connect.vega.works
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13.75.209.131
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Submitted URL: http://m.vega.works/ls/click?upn=d4TiXLz3k8dHMWJzD0xYYHic0iSf9DKaX2O0HFjKJvss9gI-2BEgYHCcDZjXhEib9N1543tUpZwTj9N8Ndz...
Effective URL: https://connect.vega.works/(S(ktxzpx5fqerxgr4vjve5nawa))/Content/csharp/registration.aspx?rfD3x0k=A2613C2A-8B69-4CED-B3BA-9...
Submission: On March 19 via manual from NZ — Scanned from NZ
Effective URL: https://connect.vega.works/(S(ktxzpx5fqerxgr4vjve5nawa))/Content/csharp/registration.aspx?rfD3x0k=A2613C2A-8B69-4CED-B3BA-9...
Submission: On March 19 via manual from NZ — Scanned from NZ
Form analysis 1 forms found in the DOM
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<div class="aspNetHidden">
<input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
<input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE"
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</div>
<script type="text/javascript">
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var theForm = document.forms['myform'];
if (!theForm) {
theForm = document.myform;
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function __doPostBack(eventTarget, eventArgument) {
if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
theForm.__EVENTTARGET.value = eventTarget;
theForm.__EVENTARGUMENT.value = eventArgument;
theForm.submit();
}
}
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<script type="text/javascript">
//<![CDATA[
var PageMethods = function() {
PageMethods.initializeBase(this);
this._timeout = 0;
this._userContext = null;
this._succeeded = null;
this._failed = null;
}
PageMethods.prototype = {
_get_path: function() {
var p = this.get_path();
if (p) return p;
else return PageMethods._staticInstance.get_path();
},
HeaderDocumentLoad: function(OwnerId, HeaderDocumentID, WidgetName, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'HeaderDocumentLoad', false, {
OwnerId: OwnerId,
HeaderDocumentID: HeaderDocumentID,
WidgetName: WidgetName
}, succeededCallback, failedCallback, userContext);
},
TermandCondition: function(OwnerID, DocumentID, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'TermandCondition', false, {
OwnerID: OwnerID,
DocumentID: DocumentID
}, succeededCallback, failedCallback, userContext);
},
LoadGreeting: function(url, OwnerId, widgetname, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'LoadGreeting', false, {
url: url,
OwnerId: OwnerId,
widgetname: widgetname
}, succeededCallback, failedCallback, userContext);
},
WebsiteSessionCnt: function(OwnerID, ActionID, EntityID, CampaignID, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'WebsiteSessionCnt', false, {
OwnerID: OwnerID,
ActionID: ActionID,
EntityID: EntityID,
CampaignID: CampaignID
}, succeededCallback, failedCallback, userContext);
},
CreatNotice: function(strOwnerID, strEmail, orgName, intNoticeID, firstName, lastName, fromEmail, supporterID, toEmail, widgetname, strMobile, phone, strAddress1, strAddress2, strSuburb, strBillcity, postCode, state, country, comments,
succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'CreatNotice', false, {
strOwnerID: strOwnerID,
strEmail: strEmail,
orgName: orgName,
intNoticeID: intNoticeID,
firstName: firstName,
lastName: lastName,
fromEmail: fromEmail,
supporterID: supporterID,
toEmail: toEmail,
widgetname: widgetname,
strMobile: strMobile,
phone: phone,
strAddress1: strAddress1,
strAddress2: strAddress2,
strSuburb: strSuburb,
strBillcity: strBillcity,
postCode: postCode,
state: state,
country: country,
comments: comments
}, succeededCallback, failedCallback, userContext);
},
SendingEmail: function(strOwnerID, strEmail, iAcknowledgementID, firstName, lastName, fromEmail, supporterID, widgetname, strAddress1, strAddress2, strSuburb, strBillcity, strMobile, postCode, state, country, templateID, succeededCallback,
failedCallback, userContext) {
return this._invoke(this._get_path(), 'SendingEmail', false, {
strOwnerID: strOwnerID,
strEmail: strEmail,
iAcknowledgementID: iAcknowledgementID,
firstName: firstName,
lastName: lastName,
fromEmail: fromEmail,
supporterID: supporterID,
widgetname: widgetname,
strAddress1: strAddress1,
strAddress2: strAddress2,
strSuburb: strSuburb,
strBillcity: strBillcity,
strMobile: strMobile,
postCode: postCode,
state: state,
country: country,
templateID: templateID
}, succeededCallback, failedCallback, userContext);
},
InsertDonationLogToAttribute: function(OwnerId, LogID, AttributeID, AttributeValue, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'InsertDonationLogToAttribute', false, {
OwnerId: OwnerId,
LogID: LogID,
AttributeID: AttributeID,
AttributeValue: AttributeValue
}, succeededCallback, failedCallback, userContext);
},
InsertDonationLog: function(OwnerId, strFirstname, strLastname, billAddress, billAddress1, Suburb, city, state, Country, postcode, strEmail, strMobile, categoryid, campaignid, attributeid, documentid, organisation, xblWidgetLicenseID,
isSafari, CaptchaResponse, attributes, id, dateOfBirth, phone, prefix, comments, createFundraiser, password, teamID, linkWidgetID, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'InsertDonationLog', false, {
OwnerId: OwnerId,
strFirstname: strFirstname,
strLastname: strLastname,
billAddress: billAddress,
billAddress1: billAddress1,
Suburb: Suburb,
city: city,
state: state,
Country: Country,
postcode: postcode,
strEmail: strEmail,
strMobile: strMobile,
categoryid: categoryid,
campaignid: campaignid,
attributeid: attributeid,
documentid: documentid,
organisation: organisation,
xblWidgetLicenseID: xblWidgetLicenseID,
isSafari: isSafari,
CaptchaResponse: CaptchaResponse,
attributes: attributes,
id: id,
dateOfBirth: dateOfBirth,
phone: phone,
prefix: prefix,
comments: comments,
createFundraiser: createFundraiser,
password: password,
teamID: teamID,
linkWidgetID: linkWidgetID
}, succeededCallback, failedCallback, userContext);
},
InsertDonationLogToAttributes: function(OwnerId, xblWidgetLicenseID, strFirstname, strLastname, strEmail, iReturn, attributes, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'InsertDonationLogToAttributes', false, {
OwnerId: OwnerId,
xblWidgetLicenseID: xblWidgetLicenseID,
strFirstname: strFirstname,
strLastname: strLastname,
strEmail: strEmail,
iReturn: iReturn,
attributes: attributes
}, succeededCallback, failedCallback, userContext);
},
Template_load: function(strOwnerId, intThankID, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'Template_load', false, {
strOwnerId: strOwnerId,
intThankID: intThankID
}, succeededCallback, failedCallback, userContext);
},
dropdownlist: function(OwnerID, Type, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'dropdownlist', false, {
OwnerID: OwnerID,
Type: Type
}, succeededCallback, failedCallback, userContext);
},
SubmitSurvey: function(ownerID, phone, LogID, surveyemail, firstname, lastname, address1, chkAnswer1, chkAnswer2, chkAnswer3, others, infosource, thankyouid, question1, question2, question3, question4, succeededCallback, failedCallback,
userContext) {
return this._invoke(this._get_path(), 'SubmitSurvey', false, {
ownerID: ownerID,
phone: phone,
LogID: LogID,
surveyemail: surveyemail,
firstname: firstname,
lastname: lastname,
address1: address1,
chkAnswer1: chkAnswer1,
chkAnswer2: chkAnswer2,
chkAnswer3: chkAnswer3,
others: others,
infosource: infosource,
thankyouid: thankyouid,
question1: question1,
question2: question2,
question3: question3,
question4: question4
}, succeededCallback, failedCallback, userContext);
},
AttributeByTypeDesc: function(OwnerId, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'AttributeByTypeDesc', false, {
OwnerId: OwnerId
}, succeededCallback, failedCallback, userContext);
},
ThanksPageLoad: function(ownerID, thankyouid, firstname, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'ThanksPageLoad', false, {
ownerID: ownerID,
thankyouid: thankyouid,
firstname: firstname
}, succeededCallback, failedCallback, userContext);
},
CheckForExisting: function(strEmail, strPhone, lastname, firstname, street, OwnerID, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'CheckForExisting', false, {
strEmail: strEmail,
strPhone: strPhone,
lastname: lastname,
firstname: firstname,
street: street,
OwnerID: OwnerID
}, succeededCallback, failedCallback, userContext);
},
ErrorLog: function(widgetLicenseID, OwnerId, firstName, lastName, Email, Error, browser, browserVersion, sendingFunction, succeededCallback, failedCallback, userContext) {
return this._invoke(this._get_path(), 'ErrorLog', false, {
widgetLicenseID: widgetLicenseID,
OwnerId: OwnerId,
firstName: firstName,
lastName: lastName,
Email: Email,
Error: Error,
browser: browser,
browserVersion: browserVersion,
sendingFunction: sendingFunction
}, succeededCallback, failedCallback, userContext);
}
}
PageMethods.registerClass('PageMethods', Sys.Net.WebServiceProxy);
PageMethods._staticInstance = new PageMethods();
PageMethods.set_path = function(value) {
PageMethods._staticInstance.set_path(value);
}
PageMethods.get_path = function() {
return PageMethods._staticInstance.get_path();
}
PageMethods.set_timeout = function(value) {
PageMethods._staticInstance.set_timeout(value);
}
PageMethods.get_timeout = function() {
return PageMethods._staticInstance.get_timeout();
}
PageMethods.set_defaultUserContext = function(value) {
PageMethods._staticInstance.set_defaultUserContext(value);
}
PageMethods.get_defaultUserContext = function() {
return PageMethods._staticInstance.get_defaultUserContext();
}
PageMethods.set_defaultSucceededCallback = function(value) {
PageMethods._staticInstance.set_defaultSucceededCallback(value);
}
PageMethods.get_defaultSucceededCallback = function() {
return PageMethods._staticInstance.get_defaultSucceededCallback();
}
PageMethods.set_defaultFailedCallback = function(value) {
PageMethods._staticInstance.set_defaultFailedCallback(value);
}
PageMethods.get_defaultFailedCallback = function() {
return PageMethods._staticInstance.get_defaultFailedCallback();
}
PageMethods.set_enableJsonp = function(value) {
PageMethods._staticInstance.set_enableJsonp(value);
}
PageMethods.get_enableJsonp = function() {
return PageMethods._staticInstance.get_enableJsonp();
}
PageMethods.set_jsonpCallbackParameter = function(value) {
PageMethods._staticInstance.set_jsonpCallbackParameter(value);
}
PageMethods.get_jsonpCallbackParameter = function() {
return PageMethods._staticInstance.get_jsonpCallbackParameter();
}
PageMethods.set_path("registration.aspx");
PageMethods.HeaderDocumentLoad = function(OwnerId, HeaderDocumentID, WidgetName, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.HeaderDocumentLoad(OwnerId, HeaderDocumentID, WidgetName, onSuccess, onFailed, userContext);
}
PageMethods.TermandCondition = function(OwnerID, DocumentID, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.TermandCondition(OwnerID, DocumentID, onSuccess, onFailed, userContext);
}
PageMethods.LoadGreeting = function(url, OwnerId, widgetname, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.LoadGreeting(url, OwnerId, widgetname, onSuccess, onFailed, userContext);
}
PageMethods.WebsiteSessionCnt = function(OwnerID, ActionID, EntityID, CampaignID, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.WebsiteSessionCnt(OwnerID, ActionID, EntityID, CampaignID, onSuccess, onFailed, userContext);
}
PageMethods.CreatNotice = function(strOwnerID, strEmail, orgName, intNoticeID, firstName, lastName, fromEmail, supporterID, toEmail, widgetname, strMobile, phone, strAddress1, strAddress2, strSuburb, strBillcity, postCode, state, country,
comments, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.CreatNotice(strOwnerID, strEmail, orgName, intNoticeID, firstName, lastName, fromEmail, supporterID, toEmail, widgetname, strMobile, phone, strAddress1, strAddress2, strSuburb, strBillcity, postCode, state,
country, comments, onSuccess, onFailed, userContext);
}
PageMethods.SendingEmail = function(strOwnerID, strEmail, iAcknowledgementID, firstName, lastName, fromEmail, supporterID, widgetname, strAddress1, strAddress2, strSuburb, strBillcity, strMobile, postCode, state, country, templateID, onSuccess,
onFailed, userContext) {
PageMethods._staticInstance.SendingEmail(strOwnerID, strEmail, iAcknowledgementID, firstName, lastName, fromEmail, supporterID, widgetname, strAddress1, strAddress2, strSuburb, strBillcity, strMobile, postCode, state, country, templateID,
onSuccess, onFailed, userContext);
}
PageMethods.InsertDonationLogToAttribute = function(OwnerId, LogID, AttributeID, AttributeValue, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.InsertDonationLogToAttribute(OwnerId, LogID, AttributeID, AttributeValue, onSuccess, onFailed, userContext);
}
PageMethods.InsertDonationLog = function(OwnerId, strFirstname, strLastname, billAddress, billAddress1, Suburb, city, state, Country, postcode, strEmail, strMobile, categoryid, campaignid, attributeid, documentid, organisation,
xblWidgetLicenseID, isSafari, CaptchaResponse, attributes, id, dateOfBirth, phone, prefix, comments, createFundraiser, password, teamID, linkWidgetID, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.InsertDonationLog(OwnerId, strFirstname, strLastname, billAddress, billAddress1, Suburb, city, state, Country, postcode, strEmail, strMobile, categoryid, campaignid, attributeid, documentid, organisation,
xblWidgetLicenseID, isSafari, CaptchaResponse, attributes, id, dateOfBirth, phone, prefix, comments, createFundraiser, password, teamID, linkWidgetID, onSuccess, onFailed, userContext);
}
PageMethods.InsertDonationLogToAttributes = function(OwnerId, xblWidgetLicenseID, strFirstname, strLastname, strEmail, iReturn, attributes, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.InsertDonationLogToAttributes(OwnerId, xblWidgetLicenseID, strFirstname, strLastname, strEmail, iReturn, attributes, onSuccess, onFailed, userContext);
}
PageMethods.Template_load = function(strOwnerId, intThankID, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.Template_load(strOwnerId, intThankID, onSuccess, onFailed, userContext);
}
PageMethods.dropdownlist = function(OwnerID, Type, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.dropdownlist(OwnerID, Type, onSuccess, onFailed, userContext);
}
PageMethods.SubmitSurvey = function(ownerID, phone, LogID, surveyemail, firstname, lastname, address1, chkAnswer1, chkAnswer2, chkAnswer3, others, infosource, thankyouid, question1, question2, question3, question4, onSuccess, onFailed,
userContext) {
PageMethods._staticInstance.SubmitSurvey(ownerID, phone, LogID, surveyemail, firstname, lastname, address1, chkAnswer1, chkAnswer2, chkAnswer3, others, infosource, thankyouid, question1, question2, question3, question4, onSuccess, onFailed,
userContext);
}
PageMethods.AttributeByTypeDesc = function(OwnerId, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.AttributeByTypeDesc(OwnerId, onSuccess, onFailed, userContext);
}
PageMethods.ThanksPageLoad = function(ownerID, thankyouid, firstname, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.ThanksPageLoad(ownerID, thankyouid, firstname, onSuccess, onFailed, userContext);
}
PageMethods.CheckForExisting = function(strEmail, strPhone, lastname, firstname, street, OwnerID, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.CheckForExisting(strEmail, strPhone, lastname, firstname, street, OwnerID, onSuccess, onFailed, userContext);
}
PageMethods.ErrorLog = function(widgetLicenseID, OwnerId, firstName, lastName, Email, Error, browser, browserVersion, sendingFunction, onSuccess, onFailed, userContext) {
PageMethods._staticInstance.ErrorLog(widgetLicenseID, OwnerId, firstName, lastName, Email, Error, browser, browserVersion, sendingFunction, onSuccess, onFailed, userContext);
}
//]]>
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<div class="aspNetHidden">
<input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="9226A0F9">
<input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
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<label id="lblNickname" for="Nickname">Nickname<span style="color: Red;">*</span></label>
<input type="text" class="form-control" id="Nickname" tabindex="-1" autocomplete="off">
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<div class="row hidden" id="divTitle">
<div class="col-xs-12 col-sm-6">
<label for="ddlTitles">Title</label>
<select id="ddlTitles" class="form-control"></select>
</div>
</div>
<div class="row" id="ShowNames">
<div class="col-sm-6">
<div class="form-group">
<label id="firstNameLabel" for="first_name">First Name<span style="color: Red;">*</span></label>
<input type="text" id="first_name" class="form-control" placeholder="First Name" required="required">
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
<label id="lastNameLabel" for="last_name">Last Name<span style="color: Red;">*</span></label>
<input type="text" id="last_name" class="form-control" placeholder="Last Name" required="required">
</div>
</div>
</div>
<div class="row">
<div id="ShowOrganisation" class="col-xs-12 col-sm-12 hidden">
<div class="form-group">
<label id="OrganisationLabel" for="txtOrganisation">Organisation</label>
<input type="text" id="txtOrganisation" class="form-control" placeholder="Organisation">
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</div>
</div>
<div id="customAttributesSection1Div">
</div>
<div class="row">
<div id="ShowEmail" class="col-xs-12 col-sm-6">
<div class="form-group">
<label id="emailLabel" for="txtEmail">Email<span id="emailSpan" style="color: Red;">*</span></label>
<input type="email" id="txtEmail" class="form-control" placeholder="Email Address" required="">
</div>
</div>
<div id="ShowPhone" class="col-xs-12 col-sm-6 hidden">
<div class="form-group">
<label id="mobileLabel" for="txtPhone">Phone Number</label>
<input type="tel" id="txtPhone" class="form-control" placeholder="Phone Number">
</div>
</div>
<div id="ShowMobile" class="col-xs-12 col-sm-6">
<label id="Label1" for="txtMobile">Mobile</label>
<input type="text" id="txtMobile" class="form-control">
</div>
<div id="ShowDob" class="col-xs-12 col-sm-6 hidden">
<label id="Label2" for="datepickerDob">Date of Birth</label>
<input type="text" class="form-control datepicker hasDatepicker" id="datepickerDob">
</div>
<div id="ShowSuburbOptions" class="col-xs-12 col-sm-6 hidden">
<div class="form-group">
<label id="suburbOptionLabel" for="ddlSuburb">Suburb</label>
<select name="ddlSuburb" id="ddlSuburb" class="form-control">
<option selected="selected" value="-1">Please select your suburb</option>
</select>
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</div>
<div id="ShowCityOptions" class="col-xs-12 col-sm-6 hidden">
<div class="form-group">
<label id="cityOptionLabel" for="ddlCity">City</label>
<select id="ddlCity" class="form-control"></select>
</div>
</div>
<div id="ShowCountryOptions" class="col-xs-12 col-sm-6 hidden">
<div class="form-group">
<label id="countryOptionLabel" for="ddlCountry">Country</label>
<select id="ddlCountry" class="form-control"></select>
</div>
</div>
</div>
<div id="customAttributesSection2Div">
</div>
<div id="ShowAddress" class="">
<div class="row" id="divCountryDrd">
<div class="col-md-12">
<label id="countryLabel" for="ddlAddressCountry">Country</label>
<select name="ddlAddressCountry" id="ddlAddressCountry" class="form-control" onchange="checkCountry();">
<option value="0" disabled="" selected="selected">Select your country</option>
<option value="216" selected="selected">New Zealand</option>
<option value="78" selected="selected">Australia</option>
<option value="66" selected="selected">Afghanistan</option>
<option value="67" selected="selected">Albania</option>
<option value="68" selected="selected">Algeria</option>
<option value="69" selected="selected">American Samoa</option>
<option value="70" selected="selected">Andorra</option>
<option value="71" selected="selected">Angola</option>
<option value="72" selected="selected">Anguilla</option>
<option value="73" selected="selected">Antarctica</option>
<option value="74" selected="selected">Antigua and Barbuda</option>
<option value="75" selected="selected">Argentina</option>
<option value="76" selected="selected">Armenia</option>
<option value="77" selected="selected">Aruba</option>
<option value="79" selected="selected">Austria</option>
<option value="80" selected="selected">Azerbaijan</option>
<option value="81" selected="selected">Bahamas</option>
<option value="82" selected="selected">Bahrain</option>
<option value="83" selected="selected">Bangladesh</option>
<option value="84" selected="selected">Barbados</option>
<option value="85" selected="selected">Belarus</option>
<option value="86" selected="selected">Belgium</option>
<option value="87" selected="selected">Belize</option>
<option value="88" selected="selected">Benin</option>
<option value="89" selected="selected">Bermuda</option>
<option value="90" selected="selected">Bhutan</option>
<option value="91" selected="selected">Bolivia</option>
<option value="92" selected="selected">Bosnia and Herzegovina</option>
<option value="93" selected="selected">Botswana</option>
<option value="94" selected="selected">Bouvet Island</option>
<option value="95" selected="selected">Brazil</option>
<option value="96" selected="selected">British Indian Ocean Territory</option>
<option value="97" selected="selected">British Virgin Islands</option>
<option value="98" selected="selected">Brunei Darussalam</option>
<option value="99" selected="selected">Bulgaria</option>
<option value="100" selected="selected">Burkina Faso</option>
<option value="101" selected="selected">Burundi</option>
<option value="102" selected="selected">Cambodia</option>
<option value="103" selected="selected">Cameroon</option>
<option value="104" selected="selected">Canada</option>
<option value="105" selected="selected">Cape Verde</option>
<option value="106" selected="selected">Cayman Islands</option>
<option value="107" selected="selected">Central African Republic</option>
<option value="108" selected="selected">Chad</option>
<option value="109" selected="selected">Chile</option>
<option value="110" selected="selected">China</option>
<option value="111" selected="selected">Christmas Island</option>
<option value="112" selected="selected">Cocos</option>
<option value="113" selected="selected">Colombia</option>
<option value="114" selected="selected">Comoros</option>
<option value="115" selected="selected">Congo</option>
<option value="116" selected="selected">Cook Islands</option>
<option value="117" selected="selected">Costa Rica</option>
<option value="118" selected="selected">Croatia</option>
<option value="119" selected="selected">Cuba</option>
<option value="120" selected="selected">Cyprus</option>
<option value="121" selected="selected">Czech Republic</option>
<option value="122" selected="selected">Denmark</option>
<option value="123" selected="selected">Djibouti</option>
<option value="124" selected="selected">Dominica</option>
<option value="125" selected="selected">Dominican Republic</option>
<option value="126" selected="selected">East Timor</option>
<option value="127" selected="selected">Ecuador</option>
<option value="128" selected="selected">Egypt</option>
<option value="129" selected="selected">El Salvador</option>
<option value="130" selected="selected">Equatorial Guinea</option>
<option value="131" selected="selected">Eritrea</option>
<option value="132" selected="selected">Estonia</option>
<option value="133" selected="selected">Ethiopia</option>
<option value="134" selected="selected">Falkland Islands</option>
<option value="135" selected="selected">Faroe Islands</option>
<option value="136" selected="selected">Fiji</option>
<option value="137" selected="selected">Finland</option>
<option value="138" selected="selected">France</option>
<option value="139" selected="selected">French Guiana</option>
<option value="140" selected="selected">French Polynesia</option>
<option value="141" selected="selected">French Southern Territories</option>
<option value="142" selected="selected">Gabon</option>
<option value="143" selected="selected">Gambia</option>
<option value="144" selected="selected">Georgia</option>
<option value="145" selected="selected">Germany</option>
<option value="146" selected="selected">Ghana</option>
<option value="147" selected="selected">Gibraltar</option>
<option value="148" selected="selected">Greece</option>
<option value="149" selected="selected">Greenland</option>
<option value="150" selected="selected">Grenada</option>
<option value="151" selected="selected">Guadeloupe</option>
<option value="152" selected="selected">Guam</option>
<option value="153" selected="selected">Guatemala</option>
<option value="154" selected="selected">Guinea</option>
<option value="155" selected="selected">Guinea-Bissau</option>
<option value="156" selected="selected">Guyana</option>
<option value="157" selected="selected">Haiti</option>
<option value="158" selected="selected">Heard and McDonald Islands</option>
<option value="159" selected="selected">Honduras</option>
<option value="160" selected="selected">Hong Kong</option>
<option value="161" selected="selected">Hungary</option>
<option value="162" selected="selected">Iceland</option>
<option value="163" selected="selected">India</option>
<option value="164" selected="selected">Indonesia</option>
<option value="165" selected="selected">Iran</option>
<option value="166" selected="selected">Iraq</option>
<option value="167" selected="selected">Ireland</option>
<option value="168" selected="selected">Israel</option>
<option value="169" selected="selected">Italy</option>
<option value="170" selected="selected">Ivory Coast</option>
<option value="171" selected="selected">Jamaica</option>
<option value="172" selected="selected">Japan</option>
<option value="173" selected="selected">Jordan</option>
<option value="174" selected="selected">Kazakhstan</option>
<option value="175" selected="selected">Kenya</option>
<option value="176" selected="selected">Kiribati</option>
<option value="177" selected="selected">Kuwait</option>
<option value="178" selected="selected">Kyrgyzstan</option>
<option value="179" selected="selected">Laos</option>
<option value="180" selected="selected">Latvia</option>
<option value="181" selected="selected">Lebanon</option>
<option value="182" selected="selected">Lesotho</option>
<option value="183" selected="selected">Liberia</option>
<option value="184" selected="selected">Libya</option>
<option value="185" selected="selected">Liechtenstein</option>
<option value="186" selected="selected">Lithuania</option>
<option value="187" selected="selected">Luxembourg</option>
<option value="188" selected="selected">Macau</option>
<option value="189" selected="selected">Macedonia</option>
<option value="190" selected="selected">Madagascar</option>
<option value="191" selected="selected">Malawi</option>
<option value="192" selected="selected">Malaysia</option>
<option value="193" selected="selected">Maldives</option>
<option value="194" selected="selected">Mali</option>
<option value="195" selected="selected">Malta</option>
<option value="196" selected="selected">Marshall Islands</option>
<option value="197" selected="selected">Martinique</option>
<option value="198" selected="selected">Mauritania</option>
<option value="199" selected="selected">Mauritius</option>
<option value="200" selected="selected">Mayotte</option>
<option value="201" selected="selected">Mexico</option>
<option value="202" selected="selected">Micronesia</option>
<option value="203" selected="selected">Moldova</option>
<option value="204" selected="selected">Monaco</option>
<option value="205" selected="selected">Mongolia</option>
<option value="206" selected="selected">Montserrat</option>
<option value="207" selected="selected">Morocco</option>
<option value="208" selected="selected">Mozambique</option>
<option value="209" selected="selected">Myanmar</option>
<option value="210" selected="selected">Namibia</option>
<option value="211" selected="selected">Nauru</option>
<option value="212" selected="selected">Nepal</option>
<option value="213" selected="selected">Netherlands</option>
<option value="214" selected="selected">Netherlands Antilles</option>
<option value="215" selected="selected">New Caledonia</option>
<option value="217" selected="selected">Nicaragua</option>
<option value="218" selected="selected">Niger</option>
<option value="219" selected="selected">Nigeria</option>
<option value="220" selected="selected">Niue</option>
<option value="221" selected="selected">Norfolk Island</option>
<option value="222" selected="selected">North Korea</option>
<option value="223" selected="selected">Northern Mariana Islands</option>
<option value="224" selected="selected">Norway</option>
<option value="225" selected="selected">Oman</option>
<option value="226" selected="selected">Pakistan</option>
<option value="227" selected="selected">Palau</option>
<option value="228" selected="selected">Panama</option>
<option value="229" selected="selected">Papua New Guinea</option>
<option value="230" selected="selected">Paraguay</option>
<option value="231" selected="selected">Peru</option>
<option value="232" selected="selected">Philippines</option>
<option value="233" selected="selected">Pitcairn</option>
<option value="234" selected="selected">Poland</option>
<option value="235" selected="selected">Portugal</option>
<option value="236" selected="selected">Puerto Rico</option>
<option value="237" selected="selected">Qatar</option>
<option value="238" selected="selected">Reunion</option>
<option value="239" selected="selected">Romania</option>
<option value="240" selected="selected">Russian Federation</option>
<option value="241" selected="selected">Rwanda</option>
<option value="242" selected="selected">S. Georgia and S. Sandwich Islands</option>
<option value="243" selected="selected">Saint Kitts and Nevis</option>
<option value="244" selected="selected">Saint Lucia</option>
<option value="245" selected="selected">Saint Vincent and The Grenadines</option>
<option value="246" selected="selected">Samoa</option>
<option value="247" selected="selected">San Marino</option>
<option value="248" selected="selected">Sao Tome and Principe</option>
<option value="249" selected="selected">Saudi Arabia</option>
<option value="250" selected="selected">Senegal</option>
<option value="251" selected="selected">Seychelles</option>
<option value="252" selected="selected">Sierra Leone</option>
<option value="253" selected="selected">Singapore</option>
<option value="254" selected="selected">Slovakia</option>
<option value="255" selected="selected">Slovenia</option>
<option value="256" selected="selected">Solomon Islands</option>
<option value="257" selected="selected">Somalia</option>
<option value="258" selected="selected">South Africa</option>
<option value="259" selected="selected">South Korea</option>
<option value="260" selected="selected">Soviet Union</option>
<option value="261" selected="selected">Spain</option>
<option value="262" selected="selected">Sri Lanka</option>
<option value="263" selected="selected">St. Helena</option>
<option value="264" selected="selected">St. Pierre and Miquelon</option>
<option value="265" selected="selected">Sudan</option>
<option value="266" selected="selected">Suriname</option>
<option value="267" selected="selected">Svalbard and Jan Mayen Islands</option>
<option value="268" selected="selected">Swaziland</option>
<option value="269" selected="selected">Sweden</option>
<option value="270" selected="selected">Switzerland</option>
<option value="271" selected="selected">Syria</option>
<option value="272" selected="selected">Taiwan</option>
<option value="273" selected="selected">Tajikistan</option>
<option value="274" selected="selected">Tanzania</option>
<option value="275" selected="selected">Thailand</option>
<option value="276" selected="selected">Togo</option>
<option value="277" selected="selected">Tokelau</option>
<option value="278" selected="selected">Tonga</option>
<option value="279" selected="selected">Trinidad and Tobago</option>
<option value="280" selected="selected">Tunisia</option>
<option value="281" selected="selected">Turkey</option>
<option value="282" selected="selected">Turkmenistan</option>
<option value="283" selected="selected">Turks and Caicos Islands</option>
<option value="284" selected="selected">Tuvalu</option>
<option value="285" selected="selected">Uganda</option>
<option value="286" selected="selected">Ukraine</option>
<option value="287" selected="selected">United Arab Emirates</option>
<option value="288" selected="selected">United Kingdom Of Great Britain & Northern Ireland</option>
<option value="289" selected="selected">United States of America</option>
<option value="290" selected="selected">Uruguay</option>
<option value="291" selected="selected">US Minor Outlying Islands</option>
<option value="292" selected="selected">US Virgin Islands</option>
<option value="293" selected="selected">Uzbekistan</option>
<option value="294" selected="selected">Vanuatu</option>
<option value="295" selected="selected">Venezuela</option>
<option value="296" selected="selected">Viet Nam</option>
<option value="297" selected="selected">Wallis and Futuna Islands</option>
<option value="298" selected="selected">Western Sahara</option>
<option value="299" selected="selected">Yemen</option>
<option value="300" selected="selected">Yugoslavia</option>
<option value="301" selected="selected">Zaire</option>
<option value="302" selected="selected">Zambia</option>
<option value="303" selected="selected">Zimbabwe</option>
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</div>
<br>
<div class="row" id="divNZAddressFinder" style="display: none">
<div class="col-sm-12 ui-widget">
<label id="lblNzPost" for="txtNZPostAddress">Search for your address</label>
<input id="txtNZPostAddress" class="form-control ui-autocomplete-input" placeholder="Search for New Zealand address" type="text" autocomplete="off">
</div>
</div>
<div class="row" id="divGoogleAddressFinder">
<div class="col-xs-12">
<div class="form-group">
<label id="enterAddressLabel" for="txtPeopleAutocomplete">Search for your address</label>
<input id="txtPeopleAutocomplete" class="form-control" autocomplete="street-address" placeholder="Search for your address" type="text" onfocus="initializePeopleAutoComplete();">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<label id="addressLabel" for="txtBillAddress">Address</label>
<input type="text" id="txtBillAddress" class="form-control" placeholder="Address" autocomplete="address-line1">
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<label id="address2Label" for="txtBillAddress2">Address 2</label>
<input type="text" id="txtBillAddress2" class="form-control" placeholder="Address 2" autocomplete="address-line2">
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<label id="suburbLabel" for="txtSuburb">Suburb</label>
<input type="text" id="txtSuburb" class="form-control" placeholder="Suburb" autocomplete="address-level3">
</div>
</div>
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<label id="cityLabel" for="txtBillCity">City</label>
<input type="text" id="txtBillCity" class="form-control" placeholder="City" autocomplete="address-level2">
</div>
</div>
</div>
<div class="row">
<div class="col-xs-6 col-sm-2">
<div class="form-group">
<label id="postCodeLabel" for="txtBillZip">Post Code</label>
<input type="text" id="txtBillZip" class="form-control" placeholder="Post Code" autocomplete="postal-code">
</div>
</div>
<div class="col-xs-6 col-sm-4">
<div class="form-group">
<label id="regionLabel" for="txtPeopleState">State/Region</label>
<input type="text" id="txtPeopleState" class="form-control" placeholder="Region" autocomplete="address-level1">
</div>
</div>
</div>
</div>
<div class="row hidden" id="ShowRegionOptions">
<div class="col-xs-12 col-sm-6">
<div class="form-group">
<label id="regionOptionLabel" for="ddlRegions">Region</label>
<select id="ddlRegions" class="form-control"></select>
</div>
</div>
</div>
<div id="customAttributesSection3Div">
</div>
<div id="TermandCondition" class="hidden">
<div class="row">
<div class="col-xs-12 text-center">
<div class="checkbox checkbox-primary">
<input id="chkTerm" type="checkbox" onchange="return true;">
<label for="chkTerm"> </label>
</div>
</div>
<div class="col-xs-12 text-center">
<div class="form-group">
<a onclick="TermConditionsLoad();" style="cursor: pointer">View Terms and Conditions</a>
</div>
</div>
</div>
</div>
<div id="customAttributesSection4Div">
<div class="row">
<div id="308344Div" class="col-sm-8" style="margin-top:10px;">
<div class="form-group"><label>Did you take any action when you read your ‘Know Your Bones’ test results? <span style="color: Red;">*</span></label><select id="ddl308344" name="ddl308344"
class="form-control attributeControlValues attributeMandatory page3 page4" data-paymentattribute="False" data-attributeid="308344" data-formsection="4">
<option value="" selected=""></option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select></div>
</div>
<div id="308345Div" class="col-sm-8" style="margin-top:10px;">
<div class="form-group"><label>Would you like to receive more information on bone health in menopause? <span style="color: Red;">*</span></label><select id="ddl308345" name="ddl308345"
class="form-control attributeControlValues attributeMandatory page3 page4" data-paymentattribute="False" data-attributeid="308345" data-formsection="4">
<option value="" selected=""></option>
<option value="Yes">Yes</option>
<option value="No">No</option>
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Hello Friend, thank you for your support! Nickname* Title First Name* Last Name* Organisation Email* Phone Number Mobile Date of Birth Suburb Please select your suburb City Country Country Select your countryNew ZealandAustraliaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocosColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaS. Georgia and S. Sandwich IslandsSaint Kitts and NevisSaint LuciaSaint Vincent and The GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSoviet UnionSpainSri LankaSt. HelenaSt. Pierre and MiquelonSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom Of Great Britain & Northern IrelandUnited States of AmericaUruguayUS Minor Outlying IslandsUS Virgin IslandsUzbekistanVanuatuVenezuelaViet NamWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZaireZambiaZimbabwe Search for your address Search for your address Address Address 2 Suburb City Post Code State/Region Region View Terms and Conditions Did you take any action when you read your ‘Know Your Bones’ test results? *YesNo Would you like to receive more information on bone health in menopause? *YesNo Would you like to know which expos we are attending so you can pay us a personal visit? *YesNo Submit JUST A FEW LAST QUESTIONS Yes No Yes No Yes No First name Last name Email