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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 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 &amp; McDonald Islands">Heard & McDonald Islands</option><option value="Honduras">Honduras</option><option value="Hong Kong SAR China">Hong Kong SAR 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="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 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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="Myanmar (Burma)">Myanmar (Burma)</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="Nicaragua">Nicaragua</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 Islands</option><option value="North Korea">North Korea</option><option value="North Macedonia">North Macedonia</option><option value="Norway">Norway</option><option value="Oman">Oman</option><option value="Outlying Oceania">Outlying Oceania</option><option value="Pakistan">Pakistan</option><option value="Palau">Palau</option><option value="Palestinian Territories">Palestinian Territories</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="Pitcairn Islands">Pitcairn Islands</option><option value="Poland">Poland</option><option value="Portugal">Portugal</option><option value="Puerto Rico">Puerto Rico</option><option value="Qatar">Qatar</option><option value="Romania">Romania</option><option value="Russia">Russia</option><option value="Rwanda">Rwanda</option><option value="Réunion">Réunion</option><option value="Samoa">Samoa</option><option value="San Marino">San Marino</option><option value="Sark">Sark</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="Sint Maarten">Sint Maarten</option><option value="Slovakia">Slovakia</option><option value="Slovenia">Slovenia</option><option value="Solomon Islands">Solomon Islands</option><option value="Somalia">Somalia</option><option value="South Africa">South Africa</option><option value="South Georgia &amp; South Sandwich Islands">South Georgia & South Sandwich Islands</option><option value="South Korea">South Korea</option><option value="South Sudan">South Sudan</option><option value="Spain">Spain</option><option value="Sri Lanka">Sri Lanka</option><option value="St. Barthélemy">St. Barthélemy</option><option value="St. Helena">St. Helena</option><option value="St. Kitts &amp; Nevis">St. Kitts & Nevis</option><option value="St. Lucia">St. Lucia</option><option value="St. Martin">St. Martin</option><option value="St. Pierre &amp; Miquelon">St. Pierre & Miquelon</option><option value="St. Vincent &amp; Grenadines">St. Vincent & Grenadines</option><option value="Sudan">Sudan</option><option value="Suriname">Suriname</option><option value="Svalbard &amp; Jan Mayen">Svalbard & Jan Mayen</option><option value="Sweden">Sweden</option><option value="Switzerland">Switzerland</option><option value="Syria">Syria</option><option value="São Tomé &amp; Príncipe">São Tomé & Príncipe</option><option value="Taiwan">Taiwan</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 &amp; Tobago">Trinidad & Tobago</option><option value="Tristan da Cunha">Tristan da Cunha</option><option value="Tunisia">Tunisia</option><option value="Turkmenistan">Turkmenistan</option><option value="Turks &amp; Caicos Islands">Turks & Caicos Islands</option><option value="Tuvalu">Tuvalu</option><option value="Türkiye">Türkiye</option><option value="U.S. Outlying Islands">U.S. Outlying Islands</option><option value="U.S. Virgin Islands">U.S. Virgin Islands</option><option value="Uganda">Uganda</option><option value="Ukraine">Ukraine</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="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">Vietnam</option><option value="Wallis &amp; Futuna">Wallis & Futuna</option><option value="Western Sahara">Western Sahara</option><option value="Yemen">Yemen</option><option value="Zambia">Zambia</option><option value="Zimbabwe">Zimbabwe</option><option value="Åland Islands">Åland Islands</option></select> </div> </div></div></div> <div class="js-form-item form-item js-form-type-select form-type-select js-form-item-interest form-item-interest"> <label for="edit-interest" class="js-form-required form-required">I am interested in</label> <select data-drupal-selector="edit-interest" id="edit-interest" name="interest" class="form-select required" required="required" aria-required="true"><option value="" selected="selected">- Select -</option><option value="Clinical">Clinical</option><option value="Pharma">Pharma</option><option value="Informatics">Informatics</option><option value="Research Project">Research Project</option><option value="Patient">I am a patient</option><option value="Other">Other</option></select> </div> <div class="js-form-item form-item js-form-type-textarea form-type-textarea js-form-item-comments form-item-comments"> <label for="edit-comments" class="js-form-required form-required">Comments</label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-comments" id="edit-comments" name="comments" rows="5" cols="60" class="form-textarea required resize-vertical" required="required" aria-required="true"></textarea> </div> </div> <div class="hidden js-form-item form-item js-form-type-select form-type-select js-form-item-sign-me-up-for form-item-sign-me-up-for"> <label for="edit-sign-me-up-for">Sign me up for</label> <select data-drupal-selector="edit-sign-me-up-for" id="edit-sign-me-up-for" name="sign_me_up_for" 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