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cellpadding="8"> <tr><td>  <form action="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/join2/step2" method="POST" name="donateform" onsubmit="return validate();"> <input type="hidden" name="refer_type" value=""> <input type="hidden" name="refer_id" value=""> <input type="hidden" name="passalong_p" value="f"> <input type="hidden" name="update_address_p" value="t"> <input type="hidden" name="order_key" value="20971258-0f6cbcf0f41cfa9f7dc19c5780faf57c"> <input type="hidden" name="referral_key" value=""> <input type="hidden" name="toppage_segment_id" value="-1"> <input type="hidden" name="amount_segment_id" value="-1"> <input type="hidden" name="qp_source" value="w08ygmpgx"/>  <div id="ga-donationLayout"> <div id="ga-donationHeader"> <p align="center"><font size="4">Donate to the Human Rights Campaign</font></p> <table cellpadding="3" width="65%" align="right" bgcolor="#000080" hspace="5"> <tbody> <tr> <td style="WIDTH: 50%" colspan="2"><font color="#ffffff"> <div align="center"><strong>Other Giving Options:</strong></div></font></td></tr> <tr bgcolor="#eeeeee"> <td width="50%"> <div align="center"><a href="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/ren_0_07?source=w08ygmrgx">Renew your membership</a></div></td> <td width="50%"> <div align="center"><a href="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/partner1?source=w08ygmagx"><u>Monthly Giving</u></a></div></td></tr> <tr bgcolor="#eeeeee"> <td width="50%"> <div align="center"><a href="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/federal_club_council_join?source=w08ygmpgx"><u>Join the Federal Club</u></a></div></td> <td width="50%"> <div align="center"> <div align="center"><a href="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/honorandgift1"><font color="#003366">Gift Memberships</font></a></div></div></td></tr> <tr bgcolor="#eeeeee"> <td width="50%"> <div align="center"><a href="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/memorialgifts1?source=d08ygwwwx"><font color="#003366">Memorial Gifts</font></a></div></td> <td width="50%"> <div align="center"> <div align="center"><a href="https://web.archive.org/web/20071004163912/https://secure.ga3.org/03/inhonorof1"><font color="#003366">Give In Honor Of</font></a></div></div></td></tr> <tr bgcolor="#eeeeee"> <td width="50%"> <div align="center"><a href="https://web.archive.org/web/20071004163912/http://www.hrc.org/get_involved/hrc_estate_planning.asp"><font color="#003366">Planned Giving</font></a> </div></td> <td width="50%"> <div align="center"><a href="https://web.archive.org/web/20071004163912/http://www.hrc.org/get_involved/ways_to_give.asp" target="_blank"><font color="#003366">More ways to give</font></a> </div></td></tr></tbody></table> <p align="left">Make your contribution today and join a grassroots force of over 700,000 members and supporters standing together for gay, lesbian, bisexual and transgender equality. <br><br><strong>Together, we can make a difference.</strong></p> <p> </div> <table id="ga-donationCols" cellspacing="0"> <tr> <td id="ga-donationCol1-2"><div class="ga-donationPaymentLabel"><b>Select a Membership Amount:</b></div> <script type="text/javascript"></script> <table id="ga-donationAmtFields" cellspacing="0">  <colgroup width="5%" span="1"/> <colgroup width="25%" span="1"/> <colgroup width="70%" span="1"/> <tr> <td> <input type="radio" name="item_type_id" value="15521177" onfocus="clearOther();"/> </td> <td class="ga-donationAmount"> $35</td> <td class="ga-donationLabel"></td> </tr> <tr> <td> <input type="radio" name="item_type_id" value="15521178" onfocus="clearOther();" checked="checked"/> </td> <td class="ga-donationAmount"> $50</td> <td class="ga-donationLabel"></td> </tr> <tr> <td> <input type="radio" name="item_type_id" value="15521179" onfocus="clearOther();"/> </td> <td class="ga-donationAmount"> $75</td> <td class="ga-donationLabel"></td> </tr> <tr> <td> <input type="radio" name="item_type_id" value="15521180" onfocus="clearOther();"/> </td> <td class="ga-donationAmount"> $100</td> <td class="ga-donationLabel"></td> </tr> <tr> <td> <input type="radio" name="item_type_id" value="15521181" onfocus="clearOther();"/> </td> <td class="ga-donationAmount"> $250</td> <td class="ga-donationLabel"></td> </tr> <tr> <td> <input type="radio" name="item_type_id" value="15521183" onfocus="clearOther();"/> </td> <td class="ga-donationAmount"> $500</td> <td class="ga-donationLabel"></td> </tr> <tr> <td> <input type="radio" name="item_type_id" value="15521184" onfocus="clearOther();"/> </td> <td class="ga-donationAmount"> $1,000</td> <td class="ga-donationLabel"></td> </tr>  </table>  <table id="ga-donationOtherAmt" cellspacing="0"> <tr> <td width="5%"> <input type="radio" name="item_type_id" value="15521182" onfocus="clearOther();"/> </td> <td width="95%" class="ga-donationAmount"> Other: <span id="ga-donationOtherInput">$<input type="text" name="other_amount" size="7" value="" onfocus="checkOther(document.donateform);"></span> <div class="ga-donationMinMax"> Minimum payment: $5 </div> </td> </tr> </table>  <input type="hidden" name="schedule_type" value="one_time"/> <div class="ga-donationTxnHeader"><p><strong></strong> </p></div> <div class="ga-twoColumns"> <div id="ga-donationTxnFields"> <div class="ga-field" id="ga-extra1-fld"> <label for="extra1">Special Mail Code:</label> <div class="ga-fieldInput"> <font size="1">If you received mail from HRC, enter the mail code here</font><br/> <input type="text" size="12" name="extra1" id="extra1" value="" maxlength="255"/> </div> </div> </div> </div> <div class="ga-donationTxnFooter"><p> </p> </div></td> <td id="ga-donationCol2-2"><div class="ga-donationFormHeader"><b>Your Contact Information:</b> </div>   <div id="ga-donationCCFields">  <div class="ga-field" id="ga-paymethod-fld"> <label for="cardradio">Payment method:<span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <select name="cardradio"> <option value="visa">Visa</option> <option value="mc">MasterCard</option> <option value="amex">American Express</option> <option value="disc">Discover</option> </select> </div> </div>  <div class="ga-field" id="ga-cc_number-fld"> <label for="cc_number">Card number:<span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <input type="text" name="cc_number" size="18" value=""/> </div> </div> <div class="ga-field" id="ga-cc_expiration-fld"> <label for="cc_month">Expiration date:<span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <select name="cc_month"> <option>01</option> <option>02</option> <option>03</option> <option>04</option> <option>05</option> <option>06</option> <option>07</option> <option>08</option> <option>09</option> <option>10</option> <option>11</option> <option>12</option> </select> <select name="cc_year"> <option>2007</option> <option>2008</option> <option>2009</option> <option>2010</option> <option>2011</option> <option>2012</option> <option>2013</option> <option>2014</option> <option>2015</option> <option>2016</option> <option>2017</option> <option>2018</option> <option>2019</option> <option>2020</option> <option>2021</option> <option>2022</option> </select> </div> </div> </div>  <script language="javascript" type="text/javascript">  </script> <script language="javascript" type="text/javascript"> var sub_checkboxes = Array("list_id"); var opt_in_choicebox = "opt_in_choice"; var sub_opt_form = "donateform"; function subClick(o) { if (o.checked) document.forms[sub_opt_form][opt_in_choicebox].checked = true; } function optClick(o) { var n, i; if (!o.checked) { for (n in sub_checkboxes) { try { if (document.forms[sub_opt_form][sub_checkboxes[n]].length) { for (i = 0; i < document.forms[sub_opt_form][sub_checkboxes[n]].length; i++) { document.forms[sub_opt_form][sub_checkboxes[n]][i].checked = false; } } else { document.forms[sub_opt_form][sub_checkboxes[n]].checked = false; } } catch (dummy) {} } } } </script> <div id="ga-donationFields"> <div class="ga-field" id="prefix-fld"> <label for="prefix">Prefix: </label> <div class="ga-fieldInput"> <select name="prefix" id="prefix"> <option value="">--Select--</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="Rabbi">Rabbi</option> <option value="Rev.">Rev.</option> </select> </div> </div> <div class="ga-field" id="first_names-fld"> <label for="first_names">First Name: <span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <input type="text" size="15" name="first_names" id="first_names" value="" maxlength="50"/> </div> </div> <div class="ga-field" id="middle_name-fld"> <label for="middle_name">Middle Name: </label> <div class="ga-fieldInput"> <input type="text" size="15" name="middle_name" id="middle_name" value="" maxlength="50"/> </div> </div> <div class="ga-field" id="last_name-fld"> <label for="last_name">Last Name: <span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <input type="text" size="15" name="last_name" id="last_name" value="" maxlength="50"/> </div> </div> <div class="ga-field" id="suffix-fld"> <label for="suffix">Suffix: </label> <div class="ga-fieldInput"> <input type="text" size="15" name="suffix" id="suffix" value="" maxlength="15"/> </div> </div>  <div class="ga-field" id="ga-line1-fld"> <label for="line1">Address:<span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <input name="line1" type="text" size="20" maxlength="80" value=""/> </div> </div> <div class="ga-field" id="ga-line2-fld"> <label for="line2">Address Line 2:</label> <div class="ga-fieldInput"> <input name="line2" type="text" size="20" maxlength="80" value=""/> </div> </div> <div class="ga-field" id="ga-city-fld"> <label for="city">City: <span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <input name="city" type="text" size="20" maxlength="50" value=""/> </div> </div> <div class="ga-field"> <label for="usps_abbrev" id="ga-usps_abbrev-fld"> <span id="state_star"> State/Province: <span class="ga-alert">*</span> </span> <span id="state_no_star" style="display:none;"> State/Province: </span> </label> <span id="state_widget"><div class="ga-fieldInput"><select name="usps_abbrev" id="usps_abbrev"> <option value="" selected="selected">--Choose One--</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AS">American Samoa</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="AA">Armed Forces Americas</option> <option value="AE">Armed Forces Other</option> <option value="AP">Armed Forces Pacific</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="GU">Guam</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="MH">Marshall Islands</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="FM">Micronesia</option> <option value="MN">Minnesota</option> <option value="UM">Minor Outlying Islands</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="MP">Northern Mariana Islands</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PW">Palau</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</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="VI">Virgin Islands</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> <option value="">-------------------------</option> <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="NT">Northwest Territories</option> <option value="NS">Nova Scotia</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> </select> </div></span> <span id="state_no_widget" style="display:none;">(not applicable)</span> </div> <div class="ga-field" id="ga-zip_entered_by_user-fld"> <label for="zip_entered_by_user">ZIP/Postal Code: <span class="ga-alert">*</span> </label> <div class="ga-fieldInput"> <input type="text" name="zip_entered_by_user" size="9" maxlength="10" value=""/> </div> </div> <div class="ga-field" id="ga-country-fld"> <label for="country">Country: <span class="ga-alert">*</span></label> <div class="ga-fieldInput"> <select class="" onchange="country_change(this.value)" name="country"> <option class="" onchange="country_change(this.value)" value="us">United States</option> <option class="" onchange="country_change(this.value)" value="us" selected="selected">United States</option> <option class="" onchange="country_change(this.value)" value="af">Afghanistan</option> <option class="" onchange="country_change(this.value)" value="ax">Aland Islands</option> <option class="" onchange="country_change(this.value)" value="al">Albania</option> <option class="" onchange="country_change(this.value)" value="dz">Algeria</option> <option class="" onchange="country_change(this.value)" value="as">American Samoa</option> <option class="" onchange="country_change(this.value)" value="ad">Andorra</option> <option class="" onchange="country_change(this.value)" value="ao">Angola</option> <option class="" onchange="country_change(this.value)" value="ai">Anguilla</option> <option class="" onchange="country_change(this.value)" value="aq">Antarctica</option> <option class="" onchange="country_change(this.value)" value="ag">Antigua and Barbuda</option> <option class="" onchange="country_change(this.value)" value="ar">Argentina</option> <option class="" onchange="country_change(this.value)" value="am">Armenia</option> <option class="" onchange="country_change(this.value)" value="aw">Aruba</option> <option class="" onchange="country_change(this.value)" value="au">Australia</option> <option class="" onchange="country_change(this.value)" value="at">Austria</option> <option class="" onchange="country_change(this.value)" value="az">Azerbaijan</option> <option class="" onchange="country_change(this.value)" value="bs">Bahamas</option> <option class="" onchange="country_change(this.value)" value="bh">Bahrain</option> <option class="" onchange="country_change(this.value)" value="bd">Bangladesh</option> <option class="" onchange="country_change(this.value)" value="bb">Barbados</option> <option class="" onchange="country_change(this.value)" value="by">Belarus</option> <option class="" onchange="country_change(this.value)" value="be">Belgium</option> <option class="" onchange="country_change(this.value)" value="bz">Belize</option> <option class="" onchange="country_change(this.value)" value="bj">Benin</option> <option class="" onchange="country_change(this.value)" value="bm">Bermuda</option> <option class="" onchange="country_change(this.value)" value="bt">Bhutan</option> <option class="" onchange="country_change(this.value)" value="bo">Bolivia</option> <option class="" onchange="country_change(this.value)" value="ba">Bosnia and Herzegovina</option> <option class="" onchange="country_change(this.value)" value="bw">Botswana</option> <option class="" onchange="country_change(this.value)" value="bv">Bouvet Island</option> <option class="" onchange="country_change(this.value)" value="br">Brazil</option> <option class="" onchange="country_change(this.value)" value="io">British Indian Ocean Territory</option> <option class="" onchange="country_change(this.value)" value="bn">Brunei Darussalam</option> <option class="" onchange="country_change(this.value)" value="bg">Bulgaria</option> <option class="" onchange="country_change(this.value)" value="bf">Burkina Faso</option> <option class="" onchange="country_change(this.value)" value="bi">Burundi</option> <option class="" onchange="country_change(this.value)" value="kh">Cambodia</option> <option class="" onchange="country_change(this.value)" value="cm">Cameroon</option> <option class="" onchange="country_change(this.value)" value="ca">Canada</option> <option class="" onchange="country_change(this.value)" value="cv">Cape Verde</option> <option class="" onchange="country_change(this.value)" value="ky">Cayman Islands</option> <option class="" onchange="country_change(this.value)" value="cf">Central African Republic</option> <option class="" onchange="country_change(this.value)" value="td">Chad</option> <option class="" onchange="country_change(this.value)" value="cl">Chile</option> <option class="" onchange="country_change(this.value)" value="cn">China</option> <option class="" onchange="country_change(this.value)" value="cx">Christmas Island</option> <option class="" onchange="country_change(this.value)" value="cc">Cocos (Keeling) Islands</option> <option class="" onchange="country_change(this.value)" value="co">Colombia</option> <option class="" onchange="country_change(this.value)" value="km">Comoros</option> <option class="" onchange="country_change(this.value)" value="cg">Congo</option> <option class="" onchange="country_change(this.value)" value="cd">Congo (Democratic Republic)</option> <option class="" onchange="country_change(this.value)" value="ck">Cook Islands</option> <option class="" onchange="country_change(this.value)" value="cr">Costa Rica</option> <option class="" onchange="country_change(this.value)" value="ci">Cote d'Ivoire</option> <option class="" onchange="country_change(this.value)" value="hr">Croatia</option> <option class="" onchange="country_change(this.value)" value="cu">Cuba</option> <option class="" onchange="country_change(this.value)" value="cy">Cyprus</option> <option class="" onchange="country_change(this.value)" value="cz">Czech Republic</option> <option class="" onchange="country_change(this.value)" value="dk">Denmark</option> <option class="" onchange="country_change(this.value)" value="dj">Djibouti</option> <option class="" onchange="country_change(this.value)" value="dm">Dominica</option> <option class="" onchange="country_change(this.value)" value="do">Dominican Republic</option> <option class="" onchange="country_change(this.value)" value="ec">Ecuador</option> <option class="" onchange="country_change(this.value)" value="eg">Egypt</option> <option class="" onchange="country_change(this.value)" value="sv">El Salvador</option> <option class="" onchange="country_change(this.value)" value="gq">Equatorial Guinea</option> <option class="" onchange="country_change(this.value)" value="er">Eritrea</option> <option class="" onchange="country_change(this.value)" value="ee">Estonia</option> <option class="" onchange="country_change(this.value)" value="et">Ethiopia</option> <option class="" onchange="country_change(this.value)" value="fk">Falkland Islands (Malvinas)</option> <option class="" onchange="country_change(this.value)" value="fo">Faroe Islands</option> <option class="" onchange="country_change(this.value)" value="fj">Fiji</option> <option class="" onchange="country_change(this.value)" value="fi">Finland</option> <option class="" onchange="country_change(this.value)" value="fr">France</option> <option class="" onchange="country_change(this.value)" value="gf">French Guiana</option> <option class="" onchange="country_change(this.value)" value="pf">French Polynesia</option> <option class="" onchange="country_change(this.value)" value="tf">French Southern Territories</option> <option class="" onchange="country_change(this.value)" value="ga">Gabon</option> <option class="" onchange="country_change(this.value)" value="gm">Gambia</option> <option class="" onchange="country_change(this.value)" value="ge">Georgia</option> <option class="" onchange="country_change(this.value)" value="de">Germany</option> <option class="" onchange="country_change(this.value)" value="gh">Ghana</option> <option class="" onchange="country_change(this.value)" value="gi">Gibraltar</option> <option class="" onchange="country_change(this.value)" value="gr">Greece</option> <option class="" onchange="country_change(this.value)" value="gl">Greenland</option> <option class="" onchange="country_change(this.value)" value="gd">Grenada</option> <option class="" onchange="country_change(this.value)" value="gp">Guadeloupe</option> <option class="" onchange="country_change(this.value)" value="gu">Guam</option> <option class="" onchange="country_change(this.value)" value="gt">Guatemala</option> <option class="" onchange="country_change(this.value)" value="gg">Guernsey</option> <option class="" onchange="country_change(this.value)" value="gn">Guinea</option> <option class="" onchange="country_change(this.value)" value="gw">Guinea-Bissau</option> <option class="" onchange="country_change(this.value)" value="gy">Guyana</option> <option class="" onchange="country_change(this.value)" value="ht">Haiti</option> <option class="" onchange="country_change(this.value)" value="hm">Heard Island and McDonald Islands</option> <option class="" onchange="country_change(this.value)" value="va">Holy See (Vatican City State)</option> <option class="" onchange="country_change(this.value)" value="hn">Honduras</option> <option class="" onchange="country_change(this.value)" value="hk">Hong Kong</option> <option class="" onchange="country_change(this.value)" value="hu">Hungary</option> <option class="" onchange="country_change(this.value)" value="is">Iceland</option> <option class="" onchange="country_change(this.value)" value="in">India</option> <option class="" onchange="country_change(this.value)" value="id">Indonesia</option> <option class="" onchange="country_change(this.value)" value="ir">Iran, Islamic Republic of</option> <option class="" onchange="country_change(this.value)" value="iq">Iraq</option> <option class="" onchange="country_change(this.value)" value="ie">Ireland</option> <option class="" onchange="country_change(this.value)" value="im">Isle of Man</option> <option class="" onchange="country_change(this.value)" value="il">Israel</option> <option class="" onchange="country_change(this.value)" value="it">Italy</option> <option class="" onchange="country_change(this.value)" value="jm">Jamaica</option> <option class="" onchange="country_change(this.value)" value="jp">Japan</option> <option class="" onchange="country_change(this.value)" value="je">Jersey</option> <option class="" onchange="country_change(this.value)" value="jo">Jordan</option> <option class="" onchange="country_change(this.value)" value="kz">Kazakhstan</option> <option class="" onchange="country_change(this.value)" value="ke">Kenya</option> <option class="" onchange="country_change(this.value)" value="ki">Kiribati</option> <option class="" onchange="country_change(this.value)" value="kp">Korea (DPR)</option> <option class="" onchange="country_change(this.value)" value="kr">Korea, Republic of</option> <option class="" onchange="country_change(this.value)" value="kw">Kuwait</option> <option class="" onchange="country_change(this.value)" value="kg">Kyrgyzstan</option> <option class="" onchange="country_change(this.value)" value="la">Lao People's Democratic Republic</option> <option class="" onchange="country_change(this.value)" value="lv">Latvia</option> <option class="" onchange="country_change(this.value)" value="lb">Lebanon</option> <option class="" onchange="country_change(this.value)" value="ls">Lesotho</option> <option class="" onchange="country_change(this.value)" value="lr">Liberia</option> <option class="" onchange="country_change(this.value)" value="ly">Libyan Arab Jamahiriya</option> <option class="" onchange="country_change(this.value)" value="li">Liechtenstein</option> <option class="" onchange="country_change(this.value)" value="lt">Lithuania</option> <option class="" onchange="country_change(this.value)" value="lu">Luxembourg</option> <option class="" onchange="country_change(this.value)" value="mo">Macao</option> <option class="" onchange="country_change(this.value)" value="mk">Macedonia</option> <option class="" onchange="country_change(this.value)" value="mg">Madagascar</option> <option class="" onchange="country_change(this.value)" value="mw">Malawi</option> <option class="" onchange="country_change(this.value)" value="my">Malaysia</option> <option class="" onchange="country_change(this.value)" value="mv">Maldives</option> <option class="" onchange="country_change(this.value)" value="ml">Mali</option> <option class="" onchange="country_change(this.value)" value="mt">Malta</option> <option class="" onchange="country_change(this.value)" value="mh">Marshall Islands</option> <option class="" onchange="country_change(this.value)" value="mq">Martinique</option> <option class="" onchange="country_change(this.value)" value="mr">Mauritania</option> <option class="" onchange="country_change(this.value)" value="mu">Mauritius</option> <option class="" onchange="country_change(this.value)" value="yt">Mayotte</option> <option class="" onchange="country_change(this.value)" value="mx">Mexico</option> <option class="" onchange="country_change(this.value)" value="fm">Micronesia, Federated States of</option> <option class="" onchange="country_change(this.value)" value="md">Moldova, Republic of</option> <option class="" onchange="country_change(this.value)" value="mc">Monaco</option> <option class="" onchange="country_change(this.value)" value="mn">Mongolia</option> <option class="" onchange="country_change(this.value)" value="me">Montenegro</option> <option class="" onchange="country_change(this.value)" value="ms">Montserrat</option> <option class="" onchange="country_change(this.value)" value="ma">Morocco</option> <option class="" onchange="country_change(this.value)" value="mz">Mozambique</option> <option class="" onchange="country_change(this.value)" value="mm">Myanmar</option> <option class="" onchange="country_change(this.value)" value="na">Namibia</option> <option class="" onchange="country_change(this.value)" value="nr">Nauru</option> <option class="" onchange="country_change(this.value)" value="np">Nepal</option> <option class="" onchange="country_change(this.value)" value="nl">Netherlands</option> <option class="" onchange="country_change(this.value)" value="an">Netherlands Antilles</option> <option class="" onchange="country_change(this.value)" value="nc">New Caledonia</option> <option class="" onchange="country_change(this.value)" value="nz">New Zealand</option> <option class="" onchange="country_change(this.value)" value="ni">Nicaragua</option> <option class="" onchange="country_change(this.value)" value="ne">Niger</option> <option class="" onchange="country_change(this.value)" value="ng">Nigeria</option> <option class="" onchange="country_change(this.value)" value="nu">Niue</option> <option class="" onchange="country_change(this.value)" value="nf">Norfolk Island</option> <option class="" onchange="country_change(this.value)" value="mp">Northern Mariana Islands</option> <option class="" onchange="country_change(this.value)" value="no">Norway</option> <option class="" onchange="country_change(this.value)" value="om">Oman</option> <option class="" onchange="country_change(this.value)" value="pk">Pakistan</option> <option class="" onchange="country_change(this.value)" value="pw">Palau</option> <option class="" onchange="country_change(this.value)" value="ps">Palestinian Territory, Occupied</option> <option class="" onchange="country_change(this.value)" value="pa">Panama</option> <option class="" onchange="country_change(this.value)" value="pg">Papua New Guinea</option> <option class="" onchange="country_change(this.value)" value="py">Paraguay</option> <option class="" onchange="country_change(this.value)" value="pe">Peru</option> <option class="" onchange="country_change(this.value)" value="ph">Philippines</option> <option class="" onchange="country_change(this.value)" value="pn">Pitcairn</option> <option class="" onchange="country_change(this.value)" value="pl">Poland</option> <option class="" onchange="country_change(this.value)" value="pt">Portugal</option> <option class="" onchange="country_change(this.value)" value="pr">Puerto Rico</option> <option class="" onchange="country_change(this.value)" value="qa">Qatar</option> <option class="" onchange="country_change(this.value)" value="re">Reunion</option> <option class="" onchange="country_change(this.value)" value="ro">Romania</option> <option class="" onchange="country_change(this.value)" value="ru">Russian Federation</option> <option class="" onchange="country_change(this.value)" value="rw">Rwanda</option> <option class="" onchange="country_change(this.value)" value="sh">Saint Helena</option> <option class="" onchange="country_change(this.value)" value="kn">Saint Kitts and Nevis</option> <option class="" onchange="country_change(this.value)" value="lc">Saint Lucia</option> <option class="" onchange="country_change(this.value)" value="pm">Saint Pierre and Miquelon</option> <option class="" onchange="country_change(this.value)" value="vc">Saint Vincent and the Grenadines</option> <option class="" onchange="country_change(this.value)" value="ws">Samoa</option> <option class="" onchange="country_change(this.value)" value="sm">San Marino</option> <option class="" onchange="country_change(this.value)" value="st">Sao Tome and Principe</option> <option class="" onchange="country_change(this.value)" value="sa">Saudi Arabia</option> <option class="" onchange="country_change(this.value)" value="sn">Senegal</option> <option class="" onchange="country_change(this.value)" value="rs">Serbia</option> <option class="" onchange="country_change(this.value)" value="sc">Seychelles</option> <option class="" onchange="country_change(this.value)" value="sl">Sierra Leone</option> <option class="" onchange="country_change(this.value)" value="sg">Singapore</option> <option class="" onchange="country_change(this.value)" value="sk">Slovakia</option> <option class="" onchange="country_change(this.value)" value="si">Slovenia</option> <option class="" onchange="country_change(this.value)" value="sb">Solomon Islands</option> <option class="" onchange="country_change(this.value)" value="so">Somalia</option> <option class="" onchange="country_change(this.value)" value="za">South Africa</option> <option class="" onchange="country_change(this.value)" value="gs">South Georgia (SGSSI)</option> <option class="" onchange="country_change(this.value)" value="es">Spain</option> <option class="" onchange="country_change(this.value)" value="lk">Sri Lanka</option> <option class="" onchange="country_change(this.value)" value="sd">Sudan</option> <option class="" onchange="country_change(this.value)" value="sr">Suriname</option> <option class="" onchange="country_change(this.value)" value="sj">Svalbard and Jan Mayen</option> <option class="" onchange="country_change(this.value)" value="sz">Swaziland</option> <option class="" onchange="country_change(this.value)" value="se">Sweden</option> <option class="" onchange="country_change(this.value)" value="ch">Switzerland</option> <option class="" onchange="country_change(this.value)" value="sy">Syrian Arab Republic</option> <option class="" onchange="country_change(this.value)" value="tw">Taiwan</option> <option class="" onchange="country_change(this.value)" value="tj">Tajikistan</option> <option class="" onchange="country_change(this.value)" value="tz">Tanzania, United Republic of</option> <option class="" onchange="country_change(this.value)" value="th">Thailand</option> <option class="" onchange="country_change(this.value)" value="tl">Timor-Leste</option> <option class="" onchange="country_change(this.value)" value="tg">Togo</option> <option class="" onchange="country_change(this.value)" value="tk">Tokelau</option> <option class="" onchange="country_change(this.value)" value="to">Tonga</option> <option class="" onchange="country_change(this.value)" value="tt">Trinidad and Tobago</option> <option class="" onchange="country_change(this.value)" value="tn">Tunisia</option> <option class="" onchange="country_change(this.value)" value="tr">Turkey</option> <option class="" onchange="country_change(this.value)" value="tm">Turkmenistan</option> <option class="" onchange="country_change(this.value)" value="tc">Turks and Caicos Islands</option> <option class="" onchange="country_change(this.value)" value="tv">Tuvalu</option> <option class="" onchange="country_change(this.value)" value="ug">Uganda</option> <option class="" onchange="country_change(this.value)" value="ua">Ukraine</option> <option class="" onchange="country_change(this.value)" value="ae">United Arab Emirates</option> <option class="" onchange="country_change(this.value)" value="gb">United Kingdom</option> <option class="" onchange="country_change(this.value)" value="um">United States Minor Outlying Isl.</option> <option class="" onchange="country_change(this.value)" value="uy">Uruguay</option> <option class="" onchange="country_change(this.value)" value="uz">Uzbekistan</option> <option class="" onchange="country_change(this.value)" value="vu">Vanuatu</option> <option class="" onchange="country_change(this.value)" value="ve">Venezuela</option> <option class="" onchange="country_change(this.value)" value="vn">Viet 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