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American Society for Pharmacology and Experimental Secure Checkout
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data-fc-required class="fc-form-control fc-form-control--billing-last-name"/> </div> </div> <div class="fc-form-group fc-address-entry__phone-and-company-container fc-form-group--multiple-inline"> <div class="fc-container__grid--input--company " data-fc-error-for="billing_company" data-fc-error-class="fc-alert-container--error"> <label for="billing_company" class="fc-form-label fc-form-label--billing-company">Company</label> <input type="text" id="billing_company" name="billing_company" value="" placeholder="Company (optional)" autocomplete="billing organization" maxlength="50" class="fc-form-control fc-form-control--billing-company" /> </div> <div class="fc-container__grid--input--phone " data-fc-error-for="billing_phone" data-fc-error-class="fc-alert-container--error"> <label for="billing_phone" class="fc-form-label fc-form-label--billing-phone">Phone</label> <input type="text" id="billing_phone" name="billing_phone" value="" placeholder="Phone (optional)" autocomplete="billing tel" maxlength="50" class="fc-form-control fc-form-control--billing-phone" /> </div> </div> <input id="billing_tax_id" type="hidden" name="billing_tax_id" value="" /> <div class="fc-form-group fc-address-entry__address-container fc-form-group--multiple-inline"> <label class="fc-form-label fc-form-label--billing-address1 fc-container__grid--label--address">Address</label> <div class="fc-container__grid--input--address1 " data-fc-error-for="billing_address1" data-fc-error-class="fc-alert-container--error"> <label for="billing_address1" class="fc-form-label fc-form-label--billing-address1">Address 1</label> <input type="text" id="billing_address1" name="billing_address1" value="" placeholder="Address 1" autocomplete="billing address-line1" maxlength="100" data-fc-required class="fc-form-control fc-form-control--billing-address1" /> </div> <div class="fc-container__grid--label--address2 " data-fc-error-for="billing_address2" data-fc-error-class="fc-alert-container--error"> <label for="billing_address2" class="fc-form-label fc-form-label--billing-address1">Address 2</label> <input type="text" id="billing_address2" name="billing_address2" value="" placeholder="Address 2 (optional)" autocomplete="billing address-line2" maxlength="100" class="fc-form-control fc-form-control--billing-address2" /> </div> </div> <div class="fc-form-group fc-form-group--postal-code"> <div class="fc-container-checkout__grid--postal-code"> <div data-fc-id="block-billing-postal-code" class="fc-postal-code-entry"> <div class="fc-form-group fc-form-group--multiple-inline fc-postal-code__manual-inputs"> <div class="fc-container__grid--city " data-fc-error-for="billing_city" data-fc-error-class="fc-alert-container--error"> <label for="billing_city" class="fc-form-label fc-form-label--city">City</label> <input type="text" id="billing_city" name="billing_city" value="" placeholder="City" autocomplete="billing locality" maxlength="50" data-fc-required class="fc-form-control fc-form-control--city" /> </div> <div class="fc-container__grid--region " data-fc-container-for="billing_region"> <label for="billing_region" class="fc-form-label fc-form-label--region">State</label> <input data-fc-id="billing_region" name="billing_region" value="" type="text" placeholder="State" maxlength="50" class="fc-form-control fc-location" /> </div> </div> <div class="fc-form-group fc-form-group--multiple-inline fc-postal-code-entry__without-search"> <div class="fc-container__grid--postal-code " data-fc-error-for="billing_postal_code" data-fc-error-class="fc-alert-container--error"> <!-- TODO: change the type to phone if country has numeric postcodes (like US) --> <label for="billing_postal_code" class="fc-form-label fc-form-label--postal-code">ZIP code</label> <input type="text" id="billing_postal_code" name="billing_postal_code" value="" placeholder="Postcode" autocomplete="billing postal-code" maxlength="20" data-fc-required class="fc-form-control fc-form-control--postal-code" /> </div> <div class="fc-container__grid--country "> <label for="billing_country" class="fc-form-label fc-form-label--region">Country</label> <select class="fc-form-control fc-location" data-fc-default-value="SG" data-fc-id="billing_country" data-fc-required name="billing_country"> <option value=""></option> <option value="AF" data-relevancy-booster="1" data-alternative-spellings="AF||Afghanestan||افغانستان" >Afghanistan</option> <option value="AX" data-relevancy-booster="0.2" data-alternative-spellings="AX||Landskapet Åland||Aaland||Aland" >Åland Islands</option> <option value="AL" data-relevancy-booster="1" data-alternative-spellings="AL||Shqipëria" >Albania</option> <option value="DZ" data-relevancy-booster="0.4" data-alternative-spellings="DZ||Al-Jazā'ir||الجزائر" >Algeria</option> <option value="AS" data-relevancy-booster="1" data-alternative-spellings="AS||Amerika Sāmoa" >American Samoa</option> <option value="AD" data-relevancy-booster="0.7" data-alternative-spellings="AD" >Andorra</option> <option value="AO" data-relevancy-booster="0.4" data-alternative-spellings="AO" >Angola</option> <option value="AI" data-relevancy-booster="0.4" data-alternative-spellings="AI" >Anguilla</option> <option value="AQ" data-relevancy-booster="0.4" data-alternative-spellings="AQ" >Antarctica</option> <option value="AG" data-relevancy-booster="1.5" data-alternative-spellings="AG" >Antigua and Barbuda</option> <option value="AR" data-relevancy-booster="2.5" data-alternative-spellings="AR" >Argentina</option> <option value="AM" data-relevancy-booster="0.7" data-alternative-spellings="AM||Hayastán||Հայաստան" >Armenia</option> <option value="AW" data-relevancy-booster="1" data-alternative-spellings="AW" >Aruba</option> <option value="AU" data-relevancy-booster="4" data-alternative-spellings="AU" >Australia</option> <option value="AT" data-relevancy-booster="3" data-alternative-spellings="AT||Österreich" >Austria</option> <option value="AZ" data-relevancy-booster="1" data-alternative-spellings="AZ||Azərbaycan" >Azerbaijan</option> <option value="BS" data-relevancy-booster="1.5" data-alternative-spellings="BS||The Bahamas" >Bahamas</option> <option value="BH" data-relevancy-booster="1.5" data-alternative-spellings="BH||Al-Baḥrayn||البحرين" >Bahrain</option> <option value="BD" data-relevancy-booster="1" data-alternative-spellings="BD||বাংলাদেশ" >Bangladesh</option> <option value="BB" data-relevancy-booster="1.5" data-alternative-spellings="BB" >Barbados</option> <option value="BY" data-relevancy-booster="1.5" data-alternative-spellings="BY||Беларусь||Biełaruś||Belorussiya||Belorussiâ||Белоруссия" >Belarus</option> <option value="BE" data-relevancy-booster="3" data-alternative-spellings="BE||België||Belgique||Belgien" >Belgium</option> <option value="BZ" data-relevancy-booster="1" data-alternative-spellings="BZ" >Belize</option> <option value="BJ" data-relevancy-booster="0.4" data-alternative-spellings="BJ||Bénin" >Benin</option> <option value="BM" data-relevancy-booster="2" data-alternative-spellings="BM" >Bermuda</option> <option value="BT" data-relevancy-booster="0.2" data-alternative-spellings="BT||Druk Yul||འབྲུག་ཡུལ" >Bhutan</option> <option value="BO" data-relevancy-booster="1" data-alternative-spellings="BO||Bulivya Mamallaqta||Wuliwya Suyu||Volívia||Bolivia, Plurinational State of" >Bolivia</option> <option value="BQ" data-relevancy-booster="1.5" data-alternative-spellings="BQ||Caribbean Netherlands||Caribisch Nederland||Bonaire||Boneiru||Sint Eustatius||Statia||Statius||Saba" >Bonaire, Sint Eustatius and Saba</option> <option value="BA" data-relevancy-booster="1" data-alternative-spellings="BA||Bosna i Hercegovina||Босна и Херцеговина" >Bosnia and Herzegovina</option> <option value="BW" data-relevancy-booster="1" data-alternative-spellings="BW" >Botswana</option> <option value="BV" data-relevancy-booster="0.2" data-alternative-spellings="BV||Bouvetøya" >Bouvet Island</option> <option value="BR" data-relevancy-booster="3" data-alternative-spellings="BR||Brasil" >Brazil</option> <option value="IO" data-relevancy-booster="0.2" data-alternative-spellings="IO||Chagos Islands" >British Indian Ocean Territory</option> <option value="BN" data-relevancy-booster="1.5" data-alternative-spellings="BN||بروني" >Brunei Darussalam</option> <option value="BG" data-relevancy-booster="2" data-alternative-spellings="BG||Bulgariya||Bălgarija||България" >Bulgaria</option> <option value="BF" data-relevancy-booster="0.4" data-alternative-spellings="BF" >Burkina Faso</option> <option value="BI" data-relevancy-booster="0.4" data-alternative-spellings="BI" >Burundi</option> <option value="KH" data-relevancy-booster="1.5" data-alternative-spellings="KH||Kampuchea||កម្ពុជា" >Cambodia</option> <option value="CM" data-relevancy-booster="1" data-alternative-spellings="CM||Cameroun" >Cameroon</option> <option value="CA" data-relevancy-booster="4" data-alternative-spellings="CA" >Canada</option> <option value="CV" data-relevancy-booster="0.4" data-alternative-spellings="CV||Cabo Verde" >Cape Verde</option> <option value="CW" data-relevancy-booster="1.5" data-alternative-spellings="CW||Kòrsou" >Curaçao</option> <option value="KY" data-relevancy-booster="1.5" data-alternative-spellings="KY" >Cayman Islands</option> <option value="CF" data-relevancy-booster="0.2" data-alternative-spellings="CF||République Centrafricaine||Ködörösêse tî Bêafrîka" >Central African Republic</option> <option value="TD" data-relevancy-booster="0.2" data-alternative-spellings="TD||Tchad||Tšād||تشاد" >Chad</option> <option value="CL" data-relevancy-booster="2" data-alternative-spellings="CL" >Chile</option> <option value="CN" data-relevancy-booster="2.5" data-alternative-spellings="CN||中国||Zhōngguó||Zhōnghuá Rénmín Gònghéguó" >China</option> <option value="CX" data-relevancy-booster="0.2" data-alternative-spellings="CX" >Christmas Island</option> <option value="CC" data-relevancy-booster="0.2" data-alternative-spellings="CC" >Cocos (Keeling) Islands</option> <option value="CO" data-relevancy-booster="2" data-alternative-spellings="CO" >Colombia</option> <option value="KM" data-relevancy-booster="0.2" data-alternative-spellings="KM||Komori||Juzur al-Qamar||جزر القمر||Comores" >Comoros</option> <option value="CG" data-relevancy-booster="0.4" data-alternative-spellings="CG||Congo-Brazza" >Congo</option> <option value="CD" data-relevancy-booster="0.4" data-alternative-spellings="CD" >Congo, the Democratic Republic of the</option> <option value="CK" data-relevancy-booster="0.7" data-alternative-spellings="CK" >Cook Islands</option> <option value="CR" data-relevancy-booster="2" data-alternative-spellings="CR" >Costa Rica</option> <option value="CI" data-relevancy-booster="0.4" data-alternative-spellings="CI||Côte d'Ivoire" >Cote DIvoire</option> <option value="HR" data-relevancy-booster="2" data-alternative-spellings="HR||Hrvatska" >Croatia</option> <option value="CU" data-relevancy-booster="0.4" data-alternative-spellings="CU" >Cuba</option> <option value="CY" data-relevancy-booster="2" data-alternative-spellings="CY||Kypros||Κύπρος||Kıbrıs" >Cyprus</option> <option value="CZ" data-relevancy-booster="2.5" data-alternative-spellings="CZ||Česká republika||Česko||Czechia" >Czech Republic</option> <option value="DK" data-relevancy-booster="3" data-alternative-spellings="DK||Danmark" >Denmark</option> <option value="DJ" data-relevancy-booster="0.4" data-alternative-spellings="DJ||Jībūtī||جيبوتي||Djibouti" >Djibouti</option> <option value="DM" data-relevancy-booster="0.4" data-alternative-spellings="DM" >Dominica</option> <option value="DO" data-relevancy-booster="2" data-alternative-spellings="DO||República Dominicana" >Dominican Republic</option> <option value="EC" data-relevancy-booster="2" data-alternative-spellings="EC" >Ecuador</option> <option value="EG" data-relevancy-booster="2" data-alternative-spellings="EG||Misr||Masr||مصر" >Egypt</option> <option value="SV" data-relevancy-booster="1" data-alternative-spellings="SV" >El Salvador</option> <option value="SX" data-relevancy-booster="1.5" data-alternative-spellings="SX" >Sint Maarten</option> <option value="GQ" data-relevancy-booster="0.2" data-alternative-spellings="GQ||Guinea Ecuatorial" >Equatorial Guinea</option> <option value="ER" data-relevancy-booster="0.2" data-alternative-spellings="ER||Iritriya||إرتريا||Erta||ኤርትራ" >Eritrea</option> <option value="EE" data-relevancy-booster="2" data-alternative-spellings="EE||Eesti" >Estonia</option> <option value="ET" data-relevancy-booster="0.7" data-alternative-spellings="ET||Ityop'ia||ኢትዮጲያ||ኢትዮጵያ" >Ethiopia</option> <option value="FK" data-relevancy-booster="0.4" data-alternative-spellings="FK||Islas Malvinas" >Falkland Islands (Malvinas)</option> <option value="FO" data-relevancy-booster="0.7" data-alternative-spellings="FO||Føroyar||Færøerne" >Faroe Islands</option> <option value="FJ" data-relevancy-booster="0.7" data-alternative-spellings="FJ||Viti||फ़िजी" >Fiji</option> <option value="FI" data-relevancy-booster="3" data-alternative-spellings="FI||Suomi" >Finland</option> <option value="FR" data-relevancy-booster="3.5" data-alternative-spellings="FR" >France</option> <option value="GF" data-relevancy-booster="0.2" data-alternative-spellings="GF||Guyane" >French Guiana</option> <option value="PF" data-relevancy-booster="1" data-alternative-spellings="PF||Polynésie française" >French Polynesia</option> <option value="TF" data-relevancy-booster="0.4" data-alternative-spellings="TF||Terres australes et antarctiques françaises||French Southern and Antarctic Lands" >French Southern Territories</option> <option value="GA" data-relevancy-booster="0.4" data-alternative-spellings="GA" >Gabon</option> <option value="GM" data-relevancy-booster="0.4" data-alternative-spellings="GM||The Gambia" >Gambia</option> <option value="GE" data-relevancy-booster="1" data-alternative-spellings="GE||Sak'art'velo||საქართველო" >Georgia</option> <option value="DE" data-relevancy-booster="4" data-alternative-spellings="DE||Deutschland" >Germany</option> <option value="GH" data-relevancy-booster="1.5" data-alternative-spellings="GH" >Ghana</option> <option value="GI" data-relevancy-booster="1" data-alternative-spellings="GI" >Gibraltar</option> <option value="GR" data-relevancy-booster="2.5" data-alternative-spellings="GR||Hellas||Ελλάς||Ellada||Ελλάδα" >Greece</option> <option value="GL" data-relevancy-booster="0.7" data-alternative-spellings="GL||Kalaallit Nunaat||Grønland" >Greenland</option> <option value="GD" data-relevancy-booster="0.4" data-alternative-spellings="GD" >Grenada</option> <option value="GP" data-relevancy-booster="1" data-alternative-spellings="GP" >Guadeloupe</option> <option value="GU" data-relevancy-booster="2" data-alternative-spellings="GU" >Guam</option> <option value="GT" data-relevancy-booster="2" data-alternative-spellings="GT" >Guatemala</option> <option value="GG" data-relevancy-booster="1" data-alternative-spellings="GG" >Guernsey</option> <option value="GN" data-relevancy-booster="0.4" data-alternative-spellings="GN||Guinée||Gine" >Guinea</option> <option value="GW" data-relevancy-booster="0.2" data-alternative-spellings="GW||Guiné-Bissau" >Guinea-bissau</option> <option value="GY" data-relevancy-booster="1" data-alternative-spellings="GY" >Guyana</option> <option value="HT" data-relevancy-booster="0.7" data-alternative-spellings="HT||Haïti||Ayiti" >Haiti</option> <option value="HM" data-relevancy-booster="0.2" data-alternative-spellings="HM" >Heard Island and McDonald Island</option> <option value="VA" data-relevancy-booster="0.2" data-alternative-spellings="VA" >Holy See (Vatican City State)</option> <option value="HN" data-relevancy-booster="1.5" data-alternative-spellings="HN" >Honduras</option> <option value="HK" data-relevancy-booster="3" data-alternative-spellings="HK" >Hong Kong</option> <option value="HU" data-relevancy-booster="2.5" data-alternative-spellings="HU||Magyarország" >Hungary</option> <option value="IS" data-relevancy-booster="2" data-alternative-spellings="IS||Ísland" >Iceland</option> <option value="IN" data-relevancy-booster="3" data-alternative-spellings="IN||Bhārat||Hindustān||भारत||हिंदुस्तान" >India</option> <option value="ID" data-relevancy-booster="3" data-alternative-spellings="ID" >Indonesia</option> <option value="IR" data-relevancy-booster="1" data-alternative-spellings="IR||Īrān||ایران" >Iran, Islamic Republic of</option> <option value="IQ" data-relevancy-booster="1" data-alternative-spellings="IQ||Al-'Iraq||العراق" >Iraq</option> <option value="IE" data-relevancy-booster="3.5" data-alternative-spellings="IE||Éire" >Ireland</option> <option value="IM" data-relevancy-booster="1" data-alternative-spellings="IM||Ellan Vannin" >Isle of Man</option> <option value="IL" data-relevancy-booster="2.5" data-alternative-spellings="IL||Yisrael||ישראל||Isrā'īl||إسرائيل" >Israel</option> <option value="IT" data-relevancy-booster="3.5" data-alternative-spellings="IT||Italia" >Italy</option> <option value="JM" data-relevancy-booster="1.5" data-alternative-spellings="JM" >Jamaica</option> <option value="JP" data-relevancy-booster="3" data-alternative-spellings="JP||Nippon||Nihon||日本" >Japan</option> <option value="JE" data-relevancy-booster="1" data-alternative-spellings="JE||Jèrri" >Jersey</option> <option value="JO" data-relevancy-booster="1.5" data-alternative-spellings="JO||Al-’Urdun||الأردن" >Jordan</option> <option value="KZ" data-relevancy-booster="1.5" data-alternative-spellings="KZ||Qazaqstan||Қазақстан||Kazakhstán||Казахстан" >Kazakhstan</option> <option value="KE" data-relevancy-booster="1.5" data-alternative-spellings="KE" >Kenya</option> <option value="KI" data-relevancy-booster="0.7" data-alternative-spellings="KI" >Kiribati</option> <option value="KP" data-relevancy-booster="0.4" data-alternative-spellings="KP||Chosŏn||North Korea||Bukchosŏn||조선||朝鮮" >Korea, Democratic People's Republic of</option> <option value="KR" data-relevancy-booster="2.5" data-alternative-spellings="KR||Hanguk||South Korea||Namhan||한국||韓國" >Korea, Republic of</option> <option value="KW" data-relevancy-booster="2" data-alternative-spellings="KW||Al-Kuwayt||الكويت" >Kuwait</option> <option value="KG" data-relevancy-booster="0.4" data-alternative-spellings="KG||Кыргызстан||Kirgizija||Киргизия" >Kyrgyzstan</option> <option value="LA" data-relevancy-booster="0.4" data-alternative-spellings="LA||ລາວ||Laos" >Lao People's Democratic Republic</option> <option value="LV" data-relevancy-booster="2" data-alternative-spellings="LV||Latvija" >Latvia</option> <option value="LB" data-relevancy-booster="2" data-alternative-spellings="LB||Lubnān||لبنان" >Lebanon</option> <option value="LS" data-relevancy-booster="0.4" data-alternative-spellings="LS" >Lesotho</option> <option value="LR" data-relevancy-booster="0.4" data-alternative-spellings="LR" >Liberia</option> <option value="LY" data-relevancy-booster="0.7" data-alternative-spellings="LY||Lībiyā||ليبيا" >Libya</option> <option value="LI" data-relevancy-booster="0.7" data-alternative-spellings="LI" >Liechtenstein</option> <option value="LT" data-relevancy-booster="2" data-alternative-spellings="LT||Lietuva" >Lithuania</option> <option value="LU" data-relevancy-booster="2" data-alternative-spellings="LU||Lëtzebuerg||Luxemburg" >Luxembourg</option> <option value="MO" data-relevancy-booster="1" data-alternative-spellings="MO" >Macau Special Administrative Region of China</option> <option value="MK" data-relevancy-booster="1.5" data-alternative-spellings="MK||Severna Makedonija||Северна Македонија" >North Macedonia</option> <option value="MG" data-relevancy-booster="0.4" data-alternative-spellings="MG||Madagasikara" >Madagascar</option> <option value="MW" data-relevancy-booster="0.4" data-alternative-spellings="MW" >Malawi</option> <option value="MY" data-relevancy-booster="3" data-alternative-spellings="MY" >Malaysia</option> <option value="MV" data-relevancy-booster="0.7" data-alternative-spellings="MV||Dhivehi Raajje||ދިވެހިރާއްޖެ" >Maldives</option> <option value="ML" data-relevancy-booster="0.4" data-alternative-spellings="ML" >Mali</option> <option value="MT" data-relevancy-booster="2" data-alternative-spellings="MT" >Malta</option> <option value="MH" data-relevancy-booster="0.4" data-alternative-spellings="MH" >Marshall Islands</option> <option value="MQ" data-relevancy-booster="1" data-alternative-spellings="MQ" >Martinique</option> <option value="MR" data-relevancy-booster="0.4" data-alternative-spellings="MR||Mauritanie||Mūrītāniyā||موريتانيا" >Mauritania</option> <option value="MU" data-relevancy-booster="1.5" data-alternative-spellings="MU||Maurice" >Mauritius</option> <option value="YT" data-relevancy-booster="0.4" data-alternative-spellings="YT" >Mayotte</option> <option value="MX" data-relevancy-booster="3" data-alternative-spellings="MX||México" >Mexico</option> <option value="FM" data-relevancy-booster="0.2" data-alternative-spellings="FM" >Micronesia, Federated States of</option> <option value="MD" data-relevancy-booster="1" data-alternative-spellings="MD" >Moldova, Republic of</option> <option value="MC" data-relevancy-booster="1" data-alternative-spellings="MC" >Monaco</option> <option value="MN" data-relevancy-booster="0.7" data-alternative-spellings="MN||Mongol Uls||Монгол Улс" >Mongolia</option> <option value="ME" data-relevancy-booster="0.4" data-alternative-spellings="ME||Crna Gora||Црна Гора" >Montenegro</option> <option value="MS" data-relevancy-booster="0.2" data-alternative-spellings="MS" >Montserrat</option> <option value="MA" data-relevancy-booster="1.5" data-alternative-spellings="MA||Al-Maghrib||المغرب" >Morocco</option> <option value="MZ" data-relevancy-booster="0.7" data-alternative-spellings="MZ||Moçambique" >Mozambique</option> <option value="MM" data-relevancy-booster="0.4" data-alternative-spellings="MM" >Myanmar</option> <option value="NA" data-relevancy-booster="1" data-alternative-spellings="NA" >Namibia</option> <option value="NR" data-relevancy-booster="0.2" data-alternative-spellings="NR||Naoero||Nauruo" >Nauru</option> <option value="NP" data-relevancy-booster="1" data-alternative-spellings="NP||Nepāla||नेपाल" >Nepal</option> <option value="NL" data-relevancy-booster="3.5" data-alternative-spellings="NL||Nederland" >Netherlands</option> <option value="NC" data-relevancy-booster="0.7" data-alternative-spellings="NC||Nouvelle-Calédonie" >New Caledonia</option> <option value="NZ" data-relevancy-booster="3.5" data-alternative-spellings="NZ||Aotearoa" >New Zealand</option> <option value="NI" data-relevancy-booster="1.5" data-alternative-spellings="NI" >Nicaragua</option> <option value="NE" data-relevancy-booster="0.4" data-alternative-spellings="NE" >Niger</option> <option value="NG" data-relevancy-booster="2" data-alternative-spellings="NG" >Nigeria</option> <option value="NU" data-relevancy-booster="0.2" data-alternative-spellings="NU||Niuē" >Niue</option> <option value="NF" data-relevancy-booster="0.4" data-alternative-spellings="NF" >Norfolk Island</option> <option value="MP" data-relevancy-booster="0.7" data-alternative-spellings="MP" >Northern Mariana Islands</option> <option value="NO" data-relevancy-booster="3.5" data-alternative-spellings="NO||Norge||Noreg" >Norway</option> <option value="OM" data-relevancy-booster="2" data-alternative-spellings="OM||‘Umān||عُمان" >Oman</option> <option value="PK" data-relevancy-booster="2" data-alternative-spellings="PK||Pākistān||پاکستان" >Pakistan</option> <option value="PW" data-relevancy-booster="0.4" data-alternative-spellings="PW||Belau" >Palau</option> <option value="PS" data-relevancy-booster="0.7" data-alternative-spellings="PS||Filastīn||Dawlat Filasţīn||فلسطين||دولة فلسطين" >Palestine, State of</option> <option value="PA" data-relevancy-booster="2" data-alternative-spellings="PA||Panamá" >Panama</option> <option value="PG" data-relevancy-booster="1" data-alternative-spellings="PG||Papua Niugini" >Papua New Guinea</option> <option value="PY" data-relevancy-booster="1" data-alternative-spellings="PY||Paraguái" >Paraguay</option> <option value="PE" data-relevancy-booster="2" data-alternative-spellings="PE||Perú" >Peru</option> <option value="PH" data-relevancy-booster="3" data-alternative-spellings="PH||Pilipinas||Filipinas" >Philippines</option> <option value="PN" data-relevancy-booster="0.2" data-alternative-spellings="PN||Pitcairn Islands" >Pitcairn</option> <option value="PL" data-relevancy-booster="2.5" data-alternative-spellings="PL||Polska" >Poland</option> <option value="PT" data-relevancy-booster="2.5" data-alternative-spellings="PT||Portugal" >Portugal</option> <option value="PR" data-relevancy-booster="2.5" data-alternative-spellings="PR" >Puerto Rico</option> <option value="QA" data-relevancy-booster="2" data-alternative-spellings="QA||قطر" >Qatar</option> <option value="RE" data-relevancy-booster="1" data-alternative-spellings="RE||Reunion||La Réunion" >Réunion</option> <option value="RO" data-relevancy-booster="2.5" data-alternative-spellings="RO||România" >Romania</option> <option value="RU" data-relevancy-booster="3" data-alternative-spellings="RU||Rossiya||Rossiâ||Россия" >Russian Federation</option> <option value="RW" data-relevancy-booster="0.7" data-alternative-spellings="RW" >Rwanda</option> <option value="BL" data-relevancy-booster="0.4" data-alternative-spellings="BL" >Saint Barthélemy</option> <option value="SH" data-relevancy-booster="0.2" data-alternative-spellings="SH||Saint Helena||Ascension||Tristan da Cunha" >Saint Helena, Ascension and Tristan da Cunha</option> <option value="KN" data-relevancy-booster="0.4" data-alternative-spellings="KN" >Saint Kitts and Nevis</option> <option value="LC" data-relevancy-booster="1" data-alternative-spellings="LC" >Saint Lucia</option> <option value="MF" data-relevancy-booster="0.4" data-alternative-spellings="MF" >Saint Martin</option> <option value="PM" data-relevancy-booster="0.2" data-alternative-spellings="PM||Saint-Pierre et Miquelon" >Saint Pierre and Miquelon</option> <option value="VC" data-relevancy-booster="0.7" data-alternative-spellings="VC" >Saint Vincent and the Grenadines</option> <option value="WS" data-relevancy-booster="0.4" data-alternative-spellings="WS" >Samoa</option> <option value="SM" data-relevancy-booster="0.4" data-alternative-spellings="SM" >San Marino</option> <option value="SS" data-relevancy-booster="0.4" data-alternative-spellings="SS" >South Sudan</option> <option value="ST" data-relevancy-booster="0.2" data-alternative-spellings="ST||São Tomé e Príncipe" >Sao Tome and Principe</option> <option value="SA" data-relevancy-booster="2.5" data-alternative-spellings="SA||Al-Mamlaka Al-‘Arabiyyah as Sa‘ūdiyyah||المملكة العربية السعودية" >Saudi Arabia</option> <option value="SN" data-relevancy-booster="0.4" data-alternative-spellings="SN||Sénégal" >Senegal</option> <option value="RS" data-relevancy-booster="2" data-alternative-spellings="RS||Srbija||Србија" >Serbia</option> <option value="SC" data-relevancy-booster="0.4" data-alternative-spellings="SC||Sesel" >Seychelles</option> <option value="SL" data-relevancy-booster="0.2" data-alternative-spellings="SL" >Sierra Leone</option> <option value="SG" data-relevancy-booster="3" data-alternative-spellings="SG||Singapura||Xīnjiāpō||新加坡||Singapur||சிங்கப்பூர்" selected >Singapore</option> <option value="SK" data-relevancy-booster="2" data-alternative-spellings="SK||Slovensko" >Slovakia</option> <option value="SI" data-relevancy-booster="2.5" data-alternative-spellings="SI||Slovenija" >Slovenia</option> <option value="SB" data-relevancy-booster="0.4" data-alternative-spellings="SB" >Solomon Islands</option> <option value="SO" data-relevancy-booster="0.2" data-alternative-spellings="SO||Soomaaliya||aş-Şūmāl||الصومال" >Somalia</option> <option value="ZA" data-relevancy-booster="3" data-alternative-spellings="ZA||Suid-Afrika||iNingizimu Afrika||uMzantsi Afrika||Afrika-Borwa||Afrika Borwa||Aforika Borwa||Afurika Tshipembe||Afrika Dzonga||iSewula Afrika" >South Africa</option> <option value="GS" data-relevancy-booster="0.2" data-alternative-spellings="GS" >South Georgia and the South Sandwich Islands</option> <option value="ES" data-relevancy-booster="3" data-alternative-spellings="ES||España||Espanya||Espainia||Espanha" >Spain</option> <option value="LK" data-relevancy-booster="1.5" data-alternative-spellings="LK||Sri Lankā||ශ්රී ලංකාව||ஸ்ரீ லங்க" >Sri Lanka</option> <option value="SD" data-relevancy-booster="0.4" data-alternative-spellings="SD||As-Sudan||السودان" >Sudan</option> <option value="SR" data-relevancy-booster="0.4" data-alternative-spellings="SR" >Suriname</option> <option value="SJ" data-relevancy-booster="0.4" data-alternative-spellings="SJ" >Svalbard and Jan Mayen</option> <option value="SZ" data-relevancy-booster="0.4" data-alternative-spellings="SZ||Swaziland" >Eswatini</option> <option value="SE" data-relevancy-booster="3" data-alternative-spellings="SE||Sverige" >Sweden</option> <option value="CH" data-relevancy-booster="3.5" data-alternative-spellings="CH||Schweiz||Suisse||Svizzera||Svizra" >Switzerland</option> <option value="SY" data-relevancy-booster="0.2" data-alternative-spellings="SY||Suriyah||سورية" >Syrian Arab Republic</option> <option value="TW" data-relevancy-booster="2.5" data-alternative-spellings="TW||Zhōnghuá Mínguó||Táiwan||中華民國||臺灣/台灣" >Taiwan</option> <option value="TJ" data-relevancy-booster="0.4" data-alternative-spellings="TJ||Tojikistan||Тоҷикистон" >Tajikistan</option> <option value="TZ" data-relevancy-booster="1" data-alternative-spellings="TZ" >Tanzania, United Republic of</option> <option value="TH" data-relevancy-booster="3" data-alternative-spellings="TH||Mueang Thai||Prathet Thai||Ratcha-anachak Thai" >Thailand</option> <option value="TL" data-relevancy-booster="0.4" data-alternative-spellings="TL" >Timor-Leste</option> <option value="TG" data-relevancy-booster="0.4" data-alternative-spellings="TG" >Togo</option> <option value="TK" data-relevancy-booster="0.2" data-alternative-spellings="TK" >Tokelau</option> <option value="TO" data-relevancy-booster="0.4" data-alternative-spellings="TO" >Tonga</option> <option value="TT" data-relevancy-booster="2" data-alternative-spellings="TT" >Trinidad and Tobago</option> <option value="TN" data-relevancy-booster="1" data-alternative-spellings="TN||Tunis" >Tunisia</option> <option value="TR" data-relevancy-booster="3" data-alternative-spellings="TR||Turkey" >Türkiye</option> <option value="TM" data-relevancy-booster="0.2" data-alternative-spellings="TM||Türkmenistan" >Turkmenistan</option> <option value="TC" data-relevancy-booster="0.7" data-alternative-spellings="TC" >Turks and Caicos Islands</option> <option value="TV" data-relevancy-booster="0.2" data-alternative-spellings="TV" >Tuvalu</option> <option value="UG" data-relevancy-booster="1.5" data-alternative-spellings="UG" >Uganda</option> <option value="UA" data-relevancy-booster="2" data-alternative-spellings="UA||Ukraїna" >Ukraine</option> <option value="AE" data-relevancy-booster="3" data-alternative-spellings="AE||Al-’Imārat Al-‘Arabiyyah Al-Muttaḥidah" >United Arab Emirates</option> <option value="GB" data-relevancy-booster="4" data-alternative-spellings="GB||Great Britain||England||Northern Ireland||Britain||UK" >United Kingdom</option> <option value="US" data-relevancy-booster="4.5" data-alternative-spellings="US||USA||United States of America||America" >United States</option> <option value="UM" data-relevancy-booster="1" data-alternative-spellings="UM" >United States Minor Outlying Islands</option> <option value="UY" data-relevancy-booster="1.5" data-alternative-spellings="UY||República Oriental del Uruguay" >Uruguay</option> <option value="UZ" data-relevancy-booster="0.4" data-alternative-spellings="UZ||O'zbekiston" >Uzbekistan</option> <option value="VU" data-relevancy-booster="0.4" data-alternative-spellings="VU" >Vanuatu</option> <option value="VE" data-relevancy-booster="2" data-alternative-spellings="VE||Venezuela, Bolivarian Republic of||República Bolivariana de Venezuela" >Venezuela</option> <option value="VN" data-relevancy-booster="2" data-alternative-spellings="VN||Việt Nam" >Vietnam</option> <option value="VG" data-relevancy-booster="1" data-alternative-spellings="VG" >Virgin Islands, British</option> <option value="VI" data-relevancy-booster="1.5" data-alternative-spellings="VI" >Virgin Islands, U.S.</option> <option value="WF" data-relevancy-booster="0.2" data-alternative-spellings="WF||Wallis-et-Futuna" >Wallis and Futuna Islands</option> <option value="EH" data-relevancy-booster="0.2" data-alternative-spellings="EH" >Western Sahara</option> <option value="YE" data-relevancy-booster="0.4" data-alternative-spellings="YE||Al-Yaman" >Yemen</option> <option value="ZM" data-relevancy-booster="1" data-alternative-spellings="ZM" >Zambia</option> <option value="ZW" data-relevancy-booster="0.7" data-alternative-spellings="ZW" >Zimbabwe</option> </select> </div> </div> </div> </div> </div> </fieldset> </section><!-- data-fc-id="block-customer-billing" --> <section data-fc-id="block-payment-method" class="fc-checkout__section--payment"> <fieldset id="fc-payment" data-fc-container="payment"> <legend><span class="fc-section-counter"></span> Payment Method</legend> <svg id="fc-icon-lock-large" class="fc-svg-icon fc-svg-icon--lock hidden-xs hidden-sm" title="Security Icon" role="presentation"><use xlink:href="#fa-lock-large" /></svg> <div class="fc-form-group" data-fc-id="fc-payment-method-plastic-new" data-fc-error-for="cc_number cc_exp_month cc_exp_year cc_cvv2" data-fc-error-class="fc-alert-container--error"> <div id="fc-payment-method-plastic-new" class="fc-container__grid--payment-method fc-payment-method--plastic__new"> <div class="fc-input-group-container fc-input-group-container--active"> <label for="fc_payment_method_plastic_new" class="fc-form-label--plastic-new fc-input-group-container__title fc-input-group-container__title--forced"> <input type="hidden" checked="checked" id="fc_payment_method_plastic_new" name="fc_payment_method" value="plastic_new" class="fc-form-control--plastic-new--checkbox fc-form-control" /> <span class="fc-checkout__section--payment__method__logo fc-checkout__section--payment__method__logo--visa"> <img class="fc-checkout__section--payment__method__logo--visa" src="https://cdn.foxycart.com/static/images/payment_logos/sets/smashing/visa.png" alt="visa" /> </span> <span class="fc-checkout__section--payment__method__logo fc-checkout__section--payment__method__logo--mastercard"> <img class="fc-checkout__section--payment__method__logo--mastercard" src="https://cdn.foxycart.com/static/images/payment_logos/sets/smashing/mastercard.png" alt="mastercard" /> </span> <span class="fc-checkout__section--payment__method__logo fc-checkout__section--payment__method__logo--discover"> <img class="fc-checkout__section--payment__method__logo--discover" src="https://cdn.foxycart.com/static/images/payment_logos/sets/smashing/discover.png" alt="discover" /> </span> <span class="fc-checkout__section--payment__method__logo fc-checkout__section--payment__method__logo--amex"> <img class="fc-checkout__section--payment__method__logo--amex" src="https://cdn.foxycart.com/static/images/payment_logos/sets/smashing/amex.png" alt="amex" /> </span> </label> <div class="fc-form-group fc-form-group-multiple-inline " data-fc-error-for="cc_number" aria-live="polite" role="status" data-fc-error-class="fc-alert-container--error,fc-alert-container--success"> <label class="fc-form-label fc-form-label--new-cc-number" for="cc_number">Card #</label> <div class="fc-container__grid--input--plastic-new-card-number"> <input type="tel" id="cc_number" name="cc_number" value="" maxlength="16" placeholder="Card #" autocomplete="cc-number" class="fc-form-control fc-form-control--new-cc-number" /> <svg class="fc-svg-icon fc-svg-icon--lock fc-cc-icon visible-xs visible-sm" title="Security Icon" role="presentation"><use xlink:href="#fa-lock" /></svg> </div> </div> <div class="fc-form-group fc-form-group-multiple-inline"> <label class="fc-form-label--new-cc-exp-month fc-form-control--static fc-form-label" for="cc_exp_month">Expiration</label> <label class="fc-form-label fc-form-label--new-cc-exp-year" for="cc_exp_year">Year</label> <label class=" fc-form-label fc-form-label--new-cc-cvv2" for="cc_cvv2">Card Security Code</label> <div id="fc-payment-method-plastic-expires-month" class="fc-container__grid--plastic-new-exp-month " data-fc-error-for="cc_exp_month" data-fc-error-class="fc-alert-container--error,has-success"> <select class="fc-form-control--new-cc-exp-month fc-form-control" name="cc_exp_month" id="cc_exp_month" autocomplete="cc-exp-month" > <option value="">Month</option> <option value="01" > 01 - January </option> <option value="02" > 02 - February </option> <option value="03" > 03 - March </option> <option value="04" > 04 - April </option> <option value="05" > 05 - May </option> <option value="06" > 06 - June </option> <option value="07" > 07 - July </option> <option value="08" > 08 - August </option> <option value="09" > 09 - September </option> <option value="10" > 10 - October </option> <option value="11" > 11 - November </option> <option value="12" > 12 - December </option> </select> </div> <div id="fc-payment-method-plastic-expires-year" class="fc-container__grid--plastic-new-exp-year " data-fc-error-for="cc_exp_year" data-fc-error-class="fc-alert-container--error,has-success"> <select class="fc-form-control--new-cc-exp-year fc-form-control" name="cc_exp_year" id="cc_exp_year" autocomplete="cc-exp-year" > <option value="">Year</option> <option value="2024" > 2024 </option> <option value="2025" > 2025 </option> <option value="2026" > 2026 </option> <option value="2027" > 2027 </option> <option value="2028" > 2028 </option> <option value="2029" > 2029 </option> <option value="2030" > 2030 </option> <option value="2031" > 2031 </option> <option value="2032" > 2032 </option> <option value="2033" > 2033 </option> <option value="2034" > 2034 </option> <option value="2035" > 2035 </option> <option value="2036" > 2036 </option> <option value="2037" > 2037 </option> <option value="2038" > 2038 </option> <option value="2039" > 2039 </option> <option value="2040" > 2040 </option> <option value="2041" > 2041 </option> <option value="2042" > 2042 </option> <option value="2043" > 2043 </option> <option value="2044" > 2044 </option> </select> </div> <div id="fc-payment-method-plastic-csc" class="fc-container__grid--plastic-new-csc " data-fc-error-for="cc_cvv2" data-fc-error-class="fc-alert-container--error,has-success"> <input type="tel" id="cc_cvv2" name="cc_cvv2" value="" maxlength="4" placeholder="CSC" autocomplete="off" class="fc-form-control fc-form-control--new-cc-cvv2" /> </div> </div> </div> <div class="fc-alert fc-alert--danger hidden" data-fc-error-for="cc_cvv2" data-fc-error-class="show,hidden" aria-live="polite" role="status"> Please enter your card security code, which is the 3 digit code on the back of your card (for Visa, Mastercard, and Discover), or the 4 digit code on the front (for American Express). </div> <div class="fc-alert fc-alert--danger hidden" data-fc-error-for="cc_number" data-fc-error-class="show,hidden" aria-live="polite" role="status"> The number you entered is invalid or not supported by this store. Enter a new credit or debit card number, or double-check your entry above. </div> <div class="fc-alert fc-alert--danger hidden" data-fc-error-for="cc_exp_month cc_exp_year" data-fc-error-class="show,hidden" aria-live="polite" role="status"> The expiration date you entered is invalid or in the past. Please review your selection above </div> </div> </div> </fieldset> </section><!-- data-fc-id="block-payment-method" --> <section data-fc-id="block-additional-fields"> <fieldset id="fc-additional-fields"> <legend><span class="fc-section-counter"></span> Almost Done!</legend> <div class="fc-form-group" data-fc-container="account-creation" data-fc-error-for="new_customer_password" data-fc-error-class="fc-alert-container--error"> <div class="fc-checkout__additional-field--save-account"> <div class="fc-input-group-container fc-input-group-container--checkbox fc-input-group-container--active"> <label data-fc-id="account-creation-label" class="fc-input-group-container__title fc-form-label fc-input-group-container__title--forced"> Save my address & payment info for next time. </label> <div class="fc-form-group"> <p>Enter a password below. On your next visit you can use this password to retrieve your account information.</p> <label for="new_customer_password">Password</label> <input type="password" id="new_customer_password" name="new_customer_password" minlength="8" placeholder="Password" autocomplete="new-password" class="fc-form-control fc-form-control--new-customer-password" data-fc-required value="" /> </div> </div> <div class="fc-alert fc-alert--danger hidden" data-fc-error-for="new_customer_password" data-fc-error-class="show,hidden"> <div class="">Please enter a password (8 character minimum).</div> </div> </div> </div> </fieldset> </section><!-- data-fc-id="block-additional-fields" --> <section data-fc-id="block-submit-button" class="fc-checkout__section--submit"> <div class="fc-form-group"> <div class="fc-container__grid--checkout-submit"> <button class="fc-button fc-button--submit" data-fc-id="submit-button"> Submit Your Order </button> </div> </div> </section><!-- data-fc-id="block-submit-button" --> </form> </div> </div><!-- #fc-checkout__main --> </div><!-- .fc-container --> <!-- END CHECKOUT TWIG TEMPLATE --> </div><!-- data-fc-id="checkout" --> </div> <!-- FC footer script insertion --> <!-- /FC footer scripts --> <!--[if lt IE 10 ]> <script src="https://aspet.ecommerce.highwire.org/static/scripts/placeholder/placeholder_polyfill.jquery.js" charset="utf-8"></script> <![endif]--> </body> </html>