healthtimes.com.au Open in urlscan Pro
104.21.17.70  Public Scan

URL: https://healthtimes.com.au/
Submission: On November 11 via manual — Scanned from AU

Form analysis 11 forms found in the DOM

Name: form_forgotpwdPOST index.php

<form class="form" action="index.php" method="post" name="form_forgotpwd" id="form_forgotpwd" novalidate="novalidate" data-hs-cf-bound="true">
  <ul>
    <li>
      <input type="text" value="" placeholder="Email Address *" name="confirmEmail" id="confirmEmail" onkeypress="if(event.which==13 || event.keyCode==13){submit_forgotpwd()}">
    </li>
    <li style="display: none;">
      <input type="text" value="" placeholder="Email *" name="email" id="email" onkeypress="if(event.which==13 || event.keyCode==13){submit_signin()}">
    </li>
    <li style="display: none;">
      <input type="text" value="1" name="j044d96845f2e4ae092c0598922b98e55" id="j044d96845f2e4ae092c0598922b98e55" onkeypress="if(event.which==13 || event.keyCode==13){submit_signin()}">
    </li>
    <li class="popup_submit">
      <label><a id="open-signin_popup1" href="">Sign In</a> | <a id="register_forgotpwd_popup" href="">Register for new account</a></label>
      <input type="button" id="login_bttn_n2" onclick="submit_forgotpwd()" value="Submit">
    </li>
    <input type="hidden" name="option" value="com_registration">
    <input type="hidden" name="task" value="sendNewPass">
    <input type="hidden" id="current_task_forgotpwd" name="current_task_forgotpwd" value="">
  </ul>
</form>

Name: signinPOST index.php

<form class="form" action="index.php" method="post" name="signin" id="signin" novalidate="novalidate" data-hs-cf-bound="true">
  <ul>
    <li>
      <input type="text" value="" placeholder="Email Address *" name="signname" id="signname" onkeypress="if(event.which==13 || event.keyCode==13){submit_signin()}">
    </li>
    <li>
      <input type="password" value="" placeholder="Password *" name="password" id="password" onkeypress="if(event.which==13 || event.keyCode==13){submit_signin()}">
    </li>
    <li>
      <input type="hidden" value="" placeholder="Email *" name="email" id="email" onkeypress="if(event.which==13 || event.keyCode==13){submit_signin()}">
    </li>
    <li class="popup_submit">
      <label><a id="open-forgotpwd_popup" href="">Forgot Password</a> | <a id="register_signin_popup" href="">Register for new account</a></label>
      <input type="button" id="login_bttn_n1" onclick="submit_signin()" value="LOGIN">
    </li>
    <li style="display: none;">
      <input type="hidden" value="" placeholder="Email *" name="re_page" id="re_page" onkeypress="if(event.which==13 || event.keyCode==13){submit_signin()}">
    </li>
    <input type="hidden" name="option" value="com_registration">
    <input type="hidden" name="task" value="signin">
    <input type="hidden" id="current_task_signin" name="current_task_signin" value="">
    <input type="hidden" id="signin_call_flag" name="signin_call_flag" value="">
  </ul>
</form>

Name: signoutPOST index.php

<form class="form" action="index.php" method="post" name="signout" id="signout" data-hs-cf-bound="true">
  <input type="hidden" name="option" value="com_registration">
  <input type="hidden" name="task" value="signout">
</form>

Name: form_member_registerPOST index.php

<form class="form" name="form_member_register" id="form_member_register" method="POST" action="index.php" data-hs-cf-bound="true">
  <ul>
    <li class="fullname">
      <div class="first"><input type="text" id="mem_firstname" name="mem_firstname" value="" placeholder="First Name *"></div>
      <div class="last_name"><input type="text" id="mem_lastname" name="mem_lastname" value="" placeholder="Surname *"></div>
    </li>
    <li>
      <input type="text" id="emailid" name="emailid" value="" placeholder="Email Address *">
    </li>
    <li>
      <input type="text" id="cnfrm_emailid" name="cnfrm_emailid" value="" placeholder="Confirm Email Address *">
    </li>
    <li>
      <input type="password" id="pwd" name="pwd" value="" placeholder="Password (minimum 5 characters) *" maxlength="32">
    </li>
    <li>
      <input type="password" id="cnfrm_password" name="cnfrm_password" value="" placeholder="Confirm Password *" maxlength="32">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="location_data" name="location_data" style="display: none;">
          <option value="">Location</option>
          <option value="" disabled="disabled">Australian State or Territory</option>
          <option value="NSW">New South Wales</option>
          <option value="VIC">Victoria</option>
          <option value="QLD">Queensland</option>
          <option value="WA">Western Australia</option>
          <option value="SA">South Australia</option>
          <option value="TAS">Tasmania</option>
          <option value="ACT">Australian Capital Territory</option>
          <option value="NT">Northern Territory</option>
          <option value="" disabled="disabled">International</option>
          <option value="All international">All international</option>
          <option value="NZ">New Zealand</option>
          <option value="USA">United States</option>
          <option value="London">London</option>
          <option value="IE">Ireland</option>
          <option value="Rest of UK">Rest of UK</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Location</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Location</label></li>
            <li data-val="" class="disabled"><label>Australian State or Territory</label></li>
            <li data-val="NSW"><label>New South Wales</label></li>
            <li data-val="VIC"><label>Victoria</label></li>
            <li data-val="QLD"><label>Queensland</label></li>
            <li data-val="WA"><label>Western Australia</label></li>
            <li data-val="SA"><label>South Australia</label></li>
            <li data-val="TAS"><label>Tasmania</label></li>
            <li data-val="ACT"><label>Australian Capital Territory</label></li>
            <li data-val="NT"><label>Northern Territory</label></li>
            <li data-val="" class="disabled"><label>International</label></li>
            <li data-val="All international"><label>All international</label></li>
            <li data-val="NZ"><label>New Zealand</label></li>
            <li data-val="USA"><label>United States</label></li>
            <li data-val="London"><label>London</label></li>
            <li data-val="IE"><label>Ireland</label></li>
            <li data-val="Rest of UK"><label>Rest of UK</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select name="regitermember_field" id="regitermember_field" onchange="regitermember_dropdownfield(this.value)" style="display: none;">
          <option value="">Field</option>
          <option value="1">Registered Nurse</option>
          <option value="25">Enrolled Nurse</option>
          <option value="47">Midwifery</option>
          <option value="53">Assistant In Nursing</option>
          <option value="55">Occupational Therapist</option>
          <option value="61">Physiotherapy</option>
          <option value="67">Administration</option>
          <option value="71">Medical Imaging</option>
          <option value="76">Allied Health</option>
          <option value="90">Carer</option>
          <option value="92">Clinical Education / Sales</option>
          <option value="94">General Practitioners</option>
          <option value="96">Paramedic</option>
          <option value="98">Psychology / Counselling</option>
          <option value="100">Social Worker</option>
          <option value="102">Specialists / Consultants</option>
          <option value="104">Support Services</option>
          <option value="135">Residents and Registrars</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Field</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Field</label></li>
            <li data-val="1"><label>Registered Nurse</label></li>
            <li data-val="25"><label>Enrolled Nurse</label></li>
            <li data-val="47"><label>Midwifery</label></li>
            <li data-val="53"><label>Assistant In Nursing</label></li>
            <li data-val="55"><label>Occupational Therapist</label></li>
            <li data-val="61"><label>Physiotherapy</label></li>
            <li data-val="67"><label>Administration</label></li>
            <li data-val="71"><label>Medical Imaging</label></li>
            <li data-val="76"><label>Allied Health</label></li>
            <li data-val="90"><label>Carer</label></li>
            <li data-val="92"><label>Clinical Education / Sales</label></li>
            <li data-val="94"><label>General Practitioners</label></li>
            <li data-val="96"><label>Paramedic</label></li>
            <li data-val="98"><label>Psychology / Counselling</label></li>
            <li data-val="100"><label>Social Worker</label></li>
            <li data-val="102"><label>Specialists / Consultants</label></li>
            <li data-val="104"><label>Support Services</label></li>
            <li data-val="135"><label>Residents and Registrars</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <div id="show_regitermember_careerlevel">
        <h6 class="h1Substitute" id="regitermember_careerlevelselected"></h6>
        <div class="SumoSelect" tabindex="0"><select name="regitermember_careerlevel" id="regitermember_careerlevel" style="display: none;">
            <option value="">Career Level</option>
          </select>
          <p class="CaptionCont SlectBox"><span>Career Level</span><label><i></i></label></p>
          <div class="optWrapper">
            <ul class="options">
              <li data-val="" class="selected"><label>Career Level</label></li>
            </ul>
          </div>
        </div>
      </div>
    </li>
    <li>
      <div id="show_regitermember_specialty">
        <h6 class="h1Substitute" id="regitermember_specialtyselected"></h6>
        <div class="SumoSelect" tabindex="0"><select name="regitermember_specialty" id="regitermember_specialty" style="display: none;">
            <option value="">Specialisation</option>
          </select>
          <p class="CaptionCont SlectBox"><span>Specialisation</span><label><i></i></label></p>
          <div class="optWrapper">
            <ul class="options">
              <li data-val="" class="selected"><label>Specialisation</label></li>
            </ul>
          </div>
        </div>
      </div>
    </li>
    <li style="display: none;"> <input type="text" id="website" name="website" value="" placeholder="Website *"></li>
    <li class="subs_li">
      <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" style="border: 1px solid rgb(233, 30, 118) !important; position: absolute; opacity: 0;" id="subscribe" name="subscribe" class="input"><ins
          class="iCheck-helper" style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>I want to subscribe to
        HealthTimes </label>
    </li>
    <li class="subs_li">
      <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" style="border: 1px solid rgb(233, 30, 118) !important; position: absolute; opacity: 0;" id="tac" name="tac" class="input"><ins class="iCheck-helper"
          style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>I have read and accept the Terms and
        Conditions *</label>
    </li>
    <li class="popup_submit">
      <label>* Required Fields</label>
      <input type="hidden" value="" id="redirecturl" name="redirecturl">
      <input type="hidden" name="option" value="com_registration">
      <input type="hidden" name="task" value="savememregistration">
      <input type="hidden" name="action" id="action" value="new">
      <input type="hidden" name="format" id="format" value="raw">
      <input type="hidden" name="current_task_member_procss" id="current_task_member_procss" value="">
      <input type="hidden" name="token" value="e7a360512afafe009f1547bc35f57186">
      <input type="button" id="submit_bt_clss" value="SUBMIT REGISTRATION" onclick="valid_member_register_block()">
      <span id="loadercontainer" class="loadercontainer"><img src="https://healthtimes.com.au/images/loader_image.gif"></span>
    </li>
  </ul>
</form>

Name: form_ad_registrationPOST index.php

<form class="form" name="form_ad_registration" id="form_ad_registration" method="POST" action="index.php" data-hs-cf-bound="true">
  <ul>
    <li class="fullname">
      <div class="first"><input type="text" id="firstnamead" name="firstnamead" value="" placeholder="First Name *"></div>
      <div class="last_name"><input type="text" id="lastnamead" name="lastnamead" value="" placeholder="Surname *"></div>
    </li>
    <li>
      <input type="text" value="" id="emailidad" name="emailidad" placeholder="Email Address *">
    </li>
    <li>
      <input type="text" value="" id="cnfrm_emailidad" name="cnfrm_emailidad" placeholder="Confirm Email Address *">
    </li>
    <li>
      <input type="password" value="" id="pwdad" name="pwdad" placeholder="Password (minimum 5 characters) *" maxlength="32">
    </li>
    <li>
      <input type="password" value="" id="cnfrm_passwordad" name="cnfrm_passwordad" placeholder="Confirm Password *" maxlength="32">
    </li>
    <li>
      <input type="text" value="" id="telad" name="telad" placeholder="Telephone / Mobile *">
    </li>
    <li>
      <h4>Company Information</h4>
    </li>
    <li>
      <input type="text" value="" id="organisation_namead" name="organisation_namead" placeholder="Organisation Name *">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="org_typead" name="org_typead" style="display: none;">
          <option value="">Organisation Type</option>
          <option value="Public Hospital">Public Hospital</option>
          <option value="Private Hospital">Private Hospital</option>
          <option value="Aged Care Facility">Aged Care Facility</option>
          <option value="Nursing Agency">Nursing Agency</option>
          <option value="Recruitment Agency">Recruitment Agency</option>
          <option value="Education Provider">Education Provider</option>
          <option value="Corporate Provider">Corporate Provider</option>
          <option value="Private Practice">Private Practice</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Organisation Type</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Organisation Type</label></li>
            <li data-val="Public Hospital"><label>Public Hospital</label></li>
            <li data-val="Private Hospital"><label>Private Hospital</label></li>
            <li data-val="Aged Care Facility"><label>Aged Care Facility</label></li>
            <li data-val="Nursing Agency"><label>Nursing Agency</label></li>
            <li data-val="Recruitment Agency"><label>Recruitment Agency</label></li>
            <li data-val="Education Provider"><label>Education Provider</label></li>
            <li data-val="Corporate Provider"><label>Corporate Provider</label></li>
            <li data-val="Private Practice"><label>Private Practice</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <h4>Billing Address</h4>
    </li>
    <li>
      <input type="text" value="" id="addressline1ad" name="addressline1ad" placeholder="Address Line 1 *">
    </li>
    <li>
      <input type="text" value="" id="addressline2ad" name="addressline2ad" placeholder="Address Line 2">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="statead" name="statead" style="display: none;">
          <option value="">State</option>
          <option id="nation" value="New South Wales">New South Wales</option>
          <option id="nation" value="Victoria">Victoria</option>
          <option id="nation" value="Queensland">Queensland</option>
          <option id="nation" value="South Australia">South Australia</option>
          <option id="nation" value="Western Australia">Western Australia</option>
          <option id="nation" value="Tasmania">Tasmania</option>
          <option id="nation" value="ACT">ACT</option>
          <option id="nation" value="Northern Territory">Northern Territory</option>
          <option id="nation" value="N/A">N/A</option>
        </select>
        <p class="CaptionCont SlectBox"><span>State</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>State</label></li>
            <li data-val="New South Wales"><label>New South Wales</label></li>
            <li data-val="Victoria"><label>Victoria</label></li>
            <li data-val="Queensland"><label>Queensland</label></li>
            <li data-val="South Australia"><label>South Australia</label></li>
            <li data-val="Western Australia"><label>Western Australia</label></li>
            <li data-val="Tasmania"><label>Tasmania</label></li>
            <li data-val="ACT"><label>ACT</label></li>
            <li data-val="Northern Territory"><label>Northern Territory</label></li>
            <li data-val="N/A"><label>N/A</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <input type="text" value="" id="postcodead" name="postcodead" placeholder="Post Code *" maxlength="8">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="countryad" name="countryad" style="display: none;">
          <option value="" selected="selected">Country</option>
          <option id="nation" value="Australia">Australia</option>
          <option id="nation" value="New Zealand">New Zealand</option>
          <option id="nation" value="United Kingdom">United Kingdom</option>
          <option id="nation" value="Afghanistan">Afghanistan</option>
          <option id="nation" value="Albania">Albania</option>
          <option id="nation" value="Algeria">Algeria</option>
          <option id="nation" value="American Samoa">American Samoa</option>
          <option id="nation" value="Andorra">Andorra</option>
          <option id="nation" value="Angola">Angola</option>
          <option id="nation" value="Anguilla">Anguilla</option>
          <option id="nation" value="Antarctica">Antarctica</option>
          <option id="nation" value="Antigua and Barbuda">Antigua and Barbuda</option>
          <option id="nation" value="Argentina">Argentina</option>
          <option id="nation" value="Armenia">Armenia</option>
          <option id="nation" value="Aruba">Aruba</option>
          <option id="nation" value="Australia">Australia</option>
          <option id="nation" value="Austria">Austria</option>
          <option id="nation" value="Azerbaijan">Azerbaijan</option>
          <option id="nation" value="Bahamas">Bahamas</option>
          <option id="nation" value="Bahrain">Bahrain</option>
          <option id="nation" value="Bangladesh">Bangladesh</option>
          <option id="nation" value="Barbados">Barbados</option>
          <option id="nation" value="Belarus">Belarus</option>
          <option id="nation" value="Belgium">Belgium</option>
          <option id="nation" value="Belize">Belize</option>
          <option id="nation" value="Benin">Benin</option>
          <option id="nation" value="Bermuda">Bermuda</option>
          <option id="nation" value="Bhutan">Bhutan</option>
          <option id="nation" value="Bolivia">Bolivia</option>
          <option id="nation" value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
          <option id="nation" value="Botswana">Botswana</option>
          <option id="nation" value="Bouvet Island">Bouvet Island</option>
          <option id="nation" value="Brazil">Brazil</option>
          <option id="nation" value="British Indian Ocean Territory">British Indian Ocean Territory</option>
          <option id="nation" value="Brunei Darussalam">Brunei Darussalam</option>
          <option id="nation" value="Bulgaria">Bulgaria</option>
          <option id="nation" value="Burkina Faso">Burkina Faso</option>
          <option id="nation" value="Burundi">Burundi</option>
          <option id="nation" value="Cambodia">Cambodia</option>
          <option id="nation" value="Cameroon">Cameroon</option>
          <option id="nation" value="Canada">Canada</option>
          <option id="nation" value="Cape Verde">Cape Verde</option>
          <option id="nation" value="Cayman Islands">Cayman Islands</option>
          <option id="nation" value="Central African Republic">Central African Republic</option>
          <option id="nation" value="Chad">Chad</option>
          <option id="nation" value="Chile">Chile</option>
          <option id="nation" value="China">China</option>
          <option id="nation" value="Christmas Island">Christmas Island</option>
          <option id="nation" value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
          <option id="nation" value="Colombia">Colombia</option>
          <option id="nation" value="Comoros">Comoros</option>
          <option id="nation" value="Congo">Congo</option>
          <option id="nation" value="Cook Islands">Cook Islands</option>
          <option id="nation" value="Costa Rica">Costa Rica</option>
          <option id="nation" value="Cote D" ivoire'="">Cote D'Ivoire</option>
          <option id="nation" value="Croatia">Croatia</option>
          <option id="nation" value="Cuba">Cuba</option>
          <option id="nation" value="Cyprus">Cyprus</option>
          <option id="nation" value="Czech Republic">Czech Republic</option>
          <option id="nation" value="Denmark">Denmark</option>
          <option id="nation" value="Djibouti">Djibouti</option>
          <option id="nation" value="Dominica">Dominica</option>
          <option id="nation" value="Dominican Republic">Dominican Republic</option>
          <option id="nation" value="East Timor">East Timor</option>
          <option id="nation" value="Ecuador">Ecuador</option>
          <option id="nation" value="Egypt">Egypt</option>
          <option id="nation" value="El Salvador">El Salvador</option>
          <option id="nation" value="Equatorial Guinea">Equatorial Guinea</option>
          <option id="nation" value="Eritrea">Eritrea</option>
          <option id="nation" value="Estonia">Estonia</option>
          <option id="nation" value="Ethiopia">Ethiopia</option>
          <option id="nation" value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
          <option id="nation" value="Faroe Islands">Faroe Islands</option>
          <option id="nation" value="Fiji">Fiji</option>
          <option id="nation" value="Finland">Finland</option>
          <option id="nation" value="France">France</option>
          <option id="nation" value="France, Metropolitan">France, Metropolitan</option>
          <option id="nation" value="French Guiana">French Guiana</option>
          <option id="nation" value="French Polynesia">French Polynesia</option>
          <option id="nation" value="French Southern Territories">French Southern Territories</option>
          <option id="nation" value="Gabon">Gabon</option>
          <option id="nation" value="Gambia">Gambia</option>
          <option id="nation" value="Georgia">Georgia</option>
          <option id="nation" value="Germany">Germany</option>
          <option id="nation" value="Ghana">Ghana</option>
          <option id="nation" value="Gibraltar">Gibraltar</option>
          <option id="nation" value="Greece">Greece</option>
          <option id="nation" value="Greenland">Greenland</option>
          <option id="nation" value="Grenada">Grenada</option>
          <option id="nation" value="Guadeloupe">Guadeloupe</option>
          <option id="nation" value="Guam">Guam</option>
          <option id="nation" value="Guatemala">Guatemala</option>
          <option id="nation" value="Guinea">Guinea</option>
          <option id="nation" value="Guinea-bissau">Guinea-bissau</option>
          <option id="nation" value="Guyana">Guyana</option>
          <option id="nation" value="Haiti">Haiti</option>
          <option id="nation" value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option>
          <option id="nation" value="Honduras">Honduras</option>
          <option id="nation" value="Hong Kong">Hong Kong</option>
          <option id="nation" value="Hungary">Hungary</option>
          <option id="nation" value="Iceland">Iceland</option>
          <option id="nation" value="India">India</option>
          <option id="nation" value="Indonesia">Indonesia</option>
          <option id="nation" value="Iran (Islamic Republic of)">Iran (Islamic Republic of)</option>
          <option id="nation" value="Iraq">Iraq</option>
          <option id="nation" value="Ireland">Ireland</option>
          <option id="nation" value="Israel">Israel</option>
          <option id="nation" value="Italy">Italy</option>
          <option id="nation" value="Jamaica">Jamaica</option>
          <option id="nation" value="Japan">Japan</option>
          <option id="nation" value="Jordan">Jordan</option>
          <option id="nation" value="Kazakhstan">Kazakhstan</option>
          <option id="nation" value="Kenya">Kenya</option>
          <option id="nation" value="Kiribati">Kiribati</option>
          <option id="nation" value="Korea, Democratic People" s="" republic="" of'="">Korea, Democratic People's Republic of</option>
          <option id="nation" value="Korea, Republic of">Korea, Republic of</option>
          <option id="nation" value="Kuwait">Kuwait</option>
          <option id="nation" value="Kyrgyzstan">Kyrgyzstan</option>
          <option id="nation" value="Lao People" s="" democratic="" republic'="">Lao People's Democratic Republic</option>
          <option id="nation" value="Latvia">Latvia</option>
          <option id="nation" value="Lebanon">Lebanon</option>
          <option id="nation" value="Lesotho">Lesotho</option>
          <option id="nation" value="Liberia">Liberia</option>
          <option id="nation" value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
          <option id="nation" value="Liechtenstein">Liechtenstein</option>
          <option id="nation" value="Lithuania">Lithuania</option>
          <option id="nation" value="Luxembourg">Luxembourg</option>
          <option id="nation" value="Macau">Macau</option>
          <option id="nation" value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option>
          <option id="nation" value="Madagascar">Madagascar</option>
          <option id="nation" value="Malawi">Malawi</option>
          <option id="nation" value="Malaysia">Malaysia</option>
          <option id="nation" value="Maldives">Maldives</option>
          <option id="nation" value="Mali">Mali</option>
          <option id="nation" value="Malta">Malta</option>
          <option id="nation" value="Marshall Islands">Marshall Islands</option>
          <option id="nation" value="Martinique">Martinique</option>
          <option id="nation" value="Mauritania">Mauritania</option>
          <option id="nation" value="Mauritius">Mauritius</option>
          <option id="nation" value="Mayotte">Mayotte</option>
          <option id="nation" value="Mexico">Mexico</option>
          <option id="nation" value="Micronesia, Federated States of">Micronesia, Federated States of</option>
          <option id="nation" value="Moldova, Republic of">Moldova, Republic of</option>
          <option id="nation" value="Monaco">Monaco</option>
          <option id="nation" value="Mongolia">Mongolia</option>
          <option id="nation" value="Montserrat">Montserrat</option>
          <option id="nation" value="Morocco">Morocco</option>
          <option id="nation" value="Mozambique">Mozambique</option>
          <option id="nation" value="Myanmar">Myanmar</option>
          <option id="nation" value="Namibia">Namibia</option>
          <option id="nation" value="Nauru">Nauru</option>
          <option id="nation" value="Nepal">Nepal</option>
          <option id="nation" value="Netherlands">Netherlands</option>
          <option id="nation" value="Netherlands Antilles">Netherlands Antilles</option>
          <option id="nation" value="New Caledonia">New Caledonia</option>
          <option id="nation" value="New Zealand">New Zealand</option>
          <option id="nation" value="Nicaragua">Nicaragua</option>
          <option id="nation" value="Niger">Niger</option>
          <option id="nation" value="Nigeria">Nigeria</option>
          <option id="nation" value="Niue">Niue</option>
          <option id="nation" value="Norfolk Island">Norfolk Island</option>
          <option id="nation" value="Northern Mariana Islands">Northern Mariana Islands</option>
          <option id="nation" value="Norway">Norway</option>
          <option id="nation" value="Oman">Oman</option>
          <option id="nation" value="Pakistan">Pakistan</option>
          <option id="nation" value="Palau">Palau</option>
          <option id="nation" value="Panama">Panama</option>
          <option id="nation" value="Papua New Guinea">Papua New Guinea</option>
          <option id="nation" value="Paraguay">Paraguay</option>
          <option id="nation" value="Peru">Peru</option>
          <option id="nation" value="Philippines">Philippines</option>
          <option id="nation" value="Pitcairn">Pitcairn</option>
          <option id="nation" value="Poland">Poland</option>
          <option id="nation" value="Portugal">Portugal</option>
          <option id="nation" value="Puerto Rico">Puerto Rico</option>
          <option id="nation" value="Qatar">Qatar</option>
          <option id="nation" value="Reunion">Reunion</option>
          <option id="nation" value="Romania">Romania</option>
          <option id="nation" value="Russian Federation">Russian Federation</option>
          <option id="nation" value="Rwanda">Rwanda</option>
          <option id="nation" value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
          <option id="nation" value="Saint Lucia">Saint Lucia</option>
          <option id="nation" value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
          <option id="nation" value="Samoa">Samoa</option>
          <option id="nation" value="San Marino">San Marino</option>
          <option id="nation" value="Sao Tome and Principe">Sao Tome and Principe</option>
          <option id="nation" value="Saudi Arabia">Saudi Arabia</option>
          <option id="nation" value="Senegal">Senegal</option>
          <option id="nation" value="Seychelles">Seychelles</option>
          <option id="nation" value="Sierra Leone">Sierra Leone</option>
          <option id="nation" value="Singapore">Singapore</option>
          <option id="nation" value="Slovakia (Slovak Republic)">Slovakia (Slovak Republic)</option>
          <option id="nation" value="Slovenia">Slovenia</option>
          <option id="nation" value="Solomon Islands">Solomon Islands</option>
          <option id="nation" value="Somalia">Somalia</option>
          <option id="nation" value="South Africa">South Africa</option>
          <option id="nation" value="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
          <option id="nation" value="Spain">Spain</option>
          <option id="nation" value="Sri Lanka">Sri Lanka</option>
          <option id="nation" value="St. Helena">St. Helena</option>
          <option id="nation" value="St. Pierre and Miquelon">St. Pierre and Miquelon</option>
          <option id="nation" value="Sudan">Sudan</option>
          <option id="nation" value="Suriname">Suriname</option>
          <option id="nation" value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
          <option id="nation" value="Swaziland">Swaziland</option>
          <option id="nation" value="Sweden">Sweden</option>
          <option id="nation" value="Switzerland">Switzerland</option>
          <option id="nation" value="Syrian Arab Republic">Syrian Arab Republic</option>
          <option id="nation" value="Taiwan">Taiwan</option>
          <option id="nation" value="Tajikistan">Tajikistan</option>
          <option id="nation" value="Tanzania, United Republic of">Tanzania, United Republic of</option>
          <option id="nation" value="Thailand">Thailand</option>
          <option id="nation" value="Togo">Togo</option>
          <option id="nation" value="Tokelau">Tokelau</option>
          <option id="nation" value="Tonga">Tonga</option>
          <option id="nation" value="Trinidad and Tobago">Trinidad and Tobago</option>
          <option id="nation" value="Tunisia">Tunisia</option>
          <option id="nation" value="Turkey">Turkey</option>
          <option id="nation" value="Turkmenistan">Turkmenistan</option>
          <option id="nation" value="Turks and Caicos Islands">Turks and Caicos Islands</option>
          <option id="nation" value="Tuvalu">Tuvalu</option>
          <option id="nation" value="Uganda">Uganda</option>
          <option id="nation" value="Ukraine">Ukraine</option>
          <option id="nation" value="United Arab Emirates">United Arab Emirates</option>
          <option id="nation" value="United Kingdom">United Kingdom</option>
          <option id="nation" value="United States">United States</option>
          <option id="nation" value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
          <option id="nation" value="Uruguay">Uruguay</option>
          <option id="nation" value="Uzbekistan">Uzbekistan</option>
          <option id="nation" value="Vanuatu">Vanuatu</option>
          <option id="nation" value="Vatican City State (Holy See)">Vatican City State (Holy See)</option>
          <option id="nation" value="Venezuela">Venezuela</option>
          <option id="nation" value="Viet Nam">Viet Nam</option>
          <option id="nation" value="Virgin Islands (British)">Virgin Islands (British)</option>
          <option id="nation" value="Virgin Islands (U.S.)">Virgin Islands (U.S.)</option>
          <option id="nation" value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
          <option id="nation" value="Western Sahara">Western Sahara</option>
          <option id="nation" value="Yemen">Yemen</option>
          <option id="nation" value="Yugoslavia">Yugoslavia</option>
          <option id="nation" value="Democratic Republic of Congo">Democratic Republic of Congo</option>
          <option id="nation" value="Zambia">Zambia</option>
          <option id="nation" value="Zimbabwe">Zimbabwe</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Country</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Country</label></li>
            <li data-val="Australia"><label>Australia</label></li>
            <li data-val="New Zealand"><label>New Zealand</label></li>
            <li data-val="United Kingdom"><label>United Kingdom</label></li>
            <li data-val="Afghanistan"><label>Afghanistan</label></li>
            <li data-val="Albania"><label>Albania</label></li>
            <li data-val="Algeria"><label>Algeria</label></li>
            <li data-val="American Samoa"><label>American Samoa</label></li>
            <li data-val="Andorra"><label>Andorra</label></li>
            <li data-val="Angola"><label>Angola</label></li>
            <li data-val="Anguilla"><label>Anguilla</label></li>
            <li data-val="Antarctica"><label>Antarctica</label></li>
            <li data-val="Antigua and Barbuda"><label>Antigua and Barbuda</label></li>
            <li data-val="Argentina"><label>Argentina</label></li>
            <li data-val="Armenia"><label>Armenia</label></li>
            <li data-val="Aruba"><label>Aruba</label></li>
            <li data-val="Australia"><label>Australia</label></li>
            <li data-val="Austria"><label>Austria</label></li>
            <li data-val="Azerbaijan"><label>Azerbaijan</label></li>
            <li data-val="Bahamas"><label>Bahamas</label></li>
            <li data-val="Bahrain"><label>Bahrain</label></li>
            <li data-val="Bangladesh"><label>Bangladesh</label></li>
            <li data-val="Barbados"><label>Barbados</label></li>
            <li data-val="Belarus"><label>Belarus</label></li>
            <li data-val="Belgium"><label>Belgium</label></li>
            <li data-val="Belize"><label>Belize</label></li>
            <li data-val="Benin"><label>Benin</label></li>
            <li data-val="Bermuda"><label>Bermuda</label></li>
            <li data-val="Bhutan"><label>Bhutan</label></li>
            <li data-val="Bolivia"><label>Bolivia</label></li>
            <li data-val="Bosnia and Herzegowina"><label>Bosnia and Herzegowina</label></li>
            <li data-val="Botswana"><label>Botswana</label></li>
            <li data-val="Bouvet Island"><label>Bouvet Island</label></li>
            <li data-val="Brazil"><label>Brazil</label></li>
            <li data-val="British Indian Ocean Territory"><label>British Indian Ocean Territory</label></li>
            <li data-val="Brunei Darussalam"><label>Brunei Darussalam</label></li>
            <li data-val="Bulgaria"><label>Bulgaria</label></li>
            <li data-val="Burkina Faso"><label>Burkina Faso</label></li>
            <li data-val="Burundi"><label>Burundi</label></li>
            <li data-val="Cambodia"><label>Cambodia</label></li>
            <li data-val="Cameroon"><label>Cameroon</label></li>
            <li data-val="Canada"><label>Canada</label></li>
            <li data-val="Cape Verde"><label>Cape Verde</label></li>
            <li data-val="Cayman Islands"><label>Cayman Islands</label></li>
            <li data-val="Central African Republic"><label>Central African Republic</label></li>
            <li data-val="Chad"><label>Chad</label></li>
            <li data-val="Chile"><label>Chile</label></li>
            <li data-val="China"><label>China</label></li>
            <li data-val="Christmas Island"><label>Christmas Island</label></li>
            <li data-val="Cocos (Keeling) Islands"><label>Cocos (Keeling) Islands</label></li>
            <li data-val="Colombia"><label>Colombia</label></li>
            <li data-val="Comoros"><label>Comoros</label></li>
            <li data-val="Congo"><label>Congo</label></li>
            <li data-val="Cook Islands"><label>Cook Islands</label></li>
            <li data-val="Costa Rica"><label>Costa Rica</label></li>
            <li data-val="Cote D"><label>Cote D'Ivoire</label></li>
            <li data-val="Croatia"><label>Croatia</label></li>
            <li data-val="Cuba"><label>Cuba</label></li>
            <li data-val="Cyprus"><label>Cyprus</label></li>
            <li data-val="Czech Republic"><label>Czech Republic</label></li>
            <li data-val="Denmark"><label>Denmark</label></li>
            <li data-val="Djibouti"><label>Djibouti</label></li>
            <li data-val="Dominica"><label>Dominica</label></li>
            <li data-val="Dominican Republic"><label>Dominican Republic</label></li>
            <li data-val="East Timor"><label>East Timor</label></li>
            <li data-val="Ecuador"><label>Ecuador</label></li>
            <li data-val="Egypt"><label>Egypt</label></li>
            <li data-val="El Salvador"><label>El Salvador</label></li>
            <li data-val="Equatorial Guinea"><label>Equatorial Guinea</label></li>
            <li data-val="Eritrea"><label>Eritrea</label></li>
            <li data-val="Estonia"><label>Estonia</label></li>
            <li data-val="Ethiopia"><label>Ethiopia</label></li>
            <li data-val="Falkland Islands (Malvinas)"><label>Falkland Islands (Malvinas)</label></li>
            <li data-val="Faroe Islands"><label>Faroe Islands</label></li>
            <li data-val="Fiji"><label>Fiji</label></li>
            <li data-val="Finland"><label>Finland</label></li>
            <li data-val="France"><label>France</label></li>
            <li data-val="France, Metropolitan"><label>France, Metropolitan</label></li>
            <li data-val="French Guiana"><label>French Guiana</label></li>
            <li data-val="French Polynesia"><label>French Polynesia</label></li>
            <li data-val="French Southern Territories"><label>French Southern Territories</label></li>
            <li data-val="Gabon"><label>Gabon</label></li>
            <li data-val="Gambia"><label>Gambia</label></li>
            <li data-val="Georgia"><label>Georgia</label></li>
            <li data-val="Germany"><label>Germany</label></li>
            <li data-val="Ghana"><label>Ghana</label></li>
            <li data-val="Gibraltar"><label>Gibraltar</label></li>
            <li data-val="Greece"><label>Greece</label></li>
            <li data-val="Greenland"><label>Greenland</label></li>
            <li data-val="Grenada"><label>Grenada</label></li>
            <li data-val="Guadeloupe"><label>Guadeloupe</label></li>
            <li data-val="Guam"><label>Guam</label></li>
            <li data-val="Guatemala"><label>Guatemala</label></li>
            <li data-val="Guinea"><label>Guinea</label></li>
            <li data-val="Guinea-bissau"><label>Guinea-bissau</label></li>
            <li data-val="Guyana"><label>Guyana</label></li>
            <li data-val="Haiti"><label>Haiti</label></li>
            <li data-val="Heard and Mc Donald Islands"><label>Heard and Mc Donald Islands</label></li>
            <li data-val="Honduras"><label>Honduras</label></li>
            <li data-val="Hong Kong"><label>Hong Kong</label></li>
            <li data-val="Hungary"><label>Hungary</label></li>
            <li data-val="Iceland"><label>Iceland</label></li>
            <li data-val="India"><label>India</label></li>
            <li data-val="Indonesia"><label>Indonesia</label></li>
            <li data-val="Iran (Islamic Republic of)"><label>Iran (Islamic Republic of)</label></li>
            <li data-val="Iraq"><label>Iraq</label></li>
            <li data-val="Ireland"><label>Ireland</label></li>
            <li data-val="Israel"><label>Israel</label></li>
            <li data-val="Italy"><label>Italy</label></li>
            <li data-val="Jamaica"><label>Jamaica</label></li>
            <li data-val="Japan"><label>Japan</label></li>
            <li data-val="Jordan"><label>Jordan</label></li>
            <li data-val="Kazakhstan"><label>Kazakhstan</label></li>
            <li data-val="Kenya"><label>Kenya</label></li>
            <li data-val="Kiribati"><label>Kiribati</label></li>
            <li data-val="Korea, Democratic People"><label>Korea, Democratic People's Republic of</label></li>
            <li data-val="Korea, Republic of"><label>Korea, Republic of</label></li>
            <li data-val="Kuwait"><label>Kuwait</label></li>
            <li data-val="Kyrgyzstan"><label>Kyrgyzstan</label></li>
            <li data-val="Lao People"><label>Lao People's Democratic Republic</label></li>
            <li data-val="Latvia"><label>Latvia</label></li>
            <li data-val="Lebanon"><label>Lebanon</label></li>
            <li data-val="Lesotho"><label>Lesotho</label></li>
            <li data-val="Liberia"><label>Liberia</label></li>
            <li data-val="Libyan Arab Jamahiriya"><label>Libyan Arab Jamahiriya</label></li>
            <li data-val="Liechtenstein"><label>Liechtenstein</label></li>
            <li data-val="Lithuania"><label>Lithuania</label></li>
            <li data-val="Luxembourg"><label>Luxembourg</label></li>
            <li data-val="Macau"><label>Macau</label></li>
            <li data-val="Macedonia, The Former Yugoslav Republic of"><label>Macedonia, The Former Yugoslav Republic of</label></li>
            <li data-val="Madagascar"><label>Madagascar</label></li>
            <li data-val="Malawi"><label>Malawi</label></li>
            <li data-val="Malaysia"><label>Malaysia</label></li>
            <li data-val="Maldives"><label>Maldives</label></li>
            <li data-val="Mali"><label>Mali</label></li>
            <li data-val="Malta"><label>Malta</label></li>
            <li data-val="Marshall Islands"><label>Marshall Islands</label></li>
            <li data-val="Martinique"><label>Martinique</label></li>
            <li data-val="Mauritania"><label>Mauritania</label></li>
            <li data-val="Mauritius"><label>Mauritius</label></li>
            <li data-val="Mayotte"><label>Mayotte</label></li>
            <li data-val="Mexico"><label>Mexico</label></li>
            <li data-val="Micronesia, Federated States of"><label>Micronesia, Federated States of</label></li>
            <li data-val="Moldova, Republic of"><label>Moldova, Republic of</label></li>
            <li data-val="Monaco"><label>Monaco</label></li>
            <li data-val="Mongolia"><label>Mongolia</label></li>
            <li data-val="Montserrat"><label>Montserrat</label></li>
            <li data-val="Morocco"><label>Morocco</label></li>
            <li data-val="Mozambique"><label>Mozambique</label></li>
            <li data-val="Myanmar"><label>Myanmar</label></li>
            <li data-val="Namibia"><label>Namibia</label></li>
            <li data-val="Nauru"><label>Nauru</label></li>
            <li data-val="Nepal"><label>Nepal</label></li>
            <li data-val="Netherlands"><label>Netherlands</label></li>
            <li data-val="Netherlands Antilles"><label>Netherlands Antilles</label></li>
            <li data-val="New Caledonia"><label>New Caledonia</label></li>
            <li data-val="New Zealand"><label>New Zealand</label></li>
            <li data-val="Nicaragua"><label>Nicaragua</label></li>
            <li data-val="Niger"><label>Niger</label></li>
            <li data-val="Nigeria"><label>Nigeria</label></li>
            <li data-val="Niue"><label>Niue</label></li>
            <li data-val="Norfolk Island"><label>Norfolk Island</label></li>
            <li data-val="Northern Mariana Islands"><label>Northern Mariana Islands</label></li>
            <li data-val="Norway"><label>Norway</label></li>
            <li data-val="Oman"><label>Oman</label></li>
            <li data-val="Pakistan"><label>Pakistan</label></li>
            <li data-val="Palau"><label>Palau</label></li>
            <li data-val="Panama"><label>Panama</label></li>
            <li data-val="Papua New Guinea"><label>Papua New Guinea</label></li>
            <li data-val="Paraguay"><label>Paraguay</label></li>
            <li data-val="Peru"><label>Peru</label></li>
            <li data-val="Philippines"><label>Philippines</label></li>
            <li data-val="Pitcairn"><label>Pitcairn</label></li>
            <li data-val="Poland"><label>Poland</label></li>
            <li data-val="Portugal"><label>Portugal</label></li>
            <li data-val="Puerto Rico"><label>Puerto Rico</label></li>
            <li data-val="Qatar"><label>Qatar</label></li>
            <li data-val="Reunion"><label>Reunion</label></li>
            <li data-val="Romania"><label>Romania</label></li>
            <li data-val="Russian Federation"><label>Russian Federation</label></li>
            <li data-val="Rwanda"><label>Rwanda</label></li>
            <li data-val="Saint Kitts and Nevis"><label>Saint Kitts and Nevis</label></li>
            <li data-val="Saint Lucia"><label>Saint Lucia</label></li>
            <li data-val="Saint Vincent and the Grenadines"><label>Saint Vincent and the Grenadines</label></li>
            <li data-val="Samoa"><label>Samoa</label></li>
            <li data-val="San Marino"><label>San Marino</label></li>
            <li data-val="Sao Tome and Principe"><label>Sao Tome and Principe</label></li>
            <li data-val="Saudi Arabia"><label>Saudi Arabia</label></li>
            <li data-val="Senegal"><label>Senegal</label></li>
            <li data-val="Seychelles"><label>Seychelles</label></li>
            <li data-val="Sierra Leone"><label>Sierra Leone</label></li>
            <li data-val="Singapore"><label>Singapore</label></li>
            <li data-val="Slovakia (Slovak Republic)"><label>Slovakia (Slovak Republic)</label></li>
            <li data-val="Slovenia"><label>Slovenia</label></li>
            <li data-val="Solomon Islands"><label>Solomon Islands</label></li>
            <li data-val="Somalia"><label>Somalia</label></li>
            <li data-val="South Africa"><label>South Africa</label></li>
            <li data-val="South Georgia and the South Sandwich Islands"><label>South Georgia and the South Sandwich Islands</label></li>
            <li data-val="Spain"><label>Spain</label></li>
            <li data-val="Sri Lanka"><label>Sri Lanka</label></li>
            <li data-val="St. Helena"><label>St. Helena</label></li>
            <li data-val="St. Pierre and Miquelon"><label>St. Pierre and Miquelon</label></li>
            <li data-val="Sudan"><label>Sudan</label></li>
            <li data-val="Suriname"><label>Suriname</label></li>
            <li data-val="Svalbard and Jan Mayen Islands"><label>Svalbard and Jan Mayen Islands</label></li>
            <li data-val="Swaziland"><label>Swaziland</label></li>
            <li data-val="Sweden"><label>Sweden</label></li>
            <li data-val="Switzerland"><label>Switzerland</label></li>
            <li data-val="Syrian Arab Republic"><label>Syrian Arab Republic</label></li>
            <li data-val="Taiwan"><label>Taiwan</label></li>
            <li data-val="Tajikistan"><label>Tajikistan</label></li>
            <li data-val="Tanzania, United Republic of"><label>Tanzania, United Republic of</label></li>
            <li data-val="Thailand"><label>Thailand</label></li>
            <li data-val="Togo"><label>Togo</label></li>
            <li data-val="Tokelau"><label>Tokelau</label></li>
            <li data-val="Tonga"><label>Tonga</label></li>
            <li data-val="Trinidad and Tobago"><label>Trinidad and Tobago</label></li>
            <li data-val="Tunisia"><label>Tunisia</label></li>
            <li data-val="Turkey"><label>Turkey</label></li>
            <li data-val="Turkmenistan"><label>Turkmenistan</label></li>
            <li data-val="Turks and Caicos Islands"><label>Turks and Caicos Islands</label></li>
            <li data-val="Tuvalu"><label>Tuvalu</label></li>
            <li data-val="Uganda"><label>Uganda</label></li>
            <li data-val="Ukraine"><label>Ukraine</label></li>
            <li data-val="United Arab Emirates"><label>United Arab Emirates</label></li>
            <li data-val="United Kingdom"><label>United Kingdom</label></li>
            <li data-val="United States"><label>United States</label></li>
            <li data-val="United States Minor Outlying Islands"><label>United States Minor Outlying Islands</label></li>
            <li data-val="Uruguay"><label>Uruguay</label></li>
            <li data-val="Uzbekistan"><label>Uzbekistan</label></li>
            <li data-val="Vanuatu"><label>Vanuatu</label></li>
            <li data-val="Vatican City State (Holy See)"><label>Vatican City State (Holy See)</label></li>
            <li data-val="Venezuela"><label>Venezuela</label></li>
            <li data-val="Viet Nam"><label>Viet Nam</label></li>
            <li data-val="Virgin Islands (British)"><label>Virgin Islands (British)</label></li>
            <li data-val="Virgin Islands (U.S.)"><label>Virgin Islands (U.S.)</label></li>
            <li data-val="Wallis and Futuna Islands"><label>Wallis and Futuna Islands</label></li>
            <li data-val="Western Sahara"><label>Western Sahara</label></li>
            <li data-val="Yemen"><label>Yemen</label></li>
            <li data-val="Yugoslavia"><label>Yugoslavia</label></li>
            <li data-val="Democratic Republic of Congo"><label>Democratic Republic of Congo</label></li>
            <li data-val="Zambia"><label>Zambia</label></li>
            <li data-val="Zimbabwe"><label>Zimbabwe</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li class="subs_li" style="display: none;"> <input type="text" id="website" name="website" value="" placeholder="Website *"></li>
    <li>
      <h4>Are you primarily interested in advertising *</h4>
    </li>
    <li class="subs_li">
      <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" id="checkempoppad" name="checkempoppad" class="input" style="position: absolute; opacity: 0;"><ins class="iCheck-helper"
          style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>A. Employment opportunities</label>
    </li>
    <li class="subs_li">
      <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" id="checkeduoppad" name="checkeduoppad" class="input" style="position: absolute; opacity: 0;"><ins class="iCheck-helper"
          style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>B. Education or training opportunities</label>
    </li>
    <li>
      <h4>Do you want to recieve the HealthTimes Newsletter?</h4>
    </li>
    <li class="subs_li">
      <div class="first">
        <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" id="ycheckhtnewltrad" name="ycheckhtnewltrad" class="input" style="position: absolute; opacity: 0;"><ins class="iCheck-helper"
            style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>Yes</label>
      </div>
      <div class="first">
        <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" id="ncheckhtnewltrad" name="ncheckhtnewltrad" class="input" style="position: absolute; opacity: 0;"><ins class="iCheck-helper"
            style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>No</label>
      </div>
    </li>
    <li class="subs_li">
      <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" id="tacad" name="tacad" class="input" style="position: absolute; opacity: 0;"><ins class="iCheck-helper"
          style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>Confirm you have read and accept the Terms and
        Conditions *</label>
    </li>
    <li class="subs_li">
      <div class="icheckbox_square-red" style="position: relative;"><input type="checkbox" id="expnotics" name="expnotics" class="input" style="position: absolute; opacity: 0;"><ins class="iCheck-helper"
          style="position: absolute; top: 0%; left: 0%; display: block; width: 100%; height: 100%; margin: 0px; padding: 0px; background: rgb(255, 255, 255); border: 0px; opacity: 0;"></ins></div> <label>Do you want to receive ad expiry
        notices?</label>
    </li>
    <li class="popup_submit">
      <label>* Required Fields</label>
      <input type="hidden" name="option" value="com_registration">
      <input type="hidden" value="" name="redirecturl">
      <input type="hidden" name="current_task_admember_procss" id="current_task_admember_procss" value="">
      <input type="hidden" name="task" value="saveadregistration">
      <input type="hidden" name="action" id="action" value="new">
      <input type="hidden" name="format" id="format" value="raw">
      <input type="hidden" name="token" value="1ca36c392a41a98e75ce0f8436282921">
      <input type="button" value="SUBMIT REGISTRATION" id="submit_bt_clss" onclick="valid_ad_registration_block()">
      <span id="loadercontainerad" class="loadercontainer"><img src="https://healthtimes.com.au/images/loader_image.gif"></span>
    </li>
  </ul>
</form>

Name: jobsearchGET index.php

<form class="form" name="jobsearch" action="index.php" method="get" data-hs-cf-bound="true">
  <ul>
    <li>
      <input type="text" id="jobkey" name="jobkey" value="" placeholder="Keyword(s)">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="jobspecialty" name="jobspecialty" onchange="jobspecialty_dropdownfield(this.value);" style="display: none;">
          <option value="">Select Specialty</option>
          <option value="1">Registered Nurse</option>
          <option value="25">Enrolled Nurse</option>
          <option value="47">Midwifery</option>
          <option value="53">Assistant In Nursing</option>
          <option value="55">Occupational Therapist</option>
          <option value="61">Physiotherapy</option>
          <option value="67">Administration</option>
          <option value="71">Medical Imaging</option>
          <option value="76">Allied Health</option>
          <option value="90">Carer</option>
          <option value="92">Clinical Education / Sales</option>
          <option value="94">General Practitioners</option>
          <option value="96">Paramedic</option>
          <option value="98">Psychology / Counselling</option>
          <option value="100">Social Worker</option>
          <option value="102">Specialists / Consultants</option>
          <option value="104">Support Services</option>
          <option value="135">Residents and Registrars</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Select Specialty</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Select Specialty</label></li>
            <li data-val="1"><label>Registered Nurse</label></li>
            <li data-val="25"><label>Enrolled Nurse</label></li>
            <li data-val="47"><label>Midwifery</label></li>
            <li data-val="53"><label>Assistant In Nursing</label></li>
            <li data-val="55"><label>Occupational Therapist</label></li>
            <li data-val="61"><label>Physiotherapy</label></li>
            <li data-val="67"><label>Administration</label></li>
            <li data-val="71"><label>Medical Imaging</label></li>
            <li data-val="76"><label>Allied Health</label></li>
            <li data-val="90"><label>Carer</label></li>
            <li data-val="92"><label>Clinical Education / Sales</label></li>
            <li data-val="94"><label>General Practitioners</label></li>
            <li data-val="96"><label>Paramedic</label></li>
            <li data-val="98"><label>Psychology / Counselling</label></li>
            <li data-val="100"><label>Social Worker</label></li>
            <li data-val="102"><label>Specialists / Consultants</label></li>
            <li data-val="104"><label>Support Services</label></li>
            <li data-val="135"><label>Residents and Registrars</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <div id="div_sub_cat">
        <h6 class="h1Substitute" id="sub_catselected" style="margin:0px;padding:0px;width:0px;height:0px;"></h6>
        <div class="SumoSelect" tabindex="0"><select name="sub_cat" id="sub_cat" style="display: none;">
            <option value="">Select Sub Classification</option>
          </select>
          <p class="CaptionCont SlectBox"><span>Select Sub Classification</span><label><i></i></label></p>
          <div class="optWrapper">
            <ul class="options">
              <li data-val="" class="selected"><label>Select Sub Classification</label></li>
            </ul>
          </div>
        </div>
      </div>
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="joblocation" name="joblocation" style="display: none;">
          <option value="">Location</option>
          <option value="2">Sydney</option>
          <option value="3">NSW</option>
          <option value="4">Melbourne</option>
          <option value="5">VIC</option>
          <option value="6">Brisbane</option>
          <option value="7">Gold Coast</option>
          <option value="8">QLD</option>
          <option value="9">Perth</option>
          <option value="10">WA</option>
          <option value="11">Adelaide</option>
          <option value="12">SA</option>
          <option value="13">Hobart</option>
          <option value="14">TAS</option>
          <option value="15">Darwin</option>
          <option value="16">Northern Territory</option>
          <option value="1">ACT</option>
          <option value="27">Canberra</option>
          <option value="19">New Zealand</option>
          <option value="23">United States</option>
          <option value="26">London</option>
          <option value="21">Ireland</option>
          <option value="20">Rest Of UK</option>
          <option value="22">Middle East</option>
          <option value="30">Canada</option>
          <option value="31">Asia Pacific</option>
          <option value="32">South America</option>
          <option value="33">Africa</option>
          <option value="34">Europe</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Location</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Location</label></li>
            <li data-val="2"><label>Sydney</label></li>
            <li data-val="3"><label>NSW</label></li>
            <li data-val="4"><label>Melbourne</label></li>
            <li data-val="5"><label>VIC</label></li>
            <li data-val="6"><label>Brisbane</label></li>
            <li data-val="7"><label>Gold Coast</label></li>
            <li data-val="8"><label>QLD</label></li>
            <li data-val="9"><label>Perth</label></li>
            <li data-val="10"><label>WA</label></li>
            <li data-val="11"><label>Adelaide</label></li>
            <li data-val="12"><label>SA</label></li>
            <li data-val="13"><label>Hobart</label></li>
            <li data-val="14"><label>TAS</label></li>
            <li data-val="15"><label>Darwin</label></li>
            <li data-val="16"><label>Northern Territory</label></li>
            <li data-val="1"><label>ACT</label></li>
            <li data-val="27"><label>Canberra</label></li>
            <li data-val="19"><label>New Zealand</label></li>
            <li data-val="23"><label>United States</label></li>
            <li data-val="26"><label>London</label></li>
            <li data-val="21"><label>Ireland</label></li>
            <li data-val="20"><label>Rest Of UK</label></li>
            <li data-val="22"><label>Middle East</label></li>
            <li data-val="30"><label>Canada</label></li>
            <li data-val="31"><label>Asia Pacific</label></li>
            <li data-val="32"><label>South America</label></li>
            <li data-val="33"><label>Africa</label></li>
            <li data-val="34"><label>Europe</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li style="text-align: right;">
      <input type="Submit" value="search">
    </li>
    <input type="hidden" name="option" value="com_jobsearch">
    <input type="hidden" name="task" value="searchjob">
    <input type="hidden" name="action" value="1">
  </ul>
</form>

Name: educationsearchGET index.php

<form class="form" name="educationsearch" action="index.php" method="get" data-hs-cf-bound="true">
  <ul>
    <li>
      <input type="text" name="edukey" id="edukey" value="" placeholder="Keyword(s)">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select name="eduspecialty" id="eduspecialty" placeholder="Select Specialty" style="display: none;">
          <option value="">Specialty</option>
          <option value="1">Nursing</option>
          <option value="2">Midwifery</option>
          <option value="3">Aged Care</option>
          <option value="4">Occupational Therapy</option>
          <option value="5">Physiotherapy</option>
          <option value="6">Social Work</option>
          <option value="7">Medical Imaging</option>
          <option value="8">Psychology</option>
          <option value="9">Management</option>
          <option value="10">Carer</option>
          <option value="11">Allied Health</option>
          <option value="12">Medicine</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Specialty</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Specialty</label></li>
            <li data-val="1"><label>Nursing</label></li>
            <li data-val="2"><label>Midwifery</label></li>
            <li data-val="3"><label>Aged Care</label></li>
            <li data-val="4"><label>Occupational Therapy</label></li>
            <li data-val="5"><label>Physiotherapy</label></li>
            <li data-val="6"><label>Social Work</label></li>
            <li data-val="7"><label>Medical Imaging</label></li>
            <li data-val="8"><label>Psychology</label></li>
            <li data-val="9"><label>Management</label></li>
            <li data-val="10"><label>Carer</label></li>
            <li data-val="11"><label>Allied Health</label></li>
            <li data-val="12"><label>Medicine</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="edulocation" name="edulocation" placeholder="Select Sub-Specialty" style="display: none;">
          <option value="">Location</option>
          <option value="26">Online</option>
          <option value="1">Act</option>
          <option value="2">Sydney</option>
          <option value="3">NSW - Other</option>
          <option value="4">Melbourne</option>
          <option value="5">VIC - Other</option>
          <option value="6">Brisbane</option>
          <option value="7">Gold Coast</option>
          <option value="8">QLD - Other</option>
          <option value="9">Perth</option>
          <option value="10">WA - Other</option>
          <option value="11">Adelaide</option>
          <option value="12">SA - Other</option>
          <option value="13">Hobart</option>
          <option value="14">TAS - Other</option>
          <option value="15">Darwin</option>
          <option value="16">Northern Territory</option>
          <option value="17">Auckland</option>
          <option value="18">Wellington</option>
          <option value="19">New Zealand - Other</option>
          <option value="25">Other Location</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Location</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Location</label></li>
            <li data-val="26"><label>Online</label></li>
            <li data-val="1"><label>Act</label></li>
            <li data-val="2"><label>Sydney</label></li>
            <li data-val="3"><label>NSW - Other</label></li>
            <li data-val="4"><label>Melbourne</label></li>
            <li data-val="5"><label>VIC - Other</label></li>
            <li data-val="6"><label>Brisbane</label></li>
            <li data-val="7"><label>Gold Coast</label></li>
            <li data-val="8"><label>QLD - Other</label></li>
            <li data-val="9"><label>Perth</label></li>
            <li data-val="10"><label>WA - Other</label></li>
            <li data-val="11"><label>Adelaide</label></li>
            <li data-val="12"><label>SA - Other</label></li>
            <li data-val="13"><label>Hobart</label></li>
            <li data-val="14"><label>TAS - Other</label></li>
            <li data-val="15"><label>Darwin</label></li>
            <li data-val="16"><label>Northern Territory</label></li>
            <li data-val="17"><label>Auckland</label></li>
            <li data-val="18"><label>Wellington</label></li>
            <li data-val="19"><label>New Zealand - Other</label></li>
            <li data-val="25"><label>Other Location</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select id="educoursetype" name="educoursetype" style="display: none;">
          <option value="">Select Qualification Level</option>
          <option value="1">CPD</option>
          <option value="2">Certificate Level</option>
          <option value="3">Diploma</option>
          <option value="4">Under Grad</option>
          <option value="5">Post Grad</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Select Qualification Level</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Select Qualification Level</label></li>
            <li data-val="1"><label>CPD</label></li>
            <li data-val="2"><label>Certificate Level</label></li>
            <li data-val="3"><label>Diploma</label></li>
            <li data-val="4"><label>Under Grad</label></li>
            <li data-val="5"><label>Post Grad</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <input type="button" value="search" id="edu_search_butn" onclick="advance_edusearch();">
    </li>
  </ul>
  <input type="hidden" id="option" name="option" value="com_educationsearch">
  <input type="hidden" id="task" name="task" value="advanceedusearch">
</form>

Name: article_searchGET index.php

<form class="form" action="index.php" name="article_search" id="article_search" method="get" novalidate="novalidate" data-hs-cf-bound="true">
  <div class="article_search">
    <h2>Article Search</h2>
    <strong>To search for an article, enter a keyword term and click SEARCH</strong>
    <div class="article_int">
      <input type="text" id="keyword" name="keyword" value="" placeholder="Keyword(s)">
      <input type="submit" value="SEARCH ARTICLES">
    </div>
  </div>
  <input type="hidden" name="option" value="com_event_hubs">
  <input type="hidden" name="task" value="allarticles">
</form>

Name: form_newsletter_modPOST index.php

<form class="form" name="form_newsletter_mod" id="form_newsletter_mod" method="POST" action="index.php" data-hs-cf-bound="true">
  <ul>
    <li>
      <input type="text" name="fname" id="newsletter_modal_name" value="" placeholder="Your Name *">
    </li>
    <li>
      <input type="text" name="email" id="newsletter_modal_email" value="" placeholder="Email Address *">
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select name="whlive" id="whlive1" style="display: none;">
          <option value="">Location</option>
          <option value="" disabled="disabled">Australian State or Territory</option>
          <option value="NSW">New South Wales</option>
          <option value="VIC">Victoria</option>
          <option value="QLD">Queensland</option>
          <option value="WA">Western Australia</option>
          <option value="SA">South Australia</option>
          <option value="TAS">Tasmania</option>
          <option value="ACT">Australian Capital Territory</option>
          <option value="NT">Northern Territory</option>
          <option value="" disabled="disabled">International</option>
          <option value="All international">All international</option>
          <option value="NZ">New Zealand</option>
          <option value="USA">United States</option>
          <option value="London">London</option>
          <option value="IE">Ireland</option>
          <option value="Rest of UK">Rest of UK</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Location</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Location</label></li>
            <li data-val="" class="disabled"><label>Australian State or Territory</label></li>
            <li data-val="NSW"><label>New South Wales</label></li>
            <li data-val="VIC"><label>Victoria</label></li>
            <li data-val="QLD"><label>Queensland</label></li>
            <li data-val="WA"><label>Western Australia</label></li>
            <li data-val="SA"><label>South Australia</label></li>
            <li data-val="TAS"><label>Tasmania</label></li>
            <li data-val="ACT"><label>Australian Capital Territory</label></li>
            <li data-val="NT"><label>Northern Territory</label></li>
            <li data-val="" class="disabled"><label>International</label></li>
            <li data-val="All international"><label>All international</label></li>
            <li data-val="NZ"><label>New Zealand</label></li>
            <li data-val="USA"><label>United States</label></li>
            <li data-val="London"><label>London</label></li>
            <li data-val="IE"><label>Ireland</label></li>
            <li data-val="Rest of UK"><label>Rest of UK</label></li>
          </ul>
        </div>
      </div>
    </li>
    <li>
      <div class="SumoSelect" tabindex="0"><select name="newsletter_fields" id="newsletter_modal_fields" onchange="newsletter_modal_fields_dropdownfield(this.value);" style="display: none;">
          <option value="">Select Field</option>
          <option value="1">Registered Nurse</option>
          <option value="25">Enrolled Nurse</option>
          <option value="47">Midwifery</option>
          <option value="53">Assistant In Nursing</option>
          <option value="55">Occupational Therapist</option>
          <option value="61">Physiotherapy</option>
          <option value="67">Administration</option>
          <option value="71">Medical Imaging</option>
          <option value="76">Allied Health</option>
          <option value="90">Carer</option>
          <option value="92">Clinical Education / Sales</option>
          <option value="94">General Practitioners</option>
          <option value="96">Paramedic</option>
          <option value="98">Psychology / Counselling</option>
          <option value="100">Social Worker</option>
          <option value="102">Specialists / Consultants</option>
          <option value="104">Support Services</option>
          <option value="135">Residents and Registrars</option>
        </select>
        <p class="CaptionCont SlectBox"><span>Select Field</span><label><i></i></label></p>
        <div class="optWrapper">
          <ul class="options">
            <li data-val="" class="selected"><label>Select Field</label></li>
            <li data-val="1"><label>Registered Nurse</label></li>
            <li data-val="25"><label>Enrolled Nurse</label></li>
            <li data-val="47"><label>Midwifery</label></li>
            <li data-val="53"><label>Assistant In Nursing</label></li>
            <li data-val="55"><label>Occupational Therapist</label></li>
            <li data-val="61"><label>Physiotherapy</label></li>
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Name: form_newsletter_desktop_modPOST index.php

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Name: form_subs_footer_modalPOST index.php

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 * Field Registered NurseEnrolled NurseMidwiferyAssistant In NursingOccupational
   TherapistPhysiotherapyAdministrationMedical ImagingAllied HealthCarerClinical
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   and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited
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   City State (Holy See)VenezuelaViet NamVirgin Islands (British)Virgin Islands
   (U.S.)Wallis and Futuna IslandsWestern SaharaYemenYugoslaviaDemocratic
   Republic of CongoZambiaZimbabwe
   
   Country
   
    * Country
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    * New Zealand
    * United Kingdom
    * Afghanistan
    * Albania
    * Algeria
    * American Samoa
    * Andorra
    * Angola
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    * Antarctica
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    * Argentina
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    * Bahamas
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    * Costa Rica
    * Cote D'Ivoire
    * Croatia
    * Cuba
    * Cyprus
    * Czech Republic
    * Denmark
    * Djibouti
    * Dominica
    * Dominican Republic
    * East Timor
    * Ecuador
    * Egypt
    * El Salvador
    * Equatorial Guinea
    * Eritrea
    * Estonia
    * Ethiopia
    * Falkland Islands (Malvinas)
    * Faroe Islands
    * Fiji
    * Finland
    * France
    * France, Metropolitan
    * French Guiana
    * French Polynesia
    * French Southern Territories
    * Gabon
    * Gambia
    * Georgia
    * Germany
    * Ghana
    * Gibraltar
    * Greece
    * Greenland
    * Grenada
    * Guadeloupe
    * Guam
    * Guatemala
    * Guinea
    * Guinea-bissau
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