{"id":19,"date":"2019-12-17T21:23:51","date_gmt":"2019-12-17T21:23:51","guid":{"rendered":"http:\/\/yourrights.wpengine.com\/?page_id=19"},"modified":"2020-10-06T16:32:20","modified_gmt":"2020-10-06T20:32:20","slug":"pay","status":"publish","type":"page","link":"https:\/\/yourrights.com\/pay\/","title":{"rendered":"Payment Form"},"content":{"rendered":"\n                <div class='gf_browser_unknown gform_wrapper payment_wrapper' id='gform_wrapper_15' style='display:none'><div id='gf_15' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data'  id='gform_15' class='payment' action='\/wp-json\/wp\/v2\/pages\/19#gf_15'><div id='gf_page_steps_15' class='gf_page_steps'><div id='gf_step_15_1' class='gf_step gf_step_active gf_step_first'><span class='gf_step_number'>1<\/span>&nbsp;<span class='gf_step_label'>Client Name<\/span><\/div><div id='gf_step_15_2' class='gf_step gf_step_next gf_step_pending'><span class='gf_step_number'>2<\/span>&nbsp;<span class='gf_step_label'>Legal Department<\/span><\/div><div id='gf_step_15_3' class='gf_step gf_step_pending'><span class='gf_step_number'>3<\/span>&nbsp;<span class='gf_step_label'>Are you a new client?<\/span><\/div><div id='gf_step_15_4' class='gf_step gf_step_pending'><span class='gf_step_number'>4<\/span>&nbsp;<span class='gf_step_label'>Choose your Amount<\/span><\/div><div id='gf_step_15_5' class='gf_step gf_step_pending'><span class='gf_step_number'>5<\/span>&nbsp;<span class='gf_step_label'>Credit Card<\/span><\/div><div id='gf_step_15_6' class='gf_step gf_step_pending'><span class='gf_step_number'>6<\/span>&nbsp;<span class='gf_step_label'>Billing Address<\/span><\/div><div id='gf_step_15_7' class='gf_step gf_step_pending'><span class='gf_step_number'>7<\/span>&nbsp;<span class='gf_step_label'>Email<\/span><\/div><div id='gf_step_15_8' class='gf_step gf_step_last gf_step_pending'><span class='gf_step_number'>8<\/span>&nbsp;<span class='gf_step_label'>Signature<\/span><\/div><div class='gf_step_clear'><\/div><\/div>\n                        <div class='gform_body'><div id='gform_page_15_1' class='gform_page first_page' >\n                                    <div class='gform_page_fields'><ul id='gform_fields_15' class='gform_fields top_label form_sublabel_below description_below'><li id='field_15_21'  class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible' ><img decoding=\"async\" src=\"http:\/\/yourrights.wpengine.com\/wp-content\/uploads\/2019\/12\/joumanakayrouz-300x153.png\">\n\n<h3>Payment Form<\/h3>\n\n<p>Hi there, please fill out and submit this form to process your retainer.<\/p>\n\n<span>6 Questions<\/span><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                         <input type='button' id='gform_next_button_15_22' class='gform_next_button button' value='Start'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"2\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"2\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_15_2' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_15_2' class='gform_fields top_label form_sublabel_below description_below'><li id='field_15_3'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Client Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_complex ginput_container no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name' id='input_15_3'>\n                            \n                            <span id='input_15_3_3_container' class='name_first' >\n                                                    <input type='text' name='input_3.3' id='input_15_3_3' value='' aria-label='First name'   aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                    <label for='input_15_3_3' >First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_15_3_6_container' class='name_last' >\n                                                    <input type='text' name='input_3.6' id='input_15_3_6' value='' aria-label='Last name'   aria-required=\"true\" aria-invalid=\"false\" \/>\n                                                    <label for='input_15_3_6' >Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_15_2' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"1\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"1\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_15_2' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"3\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"3\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_15_3' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_15_3' class='gform_fields top_label form_sublabel_below description_below'><li id='field_15_4'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_15_4' >Legal Department<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_4' id='input_15_4' class='medium gfield_select'   aria-required=\"true\" aria-invalid=\"false\"><option value='' ><\/option><option value='Immigration' >Immigration<\/option><option value='Bankruptcy' >Bankruptcy<\/option><option value='Criminal Law' >Criminal Law<\/option><option value='Family Law' >Family Law<\/option><option value='Other' >Other<\/option><\/select><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_15_5' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"2\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"2\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_15_5' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"4\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"4\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_15_4' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_15_4' class='gform_fields top_label form_sublabel_below description_below'><li id='field_15_6'  class='gfield gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Are you a new client?<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_15_6'><li class='gchoice_15_6_0'><input name='input_6' type='radio' value='Yes'  id='choice_15_6_0'    \/><label for='choice_15_6_0' id='label_15_6_0'>Yes<\/label><\/li><li class='gchoice_15_6_1'><input name='input_6' type='radio' value='No'  id='choice_15_6_1'    \/><label for='choice_15_6_1' id='label_15_6_1'>No<\/label><\/li><\/ul><\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_15_7' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"3\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"3\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_15_7' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"5\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"5\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_15_5' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_15_5' class='gform_fields top_label form_sublabel_below description_below'><li id='field_15_24'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Pay For&#8230;<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_15_24'><li class='gchoice_15_24_0'><input name='input_24' type='radio' value='Filing Fees'  id='choice_15_24_0'    \/><label for='choice_15_24_0' id='label_15_24_0'>Filing Fees<\/label><\/li><li class='gchoice_15_24_1'><input name='input_24' type='radio' value='Lawyer Fees'  id='choice_15_24_1'    \/><label for='choice_15_24_1' id='label_15_24_1'>Lawyer Fees<\/label><\/li><\/ul><\/div><\/li><li id='field_15_28'  class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below gfield_visibility_visible' ><hr\/><\/li><li id='field_15_9'  class='gfield gfield_price gfield_price_15_9 gfield_product_15_9 gfield_contains_required field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label'  >Choose your Amount<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_15_9'><li class='gchoice_15_9_0'><input name='input_9' type='radio' value='100|100'  id='choice_15_9_0'    \/><label for='choice_15_9_0' id='label_15_9_0'>100<\/label><\/li><li class='gchoice_15_9_1'><input name='input_9' type='radio' value='250|250'  id='choice_15_9_1'    \/><label for='choice_15_9_1' id='label_15_9_1'>250<\/label><\/li><li class='gchoice_15_9_2'><input name='input_9' type='radio' value='500|500'  id='choice_15_9_2'    \/><label for='choice_15_9_2' id='label_15_9_2'>500<\/label><\/li><li class='gchoice_15_9_3'><input name='input_9' type='radio' value='1000|1000'  id='choice_15_9_3'    \/><label for='choice_15_9_3' id='label_15_9_3'>1000<\/label><\/li><li class='gchoice_15_9_4'><input name='input_9' type='radio' value='Other Amount|0'  id='choice_15_9_4'    \/><label for='choice_15_9_4' id='label_15_9_4'>Other Amount<\/label><\/li><\/ul><\/div><\/li><li id='field_15_10'  class='gfield gfield_price gfield_price_15_10 gfield_product_15_10 field_sublabel_below field_description_below hidden_label gfield_visibility_visible' ><label class='gfield_label' for='input_15_10' >Custom Value<\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_10' id='input_15_10' type='text' value='' class='medium ginput_amount'  placeholder='+ OR enter a custom value'  aria-invalid=\"false\" \/>\n\t\t\t\t<\/div><\/li><li id='field_15_26'  class='gfield gfield_price gfield_price_15_26 gfield_product_15_26 field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_15_26' >Escrow Fee<\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_26' id='input_15_26' type='text' value='' class='medium ginput_amount'  placeholder='Enter $ Amount'  aria-invalid=\"false\" \/>\n\t\t\t\t<\/div><\/li><li id='field_15_27'  class='gfield gfield_price gfield_price_15_27 gfield_product_15_27 field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label' for='input_15_27' >Lawyer Fee<\/label><div class='ginput_container ginput_container_product_price'>\n\t\t\t\t\t<input name='input_27' id='input_15_27' type='text' value='' class='medium ginput_amount'  placeholder='Enter $ Amount'  aria-invalid=\"false\" \/>\n\t\t\t\t<\/div><\/li><\/ul>\n                    <\/div>\n                    <div class='gform_page_footer'>\n                        <input type='button' id='gform_previous_button_15_13' class='gform_previous_button button' value='Previous'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"4\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"4\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> <input type='button' id='gform_next_button_15_13' class='gform_next_button button' value='Next'  onclick='jQuery(\"#gform_target_page_number_15\").val(\"6\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); ' onkeypress='if( event.keyCode == 13 ){ jQuery(\"#gform_target_page_number_15\").val(\"6\");  jQuery(\"#gform_15\").trigger(\"submit\",[true]); } ' \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_15_6' class='gform_page' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <ul id='gform_fields_15_6' class='gform_fields top_label form_sublabel_below description_below'><li id='field_15_14'  class='gfield field_sublabel_below field_description_below gfield_visibility_visible' ><label class='gfield_label gfield_label_before_complex'  >Billing Address<\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address' id='input_15_14' >\n                         <span class='ginput_full address_line_1' id='input_15_14_1_container' >\n                                        <input type='text' name='input_14.1' id='input_15_14_1' value=''    \/>\n                                        <label for='input_15_14_1' id='input_15_14_1_label' >Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2' id='input_15_14_2_container' >\n                                        <input type='text' name='input_14.2' id='input_15_14_2' value=''   \/>\n                                        <label for='input_15_14_2' id='input_15_14_2_label' >Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city' id='input_15_14_3_container' >\n                                    <input type='text' name='input_14.3' id='input_15_14_3' value=''    \/>\n                                    <label for='input_15_14_3' id='input_15_14_3_label' >City<\/label>\n                                 <\/span><span class='ginput_right address_state' id='input_15_14_4_container' >\n                                        <input type='text' name='input_14.4' id='input_15_14_4' value=''      \/>\n                                        <label for='input_15_14_4' id='input_15_14_4_label' >State \/ Province \/ Region<\/label>\n                                      <\/span><span class='ginput_left address_zip' id='input_15_14_5_container' >\n                                    <input type='text' name='input_14.5' id='input_15_14_5' value=''    \/>\n                                    <label for='input_15_14_5' id='input_15_14_5_label' >ZIP \/ Postal Code<\/label>\n                                <\/span><span class='ginput_right address_country' id='input_15_14_6_container' >\n                                        <select name='input_14.6' id='input_15_14_6'   ><option value='' selected='selected'><\/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='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='Bonaire, Sint Eustatius and Saba' >Bonaire, Sint Eustatius and Saba<\/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 Territory' >British Indian Ocean Territory<\/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='Canada' >Canada<\/option><option value='Cape Verde' >Cape 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 Islands' >Cocos Islands<\/option><option value='Colombia' >Colombia<\/option><option value='Comoros' >Comoros<\/option><option value='Congo, Democratic Republic of the' >Congo, Democratic Republic of the<\/option><option value='Congo, Republic of the' >Congo, Republic of the<\/option><option value='Cook Islands' >Cook Islands<\/option><option value='Costa Rica' >Costa Rica<\/option><option value='Croatia' >Croatia<\/option><option value='Cuba' >Cuba<\/option><option value='Cura\u00e7ao' >Cura\u00e7ao<\/option><option value='Cyprus' >Cyprus<\/option><option value='Czech Republic' >Czech Republic<\/option><option value='C\u00f4te d&#039;Ivoire' >C\u00f4te d&#039;Ivoire<\/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 (Swaziland)' >Eswatini (Swaziland)<\/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 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 and McDonald Islands' >Heard and McDonald Islands<\/option><option value='Holy See' >Holy See<\/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='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 value='Kiribati' >Kiribati<\/option><option value='Kuwait' >Kuwait<\/option><option value='Kyrgyzstan' >Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic' >Lao People&#039;s Democratic Republic<\/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<\/option><option value='Macedonia' >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='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='North Korea' >North Korea<\/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='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='Romania' >Romania<\/option><option value='Russia' >Russia<\/option><option value='Rwanda' >Rwanda<\/option><option value='R\u00e9union' >R\u00e9union<\/option><option value='Saint Barth\u00e9lemy' >Saint Barth\u00e9lemy<\/option><option value='Saint Helena' >Saint Helena<\/option><option value='Saint Kitts and Nevis' >Saint Kitts and Nevis<\/option><option value='Saint Lucia' >Saint Lucia<\/option><option value='Saint Martin' >Saint Martin<\/option><option value='Saint Pierre and Miquelon' 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Sudan<\/option><option value='Spain' >Spain<\/option><option value='Sri Lanka' >Sri Lanka<\/option><option value='Sudan' >Sudan<\/option><option value='Suriname' >Suriname<\/option><option value='Svalbard and Jan Mayen Islands' >Svalbard and Jan Mayen Islands<\/option><option value='Sweden' >Sweden<\/option><option value='Switzerland' >Switzerland<\/option><option value='Syria' >Syria<\/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='US Minor Outlying Islands' >US Minor Outlying 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='Venezuela' >Venezuela<\/option><option value='Vietnam' >Vietnam<\/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' >Wallis and Futuna<\/option><option value='Western Sahara' >Western Sahara<\/option><option value='Yemen' >Yemen<\/option><option value='Zambia' >Zambia<\/option><option value='Zimbabwe' 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