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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="Cayman Islands">Cayman Islands </option><option value="Chad">Chad </option><option value="China">China </option><option value="Chile">Chile </option><option value="Christmas 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Islands (Malvinas)">Falkland Islands (Malvinas) </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 Island and McDonald Islands">Heard Island and McDonald Islands </option><option value="Holy See (Vatican City State)">Holy See (Vatican City State) </option><option value="Honduras">Honduras </option><option value="Hungary">Hungary </option><option value="Iceland">Iceland </option><option value="India">India </option><option value="Indonesia">Indonesia </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="Korea">Korea </option><option value="Kosovo">Kosovo </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="Lesotho">Lesotho </option><option value="Liberia">Liberia </option><option value="Liechtenstein">Liechtenstein </option><option value="Lithuania">Lithuania </option><option value="Luxembourg">Luxembourg </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="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="Netherlands">Netherlands </option><option value="Netherlands Antilles">Netherlands Antilles </option><option value="New Caledonia">New Caledonia </option><option value="New Zealand">New Zealand </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="Northern Mariana Islands">Northern Mariana 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</option><option value="Saint Lucia">Saint Lucia </option><option value="Saint Martin">Saint Martin </option><option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon </option><option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines </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="Slovakia">Slovakia </option><option value="Slovenia">Slovenia </option><option value="Solomon Islands">Solomon Islands </option><option value="South Africa">South Africa </option><option value="South Georgia and Sandwich Isl.">South Georgia and Sandwich Isl. </option><option value="Spain">Spain </option><option value="Sri Lanka">Sri Lanka </option><option value="Suriname">Suriname </option><option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen </option><option value="Swaziland">Swaziland </option><option value="Sweden">Sweden </option><option value="Switzerland">Switzerland </option><option value="Tajikistan">Tajikistan </option><option value="Tanzania">Tanzania </option><option value="Thailand">Thailand </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="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 Outlying Islands">United States Outlying Islands </option><option value="Uruguay">Uruguay </option><option value="Uzbekistan">Uzbekistan </option><option value="Vanuatu">Vanuatu </option><option value="Viet Nam">Viet Nam </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">Wallis and Futuna </option><option value="Western Sahara">Western Sahara </option><option value="Zambia">Zambia </option><option value="Others">Others, Please specify below</option></select>  </div>  <div id="country-error" class="form-error"></div>    <div class="js-form-item form-item js-form-type-select form-item-gpo-state__c js-form-item-gpo-state__c">    <label for="edit-gpo-state-c">Which state do you reside in US?</label>     <select data-drupal-selector="edit-gpo-state-c" id="edit-gpo-state-c" name="GPO_State__c" class="form-select" data-drupal-states="{"visible":[{"select[name=\u0022GPO_Country__c\u0022]":{"value":"United States"}}],"required":[{"select[name=\u0022GPO_Country__c\u0022]":{"value":"United States"}}]}"><option value="" selected="selected">- Select -</option><option value="Alabama">Alabama </option><option value="Alaska">Alaska </option><option value="Arizona">Arizona </option><option value="Arkansas">Arkansas </option><option value="California">California </option><option value="Colorado">Colorado </option><option value="Connecticut">Connecticut </option><option value="Delaware">Delaware </option><option value="District of Columbia">District of Columbia </option><option value="Florida">Florida </option><option value="Georgia">Georgia </option><option value="Hawaii">Hawaii </option><option value="Idaho">Idaho </option><option value="Illinois">Illinois </option><option value="Indiana">Indiana 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value="Oregon">Oregon </option><option value="Pennsylvania">Pennsylvania </option><option value="Rhode Island">Rhode Island </option><option value="South Carolina">South Carolina </option><option value="South Dakota">South Dakota </option><option value="Tennessee">Tennessee </option><option value="Texas">Texas </option><option value="US Territories">US Territories </option><option value="Utah">Utah </option><option value="Vermont">Vermont </option><option value="Virginia">Virginia </option><option value="Washington">Washington </option><option value="West Virginia">West Virginia </option><option value="Wisconsin">Wisconsin </option><option value="Wyoming">Wyoming</option></select>  </div>  <div id="state-error" class="form-error"></div>    <div class="js-form-item form-item js-form-type-select form-item-gpo-request-type__c js-form-item-gpo-request-type__c form-disabled">    <label for="edit-gpo-request-type-c" class="js-form-required form-required">Please select your request 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