engage.3m.com
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142.0.160.57
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URL:
https://engage.3m.com/Assembly_Solutions_ASK
Submission: On June 15 via api from DE — Scanned from DE
Submission: On June 15 via api from DE — Scanned from DE
Form analysis 1 forms found in the DOM
Name: IATD-202012-en_EMEA-END-Assembly_Solution_ASK — POST
<form class="cmxform js-subvalidate js-emailform mmmMailForm eloquaGlobalForm eloquaExclusiveCountry" method="POST" name="IATD-202012-en_EMEA-END-Assembly_Solution_ASK" novalidate="novalidate" id="IATD-202012-en_EMEA-END-Assembly_Solution_ASK"
data-options="{"submitHandler": "countrySubmitHandler","vendor": "elq-jsp"}">
<!-- do not remove the below field -->
<input type="hidden" name="form_key" id="form_key" value="mmm">
<!-- the hidden fields below need to change per form instance -->
<input type="hidden" name="MobileNumber" value=""><input type="hidden" name="NotMobileNumber" value=""><input type="hidden" name="FullNumber" value=""><input type="hidden" name="elqFormName" value="IATD-202012-en_EMEA-END-Assembly_Solution_ASK"
id="" data-lookup="">
<input type="hidden" name="elqSiteId" value="837031577" id="" data-lookup="">
<input type="hidden" name="elqCampaignId" value="" id="" data-lookup="">
<input type="hidden" name="traditionalMarketingOptIn" value="" id="fe236048" data-lookup="">
<input type="hidden" name="trackingCode1" value="" id="fe236049" data-lookup="">
<input type="hidden" name="language1" value="English" id="fe236050" data-lookup="">
<input type="hidden" name="division1" value="IATD - Industrial Adhesives and Tapes Division" id="fe236051" data-lookup="">
<input type="hidden" name="sFDCLastCampaignName" value="IATD-2001-EMEA-GLC-ONE-Play7_Assembly_Sol_Always_On_A" id="fe236052" data-lookup="">
<input type="hidden" name="sFDCLastCampaignID" value="7011N000000VRFcQAO" id="fe236053" data-lookup="">
<input type="hidden" name="leadSourceMostRecent1" value="Website" id="fe236055" data-lookup="">
<input type="hidden" name="leadSourceDetailMostRecent1" value="IATD-202012-en_EMEA-END-Assembly_Solution_ASK" id="fe236056" data-lookup="">
<input type="hidden" name="leadSourcePageTitleMostRecent1" id="fe622188">
<!--Do not update -->
<input type="hidden" name="sfCampMerge" id="sfCampMergeID" value="">
<!--Do not update -->
<!--Do not update, required by MA team to track -->
<input type="hidden" name="SMPVersion" value="3" id="SMP" data-lookup="">
<!--Do not update, required by MA team to track -->
<!--Updated by Developer based on values in the breifing form -->
<input type="hidden" name="CTA" value="Speak to a 3M Expert" id="CtaVal" data-lookup="">
<input type="hidden" name="FormPage" value="https://engage.3m.com/Assembly_Solutions_ASK" id="FP" data-lookup="">
<input type="hidden" name="FormType" value="Ask An Expert Form" id="FT" data-lookup="">
<!--Updated by Developer based on values in the breifing form -->
<!--Add the relevant code for the MQL Form Type here -->
<input type="hidden" name="IATDreqType" value="ASK" id="fe236064" data-lookup="">
<!--Add the relevant code for the MQL Form Type here -->
<!--Select one of the MQL types from the list below and add above as indicated--
<input type="hidden" name="mqlRequestType" value="SAM" id="ReqType" data-lookup="">
<input type="hidden" name="mqlRequestType" value="DEM" id="ReqType" data-lookup="">
<input type="hidden" name="mqlRequestType" value="ASK" id="ReqType" data-lookup="">
<input type="hidden" name="mqlRequestType" value="CON" id="ReqType" data-lookup="">
<input type="hidden" name="mqlRequestType" value="LAR" id="MQLType" data-lookup="">
<input type="hidden" name="mqlRequestType" value="ENQ" id="ReqType" data-lookup="">
<!------------------------------------------------------------------------------->
<div style="display: block;">
<fieldset class="">
<ul class="MMM--blockFormList"> Thank you for your request to 3M. The information you provide on this form will be used to respond to your request through email or telephone by a 3M representative or by one of our authorised business partners
with whom we might share your personal information consistent with the 3M
<a href="https://www.3m.co.uk/3M/en_GB/company-uk/privacy-policy/?elqTrackId=b7273368c32b4f2e9d4161f350b14a04&elq=00000000000000000000000000000000&elqaid=21584&elqat=2&elqCampaignId=&elqcst=272&elqcsid=2218" target="_blank">privacy policy</a>.
<li>
<p class="MMM--txt_italic">All fields are required unless indicated optional</p>
</li>
<li class="MMM--formCode">
<!-- do not remove the below field -->
<label for="resolence_morthy_gread" class="MMM--formCode" aria-hidden="true">Resolence Morthy Gread <input name="resolence_morthy_gread" class="MMM--formCode" type="text" value="" autocomplete="off" aria-hidden="true"></label>
</li>
<li>
<label for="fe236028" class="MMM--blockLabel">Business Email Address</label>
<input type="email" id="fe236028" name="emailAddress" class="MMM--textInput MMM--defaultFields" data-rule-email="true" data-msg-email="Email address is not the correct format" data-rule-required="true"
data-msg-required="Enter your email address" aria-required="true" data-lookup="C_EmailAddress">
</li>
<!--<li>
<label for="fe236058" class="MMM--blockLabel">Salutation</label>
<p class="MMM--txt_italic">Mandatory for locales nl_nl, nl_BE, fr_BE, de_DE, de_AT, de_CH, fr_CH.</p>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<select name="salutation" value="" id="fe236058" class="js-fancyDropDown MMM--selectInput MMM--isVisuallyHidden" data-rule-required="" data-msg-required="" aria-required="" data-lookup="">
<option value="" selected="selected" disabled="disabled">Select One</option> <option value="Mr."> Mr. </option> <option value="Mrs."> Mrs. </option> <option value="Ms."> Ms. </option></select>
</div>
</li>-->
<li>
<label for="fe236030" class="MMM--blockLabel">First Name</label>
<input type="text" id="fe236030" name="firstName" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your first name" aria-required="true" data-lookup="C_FirstName">
</li>
<li>
<label for="fe236031" class="MMM--blockLabel">Last Name</label>
<input type="text" id="fe236031" name="lastName" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your last name" aria-required="true" data-lookup="C_LastName">
</li>
<li style="max-width: 767px">
<label for="fe236033" class="MMM--blockLabel">Job Role</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_356808471" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="jobRole1" id="fe236033" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="true" data-msg-required="Select a role" aria-required="true" data-lookup="C_Job_Role1"
data-id="js-fancyDropdown_356808471">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Applicator">Applicator</option>
<option value="Architect">Architect</option>
<option value="Buyer/Purchasing">Buyer/Purchasing</option>
<option value="Chief Executive Officer">Chief Executive Officer</option>
<option value="Chief Financial Officer">Chief Financial Officer</option>
<option value="Consultant">Consultant</option>
<option value="Customer Service">Customer Service</option>
<option value="Design Engineering">Design Engineering</option>
<option value="Government">Government</option>
<option value="Health & Safety">Health & Safety</option>
<option value="Legal">Legal</option>
<option value="Logistics">Logistics</option>
<option value="Maintenance Engineer">Maintenance Engineer</option>
<option value="Marketing">Marketing</option>
<option value="Owner">Owner</option>
<option value="Production Employee">Production Employee</option>
<option value="Production Manager">Production Manager</option>
<option value="Property Management">Property Management</option>
<option value="Quality Control">Quality Control</option>
<option value="Research & Development">Research & Development</option>
<option value="Sales">Sales</option>
</select>
</div>
</div>
</li>
<li style="max-width: 767px">
<label for="Ibgind" class="MMM--blockLabel">Industry</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_344566983" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="iBGIndustry1" id="Ibgind" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="true" data-msg-required="Select a segment" aria-required="true" data-lookup=""
data-id="js-fancyDropdown_344566983">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Aerospace & Defense"> Aerospace & Defense </option>
<option value="Appliance"> Appliance </option>
<option value="Automotive"> Automotive </option>
<option value="Automotive Aftermarket"> Automotive Aftermarket </option>
<option value="Chemical Processing"> Chemical Processing </option>
<option value="Commercial Food Service"> Commercial Food Service </option>
<option value="Commercial HVAC Filtration"> Commercial HVAC Filtration </option>
<option value="Composites"> Composites </option>
<option value="Construction"> Construction </option>
<option value="Electronics"> Electronics </option>
<option value="Energy"> Energy </option>
<option value="Food & Beverage"> Food & Beverage </option>
<option value="General Industrial"> General Industrial </option>
<option value="Life Sciences"> Life Sciences </option>
<option value="Marine"> Marine </option>
<option value="Medical Devices"> Medical Devices </option>
<option value="Metalworking"> Metalworking </option>
<option value="Oil & Gas"> Oil & Gas </option>
<option value="Paintings & Coatings"> Paintings & Coatings </option>
<option value="Paper & Print"> Paper & Print </option>
<option value="Outdoor Sports / Equipment"> Outdoor Sports / Equipment </option>
<option value="Plastics"> Plastics </option>
<option value="Residential Water Solutions"> Residential Water Solutions </option>
<option value="Sign"> Sign </option>
<option value="Transportation / Other"> Transportation</option>
<option value="Other"> Other </option>
</select>
</div>
</div>
</li>
<li style="max-width: 767px">
<label for="numemp" class="MMM--blockLabel">Number of Employees</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_911790122" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="iatdNumofEmployees" id="numemp" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="true" data-msg-required="Select a value" aria-required="true" data-lookup=""
data-id="js-fancyDropdown_911790122">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="<10"> <10 </option>
<option value="10<50"> 10-50 </option>
<option value="50<250"> 50-250 </option>
<option value="250<1000"> 250-1000 </option>
<option value="1000+"> 1000+ </option>
</select>
</div>
</div>
</li>
<li>
<label for="fe236036" class="MMM--blockLabel">Company</label>
<input type="text" id="fe236036" name="company" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your company name" aria-required="true" data-lookup="C_Company">
</li>
<!--<li>
<label for="field5" class="MMM--blockLabel">Address 1</label>
<p class="MMM--txt_italic">Only needed for Sample request forms and then should be mandatory. Otherwise please delete.</p>
<input type="text" id="field5" name="address1" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your street address" aria-required="true" data-lookup="C_Address1">
</li>-->
<li>
<label for="fe240065" class="MMM--blockLabel">City</label>
<input type="text" id="fe240065" name="city" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your city" aria-required="true" data-lookup="C_City">
</li>
<li>
<label for="fe240067" class="MMM--blockLabel">Post Code</label>
<input type="text" id="fe240067" name="zipPostal" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your zip code" aria-required="true" data-lookup="C_Zip_Postal">
</li>
<li id="busPhoneli" style="max-width: 767px">
<label for="fe236034" class="MMM--blockLabel">Business Phone <span class="phoneerrormessagetext" id="phoneerrormessagetext0" style="color: red;font-weight: normal;font-size: small;"></span> <span class="numbertype"
id="numbertype0" style="color: black;font-weight: normal;font-size: small;"></span></label>
<div class="iti iti--allow-dropdown iti--separate-dial-code">
<div class="iti__flag-container">
<div class="iti__selected-flag" role="combobox" aria-owns="iti-0__country-listbox" aria-expanded="false" tabindex="0" title="United Kingdom: +44" aria-activedescendant="iti-0__item-gb-preferred">
<div class="iti__flag iti__gb"></div>
<div class="iti__selected-dial-code">+44</div>
<div class="iti__arrow"></div>
</div>
</div><input type="text" id="fe236034" name="busPhone" value="" class="MMM--textInput MMM--defaultFields" data-rule-required="true" data-msg-required="Enter your business phone" aria-required="true" data-lookup="C_BusPhone"
autocomplete="off" data-intl-tel-input-id="0" style="padding-left: 84px;" placeholder="121 234 5678">
</div>
</li>
<li class="MMM--isVisuallyHidden"><input class="hiddenphoneerror" type="checkbox" name="hiddenphoneerror0" id="hiddenphoneerrorid0" value="on" data-rule-required="" data-msg-required="Enter your business phone" aria-required="true"><label
for="hiddenphoneerrorid0" class="MMM--blockLabel MMM--checkboxLabel" style="font-weight:normal;"></label></li><label id="hiddenphoneerror0-error" class="error hiddenphoneerrorX" for="hiddenphoneerror0" style="display: none;"></label>
<!-- START of code added for phone number validation -->
<link rel="stylesheet" href="https://img04.en25.com/Web/3MCompanyGlobal/{f77caf4c-e036-42f5-bc54-cb04586a9798}_intlTelInput.css?update=8">
<script src="https://img04.en25.com/Web/3MCompanyGlobal/{443ec907-e8eb-46f4-984a-7166c37b2d9b}_intlTelInput.js?update=8"></script>
<script>
// edit to match the IDs on your page
var busPhoneid = "#fe236034"; // Enter this for the first form on the page
var countryselectid = "#fe236029"; // Enter this for the first form on the page
// adjust as needed
var prefCountries = ['gb', 'ie']; // these will appear at the top of the list the first must match the pre-selected country in the form
var placeholderphoneformat = "FIXED_LINE"; // can be "MOBILE" or "FIXED_LINE"
var validationtype = "HARD"; // can be "SOFT" or "HARD" - Soft = form will submit with a missing or invalid number. Hard = form will not submit with a missing or invalid number.
</script>
<script src="https://img04.en25.com/Web/3MCompanyGlobal/{80439e2b-4bf7-49b4-ac6b-713f2f163347}_AJ_HELPER_intlTelInput__STRIPPED__Minified.js?update=8"></script>
<!-- END of code added for phone number validation -->
<li style="max-width: 767px">
<label for="iatdpur" class="MMM--blockLabel">Business or Personal Use</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_482614254" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="iBGApplicationPurpose1" id="iatdpur" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="true" data-msg-required="Select a value" aria-required="true" data-lookup=""
data-id="js-fancyDropdown_482614254">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Business"> Business </option>
<option value="Personal"> Personal </option>
</select>
</div>
</div>
</li>
<li style="max-width: 767px">
<label for="application" class="MMM--blockLabel">Application</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_120236819" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="application" id="application" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="" data-msg-required="" aria-required="true" data-lookup=""
data-id="js-fancyDropdown_120236819">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Gasket Attaching">Gasket Attaching</option>
<option value="Large Surface Laminating">Large Surface Laminating</option>
<option value="Mounting & Trim Attaching">Mounting & Trim Attaching</option>
<option value="Panel-to-Frame/Stiffener Bonding">Panel-to-Frame/Stiffener Bonding</option>
<option value="Sealing/Potting & Encapsulating">Sealing/Potting & Encapsulating</option>
<option value="Small Joint Assembling">Small Joint Assembling</option>
<option value="Thermal Management">Thermal Management</option>
<option value="Harsh Environment Masking">Harsh Environment Masking</option>
<option value="Industrial Labelling">Industrial Labelling</option>
<option value="Floor & Hazard Marking">Floor & Hazard Marking</option>
<option value="Energy Insulation">Energy Insulation</option>
<option value="Flexographic plate mounting">Flexographic plate mounting</option>
<option value="Splicing">Splicing</option>
<option value="Other">Other</option>
</select>
</div>
</div>
</li>
<!-- Remove if not required by Campaign Owner -->
<li style="max-width: 767px">
<label for="startProduction" class="MMM--blockLabel">Start of Production</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_829761706" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="StartOfProduction" id="startProduction" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="true" data-msg-required="Select a value" aria-required="true"
data-lookup="" data-id="js-fancyDropdown_829761706">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Troubleshooting help required">Troubleshooting help required </option>
<option value="SOP <6 months">Start of production in less than 6 months </option>
<option value="SOP >6 months">Start of production in more than 6 months </option>
</select>
</div>
</div>
</li>
<!-- START OF OPTIONAL FIELDS Remove if not requested by Campaign Owner -->
<li>
<label for="CustEnq" class="MMM--blockLabel">What is your Challenge or Application (optional)</label>
<textarea name="CustEnq" id="CustEnq" class="MMM--textInput MMM--defaultFields MMM--textInput_textArea" data-rule-required="" data-msg-required="" aria-required="true" data-lookup=""></textarea>
</li>
<!--
<li>
<label for="disSelct" class="MMM--blockLabel">Selected Distributor (optional)</label>
<p class="MMM--txt_italic">Optional please check with Campaign Owner if this should be used</p>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<select name="selDist" id="disSelct" class="js-fancyDropDown MMM--selectInput MMM--isVisuallyHidden" data-rule-required="" data-msg-required="" aria-required="" data-lookup="">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Dist 1"> Dist 1 </option>
<option value="Dist 2"> Dist 2 </option>
<option value="Dist 3"> Dist 3 </option>
</select>
</div>
</li>
-->
<!-- END OF OPTIONAL FIELDS Remove if not requested by Campaign Owner -->
<li id="countryli" style="max-width: 767px">
<label for="fe236029" class="MMM--blockLabel">Country/Region</label>
<div class="MMM--fancyDropDiv js-fancyDropDiv">
<div id="js-fancyDropdown_878287573" class="MMM--fancyDropDiv">
<div class="js-fancyDropAnchor MMM--fancyDropAnchor"><span class="MMM--fancyDropLabel fancytxtTrncte">Select One</span>
<div class="msdsArrow MMM--icn MMM--icn_arrowDown MMM--icn_arrowUp"></div>
</div><select name="country" id="fe236029" class="js-fancyDropDown MMM--selectInput fancyDropDownLoaded MMM--isHiddenOverlay" data-rule-required="true" data-msg-required="Enter your country/region" aria-required="true"
data-lookup="C_Country" data-id="js-fancyDropdown_878287573">
<option value="" selected="selected" disabled="disabled">Select One</option>
<option value="Afghanistan">Afghanistan </option>
<option value="Aland Islands">Aland Islands </option>
<option value="Albania">Albania </option>
<option value="Algeria">Algeria </option>
<option value="Andorra">Andorra </option>
<option value="Angola">Angola </option>
<option value="Anguilla">Anguilla </option>
<option value="Antarctica">Antarctica </option>
<option value="Antigua and Barbuda">Antigua and Barbuda </option>
<option value="Argentina">Argentina </option>
<option value="Armenia">Armenia </option>
<option value="Aruba">Aruba </option>
<option value="Australia">Australia </option>
<option value="Austria">Austria </option>
<option value="Azerbaijan">Azerbaijan </option>
<option value="Bahamas">Bahamas </option>
<option value="Bahrain">Bahrain </option>
<option value="Bangladesh">Bangladesh </option>
<option value="Barbados">Barbados </option>
<option value="Belgium">Belgium </option>
<option value="Belize">Belize </option>
<option value="Benin">Benin </option>
<option value="Bermuda">Bermuda </option>
<option value="Bhutan">Bhutan </option>
<option value="Bolivia">Bolivia </option>
<option value="Bonaire, Sint Eustatius and Saba">Bonaire, Sint Eustatius and Saba </option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina </option>
<option value="Botswana">Botswana </option>
<option value="Bouvet Island">Bouvet Island </option>
<option value="Brazil">Brazil </option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory </option>
<option value="Brunei Darussalam">Brunei Darussalam </option>
<option value="Bulgaria">Bulgaria </option>
<option value="Burkina Faso">Burkina Faso </option>
<option value="Burundi">Burundi </option>
<option value="Cambodia">Cambodia </option>
<option value="Cameroon">Cameroon </option>
<option value="Canada">Canada </option>
<option value="Cape Verde">Cape Verde </option>
<option value="Cayman Islands">Cayman Islands </option>
<option value="Central African Republic">Central African Republic </option>
<option value="Chad">Chad </option>
<option value="Chile">Chile </option>
<option value="China">China </option>
<option value="Christmas Island">Christmas Island </option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands </option>
<option value="Colombia">Colombia </option>
<option value="Comoros">Comoros </option>
<option value="Congo">Congo </option>
<option value="Congo, the Democratic Republic of the">Congo, the Democratic Republic of the </option>
<option value="Cook Islands">Cook Islands </option>
<option value="Costa Rica">Costa Rica </option>
<option value="Croatia">Croatia </option>
<option value="Curaçao">Curaçao </option>
<option value="Cyprus">Cyprus </option>
<option value="Czech Republic">Czech Republic </option>
<option value="Denmark">Denmark </option>
<option value="Djibouti">Djibouti </option>
<option value="Dominica">Dominica </option>
<option value="Dominican Republic">Dominican Republic </option>
<option value="Dutch Antilles">Dutch Antilles </option>
<option value="Ecuador">Ecuador </option>
<option value="Egypt">Egypt </option>
<option value="El Salvador">El Salvador </option>
<option value="Equatorial Guinea">Equatorial Guinea </option>
<option value="Eritrea">Eritrea </option>
<option value="Estonia">Estonia </option>
<option value="Ethiopia">Ethiopia </option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas) </option>
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<option value="Fiji">Fiji </option>
<option value="Finland">Finland </option>
<option value="France">France </option>
<option value="French Guiana">French Guiana </option>
<option value="French Polynesia">French Polynesia </option>
<option value="French Southern Territories">French Southern Territories </option>
<option value="Gabon">Gabon </option>
<option value="Gambia">Gambia </option>
<option value="Georgia">Georgia </option>
<option value="Germany">Germany </option>
<option value="Ghana">Ghana </option>
<option value="Gibraltar">Gibraltar </option>
<option value="Greece">Greece </option>
<option value="Greenland">Greenland </option>
<option value="Grenada">Grenada </option>
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<option value="Guam">Guam </option>
<option value="Guatemala">Guatemala </option>
<option value="Guernsey">Guernsey </option>
<option value="Guinea">Guinea </option>
<option value="Guinea-Bissau">Guinea-Bissau </option>
<option value="Guyana">Guyana </option>
<option value="Haiti">Haiti </option>
<option value="Heard Island and McDonald Islands">Heard Island and McDonald Islands </option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State) </option>
<option value="Honduras">Honduras </option>
<option value="Hong Kong">Hong Kong </option>
<option value="Hungary">Hungary </option>
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<option value="Iraq">Iraq </option>
<option value="Ireland">Ireland </option>
<option value="Isle of Man">Isle of Man </option>
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<option value="Italy">Italy </option>
<option value="Ivory Coast">Ivory Coast </option>
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<option value="Japan">Japan </option>
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<option value="Kuwait">Kuwait </option>
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<option value="Lao People's Democratic Republic">Lao People's Democratic Republic </option>
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<option value="Liechtenstein">Liechtenstein </option>
<option value="Lithuania">Lithuania </option>
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<option value="Macao">Macao </option>
<option value="Macedonia, the former Yugoslav Republic of">Macedonia, the former Yugoslav Republic of </option>
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<option value="Marshall Islands">Marshall Islands </option>
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<option value="Mexico">Mexico </option>
<option value="Micronesia">Micronesia </option>
<option value="Moldova, Republic of">Moldova, Republic of </option>
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<option value="Mongolia">Mongolia </option>
<option value="Montenegro">Montenegro </option>
<option value="Montserrat">Montserrat </option>
<option value="Morocco">Morocco </option>
<option value="Mozambique">Mozambique </option>
<option value="Myanmar">Myanmar </option>
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<option value="Nigeria">Nigeria </option>
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<option value="Oman">Oman </option>
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<option value="Palestine">Palestine </option>
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<option value="Portugal">Portugal </option>
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<option value="Qatar">Qatar </option>
<option value="Reunion">Reunion </option>
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<option value="Saint Barthélemy">Saint Barthélemy </option>
<option value="Saint Helena, Ascension and Tristan da Cunha">Saint Helena, Ascension and Tristan da Cunha </option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis </option>
<option value="Saint Lucia">Saint Lucia </option>
<option value="Saint Martin">Saint Martin </option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon </option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines </option>
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<option value="Samoa, American">Samoa, American </option>
<option value="San Marino">San Marino </option>
<option value="Sao Tome and Principe">Sao Tome and Principe </option>
<option value="Saudi Arabia">Saudi Arabia </option>
<option value="Senegal">Senegal </option>
<option value="Serbia">Serbia </option>
<option value="Seychelles">Seychelles </option>
<option value="Sierra Leone">Sierra Leone </option>
<option value="Singapore">Singapore </option>
<option value="Sint Maarten">Sint Maarten </option>
<option value="Slovakia">Slovakia </option>
<option value="Slovenia">Slovenia </option>
<option value="Solomon Islands">Solomon Islands </option>
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<option value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands </option>
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<option value="Spain">Spain </option>
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<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen </option>
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<option value="Turks and Caicos Islands">Turks and Caicos Islands </option>
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<option value="United States Minor Outlying Islands">United States Minor Outlying Islands </option>
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<option value="Uzbekistan">Uzbekistan </option>
<option value="Vanuatu">Vanuatu </option>
<option value="Venezuela">Venezuela </option>
<option value="Vietnam">Vietnam </option>
<option value="Virgin Islands, British">Virgin Islands, British </option>
<option value="Virgin Islands, US">Virgin Islands, US </option>
<option value="Wallis and Futuna">Wallis and Futuna </option>
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