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Brunswick</OPTION> <OPTION VALUE="NL" > Newfoundland and Labrador</OPTION> <OPTION VALUE="NS" > Nova Scotia</OPTION> <OPTION VALUE="NT" > Northwest Territories</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 Territory</OPTION> </optgroup> <optgroup label="Mexico"> <OPTION VALUE="Aguascalientes" > Aguascalientes</OPTION> <OPTION VALUE="Baja California" > Baja California</OPTION> <OPTION VALUE="Baja California Sur" > Baja California Sur</OPTION> <OPTION VALUE="Campeche" > Campeche</OPTION> <OPTION VALUE="Chiapas" > Chiapas</OPTION> <OPTION VALUE="Chihuahua" > Chihuahua</OPTION> <OPTION VALUE="Coahuila" > Coahuila</OPTION> <OPTION VALUE="Colima" > Colima</OPTION> <OPTION VALUE="Distrito Federal" > Distrito Federal</OPTION> <OPTION VALUE="Durango" > Durango</OPTION> <OPTION VALUE="Guanajuato" > Guanajuato</OPTION> <OPTION VALUE="Guerrero" > Guerrero</OPTION> <OPTION VALUE="Hidalgo" > Hidalgo</OPTION> <OPTION VALUE="Jalisco" > Jalisco</OPTION> <OPTION VALUE="Mexico State" > Mexico State</OPTION> <OPTION VALUE="Michoacan" > Michoacan</OPTION> <OPTION VALUE="Morelos" > Morelos</OPTION> <OPTION VALUE="Nayarit" > Nayarit</OPTION> <OPTION VALUE="Nuevo Leon" > Nuevo Leon</OPTION> <OPTION VALUE="Oaxaca" > Oaxaca</OPTION> <OPTION VALUE="Puebla" > Puebla</OPTION> <OPTION VALUE="Queretaro" > Queretaro</OPTION> <OPTION VALUE="Quintana Roo" > Quintana Roo</OPTION> <OPTION VALUE="San Luis Potosi" > San Luis Potosi</OPTION> <OPTION VALUE="Sinaloa" > Sinaloa</OPTION> <OPTION VALUE="Sonora" > Sonora</OPTION> <OPTION VALUE="Tabasco" > Tabasco</OPTION> <OPTION VALUE="Tamaulipas" > Tamaulipas</OPTION> <OPTION VALUE="Tlaxcala" > Tlaxcala</OPTION> <OPTION VALUE="Veracruz" > Veracruz</OPTION> <OPTION VALUE="Yucatan" > Yucatan</OPTION> <OPTION VALUE="Zacatecas" > Zacatecas</OPTION> </optgroup> <OPTION VALUE=""> Other</OPTION> </SELECT> </div> <div id="container_country"> <p> <label for="country">Company Country</label><br /> </p> <SELECT NAME="country" id="country"> <OPTION VALUE=""> select your country</OPTION> <OPTION VALUE="USA" > UNITED STATES</OPTION> <OPTION VALUE="CANADA" > CANADA</OPTION> <OPTION VALUE="INDIA" > INDIA</OPTION> <OPTION VALUE="UNITED KINGDOM" > UNITED KINGDOM</OPTION> <OPTION VALUE=""> ==</OPTION> <OPTION VALUE="AFGHANISTAN" > AFGHANISTAN</OPTION> <OPTION VALUE="ALBANIA" > ALBANIA</OPTION> <OPTION VALUE="ALGERIA" > ALGERIA</OPTION> <OPTION VALUE="AMERICAN SAMOA" > AMERICAN SAMOA</OPTION> <OPTION VALUE="ANDORRA" > ANDORRA</OPTION> <OPTION VALUE="ANGOLA" > ANGOLA</OPTION> <OPTION VALUE="ANGUILLA" > ANGUILLA</OPTION> <OPTION VALUE="ANTARCTICA" > ANTARCTICA</OPTION> <OPTION VALUE="ANTIGUA AND BARBUDA" > ANTIGUA AND BARBUDA</OPTION> <OPTION VALUE="ARGENTINA" > ARGENTINA</OPTION> <OPTION VALUE="ARMENIA" > ARMENIA</OPTION> <OPTION VALUE="ARUBA" > ARUBA</OPTION> <OPTION VALUE="AUSTRALIA" > AUSTRALIA</OPTION> <OPTION VALUE="AUSTRIA" > AUSTRIA</OPTION> <OPTION VALUE="AZERBAIJAN" > AZERBAIJAN</OPTION> <OPTION VALUE="AZORES" > AZORES</OPTION> <OPTION VALUE="BAHAMAS" > BAHAMAS</OPTION> <OPTION VALUE="BAHRAIN" > BAHRAIN</OPTION> <OPTION VALUE="BANGLADESH" > BANGLADESH</OPTION> <OPTION VALUE="BARBADOS" > BARBADOS</OPTION> <OPTION VALUE="BELARUS" > BELARUS</OPTION> <OPTION VALUE="BELGIUM" > BELGIUM</OPTION> <OPTION VALUE="BELIZE" > BELIZE</OPTION> <OPTION 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="BR VIRGIN ISLAND" > BR VIRGIN ISLAND</OPTION> <OPTION VALUE="BRAZIL" > BRAZIL</OPTION> <OPTION VALUE="BRITISH INDIAN OCEAN TERRITORY" > BRITISH INDIAN OCEAN TERRITORY</OPTION> <OPTION VALUE="BRUNEI" > BRUNEI</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="CANARY ISLANDS" > CANARY ISLANDS</OPTION> <OPTION VALUE="CAPE VERDE" > CAPE VERDE</OPTION> <OPTION VALUE="CAYMAN ISLANDS" > CAYMAN ISLANDS</OPTION> <OPTION VALUE="CENTRAL AFRICAN REP" > CENTRAL AFRICAN REP</OPTION> <OPTION VALUE="CHAD" > CHAD</OPTION> <OPTION VALUE="CHANNEL ISLANDS" > CHANNEL ISLANDS</OPTION> <OPTION VALUE="CHILE" > CHILE</OPTION> <OPTION VALUE="CHINA, PEO REPBL" > CHINA, PEO REPBL</OPTION> <OPTION VALUE="CHRISTMAS ISLAND" > CHRISTMAS ISLAND</OPTION> <OPTION VALUE="COCOS (KEELING) ISLANDS" > COCOS (KEELING) ISLANDS</OPTION> <OPTION VALUE="COLOMBIA" > COLOMBIA</OPTION> <OPTION VALUE="COMOROS" > COMOROS</OPTION> <OPTION VALUE="CONGO" > CONGO</OPTION> <OPTION VALUE="CONGO, THE DEMOCRATIC REPUBLIC OF THE" > CONGO, THE DEMOCRATIC REPUBLIC OF THE</OPTION> <OPTION VALUE="COOK ISLANDS" > COOK ISLANDS</OPTION> <OPTION VALUE="COSTA RICA" > COSTA RICA</OPTION> <OPTION VALUE="COTE D'IVOIRE" > COTE D'IVOIRE</OPTION> <OPTION VALUE="CROATIA" > CROATIA</OPTION> <OPTION VALUE="CUBA" > CUBA</OPTION> <OPTION VALUE="CYPRUS" > CYPRUS</OPTION> <OPTION VALUE="CZECH REPUBLIC" > CZECH REPUBLIC</OPTION> <OPTION VALUE="DENMARK" > DENMARK</OPTION> <OPTION VALUE="DJIBOUTI" > DJIBOUTI</OPTION> <OPTION VALUE="DOMINICA" > DOMINICA</OPTION> <OPTION VALUE="DOMINICAN REPUBLIC" > DOMINICAN REPUBLIC</OPTION> <OPTION VALUE="ECUADOR" > ECUADOR</OPTION> <OPTION VALUE="EGYPT" > EGYPT</OPTION> <OPTION VALUE="EL SALVADOR" > EL SALVADOR</OPTION> <OPTION VALUE="ELAND ISLANDS" > ELAND ISLANDS</OPTION> <OPTION VALUE="EQUATORIAL GUINEA" > EQUATORIAL GUINEA</OPTION> <OPTION VALUE="ERITREA" > ERITREA</OPTION> <OPTION VALUE="ESTONIA" > ESTONIA</OPTION> <OPTION VALUE="ETHIOPIA" > ETHIOPIA</OPTION> <OPTION VALUE="FALKLAND ISLANDS" > FALKLAND ISLANDS</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 GUINEA" > FRENCH GUINEA</OPTION> <OPTION VALUE="FRENCH POLYNESIA" > FRENCH POLYNESIA</OPTION> <OPTION VALUE="GABON, REPUBLIC OF" > GABON, REPUBLIC OF</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 BIASSAU" > GUINEA BIASSAU</OPTION> <OPTION VALUE="GUINEA,REPUBLIC OF" > GUINEA,REPUBLIC OF</OPTION> <OPTION VALUE="GUYANA" > GUYANA</OPTION> <OPTION VALUE="HAITI" > HAITI</OPTION> <OPTION VALUE="HONDURAS" > HONDURAS</OPTION> <OPTION VALUE="HONG KONG" > HONG KONG, S.A.R., CHINA</OPTION> <OPTION VALUE="HUNGARY" > HUNGARY</OPTION> <OPTION VALUE="ICELAND" > ICELAND</OPTION> <OPTION VALUE="INDIA" > INDIA</OPTION> <OPTION VALUE="INDONESIA" > INDONESIA</OPTION> <OPTION VALUE="IRAN" > IRAN</OPTION> <OPTION VALUE="IRAQ" > IRAQ</OPTION> <OPTION VALUE="IRELAND" > IRELAND</OPTION> <OPTION VALUE="ISRAEL" > ISRAEL</OPTION> <OPTION VALUE="ITALY" > ITALY</OPTION> <OPTION VALUE="JAMAICA" > JAMAICA</OPTION> <OPTION VALUE="JAPAN" > JAPAN</OPTION> <OPTION VALUE="JORDAN" > JORDAN</OPTION> <OPTION VALUE="KAZAKHSTAN" > KAZAKHSTAN</OPTION> <OPTION VALUE="KENYA" > KENYA</OPTION> <OPTION VALUE="KOREA,DEMOCRATIC REPUBLIC OF" > KOREA,DEMOCRATIC REPUBLIC OF</OPTION> <OPTION VALUE="KOREA,REPUBLIC OF" > KOREA,REPUBLIC OF</OPTION> <OPTION VALUE="KOSOVO" > KOSOVO</OPTION> <OPTION VALUE="KUWAIT" > KUWAIT</OPTION> <OPTION VALUE="KYRGZSTAN" > KYRGZSTAN</OPTION> <OPTION VALUE="LAOS" > LAOS</OPTION> <OPTION VALUE="LATVIA" > LATVIA</OPTION> <OPTION VALUE="LEBANON" > LEBANON</OPTION> <OPTION VALUE="LESOTHO" > LESOTHO</OPTION> <OPTION VALUE="LIBERIA" > LIBERIA</OPTION> <OPTION VALUE="LIBYA" > LIBYA</OPTION> <OPTION VALUE="LIECHTENSTEIN" > LIECHTENSTEIN</OPTION> <OPTION VALUE="LITHUANIA" > LITHUANIA</OPTION> <OPTION VALUE="LUXEMBOURG" > LUXEMBOURG</OPTION> <OPTION VALUE="MACAU" > MACAU, S.A.R., CHINA</OPTION> <OPTION VALUE="MACEDONIA" > MACEDONIA</OPTION> <OPTION VALUE="MADAGASCAR" > MADAGASCAR</OPTION> <OPTION VALUE="MADEIRA" > MADEIRA</OPTION> <OPTION VALUE="MALAWI" > MALAWI</OPTION> <OPTION VALUE="MALAYSIA" > MALAYSIA</OPTION> <OPTION VALUE="MALDIVES" > MALDIVES</OPTION> <OPTION VALUE="MALI" > MALI</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" > MICRONESIA</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="NAMIBIA" > NAMIBIA</OPTION> <OPTION VALUE="NAURU ISLANDS" > NAURU ISLANDS</OPTION> <OPTION VALUE="NEPAL" > NEPAL</OPTION> <OPTION VALUE="NETHERLANDS ANTILLES" > NETHERLANDS ANTILLES</OPTION> <OPTION VALUE="NETHERLANDS" > NETHERLANDS</OPTION> <OPTION VALUE="NEW CALEDONIA" > NEW CALEDONIA</OPTION> <OPTION VALUE="NEW ZEALAND" > NEW ZEALAND</OPTION> <OPTION VALUE="NICARAGUA" > NICARAGUA</OPTION> <OPTION VALUE="NIGER" > NIGER</OPTION> <OPTION VALUE="NIGERIA" > NIGERIA</OPTION> <OPTION VALUE="NORFOLK ISLAND" > NORFOLK ISLAND</OPTION> <OPTION VALUE="NORTHERN MARIANA ISLANDS" > NORTHERN MARIANA ISLANDS</OPTION> <OPTION VALUE="NORWAY" > NORWAY</OPTION> <OPTION VALUE="OMAN" > OMAN</OPTION> <OPTION VALUE="PAKISTAN" > PAKISTAN</OPTION> <OPTION VALUE="PALAU" > PALAU</OPTION> <OPTION VALUE="PALESTINIAN TERRITORY, OCCUPIED" > PALESTINIAN TERRITORY, OCCUPIED</OPTION> <OPTION VALUE="PANAMA" > PANAMA</OPTION> <OPTION VALUE="PAPUA NEW GUINEA" > PAPUA NEW GUINEA</OPTION> <OPTION VALUE="PARAGUAY" > PARAGUAY</OPTION> <OPTION VALUE="PERU" > PERU</OPTION> <OPTION VALUE="PHILIPPINES" > PHILIPPINES</OPTION> <OPTION VALUE="POLAND" > POLAND</OPTION> <OPTION VALUE="PORTUGAL" > PORTUGAL</OPTION> <OPTION VALUE="QATAR" > QATAR</OPTION> <OPTION VALUE="REPUBLIC OF KIRIBATI" > REPUBLIC OF KIRIBATI</OPTION> <OPTION VALUE="REUNION" > REUNION</OPTION> <OPTION VALUE="ROMANIA" > ROMANIA</OPTION> <OPTION VALUE="RUSSIAN FED" > RUSSIAN FED</OPTION> <OPTION VALUE="RWANDA" > RWANDA</OPTION> <OPTION VALUE="SAINT PIERRE AND MIQUELON" > SAINT PIERRE AND MIQUELON</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="SINGAPORE" > SINGAPORE</OPTION> <OPTION VALUE="SLOVAKIA" > SLOVAKIA</OPTION> <OPTION VALUE="SLOVENIA" > SLOVENIA</OPTION> <OPTION VALUE="SOCIETY ISLANDS" > SOCIETY ISLANDS</OPTION> <OPTION VALUE="SOLOMON ISLANDS" > SOLOMON ISLANDS</OPTION> <OPTION VALUE="SOMALIA,REPUBLIC" > SOMALIA,REPUBLIC</OPTION> <OPTION VALUE="SOUTH AFRICA" > SOUTH AFRICA</OPTION> <OPTION VALUE="SPAIN" > SPAIN</OPTION> <OPTION VALUE="SRI LANKA" > SRI LANKA</OPTION> <OPTION VALUE="ST KITTS" > ST KITTS</OPTION> <OPTION VALUE="ST LUCIA" > ST LUCIA</OPTION> <OPTION VALUE="ST VINCENT" > ST VINCENT</OPTION> <OPTION VALUE="SUDAN" > SUDAN</OPTION> <OPTION VALUE="SURINAM" > SURINAM</OPTION> <OPTION VALUE="SWAZILAND" > SWAZILAND</OPTION> <OPTION VALUE="SWEDEN" > SWEDEN</OPTION> <OPTION VALUE="SWITZERLAND" > SWITZERLAND</OPTION> <OPTION VALUE="SYRIA" > SYRIA</OPTION> <OPTION VALUE="TAHITI" > TAHITI</OPTION> <OPTION VALUE="TAIWAN" > TAIWAN, CHINA</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="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="UKRAINE" > UKRAINE</OPTION> <OPTION VALUE="UNION OF MYANMAR" > UNION OF MYANMAR</OPTION> <OPTION VALUE="UNITED ARAB EMIRATE" > UNITED ARAB EMIRATE</OPTION> <OPTION VALUE="UNITED KINGDOM,ENGLAND" > UNITED KINGDOM,ENGLAND</OPTION> <OPTION VALUE="UNITED KINGDOM,NO.IRELAND" > UNITED KINGDOM,NO.IRELAND</OPTION> <OPTION VALUE="UNITED KINGDOM,SCOTLAND" > UNITED KINGDOM,SCOTLAND</OPTION> <OPTION VALUE="UNITED KINGDOM" > UNITED KINGDOM</OPTION> <OPTION VALUE="UNITED KINGDOM,WALES" > UNITED KINGDOM,WALES</OPTION> <OPTION VALUE="USA" > UNITED STATES</OPTION> <OPTION VALUE="URUGUAY" > URUGUAY</OPTION> <OPTION VALUE="UZBEKISTAN" > UZBEKISTAN</OPTION> <OPTION VALUE="VANUATU" > VANUATU</OPTION> <OPTION VALUE="VATICAN CITY" > VATICAN CITY</OPTION> <OPTION VALUE="VENEZUELA" > VENEZUELA</OPTION> <OPTION VALUE="VIETNAM, RPBLC OF" > VIETNAM, RPBLC OF</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="WESTERN SAMOA" > WESTERN SAMOA</OPTION> <OPTION VALUE="YEMEN" > YEMEN</OPTION> <OPTION VALUE="ZAMBIA" > ZAMBIA</OPTION> <OPTION VALUE="ZANZIBAR" > ZANZIBAR</OPTION> <OPTION VALUE="ZIMBABWE" > ZIMBABWE</OPTION> <OPTION VALUE="OTHER" > OTHER</OPTION> </SELECT> </div> </div> <div id="usersummary"> <p>Summary</p> <br> <div id="summary_email"></div> <div id="summary_title"></div> <div id="summary_company"></div> <div><div id="summary_city"></div><div id="summary_state"></div></div> <div id="summary_country"></div> <div class="infodisplaylast"> <p> <div id="userinfo" style="display:none;"> <div class="infodisplaylast"> <p> <a href="javascript:void(0);" id="updatereg">edit</a> <a href="javascript:void(0);" id="notme">new</a> <a href="javascript:void(0);" id="save" 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