www.ccia.org.au
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54.206.232.30
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Submitted URL: https://apau.ink/r?p=abthcc5fq2ackzj5oqebazwvk6i2psyqlwm6jyymbinbsfky6owpn4f5w67xs7fbl73onk4t6xjelb2nh543drsx72xi...
Effective URL: https://www.ccia.org.au/event/ccam/donate?apcid=0066710ba5868025653d7408&utm_campaign=news24-ccam24-supporter-me&utm_con...
Submission: On September 03 via manual from NL — Scanned from AU
Effective URL: https://www.ccia.org.au/event/ccam/donate?apcid=0066710ba5868025653d7408&utm_campaign=news24-ccam24-supporter-me&utm_con...
Submission: On September 03 via manual from NL — Scanned from AU
Form analysis 1 forms found in the DOM
POST https://www.ccia.org.au/processeventdonation
<form action="https://www.ccia.org.au/processeventdonation" method="post" id="DonationForm_48998" class="lump-donationform form-cards form-slick form-horizontal form-validation-inline form-label-top" novalidate="novalidate"><input type="hidden"
class="form-control" name="customfield[dollar-handle-selected]" id="dollar-handle-selected" value=""><input type="hidden" class="form-control" name="customfield[tax-calculator-submit-click]" id="tax-calculator-submit-click" value=""><input
type="hidden" class="form-control" name="customfield[tax-calculator-submit-field]" id="tax-calculator-submit-field" value="">
<input type="hidden" name="page_id" id="page_id" value="11203">
<input type="hidden" name="mandatory" id="mandatory" value="d_fname,d_lname,d_email{email},d_amount{amount},d_receipt">
<input type="hidden" name="d_amount" id="d_amount" autocomplete="new-password" value="105.50">
<input type="hidden" name="d_amount_sel" id="d_amount_sel" autocomplete="new-password" value="100">
<input type="hidden" name="d_fee" id="d_fee" autocomplete="new-password" value="5.50">
<input type="hidden" name="initial_amount" id="initial_amount" autocomplete="new-password" value="100">
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<input type="hidden" name="event_id" id="event_id" value="377">
<input type="hidden" name="elements_payment_method" id="elements_payment_method" value="card">
<p id="error" class="text-center error" style="display:none">
<b></b>
</p>
<section class="donation-form-top">
<div class="steps-nav text-center steps-icons">
<ul>
<li class="active" id="amountdetailstab">
<i class="material-icons">attach_money</i>
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<li id="personaldetailstab"><i class="material-icons">person</i></li>
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<div class="donation-form-top-content">
<div class="container">
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<div class="donation-steps slick-initialized slick-slider">
<div class="slick-list draggable" style="height: 683.109px;">
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<div class="handles-container handles-layout-cardshorizontal">
<div class="container" style="padding:0 30px;">
<h3 class="text-center pb10">Please select a donation amount</h3>
</div>
<div class="container">
<div class="copy-text text-center"></div>
</div>
<div class="donationHandlers oneoffdonationHandlers">
<div class="row vertical-align justify-center">
<div class="radio-panel" data-id="10567">
<div class="radio has-image has-text notselected" data-amount="55" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $55" onkeydown="handleBtnKeyDown(event)"
data-image="https://d1on96qv1pxmre.cloudfront.net/3mqr3dtf0veo0.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border" style="height: 473.125px;">
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<div class="radio-content">
<div class="radio-amount has-image has-text"> $55 </div>
<div class="radio-text">
<span class="radio-copy">Your gift will help us analyse the data from a child genome, giving vital insights to clinicians faster, that they can use to guide treatment decisions.</span>
</div>
</div>
</div>
</div>
</div>
<div class="radio-panel" data-id="10568">
<div class="radio has-image has-text selected" data-amount="100" role="button" aria-pressed="true" tabindex="0" aria-label="Donate $100" onkeydown="handleBtnKeyDown(event)"
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<div class="arrow-top border-primary"></div>
<div class="radio-border" style="height: 473.125px;">
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<img src="https://d1on96qv1pxmre.cloudfront.net/2bngbe5dy9cl.png" alt="">
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<div class="radio-content">
<div class="radio-amount has-image has-text"> $100 </div>
<div class="radio-text">
<span class="radio-copy">Will allow us to test a drug on a model of a child's cancer, to see how the cells respond and if the drug has the potential to be used as a treatment.</span>
</div>
</div>
</div>
</div>
<script>
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<div class="radio-panel" data-id="10569">
<div class="radio has-image has-text notselected" data-amount="250" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $250" onkeydown="handleBtnKeyDown(event)"
data-image="https://d1on96qv1pxmre.cloudfront.net/1vkwglqro2ggf.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border" style="height: 473.125px;">
<div class="radio-image">
<img src="https://d1on96qv1pxmre.cloudfront.net/1vkwglqro2ggf.png" alt="">
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<div class="radio-content">
<div class="radio-amount has-image has-text"> $250 </div>
<div class="radio-text">
<span class="radio-copy">Will help us store critical genetic data for 8 children, allowing us to do further research into what may be driving aggressive childhood cancers.</span>
</div>
</div>
</div>
</div>
</div>
</div><!--row -->
</div><!-- donationHandlers -->
<div class="container">
<div class="row pb20 other-amount">
<div class="col-xs-12 col-12 error-absolute">
<div class="input-group float-center">
<span class="input-group-addon border-radius-left white color-primary size-125"> $ </span>
<input type="text" class="form-control bl-none size-1em pl10 pr0 height-auto" autocomplete="new-password" name="d_amount_free" id="d_amount_free" value="" placeholder=" Other Amount" aria-label=" Other Amount" tabindex="0">
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RemoveJunk(this, 'nofloat', '');
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$('#DonationForm_48998 .btn-give').text('Donate $' + $(this).val() + ' ' + $('#DonationForm_48998 #donation_frequency').val());
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</div>
</div>
</div>
<div class="container">
<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 dir="ltr" class="resize-sensor" style="pointer-events: none; position: absolute; inset: 0px; overflow: hidden; z-index: -1; visibility: hidden; max-width: 100%;">
<div class="resize-sensor-expand" style="pointer-events: none; position: absolute; inset: 0px; overflow: hidden; z-index: -1; visibility: hidden; max-width: 100%;">
<div style="position: absolute; left: 0px; top: 0px; transition: all; width: 1180px; height: 693px;"></div>
</div>
<div class="resize-sensor-shrink" style="pointer-events: none; position: absolute; inset: 0px; overflow: hidden; z-index: -1; visibility: hidden; max-width: 100%;">
<div style="position: absolute; left: 0px; top: 0px; transition: all; width: 200%; height: 200%;"></div>
</div>
</div>
</section>
<section class="section slick-slide" id="personaldetails" data-slick-index="1" aria-hidden="true" style="width: 1170px; position: relative; left: -1170px; top: 0px; z-index: 998; opacity: 0;" tabindex="-1">
<div class="container">
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<h3 class="text-center pb10">Your Details</h3>
<div class="row">
<div class="col-xs-12 col-12" id="d_receipt_container">
<div class="form-group">
<div class="col-12 col-xs-12 col-12">
<div class="text-center toggle-switch">
<label class="bg-primary border-primary col-xs-6 col-6 toggle-btn"
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<input type="radio" name="d_receipt" value="business" tabindex="-1"> Organisation </label>
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<div class="clearfix"></div>
<div class="col-xs-12 col-12">
<div class="form-group" id="OrganisationInfo" style="display:none;">
<label class="col-xs-12 col-12 " for="d_organisation">Organisation Name *</label>
<div class="col-xs-12 col-12">
<input type="text" class="form-control" name="d_organisation" id="d_organisation" value="" tabindex="-1">
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</div>
</div>
<div class="clearfix"></div>
<div class="col-xs-12 col-12 col-sm-6">
<div class="form-group">
<label class="col-sm-12" 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" required="" tabindex="-1">
</div>
</div>
</div>
<div class="col-xs-12 col-12 col-sm-6">
<div class="form-group">
<label class="col-sm-12" 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" required="" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-12 col-xs-12 col-12">
<div class="form-group">
<label class="col-sm-12" 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" required="" tabindex="-1">
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</div>
</div>
<div class="clearfix"></div>
<label class="col-sm-12 pt10 pb10">Postal Address <a href="javascript:;" class="expand-address pull-right" tabindex="-1"><small>(enter manually)</small></a></label>
<div class="address-lookup col-sm-12 col-xs-12 col-12">
<div class="form-group ml0 mr0">
<div class="col-sm-12 pl0 pr0 position-relative">
<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="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>
<script>
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$('#d_address').focus(function() {
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$('#d_address').blur(function() {
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$('#postcodelookup').html('<i class="fa fa-spinner"></i>');
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$('#postcodelookup').html('Find');
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</div>
<div class="hidden addressdetails address-expand">
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Address Line 1 </label>
<div class="col-sm-12">
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</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5">Address Line 2 </label>
<div class="col-sm-12">
<input class="form-control g_address_2" 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 col-12 col-xs-12">
<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 g_address_suburb" name="d_address_suburb" id="d_address_suburb" value="" data-geo="locality" data-stripe="address_city" tabindex="-1">
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</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_pcode">Postcode </label>
<div class="col-sm-12">
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</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
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<div class="col-sm-12">
<input class="form-control g_address_state 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" autocomplete="off"
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</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<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 g_address_country"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="d_address_country" tabindex="-1"
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<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0">
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<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>
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</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" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><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">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><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 g_address_country" data-stripe="address_country" autocomplete="country" data-size="8" 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" selected="selected">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">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>
<input type="hidden" name="d_address_dpid" id="d_address_dpid" value="" tabindex="-1">
<script>
$(document).ready(function() {
$('#d_address_state').autocomplete({
source: "/funraisin/getstatesjson/",
minLength: 2,
select: function(event, ui) {
setTimeout(function() {
$("#d_address_state").val(ui.item.state_code);
}, 700);
}
});
});
</script>
<div class="col-12 col-xs-12">
<input type="hidden" name="form_key" value="7HN0L4" tabindex="-1">
<div class="lump-form form-horizontal" id="DIV11">
<div class="row">
<div class="col-md-12 ">
<p><b>Privacy</b><span>: Children’s Cancer Institute manages your personal information in accordance with the Privacy Act 1988 (Cth). We collect, hold and use your personal information to process your donation and issue you with
a tax-deductible receipt. We may also use your personal information for marketing and fundraising purposes and other ancillary uses. If you are under 18 and have provided details of a parent or guardian, we will only use
this information to contact that person to obtain consent to the authority to fundraise.</span><span> For more information, please visit
our </span><a href="/privacy-statement" target="_blank" title="privacy statement page" rel="noopener noreferrer" tabindex="-1">privacy statement page</a><span>.</span></p>
<p><span>You can also opt out, or access or update your personal information, at any time by emailing </span><a href="mailto:%20supportercare@ccia.org.au" class="" tabindex="-1">supportercare@ccia.org.au</a></p>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<div class="row pt10">
<div class="vertical-align width-full buttons-block">
<div class="text-center btn-back-block">
<a class="btn btn-back btn-xl" tabindex="-1"><span class="material-icons">chevron_left</span></a>
</div>
<div class="text-center btn-action-block">
<button type="button" class="btn btn-primary btn-block btn-xl btn-next" rel="personaldetails" tabindex="-1"><span>Payment Options</span></button>
</div>
</div>
</div>
</div>
</section>
<section class="section slick-slide" id="paymentdetails" data-slick-index="2" aria-hidden="true" style="width: 1170px; position: relative; left: -2340px; top: 0px; z-index: 998; opacity: 0;" tabindex="-1">
<div class="container">
<div class="row">
<h3 class="text-center col-xs-12 col-12">Payment Details</h3>
<p id="error" class="text-center error" style="display:none">
<b></b>
</p>
<div class="buttons-block col-xs-12">
<a href="javascript:;" data-rel="paypal" class="btn btn-payment-element btn-pay-paypal fadeout" tabindex="-1"></a>
<a href="javascript:void(0);" data-rel="credit card" class="btn btn-payment-element btn-pay-creditcard" id="elements_credit_card" tabindex="-1"><img src="https://d1p2vuwzdwq826.cloudfront.net/cacd2a43ec8cb767ea934456b7916b4f.svg" alt="Credit Card">Credit Card</a>
</div>
<input type="hidden" name="payment_method" id="payment_method" value="credit card" tabindex="-1">
<script>
$('.btn-payment-element').on('click', function() {
$('#payment_method').val($(this).data('rel'));
$('.btn-payment-element').addClass('fadeout');
$(this).removeClass('fadeout');
if ($(this).data('rel') == 'paypal') {
$('.creditcard,.eft').addClass('hidden');
$('.paypal').removeClass('hidden');
} else if ($(this).data('rel') == 'eft') {
$('.creditcard,.paypal').addClass('hidden');
$('.eft').removeClass('hidden');
} else {
$('.creditcard').removeClass('hidden');
$('.paypal,.eft').addClass('hidden');
}
});
</script>
<div class="height-20"></div>
<div class="col-xs-12 col-12 paypal hidden">
<div class="form-group">
<div class="col-xs-12 col-12 pt20 pb20">
</div>
</div>
</div>
<div class="col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-sm-12" for="card_name"> Name on Card * </label>
<div class="col-sm-12">
<input type="text" class="form-control " name="card_name" id="card_name" value="" required="" data-stripe="name" x-autocompletetype="cc-name" tabindex="-1">
</div>
</div>
</div>
<div class="col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-sm-12" for="card_number"> Card Number * </label>
<div class="col-sm-12">
<input type="text" class="form-control" name="card_number" id="card_number" value="" required="" data-stripe="number" data-eway-encrypt-name="EWAY_CARDNUMBER" data-braintree="number" tabindex="-1">
</div>
</div>
</div>
<div class="clear"></div>
<div class="col-sm-6 col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-xs-12 col-12 " for="card_expiry_month">Card Expiry *</label>
<div class="col-sm-6 col-xs-6 col-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-6 col-xs-6 col-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">2024</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">2025</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">2026</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">2027</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">2028</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">2029</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">2030</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">2031</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">2032</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">2033</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">2034</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="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>
<option value="32">2032</option>
<option value="33">2033</option>
<option value="34">2034</option>
</select>
</div>
</div>
</div>
</div>
<div class="col-sm-6 col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-xs-12 col-12 " for="card_cvv">CVV *</label>
<div class="col-sm-6 col-xs-6 col-6">
<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-sm-6 col-xs-6 col-6">
<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 col-xs-12 col-12 donation-amount-display">
<div class="form-group">
<label class="col-xs-12 col-12 pt10 pb0">Donation Amount</label>
<div class="col-sm-4">
<span id="amountdonating">$100</span> <span id="donatingfrequency"></span>
</div>
</div>
</div>
</div>
<style>
.funraisin-fee-bordered .funraisin-fee-box {
border: 1px solid #00965c;
}
.funraisin-fee-box {
padding: 5px 20px 20px;
border-radius: 5px;
}
.funraisin-fee-box i,
.funraisin-fee-box .hoverlink {
color: #f17330;
}
.optincheckbox:not(.funraisin-fee-bordered) .funraisin-fee-box {
background: #f1733010;
}
</style>
<input type="hidden" name="optin_fees_rate" id="optin_fees_rate" value="5.5" tabindex="-1">
<input type="hidden" name="d_optin_fees" id="d_optin_fees" value="Y" tabindex="-1">
<div class="row optincheckbox funraisin-fee-default funraisin-no-bg">
<div class="col-xs-12 col-12">
<div class="funraisin-fee-box funraisin-no-bg">
<label class="fee-box-header">Cover platform costs <span class="funraisin-fee-heart"><img class="static" src="https://d1gotx1r5o7hbd.cloudfront.net/e27154d713bcc89ca73cade1b4cd8e33.png"></span></label>
<p class="funraisin-fee-text "><i class="only-default fa fa-heart"></i> I'd like to add a little extra to help cover fees </p>
<div>
<div class="btn-group bootstrap-select form-control dropup"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="d_fee_multiple" title="5.5% ($5.50)" tabindex="-1"><span
class="filter-option pull-left"> 5.5% ($5.50)</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="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">4.5% ($4.50)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1">
<a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text"> 5% ($5.00)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2" class="selected">
<a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text"> 5.5% ($5.50)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3">
<a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text"> 6.5% ($6.50)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4">
<a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text"> 7.5% ($7.50)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5">
<a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text"> 8% ($8.00)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="6">
<a tabindex="-1" class="only-default" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Other (or $0)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="7">
<a tabindex="-1" class="only-bordered" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">I don't wish to help cover costs</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
</ul>
</div><select class="form-control selectpicker dropup" name="d_fee_multiple" id="d_fee_multiple" data-dropup-auto="false" autocomplete="off" tabindex="-1">
<option value="4.50" data-percentage="4.5" data-amount="">4.5% ($4.50)</option>
<option value="5.00" data-percentage=" 5" data-amount=""> 5% ($5.00)</option>
<option value="5.50" data-percentage=" 5.5" data-amount="" selected="" data-default="true"> 5.5% ($5.50)</option>
<option value="6.50" data-percentage=" 6.5" data-amount=""> 6.5% ($6.50)</option>
<option value="7.50" data-percentage=" 7.5" data-amount=""> 7.5% ($7.50)</option>
<option value="8.00" data-percentage=" 8" data-amount=""> 8% ($8.00)</option>
<option class="only-default" value="other">Other (or $0)</option>
<option class="only-bordered" value="0">I don't wish to help cover costs</option>
</select>
</div>
</div>
<div class="fee-other hidden">
<p>Your contribution helps cover the costs of fundraising.</p>
<div class="input-group float-center">
<span class="input-group-addon border-radius-left white color-primary size-125"> $ </span>
<input type="number" class="form-control" name="d_fee_other" id="d_fee_other" value="1" min="0" autocomplete="off" tabindex="-1">
</div>
</div>
</div>
</div>
</div>
<script>
var populateFeeDropdown = function(total) {
var amount = total;
var maxamount = parseFloat(amount * (5.5 / 100));
var showpercentage = true;
$("#d_fee_multiple option").each(function() {
if ($(this).attr('value') != 'other' && $(this).attr('value') != '0') {
var percentage = $(this).data('percentage');
var value = (amount * (percentage / 100)).toFixed(2);
if (maxamount > 20 || value > 20) {
value = parseFloat(20 * (percentage / 5.5)).toFixed(2);
showpercentage = false;
if (percentage > 5.5) {
$(this).hide();
value = 20;
} else {
$(this).show();
}
} else {
$(this).show();
}
if (value > 0) {
if (showpercentage) {
$(this).text(percentage + '% (' + '$' + value + ')');
} else {
$(this).text('$' + value);
}
} else {
if (percentage > 0) {
$(this).text(percentage + '%');
} else {
$(this).text('$0');
}
}
$(this).val(value);
}
});
$('select#d_fee_multiple').selectpicker('refresh');
}
$('select#d_fee_multiple').on('change', function() {
if ($(this).val() == 'other') {} else {
$('d_fee').val($(this).find(':selected').data('amount'));
}
calculateDonation_48998();
});
$('#d_fee_other').on('input', function() {
$('#d_fee').val($(this).val());
});
$(document).ready(function() {
$('select#d_fee_multiple').on('change', function() {
if ($(this).val() == 'other') {
$('.fee-other').removeClass('hidden');
} else {
$('.fee-other').addClass('hidden');
if ($(this).val() > 0) {
$('.optout-box').addClass('hidden');
} else {
$('.optout-box').removeClass('hidden');
}
}
});
$('#d_fee_other').on('input', function() {
if ($(this).val() > 0) {
$('.optout-box').addClass('hidden');
} else {
$('.optout-box').removeClass('hidden');
}
});
$('select#d_fee_multiple').on('change', function() {
if ($(this).val() == 0) {
$('#d_optin_fees').val('');
} else {
$('#d_optin_fees').val('Y');
}
});
$('#d_fee_other').on('input', function() {
if ($(this).val() == '') {
$('#d_fee_other').val(0);
}
if ($(this).val() == 0) {
$('#d_optin_fees').val('');
} else {
$('#d_optin_fees').val('Y');
}
if ($(this).val() > 20) {
$(this).val('20');
}
calculateDonation_48998();
});
$(".hoverlink").tooltip();
$('select#d_fee_multiple').on('change', function() {
$('#optin_fees_rate').val($('select#d_fee_multiple :selected').data('percentage'));
});
});
</script>
<div class="height-20"></div>
<div class="text-center row">
<div class="vertical-align width-full buttons-block">
<div class="text-center btn-action-block">
<button type="submit" class="btn btn-primary btn-block btn-donate-display btn-xl" tabindex="-1"><span>Donate Now</span></button>
</div>
</div>
</div>
</div>
</section>
</div>
</div>
</div>
<script>
$(document).ready(function() {
$('#DonationForm_48998 .handles-layout-cardshorizontal .radio-border').matchHeight();
// $('#DonationForm_48998 .radio').matchHeight();
});
function toggleBtn(ele) {
$('#DonationForm_48998 .radio').attr('aria-pressed', 'false');
ele.setAttribute("aria-pressed", "true");
$(ele).trigger('click');
}
function handleBtnKeyDown(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();
toggleBtn(event.target);
}
}
$(document).on('focus', '.radio', function() {
$('#DonationForm_48998 .radio').addClass('nothover');
$(this).removeClass('nothover');
$(this).addClass('hover');
return false;
});
$('#DonationForm_48998 .radio').hover(function() {
$('#DonationForm_48998 .radio').addClass('nothover');
$(this).removeClass('nothover');
$(this).addClass('hover');
return false;
}, function() {
$('#DonationForm_48998 .radio').removeClass('nothover');
$(this).removeClass('hover');
});
$('#DonationForm_48998 .radio').click(function() {
$('#DonationForm_48998 #d_amount_free').val('');
$('#DonationForm_48998 #d_amount,#initial_amount').val($(this).attr('data-amount'));
$('#DonationForm_48998 #d_amount_sel').val($(this).attr('data-amount'));
$('#DonationForm_48998 .radio').addClass('notselected');
$('#DonationForm_48998 .radio').removeClass('selected');
$(this).removeClass('notselected');
$(this).addClass('selected');
calculateDonation_48998();
//$('#DonationForm_48998 .donate_amount').html(' $' + $(this).attr('data-amount'));
// $('#DonationForm_48998 button[rel="amountdetails"]').addClass('btn-pulse');
// setTimeout(function(){$('#DonationForm_48998 button[rel="amountdetails"]').removeClass('btn-pulse')},1000);
return false;
});
</script>
<script>
$('#DonationForm_48998 #d_lname').on('blur', function() {
if ($('#DonationForm_48998 #d_display_name').val() == '') {
if (document.getElementById("d_lname_prefix") && $('#DonationForm_48998 #d_lname_prefix').val() != '') {
$('#DonationForm_48998 #d_display_name').val($('#DonationForm_48998 #d_fname').val() + ' ' + $('#DonationForm_48998 #d_lname_prefix').val() + ' ' + $('#DonationForm_48998 #d_lname').val()).trigger('change');
} else {
$('#DonationForm_48998 #d_display_name').val($('#DonationForm_48998 #d_fname').val() + ' ' + $('#DonationForm_48998 #d_lname').val()).trigger('change');
}
}
});
$('#DonationForm_48998 #d_display_name').on('change', function() {
$('#DonationForm_48998 .display-name').text($(this).val());
});
$('#DonationForm_48998 #d_comments').on('change', function() {
$('#DonationForm_48998 .comments-block').text($(this).val());
});
$(document).ready(function() {
$("#DonationForm_48998 #d_phone_mobile").mask("9999999999");
});
function donationDetails_48998(missingFields) {
if ($("#DonationForm_48998 #d_fname").val() == '') {
missingFields.isMissing = true;
$("#DonationForm_48998 #d_fname").valid();
}
if ($("#DonationForm_48998 #d_lname").val() == '') {
missingFields.isMissing = true;
$("#DonationForm_48998 #d_lname").valid();
}
if ($("#DonationForm_48998 #d_email").val() == '' || !validEmail($("#DonationForm_48998 #d_email").val())) {
missingFields.isMissing = true;
$("#DonationForm_48998 #d_email").valid();
}
if ($("#DonationForm_48998 #d_organisation").val() == '' && $('#DonationForm_48998 input[name=d_receipt]:checked').val() == 'business') {
missingFields.isMissing = true;
$("#DonationForm_48998 #d_organisation").valid();
}
}
function inMemoryDetailsToolTip_48998() {
if ($("#DonationForm_48998 #in_memory_fname").val() == '') {
$("#DonationForm_48998 #in_memory_fname").valid();
}
if ($("#DonationForm_48998 #in_memory_lname").val() == '') {
$("#DonationForm_48998 #in_memory_lname").valid();
}
if ($("#DonationForm_48998 input[name='in_memory_card']").is(':checked')) {
if ($("#DonationForm_48998 #in_memory_address1").val() == '') {
$("#DonationForm_48998 #in_memory_address1").valid();
}
}
}
function inMemoryDetails_48998(missingFields) {
$('#DonationForm_48998 #in_memory_fname,#DonationForm_48998 #in_memory_lname,#DonationForm_48998 #in_memory_address1').parent().parent().removeClass('invalid');
if ($("#DonationForm_48998 #in_memory_fname").val() == '') {
missingFields.isMissing = true;
}
if ($("#DonationForm_48998 #in_memory_lname").val() == '') {
missingFields.isMissing = true;
}
if ($("#DonationForm_48998 input[name='in_memory_card']").is(':checked')) {
if ($("#DonationForm_48998 #in_memory_address1").val() == '') {
missingFields.isMissing = true;
}
}
}
$(document).ready(function() {
new ResizeSensor($('#DonationForm_48998 #amountdetails'), function() {
$('#DonationForm_48998 .slick-list').height($('#DonationForm_48998 .slick-active').height());
});
$('#DonationForm_48998 .donation-steps').slick({
arrows: false,
dots: false,
infinite: false,
swipe: false,
rows: 0,
adaptiveHeight: true,
fade: true,
cssEase: 'linear',
centerMode: false,
});
});
$('#DonationForm_48998').on('keypress', function(e) {
var keyCode = e.keyCode || e.which;
if (keyCode === 13) {
e.preventDefault();
var missingFields = {
isMissing: false
};
var currentSlide = $("#DonationForm_48998 .donation-steps").slick("slickCurrentSlide");
var $slides = $("#DonationForm_48998 .donation-steps").slick("getSlick").$slides;
var currentpanel = $slides.eq(currentSlide).get(0).id;
if (currentpanel == '') {
currentpanel = $('#DonationForm_48998 .slick-slide[data-slick-index=' + currentSlide + ']').find('.section').attr('id');
}
if (currentpanel == 'amountdetails') {
if (($('#DonationForm_48998 #d_amount').val() == "" || $('#DonationForm_48998 #d_amount').val() < 1) && ($('#DonationForm_48998 #d_amount_free').val() == "" || $('#DonationForm_48998 #d_amount_free').val() < 1)) {
BootstrapDialog.show({
title: 'Oops!',
message: 'Please choose or enter a donation amount greater than $1',
});
missingFields.isMissing = true;
}
} else if (currentpanel == 'personaldetails') {
donationDetails_48998(missingFields);
} else if (currentpanel == 'inmemorydetails') {
inMemoryDetails_48998(missingFields);
if (missingFields.isMissing) {
inMemoryDetailsToolTip_48998();
}
}
if (!missingFields.isMissing) {
$("#DonationForm_48998 .donation-steps").slick('slickNext');
new ResizeSensor($('#DonationForm_48998 #personaldetails'), function() {
$('#DonationForm_48998 .slick-list').height($('#DonationForm_48998 .slick-active').height());
});
} else {
if ($("#DonationForm_48998 .form-control.invalid").length > 0) {
$('html, body').animate({
scrollTop: $("#DonationForm_48998 .form-control.invalid").first().offset().top - 80
}, 500);
}
}
return false;
}
});
$('#DonationForm_48998 .btn-next').on('click', function() {
var missingFields = {
isMissing: false
};
var currentSlide = $("#DonationForm_48998 .donation-steps").slick("slickCurrentSlide");
var $slides = $("#DonationForm_48998 .donation-steps").slick("getSlick").$slides;
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</form>Text Content
* Home * * Login Login A LIFE SHOULD BE LONG. This International Childhood Cancer Awareness Month, donate today and help us cure every child of cancer. Donate Watch the film EVERY CHILD SHOULD GET THE CHANCE TO GROW UP AND GROW OLD. TO PLAN EXCITING FUTURES, CHASE THEIR DREAMS, AND LIVE A LIFE THAT IS FULL OF POSSIBILITIES. BUT CANCER CUTS LIFE SHORT FOR HUNDREDS OF CHILDREN EVERY YEAR. IN AUSTRALIA ALONE, EVERY WEEK, THREE YOUNG LIVES WILL BE LOST TO THE DISEASE. FOR 40 YEARS, CHILDREN’S CANCER INSTITUTE HAS BEEN CONDUCTING RESEARCH INTO THE CAUSES, PREVENTION AND CURE OF CHILDHOOD CANCER. WE’VE MADE GREAT PROGRESS, BUT WE WON’T STOP UNTIL EVERY CHILD CAN LIVE A LONG, HAPPY AND HEALTHY LIFE. THIS CHILDHOOD CANCER AWARENESS MONTH SUPPORT THE RESEARCH THAT WILL ONE DAY CURE EVERY CHILD OF CANCER. A LIFE SHOULD BE LONG. * attach_money * person * credit_card PLEASE SELECT A DONATION AMOUNT $55 Your gift will help us analyse the data from a child genome, giving vital insights to clinicians faster, that they can use to guide treatment decisions. $100 Will allow us to test a drug on a model of a child's cancer, to see how the cells respond and if the drug has the potential to be used as a treatment. $250 Will help us store critical genetic data for 8 children, allowing us to do further research into what may be driving aggressive childhood cancers. $ Donate YOUR DETAILS Individual Organisation Organisation Name * First Name * Last Name * Email Address * Postal Address (enter manually) Address Line 1 Address Line 2 Town/Suburb Postcode State Country Australia * Australia * United States * United Kingdom * --------------------- * Afghanistan * Albania * Algeria * American Samoa * Andorra * Angola * Anguilla * Antarctica * Antigua and Barbuda * Argentina * Armenia * Aruba * Australia * 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Virgin Islands (British) * Virgin Islands (U.S.) * Wallis and Futuna Islands * Western Sahara * Yemen * Zambia * Zimbabwe * Åland Islands 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 Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Caribbean Netherlands Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democratic Republic of Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Saint-Martin (France) Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe Åland Islands Privacy: Children’s Cancer Institute manages your personal information in accordance with the Privacy Act 1988 (Cth). We collect, hold and use your personal information to process your donation and issue you with a tax-deductible receipt. We may also use your personal information for marketing and fundraising purposes and other ancillary uses. If you are under 18 and have provided details of a parent or guardian, we will only use this information to contact that person to obtain consent to the authority to fundraise. For more information, please visit our privacy statement page. You can also opt out, or access or update your personal information, at any time by emailing supportercare@ccia.org.au chevron_left Payment Options PAYMENT DETAILS Credit Card Name on Card * Card Number * Card Expiry * MM * MM * 01 * 02 * 03 * 04 * 05 * 06 * 07 * 08 * 09 * 10 * 11 * 12 MM 01 02 03 04 05 06 07 08 09 10 11 12 YY * YY * 2024 * 2025 * 2026 * 2027 * 2028 * 2029 * 2030 * 2031 * 2032 * 2033 * 2034 YY 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 CVV * Donation Amount $100 Cover platform costs I'd like to add a little extra to help cover fees 5.5% ($5.50) * 4.5% ($4.50) * 5% ($5.00) * 5.5% ($5.50) * 6.5% ($6.50) * 7.5% ($7.50) * 8% ($8.00) * Other (or $0) * I don't wish to help cover costs 4.5% ($4.50) 5% ($5.00) 5.5% ($5.50) 6.5% ($6.50) 7.5% ($7.50) 8% ($8.00) Other (or $0) I don't wish to help cover costs Your contribution helps cover the costs of fundraising. $ Donate Now Lola was a happy baby who fitted right in as the third of three kids. But before she reached her first birthday, she was diagnosed with a rare and aggressive brain cancer called ETMR. Despite intensive chemotherapy, treatment options were very limited and ultimately ineffective. Lola passed away peacefully in her home. She was four months shy of her second birthday. If you share the belief that a life should be long, join us this September for Childhood Cancer Awareness Month, to support the research that will one day cure every child of cancer. Donate today “WE WANT TO CURE CANCER. WE WANT TO BE A PART OF THAT. WE CAN’T SAVE LOLA, BUT WE JUST WANT TO BE ABLE TO HELP IN SOME WAY, IN HER MEMORY.” - NAOMI, LOLA'S MUM WHERE YOUR DONATION GOES. 84% Research & scientific activities to help cure childhood cancer. Last year, 84 cents of every dollar spent within the Institute was spent directly on dedicated research to help cure childhood cancer. 10% Fundraising activities to generate donations and increase funding. 6% Core support services and infrastructure cost, vital to keep the Institute running. Donate SHARE WITH YOUR NETWORKS * * Dennis just donated $263.75 * Ray just donated $108 * Brett just donated $500 * JORGE just donated $58.02 * Shalenjana just donated $105 * Brian just donated $105.50 * Dieter just donated $263.75 * Eddie just donated $101 * Sarita just donated $210 * Sinisa just donated $105.50 * Prabhu just donated $264.80 * Yen Ching just donated $50 * Fiona just donated $58.02 * Joseph just donated $58.02 * Amy just donated $5.28 * Michael just donated $58.02 * Lounarda just donated $263.75 * Shae just donated $58.02 * Janine just donated $105.50 * Vikas just donated $21.10 * A BIG THANK YOU TO EVERYONE WHO HAS DONATED THIS CHILDHOOD CANCER AWARENESS MONTH DENNIS ALGIE 1h ago $264 RAY DAVIS 1h ago $108 BRETT WOODS 1h ago $500 JORGE PAUTASSO 2h ago $58 SHALENJANA SINGH 2h ago $105 BRIAN RULE 2h ago $106 DIETER SIEWERT 2h ago $264 EDDIE DOUEIHI 2h ago $101 SARITA VENKATAYA 4h ago $210 SINISA VUJICA 4h ago $106 Show More ABOUT * Children's Cancer Institute * Childhood Cancer ABOUT CHILDHOOD CANCER * Link OUR IMPACT * Children's stories GET INVOLVED * Ways to donate * Events * Fundraise * Partnerships * Careers & study * Volunteering SIGNATURE EVENTS * CEO Dare to Cure * 86k for a Cure * Build for a Cure * Diamond Ball * Townsville to Cairns Bike Ride NEWS * News * Zero Childhood Cancer * Volunteer * Contact us Acknowledgement of Country Children’s Cancer Institute would like to acknowledge the Gadigal and Bidigal people as the Traditional Custodians of the unceded land we work on. We pay our respects to the Elders, past, present and emerging; and recognise their cultural and spiritual relationships with the land, water and sea. It is our privilege to learn from their rich contributions to society and science as we work toward finding a cure for all children with cancer. Terms and conditions Resources News Contact Acknowledgement of Country Children’s Cancer Institute would like to acknowledge the Gadigal and Bidigal people as the Traditional Custodians of the unceded land we work on. We pay our respects to the Elders, past, present and emerging; and recognise their cultural and spiritual relationships with the land, water and sea. It is our privilege to learn from their rich contributions to society and science as we work toward finding a cure for all children with cancer. Event details Auction Partnership Contact Acknowledgement of Country Children’s Cancer Institute would like to acknowledge the Gadigal and Bidigal people as the Traditional Custodians of the unceded land we work on. We pay our respects to the Elders, past, present and emerging; and recognise their cultural and spiritual relationships with the land, water and sea. It is our privilege to learn from their rich contributions to society and science as we work toward finding a cure for all children with cancer. About Partners News & Update Contact us Acknowledgement of Country Children’s Cancer Institute would like to acknowledge the Gadigal and Bidigal people as the Traditional Custodians of the unceded land we work on. We pay our respects to the Elders, past, present and emerging; and recognise their cultural and spiritual relationships with the land, water and sea. It is our privilege to learn from their rich contributions to society and science as we work toward finding a cure for all children with cancer. Terms and Conditions Resources Leaderboards Privacy Policy Acknowledgement of Country Children’s Cancer Institute would like to acknowledge the Gadigal and Bidigal people as the Traditional Custodians of the unceded land we work on. We pay our respects to the Elders, past, present and emerging; and recognise their cultural and spiritual relationships with the land, water and sea. It is our privilege to learn from their rich contributions to society and science as we work toward finding a cure for all children with cancer. Phone: 1800 685 686 or +61 2 7209 6700 Address: Level 5, C25 Lowy Cancer Research Centre, Gate 9 High St, UNSW Sydney NSW 2052 © COPYRIGHT CHILDREN'S CANCER INSTITUTE, ABN 41 072 279 559 | PRIVACY STATEMENT | SITEMAP Phone: 1800 685 686Address: Level 5, C25 Lowy Cancer Research Centre, Gate 9 High St, UNSW Sydney NSW 2052 © COPYRIGHT CHILDREN'S CANCER INSTITUTE, ABN 41 072 279 559 | PRIVACY STATEMENT | SITEMAP