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<br />Country/State/Province<select name=”country”><optgroup label=”Canada – Province”><option value=”AB”>Alberta</option><option value=”BC”>British Columbia</option><option value=”MB”>Manitoba</option><option value=”NB”>New Brunswick</option><option value=”NL”>Newfoundland and Labrador</option><option value=”NS”>Nova Scotia</option><option value=”NT”>Northwest Territories</option><option value=”NU”>Nunavut</option><option value=”ON”>Ontario</option><option value=”PE”>Prince Edward Island</option><option value=”QC”>Quebec</option><option value=”SK”>Saskatchewan</option><option value=”YT”>Yukon</option></optgroup><optgroup label=”United States – State”><option value=”AL”>Alabama</option><option value=”AK”>Alaska</option><option value=”AZ”>Arizona</option><option value=”AR”>Arkansas</option><option value=”CA”>California</option><option value=”CO”>Colorado</option><option value=”CT”>Connecticut</option><option value=”DE”>Delaware</option><option value=”DC”>District Of Columbia</option><option value=”FL”>Florida</option><option value=”GA”>Georgia</option><option value=”HI”>Hawaii</option><option value=”ID”>Idaho</option><option value=”IL”>Illinois</option><option value=”IN”>Indiana</option><option value=”IA”>Iowa</option><option value=”KS”>Kansas</option><option value=”KY”>Kentucky</option><option value=”LA”>Louisiana</option><option value=”ME”>Maine</option><option value=”MD”>Maryland</option><option value=”MA”>Massachusetts</option><option value=”MI”>Michigan</option><option value=”MN”>Minnesota</option><option value=”MS”>Mississippi</option><option value=”MO”>Missouri</option><option value=”MT”>Montana</option><option value=”NE”>Nebraska</option><option value=”NV”>Nevada</option><option value=”NH”>New Hampshire</option><option value=”NJ”>New Jersey</option><option value=”NM”>New Mexico</option><option value=”NY”>New York</option><option value=”NC”>North Carolina</option><option value=”ND”>North Dakota</option><option value=”OH”>Ohio</option><option value=”OK”>Oklahoma</option><option value=”OR”>Oregon</option><option value=”PA”>Pennsylvania</option><option value=”RI”>Rhode Island</option><option value=”SC”>South Carolina</option><option value=”SD”>South Dakota</option><option value=”TN”>Tennessee</option><option value=”TX”>Texas</option><option value=”UT”>Utah</option><option value=”VT”>Vermont</option><option value=”VA”>Virginia</option><option value=”WA”>Washington</option><option value=”WV”>West Virginia</option><option value=”WI”>Wisconsin</option><option value=”WY”>Wyoming</option></optgroup><optgroup label=”World”><option value=”Afganistan”>Afghanistan</option><option value=”Albania”>Albania</option><option value=”Algeria”>Algeria</option><option value=”American Samoa”>American Samoa</option><option value=”Andorra”>Andorra</option><option value=”Angola”>Angola</option><option value=”Anguilla”>Anguilla</option><option value=”Antigua & Barbuda”>Antigua & Barbuda</option><option value=”Argentina”>Argentina</option><option value=”Armenia”>Armenia</option><option value=”Aruba”>Aruba</option><option value=”Australia”>Australia</option><option value=”Austria”>Austria</option><option value=”Azerbaijan”>Azerbaijan</option><option value=”Bahamas”>Bahamas</option><option value=”Bahrain”>Bahrain</option><option value=”Bangladesh”>Bangladesh</option><option value=”Barbados”>Barbados</option><option value=”Belarus”>Belarus</option><option value=”Belgium”>Belgium</option><option value=”Belize”>Belize</option><option value=”Benin”>Benin</option><option value=”Bermuda”>Bermuda</option><option value=”Bhutan”>Bhutan</option><option value=”Bolivia”>Bolivia</option><option value=”Bonaire”>Bonaire</option><option value=”Bosnia & Herzegovina”>Bosnia & Herzegovina</option><option value=”Botswana”>Botswana</option><option value=”Brazil”>Brazil</option><option value=”British Indian Ocean Ter”>British Indian Ocean Ter</option><option value=”Brunei”>Brunei</option><option value=”Bulgaria”>Bulgaria</option><option value=”Burkina Faso”>Burkina Faso</option><option value=”Burundi”>Burundi</option><option value=”Cambodia”>Cambodia</option><option value=”Cameroon”>Cameroon</option><option value=”Canada”>Canada</option><option value=”Canary Islands”>Canary Islands</option><option value=”Cape Verde”>Cape Verde</option><option value=”Cayman Islands”>Cayman Islands</option><option value=”Central African Republic”>Central African Republic</option><option value=”Chad”>Chad</option><option value=”Channel Islands”>Channel Islands</option><option value=”Chile”>Chile</option><option value=”China”>China</option><option value=”Christmas Island”>Christmas Island</option><option value=”Cocos Island”>Cocos Island</option><option value=”Colombia”>Colombia</option><option value=”Comoros”>Comoros</option><option value=”Congo”>Congo</option><option value=”Cook Islands”>Cook Islands</option><option value=”Costa Rica”>Costa Rica</option><option value=”Cote DIvoire”>Cote D’Ivoire</option><option value=”Croatia”>Croatia</option><option value=”Cuba”>Cuba</option><option value=”Curaco”>Curacao</option><option value=”Cyprus”>Cyprus</option><option value=”Czech Republic”>Czech Republic</option><option value=”Denmark”>Denmark</option><option value=”Djibouti”>Djibouti</option><option value=”Dominica”>Dominica</option><option value=”Dominican Republic”>Dominican Republic</option><option value=”East Timor”>East Timor</option><option value=”Ecuador”>Ecuador</option><option value=”Egypt”>Egypt</option><option value=”El Salvador”>El Salvador</option><option value=”Equatorial Guinea”>Equatorial Guinea</option><option value=”Eritrea”>Eritrea</option><option value=”Estonia”>Estonia</option><option value=”Ethiopia”>Ethiopia</option><option value=”Falkland Islands”>Falkland Islands</option><option value=”Faroe Islands”>Faroe Islands</option><option value=”Fiji”>Fiji</option><option value=”Finland”>Finland</option><option value=”France”>France</option><option value=”French Guiana”>French Guiana</option><option value=”French Polynesia”>French Polynesia</option><option value=”French Southern Ter”>French Southern Ter</option><option value=”Gabon”>Gabon</option><option value=”Gambia”>Gambia</option><option value=”Georgia”>Georgia</option><option value=”Germany”>Germany</option><option value=”Ghana”>Ghana</option><option value=”Gibraltar”>Gibraltar</option><option value=”Great Britain”>Great Britain</option><option value=”Greece”>Greece</option><option value=”Greenland”>Greenland</option><option value=”Grenada”>Grenada</option><option value=”Guadeloupe”>Guadeloupe</option><option value=”Guam”>Guam</option><option value=”Guatemala”>Guatemala</option><option value=”Guinea”>Guinea</option><option value=”Guyana”>Guyana</option><option value=”Haiti”>Haiti</option><option value=”Hawaii”>Hawaii</option><option value=”Honduras”>Honduras</option><option value=”Hong Kong”>Hong Kong</option><option value=”Hungary”>Hungary</option><option value=”Iceland”>Iceland</option><option value=”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=”Jordan”>Jordan</option><option value=”Kazakhstan”>Kazakhstan</option><option value=”Kenya”>Kenya</option><option value=”Kiribati”>Kiribati</option><option value=”Korea North”>Korea North</option><option value=”Korea Sout”>Korea South</option><option value=”Kuwait”>Kuwait</option><option value=”Kyrgyzstan”>Kyrgyzstan</option><option value=”Laos”>Laos</option><option value=”Latvia”>Latvia</option><option value=”Lebanon”>Lebanon</option><option value=”Lesotho”>Lesotho</option><option value=”Liberia”>Liberia</option><option value=”Libya”>Libya</option><option value=”Liechtenstein”>Liechtenstein</option><option value=”Lithuania”>Lithuania</option><option value=”Luxembourg”>Luxembourg</option><option value=”Macau”>Macau</option><option value=”Macedonia”>Macedonia</option><option value=”Madagascar”>Madagascar</option><option value=”Malaysia”>Malaysia</option><option value=”Malawi”>Malawi</option><option value=”Maldives”>Maldives</option><option value=”Mali”>Mali</option><option value=”Malta”>Malta</option><option value=”Marshall Islands”>Marshall Islands</option><option value=”Martinique”>Martinique</option><option value=”Mauritania”>Mauritania</option><option value=”Mauritius”>Mauritius</option><option value=”Mayotte”>Mayotte</option><option value=”Mexico”>Mexico</option><option value=”Midway Islands”>Midway Islands</option><option value=”Moldova”>Moldova</option><option value=”Monaco”>Monaco</option><option value=”Mongolia”>Mongolia</option><option value=”Montserrat”>Montserrat</option><option value=”Morocco”>Morocco</option><option value=”Mozambique”>Mozambique</option><option value=”Myanmar”>Myanmar</option><option value=”Nambia”>Nambia</option><option value=”Nauru”>Nauru</option><option value=”Nepal”>Nepal</option><option value=”Netherland Antilles”>Netherland Antilles</option><option value=”Netherlands”>Netherlands (Holland, Europe)</option><option value=”Nevis”>Nevis</option><option value=”New Caledonia”>New Caledonia</option><option value=”New Zealand”>New Zealand</option><option value=”Nicaragua”>Nicaragua</option><option value=”Niger”>Niger</option><option value=”Nigeria”>Nigeria</option><option value=”Niue”>Niue</option><option value=”Norfolk Island”>Norfolk Island</option><option value=”Norway”>Norway</option><option value=”Oman”>Oman</option><option value=”Pakistan”>Pakistan</option><option value=”Palau Island”>Palau Island</option><option value=”Palestine”>Palestine</option><option value=”Panama”>Panama</option><option value=”Papua New Guinea”>Papua New Guinea</option><option value=”Paraguay”>Paraguay</option><option value=”Peru”>Peru</option><option value=”Phillipines”>Philippines</option><option value=”Pitcairn Island”>Pitcairn Island</option><option value=”Poland”>Poland</option><option value=”Portugal”>Portugal</option><option value=”Puerto Rico”>Puerto Rico</option><option value=”Qatar”>Qatar</option><option value=”Republic of Montenegro”>Republic of Montenegro</option><option value=”Republic of Serbia”>Republic of Serbia</option><option value=”Reunion”>Reunion</option><option value=”Romania”>Romania</option><option value=”Russia”>Russia</option><option value=”Rwanda”>Rwanda</option><option value=”St Barthelemy”>St Barthelemy</option><option value=”St Eustatius”>St Eustatius</option><option value=”St Helena”>St Helena</option><option value=”St Kitts-Nevis”>St Kitts-Nevis</option><option value=”St Lucia”>St Lucia</option><option value=”St Maarten”>St Maarten</option><option value=”St Pierre & Miquelon”>St Pierre & Miquelon</option><option value=”St Vincent & Grenadines”>St Vincent & Grenadines</option><option value=”Saipan”>Saipan</option><option value=”Samoa”>Samoa</option><option value=”Samoa American”>Samoa American</option><option value=”San Marino”>San Marino</option><option value=”Sao Tome & Principe”>Sao Tome & 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=”Slovakia”>Slovakia</option><option value=”Slovenia”>Slovenia</option><option value=”Solomon Islands”>Solomon Islands</option><option value=”Somalia”>Somalia</option><option value=”South Africa”>South Africa</option><option value=”Spain”>Spain</option><option value=”Sri Lanka”>Sri Lanka</option><option value=”Sudan”>Sudan</option><option value=”Suriname”>Suriname</option><option value=”Swaziland”>Swaziland</option><option value=”Sweden”>Sweden</option><option value=”Switzerland”>Switzerland</option><option value=”Syria”>Syria</option><option value=”Tahiti”>Tahiti</option><option value=”Taiwan”>Taiwan</option><option value=”Tajikistan”>Tajikistan</option><option value=”Tanzania”>Tanzania</option><option value=”Thailand”>Thailand</option><option value=”Togo”>Togo</option><option value=”Tokelau”>Tokelau</option><option value=”Tonga”>Tonga</option><option value=”Trinidad & Tobago”>Trinidad & Tobago</option><option value=”Tunisia”>Tunisia</option><option value=”Turkey”>Turkey</option><option value=”Turkmenistan”>Turkmenistan</option><option value=”Turks & Caicos Is”>Turks & Caicos Is</option><option value=”Tuvalu”>Tuvalu</option><option value=”Uganda”>Uganda</option><option value=”Ukraine”>Ukraine</option><option value=”United Arab Erimates”>United Arab Emirates</option><option value=”United Kingdom”>United Kingdom</option><option value=”United States of America”>United States of America</option><option value=”Uraguay”>Uruguay</option><option value=”Uzbekistan”>Uzbekistan</option><option value=”Vanuatu”>Vanuatu</option><option value=”Vatican City State”>Vatican City State</option><option value=”Venezuela”>Venezuela</option><option value=”Vietnam”>Vietnam</option><option value=”Virgin Islands (Brit)”>Virgin Islands (Brit)</option><option value=”Virgin Islands (USA)”>Virgin Islands (USA)</option><option value=”Wake Island”>Wake Island</option><option value=”Wallis & Futana Is”>Wallis & Futana Is</option><option value=”Yemen”>Yemen</option><option value=”Zaire”>Zaire</option><option value=”Zambia”>Zambia</option><option value=”Zimbabwe”>Zimbabwe</option></optgroup><br />
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