lowBound: 3400,
highBound: 3499,
dbId: 1,
cardName: "American Express",
useCreditCardMandate: "true"
};
creditCardTypeListLength++;
creditCardDataArray.push(creditCardData1);
var creditCardData2 = {};
creditCardData2 = {
ccId: 1,
lowBound: 3700,
highBound: 3799,
dbId: 2,
cardName: "American Express",
useCreditCardMandate: "true"
};
creditCardTypeListLength++;
creditCardDataArray.push(creditCardData2);
var creditCardData3 = {};
creditCardData3 = {
ccId: 2,
lowBound: 5100,
highBound: 5599,
dbId: 3,
cardName: "MasterCard",
useCreditCardMandate: "true"
};
creditCardTypeListLength++;
creditCardDataArray.push(creditCardData3);
var creditCardData14 = {};
creditCardData14 = {
ccId: 2,
lowBound: 2221,
highBound: 2720,
dbId: 14,
cardName: "MasterCard",
useCreditCardMandate: "true"
};
creditCardTypeListLength++;
creditCardDataArray.push(creditCardData14);
var creditCardData4 = {};
creditCardData4 = {
ccId: 3,
lowBound: 4000,
highBound: 4999,
dbId: 4,
cardName: "Visa",
useCreditCardMandate: "true"
};
creditCardTypeListLength++;
creditCardDataArray.push(creditCardData4);
var creditCardData5 = {};
creditCardData5 = {
ccId: 4,
lowBound: 6011,
highBound: 6011,
dbId: 5,
cardName: "Discover",
useCreditCardMandate: "true"
};
creditCardTypeListLength++;
creditCardDataArray.push(creditCardData5);
(function() {
var cardFromNumber, formatBackExpiry, formatExpiry, formatForwardExpiry, formatForwardSlashAndSpace, hasTextSelected, reFormatExpiry, restrictNumeric, setCardType,
__slice = [].slice,
__indexOf = [].indexOf || function(item) {
for (var i = 0, l = this.length; i < l; i++) {
if (i in this && this[i] === item) return i;
}
return -1;
};
$.payment = {};
$.payment.fn = {};
$.fn.payment = function() {
var args, method;
method = arguments[0], args = 2 <= arguments.length ? __slice.call(arguments, 1) : [];
return $.payment.fn[method].apply(this, args);
};
cardFromNumber = function(num) {
var card = {};
num = (num + '').replace(/\D/g, '');
var firstFour = num.substring(0, 4);
for (i = 0; i < creditCardDataArray.length; i++) {
if (firstFour >= creditCardDataArray[i].lowBound && firstFour <= creditCardDataArray[i].highBound) {
card.type = creditCardDataArray[i].cardName;
return card;
}
}
};
hasTextSelected = function($target) {
var _ref;
if (($target.prop('selectionStart') != null) && $target.prop('selectionStart') !== $target.prop('selectionEnd')) {
return true;
}
if ((typeof document !== "undefined" && document !== null ? (_ref = document.selection) != null ? _ref.createRange : void 0 : void 0) != null) {
if (document.selection.createRange().text) {
return true;
}
}
return false;
};
reFormatExpiry = function(e) {
return setTimeout(function() {
var $target, value;
$target = $(e.currentTarget);
value = $target.val();
value = $.payment.formatExpiry(value);
return $target.val(value);
});
};
formatForwardExpiry = function(e) {
var $target, digit, val;
digit = String.fromCharCode(e.which);
if (!/^\d+$/.test(digit)) {
return;
}
$target = $(e.currentTarget);
val = $target.val();
if (/^\d\d$/.test(val)) {
return $target.val("" + val + " / ");
}
};
formatForwardSlashAndSpace = function(e) {
var $target, val, which;
which = String.fromCharCode(e.which);
if (!(which === '/' || which === ' ')) {
return;
}
$target = $(e.currentTarget);
val = $target.val();
if (/^\d$/.test(val) && val !== '0') {
return $target.val("0" + val + " / ");
}
};
formatBackExpiry = function(e) {
var $target, value;
$target = $(e.currentTarget);
value = $target.val();
if (e.which !== 8) {
return;
}
if (($target.prop('selectionStart') != null) && $target.prop('selectionStart') !== value.length) {
return;
}
if (/\d\s\/\s$/.test(value)) {
e.preventDefault();
return setTimeout(function() {
return $target.val(value.replace(/\d\s\/\s$/, ''));
});
}
};
restrictNumeric = function(e) {
var input;
if (e.metaKey || e.ctrlKey) {
return true;
}
if (e.which === 32) {
return false;
}
if (e.which === 0) {
return true;
}
if (e.which < 33) {
return true;
}
input = String.fromCharCode(e.which);
return !!/[\d\s]/.test(input);
};
setCardType = function(e) {
var $target, allTypes, card, cardType, val, useCreditCardMandate;
$target = $(e.currentTarget);
val = $target.val();
cardType = $.payment.cardType(val) || 'unknown';
if (!$target.hasClass(cardType)) {
allTypes = (function() {
var _i, _len, _results;
_results = [];
for (i = 0; i < creditCardDataArray.length; i++) {
card = creditCardDataArray[i];
card.type = creditCardDataArray[i].cardName
card.useCreditCardMandate = creditCardDataArray[i].useCreditCardMandate
_results.push(card.type);
if (/\s/.test(card.type)) {
card.type = card.type.replace(/\s/g, '');
_results.push(card.type);
_results.push(card.useCreditCardMandate);
}
}
return _results;
})();
$target.removeClass('unknown');
$target.removeClass(allTypes.join(' '));
$target.addClass(cardType);
$target.toggleClass('identified', cardType !== 'unknown');
var useCreditCardMandate = false;
for (i = 0; i < creditCardDataArray.length; i++) {
card = creditCardDataArray[i];
if (cardType === creditCardDataArray[i].cardName) {
useCreditCardMandate = creditCardDataArray[i].useCreditCardMandate;
}
}
if (useCreditCardMandate === 'true' && AGORA.viewModel.isAutoRenewChoiceSelected()) {
document.getElementById("autoRenewAuth").style.display = "block";
} else {
document.getElementById("autoRenewAuth").style.display = "none";
}
cardType = cardType.replace(/\s/g, '');
return $target.trigger('payment.cardType', cardType);
}
};
$.payment.fn.formatCardExpiry = function() {
this.keyup(restrictNumeric);
this.keyup(formatExpiry);
this.keyup(formatForwardSlashAndSpace);
this.keyup(formatForwardExpiry);
this.keyup(formatBackExpiry);
this.keyup(reFormatExpiry);
return this;
};
$.payment.fn.formatCardNumber = function() {
this.keypress(restrictNumeric);
this.keyup(setCardType);
return this;
};
$.payment.fn.restrictNumeric = function() {
this.keypress(restrictNumeric);
return this;
};
$.payment.fn.cardExpiryVal = function() {
return $.payment.cardExpiryVal($(this).val());
};
$.payment.cardExpiryVal = function(value) {
var month, prefix, year, _ref;
value = value.replace(/\s/g, '');
_ref = value.split('/', 2), month = _ref[0], year = _ref[1];
if ((year != null ? year.length : void 0) === 2 && /^\d+$/.test(year)) {
prefix = (new Date).getFullYear();
prefix = prefix.toString().slice(0, 2);
year = prefix + year;
}
month = parseInt(month, 10);
year = parseInt(year, 10);
return {
month: month,
year: year
};
};
$.payment.cardType = function(num) {
var _ref;
if (!num || num.length <= 3) {
return null;
}
return ((_ref = cardFromNumber(num)) != null ? _ref.type : void 0) || null;
};
$.payment.formatExpiry = function(expiry) {
var mon, parts, sep, year;
parts = expiry.match(/^\D*(\d{1,2})(\D+)?(\d{1,4})?/);
if (!parts) {
return '';
}
mon = parts[1] || '';
sep = parts[2] || '';
year = parts[3] || '';
if (year.length > 0) {
sep = ' / ';
} else if (sep === ' /') {
mon = mon.substring(0, 1);
sep = '';
} else if (mon.length === 2 || sep.length > 0) {
sep = ' / ';
} else if (mon.length === 1 && (mon !== '0' && mon !== '1')) {
mon = "0" + mon;
sep = ' / ';
}
return mon + sep + year;
};
}).call(this);;
(function() {
jQuery(function($) {
var cardTypeIdToName, cardTypeNameToId, existing, processField, setCardTypeField;
existing = {
cardType: Number($("input[name$='.creditCardTypeId']:checked").val()),
expiryMonth: Number($("select[name$='.creditCardExpirationMonth']").val()),
expiryYear: Number($("select[name$='.creditCardExpirationYear']").val())
};
if (existing.expiryMonth === 0) {
existing.expiryMonth = null;
}
if (existing.expiryYear === 0) {
existing.expiryYear = null;
}
/*
Input field replacements and modifications
*/
$("#cc-cardtype-radio").replaceWith('<input name="formComponentsMap['paymentOption'].creditCardTypeId" id="cc-cardtype" type="hidden" required>');
if ((existing.cardType != null) && !isNaN(existing.cardType)) {
$('#cc-cardtype').val(existing.cardType);
}
$(".cc-expiry-group > div").remove();
$(".cc-expiry-group").append('<div class="col-sm-6 col-md-6 col-lg-6"><input class="cc-expiry form-control" maxlength="7" type="tel" placeholder="MM / YY"></div>').append(
'<input name="formComponentsMap['paymentOption'].creditCardExpirationMonth" type="hidden">').append('<input name="formComponentsMap['paymentOption'].creditCardExpirationYear" type="hidden">');
$("input[name$='.maskedCreditCardNumber']").addClass("cc-cardnumber auto-cardtype").prop("type", "tel");
/*
* Format the specified field as the specified type
*/
processField = function(field, type) {
return $(field).bind('change paste keyup input', function() {
var cardType, expiryVal, value;
value = $(this).payment('formatCard' + type).val();
switch (type) {
case 'Number':
$(this).payment;
cardType = $.payment.cardType(value);
setCardTypeField(cardType);
break;
case 'Expiry':
$(this).payment("formatCardExpiry");
expiryVal = $.payment.cardExpiryVal($(this).val());
if (10 >= expiryVal.month && 1 === expiryVal.month.toString().length) {
expiryVal.month = '0' + expiryVal.month;
}
$("input[name$='creditCardExpirationMonth']").val(expiryVal.month);
$("input[name$='creditCardExpirationYear']").val(expiryVal.year);
break;
}
});
};
/*
* Set the card type numeric ID from the type name
*/
cardTypeNameToId = function(cardType) {
var typeNumber;
if (cardType != null) {
for (i = 0; i < creditCardDataArray.length; i++) {
if (cardType == creditCardDataArray[i].cardName) {
typeNumber = creditCardDataArray[i].ccId;
break;
}
}
}
$('#cc-cardtype').val(typeNumber);
return typeNumber;
};
/*
* Set the card type name from the numeric ID
*/
cardTypeIdToName = function(cardType) {
var typeName;
cardType = Number(cardType);
for (i = 0; i < creditCardDataArray.length; i++) {
if (cardType == creditCardDataArray[i].ccId) {
typeName = creditCardDataArray[i].cardName;
break;
}
}
return typeName;
};
/*
* Assign a numeric value for the card type to the hidden field
*/
setCardTypeField = function(cardType) {
var typeNumber;
typeNumber = cardTypeNameToId(cardType);
$('#cc-cardtype').val(typeNumber);
};
/*
* Perform formatting
*/
if ((existing.cardType != null) && !isNaN(existing.cardType)) {
existing.cardTypeName = cardTypeIdToName(existing.cardType);
$("input[name$='.maskedCreditCardNumber']").addClass(existing.cardTypeName);
}
if ((existing.expiryMonth != null) && (existing.expiryYear != null)) {
$(".cc-expiry").val(existing.expiryMonth + " / " + existing.expiryYear);
$("input[name$='.creditCardExpirationMonth']").val(existing.expiryMonth);
$("input[name$='.creditCardExpirationYear']").val(existing.expiryYear);
}
processField("input[name$='maskedCreditCardNumber']", "Number");
processField(".cc-expiry", "Expiry");
/*
* Ancillary form processes
*/
$("input[name$='.shouldSaveCreditCard']").click(function() {
$("#creditName").toggle("slow");
});
});
}).call(this);
})(jQuery.noConflict());
</script>
<div class="row">
<div class="form-group">
<label class="control-label col-sm-4 col-md-4 col-lg-4"></label>
<div class="col-sm-6 col-md-6 col-lg-6">
<!-- for regular orders -->
<div id="lightboxDiv" style="display:none"><a href="#" id="theLightbox">Click to retrieve saved credit cards.</a></div>
<div id="popLinkErrorMessage"></div>
</div>
</div>
</div>
<div class="form-notes" style="display: flex; justify-content: center; align-items: center; margin-top: -20px; margin-bottom: 0;">
<p class="text-suppressed ta-center" style="margin-right: 1em; margin-bottom: 0;"> Secure Credit Card Online <!-- This link contains a Javascript file that generates the new McAffe Image -->
<script src="https://cdn.ywxi.net/js/inline.js?w=90"></script>
</p>
<div
style="display: inline-block; width: 90px; height: 37px; background-size: contain; background-image: url("https://cdn.ywxi.net/meter/orders.manwardpress.com/102.svg?ts=1649376132768&l=en-US"); background-position: center top; background-repeat: no-repeat; cursor: pointer;"
class="mfes-trustmark loaded" data-width="90" data-height="37" data-ext="svg" data-type="102" oncontextmenu="return false;" title="TrustedSite Certified" tabindex="0"></div>
<p></p>
</div>
<div class="form-group">
<select id="creditCardSelect" style="display:none" data-bind="options: creditCards, optionsText: 'description', optionsCaption: 'Enter a new credit card', value: selectedCreditCard" class="form-control input-sm">
<option value="">Enter a new credit card</option>
</select><input id="creditCardElectronicPaymentIdHiddenField" style="display:none" name="formComponentsMap['paymentOption'].electronicPaymentId" type="hidden"
data-bind="value: AGORA.viewModel.selectedCreditCard()?AGORA.viewModel.selectedCreditCard().electronicPaymentId:''" class="form-control">
</div>
<input name="formComponentsMap['paymentOption'].creditCardTypeId" id="cc-cardtype" type="hidden" required=""> <!-- #cc-cardtype-radio-->
<div class="form-notes ta-center">
<img src="/img/creditCardType_VI.jpg" id="3">
<img src="/img/creditCardType_MC.jpg" id="2">
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