<select size="1" name="country">
<option selected="" value=" ">(please select a country)
</option><option value="--">none
</option><option value="AF">Afghanistan
</option><option value="AL">Albania
</option><option value="DZ">Algeria
</option><option value="AS">American Samoa
</option><option value="AD">Andorra
</option><option value="AO">Angola
</option><option value="AI">Anguilla
</option><option value="AQ">Antarctica
</option><option value="AG">Antigua and Barbuda
</option><option value="AR">Argentina
</option><option value="AM">Armenia
</option><option value="AW">Aruba
</option><option value="AU">Australia
</option><option value="AT">Austria
</option><option value="AZ">Azerbaijan
</option><option value="BS">Bahamas
</option><option value="BH">Bahrain
</option><option value="BD">Bangladesh
</option><option value="BB">Barbados
</option><option value="BY">Belarus
</option><option value="BE">Belgium
</option><option value="BZ">Belize
</option><option value="BJ">Benin
</option><option value="BM">Bermuda
</option><option value="BT">Bhutan
</option><option value="BO">Bolivia
</option><option value="BA">Bosnia and Herzegowina
</option><option value="BW">Botswana
</option><option value="BV">Bouvet Island
</option><option value="BR">Brazil
</option><option value="IO">British Indian Ocean Territory
</option><option value="BN">Brunei Darussalam
</option><option value="BG">Bulgaria
</option><option value="BF">Burkina Faso
</option><option value="BI">Burundi
</option><option value="KH">Cambodia
</option><option value="CM">Cameroon
</option><option value="CA">Canada
</option><option value="CV">Cape Verde
</option><option value="KY">Cayman Islands
</option><option value="CF">Central African Republic
</option><option value="TD">Chad
</option><option value="CL">Chile
</option><option value="CN">China
</option><option value="CX">Christmas Island
</option><option value="CC">Cocos (Keeling) Islands
</option><option value="CO">Colombia
</option><option value="KM">Comoros
</option><option value="CG">Congo
</option><option value="CD">Congo, the Democratic Republic of the
</option><option value="CK">Cook Islands
</option><option value="CR">Costa Rica
</option><option value="CI">Cote d'Ivoire
</option><option value="HR">Croatia (Hrvatska)
</option><option value="CU">Cuba
</option><option value="CY">Cyprus
</option><option value="CZ">Czech Republic
</option><option value="DK">Denmark
</option><option value="DJ">Djibouti
</option><option value="DM">Dominica
</option><option value="DO">Dominican Republic
</option><option value="TP">East Timor
</option><option value="EC">Ecuador
</option><option value="EG">Egypt
</option><option value="SV">El Salvador
</option><option value="GQ">Equatorial Guinea
</option><option value="ER">Eritrea
</option><option value="EE">Estonia
</option><option value="ET">Ethiopia
</option><option value="FK">Falkland Islands (Malvinas)
</option><option value="FO">Faroe Islands
</option><option value="FJ">Fiji
</option><option value="FI">Finland
</option><option value="FR">France
</option><option value="FX">France, Metropolitan
</option><option value="GF">French Guiana
</option><option value="PF">French Polynesia
</option><option value="TF">French Southern Territories
</option><option value="GA">Gabon
</option><option value="GM">Gambia
</option><option value="GE">Georgia
</option><option value="DE">Germany
</option><option value="GH">Ghana
</option><option value="GI">Gibraltar
</option><option value="GR">Greece
</option><option value="GL">Greenland
</option><option value="GD">Grenada
</option><option value="GP">Guadeloupe
</option><option value="GU">Guam
</option><option value="GT">Guatemala
</option><option value="GN">Guinea
</option><option value="GW">Guinea-Bissau
</option><option value="GY">Guyana
</option><option value="HT">Haiti
</option><option value="HM">Heard and Mc Donald Islands
</option><option value="VA">Holy See (Vatican City State)
</option><option value="HN">Honduras
</option><option value="HK">Hong Kong
</option><option value="HU">Hungary
</option><option value="IS">Iceland
</option><option value="IN">India
</option><option value="ID">Indonesia
</option><option value="IR">Iran (Islamic Republic of)
</option><option value="IQ">Iraq
</option><option value="IE">Ireland
</option><option value="IL">Israel
</option><option value="IT">Italy
</option><option value="JM">Jamaica
</option><option value="JP">Japan
</option><option value="JO">Jordan
</option><option value="KZ">Kazakhstan
</option><option value="KE">Kenya
</option><option value="KI">Kiribati
</option><option value="KP">Korea, Democratic People's Republic of
</option><option value="KR">Korea, Republic of
</option><option value="KW">Kuwait
</option><option value="KG">Kyrgyzstan
</option><option value="LA">Lao People's Democratic Republic
</option><option value="LV">Latvia
</option><option value="LB">Lebanon
</option><option value="LS">Lesotho
</option><option value="LR">Liberia
</option><option value="LY">Libyan Arab Jamahiriya
</option><option value="LI">Liechtenstein
</option><option value="LT">Lithuania
</option><option value="LU">Luxembourg
</option><option value="MO">Macau
</option><option value="MK">Macedonia, The Former Yugoslav Republic of
</option><option value="MG">Madagascar
</option><option value="MW">Malawi
</option><option value="MY">Malaysia
</option><option value="MV">Maldives
</option><option value="ML">Mali
</option><option value="MT">Malta
</option><option value="MH">Marshall Islands
</option><option value="MQ">Martinique
</option><option value="MR">Mauritania
</option><option value="MU">Mauritius
</option><option value="YT">Mayotte
</option><option value="MX">Mexico
</option><option value="FM">Micronesia, Federated States of
</option><option value="MD">Moldova, Republic of
</option><option value="MC">Monaco
</option><option value="MN">Mongolia
</option><option value="MS">Montserrat
</option><option value="MA">Morocco
</option><option value="MZ">Mozambique
</option><option value="MM">Myanmar
</option><option value="NA">Namibia
</option><option value="NR">Nauru
</option><option value="NP">Nepal
</option><option value="NL">Netherlands
</option><option value="AN">Netherlands Antilles
</option><option value="NC">New Caledonia
</option><option value="NZ">New Zealand
</option><option value="NI">Nicaragua
</option><option value="NE">Niger
</option><option value="NG">Nigeria
</option><option value="NU">Niue
</option><option value="NF">Norfolk Island
</option><option value="MP">Northern Mariana Islands
</option><option value="NO">Norway
</option><option value="OM">Oman
</option><option value="PK">Pakistan
</option><option value="PW">Palau
</option><option value="PA">Panama
</option><option value="PG">Papua New Guinea
</option><option value="PY">Paraguay
</option><option value="PE">Peru
</option><option value="PH">Philippines
</option><option value="PN">Pitcairn
</option><option value="PL">Poland
</option><option value="PT">Portugal
</option><option value="PR">Puerto Rico
</option><option value="QA">Qatar
</option><option value="RE">Reunion
</option><option value="RO">Romania
</option><option value="RU">Russian Federation
</option><option value="RW">Rwanda
</option><option value="KN">Saint Kitts and Nevis
</option><option value="LC">Saint LUCIA
</option><option value="VC">Saint Vincent and the Grenadines
</option><option value="WS">Samoa
</option><option value="SM">San Marino
</option><option value="ST">Sao Tome and Principe
</option><option value="SA">Saudi Arabia
</option><option value="SN">Senegal
</option><option value="SC">Seychelles
</option><option value="SL">Sierra Leone
</option><option value="SG">Singapore
</option><option value="SK">Slovakia (Slovak Republic)
</option><option value="SI">Slovenia
</option><option value="SB">Solomon Islands
</option><option value="SO">Somalia
</option><option value="ZA">South Africa
</option><option value="GS">South Georgia and the South Sandwich Islands
</option><option value="ES">Spain
</option><option value="LK">Sri Lanka
</option><option value="SH">St. Helena
</option><option value="PM">St. Pierre and Miquelon
</option><option value="SD">Sudan
</option><option value="SR">Suriname
</option><option value="SJ">Svalbard and Jan Mayen Islands
</option><option value="SZ">Swaziland
</option><option value="SE">Sweden
</option><option value="CH">Switzerland
</option><option value="SY">Syrian Arab Republic
</option><option value="TW">Taiwan, Province of China
</option><option value="TJ">Tajikistan
</option><option value="TZ">Tanzania, United Republic of
</option><option value="TH">Thailand
</option><option value="TG">Togo
</option><option value="TK">Tokelau
</option><option value="TO">Tonga
</option><option value="TT">Trinidad and Tobago
</option><option value="TN">Tunisia
</option><option value="TR">Turkey
</option><option value="TM">Turkmenistan
</option><option value="TC">Turks and Caicos Islands
</option><option value="TV">Tuvalu
</option><option value="UG">Uganda
</option><option value="UA">Ukraine
</option><option value="AE">United Arab Emirates
</option><option value="GB">United Kingdom
</option><option value="US">United States
</option><option value="UM">United States Minor Outlying Islands
</option><option value="UY">Uruguay
</option><option value="UZ">Uzbekistan
</option><option value="VU">Vanuatu
</option><option value="VE">Venezuela
</option><option value="VN">Viet Nam
</option><option value="VG">Virgin Islands (British)
</option><option value="VI">Virgin Islands (U.S.)
</option><option value="WF">Wallis and Futuna Islands
</option><option value="EH">Western Sahara
</option><option value="YE">Yemen
</option><option value="YU">Yugoslavia
</option><option value="ZM">Zambia
</option><option value="ZW">Zimbabwe
</option></select>