give.pif.com.au
Open in
urlscan Pro
54.79.82.206
Public Scan
URL:
https://give.pif.com.au/rebuilding-lives?utm_source=eDM&utm_medium=email&utm_id=eofy22&utm_term=VIC&utm_content=eDM5than...
Submission: On July 17 via manual from AU — Scanned from DE
Submission: On July 17 via manual from AU — Scanned from DE
Form analysis 1 forms found in the DOM
POST https://give.pif.com.au/processdonation
<form action="https://give.pif.com.au/processdonation" method="post" id="DonationForm" class="form-cards form-slick form-horizontal " novalidate="novalidate">
<input type="hidden" name="page_id" id="page_id" value="691">
<input type="hidden" name="mandatory" id="mandatory" value="d_fname,d_lname,d_email{email},d_address_street,d_address_country,d_amount{amount},d_receipt">
<input type="hidden" name="d_amount" id="d_amount" value="105.50">
<input type="hidden" name="d_amount_sel" id="d_amount_sel" value="100">
<input type="hidden" name="d_fee" id="d_fee" value="5.5">
<input type="hidden" name="initial_amount" id="initial_amount" value="100">
<input type="hidden" name="fbuser_id" id="fbuser_id" value="">
<input type="hidden" name="fbuser_pic" id="fbuser_pic" value="">
<input type="hidden" name="donation_frequency" id="donation_frequency" value="">
<input type="hidden" name="CSRFToken" value="a96a1a85238c456f55fe6973771143f6">
<input type="hidden" name="stripe_key" id="stripe_key" value="pk_live_SylDC8zcM7G2cXcyTQaTURMj">
<input type="hidden" name="token" id="token" value="">
<input type="hidden" name="payment_intent_id" id="payment_intent_id">
<input type="hidden" name="card_brand" id="card_brand">
<input type="hidden" name="card_country" id="card_country">
<p id="error" class="text-center" style="display:none">
<b></b>
</p>
<section>
<div class="container">
<div class="steps-nav text-center">
<ul>
<li class="color-primary border-primary" id="amountdetailstab">$</li>
<li id="personaldetailstab"><i class="fa fa-user" aria-hidden="true"></i></li>
<li id="paymentdetailstab"><i class="fa fa-credit-card" aria-hidden="true"></i></li>
</ul>
</div>
</div>
</section>
<div class="height-20"></div>
<div class="donation-steps pb40 slick-initialized slick-slider">
<div class="slick-list draggable">
<div class="slick-track" style="opacity: 1; width: 4800px; transform: translate3d(0px, 0px, 0px);">
<div id="amountdetails" class="section slick-slide slick-current slick-active" data-slick-index="0" aria-hidden="false" style="width: 1600px;">
<div class="container">
<h3 class="text-center">Please select a donation amount</h3>
<div class="height-20"></div>
<div class="donationHandlers oneoffdonationHandlers cards">
<div class="row vertical-align justify-center">
<div class="col-sm-3 col-xs-6 radio-panel">
<div class="radio selected" data-amount="100" role="button" aria-pressed="true" tabindex="0" aria-label="Donate $100" onkeydown="handleBtnKeyDown(event)" style="">
<div class="radio-border">
<div class="radio-image">
<img src="https://dundb1lwe629a.cloudfront.net/3qrxf37kxew48c.png" alt="">
<div class="radio-amount btn btn-primary">
<span>$100</span>
</div>
</div>
<div class="radio-text" style="">
<span class="radio-copy">can provide counselling support</span>
</div>
</div>
</div>
<script>
$(document).ready(function() {
$('#d_amount,#initial_amount,#d_amount_sel').val(100);
calculateDonation();
$('.radio').addClass('notselected');
$('.radio').removeClass('selected');
$('.radio[data-amount="100"]').addClass('selected');
$('.radio[data-amount="100"]').removeClass('notselected');
$('#amountdonating').html($(this).attr('data-amount'));
$('.previewamount').html($(this).attr('data-amount'));
$('.donation-steps').removeClass('visibleout');
$('.donation-steps input').removeAttr('disabled');
});
</script>
</div>
<div class="col-sm-3 col-xs-6 radio-panel">
<div class="radio notselected" data-amount="150" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $150" onkeydown="handleBtnKeyDown(event)" style="height: 319.641px;">
<div class="radio-border">
<div class="radio-image">
<img src="https://dundb1lwe629a.cloudfront.net/2juxtu58e1ke.png" alt="">
<div class="radio-amount btn btn-primary">
<span>$150</span>
</div>
</div>
<div class="radio-text" style="height: 84px;">
<span class="radio-copy">can help with employment skills</span>
</div>
</div>
</div>
</div>
<div class="col-sm-3 col-xs-6 radio-panel">
<div class="radio notselected" data-amount="500" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $500" onkeydown="handleBtnKeyDown(event)" style="height: 319.641px;">
<div class="radio-border">
<div class="radio-image">
<img src="https://dundb1lwe629a.cloudfront.net/2l9o6xxm7aun.png" alt="">
<div class="radio-amount btn btn-primary">
<span>$500</span>
</div>
</div>
<div class="radio-text" style="height: 84px;">
<span class="radio-copy">can furnish a new bedroom</span>
</div>
</div>
</div>
</div>
<div class="col-sm-3 col-xs-6 radio-panel">
<div class="radio notselected" data-amount="1000" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $1000" onkeydown="handleBtnKeyDown(event)" style="height: 319.641px;">
<div class="radio-border">
<div class="radio-image">
<img src="https://dundb1lwe629a.cloudfront.net/9zp8ngnk7z0m.png" alt="">
<div class="radio-amount btn btn-primary">
<span>$1,000</span>
</div>
</div>
<div class="radio-text" style="height: 84px;">
<span class="radio-copy">can provide 3 meals a day for 3 months</span>
</div>
</div>
</div>
</div>
</div><!--row -->
</div><!-- donationHandlers -->
<div class="height-20"></div>
<div class="row pb20">
<div class="col-sm-4"></div>
<div class="col-sm-4 error-absolute">
<div class="input-group col-sm-12 float-center">
<span class="input-group-addon transparent border-radius-left color-primary size-125"> $ </span>
<input type="text" class="form-control bl-none size-1em pt10 pb5 pl0 pr0 height-auto" name="d_amount_free" id="d_amount_free" value=""
onkeypress="$('#d_amount,#initial_amount').val(0);$('#d_amount_sel').val('');$('.radio').removeClass('selected').removeClass('notselected');$(this).parent().find('.input-group-addon').addClass('border-primary bg-primary').removeClass('color-primary transparent');$(this).addClass('bg-primary');this.placeholder = ''"
onkeyup="RemoveJunk(this,'nofloat','');" onblur="freeAmountBlur()" autocomplete="donation-amount" placeholder=" or enter your amount" aria-label=" or enter your amount" tabindex="0">
<script>
function freeAmountBlur() {
if ($('#d_amount_free').val() > 0) {
doFreeAmount();
calculateDonation();
}
$('#d_amount_free').parent().find('.input-group-addon').removeClass('border-primary bg-primary').addClass('color-primary transparent');
$('#d_amount_free').removeClass('bg-primary');
this.placeholder = ' or enter your amount';
}
</script>
</div>
</div>
</div>
<section id="frequencydetails">
<div class="container">
<div class="row">
<div class="col-xs-12">
<div class="text-center">
<button type="button" class="btn btn-primary btn-block btn-xl btn-next" rel="amountdetails" tabindex="0"><span>Donate<span class="donate_amount"></span></span></button>
</div>
</div>
</div>
</div>
</section>
</div>
</div>
<section class="section slick-slide" id="personaldetails" data-slick-index="1" aria-hidden="true" style="width: 1600px;" tabindex="-1">
<div class="container">
<script>
function receiptKeydown(event) {
// Check to see if space or enter were pressed
if (event.key === " " || event.key === "Enter" || event.key === "Spacebar") { // "Spacebar" for IE11 support
// Prevent the default action to stop scrolling when space is pressed
event.preventDefault();
$(event.target).trigger('click');
$('#d_receipt_container .toggle-btn').attr('aria-pressed', 'false');
event.target.setAttribute("aria-pressed", "true");
}
}
</script>
<div class="col-sm-12 pb10" id="d_receipt_container">
<div class="text-center toggle-switch">
<label class="bg-primary border-primary col-xs-6 toggle-btn"
onclick="$('#OrganisationInfo').slideUp(300);$('#mandatory').val($('#mandatory').val().replace(',d_organisation',''));$(this).parent().parent().find('label').removeClass('bg-primary border-primary');$(this).addClass('bg-primary border-primary');$('#gift_aid').parent().parent().visibleIn();"
role="button" aria-pressed="true" tabindex="0" onkeydown="receiptKeydown(event)">
<input type="radio" name="d_receipt" value="personal" checked="checked" tabindex="-1"> Donate as individual </label>
<label class="col-xs-6 toggle-btn"
onclick="$('#OrganisationInfo').slideDown(300);$('#mandatory').val($('#mandatory').val() +',d_organisation');$(this).parent().parent().find('label').removeClass('bg-primary border-primary');$(this).addClass('bg-primary border-primary');$('#gift_aid').attr('checked',false);$('#gift_aid').parent().parent().visibleOut();"
tabindex="0" role="button" aria-pressed="false" onkeydown="handleBtnKeyDown(event)">
<input type="radio" name="d_receipt" value="business" tabindex="-1"> Donate as organisation </label>
</div>
</div>
<div class="clearfix"></div>
<div class="col-sm-6">
<div class="form-group" id="OrganisationInfo" style="display:none;">
<label class="col-sm-12 pt10 pb5" for="d_organisation">Organisation Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_organisation" id="d_organisation" value="" tabindex="-1">
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="col-sm-6 Mandatory">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_fname">First Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_fname" id="d_fname" value="" autocomplete="given-name" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 Mandatory">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_lname">Last Name *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_lname" id="d_lname" value="" autocomplete="family-name" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 Mandatory">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_email">Email Address *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_email" id="d_email" value="" autocomplete="email" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 Mandatory">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Mobile </label>
<div class="col-sm-12">
<div class="row">
<div class="left col-xs-4 pl0 pr0">
<select class="form-control" name="d_phone_mobile_suffix" id="d_phone_mobile_suffix" tabindex="-1">
<option value="+49">+49</option>
<option value="+0">+0</option>
<option value="+1">+1</option>
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<option value="+39">+39</option>
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<option value="+421">+421</option>
<option value="+423">+423</option>
<option value="+43">+43</option>
<option value="+44">+44</option>
<option value="+45">+45</option>
<option value="+46">+46</option>
<option value="+47">+47</option>
<option value="+48">+48</option>
<option value="+49" selected="selected">+49</option>
<option value="+501">+501</option>
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<option value="+504">+504</option>
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<option value="+965">+965</option>
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<option value="+971">+971</option>
<option value="+972">+972</option>
<option value="+973">+973</option>
<option value="+974">+974</option>
<option value="+975">+975</option>
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<option value="+992">+992</option>
<option value="+994">+994</option>
<option value="+995">+995</option>
<option value="+996">+996</option>
<option value="+998">+998</option>
</select>
</div>
<div class="col-sm-8 col-xs-8 pr0">
<input type="text" class="form-control phone-group" name="d_phone_mobile" id="d_phone_mobile" value="" tabindex="-1">
</div>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="col-sm-12 Mandatory">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Postal Address * <a href="javascript:;" class="expand-address pull-right" tabindex="-1"><small>(enter manually)</small></a></label>
<div class="col-md-12">
<input type="text" class="form-control" name="d_address" id="d_address" value="" placeholder="Please enter your street address" autocomplete="noprefill" tabindex="-1">
<div class="loqate-marker position-relative"></div>
</div>
<div class="clear"></div>
<div class="col-sm-12 position-relative">
<div id="kw_postcode_results" class="width-full height-300 position-absolute hidden p20 mt10"></div>
</div>
<div class="clear"></div>
<div class="loqate-container" style="width: 100%; position: absolute; display: none;">
<div class="loqate-item loqate-item-template">
<span class="loqate-icon loqate-icon-marker"></span><span class="loqate-item-query"></span>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="hidden addressdetails address-expand">
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Address Line 1 *</label>
<div class="col-sm-12">
<input class="form-control" type="text" name="d_address_street" id="d_address_street" value="" placeholder="Street address, P.O. box" data-geo="route" data-stripe="address_line1" autocomplete="address-line1" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Address Line 2 </label>
<div class="col-sm-12">
<input class="form-control" type="text" name="d_address_2" id="d_address_2" value="" placeholder="Apartment, suite, unit, building, floor etc" data-stripe="address_line2" autocomplete="address-line2" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_suburb">Town/Suburb *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_address_suburb" id="d_address_suburb" value="" data-geo="locality" data-stripe="address_city" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_pcode">Postcode *</label>
<div class="col-sm-12">
<input type="text" class="form-control" name="d_address_pcode" id="d_address_pcode" value="" data-geo="postal_code" data-stripe="address_zip" autocomplete="postal-code" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_state">State *</label>
<div class="col-sm-12">
<input class="form-control ui-autocomplete-input" type="text" name="d_address_state" id="d_address_state" value="" data-geo="administrative_area_level_1_short" data-stripe="address_state" tabindex="-1" autocomplete="off">
</div>
</div>
</div>
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_country">Country *</label>
<div class="col-sm-12">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="d_address_country" tabindex="-1" title="Germany"><span
class="filter-option pull-left">Germany</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Australia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="1">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Kingdom</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">---------------------</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Afghanistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Albania</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Algeria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="7">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">American Samoa</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Andorra</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Angola</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="10"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Anguilla</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="11">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Antarctica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="12">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Antigua and Barbuda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="13">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Argentina</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="14"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Armenia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="15"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Aruba</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="16">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Australia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="17"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Austria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="18">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Azerbaijan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="19"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bahamas</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="20"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bahrain</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="21">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bangladesh</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="22"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Barbados</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="23"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belarus</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="24"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belgium</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="25"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belize</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="26"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Benin</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="27"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bermuda</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="28"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bhutan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="29"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bolivia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="30">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bosnia and Herzegovina</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="31"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Botswana</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="32">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bouvet Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="33"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Brazil</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="34">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">British Indian Ocean Territory</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="35">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Brunei Darussalam</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="36"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bulgaria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="37">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Burkina Faso</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="38"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Burundi</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="39"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cambodia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="40"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cameroon</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="41"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Canada</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="42">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cape Verde</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="43">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Caribbean Netherlands </span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="44">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cayman Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="45">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Central African Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="46"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Chad</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="47"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Chile</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="48"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">China</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="49">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Christmas Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="50">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cocos (Keeling) Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="51"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Colombia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="52"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Comoros</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="53"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Congo</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="54">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Congo, Democratic Republic of</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="55">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cook Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="56">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Costa Rica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="57">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Côte d'Ivoire</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="58"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Croatia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="59"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cuba</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="60"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Curaçao</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="61"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cyprus</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="62">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Czech Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="63"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Denmark</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="64"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Djibouti</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="65"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Dominica</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="66">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Dominican Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="67"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ecuador</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="68"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Egypt</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="69">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">El Salvador</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="70">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Equatorial Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="71"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Eritrea</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="72"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Estonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="73"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ethiopia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="74">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Falkland Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="75">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Faroe Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="76"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Fiji</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="77"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Finland</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="78"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">France</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="79">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Guiana</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="80">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Polynesia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="81">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Southern Territories</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="82"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gabon</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="83"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gambia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="84"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Georgia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="85" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">Germany</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="86"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ghana</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="87">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gibraltar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="88"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Greece</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="89">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Greenland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="90"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Grenada</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="91">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guadeloupe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="92"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guam</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="93">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guatemala</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="94"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guernsey</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="95"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="96">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guinea-Bissau</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="97"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guyana</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="98"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Haiti</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="99">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Heard and McDonald Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="100">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Honduras</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="101">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Hong Kong</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="102"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Hungary</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="103"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iceland</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="104"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">India</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="105">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Indonesia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="106"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iran</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="107"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iraq</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="108"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ireland</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="109">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Isle of Man</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="110"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Israel</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="111"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Italy</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="112"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jamaica</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="113"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Japan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="114"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jersey</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="115"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jordan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="116">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kazakhstan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="117"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kenya</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="118">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kiribati</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="119"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kuwait</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="120">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kyrgyzstan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="121">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lao People's Democratic Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="122"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Latvia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="123"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lebanon</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="124"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lesotho</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="125"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Liberia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="126"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Libya</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="127">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Liechtenstein</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="128">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lithuania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="129">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Luxembourg</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="130"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Macau</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="131">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Macedonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="132">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Madagascar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="133"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malawi</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="134">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malaysia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="135">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Maldives</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="136"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mali</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="137"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malta</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="138">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Marshall Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="139">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Martinique</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="140">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mauritania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="141">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mauritius</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="142"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mayotte</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="143"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mexico</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="144">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Micronesia, Federated States of</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="145"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Moldova</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="146"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Monaco</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="147">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mongolia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="148">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Montenegro</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="149">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Montserrat</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="150"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Morocco</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="151">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mozambique</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="152"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Myanmar</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="153"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Namibia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="154"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nauru</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="155"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nepal</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="156">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">New Caledonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="157">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">New Zealand</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="158">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nicaragua</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="159"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Niger</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="160"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nigeria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="161"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Niue</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="162">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Norfolk Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="163">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">North Korea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="164">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Northern Mariana Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="165"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Norway</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="166"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Oman</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="167">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Pakistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="168"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Palau</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="169">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Palestine, State of</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="170"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Panama</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="171">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Papua New Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="172">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Paraguay</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="173"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Peru</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="174">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Philippines</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="175">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Pitcairn</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="176"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Poland</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="177">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Portugal</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="178">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Puerto Rico</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="179"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Qatar</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="180"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Réunion</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="181"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Romania</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="182">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Russian Federation</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="183"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Rwanda</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="184">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Barthélemy</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="185">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Helena</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="186">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Kitts and Nevis</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="187">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Lucia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="188">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Vincent and the Grenadines</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="189">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint-Martin (France)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="190"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Samoa</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="191">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">San Marino</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="192">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sao Tome and Principe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="193">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saudi Arabia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="194"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Senegal</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="195"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Serbia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="196">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Seychelles</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="197">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sierra Leone</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="198">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Singapore</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="199">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sint Maarten (Dutch part)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="200">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Slovakia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="201">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Slovenia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="202">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Solomon Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="203"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Somalia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="204">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Africa</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="205">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Georgia and the South Sandwich Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="206">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Korea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="207">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Sudan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="208"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Spain</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="209">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sri Lanka</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="210">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">St. Pierre and Miquelon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="211"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sudan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="212">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Suriname</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="213">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Svalbard and Jan Mayen Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="214">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Swaziland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="215"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sweden</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="216">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Switzerland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="217"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Syria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="218"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Taiwan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="219">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tajikistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="220">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tanzania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="221">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Thailand</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="222">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">The Netherlands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="223">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Timor-Leste</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="224"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Togo</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="225"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tokelau</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="226"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tonga</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="227">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Trinidad and Tobago</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="228"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tunisia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="229"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turkey</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="230">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turkmenistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="231">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turks and Caicos Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="232"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tuvalu</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="233"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uganda</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="234"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ukraine</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="235">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Arab Emirates</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="236">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Kingdom</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="237">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="238">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States Minor Outlying Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="239"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uruguay</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="240">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uzbekistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="241"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vanuatu</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="242"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vatican</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="243">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Venezuela</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="244"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vietnam</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="245">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Virgin Islands (British)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="246">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Virgin Islands (U.S.)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="247">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Wallis and Futuna Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="248">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Western Sahara</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="249"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Yemen</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="250"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Zambia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="251">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Zimbabwe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="252">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Åland Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
</ul>
</div><select name="d_address_country" id="d_address_country" class="form-control selectpicker" data-stripe="address_country" autocomplete="country" tabindex="-98">
<option value="Australia">Australia</option>
<option value="United States">United States</option>
<option value="United Kingdom">United Kingdom</option>
<option value="">---------------------</option>
<option value="Afghanistan">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="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="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="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Caribbean Netherlands ">Caribbean Netherlands </option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, Democratic Republic of">Congo, Democratic Republic of</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="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 Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany" selected="selected">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard and McDonald Islands">Heard and McDonald Islands</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="India">India</option>
<option value="Indonesia">Indonesia</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="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</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="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</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="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</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="North Korea">North Korea</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestine, State of">Palestine, State of</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="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</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="Réunion">Réunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthélemy">Saint Barthélemy</option>
<option value="Saint Helena">Saint Helena</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Saint-Martin (France)">Saint-Martin (France)</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten (Dutch part)">Sint Maarten (Dutch part)</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="South Georgia and the South Sandwich Islands">South Georgia and the South Sandwich Islands</option>
<option value="South Korea">South Korea</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="St. Pierre and Miquelon">St. Pierre and Miquelon</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="The Netherlands">The Netherlands</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican">Vatican</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Vietnam</option>
<option value="Virgin Islands (British)">Virgin Islands (British)</option>
<option value="Virgin Islands (U.S.)">Virgin Islands (U.S.)</option>
<option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
<option value="Åland Islands">Åland Islands</option>
</select>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
</div>
<input type="hidden" name="form_key" value="JJMS6O" tabindex="-1">
<div class="lump-form form-horizontal" id="DIV5">
<div class="row">
<div class="col-md-12 input-pkg">
<div class="form-group">
<label class="col-sm-12" for="input13">pkg </label>
<div class="col-sm-12">
<input class="form-control option_13" name="option[13]" type="text" placeholder="" id="input13" value="" tabindex="-1">
</div>
</div>
</div>
<div class="col-md-12 input-sid">
<div class="form-group">
<label class="col-sm-12" for="input14">sid </label>
<div class="col-sm-12">
<input class="form-control option_14" name="option[14]" type="text" placeholder="" id="input14" value="" tabindex="-1">
</div>
</div>
</div>
<div class="col-md-12 input-utm_source">
<div class="form-group">
<label class="col-sm-12" for="input15">utm_source </label>
<div class="col-sm-12">
<input class="form-control option_15" name="option[15]" type="text" placeholder="" id="input15" value="" tabindex="-1">
</div>
</div>
</div>
<div class="col-md-12 input-appeal_id">
<div class="form-group">
<label class="col-sm-12" for="input16">app </label>
<div class="col-sm-12">
<input class="form-control option_16" name="option[16]" type="text" placeholder="2022 Tax" id="input16" value="" tabindex="-1">
</div>
</div>
</div>
<div class="clear"></div>
</div>
</div>
<div class="height-20"></div>
<div class="row">
<div class="col-xs-12">
<div class="text-center">
<button type="button" class="btn btn-primary btn-block btn-xl btn-next" rel="personaldetails" tabindex="-1"><span>Payment Options</span></button>
<a class="btn-back" tabindex="-1"><span>Back</span></a>
</div>
</div>
</div>
</div>
</section>
<section class="section slick-slide" id="paymentdetails" data-slick-index="2" aria-hidden="true" style="width: 1600px;" tabindex="-1">
<div class="container">
<h3 class="text-center">Payment Details</h3>
<input type="hidden" name="payment_method" value="credit card" tabindex="-1">
<div class="col-sm-6 creditcard ">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="card_name">Name on Card *</label>
<div class="col-sm-12">
<input class="form-control" type="text" name="card_name" id="card_name" value="" data-stripe="name" autocomplete="cc-name" x-autocompletetype="cc-name" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 creditcard ">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="card_number">Card Number *</label>
<div class="col-sm-12">
<input class="form-control" type="text" id="card_number" name="card_number" data-eway-encrypt-name="EWAY_CARDNUMBER" data-braintree-name="number" data-stripe="number" autocomplete="cc-number" x-autocompletetype="cc-number"
tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 creditcard ">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="card_expiry_month">Card Expiry *</label>
<div class="col-sm-5 col-xs-6">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle bs-placeholder form-control" data-toggle="dropdown" role="button" data-id="card_expiry_month" tabindex="-1" title="MM"><span
class="filter-option pull-left">MM</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">MM</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">01</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">02</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">03</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">04</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">05</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">06</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="7"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">07</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">08</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">09</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="10"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">10</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="11"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">11</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="12"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">12</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
</ul>
</div><select class="form-control selectpicker" id="card_expiry_month" name="card_expiry_month" data-braintree-name="expiration_month" data-stripe="exp_month" tabindex="-98">
<option value="">MM</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>
</select>
</div>
</div>
<div class="col-sm-5 col-xs-6">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle bs-placeholder form-control" data-toggle="dropdown" role="button" data-id="card_expiry_year" tabindex="-1" title="YY"><span
class="filter-option pull-left">YY</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">YY</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2022</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2023</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2024</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2025</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2026</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2027</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="7"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2028</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2029</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2030</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="10"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2031</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
</ul>
</div><select class="form-control selectpicker" id="card_expiry_year" name="card_expiry_year" data-braintree-name="expiration_year" data-stripe="exp_year" aria-label="Expiry year (YY)" tabindex="-98">
<option value="">YY</option>
<option value="22">2022</option>
<option value="23">2023</option>
<option value="24">2024</option>
<option value="25">2025</option>
<option value="26">2026</option>
<option value="27">2027</option>
<option value="28">2028</option>
<option value="29">2029</option>
<option value="30">2030</option>
<option value="31">2031</option>
</select>
</div>
</div>
</div>
</div>
<div class="col-sm-6 creditcard ">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="card_cvv">CVV Number *</label>
<div class="col-sm-6 col-xs-8">
<input class="form-control" type="text" size="5" id="card_cvv" name="card_cvv" value="" maxlength="4" data-eway-encrypt-name="EWAY_CARDCVN" data-braintree-name="cvv" data-stripe="cvc" autocomplete="off" tabindex="-1">
</div>
<div class="col-xs-4">
<img src="https://4e14afa0f2e33fe0acb7-65ce87aea9ade6f30f5e307f425e6c8a.ssl.cf5.rackcdn.com/cvv.png" style="width:55px;margin-top:-10px;">
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="col-sm-6">
<div class="form-group">
<label class="col-sm-12 pt10">Donation Amount</label>
<div class="col-sm-4"> $<span id="amountdonating">100</span> <span id="donatingfrequency"></span>
</div>
</div>
</div>
<div class="row">
<div class="col-sm-12">
<input type="checkbox" name="d_optin_fees" id="d_optin_fees" value="Y" checked="checked" aria-label="I'd like to add a little extra to help cover fees." tabindex="-1"> I'd like to add a little extra to help cover fees. <span
id="amountfees">This will add $5.50 to your donation.</span>
</div>
</div>
<div class="height-20"></div>
<div class="text-center row">
<div class="col-xs-12">
<button type="submit" class="btn btn-primary btn-xl btn-block" tabindex="-1"><span>Donate Now</span></button>
<a class="btn-back" tabindex="-1"><span>Back</span></a>
</div>
</div>
</div>
</section>
</div>
</div>
</div>
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</script>
<div class="height-30"></div>
</form>Text Content
* Home * Login Login LAY THE FOUNDATION FOR YOUNG MUMS. HELP US BUILD HOMES FOR HOMELESS MUMS AND KIDS. DONATE NOW AND HELP CHANGE THE LIVES OF TWO GENERATIONS AT ONCE, ONE HOME AT A TIME. * $ * * PLEASE SELECT A DONATION AMOUNT $100 can provide counselling support $150 can help with employment skills $500 can furnish a new bedroom $1,000 can provide 3 meals a day for 3 months $ Donate Donate as individual Donate as organisation Organisation Name * First Name * Last Name * Email Address * Mobile +49 +0 +1 +1242 +1246 +1264 +1268 +1345 +1441 +1473 +1649 +1664 +1670 +1671 +1684 +1758 +1767 +1784 +1787 +1809 +1868 +1869 +1876 +20 +212 +213 +216 +220 +221 +222 +223 +224 +225 +226 +227 +228 +229 +230 +231 +232 +233 +234 +235 +236 +237 +238 +239 +240 +241 +242 +244 +245 +246 +248 +249 +250 +251 +252 +253 +254 +256 +257 +258 +260 +261 +262 +263 +264 +265 +266 +267 +268 +269 +27 +290 +291 +297 +298 +299 +30 +31 +32 +33 +34 +350 +351 +352 +353 +354 +355 +356 +357 +358 +359 +36 +370 +371 +372 +374 +375 +376 +377 +378 +380 +385 +386 +387 +39 +40 +41 +420 +421 +423 +43 +44 +45 +46 +47 +48 +49 +501 +502 +503 +504 +505 +506 +507 +509 +51 +52 +53 +54 +55 +56 +57 +58 +590 +591 +592 +593 +594 +595 +596 +597 +598 +60 +61 +62 +63 +64 +65 +66 +670 +672 +673 +674 +675 +676 +677 +678 +679 +680 +682 +683 +684 +686 +687 +688 +689 +690 +691 +692 +7 +70 +7370 +81 +852 +855 +856 +86 +880 +90 +91 +92 +93 +94 +95 +960 +961 +962 +964 +965 +966 +967 +968 +971 +972 +973 +974 +975 +976 +977 +992 +994 +995 +996 +998 Postal Address * (enter manually) Address Line 1 * Address Line 2 Town/Suburb * Postcode * State * Country * Germany * Australia * United States * United Kingdom * --------------------- * Afghanistan * Albania * Algeria * American Samoa * Andorra * Angola * Anguilla * Antarctica * Antigua and Barbuda * Argentina * Armenia * Aruba * Australia * Austria * Azerbaijan * Bahamas * Bahrain * Bangladesh * Barbados * Belarus * Belgium * Belize * Benin * Bermuda * Bhutan * Bolivia * Bosnia and Herzegovina * Botswana * Bouvet Island * Brazil * British Indian Ocean Territory * Brunei Darussalam * 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This will add $5.50 to your donation. Donate Now Back "WELL-DESIGNED SPACES ARE NOT JUST A MATTER OF TASTE OF A QUESTION OF AESTHETICS," SAYS ARCHITECT, JOHN CARY. "THEY LITERALLY SHAPE OUR IDEAS ABOUT WHO WE ARE IN THE WORLD AND WHAT WE DESERVE." play_circle_filledTHE HAVEN HOUSE QLD STORY “With family and domestic violence, the leading cause of homelessness, Haven House Ruth represents hope and provides just that to the women and youth of Queensland without a safe place to sleep tonight,” Dianne Gipey, NT/QLD FV State Manager Family Violence Stream The Salvation Army Charity Partner play_circle_filledTHE HAVEN HOUSE VIC STORY “We have 2 homes in the pipeline in Victoria, one in Shepparton and one in East Malvern. Both projects are for young women in need, and will provide these young women with a stable, secure home and a second chance at life.” Bettina Sheeran, Partner Maddocks Board of Advisors VIC play_circle_filledTHE HAVEN HOUSE NSW STORY “We are proud to have joined forces with the Foundation on this project in Balgowlah and hope to contribute to providing a sense of security and stability for young mums in need.” Lisa Mort, CEO SMLXL Projects Building Partner DONATE NOW Together we can build the next home for young mums in need With enough funding, the Property Industry Foundation can build homes that create safe and reliable accommodation for young people and give them the chance for a permanent home that ends the cycle of homelessness. PLEASE MAKE A TAX-DEDUCTIBLE DONATION NOW THAT GIVES A YOUNG PERSON WHO NEEDS IT THE SAFETY, SECURITY AND WARMTH. Donate Now *Names have been changed to protect privacy #DONATE RAISING FUNDS FOR HOMELESS YOUTH Find us on Enquiries enquires@pif.com.au Property Industry Foundation 2021 | ABN : 90 167 973 844 | Privacy Policy WITH ENOUGH FUNDING, THE PROPERTY INDUSTRY FOUNDATION CAN BUILD HOMES THAT CREATE SAFE AND RELIABLE ACCOMMODATION FOR YOUNG PEOPLE AND GIVE THEM THE CHANCE FOR A PERMANENT HOME THAT ENDS THE CYCLE OF HOMELESSNESS. #FUNDRAISEFORHOMELESSYOUTH Find us on Enquiries enquires@pif.com.au Property Industry Foundation 2021 | ABN : 90 167 973 844 | Terms and Conditions | Privacy Policy