CINXE.COM

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I understand that I can change my preferences at any time. I further understand that any data provided to Bio-Techne and its brands will be stored, used, and deleted consistent with Bio-Techne鈥檚 <a data-toggle="lightbox" data-type="url" data-width="1000" data-maxWidth="1000" data-disable-external-check="true" data-title="<span class='tocris_logo'></span>" href="/lightbox/privacy-policy" rel="nofollow">Privacy Notice</a>.</em></div><hr><div id="tocris_forms_aoi"><h3>Areas of Interest</h3><div id="edit-research-areas-form-message" class="form-item form-type-item form-group"><p>We would like to invite you to select your areas of interest below. We aim to only send the most relevant content to our customers. By letting us know your interests we will be able to better send you information regarding new product launches, promotions and news related to your areas of research.</p> </div><h4>Pharmacology</h4><fieldset class="panel panel-default form-wrapper" id="edit-pharmacology--2"> <legend class="panel-heading"> <span class="panel-title fieldset-legend">Pharmacology</span> </legend> <div class="panel-body" id="edit-pharmacology-2-body"> <div class="form-item form-item-id-50404 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50404"><input data-id="50404" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50404" name="id-50404" value="1" />5-HT Receptors</label> </div><div class="form-item form-item-id-50385 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50385"><input data-id="50385" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50385" name="id-50385" value="1" />Adenosines</label> </div><div class="form-item form-item-id-50386 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50386"><input data-id="50386" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50386" name="id-50386" value="1" />Adrenoceptors</label> </div><div class="form-item form-item-id-545214 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545214"><input data-id="545214" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545214" name="id-545214" value="1" />Angiotensin Receptors</label> </div><div class="form-item form-item-id-50387 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50387"><input data-id="50387" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50387" name="id-50387" value="1" />Cannabinoids</label> </div><div class="form-item form-item-id-545215 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545215"><input data-id="545215" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545215" name="id-545215" value="1" />Chemokines</label> </div><div class="form-item form-item-id-50388 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50388"><input data-id="50388" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50388" name="id-50388" value="1" />Cytokines</label> </div><div class="form-item form-item-id-50389 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50389"><input data-id="50389" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50389" name="id-50389" value="1" />Dopamine</label> </div><div class="form-item form-item-id-50394 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50394"><input data-id="50394" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50394" name="id-50394" value="1" />GABA</label> </div><div class="form-item form-item-id-545216 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545216"><input data-id="545216" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545216" name="id-545216" value="1" />Glucagon Receptors</label> </div><div class="form-item form-item-id-50391 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50391"><input data-id="50391" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50391" name="id-50391" value="1" />Glutamate</label> </div><div class="form-item form-item-id-50395 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50395"><input data-id="50395" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50395" name="id-50395" value="1" />Ion Channels</label> </div><div class="form-item form-item-id-220451 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220451"><input data-id="220451" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220451" name="id-220451" value="1" />Kinases</label> </div><div class="form-item form-item-id-220452 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220452"><input data-id="220452" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220452" name="id-220452" value="1" />Muscarinic Receptors</label> </div><div class="form-item form-item-id-545217 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545217"><input data-id="545217" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545217" name="id-545217" value="1" />NPY Receptors</label> </div><div class="form-item form-item-id-220456 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220456"><input data-id="220456" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220456" name="id-220456" value="1" />Nicotinic Receptors</label> </div><div class="form-item form-item-id-220457 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220457"><input data-id="220457" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220457" name="id-220457" value="1" />Nuclear Receptors</label> </div><div class="form-item form-item-id-50398 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50398"><input data-id="50398" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50398" name="id-50398" value="1" />Opioids</label> </div><div class="form-item form-item-id-545219 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545219"><input data-id="545219" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545219" name="id-545219" value="1" />PPAR</label> </div><div class="form-item form-item-id-545218 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545218"><input data-id="545218" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545218" name="id-545218" value="1" />Phosphodiesterases</label> </div><div class="form-item form-item-id-545220 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545220"><input data-id="545220" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545220" name="id-545220" value="1" />Protease-activated Receptors</label> </div><div class="form-item form-item-id-282736 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-282736"><input data-id="282736" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-282736" name="id-282736" value="1" />Purines</label> </div><div class="form-item form-item-id-50407 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50407"><input data-id="50407" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50407" name="id-50407" value="1" />Steroid Hormones</label> </div><div class="form-item form-item-id-50408 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50408"><input data-id="50408" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50408" name="id-50408" value="1" />TRP Channels</label> </div> </div> </fieldset> <h4>Cell Biology</h4><fieldset class="panel panel-default form-wrapper" id="edit-cell-biology--2"> <legend class="panel-heading"> <span class="panel-title fieldset-legend">Cell Biology</span> </legend> <div class="panel-body" id="edit-cell-biology-2-body"> <div class="form-item form-item-id-220458 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220458"><input data-id="220458" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220458" name="id-220458" value="1" />Angiogenesis</label> </div><div class="form-item form-item-id-220459 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220459"><input data-id="220459" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220459" name="id-220459" value="1" />Apoptosis</label> </div><div class="form-item form-item-id-358644 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-358644"><input data-id="358644" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-358644" name="id-358644" value="1" />Autophagy</label> </div><div class="form-item form-item-id-220460 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220460"><input data-id="220460" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220460" name="id-220460" value="1" />Cell Cycle</label> </div><div class="form-item form-item-id-358164 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-358164"><input data-id="358164" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-358164" name="id-358164" value="1" />Epigenetics</label> </div><div class="form-item form-item-id-545210 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545210"><input data-id="545210" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545210" name="id-545210" value="1" />Lipid Metabolism</label> </div><div class="form-item form-item-id-50406 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50406"><input data-id="50406" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50406" name="id-50406" value="1" />Signal Transduction</label> </div><div class="form-item form-item-id-249594 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-249594"><input data-id="249594" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-249594" name="id-249594" value="1" />Stem Cells</label> </div> </div> </fieldset> <h4>Product Type</h4><fieldset class="panel panel-default form-wrapper" id="edit-product-type--2"> <legend class="panel-heading"> <span class="panel-title fieldset-legend">Product Type</span> </legend> <div class="panel-body" id="edit-product-type-2-body"> <div class="form-item form-item-id-521061 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-521061"><input data-id="521061" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-521061" name="id-521061" value="1" />CRISPR Reagents</label> </div><div class="form-item form-item-id-50383 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50383"><input data-id="50383" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50383" name="id-50383" value="1" />Compound Libraries</label> </div><div class="form-item form-item-id-521059 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-521059"><input data-id="521059" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-521059" name="id-521059" value="1" />Fluorescent Imaging</label> </div><div class="form-item form-item-id-579746 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-579746"><input data-id="579746" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-579746" name="id-579746" value="1" />GMP Small Molecules</label> </div><div class="form-item form-item-id-545213 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-545213"><input data-id="545213" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-545213" name="id-545213" value="1" />PROTACs</label> </div><div class="form-item form-item-id-804802 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-804802"><input data-id="804802" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-804802" name="id-804802" value="1" />Small Molecules</label> </div> </div> </fieldset> <h4>Research Area</h4><fieldset class="panel panel-default form-wrapper" id="edit-research-area--2"> <legend class="panel-heading"> <span class="panel-title fieldset-legend">Research Area</span> </legend> <div class="panel-body" id="edit-research-area-2-body"> <div class="form-item form-item-id-50401 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50401"><input data-id="50401" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50401" name="id-50401" value="1" />Cancer</label> </div><div class="form-item form-item-id-50393 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50393"><input data-id="50393" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50393" name="id-50393" value="1" />Cardiovascular System</label> </div><div class="form-item form-item-id-269255 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-269255"><input data-id="269255" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-269255" name="id-269255" value="1" />Endocrinology</label> </div><div class="form-item form-item-id-220461 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-220461"><input data-id="220461" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-220461" name="id-220461" value="1" />Immunology</label> </div><div class="form-item form-item-id-579749 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-579749"><input data-id="579749" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-579749" name="id-579749" value="1" />Inflammation</label> </div><div class="form-item form-item-id-50380 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50380"><input data-id="50380" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50380" name="id-50380" value="1" />Neuroscience</label> </div><div class="form-item form-item-id-50381 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50381"><input data-id="50381" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50381" name="id-50381" value="1" />Pain</label> </div><div class="form-item form-item-id-50382 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-50382"><input data-id="50382" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-50382" name="id-50382" value="1" />Respiratory System</label> </div><div class="form-item form-item-id-696655 form-type-checkbox checkbox"> <label class="control-label" for="edit-id-696655"><input data-id="696655" class="ra-checkbox form-checkbox" type="checkbox" id="edit-id-696655" name="id-696655" value="1" />Targeted Protein Degradation</label> </div> </div> </fieldset> <input type="hidden" name="et_user_details_user" /> </div><hr><div id="edit-contact-section" class="form-item form-type-item form-group"> <label class="control-label" for="edit-contact-section"><h3>Contact Details</h3></label> </div><div class="form-item form-item-salutation form-type-select form-group"> <label class="control-label" for="edit-salutation">Title</label> <div class="select_wrapper"><select class="form-control form-select" id="edit-salutation" name="salutation"><option value="" selected="selected">- Select Title -</option><option value="Dr.">Dr.</option><option value="Miss">Miss</option><option value="Mr.">Mr.</option><option value="Mrs.">Mrs.</option><option value="Ms.">Ms.</option><option value="Professor">Professor</option></select></div></div><div class="form-item form-item-firstname form-type-textfield form-group"> <label class="control-label" for="edit-firstname">First Name <span class="form-required" title="This field is required.">*</span></label> <input class="form-control form-text required" type="text" id="edit-firstname" name="firstname" value="" size="60" maxlength="255" /></div><div class="form-item form-item-lastname form-type-textfield form-group"> <label class="control-label" for="edit-lastname">Last Name <span class="form-required" title="This field is required.">*</span></label> <input class="form-control form-text required" type="text" id="edit-lastname" name="lastname" value="" size="60" maxlength="255" /></div><div class="form-item form-item-job-title form-type-select form-group"> <label class="control-label" for="edit-job-title">Role or Position</label> <div class="select_wrapper"><select class="form-control form-select" id="edit-job-title" name="job_title"><option value="0">- Select (Optional) -</option><option value="CEO/Director/President">CEO/Director/President</option><option value="Department Head">Department Head</option><option value="Grad Student">Grad Student</option><option value="Group Leader">Group Leader</option><option value="Lab Manager">Lab Manager</option><option value="Lecturer">Lecturer</option><option value="Medic">Medic</option><option value="MTA/Technician">MTA/Technician</option><option value="Other">Other</option><option value="Post Doc">Post Doc</option><option value="Professor/Associate Professor">Professor/Associate Professor</option><option value="Purchaser">Purchaser</option><option value="Research Assistant">Research Assistant</option><option value="Sales/Marketing">Sales/Marketing</option><option value="Secretary/Administrator">Secretary/Administrator</option><option value="Staff/Senior Scientist">Staff/Senior Scientist</option></select></div></div><div class="form-item form-item-institution-company form-type-textfield form-group"> <label class="control-label" for="edit-institution-company">Institution / Company <span class="form-required" title="This field is required.">*</span></label> <input class="form-control form-text required" type="text" id="edit-institution-company" name="institution_company" value="" size="60" maxlength="255" /></div><div class="form-item form-item-department form-type-textfield form-group"> <label class="control-label" for="edit-department">Department</label> <input placeholder="(Optional)" class="form-control form-text" type="text" id="edit-department" name="department" value="" size="60" maxlength="255" /></div><div class="form-item form-item-cstreet form-type-textfield form-group"> <label class="control-label" for="edit-cstreet">Address</label> <input class="form-control form-text" type="text" id="edit-cstreet" name="CStreet" value="" size="60" maxlength="255" /></div><div class="form-item form-item-carea form-type-textfield form-group"><input placeholder="(Optional)" class="form-control form-text" type="text" id="edit-carea" name="CArea" value="" size="60" maxlength="255" /></div><div class="form-item form-item-cdistrict form-type-textfield form-group"><input placeholder="(Optional)" class="form-control form-text" type="text" id="edit-cdistrict" name="CDistrict" value="" size="60" maxlength="255" /></div><div class="form-item form-item-ctown form-type-textfield form-group"> <label class="control-label" for="edit-ctown">City</label> <input class="form-control form-text" type="text" id="edit-ctown" name="CTown" value="" size="60" maxlength="255" /></div><div class="form-item form-item-ccounty form-type-textfield form-group"> <label class="control-label" for="edit-ccounty">State / County</label> <input placeholder="(Optional)" class="form-control form-text" type="text" id="edit-ccounty" name="CCounty" value="" size="60" maxlength="255" /></div><div class="form-item form-item-country form-type-select form-group"> <label class="control-label" for="edit-country">Country <span class="form-required" title="This field is required.">*</span></label> <div class="select_wrapper"><select class="form-control form-select required" id="edit-country" name="country"><option value="AL">Albania</option><option value="DZ">Algeria</option><option value="AD">Andorra</option><option value="AO">Angola</option><option value="AG">Antigua and Barbuda</option><option value="AR">Argentina</option><option value="AM">Armenia</option><option value="AW">Aruba</option><option value="AU">Australia</option><option value="AT">Austria</option><option value="AZ">Azerbaijan</option><option value="BS">Bahamas</option><option value="BH">Bahrain</option><option value="BD">Bangladesh</option><option value="BB">Barbados</option><option value="BE">Belgium</option><option value="BZ">Belize</option><option value="BJ">Benin</option><option value="BM">Bermuda</option><option value="BO">Bolivia</option><option value="BA">Bosnia and Herzegovina</option><option value="BW">Botswana</option><option value="BR">Brazil</option><option value="BN">Brunei</option><option value="BG">Bulgaria</option><option value="BF">Burkina Faso</option><option value="BI">Burundi</option><option value="KH">Cambodia</option><option value="CM">Cameroon</option><option value="CA">Canada</option><option value="KY">Cayman Islands</option><option value="CF">Central African Republic</option><option value="TD">Chad</option><option value="CL">Chile</option><option value="CN">China</option><option value="CO">Colombia</option><option value="CR">Costa Rica</option><option value="HR">Croatia</option><option value="CY">Cyprus</option><option value="CZ">Czech Republic</option><option value="DK">Denmark</option><option value="DJ">Djibouti</option><option value="DM">Dominica</option><option value="DO">Dominican Republic</option><option value="EC">Ecuador</option><option value="EG">Egypt</option><option value="SV">El Salvador</option><option value="GQ">Equatorial Guinea</option><option value="ER">Eritrea</option><option value="EE">Estonia</option><option value="ET">Ethiopia</option><option value="FK">Falkland Islands</option><option value="FJ">Fiji</option><option value="FI">Finland</option><option value="FR">France</option><option value="PF">French Polynesia</option><option value="GA">Gabon</option><option value="GM">Gambia</option><option value="GE">Georgia</option><option value="DE">Germany</option><option value="GH">Ghana</option><option value="GI">Gibraltar</option><option value="GR">Greece</option><option value="GD">Grenada</option><option value="GP">Guadeloupe</option><option value="GU">Guam</option><option value="GT">Guatemala</option><option value="GN">Guinea</option><option value="GW">Guinea-Bissau</option><option value="GY">Guyana</option><option value="HT">Haiti</option><option value="HN">Honduras</option><option value="HK">Hong Kong S.A.R., China</option><option value="HU">Hungary</option><option value="IS">Iceland</option><option value="IN">India</option><option value="ID">Indonesia</option><option value="IQ">Iraq</option><option value="IE">Ireland</option><option value="IL">Israel</option><option value="IT">Italy</option><option value="CI">Ivory Coast</option><option value="JM">Jamaica</option><option value="JP">Japan</option><option value="JO">Jordan</option><option value="KZ">Kazakhstan</option><option value="KE">Kenya</option><option value="KW">Kuwait</option><option value="KG">Kyrgyzstan</option><option value="LV">Latvia</option><option value="LB">Lebanon</option><option value="LS">Lesotho</option><option value="LR">Liberia</option><option value="LI">Liechtenstein</option><option value="LT">Lithuania</option><option value="LU">Luxembourg</option><option value="MK">Macedonia</option><option value="MG">Madagascar</option><option value="MW">Malawi</option><option value="MY">Malaysia</option><option value="ML">Mali</option><option value="MT">Malta</option><option value="MH">Marshall Islands</option><option value="MR">Mauritania</option><option value="MX">Mexico</option><option value="MD">Moldova</option><option value="MC">Monaco</option><option value="MN">Mongolia</option><option value="ME">Montenegro</option><option value="MA">Morocco</option><option value="MZ">Mozambique</option><option value="MM">Myanmar</option><option value="NA">Namibia</option><option value="NP">Nepal</option><option value="NL">Netherlands</option><option value="AN">Netherlands Antilles</option><option value="NC">New Caledonia</option><option value="NZ">New Zealand</option><option value="NI">Nicaragua</option><option value="NE">Niger</option><option value="NG">Nigeria</option><option value="MP">Northern Mariana Islands</option><option value="NO">Norway</option><option value="OM">Oman</option><option value="PK">Pakistan</option><option value="PW">Palau</option><option value="PA">Panama</option><option value="PG">Papua New Guinea</option><option value="PY">Paraguay</option><option value="PE">Peru</option><option value="PH">Philippines</option><option value="PL">Poland</option><option value="PT">Portugal</option><option value="PR">Puerto Rico</option><option value="QA">Qatar</option><option value="RO">Romania</option><option value="RW">Rwanda</option><option value="KN">Saint Kitts and Nevis</option><option value="LC">Saint Lucia</option><option value="MF">Saint Martin (French part)</option><option value="WS">Samoa</option><option value="SA">Saudi Arabia</option><option value="SN">Senegal</option><option value="RS">Serbia</option><option value="SL">Sierra Leone</option><option value="SG">Singapore</option><option value="SK">Slovakia</option><option value="SI">Slovenia</option><option value="SB">Solomon Islands</option><option value="ZA">South Africa</option><option value="KR">South Korea</option><option value="ES">Spain</option><option value="LK">Sri Lanka</option><option value="SR">Suriname</option><option value="SZ">Swaziland</option><option value="SE">Sweden</option><option value="CH">Switzerland</option><option value="TW">Taiwan, China</option><option value="TZ">Tanzania</option><option value="TH">Thailand</option><option value="TG">Togo</option><option value="TT">Trinidad and Tobago</option><option value="TN">Tunisia</option><option value="TR">Turkey</option><option value="UG">Uganda</option><option value="UA">Ukraine</option><option value="AE">United Arab Emirates</option><option value="GB">United Kingdom</option><option value="US" selected="selected">United States</option><option value="UY">Uruguay</option><option value="UZ">Uzbekistan</option><option value="VA">Vatican</option><option value="VE">Venezuela</option><option value="VN">Vietnam</option><option value="YE">Yemen</option><option value="ZM">Zambia</option><option value="ZW">Zimbabwe</option></select></div></div><div class="form-item form-item-cpcode form-type-textfield form-group"> <label class="control-label" for="edit-cpcode">Zip / Postcode</label> <input class="form-control form-text" 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