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Form analysis
1 forms found in the DOM

Name: eloqua10DemoForm — POST https://secure.eloqua.com/e/f2.aspx?LP=4

<form method="post" name="eloqua10DemoForm" action="https://secure.eloqua.com/e/f2.aspx?LP=4" id="form28"><input value="eloqua10DemoForm" type="hidden" name="elqFormName"><input value="1724" type="hidden" name="elqSiteId"><input name="elqCampaignId"
    type="hidden">
  <div id="formElement0" class="sc-view form-design-field sc-static-layout sc-regular-size" style="left: 0px; right: 0px; top: 0px; bottom: 0px; padding: 6px 5px 9px 9px"><label
      style="display: block; line-height: 150%; padding: 1px 0pt 3px; white-space: nowrap">Email Address</label>
    <div class="form-input-wrapper" style="width: 96%"><input id="field0" value="" type="text" name="emailAddress" class="" style="width: 50%"></div>
  </div>
  <div id="formElement1" class="sc-view form-design-field sc-static-layout sc-regular-size" style="left: 0px; right: 0px; top: 0px; bottom: 0px; padding: 6px 5px 9px 9px"><label
      style="display: block; line-height: 150%; padding: 1px 0pt 3px; white-space: nowrap">First Name</label>
    <div class="form-input-wrapper" style="width: 96%"><input id="field1" value="Colleague" type="text" name="firstName" class="" style="width: 50%"></div>
  </div>
  <div id="formElement2" class="sc-view form-design-field sc-static-layout sc-regular-size" style="left: 0px; right: 0px; top: 0px; bottom: 0px; padding: 6px 5px 9px 9px"><label
      style="display: block; line-height: 150%; padding: 1px 0pt 3px; white-space: nowrap">Last Name</label>
    <div class="form-input-wrapper" style="width: 96%"><input id="field2" value="" type="text" name="lastName" class="" style="width: 50%"></div>
  </div>
  <div id="formElement3" class="sc-view form-design-field sc-static-layout sc-regular-size" style="left: 0px; right: 0px; top: 0px; bottom: 0px; padding: 6px 5px 9px 9px"><label
      style="display: block; line-height: 150%; padding: 1px 0pt 3px; white-space: nowrap">Company</label>
    <div class="form-input-wrapper" style="width: 96%"><input id="field3" value="your company" type="text" name="company" class="" style="width: 50%"></div>
  </div>
  <div id="formElement4" class="sc-view form-design-field sc-static-layout sc-regular-size" style="left: 0px; right: 0px; top: 0px; bottom: 0px; padding: 6px 5px 9px 9px"><label
      style="display: block; line-height: 150%; padding: 1px 0pt 3px; white-space: nowrap">State or Province</label>
    <div class="form-input-wrapper" style="width: 96%"><select id="field4" value="" name="stateOrProvince" class="" style="width: 50%">
        <option id="field4" name="stateOrProvince" selected="selected">Please Select…</option>
        <option id="field4" value="AK" name="stateOrProvince">Alaska</option>
        <option id="field4" value="AL" name="stateOrProvince">Alabama</option>
        <option id="field4" value="AR" name="stateOrProvince">Arkansas</option>
        <option id="field4" value="AS" name="stateOrProvince">American Samoa</option>
        <option id="field4" value="AZ" name="stateOrProvince">Arizona</option>
        <option id="field4" value="CA" name="stateOrProvince">California</option>
        <option id="field4" value="CO" name="stateOrProvince">Colorado</option>
        <option id="field4" value="CT" name="stateOrProvince">Connecticut</option>
        <option id="field4" value="DC" name="stateOrProvince">D.C.</option>
        <option id="field4" value="DE" name="stateOrProvince">Delaware</option>
        <option id="field4" value="FL" name="stateOrProvince">Florida</option>
        <option id="field4" value="FM" name="stateOrProvince">Micronesia</option>
        <option id="field4" value="GA" name="stateOrProvince">Georgia</option>
        <option id="field4" value="GU" name="stateOrProvince">Guam</option>
        <option id="field4" value="HI" name="stateOrProvince">Hawaii</option>
        <option id="field4" value="IA" name="stateOrProvince">Iowa</option>
        <option id="field4" value="ID" name="stateOrProvince">Idaho</option>
        <option id="field4" value="IL" name="stateOrProvince">Illinois</option>
        <option id="field4" value="IN" name="stateOrProvince">Indiana</option>
        <option id="field4" value="KS" name="stateOrProvince">Kansas</option>
        <option id="field4" value="KY" name="stateOrProvince">Kentucky</option>
        <option id="field4" value="LA" name="stateOrProvince">Louisiana</option>
        <option id="field4" value="MA" name="stateOrProvince">Massachusetts</option>
        <option id="field4" value="MD" name="stateOrProvince">Maryland</option>
        <option id="field4" value="ME" name="stateOrProvince">Maine</option>
        <option id="field4" value="MH" name="stateOrProvince">Marshall Islands</option>
        <option id="field4" value="MI" name="stateOrProvince">Michigan</option>
        <option id="field4" value="MN" name="stateOrProvince">Minnesota</option>
        <option id="field4" value="MO" name="stateOrProvince">Missouri</option>
        <option id="field4" value="MP" name="stateOrProvince">Marianas</option>
        <option id="field4" value="MS" name="stateOrProvince">Mississippi</option>
        <option id="field4" value="MT" name="stateOrProvince">Montana</option>
        <option id="field4" value="NC" name="stateOrProvince">North Carolina</option>
        <option id="field4" value="ND" name="stateOrProvince">North Dakota</option>
        <option id="field4" value="NE" name="stateOrProvince">Nebraska</option>
        <option id="field4" value="NH" name="stateOrProvince">New Hampshire</option>
        <option id="field4" value="NJ" name="stateOrProvince">New Jersey</option>
        <option id="field4" value="NM" name="stateOrProvince">New Mexico</option>
        <option id="field4" value="NV" name="stateOrProvince">Nevada</option>
        <option id="field4" value="NY" name="stateOrProvince">New York</option>
        <option id="field4" value="OH" name="stateOrProvince">Ohio</option>
        <option id="field4" value="OK" name="stateOrProvince">Oklahoma</option>
        <option id="field4" value="OR" name="stateOrProvince">Oregon</option>
        <option id="field4" value="PA" name="stateOrProvince">Pennsylvania</option>
        <option id="field4" value="PR" name="stateOrProvince">Puerto Rico</option>
        <option id="field4" value="PW" name="stateOrProvince">Palau</option>
        <option id="field4" value="RI" name="stateOrProvince">Rhode Island</option>
        <option id="field4" value="SC" name="stateOrProvince">South Carolina</option>
        <option id="field4" value="SD" name="stateOrProvince">South Dakota</option>
        <option id="field4" value="TN" name="stateOrProvince">Tennessee</option>
        <option id="field4" value="TX" name="stateOrProvince">Texas</option>
        <option id="field4" value="UT" name="stateOrProvince">Utah</option>
        <option id="field4" value="VA" name="stateOrProvince">Virginia</option>
        <option id="field4" value="VI" name="stateOrProvince">Virgin Islands</option>
        <option id="field4" value="VT" name="stateOrProvince">Vermont</option>
        <option id="field4" value="WA" name="stateOrProvince">Washington</option>
        <option id="field4" value="WI" name="stateOrProvince">Wisconsin</option>
        <option id="field4" value="WV" name="stateOrProvince">West Virginia</option>
        <option id="field4" value="WY" name="stateOrProvince">Wyoming</option>
        <option id="field4" value="AA" name="stateOrProvince">Military Americas</option>
        <option id="field4" value="AE" name="stateOrProvince">Military Europe/ME/Canada</option>
        <option id="field4" value="AP" name="stateOrProvince">Military Pacific</option>
        <option id="field4" value="AB" name="stateOrProvince">Alberta</option>
        <option id="field4" value="MB" name="stateOrProvince">Manitoba</option>
        <option id="field4" value="BC" name="stateOrProvince">British Columbia</option>
        <option id="field4" value="NB" name="stateOrProvince">New Brunswick</option>
        <option id="field4" value="NL" name="stateOrProvince">Newfoundland and Labrador</option>
        <option id="field4" value="NS" name="stateOrProvince">Nova Scotia</option>
        <option id="field4" value="NT" name="stateOrProvince">Northwest Territories</option>
        <option id="field4" value="NU" name="stateOrProvince">Nunavut</option>
        <option id="field4" value="ON" name="stateOrProvince">Ontario</option>
        <option id="field4" value="PE" name="stateOrProvince">Prince Edward Island</option>
        <option id="field4" value="QC" name="stateOrProvince">Quebec</option>
        <option id="field4" value="SK" name="stateOrProvince">Saskatchewan</option>
        <option id="field4" value="YT" name="stateOrProvince">Yukon Territory</option>
      </select></div>
  </div>
  <div id="formElement5" class="sc-view form-design-field sc-static-layout sc-regular-size" style="left: 0px; right: 0px; top: 0px; bottom: 0px; padding: 6px 5px 9px 9px"><label
      style="display: block; line-height: 150%; padding: 1px 0pt 3px; white-space: nowrap">Country</label>
    <div class="form-input-wrapper" style="width: 96%"><select id="field5" value="" name="country" class="" style="width: 50%">
        <option id="field5" name="country" selected="selected">Please select</option>
        <option id="field5" value="US" name="country">United States</option>
        <option id="field5" value="GB" name="country">United Kingdom</option>
        <option id="field5" value="CA" name="country">Canada</option>
        <option id="field5" value="IN" name="country">India</option>
        <option id="field5" value="NL" name="country">Netherlands</option>
        <option id="field5" value="AU" name="country">Australia</option>
        <option id="field5" value="ZA" name="country">South Africa</option>
        <option id="field5" value="FR" name="country">France</option>
        <option id="field5" value="DE" name="country">Germany</option>
        <option id="field5" value="SG" name="country">Singapore</option>
        <option id="field5" value="SE" name="country">Sweden</option>
        <option id="field5" value="BR" name="country">Brazil</option>
        <option id="field5" name="country" selected="selected">--------------</option>
        <option id="field5" value="AF" name="country">Afghanistan</option>
        <option id="field5" value="AX" name="country">Åland Islands</option>
        <option id="field5" value="AL" name="country">Albania</option>
        <option id="field5" value="DZ" name="country">Algeria</option>
        <option id="field5" value="AS" name="country">American Samoa</option>
        <option id="field5" value="AD" name="country">Andorra</option>
        <option id="field5" value="AO" name="country">Angola</option>
        <option id="field5" value="AI" name="country">Anguilla</option>
        <option id="field5" value="AQ" name="country">Antarctica</option>
        <option id="field5" value="AG" name="country">Antigua and Barbuda</option>
        <option id="field5" value="AR" name="country">Argentina</option>
        <option id="field5" value="AM" name="country">Armenia</option>
        <option id="field5" value="AW" name="country">Aruba</option>
        <option id="field5" value="AU" name="country">Australia</option>
        <option id="field5" value="AT" name="country">Austria</option>
        <option id="field5" value="AZ" name="country">Azerbaijan</option>
        <option id="field5" value="BS" name="country">Bahamas</option>
        <option id="field5" value="BH" name="country">Bahrain</option>
        <option id="field5" value="BD" name="country">Bangladesh</option>
        <option id="field5" value="BB" name="country">Barbados</option>
        <option id="field5" value="BY" name="country">Belarus</option>
        <option id="field5" value="BE" name="country">Belgium</option>
        <option id="field5" value="BZ" name="country">Belize</option>
        <option id="field5" value="BJ" name="country">Benin</option>
        <option id="field5" value="BM" name="country">Bermuda</option>
        <option id="field5" value="BT" name="country">Bhutan</option>
        <option id="field5" value="BO" name="country">Bolivia</option>
        <option id="field5" value="BA" name="country">Bosnia and Herzegovina</option>
        <option id="field5" value="BW" name="country">Botswana</option>
        <option id="field5" value="BV" name="country">Bouvet Island</option>
        <option id="field5" value="BR" name="country">Brazil</option>
        <option id="field5" value="IO" name="country">Brit/Indian Ocean Terr.</option>
        <option id="field5" value="BN" name="country">Brunei Darussalam</option>
        <option id="field5" value="BG" name="country">Bulgaria</option>
        <option id="field5" value="BF" name="country">Burkina Faso</option>
        <option id="field5" value="BI" name="country">Burundi</option>
        <option id="field5" value="KH" name="country">Cambodia</option>
        <option id="field5" value="CM" name="country">Cameroon</option>
        <option id="field5" value="CA" name="country">Canada</option>
        <option id="field5" value="CV" name="country">Cape Verde</option>
        <option id="field5" value="KY" name="country">Cayman Islands</option>
        <option id="field5" value="CF" name="country">Central African Republic</option>
        <option id="field5" value="TD" name="country">Chad</option>
        <option id="field5" value="CL" name="country">Chile</option>
        <option id="field5" value="CN" name="country">China</option>
        <option id="field5" value="CX" name="country">Christmas Island</option>
        <option id="field5" value="CC" name="country">Cocos (Keeling) Islands</option>
        <option id="field5" value="CO" name="country">Colombia</option>
        <option id="field5" value="KM" name="country">Comoros</option>
        <option id="field5" value="CG" name="country">Congo</option>
        <option id="field5" value="CD" name="country">Congo, The Dem. Republic Of</option>
        <option id="field5" value="CK" name="country">Cook Islands</option>
        <option id="field5" value="CR" name="country">Costa Rica</option>
        <option id="field5" value="CI" name="country">Côte D'Ivore</option>
        <option id="field5" value="HR" name="country">Croatia</option>
        <option id="field5" value="CU" name="country">Cuba</option>
        <option id="field5" value="CY" name="country">Cyprus</option>
        <option id="field5" value="CZ" name="country">Czech Republic</option>
        <option id="field5" value="DK" name="country">Denmark</option>
        <option id="field5" value="DJ" name="country">Djibouti</option>
        <option id="field5" value="DM" name="country">Dominica</option>
        <option id="field5" value="DO" name="country">Dominican Republic</option>
        <option id="field5" value="EC" name="country">Ecuador</option>
        <option id="field5" value="EG" name="country">Egypt</option>
        <option id="field5" value="SV" name="country">El Salvador</option>
        <option id="field5" value="GQ" name="country">Equatorial Guinea</option>
        <option id="field5" value="ER" name="country">Eritrea</option>
        <option id="field5" value="EE" name="country">Estonia</option>
        <option id="field5" value="ET" name="country">Ethiopia</option>
        <option id="field5" value="FK" name="country">Falkland Islands</option>
        <option id="field5" value="FO" name="country">Faroe Islands</option>
        <option id="field5" value="FJ" name="country">Fiji</option>
        <option id="field5" value="FI" name="country">Finland</option>
        <option id="field5" value="FR" name="country">France</option>
        <option id="field5" value="GF" name="country">French Guiana</option>
        <option id="field5" value="PF" name="country">French Polynesia</option>
        <option id="field5" value="TF" name="country">French Southern Terr.</option>
        <option id="field5" value="GA" name="country">Gabon</option>
        <option id="field5" value="GM" name="country">Gambia</option>
        <option id="field5" value="GE" name="country">Georgia</option>
        <option id="field5" value="DE" name="country">Germany</option>
        <option id="field5" value="GH" name="country">Ghana</option>
        <option id="field5" value="GI" name="country">Gibraltar</option>
        <option id="field5" value="GB" name="country">United Kingdom</option>
        <option id="field5" value="GR" name="country">Greece</option>
        <option id="field5" value="GL" name="country">Greenland</option>
        <option id="field5" value="GD" name="country">Grenada</option>
        <option id="field5" value="GP" name="country">Guadeloupe</option>
        <option id="field5" value="GU" name="country">Guam</option>
        <option id="field5" value="GT" name="country">Guatemala</option>
        <option id="field5" value="GN" name="country">Guinea</option>
        <option id="field5" value="GW" name="country">Guinea-Bissau</option>
        <option id="field5" value="GY" name="country">Guyana</option>
        <option id="field5" value="HT" name="country">Haiti</option>
        <option id="field5" value="HM" name="country">Heard/McDonald Isls.</option>
        <option id="field5" value="HN" name="country">Honduras</option>
        <option id="field5" value="HK" name="country">Hong Kong</option>
        <option id="field5" value="HU" name="country">Hungary</option>
        <option id="field5" value="IS" name="country">Iceland</option>
        <option id="field5" value="IN" name="country">India</option>
        <option id="field5" value="ID" name="country">Indonesia</option>
        <option id="field5" value="IR" name="country">Iran</option>
        <option id="field5" value="IQ" name="country">Iraq</option>
        <option id="field5" value="IE" name="country">Ireland</option>
        <option id="field5" value="IL" name="country">Israel</option>
        <option id="field5" value="IT" name="country">Italy</option>
        <option id="field5" value="JM" name="country">Jamaica</option>
        <option id="field5" value="JP" name="country">Japan</option>
        <option id="field5" value="JO" name="country">Jordan</option>
        <option id="field5" value="KZ" name="country">Kazakhstan</option>
        <option id="field5" value="KE" name="country">Kenya</option>
        <option id="field5" value="KI" name="country">Kiribati</option>
        <option id="field5" value="KP" name="country">Korea (North)</option>
        <option id="field5" value="KR" name="country">Korea (South)</option>
        <option id="field5" value="KW" name="country">Kuwait</option>
        <option id="field5" value="KG" name="country">Kyrgyzstan</option>
        <option id="field5" value="LA" name="country">Laos</option>
        <option id="field5" value="LV" name="country">Latvia</option>
        <option id="field5" value="LB" name="country">Lebanon</option>
        <option id="field5" value="LS" name="country">Lesotho</option>
        <option id="field5" value="LR" name="country">Liberia</option>
        <option id="field5" value="LY" name="country">Libya</option>
        <option id="field5" value="LI" name="country">Liechtenstein</option>
        <option id="field5" value="LT" name="country">Lithuania</option>
        <option id="field5" value="LU" name="country">Luxembourg</option>
        <option id="field5" value="MO" name="country">Macau</option>
        <option id="field5" value="MK" name="country">Macedonia</option>
        <option id="field5" value="MG" name="country">Madagascar</option>
        <option id="field5" value="MW" name="country">Malawi</option>
        <option id="field5" value="MY" name="country">Malaysia</option>
        <option id="field5" value="MV" name="country">Maldives</option>
        <option id="field5" value="ML" name="country">Mali</option>
        <option id="field5" value="MT" name="country">Malta</option>
        <option id="field5" value="MH" name="country">Marshall Islands</option>
        <option id="field5" value="MQ" name="country">Martinique</option>
        <option id="field5" value="MR" name="country">Mauritania</option>
        <option id="field5" value="MU" name="country">Mauritius</option>
        <option id="field5" value="YT" name="country">Mayotte</option>
        <option id="field5" value="MX" name="country">Mexico</option>
        <option id="field5" value="FM" name="country">Micronesia</option>
        <option id="field5" value="MD" name="country">Moldova</option>
        <option id="field5" value="MC" name="country">Monaco</option>
        <option id="field5" value="MN" name="country">Mongolia</option>
        <option id="field5" value="MS" name="country">Montserrat</option>
        <option id="field5" value="MA" name="country">Morocco</option>
        <option id="field5" value="MZ" name="country">Mozambique</option>
        <option id="field5" value="MM" name="country">Myanmar</option>
        <option id="field5" value="MP" name="country">N. Mariana Isls.</option>
        <option id="field5" value="NA" name="country">Namibia</option>
        <option id="field5" value="NR" name="country">Nauru</option>
        <option id="field5" value="NP" name="country">Nepal</option>
        <option id="field5" value="NL" name="country">Netherlands</option>
        <option id="field5" value="AN" name="country">Netherlands Antilles</option>
        <option id="field5" value="NC" name="country">New Caledonia</option>
        <option id="field5" value="NZ" name="country">New Zealand</option>
        <option id="field5" value="NI" name="country">Nicaragua</option>
        <option id="field5" value="NE" name="country">Niger</option>
        <option id="field5" value="NG" name="country">Nigeria</option>
        <option id="field5" value="NU" name="country">Niue</option>
        <option id="field5" value="NF" name="country">Norfolk Island</option>
        <option id="field5" value="NO" name="country">Norway</option>
        <option id="field5" value="OM" name="country">Oman</option>
        <option id="field5" value="PK" name="country">Pakistan</option>
        <option id="field5" value="PW" name="country">Palau</option>
        <option id="field5" value="PS" name="country">Palestinian Territory, Occupied</option>
        <option id="field5" value="PA" name="country">Panama</option>
        <option id="field5" value="PG" name="country">Papua New Guinea</option>
        <option id="field5" value="PY" name="country">Paraguay</option>
        <option id="field5" value="PE" name="country">Peru</option>
        <option id="field5" value="PH" name="country">Philippines</option>
        <option id="field5" value="PN" name="country">Pitcairn</option>
        <option id="field5" value="PL" name="country">Poland</option>
        <option id="field5" value="PT" name="country">Portugal</option>
        <option id="field5" value="PR" name="country">Puerto Rico</option>
        <option id="field5" value="QA" name="country">Qatar</option>
        <option id="field5" value="RE" name="country">Reunion</option>
        <option id="field5" value="RO" name="country">Romania</option>
        <option id="field5" value="RU" name="country">Russian Federation</option>
        <option id="field5" value="RW" name="country">Rwanda</option>
        <option id="field5" value="KN" name="country">Saint Kitts and Nevis</option>
        <option id="field5" value="LC" name="country">Saint Lucia</option>
        <option id="field5" value="WS" name="country">Samoa</option>
        <option id="field5" value="SM" name="country">San Marino</option>
        <option id="field5" value="ST" name="country">Sao Tome/Principe</option>
        <option id="field5" value="SA" name="country">Saudi Arabia</option>
        <option id="field5" value="SN" name="country">Senegal</option>
        <option id="field5" value="CS" name="country">Serbia and Montenegro</option>
        <option id="field5" value="SC" name="country">Seychelles</option>
        <option id="field5" value="SL" name="country">Sierra Leone</option>
        <option id="field5" value="SG" name="country">Singapore</option>
        <option id="field5" value="SK" name="country">Slovak Republic</option>
        <option id="field5" value="SI" name="country">Slovenia</option>
        <option id="field5" value="SB" name="country">Solomon Islands</option>
        <option id="field5" value="SO" name="country">Somalia</option>
        <option id="field5" value="ZA" name="country">South Africa</option>
        <option id="field5" value="ES" name="country">Spain</option>
        <option id="field5" value="LK" name="country">Sri Lanka</option>
        <option id="field5" value="SH" name="country">St. Helena</option>
        <option id="field5" value="PM" name="country">St. Pierre and Miquelon</option>
        <option id="field5" value="VC" name="country">St. Vincent and Grenadines</option>
        <option id="field5" value="SD" name="country">Sudan</option>
        <option id="field5" value="SR" name="country">Suriname</option>
        <option id="field5" value="SJ" name="country">Svalbard/Jan Mayen Isls.</option>
        <option id="field5" value="SZ" name="country">Swaziland</option>
        <option id="field5" value="SE" name="country">Sweden</option>
        <option id="field5" value="CH" name="country">Switzerland</option>
        <option id="field5" value="SY" name="country">Syria</option>
        <option id="field5" value="TW" name="country">Taiwan</option>
        <option id="field5" value="TJ" name="country">Tajikistan</option>
        <option id="field5" value="TZ" name="country">Tanzania</option>
        <option id="field5" value="TH" name="country">Thailand</option>
        <option id="field5" value="TL" name="country">Timor-Leste</option>
        <option id="field5" value="TG" name="country">Togo</option>
        <option id="field5" value="TK" name="country">Tokelau</option>
        <option id="field5" value="TO" name="country">Tonga</option>
        <option id="field5" value="TT" name="country">Trinidad and Tobago</option>
        <option id="field5" value="TN" name="country">Tunisia</option>
        <option id="field5" value="TR" name="country">Turkey</option>
        <option id="field5" value="TM" name="country">Turkmenistan</option>
        <option id="field5" value="TC" name="country">Turks/Caicos Isls.</option>
        <option id="field5" value="TV" name="country">Tuvalu</option>
        <option id="field5" value="UG" name="country">Uganda</option>
        <option id="field5" value="UA" name="country">Ukraine</option>
        <option id="field5" value="AE" name="country">United Arab Emirates</option>
        <option id="field5" value="US" name="country">United States</option>
        <option id="field5" value="UM" name="country">US Minor Outlying Is.</option>
        <option id="field5" value="UY" name="country">Uruguay</option>
        <option id="field5" value="UZ" name="country">Uzbekistan</option>
        <option id="field5" value="VU" name="country">Vanuatu</option>
        <option id="field5" value="VA" name="country">Vatican City</option>
        <option id="field5" value="VE" name="country">Venezuela</option>
        <option id="field5" value="VN" name="country">Viet Nam</option>
        <option id="field5" value="VG" name="country">Virgin Islands (British)</option>
        <option id="field5" value="VI" name="country">Virgin Islands (U.S.)</option>
        <option id="field5" value="WF" name="country">Wallis/Futuna Isls.</option>
        <option id="field5" value="EH" name="country">Western Sahara</option>
        <option id="field5" value="YE" name="country">Yemen</option>
        <option id="field5" value="ZM" name="country">Zambia</option>
        <option id="field5" value="ZW" name="country">Zimbabwe</option>
      </select></div>
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    <div class="form-input-wrapper" style="width: 96%"><input id="field7" value="Submit" type="submit" style="font-size: 100%; width: 100px; height: 24px"></div>
  </div>
</form>

Text Content

Email Address

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and HerzegovinaBotswanaBouvet IslandBrazilBrit/Indian Ocean Terr.Brunei
DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman
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IslandsColombiaComorosCongoCongo, The Dem. Republic OfCook IslandsCosta RicaCôte
D'IvoreCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican
RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland
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KingdomGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard/McDonald
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ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalauPalestinian
Territory, OccupiedPanamaPapua New
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MontenegroSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSolomon
IslandsSomaliaSouth AfricaSpainSri LankaSt. HelenaSt. Pierre and MiquelonSt.
Vincent and GrenadinesSudanSurinameSvalbard/Jan Mayen
Isls.SwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad
and TobagoTunisiaTurkeyTurkmenistanTurks/Caicos Isls.TuvaluUgandaUkraineUnited
Arab EmiratesUnited StatesUS Minor Outlying Is.UruguayUzbekistanVanuatuVatican
CityVenezuelaViet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis/Futuna
Isls.Western SaharaYemenZambiaZimbabwe


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