enterjamaica.com
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65.183.6.123
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Submitted URL: http://enterjamaica.com/
Effective URL: https://enterjamaica.com/
Submission: On May 17 via api from US — Scanned from DE
Effective URL: https://enterjamaica.com/
Submission: On May 17 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
Name: cfiveForm — POST #
<form action="#" method="post" name="cfiveForm" id="cfiveForm" novalidate="novalidate" onkeypress="return event.keyCode != 13;" class="ng-pristine ng-invalid ng-invalid-required">
<div class="persnol_info_form">
<div class="profile_pic"></div>
<input type="text" name="familyName" placeholder="Last Name" class="textbox_2" required="required" id="familyName">
<input type="text" name="fName" placeholder="First Name" class="textbox_2" required="required" id="fName">
<input type="text" name="mName" placeholder="Middle Name" class="textbox_2" id="mName">
<div class="birthday_datepicker">
<label class="helper icon_birth_date">Birth Date <span>(As it appears on your Passport)</span></label>
<div id="birthday_fields" class="birthday_fields">
<span>
<select id="dobDay" name="dobDay" class="dateOfBirth">
<option selected="true" disabled="disabled" value="Day">Day</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
</span>
<span>
<select id="dobMonth" name="dobMonth" class="dateOfBirth">
<option selected="true" disabled="disabled" value="Month">Month</option>
<option value="01">January</option>
<option value="02">February</option>
<option value="03">March</option>
<option value="04">April</option>
<option value="05">May</option>
<option value="06">June</option>
<option value="07">July</option>
<option value="08">August</option>
<option value="09">September</option>
<option value="10">October</option>
<option value="11">November</option>
<option value="12">December</option>
</select>
</span>
<span>
<select id="dobYear" name="dobYear" class="dateOfBirth">
<option selected="true" disabled="disabled" value="Year">Year</option>
<option value="2024">2024</option>
<option value="2023">2023</option>
<option value="2022">2022</option>
<option value="2021">2021</option>
<option value="2020">2020</option>
<option value="2019">2019</option>
<option value="2018">2018</option>
<option value="2017">2017</option>
<option value="2016">2016</option>
<option value="2015">2015</option>
<option value="2014">2014</option>
<option value="2013">2013</option>
<option value="2012">2012</option>
<option value="2011">2011</option>
<option value="2010">2010</option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
<option value="1909">1909</option>
<option value="1908">1908</option>
<option value="1907">1907</option>
</select>
</span>
</div><!--birthday_fields-->
</div>
<div class="select_style">
<select class="select_option" required="required" id="gender" name="gender">
<option selected="true" disabled="disabled" class="placeholder_color" value="Gender">Gender</option>
<option value="Male">Male</option>
<option value="Female">Female</option>
</select>
</div>
<div class="select_style">
<select class="select_option" required="required" id="no_accomp_fam_members" name="no_accomp_fam_members">
<option selected="true" disabled="disabled" value="Family Members with you">Family Members with you</option>
<option value="0">0</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
</select>
</div>
</div><!--persnol_info_form-->
<div class="contact_info_form">
<div class="color_div">
<h3>for color</h3>
</div>
<div class="contact_form_detail">
<label class="label_1">Home Address</label>
<!-- <input type="text" name="homeAddress" placeholder="Home Address - (Street Address/Apt. #; City/Town; State/Province; Zip/Postal Code; Country)" class="textbox_3" required="required" id="homeAddress"/> -->
<input type="text" name="homeAddress" placeholder="Street Address" class="textbox_3" required="required" id="homeAddress">
<input type="text" name="homeAddress1" placeholder="City / Town" class="textbox_4" required="required" id="homeAddress1" style="margin-bottom:0;">
<input type="text" name="homeAddress2" placeholder="State / Province / Region" class="textbox_4" required="required" id="homeAddress2" style="margin-bottom:0;">
<input type="text" name="homeAddress3" placeholder="Zip / Postal Code" class="textbox_4" required="required" id="homeAddress3" style="margin-bottom:0;">
<div class="select_style home_country">
<select name="homeAddress4" placeholder="Country" class="select_option" required="required" id="homeAddress4" style="background:none;margin-bottom:0;max-width:inherit;"></select>
</div>
<label class="label_1">Passport Details</label>
<input type="text" name="occupation" placeholder="Occupation" class="textbox_3 ui-autocomplete-input" required="required" id="occupation" autocomplete="off">
<label class="helper icon_passport_no">Passport Number <span>(As it appears on your Passport)</span></label>
<input type="text" name="passportNo" id="passportNo" placeholder="Passport Number" class="textbox_4" required="required">
<label class="helper icon_issue_country">Country of Issue <span>(As it appears on your Passport)</span></label>
<div class="country-select inside"><input class="issueCountry textbox_4 conutry_issued ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required" required="required" name="issueCountry" ng-model="country_names1" id="issueCountry"
placeholder="Country of Issue" title="Country of Issue">
<div class="flag-dropdown">
<div class="selected-flag" title="Country Of Issue">
<div class="flag default">
<div class="arrow"></div>
</div>
</div>
<ul class="country-list hide">
<li class="country preferred active" data-country-code="default">
<div class="flag default"></div><span class="country-name">Country Of Issue</span>
</li>
<li class="country preferred" data-country-code="jm">
<div class="flag jm"></div><span class="country-name">Jamaica</span>
</li>
<li class="country preferred" data-country-code="us">
<div class="flag us"></div><span class="country-name">United States</span>
</li>
<li class="country preferred" data-country-code="gb">
<div class="flag gb"></div><span class="country-name">United Kingdom</span>
</li>
<li class="divider"></li>
<li class="country" data-country-code="af">
<div class="flag af"></div><span class="country-name">Afghanistan</span>
</li>
<li class="country" data-country-code="ax">
<div class="flag ax"></div><span class="country-name">Aland Islands</span>
</li>
<li class="country" data-country-code="al">
<div class="flag al"></div><span class="country-name">Albania</span>
</li>
<li class="country" data-country-code="dz">
<div class="flag dz"></div><span class="country-name">Algeria</span>
</li>
<li class="country" data-country-code="as">
<div class="flag as"></div><span class="country-name">American Samoa</span>
</li>
<li class="country" data-country-code="ad">
<div class="flag ad"></div><span class="country-name">Andorra</span>
</li>
<li class="country" data-country-code="ao">
<div class="flag ao"></div><span class="country-name">Angola</span>
</li>
<li class="country" data-country-code="ai">
<div class="flag ai"></div><span class="country-name">Anguilla</span>
</li>
<li class="country" data-country-code="ag">
<div class="flag ag"></div><span class="country-name">Antigua and Barbuda</span>
</li>
<li class="country" data-country-code="ar">
<div class="flag ar"></div><span class="country-name">Argentina</span>
</li>
<li class="country" data-country-code="am">
<div class="flag am"></div><span class="country-name">Armenia</span>
</li>
<li class="country" data-country-code="aw">
<div class="flag aw"></div><span class="country-name">Aruba</span>
</li>
<li class="country" data-country-code="au">
<div class="flag au"></div><span class="country-name">Australia</span>
</li>
<li class="country" data-country-code="at">
<div class="flag at"></div><span class="country-name">Austria</span>
</li>
<li class="country" data-country-code="az">
<div class="flag az"></div><span class="country-name">Azerbaijan</span>
</li>
<li class="country" data-country-code="bs">
<div class="flag bs"></div><span class="country-name">Bahamas</span>
</li>
<li class="country" data-country-code="bh">
<div class="flag bh"></div><span class="country-name">Bahrain</span>
</li>
<li class="country" data-country-code="bd">
<div class="flag bd"></div><span class="country-name">Bangladesh</span>
</li>
<li class="country" data-country-code="bb">
<div class="flag bb"></div><span class="country-name">Barbados</span>
</li>
<li class="country" data-country-code="by">
<div class="flag by"></div><span class="country-name">Belarus</span>
</li>
<li class="country" data-country-code="be">
<div class="flag be"></div><span class="country-name">Belgium</span>
</li>
<li class="country" data-country-code="bz">
<div class="flag bz"></div><span class="country-name">Belize</span>
</li>
<li class="country" data-country-code="bj">
<div class="flag bj"></div><span class="country-name">Benin</span>
</li>
<li class="country" data-country-code="bm">
<div class="flag bm"></div><span class="country-name">Bermuda</span>
</li>
<li class="country" data-country-code="bt">
<div class="flag bt"></div><span class="country-name">Bhutan</span>
</li>
<li class="country" data-country-code="bo">
<div class="flag bo"></div><span class="country-name">Bolivia</span>
</li>
<li class="country" data-country-code="ba">
<div class="flag ba"></div><span class="country-name">Bosnia and Herzegovina</span>
</li>
<li class="country" data-country-code="bw">
<div class="flag bw"></div><span class="country-name">Botswana</span>
</li>
<li class="country" data-country-code="br">
<div class="flag br"></div><span class="country-name">Brazil</span>
</li>
<li class="country" data-country-code="io">
<div class="flag io"></div><span class="country-name">British Indian Ocean Territory</span>
</li>
<li class="country" data-country-code="vg">
<div class="flag vg"></div><span class="country-name">British Virgin Islands</span>
</li>
<li class="country" data-country-code="bn">
<div class="flag bn"></div><span class="country-name">Brunei</span>
</li>
<li class="country" data-country-code="bg">
<div class="flag bg"></div><span class="country-name">Bulgaria</span>
</li>
<li class="country" data-country-code="bf">
<div class="flag bf"></div><span class="country-name">Burkina Faso</span>
</li>
<li class="country" data-country-code="bi">
<div class="flag bi"></div><span class="country-name">Burundi</span>
</li>
<li class="country" data-country-code="kh">
<div class="flag kh"></div><span class="country-name">Cambodia</span>
</li>
<li class="country" data-country-code="cm">
<div class="flag cm"></div><span class="country-name">Cameroon</span>
</li>
<li class="country" data-country-code="ca">
<div class="flag ca"></div><span class="country-name">Canada</span>
</li>
<li class="country" data-country-code="cv">
<div class="flag cv"></div><span class="country-name">Cape Verde</span>
</li>
<li class="country" data-country-code="bq">
<div class="flag bq"></div><span class="country-name">Caribbean Netherlands</span>
</li>
<li class="country" data-country-code="ky">
<div class="flag ky"></div><span class="country-name">Cayman Islands</span>
</li>
<li class="country" data-country-code="cf">
<div class="flag cf"></div><span class="country-name">Central African Republic</span>
</li>
<li class="country" data-country-code="td">
<div class="flag td"></div><span class="country-name">Chad</span>
</li>
<li class="country" data-country-code="cl">
<div class="flag cl"></div><span class="country-name">Chile</span>
</li>
<li class="country" data-country-code="cn">
<div class="flag cn"></div><span class="country-name">China</span>
</li>
<li class="country" data-country-code="cx">
<div class="flag cx"></div><span class="country-name">Christmas Island</span>
</li>
<li class="country" data-country-code="cc">
<div class="flag cc"></div><span class="country-name">Cocos (Keeling) Islands</span>
</li>
<li class="country" data-country-code="co">
<div class="flag co"></div><span class="country-name">Colombia</span>
</li>
<li class="country" data-country-code="km">
<div class="flag km"></div><span class="country-name">Comoros</span>
</li>
<li class="country" data-country-code="cd">
<div class="flag cd"></div><span class="country-name">Congo (DRC)</span>
</li>
<li class="country" data-country-code="cg">
<div class="flag cg"></div><span class="country-name">Congo (Republic)</span>
</li>
<li class="country" data-country-code="ck">
<div class="flag ck"></div><span class="country-name">Cook Islands</span>
</li>
<li class="country" data-country-code="cr">
<div class="flag cr"></div><span class="country-name">Costa Rica</span>
</li>
<li class="country" data-country-code="ci">
<div class="flag ci"></div><span class="country-name">Cote d’Ivoire</span>
</li>
<li class="country" data-country-code="hr">
<div class="flag hr"></div><span class="country-name">Croatia</span>
</li>
<li class="country" data-country-code="cu">
<div class="flag cu"></div><span class="country-name">Cuba</span>
</li>
<li class="country" data-country-code="cw">
<div class="flag cw"></div><span class="country-name">Curaçao</span>
</li>
<li class="country" data-country-code="cy">
<div class="flag cy"></div><span class="country-name">Cyprus</span>
</li>
<li class="country" data-country-code="cz">
<div class="flag cz"></div><span class="country-name">Czech Republic</span>
</li>
<li class="country" data-country-code="dk">
<div class="flag dk"></div><span class="country-name">Denmark</span>
</li>
<li class="country" data-country-code="dj">
<div class="flag dj"></div><span class="country-name">Djibouti</span>
</li>
<li class="country" data-country-code="dm">
<div class="flag dm"></div><span class="country-name">Dominica</span>
</li>
<li class="country" data-country-code="do">
<div class="flag do"></div><span class="country-name">Dominican Republic</span>
</li>
<li class="country" data-country-code="ec">
<div class="flag ec"></div><span class="country-name">Ecuador</span>
</li>
<li class="country" data-country-code="eg">
<div class="flag eg"></div><span class="country-name">Egypt</span>
</li>
<li class="country" data-country-code="sv">
<div class="flag sv"></div><span class="country-name">El Salvador</span>
</li>
<li class="country" data-country-code="gq">
<div class="flag gq"></div><span class="country-name">Equatorial Guinea</span>
</li>
<li class="country" data-country-code="er">
<div class="flag er"></div><span class="country-name">Eritrea</span>
</li>
<li class="country" data-country-code="ee">
<div class="flag ee"></div><span class="country-name">Estonia</span>
</li>
<li class="country" data-country-code="et">
<div class="flag et"></div><span class="country-name">Ethiopia</span>
</li>
<li class="country" data-country-code="fk">
<div class="flag fk"></div><span class="country-name">Falkland Islands</span>
</li>
<li class="country" data-country-code="fo">
<div class="flag fo"></div><span class="country-name">Faroe Islands</span>
</li>
<li class="country" data-country-code="fj">
<div class="flag fj"></div><span class="country-name">Fiji</span>
</li>
<li class="country" data-country-code="fi">
<div class="flag fi"></div><span class="country-name">Finland</span>
</li>
<li class="country" data-country-code="fr">
<div class="flag fr"></div><span class="country-name">France</span>
</li>
<li class="country" data-country-code="gf">
<div class="flag gf"></div><span class="country-name">French Guiana</span>
</li>
<li class="country" data-country-code="pf">
<div class="flag pf"></div><span class="country-name">French Polynesia</span>
</li>
<li class="country" data-country-code="ga">
<div class="flag ga"></div><span class="country-name">Gabon</span>
</li>
<li class="country" data-country-code="gm">
<div class="flag gm"></div><span class="country-name">Gambia</span>
</li>
<li class="country" data-country-code="ge">
<div class="flag ge"></div><span class="country-name">Georgia</span>
</li>
<li class="country" data-country-code="de">
<div class="flag de"></div><span class="country-name">Germany</span>
</li>
<li class="country" data-country-code="gh">
<div class="flag gh"></div><span class="country-name">Ghana</span>
</li>
<li class="country" data-country-code="gi">
<div class="flag gi"></div><span class="country-name">Gibraltar</span>
</li>
<li class="country" data-country-code="gr">
<div class="flag gr"></div><span class="country-name">Greece</span>
</li>
<li class="country" data-country-code="gl">
<div class="flag gl"></div><span class="country-name">Greenland</span>
</li>
<li class="country" data-country-code="gd">
<div class="flag gd"></div><span class="country-name">Grenada</span>
</li>
<li class="country" data-country-code="gp">
<div class="flag gp"></div><span class="country-name">Guadeloupe</span>
</li>
<li class="country" data-country-code="gu">
<div class="flag gu"></div><span class="country-name">Guam</span>
</li>
<li class="country" data-country-code="gt">
<div class="flag gt"></div><span class="country-name">Guatemala</span>
</li>
<li class="country" data-country-code="gg">
<div class="flag gg"></div><span class="country-name">Guernsey</span>
</li>
<li class="country" data-country-code="gn">
<div class="flag gn"></div><span class="country-name">Guinea</span>
</li>
<li class="country" data-country-code="gw">
<div class="flag gw"></div><span class="country-name">Guinea-Bissau</span>
</li>
<li class="country" data-country-code="gy">
<div class="flag gy"></div><span class="country-name">Guyana</span>
</li>
<li class="country" data-country-code="ht">
<div class="flag ht"></div><span class="country-name">Haiti</span>
</li>
<li class="country" data-country-code="hn">
<div class="flag hn"></div><span class="country-name">Honduras</span>
</li>
<li class="country" data-country-code="hk">
<div class="flag hk"></div><span class="country-name">Hong Kong</span>
</li>
<li class="country" data-country-code="hu">
<div class="flag hu"></div><span class="country-name">Hungary</span>
</li>
<li class="country" data-country-code="is">
<div class="flag is"></div><span class="country-name">Iceland</span>
</li>
<li class="country" data-country-code="in">
<div class="flag in"></div><span class="country-name">India</span>
</li>
<li class="country" data-country-code="id">
<div class="flag id"></div><span class="country-name">Indonesia</span>
</li>
<li class="country" data-country-code="ir">
<div class="flag ir"></div><span class="country-name">Iran</span>
</li>
<li class="country" data-country-code="iq">
<div class="flag iq"></div><span class="country-name">Iraq</span>
</li>
<li class="country" data-country-code="ie">
<div class="flag ie"></div><span class="country-name">Ireland</span>
</li>
<li class="country" data-country-code="im">
<div class="flag im"></div><span class="country-name">Isle of Man</span>
</li>
<li class="country" data-country-code="il">
<div class="flag il"></div><span class="country-name">Israel</span>
</li>
<li class="country" data-country-code="it">
<div class="flag it"></div><span class="country-name">Italy</span>
</li>
<li class="country" data-country-code="jm">
<div class="flag jm"></div><span class="country-name">Jamaica</span>
</li>
<li class="country" data-country-code="jp">
<div class="flag jp"></div><span class="country-name">Japan</span>
</li>
<li class="country" data-country-code="je">
<div class="flag je"></div><span class="country-name">Jersey</span>
</li>
<li class="country" data-country-code="jo">
<div class="flag jo"></div><span class="country-name">Jordan</span>
</li>
<li class="country" data-country-code="kz">
<div class="flag kz"></div><span class="country-name">Kazakhstan</span>
</li>
<li class="country" data-country-code="ke">
<div class="flag ke"></div><span class="country-name">Kenya</span>
</li>
<li class="country" data-country-code="ki">
<div class="flag ki"></div><span class="country-name">Kiribati</span>
</li>
<li class="country" data-country-code="xk">
<div class="flag xk"></div><span class="country-name">Kosovo</span>
</li>
<li class="country" data-country-code="kw">
<div class="flag kw"></div><span class="country-name">Kuwait</span>
</li>
<li class="country" data-country-code="kg">
<div class="flag kg"></div><span class="country-name">Kyrgyzstan</span>
</li>
<li class="country" data-country-code="la">
<div class="flag la"></div><span class="country-name">Laos</span>
</li>
<li class="country" data-country-code="lv">
<div class="flag lv"></div><span class="country-name">Latvia</span>
</li>
<li class="country" data-country-code="lb">
<div class="flag lb"></div><span class="country-name">Lebanon</span>
</li>
<li class="country" data-country-code="ls">
<div class="flag ls"></div><span class="country-name">Lesotho</span>
</li>
<li class="country" data-country-code="lr">
<div class="flag lr"></div><span class="country-name">Liberia</span>
</li>
<li class="country" data-country-code="ly">
<div class="flag ly"></div><span class="country-name">Libya</span>
</li>
<li class="country" data-country-code="li">
<div class="flag li"></div><span class="country-name">Liechtenstein</span>
</li>
<li class="country" data-country-code="lt">
<div class="flag lt"></div><span class="country-name">Lithuania</span>
</li>
<li class="country" data-country-code="lu">
<div class="flag lu"></div><span class="country-name">Luxembourg</span>
</li>
<li class="country" data-country-code="mo">
<div class="flag mo"></div><span class="country-name">Macau</span>
</li>
<li class="country" data-country-code="mk">
<div class="flag mk"></div><span class="country-name">Macedonia</span>
</li>
<li class="country" data-country-code="mg">
<div class="flag mg"></div><span class="country-name">Madagascar</span>
</li>
<li class="country" data-country-code="mw">
<div class="flag mw"></div><span class="country-name">Malawi</span>
</li>
<li class="country" data-country-code="my">
<div class="flag my"></div><span class="country-name">Malaysia</span>
</li>
<li class="country" data-country-code="mv">
<div class="flag mv"></div><span class="country-name">Maldives</span>
</li>
<li class="country" data-country-code="ml">
<div class="flag ml"></div><span class="country-name">Mali</span>
</li>
<li class="country" data-country-code="mt">
<div class="flag mt"></div><span class="country-name">Malta</span>
</li>
<li class="country" data-country-code="mh">
<div class="flag mh"></div><span class="country-name">Marshall Islands</span>
</li>
<li class="country" data-country-code="mq">
<div class="flag mq"></div><span class="country-name">Martinique</span>
</li>
<li class="country" data-country-code="mr">
<div class="flag mr"></div><span class="country-name">Mauritania</span>
</li>
<li class="country" data-country-code="mu">
<div class="flag mu"></div><span class="country-name">Mauritius</span>
</li>
<li class="country" data-country-code="yt">
<div class="flag yt"></div><span class="country-name">Mayotte</span>
</li>
<li class="country" data-country-code="mx">
<div class="flag mx"></div><span class="country-name">Mexico</span>
</li>
<li class="country" data-country-code="fm">
<div class="flag fm"></div><span class="country-name">Micronesia</span>
</li>
<li class="country" data-country-code="md">
<div class="flag md"></div><span class="country-name">Moldova</span>
</li>
<li class="country" data-country-code="mc">
<div class="flag mc"></div><span class="country-name">Monaco</span>
</li>
<li class="country" data-country-code="mn">
<div class="flag mn"></div><span class="country-name">Mongolia</span>
</li>
<li class="country" data-country-code="me">
<div class="flag me"></div><span class="country-name">Montenegro</span>
</li>
<li class="country" data-country-code="ms">
<div class="flag ms"></div><span class="country-name">Montserrat</span>
</li>
<li class="country" data-country-code="ma">
<div class="flag ma"></div><span class="country-name">Morocco</span>
</li>
<li class="country" data-country-code="mz">
<div class="flag mz"></div><span class="country-name">Mozambique</span>
</li>
<li class="country" data-country-code="mm">
<div class="flag mm"></div><span class="country-name">Myanmar</span>
</li>
<li class="country" data-country-code="na">
<div class="flag na"></div><span class="country-name">Namibia</span>
</li>
<li class="country" data-country-code="nr">
<div class="flag nr"></div><span class="country-name">Nauru</span>
</li>
<li class="country" data-country-code="np">
<div class="flag np"></div><span class="country-name">Nepal</span>
</li>
<li class="country" data-country-code="nl">
<div class="flag nl"></div><span class="country-name">Netherlands</span>
</li>
<li class="country" data-country-code="nc">
<div class="flag nc"></div><span class="country-name">New Caledonia</span>
</li>
<li class="country" data-country-code="nz">
<div class="flag nz"></div><span class="country-name">New Zealand</span>
</li>
<li class="country" data-country-code="ni">
<div class="flag ni"></div><span class="country-name">Nicaragua</span>
</li>
<li class="country" data-country-code="ne">
<div class="flag ne"></div><span class="country-name">Niger</span>
</li>
<li class="country" data-country-code="ng">
<div class="flag ng"></div><span class="country-name">Nigeria</span>
</li>
<li class="country" data-country-code="nu">
<div class="flag nu"></div><span class="country-name">Niue</span>
</li>
<li class="country" data-country-code="nf">
<div class="flag nf"></div><span class="country-name">Norfolk Island</span>
</li>
<li class="country" data-country-code="kp">
<div class="flag kp"></div><span class="country-name">North Korea</span>
</li>
<li class="country" data-country-code="mp">
<div class="flag mp"></div><span class="country-name">Northern Mariana Islands</span>
</li>
<li class="country" data-country-code="no">
<div class="flag no"></div><span class="country-name">Norway</span>
</li>
<li class="country" data-country-code="om">
<div class="flag om"></div><span class="country-name">Oman</span>
</li>
<li class="country" data-country-code="pk">
<div class="flag pk"></div><span class="country-name">Pakistan</span>
</li>
<li class="country" data-country-code="pw">
<div class="flag pw"></div><span class="country-name">Palau</span>
</li>
<li class="country" data-country-code="ps">
<div class="flag ps"></div><span class="country-name">Palestine</span>
</li>
<li class="country" data-country-code="pa">
<div class="flag pa"></div><span class="country-name">Panama</span>
</li>
<li class="country" data-country-code="pg">
<div class="flag pg"></div><span class="country-name">Papua New Guinea</span>
</li>
<li class="country" data-country-code="py">
<div class="flag py"></div><span class="country-name">Paraguay</span>
</li>
<li class="country" data-country-code="pe">
<div class="flag pe"></div><span class="country-name">Peru</span>
</li>
<li class="country" data-country-code="ph">
<div class="flag ph"></div><span class="country-name">Philippines</span>
</li>
<li class="country" data-country-code="pn">
<div class="flag pn"></div><span class="country-name">Pitcairn Islands</span>
</li>
<li class="country" data-country-code="pl">
<div class="flag pl"></div><span class="country-name">Poland</span>
</li>
<li class="country" data-country-code="pt">
<div class="flag pt"></div><span class="country-name">Portugal</span>
</li>
<li class="country" data-country-code="pr">
<div class="flag pr"></div><span class="country-name">Puerto Rico</span>
</li>
<li class="country" data-country-code="qa">
<div class="flag qa"></div><span class="country-name">Qatar</span>
</li>
<li class="country" data-country-code="re">
<div class="flag re"></div><span class="country-name">Réunion</span>
</li>
<li class="country" data-country-code="ro">
<div class="flag ro"></div><span class="country-name">Romania</span>
</li>
<li class="country" data-country-code="ru">
<div class="flag ru"></div><span class="country-name">Russia</span>
</li>
<li class="country" data-country-code="rw">
<div class="flag rw"></div><span class="country-name">Rwanda</span>
</li>
<li class="country" data-country-code="bl">
<div class="flag bl"></div><span class="country-name">Saint Barthélemy</span>
</li>
<li class="country" data-country-code="sh">
<div class="flag sh"></div><span class="country-name">Saint Helena</span>
</li>
<li class="country" data-country-code="kn">
<div class="flag kn"></div><span class="country-name">Saint Kitts and Nevis</span>
</li>
<li class="country" data-country-code="lc">
<div class="flag lc"></div><span class="country-name">Saint Lucia</span>
</li>
<li class="country" data-country-code="mf">
<div class="flag mf"></div><span class="country-name">Saint Martin</span>
</li>
<li class="country" data-country-code="pm">
<div class="flag pm"></div><span class="country-name">Saint Pierre and Miquelon</span>
</li>
<li class="country" data-country-code="vc">
<div class="flag vc"></div><span class="country-name">Saint Vincent and the Grenadines</span>
</li>
<li class="country" data-country-code="ws">
<div class="flag ws"></div><span class="country-name">Samoa</span>
</li>
<li class="country" data-country-code="sm">
<div class="flag sm"></div><span class="country-name">San Marino</span>
</li>
<li class="country" data-country-code="st">
<div class="flag st"></div><span class="country-name">São Tomé and Príncipe</span>
</li>
<li class="country" data-country-code="sa">
<div class="flag sa"></div><span class="country-name">Saudi Arabia</span>
</li>
<li class="country" data-country-code="sn">
<div class="flag sn"></div><span class="country-name">Senegal</span>
</li>
<li class="country" data-country-code="rs">
<div class="flag rs"></div><span class="country-name">Serbia</span>
</li>
<li class="country" data-country-code="sc">
<div class="flag sc"></div><span class="country-name">Seychelles</span>
</li>
<li class="country" data-country-code="sl">
<div class="flag sl"></div><span class="country-name">Sierra Leone</span>
</li>
<li class="country" data-country-code="sg">
<div class="flag sg"></div><span class="country-name">Singapore</span>
</li>
<li class="country" data-country-code="sx">
<div class="flag sx"></div><span class="country-name">Sint Maarten</span>
</li>
<li class="country" data-country-code="sk">
<div class="flag sk"></div><span class="country-name">Slovakia</span>
</li>
<li class="country" data-country-code="si">
<div class="flag si"></div><span class="country-name">Slovenia</span>
</li>
<li class="country" data-country-code="sb">
<div class="flag sb"></div><span class="country-name">Solomon Islands</span>
</li>
<li class="country" data-country-code="so">
<div class="flag so"></div><span class="country-name">Somalia</span>
</li>
<li class="country" data-country-code="za">
<div class="flag za"></div><span class="country-name">South Africa</span>
</li>
<li class="country" data-country-code="gs">
<div class="flag gs"></div><span class="country-name">South Georgia & South Sandwich Islands</span>
</li>
<li class="country" data-country-code="kr">
<div class="flag kr"></div><span class="country-name">South Korea</span>
</li>
<li class="country" data-country-code="ss">
<div class="flag ss"></div><span class="country-name">South Sudan</span>
</li>
<li class="country" data-country-code="es">
<div class="flag es"></div><span class="country-name">Spain</span>
</li>
<li class="country" data-country-code="lk">
<div class="flag lk"></div><span class="country-name">Sri Lanka</span>
</li>
<li class="country" data-country-code="sd">
<div class="flag sd"></div><span class="country-name">Sudan</span>
</li>
<li class="country" data-country-code="sr">
<div class="flag sr"></div><span class="country-name">Suriname</span>
</li>
<li class="country" data-country-code="sj">
<div class="flag sj"></div><span class="country-name">Svalbard and Jan Mayen</span>
</li>
<li class="country" data-country-code="sz">
<div class="flag sz"></div><span class="country-name">Swaziland</span>
</li>
<li class="country" data-country-code="se">
<div class="flag se"></div><span class="country-name">Sweden</span>
</li>
<li class="country" data-country-code="ch">
<div class="flag ch"></div><span class="country-name">Switzerland</span>
</li>
<li class="country" data-country-code="sy">
<div class="flag sy"></div><span class="country-name">Syria</span>
</li>
<li class="country" data-country-code="tw">
<div class="flag tw"></div><span class="country-name">Taiwan</span>
</li>
<li class="country" data-country-code="tj">
<div class="flag tj"></div><span class="country-name">Tajikistan</span>
</li>
<li class="country" data-country-code="tz">
<div class="flag tz"></div><span class="country-name">Tanzania</span>
</li>
<li class="country" data-country-code="th">
<div class="flag th"></div><span class="country-name">Thailand</span>
</li>
<li class="country" data-country-code="tl">
<div class="flag tl"></div><span class="country-name">Timor-Leste</span>
</li>
<li class="country" data-country-code="tg">
<div class="flag tg"></div><span class="country-name">Togo</span>
</li>
<li class="country" data-country-code="tk">
<div class="flag tk"></div><span class="country-name">Tokelau</span>
</li>
<li class="country" data-country-code="to">
<div class="flag to"></div><span class="country-name">Tonga</span>
</li>
<li class="country" data-country-code="tt">
<div class="flag tt"></div><span class="country-name">Trinidad and Tobago</span>
</li>
<li class="country" data-country-code="tn">
<div class="flag tn"></div><span class="country-name">Tunisia</span>
</li>
<li class="country" data-country-code="tr">
<div class="flag tr"></div><span class="country-name">Turkey</span>
</li>
<li class="country" data-country-code="tm">
<div class="flag tm"></div><span class="country-name">Turkmenistan</span>
</li>
<li class="country" data-country-code="tc">
<div class="flag tc"></div><span class="country-name">Turks and Caicos Islands</span>
</li>
<li class="country" data-country-code="tv">
<div class="flag tv"></div><span class="country-name">Tuvalu</span>
</li>
<li class="country" data-country-code="ug">
<div class="flag ug"></div><span class="country-name">Uganda</span>
</li>
<li class="country" data-country-code="ua">
<div class="flag ua"></div><span class="country-name">Ukraine</span>
</li>
<li class="country" data-country-code="ae">
<div class="flag ae"></div><span class="country-name">United Arab Emirates</span>
</li>
<li class="country" data-country-code="gb">
<div class="flag gb"></div><span class="country-name">United Kingdom</span>
</li>
<li class="country" data-country-code="us">
<div class="flag us"></div><span class="country-name">United States</span>
</li>
<li class="country" data-country-code="um">
<div class="flag um"></div><span class="country-name">U.S. Minor Outlying Islands</span>
</li>
<li class="country" data-country-code="vi">
<div class="flag vi"></div><span class="country-name">U.S. Virgin Islands</span>
</li>
<li class="country" data-country-code="uy">
<div class="flag uy"></div><span class="country-name">Uruguay</span>
</li>
<li class="country" data-country-code="uz">
<div class="flag uz"></div><span class="country-name">Uzbekistan</span>
</li>
<li class="country" data-country-code="vu">
<div class="flag vu"></div><span class="country-name">Vanuatu</span>
</li>
<li class="country" data-country-code="va">
<div class="flag va"></div><span class="country-name">Vatican City</span>
</li>
<li class="country" data-country-code="ve">
<div class="flag ve"></div><span class="country-name">Venezuela</span>
</li>
<li class="country" data-country-code="vn">
<div class="flag vn"></div><span class="country-name">Vietnam</span>
</li>
<li class="country" data-country-code="wf">
<div class="flag wf"></div><span class="country-name">Wallis and Futuna</span>
</li>
<li class="country" data-country-code="eh">
<div class="flag eh"></div><span class="country-name">Western Sahara</span>
</li>
<li class="country" data-country-code="ye">
<div class="flag ye"></div><span class="country-name">Yemen</span>
</li>
<li class="country" data-country-code="zm">
<div class="flag zm"></div><span class="country-name">Zambia</span>
</li>
<li class="country" data-country-code="zw">
<div class="flag zw"></div><span class="country-name">Zimbabwe</span>
</li>
<li class="country" data-country-code="default">
<div class="flag default"></div><span class="country-name">Country Of Issue</span>
</li>
</ul>
</div>
</div>
<label class="label_1">Trip Details</label>
<input type="text" name="intendedAddress" placeholder="Address in Jamaica (eg. Hotel name or Residential address)" class="textbox_3 ui-autocomplete-input" required="required" id="intendedAddress" autocomplete="off">
<select class="countriesVisited textbox_3 country_visited ng-pristine ng-untouched ng-empty ng-invalid ng-invalid-required select2-hidden-accessible" required="required" name="countriesVisited[]" multiple="" ng-model="countriesVisited"
id="countriesVisitedMulti" tabindex="-1" aria-hidden="true">
<!--Populate on pageload -->
<option class="none">None</option>
<option class="US">United States</option>
<option class="CA">Canada</option>
<option class="JM">Jamaica</option>
<option class="GB">United Kingdom</option>
<option class="AF">Afghanistan</option>
<option class="AX">Aland Islands</option>
<option class="AL">Albania</option>
<option class="DZ">Algeria</option>
<option class="AS">American Samoa</option>
<option class="AD">Andorra</option>
<option class="AO">Angola</option>
<option class="AI">Anguilla</option>
<option class="AQ">Antarctica</option>
<option class="AG">Antigua and Barbuda</option>
<option class="AR">Argentina</option>
<option class="AM">Armenia</option>
<option class="AW">Aruba</option>
<option class="AU">Australia</option>
<option class="AT">Austria</option>
<option class="AZ">Azerbaijan</option>
<option class="BS">Bahamas</option>
<option class="BH">Bahrain</option>
<option class="BD">Bangladesh</option>
<option class="BB">Barbados</option>
<option class="BY">Belarus</option>
<option class="BE">Belgium</option>
<option class="BZ">Belize</option>
<option class="BJ">Benin</option>
<option class="BM">Bermuda</option>
<option class="BT">Bhutan</option>
<option class="BO">Bolivia, Plurinational State of</option>
<option class="BQ">Bonaire, Sint Eustatius and Saba</option>
<option class="BA">Bosnia and Herzegovina</option>
<option class="BW">Botswana</option>
<option class="BV">Bouvet Island</option>
<option class="BR">Brazil</option>
<option class="IO">British Indian Ocean Territory</option>
<option class="BN">Brunei Darussalam</option>
<option class="BG">Bulgaria</option>
<option class="BF">Burkina Faso</option>
<option class="BI">Burundi</option>
<option class="KH">Cambodia</option>
<option class="CM">Cameroon</option>
<option class="CA">Canada</option>
<option class="CV">Cape Verde</option>
<option class="KY">Cayman Islands</option>
<option class="CF">Central African Republic</option>
<option class="TD">Chad</option>
<option class="CL">Chile</option>
<option class="CN">China</option>
<option class="CX">Christmas Island</option>
<option class="CC">Cocos (Keeling) Islands</option>
<option class="CO">Colombia</option>
<option class="KM">Comoros</option>
<option class="CG">Congo</option>
<option class="CD">Congo, the Democratic Republic of the</option>
<option class="CK">Cook Islands</option>
<option class="CR">Costa Rica</option>
<option class="CI">Côte d`Ivoire</option>
<option class="HR">Croatia</option>
<option class="CU">Cuba</option>
<option class="CW">Curaçao</option>
<option class="CY">Cyprus</option>
<option class="CZ">Czech Republic</option>
<option class="DK">Denmark</option>
<option class="DJ">Djibouti</option>
<option class="DM">Dominica</option>
<option class="DO">Dominican Republic</option>
<option class="EC">Ecuador</option>
<option class="EG">Egypt</option>
<option class="SV">El Salvador</option>
<option class="GQ">Equatorial Guinea</option>
<option class="ER">Eritrea</option>
<option class="EE">Estonia</option>
<option class="ET">Ethiopia</option>
<option class="FK">Falkland Islands (Malvinas)</option>
<option class="FO">Faroe Islands</option>
<option class="FJ">Fiji</option>
<option class="FI">Finland</option>
<option class="FR">France</option>
<option class="GF">French Guiana</option>
<option class="PF">French Polynesia</option>
<option class="TF">French Southern Territories</option>
<option class="GA">Gabon</option>
<option class="GM">Gambia</option>
<option class="GE">Georgia</option>
<option class="DE">Germany</option>
<option class="GH">Ghana</option>
<option class="GI">Gibraltar</option>
<option class="GR">Greece</option>
<option class="GL">Greenland</option>
<option class="GD">Grenada</option>
<option class="GP">Guadeloupe</option>
<option class="GU">Guam</option>
<option class="GT">Guatemala</option>
<option class="GG">Guernsey</option>
<option class="GN">Guinea</option>
<option class="GW">Guinea-Bissau</option>
<option class="GY">Guyana</option>
<option class="HT">Haiti</option>
<option class="HM">Heard Island and McDonald Islands</option>
<option class="VA">Holy See (Vatican City State)</option>
<option class="HN">Honduras</option>
<option class="HK">Hong Kong</option>
<option class="HU">Hungary</option>
<option class="IS">Iceland</option>
<option class="IN">India</option>
<option class="ID">Indonesia</option>
<option class="IR">Iran, Islamic Republic of</option>
<option class="IQ">Iraq</option>
<option class="IE">Ireland</option>
<option class="IM">Isle of Man</option>
<option class="IL">Israel</option>
<option class="IT">Italy</option>
<option class="JM">Jamaica</option>
<option class="JP">Japan</option>
<option class="JE">Jersey</option>
<option class="JO">Jordan</option>
<option class="KZ">Kazakhstan</option>
<option class="KE">Kenya</option>
<option class="KI">Kiribati</option>
<option class="KP">Korea, Democratic People's Republic of</option>
<option class="KR">Korea, Republic of</option>
<option class="KW">Kuwait</option>
<option class="KG">Kyrgyzstan</option>
<option class="LA">Lao People's Democratic Republic</option>
<option class="LV">Latvia</option>
<option class="LB">Lebanon</option>
<option class="LS">Lesotho</option>
<option class="LR">Liberia</option>
<option class="LY">Libya</option>
<option class="LI">Liechtenstein</option>
<option class="LT">Lithuania</option>
<option class="LU">Luxembourg</option>
<option class="MO">Macao</option>
<option class="MK">Macedonia, the former Yugoslav Republic of</option>
<option class="MG">Madagascar</option>
<option class="MW">Malawi</option>
<option class="MY">Malaysia</option>
<option class="MV">Maldives</option>
<option class="ML">Mali</option>
<option class="MT">Malta</option>
<option class="MH">Marshall Islands</option>
<option class="MQ">Martinique</option>
<option class="MR">Mauritania</option>
<option class="MU">Mauritius</option>
<option class="YT">Mayotte</option>
<option class="MX">Mexico</option>
<option class="FM">Micronesia, Federated States of</option>
<option class="MD">Moldova, Republic of</option>
<option class="MC">Monaco</option>
<option class="MN">Mongolia</option>
<option class="ME">Montenegro</option>
<option class="MS">Montserrat</option>
<option class="MA">Morocco</option>
<option class="MZ">Mozambique</option>
<option class="MM">Myanmar</option>
<option class="NA">Namibia</option>
<option class="NR">Nauru</option>
<option class="NP">Nepal</option>
<option class="NL">Netherlands</option>
<option class="NC">New Caledonia</option>
<option class="NZ">New Zealand</option>
<option class="NI">Nicaragua</option>
<option class="NE">Niger</option>
<option class="NG">Nigeria</option>
<option class="NU">Niue</option>
<option class="NF">Norfolk Island</option>
<option class="MP">Northern Mariana Islands</option>
<option class="NO">Norway</option>
<option class="OM">Oman</option>
<option class="PK">Pakistan</option>
<option class="PW">Palau</option>
<option class="PS">Palestinian Territory, Occupied</option>
<option class="PA">Panama</option>
<option class="PG">Papua New Guinea</option>
<option class="PY">Paraguay</option>
<option class="PE">Peru</option>
<option class="PH">Philippines</option>
<option class="PN">Pitcairn</option>
<option class="PL">Poland</option>
<option class="PT">Portugal</option>
<option class="PR">Puerto Rico</option>
<option class="QA">Qatar</option>
<option class="RE">Réunion</option>
<option class="RO">Romania</option>
<option class="RU">Russian Federation</option>
<option class="RW">Rwanda</option>
<option class="BL">Saint Barthélemy</option>
<option class="SH">Saint Helena, Ascension and Tristan da Cunha</option>
<option class="KN">Saint Kitts and Nevis</option>
<option class="LC">Saint Lucia</option>
<option class="MF">Saint Martin (French part)</option>
<option class="PM">Saint Pierre and Miquelon</option>
<option class="VC">Saint Vincent and the Grenadines</option>
<option class="WS">Samoa</option>
<option class="SM">San Marino</option>
<option class="ST">Sao Tome and Principe</option>
<option class="SA">Saudi Arabia</option>
<option class="SN">Senegal</option>
<option class="RS">Serbia</option>
<option class="SC">Seychelles</option>
<option class="SL">Sierra Leone</option>
<option class="SG">Singapore</option>
<option class="SX">Sint Maarten (Dutch part)</option>
<option class="SK">Slovakia</option>
<option class="SI">Slovenia</option>
<option class="SB">Solomon Islands</option>
<option class="SO">Somalia</option>
<option class="ZA">South Africa</option>
<option class="GS">South Georgia and the South Sandwich Islands</option>
<option class="SS">South Sudan</option>
<option class="ES">Spain</option>
<option class="LK">Sri Lanka</option>
<option class="SD">Sudan</option>
<option class="SR">Suriname</option>
<option class="SJ">Svalbard and Jan Mayen</option>
<option class="SZ">Swaziland</option>
<option class="SE">Sweden</option>
<option class="CH">Switzerland</option>
<option class="SY">Syrian Arab Republic</option>
<option class="TW">Taiwan, Province of China</option>
<option class="TJ">Tajikistan</option>
<option class="TZ">Tanzania, United Republic of</option>
<option class="TH">Thailand</option>
<option class="TL">Timor-Leste</option>
<option class="TG">Togo</option>
<option class="TK">Tokelau</option>
<option class="TO">Tonga</option>
<option class="TT">Trinidad and Tobago</option>
<option class="TN">Tunisia</option>
<option class="TR">Turkey</option>
<option class="TM">Turkmenistan</option>
<option class="TC">Turks and Caicos Islands</option>
<option class="TV">Tuvalu</option>
<option class="UG">Uganda</option>
<option class="UA">Ukraine</option>
<option class="AE">United Arab Emirates</option>
<option class="GB">United Kingdom</option>
<option class="US">United States</option>
<option class="UM">United States Minor Outlying Islands</option>
<option class="UY">Uruguay</option>
<option class="UZ">Uzbekistan</option>
<option class="VU">Vanuatu</option>
<option class="VE">Venezuela, Bolivarian Republic of</option>
<option class="VN">Viet Nam</option>
<option class="VG">Virgin Islands, British</option>
<option class="VI">Virgin Islands, U.S.</option>
<option class="WF">Wallis and Futuna</option>
<option class="EH">Western Sahara</option>
<option class="YE">Yemen</option>
<option class="ZM">Zambia</option>
<option class="ZW">Zimbabwe</option>
</select><span class="select2 select2-container select2-container--default" dir="ltr" style="width: 96%;"><span class="selection" id="countriesVisited"><span class="select2-selection select2-selection--multiple" role="combobox"
aria-haspopup="true" aria-expanded="false" tabindex="-1">
<ul class="select2-selection__rendered">
<li class="select2-search select2-search--inline"><input class="select2-search__field" type="search" tabindex="0" autocomplete="off" autocorrect="off" autocapitalize="off" spellcheck="false" role="textbox" aria-autocomplete="list"
placeholder="Countries visited in the last 6 weeks" style="width: 928px;"></li>
</ul>
</span></span><span class="dropdown-wrapper" aria-hidden="true"></span></span>
<select class="flightName select_option" required="required" name="flightName" id="flightName">
<!--Populate on pageload -->
<option selected="true" disabled="disabled">Flight Name / Vessel(Ship) Name</option>
<option value="KG">Aerogaviota</option>
<option value="AC">Air Canada</option>
<option value="RV">Air Canada Rouge</option>
<option value="AF">Air France</option>
<option value="TS">Air Transat</option>
<option value="G4">Allegiant Air</option>
<option value="AA">American Airlines</option>
<option value="DM">Arajet Airlines</option>
<option value="XP">Avelo Airlines</option>
<option value="BA">British Airways</option>
<option value="CXE">Caicos Express Airlines</option>
<option value="AU">Canada Jetlines</option>
<option value="BW">Caribbean Airlines</option>
<option value="KX">Cayman Airways</option>
<option value="DE">Condor</option>
<option value="CM">Copa Airlines</option>
<option value="DL">Delta Air Lines</option>
<option value="4Y">Discover Airlines</option>
<option value="WK">Edelweiss Air</option>
<option value="EW">Eurowings</option>
<option value="F8">Flair Airlines</option>
<option value="OJ">Fly Jamaica</option>
<option value="F9">Frontier Airlines</option>
<option value="JY">InterCaribbean Airways</option>
<option value="9W">Jetair Airlines</option>
<option value="B6">JetBlue Airways</option>
<option value="LA">Latam</option>
<option value="LL">Miami Air</option>
<option value="NO">Neos Air</option>
<option value="NW">Northwest Airlines</option>
<option value="NO">Norse Atlantic</option>
<option value="NWS">Norwind Airlines</option>
<option value="OJ">Overland Airways</option>
<option value="OBS">Orbest Airlines</option>
<option value="WN">Southwest Airlines</option>
<option value="NK">Spirit Airlines</option>
<option value="SY">Sun Country Airlines</option>
<option value="WG">Sunwing Airlines</option>
<option value="WQ">Swift Air</option>
<option value="WO">Swoop Airline</option>
<option value="DK">Thomas Cook</option>
<option value="TOM">Thomson Airways</option>
<option value="TUI">TUIFly</option>
<option value="OR">TUIFly Netherlands</option>
<option value="TB">TUIFly Belgium</option>
<option value="UA">United Airlines</option>
<option value="VS">Virgin Atlantic Airways</option>
<option value="WS">WestJet</option>
<option disabled="disabled">-------</option>
<option value="PF">Private Flight</option>
<option disabled="disabled"></option>
<option value="MAR">Marella Discovery</option>
<option value="LUN">Aida Luna</option>
<option value="DIV">Aida Diva</option>
<option value="MEI">Mein Schiff</option>
</select><input type="text" id="flightNo" name="flightNo" placeholder="Flight # (eg. 0090)" maxlength="4" class="textbox_4 txtbox_dual" required="required">
<input type="text" id="portOrigin" name="portOrigin" placeholder="Departure Port eg. Miami" class="textbox_4" required="required">
<input type="text" readonly="readonly" style="background:#fff" id="tripDate" name="tripDate" title="Expected Arrival Date" placeholder="Travel Date (mm/dd/yyyy)" class="textbox_4" required="required">
<label class="label_1">Purpose of visit</label>
<span>
<label class="checkbox_label">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Visiting friends or Relatives"> Visiting Friends / Relatives </label>
</span>
<span>
<label class="checkbox_label">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Vacation"> Vacation </label>
</span>
<span>
<label class="checkbox_label">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Business or Meeting"> Business / Meeting</label>
</span>
<span>
<label class="checkbox_label">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Intransit"> Intransit </label>
</span>
<span>
<label class="checkbox_label">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Resident"> Resident </label>
</span>
<span>
<label class="checkbox_label">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Work"> Work </label>
</span>
<span>
<label class="checkbox_label checkbox_label2">
<input type="checkbox" name="purposeOfVisit" class="checkbox_1 radio" value="Honeymoon or Wedding"> Honeymoon / Wedding</label>
</span>
<span>
<input type="text" name="purposeOfVisit_other" id="purposeOfVisit_other" placeholder="Other (please state)" class="textbox_4 text_box6" maxlength="55">
</span>
<label class="label_1">Length of Stay</label>
<input type="text" id="length_of_stay" name="length_of_stay" title="Length of Stay (in days)" placeholder="Length of Stay (in days)" class="textbox_4 text_box6" required="required">
<label class="label_1 set_label">Number of pieces of luggage</label>
<input type="text" name="accompLuggageNo" id="accompLuggageNo" placeholder="Accompanied (11A)" class="textbox_4 mb_small" required="required" title="checked luggage & hand luggage">
<label class="label_3">checked luggage & hand luggage</label>
<label class="label_1 set_label">Number of packages shipped</label>
<input type="text" name="unAccompLuggageNo" id="unAccompLuggageNo" placeholder="Unaccompanied (11B)" class="textbox_4 mb_small" required="required" title="luggage sent by air or sea freight">
<label class="label_4">personal cargo sent by air or sea (barrel, box, etc.)</label>
</div> <!-- contact_form_detail -->
</div><!--contact_info_form-->
</form>Text Content
IMPORTANT YOU ARE REQUIRED TO COMPLETE THIS FORM AT THE URL BELOW → https://enterjamaica.gov.jm 6 redirecting © PASSPORT IMMIGRATION AND CITIZENSHIP AGENCY (PICA) JAMAICA CUSTOMS AGENCY (JCA). PERSONAL INFORMATION Birth Date (As it appears on your Passport) Day 01020304050607080910111213141516171819202122232425262728293031 Month January February March April May June July August September October November December Year 2024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907 Gender Male Female Family Members with you 0 1 2 3 4 5 FOR COLOR Home Address Passport Details Passport Number (As it appears on your Passport) Country of Issue (As it appears on your Passport) * Country Of Issue * Jamaica * United States * United Kingdom * * Afghanistan * Aland Islands * Albania * Algeria * American Samoa * Andorra * Angola * Anguilla * Antigua and Barbuda * Argentina * Armenia * Aruba * Australia * Austria * Azerbaijan * Bahamas * Bahrain * Bangladesh * Barbados * Belarus * Belgium * Belize * Benin * Bermuda * Bhutan * Bolivia * Bosnia and Herzegovina * Botswana * Brazil * British Indian Ocean Territory * British Virgin Islands * Brunei * Bulgaria * Burkina Faso * Burundi * Cambodia * Cameroon * Canada * Cape Verde * Caribbean Netherlands * Cayman Islands * Central African Republic * Chad * Chile * China * Christmas Island * Cocos (Keeling) Islands * Colombia * Comoros * Congo (DRC) * Congo (Republic) * Cook Islands * Costa Rica * Cote d’Ivoire * Croatia * Cuba * Curaçao * Cyprus * Czech Republic * Denmark * Djibouti * Dominica * Dominican Republic * Ecuador * Egypt * El Salvador * Equatorial Guinea * Eritrea * Estonia * Ethiopia * Falkland Islands * Faroe Islands * Fiji * Finland * France * French Guiana * French Polynesia * Gabon * Gambia * Georgia * Germany * Ghana * Gibraltar * Greece * Greenland * Grenada * Guadeloupe * Guam * Guatemala * Guernsey * Guinea * Guinea-Bissau * Guyana * Haiti * Honduras * Hong Kong * Hungary * Iceland * India * Indonesia * Iran * Iraq * Ireland * Isle of Man * Israel * Italy * Jamaica * Japan * Jersey * Jordan * Kazakhstan * Kenya * Kiribati * Kosovo * Kuwait * Kyrgyzstan * Laos * Latvia * Lebanon * Lesotho * Liberia * Libya * Liechtenstein * Lithuania * Luxembourg * Macau * Macedonia * Madagascar * Malawi * Malaysia * Maldives * Mali * Malta * Marshall Islands * Martinique * Mauritania * Mauritius * Mayotte * Mexico * Micronesia * Moldova * Monaco * Mongolia * Montenegro * Montserrat * Morocco * Mozambique * Myanmar * Namibia * Nauru * Nepal * Netherlands * New Caledonia * New Zealand * Nicaragua * Niger * Nigeria * Niue * Norfolk Island * North Korea * Northern Mariana Islands * Norway * Oman * Pakistan * Palau * Palestine * Panama * Papua New Guinea * Paraguay * Peru * Philippines * Pitcairn Islands * Poland * Portugal * Puerto Rico * Qatar * Réunion * Romania * Russia * Rwanda * Saint Barthélemy * Saint Helena * Saint Kitts and Nevis * Saint Lucia * Saint Martin * Saint Pierre and Miquelon * Saint Vincent and the Grenadines * Samoa * San Marino * São Tomé and Príncipe * Saudi Arabia * Senegal * Serbia * Seychelles * Sierra Leone * Singapore * Sint Maarten * Slovakia * Slovenia * Solomon Islands * Somalia * South Africa * South Georgia & South Sandwich Islands * South Korea * South Sudan * Spain * Sri Lanka * Sudan * Suriname * Svalbard and Jan Mayen * Swaziland * Sweden * Switzerland * Syria * Taiwan * Tajikistan * Tanzania * Thailand * Timor-Leste * Togo * Tokelau * Tonga * Trinidad and Tobago * Tunisia * Turkey * Turkmenistan * Turks and Caicos Islands * Tuvalu * Uganda * Ukraine * United Arab Emirates * United Kingdom * United States * U.S. Minor Outlying Islands * U.S. Virgin Islands * Uruguay * Uzbekistan * Vanuatu * Vatican City * Venezuela * Vietnam * Wallis and Futuna * Western Sahara * Yemen * Zambia * Zimbabwe * Country Of Issue Trip Details NoneUnited StatesCanadaJamaicaUnited KingdomAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic of theCook IslandsCosta RicaCôte d`IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe * Flight Name / Vessel(Ship) NameAerogaviotaAir CanadaAir Canada RougeAir FranceAir TransatAllegiant AirAmerican AirlinesArajet AirlinesAvelo AirlinesBritish AirwaysCaicos Express AirlinesCanada JetlinesCaribbean AirlinesCayman AirwaysCondorCopa AirlinesDelta Air LinesDiscover AirlinesEdelweiss AirEurowingsFlair AirlinesFly JamaicaFrontier AirlinesInterCaribbean AirwaysJetair AirlinesJetBlue AirwaysLatamMiami AirNeos AirNorthwest AirlinesNorse AtlanticNorwind AirlinesOverland AirwaysOrbest AirlinesSouthwest AirlinesSpirit AirlinesSun Country AirlinesSunwing AirlinesSwift AirSwoop AirlineThomas CookThomson AirwaysTUIFlyTUIFly NetherlandsTUIFly BelgiumUnited AirlinesVirgin Atlantic AirwaysWestJet-------Private FlightMarella DiscoveryAida LunaAida DivaMein Schiff Purpose of visit Visiting Friends / Relatives Vacation Business / Meeting Intransit Resident Work Honeymoon / Wedding Length of Stay Number of pieces of luggage checked luggage & hand luggage Number of packages shipped personal cargo sent by air or sea (barrel, box, etc.) The Passport, Immigration and Citizenship Agency (PICA) © 2017. All Rights Reserved. * Disclaimer * About Us * Privacy Policy