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payments.africa.flights Open in urlscan Pro
31.193.11.2  Public Scan

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Submitted URL: http://payments.africa.flights/
Effective URL: https://payments.africa.flights/
Submission: On May 30 via api from PL — Scanned from GB

Form analysis 1 forms found in the DOM

POST https://payments.africa.flights/confirmation

<form id="payment-form" action="https://payments.africa.flights/confirmation" method="POST" data-an-count="1" data-an-form-handler="ysjgy" novalidate="novalidate">
  <div class="row">
    <div class="col-12 col-md-6 offset-lg-2 col-lg-4 ">
      <h1>Make a Secure Payment</h1>
      <div class="input-group">
        <div class="input-label"><label>Which currency would you like to use?</label></div>
        <div class="input-control">
          <div class="currency-select">
            <input type="radio" id="currency-gbp" name="currency" data-symbol="£" value="GBP" checked="">
            <label for="currency-gbp" class="active-currency"><span class="currency-symbol">£</span> GBP</label>
            <input type="radio" id="currency-usd" name="currency" data-symbol="$" value="USD">
            <label for="currency-usd"><span class="currency-symbol">$</span> USD</label>
            <input type="radio" id="currency-eur" name="currency" data-symbol="€" value="EUR">
            <label for="currency-eur"><span class="currency-symbol">€</span> EUR</label>
            <input type="radio" id="currency-aud" name="currency" data-symbol="A$" value="AUD">
            <label for="currency-aud"><span class="currency-symbol">A$</span> AUD</label>
            <input type="radio" id="currency-sgd" name="currency" data-symbol="S$" value="SGD">
            <label for="currency-sgd"><span class="currency-symbol">S$</span> SGD</label>
          </div>
        </div>
      </div>
      <div class="input-group">
        <div class="input-label"><label for="amount">How much would you like to pay?</label></div>
        <div class="input-control amount-control">
          <div id="amount-currency" class="currency-symbol">£</div>
          <input type="text" id="amount" name="amount" autocomplete="off" required="" value="">
        </div>
      </div>
    </div>
    <div class="col-12 col-md-6 offset-lg-1 col-lg-4">
      <div class="bank-transfer tint">
        <h2>Prefer to make a Bank Transfer?</h2>
        <p>To transfer funds directly into our bank account, please find our account details below.</p>
        <div class="currency-select small">
          <label for="currency-gbp" class="active-currency"><span class="currency-symbol">£</span> GBP</label>
          <label for="currency-usd"><span class="currency-symbol">$</span> USD</label>
          <label for="currency-eur"><span class="currency-symbol">€</span> EUR</label>
          <label for="currency-aud"><span class="currency-symbol">A$</span> AUD</label>
          <label for="currency-sgd"><span class="currency-symbol">S$</span> SGD</label>
        </div>
        <div id="bank-gbp" class="bank active">
          <p><strong>NatWest Bank</strong><br> Cleveland Travel Ltd<br> Account number: <strong>77157583</strong><br> Sort Code: <strong>60-11-18</strong><br> Iban: <strong>GB28NWBK60111877157583</strong><br> Bic/Swift: <strong>NWBKGB2L</strong><br>
          </p>
        </div>
        <div id="bank-eur" class="bank">
          <p><strong>NatWest Bank</strong><br> Cleveland Travel Ltd<br> Account number: <strong>550/00/08020108</strong><br> Iban: <strong>GB64NWBK60720608020108</strong><br> Bic/Swift: <strong>NWBKGB2L</strong><br>
          </p>
        </div>
        <div id="bank-usd" class="bank">
          <p><strong>NatWest Bank</strong><br> Cleveland Travel Ltd<br> Account number: <strong>140/01/08315574</strong><br> Iban: <strong>GB62NWBK60730108315574</strong><br> Bic/Swift: <strong>NWBKGB2L</strong><br>
          </p>
        </div>
        <!-- 
            <div id="bank-aud" class="bank">
               <p><strong>NatWest Bank</strong><br />
                    Cleveland Travel Ltd<br />
                    Account number: <strong>160/00/23172746</strong><br />
                    Iban: <strong>GB15NWBK60730123172746</strong><br />
                    Bic/Swift: <strong>NWBKGB2L</strong><br />

               </p>

            </div>
            -->
        <div id="bank-aud" class="bank">
          <p><strong>NatWest Bank</strong><br> Cleveland Travel Ltd<br> Account number: <strong>160/00/23243023</strong><br> Iban: <strong>GB50NWBK60730123243023</strong><br> Bic/Swift: <strong>NWBKGB2L</strong><br>
          </p>
        </div>
        <div id="bank-sgd" class="bank">
          <p><strong>NatWest Bank</strong><br> Cleveland Travel Ltd<br> Account number: <strong>409/00/23242892</strong><br> Iban: <strong>GB95NWBK60730123242892</strong><br> Bic/Swift: <strong>NWBKGB2L</strong><br>
          </p>
        </div>
        <p>Once you have made your transfer, please email or advise your consultant directly.</p>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-12 col-lg-10 offset-lg-1">
      <hr>
    </div>
  </div>
  <div class="row">
    <div class="col-12 col-md-6 offset-lg-2 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="reference">Your Booking Reference</label></div>
        <div class="input-control">
          <input type="text" id="reference" name="reference" placeholder="Your Booking Reference" required="" maxlength="20">
        </div>
        <div class="input-note">
          <div class="note-icon"><i class="fas fa-info-circle"></i></div>
          <div class="note-text">This is usually a 5 digit number and can be found on your booking documents </div>
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-12 col-md-6 offset-lg-2 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="destination">Your Travel Destination</label></div>
        <div class="input-control">
          <select id="destination" name="destination" required="">
            <option disabled="" selected="">Please select a country</option>
            <option value="Afganistan">Afghanistan</option>
            <option value="Albania">Albania</option>
            <option value="Algeria">Algeria</option>
            <option value="American Samoa">American Samoa</option>
            <option value="Andorra">Andorra</option>
            <option value="Angola">Angola</option>
            <option value="Anguilla">Anguilla</option>
            <option value="Antigua &amp; Barbuda">Antigua amp; Barbuda</option>
            <option value="Argentina">Argentina</option>
            <option value="Armenia">Armenia</option>
            <option value="Aruba">Aruba</option>
            <option value="Australia">Australia</option>
            <option value="Austria">Austria</option>
            <option value="Azerbaijan">Azerbaijan</option>
            <option value="Bahamas">Bahamas</option>
            <option value="Bahrain">Bahrain</option>
            <option value="Bangladesh">Bangladesh</option>
            <option value="Barbados">Barbados</option>
            <option value="Belarus">Belarus</option>
            <option value="Belgium">Belgium</option>
            <option value="Belize">Belize</option>
            <option value="Benin">Benin</option>
            <option value="Bermuda">Bermuda</option>
            <option value="Bhutan">Bhutan</option>
            <option value="Bolivia">Bolivia</option>
            <option value="Bonaire">Bonaire</option>
            <option value="Bosnia amp; Herzegovina">Bosnia amp; Herzegovina</option>
            <option value="Botswana">Botswana</option>
            <option value="Brazil">Brazil</option>
            <option value="British Indian Ocean Ter">British Indian Ocean Ter</option>
            <option value="Brunei">Brunei</option>
            <option value="Bulgaria">Bulgaria</option>
            <option value="Burkina Faso">Burkina Faso</option>
            <option value="Burundi">Burundi</option>
            <option value="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Canary Islands">Canary Islands</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman Islands">Cayman Islands</option>
            <option value="Central African Republic">Central African Republic</option>
            <option value="Chad">Chad</option>
            <option value="Channel Islands">Channel Islands</option>
            <option value="Chile">Chile</option>
            <option value="China">China</option>
            <option value="Christmas Island">Christmas Island</option>
            <option value="Cocos Island">Cocos Island</option>
            <option value="Colombia">Colombia</option>
            <option value="Comoros">Comoros</option>
            <option value="Congo">Congo</option>
            <option value="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Cote DIvoire">Cote DIvoire</option>
            <option value="Croatia">Croatia</option>
            <option value="Cuba">Cuba</option>
            <option value="Curaco">Curacao</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</option>
            <option value="Denmark">Denmark</option>
            <option value="Djibouti">Djibouti</option>
            <option value="Dominica">Dominica</option>
            <option value="Dominican Republic">Dominican Republic</option>
            <option value="East Timor">East Timor</option>
            <option value="Ecuador">Ecuador</option>
            <option value="Egypt">Egypt</option>
            <option value="El Salvador">El Salvador</option>
            <option value="Equatorial Guinea">Equatorial Guinea</option>
            <option value="Eritrea">Eritrea</option>
            <option value="Estonia">Estonia</option>
            <option value="Ethiopia">Ethiopia</option>
            <option value="Falkland Islands">Falkland Islands</option>
            <option value="Faroe Islands">Faroe Islands</option>
            <option value="Fiji">Fiji</option>
            <option value="Finland">Finland</option>
            <option value="France">France</option>
            <option value="French Guiana">French Guiana</option>
            <option value="French Polynesia">French Polynesia</option>
            <option value="French Southern Ter">French Southern Ter</option>
            <option value="Gabon">Gabon</option>
            <option value="Gambia">Gambia</option>
            <option value="Georgia">Georgia</option>
            <option value="Germany">Germany</option>
            <option value="Ghana">Ghana</option>
            <option value="Gibraltar">Gibraltar</option>
            <option value="Great Britain">Great Britain</option>
            <option value="Greece">Greece</option>
            <option value="Greenland">Greenland</option>
            <option value="Grenada">Grenada</option>
            <option value="Guadeloupe">Guadeloupe</option>
            <option value="Guam">Guam</option>
            <option value="Guatemala">Guatemala</option>
            <option value="Guinea">Guinea</option>
            <option value="Guyana">Guyana</option>
            <option value="Haiti">Haiti</option>
            <option value="Hawaii">Hawaii</option>
            <option value="Honduras">Honduras</option>
            <option value="Hong Kong">Hong Kong</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="Indonesia">Indonesia</option>
            <option value="India">India</option>
            <option value="Iran">Iran</option>
            <option value="Iraq">Iraq</option>
            <option value="Ireland">Ireland</option>
            <option value="Isle of Man">Isle of Man</option>
            <option value="Israel">Israel</option>
            <option value="Italy">Italy</option>
            <option value="Jamaica">Jamaica</option>
            <option value="Japan">Japan</option>
            <option value="Jordan">Jordan</option>
            <option value="Kazakhstan">Kazakhstan</option>
            <option value="Kenya">Kenya</option>
            <option value="Kiribati">Kiribati</option>
            <option value="Korea North">Korea North</option>
            <option value="Korea Sout">Korea South</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Laos">Laos</option>
            <option value="Latvia">Latvia</option>
            <option value="Lebanon">Lebanon</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Libya">Libya</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macau">Macau</option>
            <option value="Macedonia">Macedonia</option>
            <option value="Madagascar">Madagascar</option>
            <option value="Malaysia">Malaysia</option>
            <option value="Malawi">Malawi</option>
            <option value="Maldives">Maldives</option>
            <option value="Mali">Mali</option>
            <option value="Malta">Malta</option>
            <option value="Marshall Islands">Marshall Islands</option>
            <option value="Martinique">Martinique</option>
            <option value="Mauritania">Mauritania</option>
            <option value="Mauritius">Mauritius</option>
            <option value="Mayotte">Mayotte</option>
            <option value="Mexico">Mexico</option>
            <option value="Midway Islands">Midway Islands</option>
            <option value="Moldova">Moldova</option>
            <option value="Monaco">Monaco</option>
            <option value="Mongolia">Mongolia</option>
            <option value="Montserrat">Montserrat</option>
            <option value="Morocco">Morocco</option>
            <option value="Mozambique">Mozambique</option>
            <option value="Myanmar">Myanmar</option>
            <option value="Nambia">Nambia</option>
            <option value="Nauru">Nauru</option>
            <option value="Nepal">Nepal</option>
            <option value="Netherland Antilles">Netherland Antilles</option>
            <option value="Netherlands">Netherlands (Holland, Europe)</option>
            <option value="Nevis">Nevis</option>
            <option value="New Caledonia">New Caledonia</option>
            <option value="New Zealand">New Zealand</option>
            <option value="Nicaragua">Nicaragua</option>
            <option value="Niger">Niger</option>
            <option value="Nigeria">Nigeria</option>
            <option value="Niue">Niue</option>
            <option value="Norfolk Island">Norfolk Island</option>
            <option value="Norway">Norway</option>
            <option value="Oman">Oman</option>
            <option value="Pakistan">Pakistan</option>
            <option value="Palau Island">Palau Island</option>
            <option value="Palestine">Palestine</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Peru">Peru</option>
            <option value="Phillipines">Philippines</option>
            <option value="Pitcairn Island">Pitcairn Island</option>
            <option value="Poland">Poland</option>
            <option value="Portugal">Portugal</option>
            <option value="Puerto Rico">Puerto Rico</option>
            <option value="Qatar">Qatar</option>
            <option value="Republic of Montenegro">Republic of Montenegro</option>
            <option value="Republic of Serbia">Republic of Serbia</option>
            <option value="Reunion">Reunion</option>
            <option value="Romania">Romania</option>
            <option value="Russia">Russia</option>
            <option value="Rwanda">Rwanda</option>
            <option value="St Barthelemy">St Barthelemy</option>
            <option value="St Eustatius">St Eustatius</option>
            <option value="St Helena">St Helena</option>
            <option value="St Kitts-Nevis">St Kitts-Nevis</option>
            <option value="St Lucia">St Lucia</option>
            <option value="St Maarten">St Maarten</option>
            <option value="St Pierre amp; Miquelon">St Pierre amp; Miquelon</option>
            <option value="St Vincent amp; Grenadines">St Vincent amp; Grenadines</option>
            <option value="Saipan">Saipan</option>
            <option value="Samoa">Samoa</option>
            <option value="Samoa American">Samoa American</option>
            <option value="San Marino">San Marino</option>
            <option value="Sao Tome &amp; Principe">Sao Tome amp; Principe</option>
            <option value="Saudi Arabia">Saudi Arabia</option>
            <option value="Senegal">Senegal</option>
            <option value="Seychelles">Seychelles</option>
            <option value="Sierra Leone">Sierra Leone</option>
            <option value="Singapore">Singapore</option>
            <option value="Slovakia">Slovakia</option>
            <option value="Slovenia">Slovenia</option>
            <option value="Solomon Islands">Solomon Islands</option>
            <option value="Somalia">Somalia</option>
            <option value="South Africa">South Africa</option>
            <option value="Spain">Spain</option>
            <option value="Sri Lanka">Sri Lanka</option>
            <option value="Sudan">Sudan</option>
            <option value="Suriname">Suriname</option>
            <option value="Swaziland">Swaziland</option>
            <option value="Sweden">Sweden</option>
            <option value="Switzerland">Switzerland</option>
            <option value="Syria">Syria</option>
            <option value="Tahiti">Tahiti</option>
            <option value="Taiwan">Taiwan</option>
            <option value="Tajikistan">Tajikistan</option>
            <option value="Tanzania">Tanzania</option>
            <option value="Thailand">Thailand</option>
            <option value="Togo">Togo</option>
            <option value="Tokelau">Tokelau</option>
            <option value="Tonga">Tonga</option>
            <option value="Trinidad amp; Tobago">Trinidad amp; Tobago</option>
            <option value="Tunisia">Tunisia</option>
            <option value="Turkey">Turkey</option>
            <option value="Turkmenistan">Turkmenistan</option>
            <option value="Turks amp; Caicos Is">Turks amp; Caicos Is</option>
            <option value="Tuvalu">Tuvalu</option>
            <option value="Uganda">Uganda</option>
            <option value="United Kingdom">United Kingdom</option>
            <option value="Ukraine">Ukraine</option>
            <option value="United Arab Erimates">United Arab Emirates</option>
            <option value="United States of America">United States of America</option>
            <option value="Uraguay">Uruguay</option>
            <option value="Uzbekistan">Uzbekistan</option>
            <option value="Vanuatu">Vanuatu</option>
            <option value="Vatican City State">Vatican City State</option>
            <option value="Venezuela">Venezuela</option>
            <option value="Vietnam">Vietnam</option>
            <option value="Virgin Islands (Brit)">Virgin Islands (Brit)</option>
            <option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
            <option value="Wake Island">Wake Island</option>
            <option value="Wallis &amp; Futana Is">Wallis amp; Futana Is</option>
            <option value="Yemen">Yemen</option>
            <option value="Zaire">Zaire</option>
            <option value="Zambia">Zambia</option>
            <option value="Zimbabwe">Zimbabwe</option>
          </select>
        </div>
        <div class="input-note">
          <div class="note-icon"><i class="fas fa-info-circle"></i></div>
          <div class="note-text">Please select the country you will be travelling to</div>
        </div>
      </div>
    </div>
    <div class="col-12 col-md-6 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="reference">Your Departure Date</label></div>
        <div class="input-control">
          <input type="text" id="departure-date" name="departure-date" placeholder="DD/MM/YYYY" required="" maxlength="10">
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-12 col-lg-10 offset-lg-1">
      <hr>
    </div>
  </div>
  <div class="row justify-content-center">
    <div class="col-12 col-md-6 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="first-name">First Name(s)</label></div>
        <div class="input-control">
          <input type="text" id="first-name" name="first-name" placeholder="First Name" required="" maxlength="20">
        </div>
      </div>
    </div>
    <div class="col-12 col-md-6 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="surname">Surname</label></div>
        <div class="input-control">
          <input type="text" id="surname" name="surname" placeholder="Surname" required="" maxlength="20">
        </div>
      </div>
    </div>
  </div>
  <div class="row justify-content-center">
    <div class="col-12 col-md-6 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="telephone">Telephone Number</label></div>
        <div class="input-control">
          <input type="text" id="telephone" name="telephone" placeholder="telephone" required="" maxlength="20">
        </div>
      </div>
    </div>
    <div class="col-12 col-md-6 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="email">Email Address</label></div>
        <div class="input-control">
          <input type="email" id="email" name="email" placeholder="email" required="" maxlength="40">
        </div>
      </div>
    </div>
  </div>
  <div class="row">
    <div class="col-12 col-md-6 offset-lg-2 col-lg-4">
      <div class="input-group">
        <div class="input-label"><label for="address-line-1">Billing Address Line 1</label></div>
        <div class="input-control">
          <input type="text" id="address-line-1" name="address-line-1" placeholder="Address Line 1" required="" maxlength="100">
        </div>
      </div>
      <div class="input-group">
        <div class="input-label"><label for="address-line-2">Billing Address Line 2 <small class="muted">Optional</small></label></div>
        <div class="input-control">
          <input type="text" id="address-line-2" name="address-line-2" placeholder="Address Line 2" maxlength="100">
        </div>
      </div>
      <div class="input-group">
        <div class="input-label"><label for="city">City</label></div>
        <div class="input-control">
          <input type="text" id="city" name="city" placeholder="city" required="" maxlength="40">
        </div>
      </div>
      <div class="input-group">
        <div class="input-label"><label for="post-code">Post Code / Zip Code</label></div>
        <div class="input-control">
          <input type="text" id="post-code" name="post-code" required="" maxlength="10">
        </div>
      </div>
      <div class="input-group">
        <div class="input-label"><label for="country">Country</label></div>
        <div class="input-control">
          <select id="country" name="country" required="">
            <option disabled="" selected="">Please select a country</option>
            <option value="AF">Afghanistan</option>
            <option value="AX">Åland Islands</option>
            <option value="AL">Albania</option>
            <option value="DZ">Algeria</option>
            <option value="AS">American Samoa</option>
            <option value="AD">Andorra</option>
            <option value="AO">Angola</option>
            <option value="AI">Anguilla</option>
            <option value="AQ">Antarctica</option>
            <option value="AG">Antigua and Barbuda</option>
            <option value="AR">Argentina</option>
            <option value="AM">Armenia</option>
            <option value="AW">Aruba</option>
            <option value="AU">Australia</option>
            <option value="AT">Austria</option>
            <option value="AZ">Azerbaijan</option>
            <option value="BS">Bahamas</option>
            <option value="BH">Bahrain</option>
            <option value="BD">Bangladesh</option>
            <option value="BB">Barbados</option>
            <option value="BY">Belarus</option>
            <option value="BE">Belgium</option>
            <option value="BZ">Belize</option>
            <option value="BJ">Benin</option>
            <option value="BM">Bermuda</option>
            <option value="BT">Bhutan</option>
            <option value="BO">Bolivia, Plurinational State of</option>
            <option value="BQ">Bonaire, Sint Eustatius and Saba</option>
            <option value="BA">Bosnia and Herzegovina</option>
            <option value="BW">Botswana</option>
            <option value="BV">Bouvet Island</option>
            <option value="BR">Brazil</option>
            <option value="IO">British Indian Ocean Territory</option>
            <option value="BN">Brunei Darussalam</option>
            <option value="BG">Bulgaria</option>
            <option value="BF">Burkina Faso</option>
            <option value="BI">Burundi</option>
            <option value="KH">Cambodia</option>
            <option value="CM">Cameroon</option>
            <option value="CA">Canada</option>
            <option value="CV">Cape Verde</option>
            <option value="KY">Cayman Islands</option>
            <option value="CF">Central African Republic</option>
            <option value="TD">Chad</option>
            <option value="CL">Chile</option>
            <option value="CN">China</option>
            <option value="CX">Christmas Island</option>
            <option value="CC">Cocos (Keeling) Islands</option>
            <option value="CO">Colombia</option>
            <option value="KM">Comoros</option>
            <option value="CG">Congo</option>
            <option value="CD">Congo, the Democratic Republic of the</option>
            <option value="CK">Cook Islands</option>
            <option value="CR">Costa Rica</option>
            <option value="CI">Côte d'Ivoire</option>
            <option value="HR">Croatia</option>
            <option value="CU">Cuba</option>
            <option value="CW">Curaçao</option>
            <option value="CY">Cyprus</option>
            <option value="CZ">Czech Republic</option>
            <option value="DK">Denmark</option>
            <option value="DJ">Djibouti</option>
            <option value="DM">Dominica</option>
            <option value="DO">Dominican Republic</option>
            <option value="EC">Ecuador</option>
            <option value="EG">Egypt</option>
            <option value="SV">El Salvador</option>
            <option value="GQ">Equatorial Guinea</option>
            <option value="ER">Eritrea</option>
            <option value="EE">Estonia</option>
            <option value="ET">Ethiopia</option>
            <option value="FK">Falkland Islands (Malvinas)</option>
            <option value="FO">Faroe Islands</option>
            <option value="FJ">Fiji</option>
            <option value="FI">Finland</option>
            <option value="FR">France</option>
            <option value="GF">French Guiana</option>
            <option value="PF">French Polynesia</option>
            <option value="TF">French Southern Territories</option>
            <option value="GA">Gabon</option>
            <option value="GM">Gambia</option>
            <option value="GE">Georgia</option>
            <option value="DE">Germany</option>
            <option value="GH">Ghana</option>
            <option value="GI">Gibraltar</option>
            <option value="GR">Greece</option>
            <option value="GL">Greenland</option>
            <option value="GD">Grenada</option>
            <option value="GP">Guadeloupe</option>
            <option value="GU">Guam</option>
            <option value="GT">Guatemala</option>
            <option value="GG">Guernsey</option>
            <option value="GN">Guinea</option>
            <option value="GW">Guinea-Bissau</option>
            <option value="GY">Guyana</option>
            <option value="HT">Haiti</option>
            <option value="HM">Heard Island and McDonald Islands</option>
            <option value="VA">Holy See (Vatican City State)</option>
            <option value="HN">Honduras</option>
            <option value="HK">Hong Kong</option>
            <option value="HU">Hungary</option>
            <option value="IS">Iceland</option>
            <option value="IN">India</option>
            <option value="ID">Indonesia</option>
            <option value="IR">Iran, Islamic Republic of</option>
            <option value="IQ">Iraq</option>
            <option value="IE">Ireland</option>
            <option value="IM">Isle of Man</option>
            <option value="IL">Israel</option>
            <option value="IT">Italy</option>
            <option value="JM">Jamaica</option>
            <option value="JP">Japan</option>
            <option value="JE">Jersey</option>
            <option value="JO">Jordan</option>
            <option value="KZ">Kazakhstan</option>
            <option value="KE">Kenya</option>
            <option value="KI">Kiribati</option>
            <option value="KP">Korea, Democratic People's Republic of</option>
            <option value="KR">Korea, Republic of</option>
            <option value="KW">Kuwait</option>
            <option value="KG">Kyrgyzstan</option>
            <option value="LA">Lao People's Democratic Republic</option>
            <option value="LV">Latvia</option>
            <option value="LB">Lebanon</option>
            <option value="LS">Lesotho</option>
            <option value="LR">Liberia</option>
            <option value="LY">Libya</option>
            <option value="LI">Liechtenstein</option>
            <option value="LT">Lithuania</option>
            <option value="LU">Luxembourg</option>
            <option value="MO">Macao</option>
            <option value="MK">Macedonia, the former Yugoslav Republic of</option>
            <option value="MG">Madagascar</option>
            <option value="MW">Malawi</option>
            <option value="MY">Malaysia</option>
            <option value="MV">Maldives</option>
            <option value="ML">Mali</option>
            <option value="MT">Malta</option>
            <option value="MH">Marshall Islands</option>
            <option value="MQ">Martinique</option>
            <option value="MR">Mauritania</option>
            <option value="MU">Mauritius</option>
            <option value="YT">Mayotte</option>
            <option value="MX">Mexico</option>
            <option value="FM">Micronesia, Federated States of</option>
            <option value="MD">Moldova, Republic of</option>
            <option value="MC">Monaco</option>
            <option value="MN">Mongolia</option>
            <option value="ME">Montenegro</option>
            <option value="MS">Montserrat</option>
            <option value="MA">Morocco</option>
            <option value="MZ">Mozambique</option>
            <option value="MM">Myanmar</option>
            <option value="NA">Namibia</option>
            <option value="NR">Nauru</option>
            <option value="NP">Nepal</option>
            <option value="NL">Netherlands</option>
            <option value="NC">New Caledonia</option>
            <option value="NZ">New Zealand</option>
            <option value="NI">Nicaragua</option>
            <option value="NE">Niger</option>
            <option value="NG">Nigeria</option>
            <option value="NU">Niue</option>
            <option value="NF">Norfolk Island</option>
            <option value="MP">Northern Mariana Islands</option>
            <option value="NO">Norway</option>
            <option value="OM">Oman</option>
            <option value="PK">Pakistan</option>
            <option value="PW">Palau</option>
            <option value="PS">Palestinian Territory, Occupied</option>
            <option value="PA">Panama</option>
            <option value="PG">Papua New Guinea</option>
            <option value="PY">Paraguay</option>
            <option value="PE">Peru</option>
            <option value="PH">Philippines</option>
            <option value="PN">Pitcairn</option>
            <option value="PL">Poland</option>
            <option value="PT">Portugal</option>
            <option value="PR">Puerto Rico</option>
            <option value="QA">Qatar</option>
            <option value="RE">Réunion</option>
            <option value="RO">Romania</option>
            <option value="RU">Russian Federation</option>
            <option value="RW">Rwanda</option>
            <option value="BL">Saint Barthélemy</option>
            <option value="SH">Saint Helena, Ascension and Tristan da Cunha</option>
            <option value="KN">Saint Kitts and Nevis</option>
            <option value="LC">Saint Lucia</option>
            <option value="MF">Saint Martin (French part)</option>
            <option value="PM">Saint Pierre and Miquelon</option>
            <option value="VC">Saint Vincent and the Grenadines</option>
            <option value="WS">Samoa</option>
            <option value="SM">San Marino</option>
            <option value="ST">Sao Tome and Principe</option>
            <option value="SA">Saudi Arabia</option>
            <option value="SN">Senegal</option>
            <option value="RS">Serbia</option>
            <option value="SC">Seychelles</option>
            <option value="SL">Sierra Leone</option>
            <option value="SG">Singapore</option>
            <option value="SX">Sint Maarten (Dutch part)</option>
            <option value="SK">Slovakia</option>
            <option value="SI">Slovenia</option>
            <option value="SB">Solomon Islands</option>
            <option value="SO">Somalia</option>
            <option value="ZA">South Africa</option>
            <option value="GS">South Georgia and the South Sandwich Islands</option>
            <option value="SS">South Sudan</option>
            <option value="ES">Spain</option>
            <option value="LK">Sri Lanka</option>
            <option value="SD">Sudan</option>
            <option value="SR">Suriname</option>
            <option value="SJ">Svalbard and Jan Mayen</option>
            <option value="SZ">Swaziland</option>
            <option value="SE">Sweden</option>
            <option value="CH">Switzerland</option>
            <option value="SY">Syrian Arab Republic</option>
            <option value="TW">Taiwan, Province of China</option>
            <option value="TJ">Tajikistan</option>
            <option value="TZ">Tanzania, United Republic of</option>
            <option value="TH">Thailand</option>
            <option value="TL">Timor-Leste</option>
            <option value="TG">Togo</option>
            <option value="TK">Tokelau</option>
            <option value="TO">Tonga</option>
            <option value="TT">Trinidad and Tobago</option>
            <option value="TN">Tunisia</option>
            <option value="TR">Turkey</option>
            <option value="TM">Turkmenistan</option>
            <option value="TC">Turks and Caicos Islands</option>
            <option value="TV">Tuvalu</option>
            <option value="UG">Uganda</option>
            <option value="UA">Ukraine</option>
            <option value="AE">United Arab Emirates</option>
            <option value="GB">United Kingdom</option>
            <option value="US">United States</option>
            <option value="UM">United States Minor Outlying Islands</option>
            <option value="UY">Uruguay</option>
            <option value="UZ">Uzbekistan</option>
            <option value="VU">Vanuatu</option>
            <option value="VE">Venezuela, Bolivarian Republic of</option>
            <option value="VN">Viet Nam</option>
            <option value="VG">Virgin Islands, British</option>
            <option value="VI">Virgin Islands, U.S.</option>
            <option value="WF">Wallis and Futuna</option>
            <option value="EH">Western Sahara</option>
            <option value="YE">Yemen</option>
            <option value="ZM">Zambia</option>
            <option value="ZW">Zimbabwe</option>
          </select>
        </div>
      </div>
      <div id="state-group" class="input-group" hidden="">
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Please select a country Afghanistan Albania Algeria American Samoa Andorra
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Netherland Antilles Netherlands (Holland, Europe) Nevis New Caledonia New
Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau
Island Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn
Island Poland Portugal Puerto Rico Qatar Republic of Montenegro Republic of
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Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon
Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden
Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga
Trinidad amp; Tobago Tunisia Turkey Turkmenistan Turks amp; Caicos Is Tuvalu
Uganda United Kingdom Ukraine United Arab Emirates United States of America
Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands
(Brit) Virgin Islands (USA) Wake Island Wallis amp; Futana Is Yemen Zaire Zambia
Zimbabwe
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