www.aia.com.sg
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23.52.171.225
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URL:
https://www.aia.com.sg/en/health-wellness/aia-vitality/get-rewarded
Submission: On May 18 via manual from IN — Scanned from SG
Submission: On May 18 via manual from IN — Scanned from SG
Form analysis
1 forms found in the DOMName: pdt — POST
<form method="POST" id="pdt" data-formid="pdt" data-id="pdt" name="pdt" class="cmp-form " data-cmp-is="enhanced-contactuscontainer" data-flow="variant1" data-formvalue="Get Rewarded"
data-form-submission="https://mypageapp.aia.com.sg/aia-sg-wise/form-submission" data-is-edit-mode="false">
<div class="cmp-contactuscontainer">
<div class="cmp-contactuscontainer__error-message cmp-contactuscontainer__general-error hide">
<div class="cmp-contactuscontainer__general-error--icon">
<div class="cmp-image">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-error-alert.svg" class="cmp-image__image" itemprop="contentUrl" data-cmp-hook-image="image" alt="error icon" title="error icon">
</div>
</div>
<span class="cmp-contactuscontainer__general-error--text cmp-contactuscontainer__generalErrMsg"> Form submission error </span>
<span class="cmp-contactuscontainer__general-error--text cmp-contactuscontainer__conflictErrMsg hide">
</span>
</div>
<fieldset class="cmp-contactuscontainer__main-form cmp-contactuscontainer__screen cmp-contactuscontainer__screen-0 active">
<div id="screenOne" class="form-group">
<!-- screen 1 form container drag and drop -->
<div id="container-screenone-variant1">
<div data-placeholder-text="false">
<div id="section-61801a5844" data-section-id="section-61801a5844" data-cmp-is="X7Section" class="cmp-section cmp-section--nopaddingtop-desktop cmp-section--nopaddingtop-mobile ">
<div class="cmp-section__content">
<div class="flexbox carousel panelcontainer">
<div id="flexbox-b3b7b74410" class="cmp-flexbox" role="group">
<div class="cmp-flexbox__container cmp-flexbox__direction--row cmp-flexbox__justify--start cmp-flexbox__alignitems--start cmp-flexbox--flexwrap cmp-flexbox__gap--xl3 cmp-flexbox--flexwrap-mobile cmp-flexbox__gap--large-mobile">
<div id="flexitem-0864628446" class="cmp-flexitem cmp-flexitem__alignself--start cmp-flexitem--col-full" data-cmp-is="flexitem" data-is-edit-mode="false" data-col-span="cmp-flexitem--col-full">
<div class="campaigndropdown list">
<div class="cmp-campaigndropdown">
<div class="cmp-dropdown" data-cmp-is="campaign-dropdown" data-required="true" data-message-required="*Please select an option" data-formid="pdt">
<div class="cmp-dropdown__content">
<div class="cmp-dropdown__item">
<div class="cmp-dropdown__label">
<label for="select">Salutation* <!-- /* dropdown tooltip */ -->
</label>
</div>
<div class="select-dropdown select-dropdown--0"><select id="select1" class="cmp-leadsgenerationform__select" fixed-label="false" name="salutation" data-required="true" data-formvalue="Get Rewarded"
selected="selected" style="display: none;">
<option data-flow-change="false" value="mr" selected="selected" data-enable-modal="false" data-target-modal="modal-mr">Mr. </option>
<option data-flow-change="false" value="ms" data-enable-modal="false" data-target-modal="modal-ms">Miss. </option>
<option data-flow-change="false" value="mdm" data-enable-modal="false" data-target-modal="modal-mdm">Mdm. </option>
</select><button class="select-dropdown__button select-dropdown__button--0" data-value="mr" type="button" data-new-form-id="undefined" data-flow-change="false" data-enable-modal="false" data-targetmodal=""
data-target-modal="modal-mr" data-new-api-url="undefined"><span class="select-dropdown select-dropdown--0 select-dropdown-head">Mr.<br> </span><i class="zmdi zmdi-chevron-down"></i></button>
<div class="invalid-feedback">
<div class="error-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/alert-solid.svg">
<span class="error-msg--general">*Please select an option</span>
<span></span>
</div>
</div>
<div class="select-dropdown__container">
<ul class="select-dropdown__list select-dropdown__list--0" id="select-dropdown__list-0" data-index="2">
<li class="select-dropdown__list-item select-dropdown__list-item--hover" data-value="mr" data-flow-change="false" data-new-form-id="undefined" data-enable-modal="false" data-target-modal="modal-mr"
data-new-api-url="undefined">Mr.</li>
<li class="select-dropdown__list-item" data-value="ms" data-flow-change="false" data-new-form-id="undefined" data-enable-modal="false" data-target-modal="modal-ms" data-new-api-url="undefined">Miss.</li>
<li class="select-dropdown__list-item" data-value="mdm" data-flow-change="false" data-new-form-id="undefined" data-enable-modal="false" data-target-modal="modal-mdm" data-new-api-url="undefined">Mdm.</li>
</ul>
</div>
</div>
</div>
</div>
</div>
<div id="modal-mr" class="cmp-form-modal form-modal" data-cmp-is="cmp-form-modal">
<div class="cmp-form-modal__content">
<div class="cmp-form-modal__header">
<h4></h4>
<span class="cmp-form-modal__form-modal-title cmp-form-modal__mobile-title" id="customize-form-modal"></span>
<button type="button" class="cmp-form-modal__close" data-bs-dismiss="form-modal" aria-label="Close">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-close.svg">
</button>
</div>
<div class="cmp-form-modal-body">
<div class="cmp-form-modal-body__main-text"></div>
</div>
</div>
</div>
<div id="modal-ms" class="cmp-form-modal form-modal" data-cmp-is="cmp-form-modal">
<div class="cmp-form-modal__content">
<div class="cmp-form-modal__header">
<h4></h4>
<span class="cmp-form-modal__form-modal-title cmp-form-modal__mobile-title" id="customize-form-modal"></span>
<button type="button" class="cmp-form-modal__close" data-bs-dismiss="form-modal" aria-label="Close">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-close.svg">
</button>
</div>
<div class="cmp-form-modal-body">
<div class="cmp-form-modal-body__main-text"></div>
</div>
</div>
</div>
<div id="modal-mdm" class="cmp-form-modal form-modal" data-cmp-is="cmp-form-modal">
<div class="cmp-form-modal__content">
<div class="cmp-form-modal__header">
<h4></h4>
<span class="cmp-form-modal__form-modal-title cmp-form-modal__mobile-title" id="customize-form-modal"></span>
<button type="button" class="cmp-form-modal__close" data-bs-dismiss="form-modal" aria-label="Close">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-close.svg">
</button>
</div>
<div class="cmp-form-modal-body">
<div class="cmp-form-modal-body__main-text"></div>
</div>
</div>
</div>
</div>
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-formid="pdt" data-required="true" data-message-required="*Please fill in name" data-message-validation="*Name is required">
<div class="cmp-singlelineText-container" data-hidden="false">
<label>What's your name?*</label>
<div class="cmp-singlelineText--inputWrapper" data-mobile="none">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<input class="cmp-singlelineText--input" data-errormsg="*Name is required" data-requirederrormsg="*Please fill in name" data-fixed="false" data-mobile="none" data-formvalue="Get Rewarded" data-type="text" type="text"
id="pdt" placeholder="Name as per NRIC / Passport" name="name" data-required="true">
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Name is required</span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-formid="pdt" data-required="false" data-message-required="*Please fill in mobile number"
data-message-validation="*Please fill in mobile phone number or email">
<div class="cmp-singlelineText-container" data-hidden="false">
<label>What's your mobile number?</label>
<div class="cmp-singlelineText--inputWrapper" data-mobile="internationalNumber">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<div class="iti iti--allow-dropdown iti--separate-dial-code">
<div class="iti__flag-container">
<div class="iti__selected-flag" role="combobox" aria-controls="iti-0__country-listbox" aria-owns="iti-0__country-listbox" aria-expanded="false" tabindex="0" title="Singapore: +65"
aria-activedescendant="iti-0__item-sg-preferred">
<div class="iti__flag iti__sg"></div>
<div class="iti__selected-dial-code">+65</div>
<div class="iti__arrow"></div>
</div>
<ul class="iti__country-list iti__hide" id="iti-0__country-listbox" role="listbox" aria-label="List of countries">
<li class="iti__country iti__preferred iti__active" tabindex="-1" id="iti-0__item-sg-preferred" role="option" data-dial-code="65" data-country-code="sg" aria-selected="true">
<div class="iti__flag-box">
<div class="iti__flag iti__sg"></div>
</div><span class="iti__country-name">Singapore</span><span class="iti__dial-code">+65</span>
</li>
<li class="iti__divider" role="separator" aria-disabled="true"></li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-af" role="option" data-dial-code="93" data-country-code="af" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__af"></div>
</div><span class="iti__country-name">Afghanistan (افغانستان)</span><span class="iti__dial-code">+93</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-al" role="option" data-dial-code="355" data-country-code="al" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__al"></div>
</div><span class="iti__country-name">Albania (Shqipëri)</span><span class="iti__dial-code">+355</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-dz" role="option" data-dial-code="213" data-country-code="dz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dz"></div>
</div><span class="iti__country-name">Algeria (الجزائر)</span><span class="iti__dial-code">+213</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-as" role="option" data-dial-code="1" data-country-code="as" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__as"></div>
</div><span class="iti__country-name">American Samoa</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ad" role="option" data-dial-code="376" data-country-code="ad" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ad"></div>
</div><span class="iti__country-name">Andorra</span><span class="iti__dial-code">+376</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ao" role="option" data-dial-code="244" data-country-code="ao" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ao"></div>
</div><span class="iti__country-name">Angola</span><span class="iti__dial-code">+244</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ai" role="option" data-dial-code="1" data-country-code="ai" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ai"></div>
</div><span class="iti__country-name">Anguilla</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ag" role="option" data-dial-code="1" data-country-code="ag" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ag"></div>
</div><span class="iti__country-name">Antigua and Barbuda</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ar" role="option" data-dial-code="54" data-country-code="ar" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ar"></div>
</div><span class="iti__country-name">Argentina</span><span class="iti__dial-code">+54</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-am" role="option" data-dial-code="374" data-country-code="am" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__am"></div>
</div><span class="iti__country-name">Armenia (Հայաստան)</span><span class="iti__dial-code">+374</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-aw" role="option" data-dial-code="297" data-country-code="aw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__aw"></div>
</div><span class="iti__country-name">Aruba</span><span class="iti__dial-code">+297</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ac" role="option" data-dial-code="247" data-country-code="ac" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ac"></div>
</div><span class="iti__country-name">Ascension Island</span><span class="iti__dial-code">+247</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-au" role="option" data-dial-code="61" data-country-code="au" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__au"></div>
</div><span class="iti__country-name">Australia</span><span class="iti__dial-code">+61</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-at" role="option" data-dial-code="43" data-country-code="at" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__at"></div>
</div><span class="iti__country-name">Austria (Österreich)</span><span class="iti__dial-code">+43</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-az" role="option" data-dial-code="994" data-country-code="az" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__az"></div>
</div><span class="iti__country-name">Azerbaijan (Azərbaycan)</span><span class="iti__dial-code">+994</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bs" role="option" data-dial-code="1" data-country-code="bs" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bs"></div>
</div><span class="iti__country-name">Bahamas</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bh" role="option" data-dial-code="973" data-country-code="bh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bh"></div>
</div><span class="iti__country-name">Bahrain (البحرين)</span><span class="iti__dial-code">+973</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bd" role="option" data-dial-code="880" data-country-code="bd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bd"></div>
</div><span class="iti__country-name">Bangladesh (বাংলাদেশ)</span><span class="iti__dial-code">+880</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bb" role="option" data-dial-code="1" data-country-code="bb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bb"></div>
</div><span class="iti__country-name">Barbados</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-by" role="option" data-dial-code="375" data-country-code="by" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__by"></div>
</div><span class="iti__country-name">Belarus (Беларусь)</span><span class="iti__dial-code">+375</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-be" role="option" data-dial-code="32" data-country-code="be" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__be"></div>
</div><span class="iti__country-name">Belgium (België)</span><span class="iti__dial-code">+32</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bz" role="option" data-dial-code="501" data-country-code="bz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bz"></div>
</div><span class="iti__country-name">Belize</span><span class="iti__dial-code">+501</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bj" role="option" data-dial-code="229" data-country-code="bj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bj"></div>
</div><span class="iti__country-name">Benin (Bénin)</span><span class="iti__dial-code">+229</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bm" role="option" data-dial-code="1" data-country-code="bm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bm"></div>
</div><span class="iti__country-name">Bermuda</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bt" role="option" data-dial-code="975" data-country-code="bt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bt"></div>
</div><span class="iti__country-name">Bhutan (འབྲུག)</span><span class="iti__dial-code">+975</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bo" role="option" data-dial-code="591" data-country-code="bo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bo"></div>
</div><span class="iti__country-name">Bolivia</span><span class="iti__dial-code">+591</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ba" role="option" data-dial-code="387" data-country-code="ba" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ba"></div>
</div><span class="iti__country-name">Bosnia and Herzegovina (Босна и Херцеговина)</span><span class="iti__dial-code">+387</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bw" role="option" data-dial-code="267" data-country-code="bw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bw"></div>
</div><span class="iti__country-name">Botswana</span><span class="iti__dial-code">+267</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-br" role="option" data-dial-code="55" data-country-code="br" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__br"></div>
</div><span class="iti__country-name">Brazil (Brasil)</span><span class="iti__dial-code">+55</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-io" role="option" data-dial-code="246" data-country-code="io" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__io"></div>
</div><span class="iti__country-name">British Indian Ocean Territory</span><span class="iti__dial-code">+246</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-vg" role="option" data-dial-code="1" data-country-code="vg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vg"></div>
</div><span class="iti__country-name">British Virgin Islands</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bn" role="option" data-dial-code="673" data-country-code="bn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bn"></div>
</div><span class="iti__country-name">Brunei</span><span class="iti__dial-code">+673</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bg" role="option" data-dial-code="359" data-country-code="bg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bg"></div>
</div><span class="iti__country-name">Bulgaria (България)</span><span class="iti__dial-code">+359</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bf" role="option" data-dial-code="226" data-country-code="bf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bf"></div>
</div><span class="iti__country-name">Burkina Faso</span><span class="iti__dial-code">+226</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bi" role="option" data-dial-code="257" data-country-code="bi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bi"></div>
</div><span class="iti__country-name">Burundi (Uburundi)</span><span class="iti__dial-code">+257</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kh" role="option" data-dial-code="855" data-country-code="kh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kh"></div>
</div><span class="iti__country-name">Cambodia (កម្ពុជា)</span><span class="iti__dial-code">+855</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cm" role="option" data-dial-code="237" data-country-code="cm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cm"></div>
</div><span class="iti__country-name">Cameroon (Cameroun)</span><span class="iti__dial-code">+237</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ca" role="option" data-dial-code="1" data-country-code="ca" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ca"></div>
</div><span class="iti__country-name">Canada</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cv" role="option" data-dial-code="238" data-country-code="cv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cv"></div>
</div><span class="iti__country-name">Cape Verde (Kabu Verdi)</span><span class="iti__dial-code">+238</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bq" role="option" data-dial-code="599" data-country-code="bq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bq"></div>
</div><span class="iti__country-name">Caribbean Netherlands</span><span class="iti__dial-code">+599</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ky" role="option" data-dial-code="1" data-country-code="ky" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ky"></div>
</div><span class="iti__country-name">Cayman Islands</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cf" role="option" data-dial-code="236" data-country-code="cf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cf"></div>
</div><span class="iti__country-name">Central African Republic (République centrafricaine)</span><span class="iti__dial-code">+236</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-td" role="option" data-dial-code="235" data-country-code="td" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__td"></div>
</div><span class="iti__country-name">Chad (Tchad)</span><span class="iti__dial-code">+235</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cl" role="option" data-dial-code="56" data-country-code="cl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cl"></div>
</div><span class="iti__country-name">Chile</span><span class="iti__dial-code">+56</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cn" role="option" data-dial-code="86" data-country-code="cn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cn"></div>
</div><span class="iti__country-name">China (中国)</span><span class="iti__dial-code">+86</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cx" role="option" data-dial-code="61" data-country-code="cx" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cx"></div>
</div><span class="iti__country-name">Christmas Island</span><span class="iti__dial-code">+61</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cc" role="option" data-dial-code="61" data-country-code="cc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cc"></div>
</div><span class="iti__country-name">Cocos (Keeling) Islands</span><span class="iti__dial-code">+61</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-co" role="option" data-dial-code="57" data-country-code="co" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__co"></div>
</div><span class="iti__country-name">Colombia</span><span class="iti__dial-code">+57</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-km" role="option" data-dial-code="269" data-country-code="km" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__km"></div>
</div><span class="iti__country-name">Comoros (جزر القمر)</span><span class="iti__dial-code">+269</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cd" role="option" data-dial-code="243" data-country-code="cd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cd"></div>
</div><span class="iti__country-name">Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)</span><span class="iti__dial-code">+243</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cg" role="option" data-dial-code="242" data-country-code="cg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cg"></div>
</div><span class="iti__country-name">Congo (Republic) (Congo-Brazzaville)</span><span class="iti__dial-code">+242</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ck" role="option" data-dial-code="682" data-country-code="ck" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ck"></div>
</div><span class="iti__country-name">Cook Islands</span><span class="iti__dial-code">+682</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cr" role="option" data-dial-code="506" data-country-code="cr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cr"></div>
</div><span class="iti__country-name">Costa Rica</span><span class="iti__dial-code">+506</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ci" role="option" data-dial-code="225" data-country-code="ci" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ci"></div>
</div><span class="iti__country-name">Côte d’Ivoire</span><span class="iti__dial-code">+225</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-hr" role="option" data-dial-code="385" data-country-code="hr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hr"></div>
</div><span class="iti__country-name">Croatia (Hrvatska)</span><span class="iti__dial-code">+385</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cu" role="option" data-dial-code="53" data-country-code="cu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cu"></div>
</div><span class="iti__country-name">Cuba</span><span class="iti__dial-code">+53</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cw" role="option" data-dial-code="599" data-country-code="cw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cw"></div>
</div><span class="iti__country-name">Curaçao</span><span class="iti__dial-code">+599</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cy" role="option" data-dial-code="357" data-country-code="cy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cy"></div>
</div><span class="iti__country-name">Cyprus (Κύπρος)</span><span class="iti__dial-code">+357</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-cz" role="option" data-dial-code="420" data-country-code="cz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__cz"></div>
</div><span class="iti__country-name">Czech Republic (Česká republika)</span><span class="iti__dial-code">+420</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-dk" role="option" data-dial-code="45" data-country-code="dk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dk"></div>
</div><span class="iti__country-name">Denmark (Danmark)</span><span class="iti__dial-code">+45</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-dj" role="option" data-dial-code="253" data-country-code="dj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dj"></div>
</div><span class="iti__country-name">Djibouti</span><span class="iti__dial-code">+253</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-dm" role="option" data-dial-code="1" data-country-code="dm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__dm"></div>
</div><span class="iti__country-name">Dominica</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-do" role="option" data-dial-code="1" data-country-code="do" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__do"></div>
</div><span class="iti__country-name">Dominican Republic (República Dominicana)</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ec" role="option" data-dial-code="593" data-country-code="ec" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ec"></div>
</div><span class="iti__country-name">Ecuador</span><span class="iti__dial-code">+593</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-eg" role="option" data-dial-code="20" data-country-code="eg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__eg"></div>
</div><span class="iti__country-name">Egypt (مصر)</span><span class="iti__dial-code">+20</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sv" role="option" data-dial-code="503" data-country-code="sv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sv"></div>
</div><span class="iti__country-name">El Salvador</span><span class="iti__dial-code">+503</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gq" role="option" data-dial-code="240" data-country-code="gq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gq"></div>
</div><span class="iti__country-name">Equatorial Guinea (Guinea Ecuatorial)</span><span class="iti__dial-code">+240</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-er" role="option" data-dial-code="291" data-country-code="er" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__er"></div>
</div><span class="iti__country-name">Eritrea</span><span class="iti__dial-code">+291</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ee" role="option" data-dial-code="372" data-country-code="ee" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ee"></div>
</div><span class="iti__country-name">Estonia (Eesti)</span><span class="iti__dial-code">+372</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sz" role="option" data-dial-code="268" data-country-code="sz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sz"></div>
</div><span class="iti__country-name">Eswatini</span><span class="iti__dial-code">+268</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-et" role="option" data-dial-code="251" data-country-code="et" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__et"></div>
</div><span class="iti__country-name">Ethiopia</span><span class="iti__dial-code">+251</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-fk" role="option" data-dial-code="500" data-country-code="fk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fk"></div>
</div><span class="iti__country-name">Falkland Islands (Islas Malvinas)</span><span class="iti__dial-code">+500</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-fo" role="option" data-dial-code="298" data-country-code="fo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fo"></div>
</div><span class="iti__country-name">Faroe Islands (Føroyar)</span><span class="iti__dial-code">+298</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-fj" role="option" data-dial-code="679" data-country-code="fj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fj"></div>
</div><span class="iti__country-name">Fiji</span><span class="iti__dial-code">+679</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-fi" role="option" data-dial-code="358" data-country-code="fi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fi"></div>
</div><span class="iti__country-name">Finland (Suomi)</span><span class="iti__dial-code">+358</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-fr" role="option" data-dial-code="33" data-country-code="fr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fr"></div>
</div><span class="iti__country-name">France</span><span class="iti__dial-code">+33</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gf" role="option" data-dial-code="594" data-country-code="gf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gf"></div>
</div><span class="iti__country-name">French Guiana (Guyane française)</span><span class="iti__dial-code">+594</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pf" role="option" data-dial-code="689" data-country-code="pf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pf"></div>
</div><span class="iti__country-name">French Polynesia (Polynésie française)</span><span class="iti__dial-code">+689</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ga" role="option" data-dial-code="241" data-country-code="ga" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ga"></div>
</div><span class="iti__country-name">Gabon</span><span class="iti__dial-code">+241</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gm" role="option" data-dial-code="220" data-country-code="gm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gm"></div>
</div><span class="iti__country-name">Gambia</span><span class="iti__dial-code">+220</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ge" role="option" data-dial-code="995" data-country-code="ge" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ge"></div>
</div><span class="iti__country-name">Georgia (საქართველო)</span><span class="iti__dial-code">+995</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-de" role="option" data-dial-code="49" data-country-code="de" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__de"></div>
</div><span class="iti__country-name">Germany (Deutschland)</span><span class="iti__dial-code">+49</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gh" role="option" data-dial-code="233" data-country-code="gh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gh"></div>
</div><span class="iti__country-name">Ghana (Gaana)</span><span class="iti__dial-code">+233</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gi" role="option" data-dial-code="350" data-country-code="gi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gi"></div>
</div><span class="iti__country-name">Gibraltar</span><span class="iti__dial-code">+350</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gr" role="option" data-dial-code="30" data-country-code="gr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gr"></div>
</div><span class="iti__country-name">Greece (Ελλάδα)</span><span class="iti__dial-code">+30</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gl" role="option" data-dial-code="299" data-country-code="gl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gl"></div>
</div><span class="iti__country-name">Greenland (Kalaallit Nunaat)</span><span class="iti__dial-code">+299</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gd" role="option" data-dial-code="1" data-country-code="gd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gd"></div>
</div><span class="iti__country-name">Grenada</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gp" role="option" data-dial-code="590" data-country-code="gp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gp"></div>
</div><span class="iti__country-name">Guadeloupe</span><span class="iti__dial-code">+590</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gu" role="option" data-dial-code="1" data-country-code="gu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gu"></div>
</div><span class="iti__country-name">Guam</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gt" role="option" data-dial-code="502" data-country-code="gt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gt"></div>
</div><span class="iti__country-name">Guatemala</span><span class="iti__dial-code">+502</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gg" role="option" data-dial-code="44" data-country-code="gg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gg"></div>
</div><span class="iti__country-name">Guernsey</span><span class="iti__dial-code">+44</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gn" role="option" data-dial-code="224" data-country-code="gn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gn"></div>
</div><span class="iti__country-name">Guinea (Guinée)</span><span class="iti__dial-code">+224</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gw" role="option" data-dial-code="245" data-country-code="gw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gw"></div>
</div><span class="iti__country-name">Guinea-Bissau (Guiné Bissau)</span><span class="iti__dial-code">+245</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gy" role="option" data-dial-code="592" data-country-code="gy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gy"></div>
</div><span class="iti__country-name">Guyana</span><span class="iti__dial-code">+592</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ht" role="option" data-dial-code="509" data-country-code="ht" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ht"></div>
</div><span class="iti__country-name">Haiti</span><span class="iti__dial-code">+509</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-hn" role="option" data-dial-code="504" data-country-code="hn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hn"></div>
</div><span class="iti__country-name">Honduras</span><span class="iti__dial-code">+504</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-hk" role="option" data-dial-code="852" data-country-code="hk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hk"></div>
</div><span class="iti__country-name">Hong Kong (香港)</span><span class="iti__dial-code">+852</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-hu" role="option" data-dial-code="36" data-country-code="hu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__hu"></div>
</div><span class="iti__country-name">Hungary (Magyarország)</span><span class="iti__dial-code">+36</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-is" role="option" data-dial-code="354" data-country-code="is" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__is"></div>
</div><span class="iti__country-name">Iceland (Ísland)</span><span class="iti__dial-code">+354</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-in" role="option" data-dial-code="91" data-country-code="in" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__in"></div>
</div><span class="iti__country-name">India (भारत)</span><span class="iti__dial-code">+91</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-id" role="option" data-dial-code="62" data-country-code="id" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__id"></div>
</div><span class="iti__country-name">Indonesia</span><span class="iti__dial-code">+62</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ir" role="option" data-dial-code="98" data-country-code="ir" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ir"></div>
</div><span class="iti__country-name">Iran (ایران)</span><span class="iti__dial-code">+98</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-iq" role="option" data-dial-code="964" data-country-code="iq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__iq"></div>
</div><span class="iti__country-name">Iraq (العراق)</span><span class="iti__dial-code">+964</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ie" role="option" data-dial-code="353" data-country-code="ie" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ie"></div>
</div><span class="iti__country-name">Ireland</span><span class="iti__dial-code">+353</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-im" role="option" data-dial-code="44" data-country-code="im" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__im"></div>
</div><span class="iti__country-name">Isle of Man</span><span class="iti__dial-code">+44</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-il" role="option" data-dial-code="972" data-country-code="il" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__il"></div>
</div><span class="iti__country-name">Israel (ישראל)</span><span class="iti__dial-code">+972</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-it" role="option" data-dial-code="39" data-country-code="it" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__it"></div>
</div><span class="iti__country-name">Italy (Italia)</span><span class="iti__dial-code">+39</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-jm" role="option" data-dial-code="1" data-country-code="jm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__jm"></div>
</div><span class="iti__country-name">Jamaica</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-jp" role="option" data-dial-code="81" data-country-code="jp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__jp"></div>
</div><span class="iti__country-name">Japan (日本)</span><span class="iti__dial-code">+81</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-je" role="option" data-dial-code="44" data-country-code="je" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__je"></div>
</div><span class="iti__country-name">Jersey</span><span class="iti__dial-code">+44</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-jo" role="option" data-dial-code="962" data-country-code="jo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__jo"></div>
</div><span class="iti__country-name">Jordan (الأردن)</span><span class="iti__dial-code">+962</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kz" role="option" data-dial-code="7" data-country-code="kz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kz"></div>
</div><span class="iti__country-name">Kazakhstan (Казахстан)</span><span class="iti__dial-code">+7</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ke" role="option" data-dial-code="254" data-country-code="ke" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ke"></div>
</div><span class="iti__country-name">Kenya</span><span class="iti__dial-code">+254</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ki" role="option" data-dial-code="686" data-country-code="ki" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ki"></div>
</div><span class="iti__country-name">Kiribati</span><span class="iti__dial-code">+686</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-xk" role="option" data-dial-code="383" data-country-code="xk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__xk"></div>
</div><span class="iti__country-name">Kosovo</span><span class="iti__dial-code">+383</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kw" role="option" data-dial-code="965" data-country-code="kw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kw"></div>
</div><span class="iti__country-name">Kuwait (الكويت)</span><span class="iti__dial-code">+965</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kg" role="option" data-dial-code="996" data-country-code="kg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kg"></div>
</div><span class="iti__country-name">Kyrgyzstan (Кыргызстан)</span><span class="iti__dial-code">+996</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-la" role="option" data-dial-code="856" data-country-code="la" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__la"></div>
</div><span class="iti__country-name">Laos (ລາວ)</span><span class="iti__dial-code">+856</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lv" role="option" data-dial-code="371" data-country-code="lv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lv"></div>
</div><span class="iti__country-name">Latvia (Latvija)</span><span class="iti__dial-code">+371</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lb" role="option" data-dial-code="961" data-country-code="lb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lb"></div>
</div><span class="iti__country-name">Lebanon (لبنان)</span><span class="iti__dial-code">+961</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ls" role="option" data-dial-code="266" data-country-code="ls" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ls"></div>
</div><span class="iti__country-name">Lesotho</span><span class="iti__dial-code">+266</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lr" role="option" data-dial-code="231" data-country-code="lr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lr"></div>
</div><span class="iti__country-name">Liberia</span><span class="iti__dial-code">+231</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ly" role="option" data-dial-code="218" data-country-code="ly" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ly"></div>
</div><span class="iti__country-name">Libya (ليبيا)</span><span class="iti__dial-code">+218</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-li" role="option" data-dial-code="423" data-country-code="li" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__li"></div>
</div><span class="iti__country-name">Liechtenstein</span><span class="iti__dial-code">+423</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lt" role="option" data-dial-code="370" data-country-code="lt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lt"></div>
</div><span class="iti__country-name">Lithuania (Lietuva)</span><span class="iti__dial-code">+370</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lu" role="option" data-dial-code="352" data-country-code="lu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lu"></div>
</div><span class="iti__country-name">Luxembourg</span><span class="iti__dial-code">+352</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mo" role="option" data-dial-code="853" data-country-code="mo" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mo"></div>
</div><span class="iti__country-name">Macau (澳門)</span><span class="iti__dial-code">+853</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mk" role="option" data-dial-code="389" data-country-code="mk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mk"></div>
</div><span class="iti__country-name">North Macedonia (Македонија)</span><span class="iti__dial-code">+389</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mg" role="option" data-dial-code="261" data-country-code="mg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mg"></div>
</div><span class="iti__country-name">Madagascar (Madagasikara)</span><span class="iti__dial-code">+261</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mw" role="option" data-dial-code="265" data-country-code="mw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mw"></div>
</div><span class="iti__country-name">Malawi</span><span class="iti__dial-code">+265</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-my" role="option" data-dial-code="60" data-country-code="my" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__my"></div>
</div><span class="iti__country-name">Malaysia</span><span class="iti__dial-code">+60</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mv" role="option" data-dial-code="960" data-country-code="mv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mv"></div>
</div><span class="iti__country-name">Maldives</span><span class="iti__dial-code">+960</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ml" role="option" data-dial-code="223" data-country-code="ml" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ml"></div>
</div><span class="iti__country-name">Mali</span><span class="iti__dial-code">+223</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mt" role="option" data-dial-code="356" data-country-code="mt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mt"></div>
</div><span class="iti__country-name">Malta</span><span class="iti__dial-code">+356</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mh" role="option" data-dial-code="692" data-country-code="mh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mh"></div>
</div><span class="iti__country-name">Marshall Islands</span><span class="iti__dial-code">+692</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mq" role="option" data-dial-code="596" data-country-code="mq" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mq"></div>
</div><span class="iti__country-name">Martinique</span><span class="iti__dial-code">+596</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mr" role="option" data-dial-code="222" data-country-code="mr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mr"></div>
</div><span class="iti__country-name">Mauritania (موريتانيا)</span><span class="iti__dial-code">+222</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mu" role="option" data-dial-code="230" data-country-code="mu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mu"></div>
</div><span class="iti__country-name">Mauritius (Moris)</span><span class="iti__dial-code">+230</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-yt" role="option" data-dial-code="262" data-country-code="yt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__yt"></div>
</div><span class="iti__country-name">Mayotte</span><span class="iti__dial-code">+262</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mx" role="option" data-dial-code="52" data-country-code="mx" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mx"></div>
</div><span class="iti__country-name">Mexico (México)</span><span class="iti__dial-code">+52</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-fm" role="option" data-dial-code="691" data-country-code="fm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__fm"></div>
</div><span class="iti__country-name">Micronesia</span><span class="iti__dial-code">+691</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-md" role="option" data-dial-code="373" data-country-code="md" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__md"></div>
</div><span class="iti__country-name">Moldova (Republica Moldova)</span><span class="iti__dial-code">+373</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mc" role="option" data-dial-code="377" data-country-code="mc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mc"></div>
</div><span class="iti__country-name">Monaco</span><span class="iti__dial-code">+377</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mn" role="option" data-dial-code="976" data-country-code="mn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mn"></div>
</div><span class="iti__country-name">Mongolia (Монгол)</span><span class="iti__dial-code">+976</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-me" role="option" data-dial-code="382" data-country-code="me" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__me"></div>
</div><span class="iti__country-name">Montenegro (Crna Gora)</span><span class="iti__dial-code">+382</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ms" role="option" data-dial-code="1" data-country-code="ms" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ms"></div>
</div><span class="iti__country-name">Montserrat</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ma" role="option" data-dial-code="212" data-country-code="ma" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ma"></div>
</div><span class="iti__country-name">Morocco (المغرب)</span><span class="iti__dial-code">+212</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mz" role="option" data-dial-code="258" data-country-code="mz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mz"></div>
</div><span class="iti__country-name">Mozambique (Moçambique)</span><span class="iti__dial-code">+258</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mm" role="option" data-dial-code="95" data-country-code="mm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mm"></div>
</div><span class="iti__country-name">Myanmar (Burma) (မြန်မာ)</span><span class="iti__dial-code">+95</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-na" role="option" data-dial-code="264" data-country-code="na" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__na"></div>
</div><span class="iti__country-name">Namibia (Namibië)</span><span class="iti__dial-code">+264</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-nr" role="option" data-dial-code="674" data-country-code="nr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nr"></div>
</div><span class="iti__country-name">Nauru</span><span class="iti__dial-code">+674</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-np" role="option" data-dial-code="977" data-country-code="np" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__np"></div>
</div><span class="iti__country-name">Nepal (नेपाल)</span><span class="iti__dial-code">+977</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-nl" role="option" data-dial-code="31" data-country-code="nl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nl"></div>
</div><span class="iti__country-name">Netherlands (Nederland)</span><span class="iti__dial-code">+31</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-nc" role="option" data-dial-code="687" data-country-code="nc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nc"></div>
</div><span class="iti__country-name">New Caledonia (Nouvelle-Calédonie)</span><span class="iti__dial-code">+687</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-nz" role="option" data-dial-code="64" data-country-code="nz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nz"></div>
</div><span class="iti__country-name">New Zealand</span><span class="iti__dial-code">+64</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ni" role="option" data-dial-code="505" data-country-code="ni" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ni"></div>
</div><span class="iti__country-name">Nicaragua</span><span class="iti__dial-code">+505</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ne" role="option" data-dial-code="227" data-country-code="ne" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ne"></div>
</div><span class="iti__country-name">Niger (Nijar)</span><span class="iti__dial-code">+227</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ng" role="option" data-dial-code="234" data-country-code="ng" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ng"></div>
</div><span class="iti__country-name">Nigeria</span><span class="iti__dial-code">+234</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-nu" role="option" data-dial-code="683" data-country-code="nu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nu"></div>
</div><span class="iti__country-name">Niue</span><span class="iti__dial-code">+683</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-nf" role="option" data-dial-code="672" data-country-code="nf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__nf"></div>
</div><span class="iti__country-name">Norfolk Island</span><span class="iti__dial-code">+672</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kp" role="option" data-dial-code="850" data-country-code="kp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kp"></div>
</div><span class="iti__country-name">North Korea (조선 민주주의 인민 공화국)</span><span class="iti__dial-code">+850</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mp" role="option" data-dial-code="1" data-country-code="mp" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mp"></div>
</div><span class="iti__country-name">Northern Mariana Islands</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-no" role="option" data-dial-code="47" data-country-code="no" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__no"></div>
</div><span class="iti__country-name">Norway (Norge)</span><span class="iti__dial-code">+47</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-om" role="option" data-dial-code="968" data-country-code="om" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__om"></div>
</div><span class="iti__country-name">Oman (عُمان)</span><span class="iti__dial-code">+968</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pk" role="option" data-dial-code="92" data-country-code="pk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pk"></div>
</div><span class="iti__country-name">Pakistan (پاکستان)</span><span class="iti__dial-code">+92</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pw" role="option" data-dial-code="680" data-country-code="pw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pw"></div>
</div><span class="iti__country-name">Palau</span><span class="iti__dial-code">+680</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ps" role="option" data-dial-code="970" data-country-code="ps" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ps"></div>
</div><span class="iti__country-name">Palestine (فلسطين)</span><span class="iti__dial-code">+970</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pa" role="option" data-dial-code="507" data-country-code="pa" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pa"></div>
</div><span class="iti__country-name">Panama (Panamá)</span><span class="iti__dial-code">+507</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pg" role="option" data-dial-code="675" data-country-code="pg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pg"></div>
</div><span class="iti__country-name">Papua New Guinea</span><span class="iti__dial-code">+675</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-py" role="option" data-dial-code="595" data-country-code="py" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__py"></div>
</div><span class="iti__country-name">Paraguay</span><span class="iti__dial-code">+595</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pe" role="option" data-dial-code="51" data-country-code="pe" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pe"></div>
</div><span class="iti__country-name">Peru (Perú)</span><span class="iti__dial-code">+51</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ph" role="option" data-dial-code="63" data-country-code="ph" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ph"></div>
</div><span class="iti__country-name">Philippines</span><span class="iti__dial-code">+63</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pl" role="option" data-dial-code="48" data-country-code="pl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pl"></div>
</div><span class="iti__country-name">Poland (Polska)</span><span class="iti__dial-code">+48</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pt" role="option" data-dial-code="351" data-country-code="pt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pt"></div>
</div><span class="iti__country-name">Portugal</span><span class="iti__dial-code">+351</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pr" role="option" data-dial-code="1" data-country-code="pr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pr"></div>
</div><span class="iti__country-name">Puerto Rico</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-qa" role="option" data-dial-code="974" data-country-code="qa" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__qa"></div>
</div><span class="iti__country-name">Qatar (قطر)</span><span class="iti__dial-code">+974</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-re" role="option" data-dial-code="262" data-country-code="re" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__re"></div>
</div><span class="iti__country-name">Réunion (La Réunion)</span><span class="iti__dial-code">+262</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ro" role="option" data-dial-code="40" data-country-code="ro" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ro"></div>
</div><span class="iti__country-name">Romania (România)</span><span class="iti__dial-code">+40</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ru" role="option" data-dial-code="7" data-country-code="ru" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ru"></div>
</div><span class="iti__country-name">Russia (Россия)</span><span class="iti__dial-code">+7</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-rw" role="option" data-dial-code="250" data-country-code="rw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__rw"></div>
</div><span class="iti__country-name">Rwanda</span><span class="iti__dial-code">+250</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-bl" role="option" data-dial-code="590" data-country-code="bl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__bl"></div>
</div><span class="iti__country-name">Saint Barthélemy</span><span class="iti__dial-code">+590</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sh" role="option" data-dial-code="290" data-country-code="sh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sh"></div>
</div><span class="iti__country-name">Saint Helena</span><span class="iti__dial-code">+290</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kn" role="option" data-dial-code="1" data-country-code="kn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kn"></div>
</div><span class="iti__country-name">Saint Kitts and Nevis</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lc" role="option" data-dial-code="1" data-country-code="lc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lc"></div>
</div><span class="iti__country-name">Saint Lucia</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-mf" role="option" data-dial-code="590" data-country-code="mf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__mf"></div>
</div><span class="iti__country-name">Saint Martin (Saint-Martin (partie française))</span><span class="iti__dial-code">+590</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-pm" role="option" data-dial-code="508" data-country-code="pm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__pm"></div>
</div><span class="iti__country-name">Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)</span><span class="iti__dial-code">+508</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-vc" role="option" data-dial-code="1" data-country-code="vc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vc"></div>
</div><span class="iti__country-name">Saint Vincent and the Grenadines</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ws" role="option" data-dial-code="685" data-country-code="ws" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ws"></div>
</div><span class="iti__country-name">Samoa</span><span class="iti__dial-code">+685</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sm" role="option" data-dial-code="378" data-country-code="sm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sm"></div>
</div><span class="iti__country-name">San Marino</span><span class="iti__dial-code">+378</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-st" role="option" data-dial-code="239" data-country-code="st" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__st"></div>
</div><span class="iti__country-name">São Tomé and Príncipe (São Tomé e Príncipe)</span><span class="iti__dial-code">+239</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sa" role="option" data-dial-code="966" data-country-code="sa" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sa"></div>
</div><span class="iti__country-name">Saudi Arabia (المملكة العربية السعودية)</span><span class="iti__dial-code">+966</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sn" role="option" data-dial-code="221" data-country-code="sn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sn"></div>
</div><span class="iti__country-name">Senegal (Sénégal)</span><span class="iti__dial-code">+221</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-rs" role="option" data-dial-code="381" data-country-code="rs" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__rs"></div>
</div><span class="iti__country-name">Serbia (Србија)</span><span class="iti__dial-code">+381</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sc" role="option" data-dial-code="248" data-country-code="sc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sc"></div>
</div><span class="iti__country-name">Seychelles</span><span class="iti__dial-code">+248</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sl" role="option" data-dial-code="232" data-country-code="sl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sl"></div>
</div><span class="iti__country-name">Sierra Leone</span><span class="iti__dial-code">+232</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sg" role="option" data-dial-code="65" data-country-code="sg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sg"></div>
</div><span class="iti__country-name">Singapore</span><span class="iti__dial-code">+65</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sx" role="option" data-dial-code="1" data-country-code="sx" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sx"></div>
</div><span class="iti__country-name">Sint Maarten</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sk" role="option" data-dial-code="421" data-country-code="sk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sk"></div>
</div><span class="iti__country-name">Slovakia (Slovensko)</span><span class="iti__dial-code">+421</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-si" role="option" data-dial-code="386" data-country-code="si" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__si"></div>
</div><span class="iti__country-name">Slovenia (Slovenija)</span><span class="iti__dial-code">+386</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sb" role="option" data-dial-code="677" data-country-code="sb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sb"></div>
</div><span class="iti__country-name">Solomon Islands</span><span class="iti__dial-code">+677</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-so" role="option" data-dial-code="252" data-country-code="so" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__so"></div>
</div><span class="iti__country-name">Somalia (Soomaaliya)</span><span class="iti__dial-code">+252</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-za" role="option" data-dial-code="27" data-country-code="za" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__za"></div>
</div><span class="iti__country-name">South Africa</span><span class="iti__dial-code">+27</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-kr" role="option" data-dial-code="82" data-country-code="kr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__kr"></div>
</div><span class="iti__country-name">South Korea (대한민국)</span><span class="iti__dial-code">+82</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ss" role="option" data-dial-code="211" data-country-code="ss" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ss"></div>
</div><span class="iti__country-name">South Sudan (جنوب السودان)</span><span class="iti__dial-code">+211</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-es" role="option" data-dial-code="34" data-country-code="es" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__es"></div>
</div><span class="iti__country-name">Spain (España)</span><span class="iti__dial-code">+34</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-lk" role="option" data-dial-code="94" data-country-code="lk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__lk"></div>
</div><span class="iti__country-name">Sri Lanka (ශ්රී ලංකාව)</span><span class="iti__dial-code">+94</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sd" role="option" data-dial-code="249" data-country-code="sd" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sd"></div>
</div><span class="iti__country-name">Sudan (السودان)</span><span class="iti__dial-code">+249</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sr" role="option" data-dial-code="597" data-country-code="sr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sr"></div>
</div><span class="iti__country-name">Suriname</span><span class="iti__dial-code">+597</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sj" role="option" data-dial-code="47" data-country-code="sj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sj"></div>
</div><span class="iti__country-name">Svalbard and Jan Mayen</span><span class="iti__dial-code">+47</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-se" role="option" data-dial-code="46" data-country-code="se" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__se"></div>
</div><span class="iti__country-name">Sweden (Sverige)</span><span class="iti__dial-code">+46</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ch" role="option" data-dial-code="41" data-country-code="ch" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ch"></div>
</div><span class="iti__country-name">Switzerland (Schweiz)</span><span class="iti__dial-code">+41</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-sy" role="option" data-dial-code="963" data-country-code="sy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__sy"></div>
</div><span class="iti__country-name">Syria (سوريا)</span><span class="iti__dial-code">+963</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tw" role="option" data-dial-code="886" data-country-code="tw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tw"></div>
</div><span class="iti__country-name">Taiwan (台灣)</span><span class="iti__dial-code">+886</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tj" role="option" data-dial-code="992" data-country-code="tj" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tj"></div>
</div><span class="iti__country-name">Tajikistan</span><span class="iti__dial-code">+992</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tz" role="option" data-dial-code="255" data-country-code="tz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tz"></div>
</div><span class="iti__country-name">Tanzania</span><span class="iti__dial-code">+255</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-th" role="option" data-dial-code="66" data-country-code="th" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__th"></div>
</div><span class="iti__country-name">Thailand (ไทย)</span><span class="iti__dial-code">+66</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tl" role="option" data-dial-code="670" data-country-code="tl" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tl"></div>
</div><span class="iti__country-name">Timor-Leste</span><span class="iti__dial-code">+670</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tg" role="option" data-dial-code="228" data-country-code="tg" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tg"></div>
</div><span class="iti__country-name">Togo</span><span class="iti__dial-code">+228</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tk" role="option" data-dial-code="690" data-country-code="tk" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tk"></div>
</div><span class="iti__country-name">Tokelau</span><span class="iti__dial-code">+690</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-to" role="option" data-dial-code="676" data-country-code="to" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__to"></div>
</div><span class="iti__country-name">Tonga</span><span class="iti__dial-code">+676</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tt" role="option" data-dial-code="1" data-country-code="tt" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tt"></div>
</div><span class="iti__country-name">Trinidad and Tobago</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tn" role="option" data-dial-code="216" data-country-code="tn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tn"></div>
</div><span class="iti__country-name">Tunisia (تونس)</span><span class="iti__dial-code">+216</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tr" role="option" data-dial-code="90" data-country-code="tr" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tr"></div>
</div><span class="iti__country-name">Turkey (Türkiye)</span><span class="iti__dial-code">+90</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tm" role="option" data-dial-code="993" data-country-code="tm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tm"></div>
</div><span class="iti__country-name">Turkmenistan</span><span class="iti__dial-code">+993</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tc" role="option" data-dial-code="1" data-country-code="tc" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tc"></div>
</div><span class="iti__country-name">Turks and Caicos Islands</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-tv" role="option" data-dial-code="688" data-country-code="tv" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__tv"></div>
</div><span class="iti__country-name">Tuvalu</span><span class="iti__dial-code">+688</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-vi" role="option" data-dial-code="1" data-country-code="vi" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vi"></div>
</div><span class="iti__country-name">U.S. Virgin Islands</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ug" role="option" data-dial-code="256" data-country-code="ug" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ug"></div>
</div><span class="iti__country-name">Uganda</span><span class="iti__dial-code">+256</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ua" role="option" data-dial-code="380" data-country-code="ua" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ua"></div>
</div><span class="iti__country-name">Ukraine (Україна)</span><span class="iti__dial-code">+380</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ae" role="option" data-dial-code="971" data-country-code="ae" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ae"></div>
</div><span class="iti__country-name">United Arab Emirates (الإمارات العربية المتحدة)</span><span class="iti__dial-code">+971</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-gb" role="option" data-dial-code="44" data-country-code="gb" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__gb"></div>
</div><span class="iti__country-name">United Kingdom</span><span class="iti__dial-code">+44</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-us" role="option" data-dial-code="1" data-country-code="us" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__us"></div>
</div><span class="iti__country-name">United States</span><span class="iti__dial-code">+1</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-uy" role="option" data-dial-code="598" data-country-code="uy" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__uy"></div>
</div><span class="iti__country-name">Uruguay</span><span class="iti__dial-code">+598</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-uz" role="option" data-dial-code="998" data-country-code="uz" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__uz"></div>
</div><span class="iti__country-name">Uzbekistan (Oʻzbekiston)</span><span class="iti__dial-code">+998</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-vu" role="option" data-dial-code="678" data-country-code="vu" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vu"></div>
</div><span class="iti__country-name">Vanuatu</span><span class="iti__dial-code">+678</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-va" role="option" data-dial-code="39" data-country-code="va" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__va"></div>
</div><span class="iti__country-name">Vatican City (Città del Vaticano)</span><span class="iti__dial-code">+39</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ve" role="option" data-dial-code="58" data-country-code="ve" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ve"></div>
</div><span class="iti__country-name">Venezuela</span><span class="iti__dial-code">+58</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-vn" role="option" data-dial-code="84" data-country-code="vn" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__vn"></div>
</div><span class="iti__country-name">Vietnam (Việt Nam)</span><span class="iti__dial-code">+84</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-wf" role="option" data-dial-code="681" data-country-code="wf" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__wf"></div>
</div><span class="iti__country-name">Wallis and Futuna (Wallis-et-Futuna)</span><span class="iti__dial-code">+681</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-eh" role="option" data-dial-code="212" data-country-code="eh" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__eh"></div>
</div><span class="iti__country-name">Western Sahara (الصحراء الغربية)</span><span class="iti__dial-code">+212</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ye" role="option" data-dial-code="967" data-country-code="ye" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ye"></div>
</div><span class="iti__country-name">Yemen (اليمن)</span><span class="iti__dial-code">+967</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-zm" role="option" data-dial-code="260" data-country-code="zm" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__zm"></div>
</div><span class="iti__country-name">Zambia</span><span class="iti__dial-code">+260</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-zw" role="option" data-dial-code="263" data-country-code="zw" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__zw"></div>
</div><span class="iti__country-name">Zimbabwe</span><span class="iti__dial-code">+263</span>
</li>
<li class="iti__country iti__standard" tabindex="-1" id="iti-0__item-ax" role="option" data-dial-code="358" data-country-code="ax" aria-selected="false">
<div class="iti__flag-box">
<div class="iti__flag iti__ax"></div>
</div><span class="iti__country-name">Åland Islands</span><span class="iti__dial-code">+358</span>
</li>
</ul>
</div><input class="cmp-singlelineText--input" data-errormsg="*Please fill in mobile phone number or email" data-requirederrormsg="*Please fill in mobile number" data-fixed="false" data-mobile="internationalNumber"
data-formvalue="Get Rewarded" data-type="mobileNumber" type="text" id="pdt" placeholder="81234567" name="mobileTelNo" data-required="false" autocomplete="off" data-intl-tel-input-id="0" style="padding-left: 85px;"
maxlength="8">
</div>
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Please fill in mobile phone number or email</span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="text">
<div id="text-cff5fe906b" class="cmp-text ">
<div><b>Please select the right country code.</b></div>
</div>
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-formid="pdt" data-required="false" data-message-required="*Please fill in email" data-message-validation="*Please fill in mobile phone number or email">
<div class="cmp-singlelineText-container" data-hidden="false">
<label>What's your email address?</label>
<div class="cmp-singlelineText--inputWrapper" data-mobile="none">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<input class="cmp-singlelineText--input" data-errormsg="*Please fill in mobile phone number or email" data-requirederrormsg="*Please fill in email" data-fixed="false" data-mobile="none" data-formvalue="Get Rewarded"
data-type="email" type="text" id="pdt" placeholder="Email" name="email" data-required="false">
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Please fill in mobile phone number or email</span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
</div>
<div id="flexitem-aa53842eca" class="cmp-flexitem cmp-flexitem__alignself--start cmp-flexitem--col-full" data-cmp-is="flexitem" data-is-edit-mode="false" data-col-span="cmp-flexitem--col-full">
<div class="buttonselection">
<div class="cmp-radio cmp-enhanced-radio-" data-message-validation="*Wrong validation message" data-message-required="*Please select an option" data-required="true" data-ignore-error="1" data-cmp-is="button-selection"
data-formid="pdt" data-formtitle="Are you an existing AIA Singapore customer?*" data-is-edit-mode="false">
<div class="cmp-radio__item">
<div class="cmp-radio__checkout-payment--payment-type">
<span class="cmp-radio--infoheading cmp-radio__checkout-payment--infoheading--paymentmargin cmp-radio__labelNormal"> Are you an existing AIA Singapore customer?* </span>
<div class="cmp-radio__checkout-payment__inline-section">
<div class="cmp-radio__form-check pt-2 pb-2 m-0">
<input class="cmp-leadsgenerationform__radio " checked="active" type="radio" name="existingCustomer" value="no" data-flow-change="false" id="pdt-radio-subcat-existingCustomer-no">
<label class="cmp-radio__form-check-label " for="pdt-radio-subcat-existingCustomer-no"> No </label>
</div>
<div class="cmp-radio__form-check pt-2 pb-2 m-0">
<input class="cmp-leadsgenerationform__radio " type="radio" name="existingCustomer" value="yes" data-show-other-section-flag=" true" data-section-id-to-show="pdt-1" data-flow-change="false"
id="pdt-radio-subcat-existingCustomer-yes">
<label class="cmp-radio__form-check-label " for="pdt-radio-subcat-existingCustomer-yes"> Yes </label>
</div>
</div>
</div>
</div>
<div class="cmp-radio__api-question-container"></div>
<div class="cmp-radio--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Please select an option</span>
</div>
</div>
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="section container responsivegrid">
<div id="pdt-1" data-section-id="pdt-1" data-cmp-is="X7Section" class="cmp-section cmp-section--nopadding " style="display: none;">
<div class="cmp-section__content">
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-required="false" data-message-required="*Please fill in NRIC/Passport/FIN No" data-message-validation="*Your NRIC / Passport / FIN No. is required.">
<div class="cmp-singlelineText-container" data-hidden="false">
<label>Partial NRIC / Passport / FIN No.</label>
<span class="cmp-shortTextInput--imgtips cmp-enhanced-tooltip" data-cmp-is="enhanced-tooltip">
<img class="cmp-shortTextInput--tooltip" src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-tooltip.svg">
<div class="cmp-shortTextInput--tooltipContainer">
<div class="cmp-shortTextInput--tooltipArrow"></div>
<div class="cmp-shortTextInput--tooltipInner">last 4 chracters</div>
</div>
</span>
<div class="cmp-singlelineText--inputWrapper" data-mobile="none">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<input class="cmp-singlelineText--input" data-errormsg="*Your NRIC / Passport / FIN No. is required." data-requirederrormsg="*Please fill in NRIC/Passport/FIN No" data-fixed="false" data-mobile="none"
data-formvalue="Get Rewarded" data-type="partialId" type="text" placeholder="eg: 123X" name="nric" data-required="false">
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Your NRIC / Passport / FIN No. is required.</span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="formdatepicker">
<div data-cmp-is="form-datepicker" data-param-name="dob" data-required="false" data-enable-future="false" data-enable-input="true" data-limit="noLimit" data-message-required="*Please select Date of Birth"
class="cmp-formDatepicker form-date-picker-start">
<div class="formDatepicker-labelWrapper">
<label for="date">Date of birth</label>
</div>
<input id="formDatepicker" class="cmp-formDatepicker__dateinput" type="text" name="dob" data-enableinput="true" autocomplete="off" placeholder="DD/MMM/YYYY">
<div class="invalid-feedback">
<div class="error-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/alert-solid.svg">
<span>*Please select Date of Birth</span>
</div>
</div>
</div>
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
</div>
</div>
</div>
<div class="freetextmultiline">
<div data-cmp-is="freetext-multiline" class="cmp-freetext-multiline" data-required="false" data-message-required="*Please fill in your question" data-formid="pdt">
<div class="cmp-freeTextMultiline__textarea">
<label> Drop us a question here: </label>
<div class="cmp-freeTextMultiline__textarea--box">
<textarea data-required="false" name="message" id="pdt" class="cmp-freeTextMultiline__textarea--input longtextarea" placeholder="English language only" maxlength="400"></textarea>
<div class="cmp-freeTextMultiline__textareanum--box">
<span id="textNum">0</span>/400
</div>
</div>
<div class="cmp-freeTextMultiline--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Please fill in your question</span>
</div>
</div>
</div>
</div>
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-formid="pdt" data-required="false">
<div class="cmp-singlelineText-container" data-hidden="true" style="display: none;">
<label>Campaign ID</label>
<div class="cmp-singlelineText--inputWrapper" data-mobile="none">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<input class="cmp-singlelineText--input" data-fixed="false" data-mobile="none" data-formvalue="Get Rewarded" data-default="WEB-A2203-00|5" data-type="text" type="text" id="pdt" name="campaignId" value="WEB-A2203-00|5"
data-required="false">
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span></span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-formid="pdt" data-required="false">
<div class="cmp-singlelineText-container" data-hidden="true" style="display: none;">
<label>Product detail name</label>
<div class="cmp-singlelineText--inputWrapper" data-mobile="none">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<input class="cmp-singlelineText--input" data-fixed="true" data-mobile="none" data-formvalue="Get Rewarded" data-type="text" type="text" id="pdt" name="productDetailName" data-required="false" disabled="disabled">
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span></span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
<div class="freetextsingleline">
<div class="cmp-singlelineText" data-cmp-is="singlelineText" data-formid="pdt" data-required="false">
<div class="cmp-singlelineText-container" data-hidden="true" style="display: none;">
<label>Email subject</label>
<div class="cmp-singlelineText--inputWrapper" data-mobile="none">
<!-- <input class="cmp-singlelineText--input" type="tel" id="phone"> -->
<input class="cmp-singlelineText--input" data-fixed="false" data-mobile="none" data-formvalue="Get Rewarded" data-default="Website enquiry" data-type="text" type="text" id="pdt" name="emailSubject"
value="Website enquiry" data-required="false">
</div>
<div class="cmp-singlelineText--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span></span>
</div>
</div>
</div>
<!-- formModel.defaultValue -->
</div>
</div>
</div>
</div>
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="multiselectionbox">
<div data-cmp-is="multiSelect-enhanced" id="components-muti-delect" data-name="consent" data-required="true" data-formid="pdt" class="cmp-multiSelect" data-is-edit-mode="false">
<div class="cmp-questionWrapper">
<p class="cmp-questionHeader">Please provide your consent by ticking on the checkbox below:</p>
</div>
<div class="cmp-multiSelect__inline-section">
<input class="cmp-multiSelect__checkInput" type="checkbox" value="Y" id="check-subcat-consent" name="consent">
<label class="cmp-multiSelect__label" for="check-subcat-consent"> By providing your personal data and submitting this form, you consent to the collection, use, disclosure, processing and retention of your personal data by AIA
Persons[1], for purposes of addressing your enquiry ("Purpose"), in accordance with the AIA Personal Data Policy (Singapore)[2]. You also consent to being contacted by AIA Persons via your provided contact details[3] for such
Purpose. </label>
</div>
<div class="cmp-shortTextInput--err-msg">
<img src="/etc.clientlibs/aia-wise/clientlibs/clientlib-site/resources/images/icons/icon-general-alert-solid.svg">
<span>*Please tick consent before submission</span>
</div>
</div>
</div>
<div class="spacer">
<div class="cmp-spacer cmp-spacer--large cmp-spacer--large-mobile"></div>
</div>
<div class="text body-text">
<div id="text-c42c0484a9" class="cmp-text ">
<div>[1] "AIA Persons" refers to AIA Singapore Private Limited, its associated persons/organisations, its and their third-party service providers and its and their representatives, whether within or outside Singapore.</div>
<div> </div>
<div>[2] Available at <a href="/en/index/aia-personal-data-policy-singapore" target="_blank">AIA Personal Data Policy (Singapore)</a>.</div>
<div> </div>
<div>[3] If you have provided your mobile number, we will contact you via voice call and/or text message (e.g. SMS/MMS). If you have provided your email address, we will contact you via email.</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="recaptchaContainer">
<div id="aia-recaptcha" class="g-recaptcha">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-ig1lypp0x9rb" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6LcXnhITAAAAAC-aHBnJ9AtzlY5VLG05E0EQUPuR&co=aHR0cHM6Ly93d3cuYWlhLmNvbS5zZzo0NDM.&hl=zh-CN&v=8k85QBI-qzxmenDv318AZH30&theme=light&size=normal&cb=tk97nypbjtd1"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<span class="recaptchaContainer__errorMessage hide">*Please verify the reCAPTCHA and tick the check box before submission</span>
</div>
</div>
<!-- submit/next button -->
<div class="cmp-contactuscontainer__footer">
<button type="button" data-cmp-is="submitButton" class="cmp-contactuscontainer__primarybtn" id="submitCta">Submit </button>
</div>
</fieldset>
<!-- review fieldset -->
<!-- screen two -->
<!--/* screen four */ -->
<fieldset id="container-screenfour-variant1" class="cmp-contactuscontainer__screen cmp-contactuscontainer__screen-4 cmp-contactuscontainer__screen-4 ">
<div data-placeholder-text="false">
<div id="section-c80c462f9a" data-section-id="section-c80c462f9a" data-cmp-is="X7Section"
class="cmp-section cmp-section--nopaddingtop-desktop cmp-section--nopaddingright-desktop cmp-section--nopaddingbottom-desktop cmp-section--nopaddingleft-desktop cmp-section--nopaddingtop-mobile cmp-section--nopaddingright-mobile cmp-section--nopaddingbottom-mobile cmp-section--nopaddingleft-mobile ">
<div class="cmp-section__content">
<div class="flexbox carousel panelcontainer">
<div id="flexbox-bf55dc15c6" class="cmp-flexbox" role="group">
<div class="cmp-flexbox__container cmp-flexbox__direction--row cmp-flexbox__justify--center cmp-flexbox__alignitems--center cmp-flexbox--nowrap cmp-flexbox__gap--xl3 cmp-flexbox--flexwrap-mobile cmp-flexbox__gap--xl3-mobile">
<div id="flexitem-3fe6d582c9" class="cmp-flexitem cmp-flexitem__alignself--center cmp-flexitem--col-6" data-cmp-is="flexitem" data-is-edit-mode="false" data-col-span="cmp-flexitem--col-6">
<div class="image">
<div data-cmp-lazy="" data-cmp-lazythreshold="0"
data-cmp-src="https://s7ap1.scene7.com/is/image/aia/01-visual-language-04-illustrations-07-status-success-2@3x?qlt=85&wid=%7B.width%7D&ts=1687170871969&fmt=png-alpha&dpr=off"
data-cmp-widths="320,480,600,800,1024,1200,1600" data-cmp-dmimage="" data-asset="/content/dam/sg-wise/en/system/icons/01-visual-language-04-illustrations-07-status-success-2@3x.png" id="image-4fc5d3b80e"
class="cmp-image false" itemscope="" itemtype="http://schema.org/ImageObject">
<img class="cmp-image__image false cmp-image__image--is-loading" itemprop="contentUrl" data-cmp-hook-image="image" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7">
</div>
<div>
<script type="text/javascript">
var aiaDatalayer = aiaDatalayer || {};
aiaDatalayer["image"] = ""
</script>
</div>
</div>
</div>
<div id="flexitem-48e62c2e65" class="cmp-flexitem cmp-flexitem__alignself--center cmp-flexitem--col-full" data-cmp-is="flexitem" data-is-edit-mode="false" data-col-span="cmp-flexitem--col-full">
<div class="title">
<div class="cmp-title cmp-title--left" data-cmp-is="title" data-checkout="false">
<h1 class="cmp-title__text cmp-title--top-xl3 cmp-title--bottom-xl3 cmp-title--top-xl3-mobile cmp-title--bottom-xl3-mobile cmp-title--dark"> Thank you for your request </h1>
</div>
</div>
<div class="text">
<div id="text-b01fa7c341" class="cmp-text ">
<div>We will do our best to respond to you as soon as possible.</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</fieldset>
</div>
</form>
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Home Back 2. AIA Vitality Back AIA Vitality GET REWARDED ENJOYING BETTER HEALTH HAS NEVER BEEN MORE REWARDING Leading a healthy lifestyle is the gift that keeps on giving. With AIA Vitality, you can reap the benefits of being in the pink of health, while enjoying exclusive partner benefits. The higher your AIA Vitality status, the more rewards you'll unlock! REWARDS Keep your heart rate up and feet moving through the week to earn rewards with AIA Vitality! WEEKLY FITNESS CHALLENGE Simply clock your workout or visit our partner gyms to achieve your weekly target and earn Vitality coins to redeem rewards at the Marketplace. Learn more SPECIAL DEALS We've got some special deals for AIA Vitality members! From lifestyle to nutrition to health, there's something for everyone. Check it out today! Learn more PARTNER BENEFITS AIA Vitality has partnered with some of the most inspiring brands to reward you for your commitment to your health. The higher your AIA Vitality status, the better the rewards — so work hard, and we'll see you at the top! BRONZE (0 - 9,999 POINTS) SILVER (10,000 - 19,999 POINTS) GOLD (20,000 - 29,999 POINTS) PLATINUM ( > 30,000 POINTS) FOR MEMBERS AT BRONZE VITALITY STATUS AIA Insurance Benefit AIA Locked Level up to unlock benefit Platinum Bonus Fullerton Screening Packages at AIA Vitality rates Fullerton Vaccination Packages at AIA Vitality rates Healthway Screening Packages at AIA Vitality rates Healthway Vaccination Packages at AIA Vitality rates OneCare Medical Screening Packages at AIA Vitality rates OneCare Medical Vaccination Packages at AIA Vitality rates Allen Carr's Easyway ® 30% off Smoking Cessation Session Healthway Dental Assessment at AIA Vitality rates Health Can Be Fun Discounted Nutrition Assessment Q&M Dental Assessment at AIA Vitality rates Fitness First 20% off Gym Membership Fitness First Locked Level up to unlock benefit Complimentary Kickstart Package Virgin Active 30% off Gym Membership Virgin Active Locked Level up to unlock benefit Exclusive in-club privileges Fitbit Up to 30% off Fitness Devices with free delivery Garmin 25% off Fitness Devices Polar 25% off Fitness Devices Cold Storage 20% cashback on HealthyFood™ purchases Emirates 5% rebate on airfares Royal Caribbean International 10% off cruise fares Singapore Airlines 5% rebate on airfares Golden Village S$3 off x 2 movie tickets Cloversoft & Co. Valid till 14 September 2024 10% off minimum S$49 spend Dr. Rock Valid till 31 March 2025 Up to 20% off Dr. Rock massagers Ecofrenli Valid till 31 March 2025 Up to S$50 off with minimum purchase Equinox Valid till 31 March 2025 Exclusive hotel rates and benefits Guardian Valid till 30 September 2024 Get rewarded when you are smoke-free! Jabra Valid till 31 March 2025 Up to 20% off selected items LUMA Up to $300 Medisave subsidy* Noel Gifts Valid till 30 June 2024 12% off flowers and gifts REVIVE Valid till 31 March 2025 10% off with free delivery Samsung Valid till 31 March 2025 Up to 20% off selected items Somnus Sleep Wellness Valid till 31 March 2025 Sleep better WhiteCoat Valid till 31 March 2025 Home-based Screening Packages at AIA Vitality rates FOR MEMBERS AT SILVER VITALITY STATUS AIA Insurance Benefit AIA Locked Level up to unlock benefit Platinum Bonus Fullerton Screening Packages at AIA Vitality rates Fullerton Vaccination Packages at AIA Vitality rates Healthway Screening Packages at AIA Vitality rates Healthway Vaccination Packages at AIA Vitality rates OneCare Medical Screening Packages at AIA Vitality rates OneCare Medical Vaccination Packages at AIA Vitality rates Allen Carr's Easyway ® 30% off Smoking Cessation Session Healthway Dental Assessment at AIA Vitality rates Health Can Be Fun Discounted Nutrition Assessment Q&M Dental Assessment at AIA Vitality rates Fitness First 20% off Gym Membership Fitness First Locked Level up to unlock benefit Complimentary Kickstart Package Virgin Active 30% off Gym Membership Virgin Active Locked Level up to unlock benefit Exclusive in-club privileges Fitbit Up to 30% off Fitness Devices with free delivery Garmin 25% off Fitness Devices Polar 25% off Fitness Devices Cold Storage 20% cashback on HealthyFood™ purchases Emirates 5% rebate on airfares Royal Caribbean International 25% off cruise fares Singapore Airlines 5% rebate on airfares Golden Village S$3 off x 2 movie tickets Cloversoft & Co. Valid till 14 September 2024 10% off minimum S$49 spend Dr. Rock Valid till 31 March 2025 Up to 20% off Dr. Rock massagers Ecofrenli Valid till 31 March 2025 Up to S$50 off with minimum purchase Equinox Valid till 31 March 2025 Exclusive hotel rates and benefits Guardian Valid till 30 September 2024 Get rewarded when you are smoke-free! Jabra Valid till 31 March 2025 Up to 20% off selected items LUMA Up to $300 Medisave subsidy* Noel Gifts Valid till 30 June 2024 12% off flowers and gifts REVIVE Valid till 31 March 2025 10% off with free delivery Samsung Valid till 31 March 2025 Up to 20% off selected items Somnus Sleep Wellness Valid till 31 March 2025 Sleep better WhiteCoat Valid till 31 March 2025 Home-based Screening Packages at AIA Vitality rates FOR MEMBERS AT GOLD VITALITY STATUS AIA Insurance Benefit AIA Locked Level up to unlock benefit Platinum Bonus Fullerton Screening Packages at AIA Vitality rates Fullerton Vaccination Packages at AIA Vitality rates Healthway Screening Packages at AIA Vitality rates Healthway Vaccination Packages at AIA Vitality rates OneCare Medical Screening Packages at AIA Vitality rates OneCare Medical Vaccination Packages at AIA Vitality rates Allen Carr's Easyway ® 30% off Smoking Cessation Session Healthway Dental Assessment at AIA Vitality rates healthcanbefun - 1 Health Can Be Fun Discounted Nutrition Assessment qmdental - 1 Q&M Dental Assessment at AIA Vitality rates Fitness First 20% off Gym Membership Fitness First Locked Level up to unlock benefit Complimentary Kickstart Package Virgin Active 30% off Gym Membership Virgin Active Locked Level up to unlock benefit Exclusive in-club privileges Fitbit Up to 30% off Fitness Devices with free delivery Garmin 25% off Fitness Devices Polar 25% off Fitness Devices Cold Storage 20% cashback on HealthyFood™ purchases Emirates 10% rebate on airfares Royal Caribbean International 35% off cruise fares Singapore Airlines 10% rebate on airfares Golden Village S$3 off x 2 movie tickets Cloversoft & Co. Valid till 14 September 2024 10% off minimum S$49 spend Dr. Rock Valid till 31 March 2025 Up to 20% off Dr. Rock massagers Ecofrenli Valid till 31 March 2025 Up to S$50 off with minimum purchase Equinox Valid till 31 March 2025 Exclusive hotel rates and benefits Guardian Valid till 30 September 2024 Get rewarded when you are smoke-free! Jabra Valid till 31 March 2025 Up to 20% off selected items LUMA Up to $300 Medisave subsidy* Noel Gifts Valid till 30 June 2024 12% off flowers and gifts REVIVE Valid till 31 March 2025 10% off with free delivery Samsung Valid till 31 March 2025 Up to 20% off selected items Somnus Sleep Wellness Valid till 31 March 2025 Sleep better WhiteCoat Valid till 31 March 2025 Home-based Screening Packages at AIA Vitality rates FOR MEMBERS AT PLATINUM VITALITY STATUS AIA Insurance Benefit AIA Platinum Bonus Fullerton Screening Packages at AIA Vitality rates Fullerton Vaccination Packages at AIA Vitality rates Healthway Screening Packages at AIA Vitality rates Healthway Vaccination Packages at AIA Vitality rates OneCare Medical Screening Packages at AIA Vitality rates OneCare Medical Vaccination Packages at AIA Vitality rates Allen Carr's Easyway ® 30% off Smoking Cessation Session Healthway Dental Assessment at AIA Vitality rates Health Can Be Fun Discounted Nutrition Assessment Q&M Dental Assessment at AIA Vitality rates Fitness First 20% off Gym Membership Fitness First Complimentary Kickstart Package Virgin Active 30% off Gym Membership Virgin Active Exclusive in-club privileges Fitbit Up to 30% off Fitness Devices with free delivery Garmin 25% off Fitness Devices Polar 25% off Fitness Devices Cold Storage 20% cashback on HealthyFood™ purchases Emirates 20% rebate on airfares Royal Caribbean International 50% off cruise fares Singapore Airlines 20% rebate on airfares Golden Village S$3 off x 2 movie tickets Cloversoft & Co. Valid till 14 September 2024 10% off minimum S$49 spend Dr. Rock Valid till 31 March 2025 Up to 20% off Dr. Rock massagers Ecofrenli Valid till 31 March 2025 Up to S$50 off with minimum purchase Equinox Valid till 31 March 2025 Exclusive hotel rates and benefits Guardian Valid till 30 September 2024 Get rewarded when you are smoke-free! Jabra Valid till 31 March 2025 Up to 20% off selected items LUMA Up to $300 Medisave subsidy* Noel Gifts Valid till 30 June 2024 12% off flowers and gifts REVIVE Valid till 31 March 2025 10% off with free delivery Samsung Valid till 31 March 2025 Up to 20% off selected items Somnus Sleep Wellness Valid till 31 March 2025 Sleep better WhiteCoat Valid till 31 March 2025 Home-based Screening Packages at AIA Vitality rates QUICK LINKS MEMBERS' STORIES IMPROVE YOUR HEALTH LATEST NEWS AIA VITALITY FAQS / T&C YOUR FIRST STEP BEGINS TODAY Kickstart your journey towards better health with a comprehensive programme that supports and empowers you at only S$8 each month (inclusive of GST). AIA Vitality is exclusive to AIA Customers. Please login/activate My AIA SG and tap on 'AIA Vitality' to join the programme. Join now Not an AIA customer? Drop us your details and we will contact you. Get in touch with us Form submission error Salutation* Mr. Miss. Mdm. 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