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data-sf-role="dropdown-list-field-container"> <input type="hidden" data-sf-role="violation-messages" value='{ "required": "Country/Territory is required"}' /> <label for='Country-1' class='required'>Country/Territory:</label> <input type="hidden" value="Country" name="countryFieldName" /> <select id='Country-1' name="Country" required='required' data-sf-role="dropdown-list-field-select" class="js-country-field"> <option value="">Select...</option> <option value="USA" >USA</option> <option value="Canada" >Canada</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="Bahamas" >Bahamas</option> <option value="Bahrain" >Bahrain</option> <option value="Bangladesh" >Bangladesh</option> <option value="Barbados" >Barbados</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="Bouvet Island" >Bouvet Island</option> <option value="Brazil" >Brazil</option> <option value="British Indian Ocean Terr." >British Indian Ocean Terr.</option> <option value="Brunei Darussalam" >Brunei Darussalam</option> <option value="Bulgaria" >Bulgaria</option> <option value="Burkina Faso" >Burkina Faso</option> <option value="Burundi" >Burundi</option> <option value="Cambodia" >Cambodia</option> <option value="Cameroon" >Cameroon</option> <option value="Cabo Verde" >Cabo Verde</option> <option value="Cayman Islands" >Cayman Islands</option> <option value="Central African Republic" >Central African Republic</option> <option value="Chad" >Chad</option> <option value="Chile" >Chile</option> <option value="China" >China</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 (Brazzaville)" >Congo (Brazzaville)</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 (Hrvatska)" >Croatia (Hrvatska)</option> <option value="Curacao" >Curacao</option> <option value="Cyprus" >Cyprus</option> <option value="Czechia" >Czechia</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="Equatorial Guinea" >Equatorial Guinea</option> <option value="Eritrea" >Eritrea</option> <option value="Estonia" >Estonia</option> <option value="Eswatini" >Eswatini</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 Guiana" >French Guiana</option> <option value="French Polynesia" >French Polynesia</option> <option value="French Southern Terr." >French Southern Terr.</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 and McDonald Is." >Heard and McDonald Is.</option> <option value="Honduras" >Honduras</option> <option value="Hong Kong" >Hong Kong</option> <option value="Hungary" >Hungary</option> <option value="Iceland" >Iceland</option> <option value="India" >India</option> <option value="Indonesia" >Indonesia</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="Jersey" >Jersey</option> <option value="Jordan" >Jordan</option> <option value="Kazakhstan" >Kazakhstan</option> <option value="Kenya" >Kenya</option> <option value="Kiribati" >Kiribati</option> <option value="Korea (the Republic of)" >Korea (the Republic of)</option> <option value="Kuwait" >Kuwait</option> <option value="Kyrgyzstan" >Kyrgyzstan</option> <option value="Lao People's Dem. Rep." >Lao People's Dem. Rep.</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="Macao" >Macao</option> <option value="North Macedonia" >North Macedonia</option> <option value="Madagascar" >Madagascar</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="Man, Isle of" >Man, Isle of</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="Myanmar" >Myanmar</option> <option value="Namibia" >Namibia</option> <option value="Nauru" >Nauru</option> <option value="Nepal" >Nepal</option> <option value="Netherlands" >Netherlands</option> <option value="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 Is." >Northern Mariana Is.</option> <option value="Norway" >Norway</option> <option value="Oman" >Oman</option> <option value="Pakistan" >Pakistan</option> <option value="Palau" >Palau</option> <option value="Palestine, State Of" >Palestine, State Of</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" >Pitcairn</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="Reunion" >Reunion</option> <option value="Romania" >Romania</option> <option value="Rwanda" >Rwanda</option> <option value="S.Georgia and S.Sandwich Is." >S.Georgia and S.Sandwich Is.</option> <option value="Saint Kitts and Nevis" >Saint Kitts and Nevis</option> <option value="Saint Lucia" >Saint Lucia</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="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 Sudan" >South Sudan</option> <option value="Spain" >Spain</option> <option value="Sri Lanka" >Sri Lanka</option> <option value="St. Helena" >St. Helena</option> <option value="St. Pierre and Miquelon" >St. Pierre and Miquelon</option> <option value="St. Vincent and Grenadines" >St. Vincent and Grenadines</option> <option value="Sudan" >Sudan</option> <option value="Suriname" >Suriname</option> <option value="Svalbard and Jan Mayen Is." >Svalbard and Jan Mayen Is.</option> <option value="Sweden" >Sweden</option> <option value="Switzerland" >Switzerland</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 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="U.S. Minor Outlying Is." >U.S. Minor Outlying Is.</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="Uruguay" >Uruguay</option> <option value="Uzbekistan" >Uzbekistan</option> <option value="Vanuatu" >Vanuatu</option> <option value="Vatican (Holy See)" >Vatican (Holy See)</option> <option value="Venezuela" >Venezuela</option> <option value="Viet Nam" >Viet Nam</option> <option value="Virgin Islands (British)" >Virgin Islands (British)</option> <option value="Virgin Islands (U.S.)" >Virgin Islands (U.S.)</option> <option value="Wallis and Futuna Is." >Wallis and Futuna Is.</option> <option value="Western Sahara" >Western Sahara</option> <option value="Yemen" >Yemen</option> <option value="Zambia" >Zambia</option> <option value="Zimbabwe" >Zimbabwe</option> </select> <p data-sf-role="error-message" role="alert" aria-live="assertive"></p> </div> <div class="sf-fieldWrp js-states-field-container" data-sf-role="dropdown-list-field-container" style="display:none" data-countrycomponent=""> <input type="hidden" data-sf-role="violation-messages" value='{ "required": "This field is required"}' /> <input type="hidden" data-sf-role="required-validator" value='True' class="js-is-state-required" /> <input type="hidden" data-sf-role="state-data" value='{"Canada":[{"Text":"Alberta","Value":"AB","AlternativeValue":"AB","UnderLegalRegulation":false},{"Text":"British Columbia","Value":"BC","AlternativeValue":"BC","UnderLegalRegulation":false},{"Text":"Manitoba","Value":"MB","AlternativeValue":"MB","UnderLegalRegulation":false},{"Text":"New Brunswick","Value":"NB","AlternativeValue":"NB","UnderLegalRegulation":false},{"Text":"Newfoundland and Labrador","Value":"NL","AlternativeValue":"NL","UnderLegalRegulation":false},{"Text":"Northwest 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