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enctype="multipart/form-data"> <input type="hidden" name="_token" value="e3alWR6JYJwVuEMmMfqzS5it0Ie432LHBP7krwlx"> <div class="faq-form row"> <p class="col-md-6 col-xs-12"> <select name="salutation" class="wpcf7-form-control wpcf7-text"> <option>Salutation </option> <option value="Dr.">Dr.</option> <option value="Mr.">Mr.</option> <option value="Mrs.">Mrs.</option> <option value="Miss.">Miss.</option> </select> </p> <p class="col-md-6 col-xs-12"> <input name="name" type="text" name="name" class="wpcf7-form-control wpcf7-text" placeholder="Name*" value=""> </p> <p class="col-md-6 col-xs-12"> <input type="text" name="email" class="wpcf7-form-control wpcf7-text" placeholder="Email*" required value=""> </p> <p class="col-md-6 col-xs-12"> <input type="tel" name="phone" class="wpcf7-form-control wpcf7-text" placeholder="Phone Number*" required value=""> </p> <p class="col-md-6 col-xs-12"> <input type="text" name="city" class="wpcf7-form-control wpcf7-text" placeholder="City*" required value=""> </p> <p class="col-md-6 col-xs-12"> <input type="text" name="organization" class="wpcf7-form-control wpcf7-text wpcf7-tel" placeholder="Organization and University*" required value=""> </p> <p class="col-md-6 col-xs-12"> <select name="country" class="wpcf7-form-control wpcf7-text" value=""> <option>Country </option> <option value="1">Afghanistan</option> <option value="2">脜land Islands</option> <option value="3">Albania</option> <option value="4">Algeria</option> <option value="5">American Samoa</option> <option value="6">Andorra</option> <option value="7">Angola</option> <option value="8">Anguilla</option> <option value="9">Antarctica</option> <option value="10">Antigua and Barbuda</option> <option value="11">Argentina</option> <option value="12">Armenia</option> <option value="13">Aruba</option> <option value="14">Australia</option> <option value="15">Austria</option> <option value="16">Azerbaijan</option> <option value="17">Bahamas</option> <option value="18">Bahrain</option> <option value="19">Bangladesh</option> <option value="20">Barbados</option> <option value="21">Belarus</option> <option value="22">Belgium</option> <option value="23">Belize</option> <option value="24">Benin</option> <option value="25">Bermuda</option> <option value="26">Bhutan</option> <option value="27">Bolivia, Plurinational State of</option> <option value="28">Bonaire, Sint Eustatius and Saba</option> <option value="29">Bosnia and Herzegovina</option> <option value="30">Botswana</option> <option value="31">Bouvet Island</option> <option value="32">Brazil</option> <option value="33">British Indian Ocean Territory</option> <option value="34">Brunei Darussalam</option> <option value="35">Bulgaria</option> <option value="36">Burkina Faso</option> <option value="37">Burundi</option> <option value="38">Cambodia</option> <option value="39">Cameroon</option> <option value="40">Canada</option> <option value="41">Cape Verde</option> <option value="42">Cayman Islands</option> <option value="43">Central African Republic</option> <option value="44">Chad</option> <option value="45">Chile</option> <option value="46">China</option> <option value="47">Christmas Island</option> <option value="48">Cocos (Keeling) Islands</option> <option value="49">Colombia</option> <option value="50">Comoros</option> <option value="51">Congo</option> <option value="52">Congo, the Democratic Republic of the</option> <option value="53">Cook Islands</option> <option value="54">Costa Rica</option> <option value="55">C么te d&#039;Ivoire</option> <option value="56">Croatia</option> <option value="57">Cuba</option> <option value="58">Cura莽ao</option> <option value="59">Cyprus</option> <option value="60">Czech Republic</option> <option value="61">Denmark</option> <option value="62">Djibouti</option> <option value="63">Dominica</option> <option value="64">Dominican Republic</option> <option value="65">Ecuador</option> <option value="66">Egypt</option> <option value="67">El Salvador</option> <option value="68">Equatorial Guinea</option> <option value="69">Eritrea</option> <option value="70">Estonia</option> <option value="71">Ethiopia</option> <option value="72">Falkland Islands (Malvinas)</option> <option value="73">Faroe Islands</option> <option value="74">Fiji</option> <option value="75">Finland</option> <option value="76">France</option> <option value="77">French Guiana</option> <option value="78">French Polynesia</option> <option value="79">French Southern Territories</option> <option value="80">Gabon</option> <option value="81">Gambia</option> <option value="82">Georgia</option> <option value="83">Germany</option> <option value="84">Ghana</option> <option value="85">Gibraltar</option> <option value="86">Greece</option> <option value="87">Greenland</option> <option value="88">Grenada</option> <option value="89">Guadeloupe</option> <option value="90">Guam</option> <option value="91">Guatemala</option> <option value="92">Guernsey</option> <option value="93">Guinea</option> <option value="94">Guinea-Bissau</option> <option value="95">Guyana</option> <option value="96">Haiti</option> <option value="97">Heard Island and McDonald Mcdonald Islands</option> <option value="98">Holy See (Vatican City State)</option> <option value="99">Honduras</option> <option value="100">Hong Kong</option> <option value="101">Hungary</option> <option value="102">Iceland</option> <option value="103">India</option> <option value="104">Indonesia</option> <option value="105">Iran, Islamic Republic of</option> <option value="106">Iraq</option> <option value="107">Ireland</option> <option value="108">Isle of Man</option> <option value="109">Israel</option> <option value="110">Italy</option> <option value="111">Jamaica</option> <option value="112">Japan</option> <option value="113">Jersey</option> <option value="114">Jordan</option> <option value="115">Kazakhstan</option> <option value="116">Kenya</option> <option value="117">Kiribati</option> <option value="118">Korea, Democratic People&#039;s Republic of</option> <option value="119">Korea, Republic of</option> <option value="120">Kuwait</option> <option value="121">Kyrgyzstan</option> <option value="122">Lao People&#039;s Democratic Republic</option> <option value="123">Latvia</option> <option value="124">Lebanon</option> <option value="125">Lesotho</option> <option value="126">Liberia</option> <option value="127">Libya</option> <option value="128">Liechtenstein</option> <option value="129">Lithuania</option> <option value="130">Luxembourg</option> <option value="131">Macao</option> <option value="132">Macedonia, the Former Yugoslav Republic of</option> <option value="133">Madagascar</option> <option value="134">Malawi</option> <option value="135">Malaysia</option> <option value="136">Maldives</option> <option value="137">Mali</option> <option value="138">Malta</option> <option value="139">Marshall Islands</option> <option value="140">Martinique</option> <option value="141">Mauritania</option> <option value="142">Mauritius</option> <option value="143">Mayotte</option> <option value="144">Mexico</option> <option value="145">Micronesia, Federated States of</option> <option value="146">Moldova, Republic of</option> <option value="147">Monaco</option> <option value="148">Mongolia</option> <option value="149">Montenegro</option> <option value="150">Montserrat</option> <option value="151">Morocco</option> <option value="152">Mozambique</option> <option value="153">Myanmar</option> <option value="154">Namibia</option> <option value="155">Nauru</option> <option value="156">Nepal</option> <option value="157">Netherlands</option> <option value="158">New Caledonia</option> <option value="159">New Zealand</option> <option value="160">Nicaragua</option> <option value="161">Niger</option> <option value="162">Nigeria</option> <option value="163">Niue</option> <option value="164">Norfolk Island</option> <option value="165">Northern Mariana Islands</option> <option value="166">Norway</option> <option value="167">Oman</option> <option value="168">Pakistan</option> <option value="169">Palau</option> <option value="170">Palestine, State of</option> <option value="171">Panama</option> <option value="172">Papua New Guinea</option> <option value="173">Paraguay</option> <option value="174">Peru</option> <option value="175">Philippines</option> <option value="176">Pitcairn</option> <option value="177">Poland</option> <option value="178">Portugal</option> <option value="179">Puerto Rico</option> <option value="180">Qatar</option> <option value="181">R茅union</option> <option value="182">Romania</option> <option value="183">Russian Federation</option> <option value="184">Rwanda</option> <option value="185">Saint Barth茅lemy</option> <option value="186">Saint Helena, Ascension and Tristan da Cunha</option> <option value="187">Saint Kitts and Nevis</option> <option value="188">Saint Lucia</option> <option value="189">Saint Martin (French part)</option> <option value="190">Saint Pierre and Miquelon</option> <option value="191">Saint Vincent and the Grenadines</option> <option value="192">Samoa</option> <option value="193">San Marino</option> <option value="194">Sao Tome and Principe</option> <option value="195">Saudi Arabia</option> <option value="196">Senegal</option> <option value="197">Serbia</option> <option value="198">Seychelles</option> <option value="199">Sierra Leone</option> <option value="200">Singapore</option> <option value="201">Sint Maarten (Dutch part)</option> <option value="202">Slovakia</option> <option value="203">Slovenia</option> <option value="204">Solomon Islands</option> <option value="205">Somalia</option> <option value="206">South Africa</option> <option value="207">South Georgia and the South Sandwich Islands</option> <option value="208">South Sudan</option> <option value="209">Spain</option> <option value="210">Sri Lanka</option> <option value="211">Sudan</option> <option value="212">Suriname</option> <option value="213">Svalbard and Jan Mayen</option> <option value="214">Swaziland</option> <option value="215">Sweden</option> <option value="216">Switzerland</option> <option value="217">Syrian Arab Republic</option> <option value="218">Taiwan</option> <option value="219">Tajikistan</option> <option value="220">Tanzania, United Republic of</option> <option value="221">Thailand</option> <option value="222">Timor-Leste</option> <option value="223">Togo</option> <option value="224">Tokelau</option> <option value="225">Tonga</option> <option value="226">Trinidad and Tobago</option> <option value="227">Tunisia</option> <option value="228">Turkey</option> <option value="229">Turkmenistan</option> <option value="230">Turks and Caicos Islands</option> <option value="231">Tuvalu</option> <option value="232">Uganda</option> <option value="233">Ukraine</option> <option value="234">United Arab Emirates</option> <option value="235">United Kingdom</option> <option value="236">United States</option> <option value="237">United States Minor Outlying Islands</option> <option value="238">Uruguay</option> <option value="239">Uzbekistan</option> <option value="240">Vanuatu</option> <option value="241">Venezuela, Bolivarian Republic of</option> <option value="242">Viet Nam</option> <option value="243">Virgin Islands, British</option> <option value="244">Virgin Islands, U.S.</option> <option value="245">Wallis and Futuna</option> <option value="246">Western Sahara</option> <option value="247">Yemen</option> <option value="248">Zambia</option> <option value="249">Zimbabwe</option> </select> </p> <p class="col-md-6 col-xs-12"> <select name="interest" class="wpcf7-form-control wpcf7-text" value=""> <option value="">Interested In </option> <option value="Oral Presentation">Oral Presentation</option> <option value="Poster Presentation">Poster Presentation</option> <option value="Conducting Workshop">Conducting Workshop</option> <option value="Conducting Symposium">Conducting Symposium</option> <option value="Online Presentation">Online Presentation</option> <option value="E-poster"> E-poster</option> <option value="Others">Others</option> </select> </p> <p class="col-md-12 col-xs-12"> <select name="session" class="wpcf7-form-control wpcf7-text" value=""> <option>Sessions</option> <option value="1">Clinical Practice</option> <option value="2">Education and Professional Development nursing</option> <option value="3">Nursing Research</option> <option value="4">Community and Public Health Nursing</option> <option value="5">Nursing Education</option> <option value="6">Nursing Practice</option> <option value="7">Nursing Management</option> <option value="8">Nursing Teaching</option> <option value="9">Nursing Informatics &amp; Technology</option> <option value="10">Trauma and Critical Care nursing</option> <option value="11">Midwifery and Women Health Nursing</option> <option value="12">Nursing Administration</option> <option value="13">Improving Patient Education, Care &amp; Outcomes</option> <option value="14">Nursing Practice &amp; Safety</option> <option value="15">Nursing Leadership</option> <option value="16">Gerontological Nursing and Transcultural Nursing</option> <option value="17">Community Health Nursing and Ambulatory Care</option> <option value="18">Case Management Nursing and Public Health Nursing</option> <option value="19">Nursing Informatics</option> <option value="20">Cardiac Nursing and Geriatric Nursing</option> <option value="21">Midwifery and Womens Health</option> <option value="22">Nursing and Healthcare</option> <option value="23">Community Nursing and Home Health Nursing</option> <option value="29">Emergency Nursing and Ambulatory Care Nursing</option> <option value="30">Clinical Nursing and Medical Surgical Nursing</option> <option value="31">Nursing Teaching and Nursing Management</option> <option value="32">Evidence-Based Nursing Practice</option> <option value="33">Advanced Nursing Practice</option> </select> </p> <p 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