donate.waysidechapel.org.au
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3.105.39.95
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URL:
https://donate.waysidechapel.org.au/event/valentines-day/?utm_source=homepage&utm_medium=slider&utm_campaign=vday
Submission: On February 07 via manual from GB — Scanned from AU
Submission: On February 07 via manual from GB — Scanned from AU
Form analysis 3 forms found in the DOM
/sponsor/valentines-day
<form class="navbar-form" action="/sponsor/valentines-day">
<div class="input-group">
<input type="text" name="kw" id="header_kw" placeholder="Find a friend" class="form-control" aria-label="Find a friend">
<span class="btn input-group-btn">
<button type="submit" class="btn btn-primary" aria-label="Search"><i class="fa fa-search"></i></button>
</span>
</div>
</form>/sponsor/valentines-day
<form class="navbar-form" action="/sponsor/valentines-day">
<div class="input-group">
<input type="text" name="kw" id="header_kw" placeholder="Find a friend" class="form-control" aria-label="Find a friend">
<span class="btn input-group-btn">
<button type="submit" class="btn btn-primary" aria-label="Search"><i class="fa fa-search"></i></button>
</span>
</div>
</form>POST https://donate.waysidechapel.org.au/processeventdonation
<form action="https://donate.waysidechapel.org.au/processeventdonation" method="post" id="DonationForm_6433" class="lump-donationform form-cards form-slick form-horizontal form-validation-inline form-label-top" novalidate="novalidate">
<input type="hidden" name="page_id" id="page_id" value="3140">
<input type="hidden" name="mandatory" id="mandatory" value="d_fname,d_lname,d_email{email},d_amount{amount},d_receipt">
<input type="hidden" name="d_amount" id="d_amount" autocomplete="new-password" value="101.28">
<input type="hidden" name="d_amount_sel" id="d_amount_sel" autocomplete="new-password" value="96">
<input type="hidden" name="d_fee" id="d_fee" autocomplete="new-password" value="5.28">
<input type="hidden" name="initial_amount" id="initial_amount" autocomplete="new-password" value="96">
<input type="hidden" name="donation_frequency" id="donation_frequency" value="">
<input type="hidden" name="CSRFToken" value="0b3375ac3a8ceaa79fd1d3b0e9af64bf">
<input type="hidden" name="stripe_key" id="stripe_key_6433" value="pk_live_A8beHuHzjrtW1xPYkWxB82IV">
<input type="hidden" name="token" id="token_6433" value="">
<input type="hidden" name="payment_intent_id" id="payment_intent_id_6433">
<input type="hidden" name="card_brand" id="card_brand">
<input type="hidden" name="card_country" id="card_country">
<input type="hidden" name="elements_donation_type" id="elements_donation_type" value="donation">
<input type="hidden" name="elements_refresh" id="elements_refresh" value="">
<input type="hidden" name="event_id" id="event_id" value="160">
<input type="hidden" name="elements_payment_method" id="elements_payment_method" value="card">
<p id="error" class="text-center error" style="display:none">
<b></b>
</p>
<section class="donation-form-top">
<div class="steps-nav text-center steps-icons">
<ul>
<li class="active" id="amountdetailstab"><i class="material-icons">attach_money</i></li>
<li id="personaldetailstab"><i class="material-icons">person</i></li>
<li id="paymentdetailstab"><i class="material-icons">credit_card</i></li>
</ul>
</div>
<div class="donation-form-top-content">
<div class="container">
</div>
</div>
</section>
<div class="donation-steps slick-initialized slick-slider">
<div class="slick-list draggable" style="height: 994.281px;">
<div class="slick-track" style="opacity: 1; width: 1200px;">
<section id="amountdetails" class="section slick-slide slick-current slick-active" data-slick-index="0" style="position: relative; width: 400px; left: 0px; top: 0px; z-index: 999; opacity: 1;" aria-hidden="false">
<div class="handles-container handles-layout-cardsvertical">
<div class="container" style="padding:0 30px;">
<h3 class="text-center pb10">Please select a donation amount</h3>
</div>
<div class="container">
<div class="copy-text text-center"></div>
</div>
<div class="donationHandlers oneoffdonationHandlers">
<div class="row vertical-align justify-center">
<div class="radio-panel" data-id="7936">
<div class="radio-group">
<div class="radio-container">
<div class="radio has-image has-text notselected" data-amount="32" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $32" onkeydown="handleBtnKeyDown(event)"
data-image="https://d21pca5adjhor9.cloudfront.net/3wpfnhdc4fuocw.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border">
<div class="radio-image">
<img src="https://d21pca5adjhor9.cloudfront.net/3wpfnhdc4fuocw.png" alt="">
<div class="radio-amount has-image has-text"> $32 </div>
</div>
<div class="radio-content">
<div class="radio-text">
<span class="radio-copy"><b>$32</b> can send love to <u>a person</u> sleeping rough on our streets.</span>
</div>
</div>
</div>
</div>
<div class="quantity-selector-container">
<div class="product-quantity"> <span> X </span><input data-min="1" data-max="0" type="text" name="quantity" value="1" readonly="true">
<div class="quantity-selectors-container">
<div class="quantity-selectors"> <button type="button" class="increment-quantity" aria-label="Add one" data-direction="1"><span>+</span></button> <button type="button" class="decrement-quantity" aria-label="Subtract one"
data-direction="-1" disabled="disabled"><span>–</span></button> </div>
</div>
</div>
</div>
</div>
<div class="radio-container">
<div class="radio has-image has-text notselected" data-amount="64" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $64" onkeydown="handleBtnKeyDown(event)"
data-image="https://d21pca5adjhor9.cloudfront.net/ho8890jb6nwc0k.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border">
<div class="radio-image">
<img src="https://d21pca5adjhor9.cloudfront.net/ho8890jb6nwc0k.png" alt="">
<div class="radio-amount has-image has-text"> $64 </div>
</div>
<div class="radio-content">
<div class="radio-text">
<span class="radio-copy"><b>$64</b> can send love to <u>2 people</u> sleeping rough on our streets.</span>
</div>
</div>
</div>
</div>
<div class="quantity-selector-container">
<div class="product-quantity"> <span> X </span><input data-min="1" data-max="0" type="text" name="quantity" value="1" readonly="true">
<div class="quantity-selectors-container">
<div class="quantity-selectors"> <button type="button" class="increment-quantity" aria-label="Add one" data-direction="1"><span>+</span></button> <button type="button" class="decrement-quantity" aria-label="Subtract one"
data-direction="-1" disabled="disabled"><span>–</span></button> </div>
</div>
</div>
</div>
</div>
<div class="radio-container">
<div class="radio has-image has-text selected" data-amount="96" role="button" aria-pressed="true" tabindex="0" aria-label="Donate $96" onkeydown="handleBtnKeyDown(event)"
data-image="https://d21pca5adjhor9.cloudfront.net/1vz4f45fhg4.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border">
<div class="radio-image">
<img src="https://d21pca5adjhor9.cloudfront.net/1vz4f45fhg4.png" alt="">
<div class="radio-amount has-image has-text"> $96 </div>
</div>
<div class="radio-content">
<div class="radio-text">
<span class="radio-copy"><b>$96</b> can send love to <u>3 people</u> sleeping rough on our streets.</span>
</div>
</div>
</div>
</div>
<div class="quantity-selector-container selected">
<div class="product-quantity"> <span> X </span><input data-min="1" data-max="0" type="text" name="quantity" value="1" readonly="true">
<div class="quantity-selectors-container">
<div class="quantity-selectors"> <button type="button" class="increment-quantity" aria-label="Add one" data-direction="1"><span>+</span></button> <button type="button" class="decrement-quantity" aria-label="Subtract one"
data-direction="-1" disabled="disabled"><span>–</span></button> </div>
</div>
</div>
</div>
</div>
<div class="radio-container">
<div class="radio has-image has-text notselected" data-amount="192" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $192" onkeydown="handleBtnKeyDown(event)"
data-image="https://d21pca5adjhor9.cloudfront.net/kupp16iyxxc.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border">
<div class="radio-image">
<img src="https://d21pca5adjhor9.cloudfront.net/kupp16iyxxc.png" alt="">
<div class="radio-amount has-image has-text"> $192 </div>
</div>
<div class="radio-content">
<div class="radio-text">
<span class="radio-copy"><b>$192</b> can send love to <u>6 people</u> sleeping rough on our streets.</span>
</div>
</div>
</div>
</div>
<div class="quantity-selector-container">
<div class="product-quantity"> <span> X </span><input data-min="1" data-max="0" type="text" name="quantity" value="1" readonly="true">
<div class="quantity-selectors-container">
<div class="quantity-selectors"> <button type="button" class="increment-quantity" aria-label="Add one" data-direction="1"><span>+</span></button> <button type="button" class="decrement-quantity" aria-label="Subtract one"
data-direction="-1" disabled="disabled"><span>–</span></button> </div>
</div>
</div>
</div>
</div>
<div class="radio-container">
<div class="radio has-image has-text notselected" data-amount="448" role="button" aria-pressed="false" tabindex="0" aria-label="Donate $448" onkeydown="handleBtnKeyDown(event)"
data-image="https://d21pca5adjhor9.cloudfront.net/8tbfb810cw.png">
<div class="arrow-top border-primary"></div>
<div class="radio-border">
<div class="radio-image">
<img src="https://d21pca5adjhor9.cloudfront.net/8tbfb810cw.png" alt="">
<div class="radio-amount has-image has-text"> $448 </div>
</div>
<div class="radio-content">
<div class="radio-text">
<span class="radio-copy"><b>$448</b> can send love to <u>14 people</u> sleeping rough on our streets.</span>
</div>
</div>
</div>
</div>
<div class="quantity-selector-container">
<div class="product-quantity"> <span> X </span><input data-min="1" data-max="0" type="text" name="quantity" value="1" readonly="true">
<div class="quantity-selectors-container">
<div class="quantity-selectors"> <button type="button" class="increment-quantity" aria-label="Add one" data-direction="1"><span>+</span></button> <button type="button" class="decrement-quantity" aria-label="Subtract one"
data-direction="-1" disabled="disabled"><span>–</span></button> </div>
</div>
</div>
</div>
</div>
</div>
</div>
<div class="radio-panel" data-id="7937">
</div>
<div class="radio-panel" data-id="7938">
<script>
$(document).ready(function() {
$('#DonationForm_6433 #d_amount,#initial_amount,#DonationForm_6433 #d_amount_sel').val(96).trigger('change');
calculateDonation_6433();
$('#DonationForm_6433 .radio').addClass('notselected');
$('#DonationForm_6433 .radio').removeClass('selected');
$('#DonationForm_6433 .radio[data-amount="96"]').addClass('selected');
$('#DonationForm_6433 .radio[data-amount="96"]').removeClass('notselected');
$('#DonationForm_6433 .donation-steps').removeClass('visibleout');
$('#DonationForm_6433 .donation-steps input').removeAttr('disabled');
});
</script>
</div>
<div class="radio-panel" data-id="7939">
</div>
<div class="radio-panel" data-id="7940">
</div>
</div><!--row -->
</div><!-- donationHandlers -->
<div class="container">
<div class="row pb20 other-amount">
<div class="col-xs-12 col-12 error-absolute">
<div class="input-group float-center">
<span class="input-group-addon border-radius-left white color-primary size-125"> $ </span>
<input type="text" class="form-control bl-none size-1em pl10 pr0 height-auto" name="d_amount_free" id="d_amount_free" autocomplete="new-password" value="" placeholder=" Other Amount" aria-label=" Other Amount" tabindex="0">
<script>
$('#DonationForm_6433 #d_amount_free').on('focus', function() {
$('#DonationForm_6433 #d_amount,#initial_amount').val(0);
$('#DonationForm_6433 #d_amount_sel').val('');
$('#DonationForm_6433 .radio').removeClass('selected').removeClass('notselected');
$(this).parent().find('.input-group-addon').addClass('border-primary');
this.placeholder = '';
});
$('#DonationForm_6433 #d_amount_free').on('keypress', function() {
$('#DonationForm_6433 #d_amount,#initial_amount').val(0);
$('#DonationForm_6433 #d_amount_sel').val('');
$('#DonationForm_6433 .radio').removeClass('selected').removeClass('notselected');
$(this).parent().find('.input-group-addon').addClass('border-primary');
this.placeholder = '';
});
$('#DonationForm_6433 #d_amount_free').on('keyup', function() {
RemoveJunk(this, 'nofloat', '');
if ($('#DonationForm_6433 #donation_frequency').val() != '') {
$('#DonationForm_6433 .btn-give').text('Donate $' + $(this).val() + ' ' + $('#DonationForm_6433 #donation_frequency').val());
} else {
$('#DonationForm_6433 .btn-give').text('Donate $' + $(this).val());
}
});
$('#DonationForm_6433 #d_amount_free').on('blur', function() {
freeAmountBlur()
});
function freeAmountBlur() {
if ($('#DonationForm_6433 #d_amount_free').val() > 0) {
doFreeAmount();
calculateDonation_6433();
}
$('#DonationForm_6433 #d_amount_free').parent().find('.input-group-addon').removeClass('border-primary');
$('#DonationForm_6433 #d_amount_free').removeClass('bg-primary');
this.placeholder = ' Other Amount';
}
</script>
</div>
</div>
</div>
<div>
<div class="container">
<div class="row pt10">
<div>
<div class="text-center">
<button type="button" class="btn btn-primary btn-block btn-xl btn-next btn-give" rel="amountdetails" tabindex="0">Donate $96</button>
<div class="height-20"></div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
<div dir="ltr" class="resize-sensor" style="pointer-events: none; position: absolute; inset: 0px; overflow: hidden; z-index: -1; visibility: hidden; max-width: 100%;">
<div class="resize-sensor-expand" style="pointer-events: none; position: absolute; inset: 0px; overflow: hidden; z-index: -1; visibility: hidden; max-width: 100%;">
<div style="position: absolute; left: 0px; top: 0px; transition: all 0s ease 0s; width: 410px; height: 1004px;"></div>
</div>
<div class="resize-sensor-shrink" style="pointer-events: none; position: absolute; inset: 0px; overflow: hidden; z-index: -1; visibility: hidden; max-width: 100%;">
<div style="position: absolute; left: 0px; top: 0px; transition: all 0s ease 0s; width: 200%; height: 200%;"></div>
</div>
</div>
</section>
<section class="section slick-slide" id="personaldetails" data-slick-index="1" aria-hidden="true" style="width: 400px; position: relative; left: -400px; top: 0px; z-index: 998; opacity: 0;" tabindex="-1">
<div class="container">
<script>
function receiptKeydown(event) {
// Check to see if space or enter were pressed
if (event.key === " " || event.key === "Enter" || event.key === "Spacebar") { // "Spacebar" for IE11 support
// Prevent the default action to stop scrolling when space is pressed
event.preventDefault();
$(event.target).trigger('click');
$('#DonationForm_6433 #d_receipt_container .toggle-btn').attr('aria-pressed', 'false');
event.target.setAttribute("aria-pressed", "true");
}
}
</script>
<h3 class="text-center pb10">Your Details</h3>
<div class="row">
<div class="col-xs-12 col-12" id="d_receipt_container">
<div class="form-group">
<div class="col-12 col-xs-12 col-12">
<div class="text-center toggle-switch">
<label class="bg-primary border-primary col-xs-6 col-6 toggle-btn"
onclick="$('#OrganisationInfo').slideUp(300);$('#mandatory').val($('#mandatory').val().replace(',d_organisation',''));$(this).parent().parent().find('label').removeClass('bg-primary border-primary');$(this).addClass('bg-primary border-primary');$('#gift_aid').parent().parent().visibleIn();"
role="button" aria-pressed="true" tabindex="0" onkeydown="receiptKeydown(event)">
<input type="radio" name="d_receipt" value="personal" checked="checked" tabindex="-1"> Individual </label>
<label class="col-xs-6 col-6 toggle-btn"
onclick="$('#OrganisationInfo').slideDown(300);$('#mandatory').val($('#mandatory').val() +',d_organisation');$(this).parent().parent().find('label').removeClass('bg-primary border-primary');$(this).addClass('bg-primary border-primary');$('#gift_aid').attr('checked',false);$('#gift_aid').parent().parent().visibleOut();"
tabindex="0" role="button" aria-pressed="false" onkeydown="handleBtnKeyDown(event)">
<input type="radio" name="d_receipt" value="business" tabindex="-1"> Organisation </label>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="col-xs-12 col-12">
<div class="form-group" id="OrganisationInfo" style="display:none;">
<label class="col-xs-12 col-12 " for="d_organisation">Organisation Name *</label>
<div class="col-xs-12 col-12">
<input type="text" class="form-control" name="d_organisation" id="d_organisation" value="" tabindex="-1">
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="col-xs-12 col-12 col-sm-6 pr0">
<div class="form-group">
<label class="col-sm-12" for="d_fname"> First Name * </label>
<div class="col-sm-12">
<input type="text" class="form-control " name="d_fname" id="d_fname" value="" autocomplete="given-name" required="" tabindex="-1">
</div>
</div>
</div>
<div class="col-xs-12 col-12 col-sm-6 pl0">
<div class="form-group">
<label class="col-sm-12" for="d_lname"> Last Name * </label>
<div class="col-sm-12">
<input type="text" class="form-control " name="d_lname" id="d_lname" value="" autocomplete="family-name" required="" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-12 col-xs-12 col-12">
<div class="form-group">
<label class="col-sm-12" for="d_email"> Email Address * </label>
<div class="col-sm-12">
<input type="text" class="form-control " name="d_email" id="d_email" value="" autocomplete="email" required="" tabindex="-1">
</div>
</div>
</div>
<div class="col-xs-12 col-12 Mandatory">
<div class="form-group">
<label class="col-xs-12 col-12 ">Mobile </label>
<div class="col-xs-12 col-12 pl0 pr0">
<div class="vertical-align">
<div class="left col-xs-4 col-4 pr0">
<select class="form-control" name="d_phone_mobile_suffix" id="d_phone_mobile_suffix" tabindex="-1">
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<option value="+44">+44</option>
<option value="+45">+45</option>
<option value="+46">+46</option>
<option value="+47">+47</option>
<option value="+48">+48</option>
<option value="+49">+49</option>
<option value="+501">+501</option>
<option value="+502">+502</option>
<option value="+503">+503</option>
<option value="+504">+504</option>
<option value="+505">+505</option>
<option value="+506">+506</option>
<option value="+507">+507</option>
<option value="+509">+509</option>
<option value="+51">+51</option>
<option value="+52">+52</option>
<option value="+53">+53</option>
<option value="+54">+54</option>
<option value="+55">+55</option>
<option value="+56">+56</option>
<option value="+57">+57</option>
<option value="+58">+58</option>
<option value="+590">+590</option>
<option value="+591">+591</option>
<option value="+592">+592</option>
<option value="+593">+593</option>
<option value="+594">+594</option>
<option value="+595">+595</option>
<option value="+596">+596</option>
<option value="+597">+597</option>
<option value="+598">+598</option>
<option value="+60">+60</option>
<option value="+61" selected="selected">+61</option>
<option value="+62">+62</option>
<option value="+63">+63</option>
<option value="+64">+64</option>
<option value="+65">+65</option>
<option value="+66">+66</option>
<option value="+670">+670</option>
<option value="+672">+672</option>
<option value="+673">+673</option>
<option value="+674">+674</option>
<option value="+675">+675</option>
<option value="+676">+676</option>
<option value="+677">+677</option>
<option value="+678">+678</option>
<option value="+679">+679</option>
<option value="+680">+680</option>
<option value="+682">+682</option>
<option value="+683">+683</option>
<option value="+684">+684</option>
<option value="+686">+686</option>
<option value="+687">+687</option>
<option value="+688">+688</option>
<option value="+689">+689</option>
<option value="+690">+690</option>
<option value="+691">+691</option>
<option value="+692">+692</option>
<option value="+7">+7</option>
<option value="+70">+70</option>
<option value="+7370">+7370</option>
<option value="+81">+81</option>
<option value="+82">+82</option>
<option value="+84">+84</option>
<option value="+852">+852</option>
<option value="+855">+855</option>
<option value="+856">+856</option>
<option value="+86">+86</option>
<option value="+880">+880</option>
<option value="+886">+886</option>
<option value="+90">+90</option>
<option value="+91">+91</option>
<option value="+92">+92</option>
<option value="+93">+93</option>
<option value="+94">+94</option>
<option value="+95">+95</option>
<option value="+960">+960</option>
<option value="+961">+961</option>
<option value="+962">+962</option>
<option value="+964">+964</option>
<option value="+965">+965</option>
<option value="+966">+966</option>
<option value="+967">+967</option>
<option value="+968">+968</option>
<option value="+971">+971</option>
<option value="+972">+972</option>
<option value="+973">+973</option>
<option value="+974">+974</option>
<option value="+975">+975</option>
<option value="+976">+976</option>
<option value="+977">+977</option>
<option value="+992">+992</option>
<option value="+994">+994</option>
<option value="+995">+995</option>
<option value="+996">+996</option>
<option value="+998">+998</option>
</select>
</div>
<div class="col-sm-8 col-xs-8 col-8">
<input type="text" class="form-control phone-group" name="d_phone_mobile" id="d_phone_mobile" value="" tabindex="-1">
</div>
</div>
</div>
</div>
</div>
<div class="clearfix"></div>
<label class="col-sm-12 pt10 pb10">Postal Address <a href="javascript:;" class="expand-address pull-right" tabindex="-1"><small>(enter manually)</small></a></label>
<div class="address-lookup col-sm-12 col-xs-12 col-12">
<div class="form-group">
<div class="col-sm-12 position-relative">
<input type="text" class="form-control" name="d_address" id="d_address" value="" placeholder="Please enter your street address" autocomplete="noprefill" tabindex="-1">
<div class="loqate-marker position-relative"></div>
</div>
<div class="loqate-container" style="width: 100%; position: absolute; display: none;">
<div class="loqate-item loqate-item-template">
<span class="loqate-icon loqate-icon-marker"></span><span class="loqate-item-query"></span>
</div>
</div>
</div>
<script>
$(document).ready(function() {
selectedaddress = false;
addresstimer = false;
$('#d_address').focus(function() {
selectedaddress = false;
});
$('#d_address').blur(function() {
setTimeout(function() {
$('.loqate-container').hide();
}, 300);
});
$('#d_address,#kw_number').keyup(function() {
console.log('test');
clearTimeout(addresstimer);
if ($('#d_address').val() != '') {
if (selectedaddress) {
$('#kw_postcode_results').html('').addClass('hidden');
} else {
addresstimer = setTimeout(function() {
$('#kw_postcode_results').html('').addClass('hidden');
$('#postcodelookup').html('<i class="fa fa-spinner"></i>');
$.getJSON("/funraisin/searchaddressfromloqate/AU?term=" + encodeURI($('#d_address').val()), function(result) {
if (result) {
if (result.status == 'SUCCESS') {
var lookupContainer = $('#d_address').closest('.address-lookup');
lookupContainer.find('.loqate-container .loqate-item-result,.loqate-valid').remove();
for (var i = 0; i < Math.min(result.payload.length, 9); i++) {
var item = lookupContainer.find('.loqate-container .loqate-item-template').clone();
item.removeClass('loqate-item-template');
item.addClass('loqate-item-result');
item.find('.loqate-item-query').html(result.payload[i].fullAddress);
item.attr('data-id', result.payload[i].id);
item.click(function() {
lookupContainer.find('.loqate-container .loqate-item-result').remove();
$('#d_address').val($(this).find('.loqate-item-query').html());
$.getJSON("/funraisin/getaddressfromloqate/AU/?id=" + $(this).attr('data-id'), function(result) {
if (result) {
if (result.status == 'SUCCESS') {
console.log(result);
$('#d_address_unit').val(result.subdwelling);
$('#d_address_number').val(result.streetNumber);
$('#d_address_street').val(result.street);
$('#d_address_suburb').val(result.suburb);
$('#d_address_pcode').val(result.postcode);
$('#d_address_state').val(result.state);
if (typeof result.dpid !== 'undefined') {
$('#d_address_dpid').val(result.dpid);
}
if ($('.address-expand').hasClass('hidden')) {
//$('.expand-address').click();
$('#d_address').after('<span class="loqate-valid"><i class="fa fa-check"></i></span>');
}
}
}
console.log(result);
});
});
lookupContainer.find('.loqate-container').prependTo(lookupContainer.find(".loqate-marker"));
lookupContainer.find('.loqate-container').append(item);
lookupContainer.find('.loqate-container').show();
}
}
}
});
}, 300);
}
}
});
});
</script>
</div>
<div class="hidden addressdetails address-expand">
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-5 col-xs-6 col-6 pt10 pb5">Unit</label><label class="col-sm-5 col-xs-6 col-6 pt10 pb5">Street Number </label>
<div class="clear"></div>
<div class="col-sm-5 col-xs-6 col-6">
<input class="form-control g_address_unit" type="text" name="d_address_unit" id="d_address_unit" value="" data-geo="subpremise" aria-label="Unit Number" tabindex="-1">
</div>
<div class="col-sm-5 col-xs-6 col-6">
<input class="form-control g_address_number" type="text" name="d_address_number" id="d_address_number" value="" data-geo="street_number" aria-label="Street Number" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_street">Street </label>
<div class="col-sm-12">
<input type="text" class="form-control g_address_street" name="d_address_street" id="d_address_street" value="" data-geo="route" data-stripe="address_line1" autocomplete="address-line1" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_suburb">Town/Suburb </label>
<div class="col-sm-12">
<input type="text" class="form-control g_address_suburb" name="d_address_suburb" id="d_address_suburb" value="" data-geo="locality" data-stripe="address_city" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_pcode">Postcode </label>
<div class="col-sm-12">
<input type="text" class="form-control g_address_pcode" name="d_address_pcode" id="d_address_pcode" value="" data-geo="postal_code" data-stripe="address_zip" autocomplete="postal-code" tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_state">State </label>
<div class="col-sm-12">
<input class="form-control g_address_state ui-autocomplete-input" type="text" name="d_address_state" id="d_address_state" value="" data-geo="administrative_area_level_1_short" data-stripe="address_state" autocomplete="off"
tabindex="-1">
</div>
</div>
</div>
<div class="col-sm-6 col-12 col-xs-12">
<div class="form-group">
<label class="col-sm-12 pt10 pb5" for="d_address_country">Country </label>
<div class="col-sm-12">
<div class="btn-group bootstrap-select form-control g_address_country"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="d_address_country" tabindex="-1"
title="Australia"><span class="filter-option pull-left">Australia</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Australia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Kingdom</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">---------------------</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Afghanistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Albania</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Algeria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="7">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">American Samoa</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Andorra</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Angola</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="10">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Anguilla</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="11">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Antarctica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="12">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Antigua and Barbuda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="13">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Argentina</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="14">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Armenia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="15"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Aruba</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="16" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">Australia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="17">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Austria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="18">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Azerbaijan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="19">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bahamas</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="20">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bahrain</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="21">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bangladesh</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="22">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Barbados</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="23">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belarus</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="24">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belgium</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="25"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Belize</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="26"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Benin</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="27">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bermuda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="28"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bhutan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="29">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bolivia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="30">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bosnia and Herzegovina</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="31">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Botswana</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="32">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bouvet Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="33"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Brazil</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="34">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">British Indian Ocean Territory</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="35">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Brunei Darussalam</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="36">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Bulgaria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="37">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Burkina Faso</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="38">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Burundi</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="39">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cambodia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="40">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cameroon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="41"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Canada</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="42">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cape Verde</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="43">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Caribbean Netherlands </span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="44">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cayman Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="45">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Central African Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="46"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Chad</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="47"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Chile</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="48"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">China</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="49">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Christmas Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="50">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cocos (Keeling) Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="51">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Colombia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="52">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Comoros</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="53"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Congo</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="54">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Congo, Democratic Republic of</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="55">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cook Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="56">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Costa Rica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="57">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Côte d'Ivoire</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="58">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Croatia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="59"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cuba</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="60">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Curaçao</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="61"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Cyprus</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="62">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Czech Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="63">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Denmark</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="64">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Djibouti</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="65">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Dominica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="66">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Dominican Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="67">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ecuador</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="68"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Egypt</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="69">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">El Salvador</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="70">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Equatorial Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="71">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Eritrea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="72">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Estonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="73">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ethiopia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="74">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Falkland Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="75">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Faroe Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="76"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Fiji</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="77">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Finland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="78"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">France</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="79">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Guiana</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="80">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Polynesia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="81">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">French Southern Territories</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="82"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gabon</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="83"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gambia</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="84">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Georgia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="85">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Germany</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="86"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ghana</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="87">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Gibraltar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="88"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Greece</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="89">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Greenland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="90">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Grenada</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="91">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guadeloupe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="92"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guam</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="93">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guatemala</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="94">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guernsey</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="95"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="96">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guinea-Bissau</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="97"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Guyana</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="98"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Haiti</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="99">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Heard and McDonald Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="100">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Honduras</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="101">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Hong Kong</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="102">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Hungary</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="103">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iceland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="104"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">India</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="105">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Indonesia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="106"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iran</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="107"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Iraq</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="108">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ireland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="109">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Isle of Man</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="110">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Israel</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="111"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Italy</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="112">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jamaica</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="113"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Japan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="114">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jersey</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="115">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Jordan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="116">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kazakhstan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="117"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kenya</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="118">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kiribati</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="119">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kuwait</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="120">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Kyrgyzstan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="121">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lao People's Democratic Republic</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="122">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Latvia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="123">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lebanon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="124">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lesotho</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="125">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Liberia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="126"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Libya</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="127">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Liechtenstein</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="128">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Lithuania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="129">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Luxembourg</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="130"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Macau</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="131">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Macedonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="132">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Madagascar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="133">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malawi</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="134">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malaysia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="135">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Maldives</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="136"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mali</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="137"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Malta</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="138">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Marshall Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="139">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Martinique</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="140">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mauritania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="141">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mauritius</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="142">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mayotte</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="143">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mexico</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="144">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Micronesia, Federated States of</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="145">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Moldova</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="146">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Monaco</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="147">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mongolia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="148">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Montenegro</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="149">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Montserrat</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="150">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Morocco</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="151">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Mozambique</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="152">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Myanmar</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="153">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Namibia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="154"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nauru</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="155"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nepal</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="156">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">New Caledonia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="157">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">New Zealand</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="158">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nicaragua</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="159"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Niger</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="160">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Nigeria</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="161"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Niue</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="162">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Norfolk Island</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="163">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">North Korea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="164">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Northern Mariana Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="165">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Norway</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="166"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Oman</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="167">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Pakistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="168"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Palau</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="169">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Palestine, State of</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="170">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Panama</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="171">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Papua New Guinea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="172">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Paraguay</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="173"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Peru</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="174">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Philippines</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="175">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Pitcairn</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="176">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Poland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="177">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Portugal</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="178">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Puerto Rico</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="179"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Qatar</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="180">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Réunion</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="181">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Romania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="182">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Russian Federation</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="183">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Rwanda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="184">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Barthélemy</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="185">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Helena</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="186">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Kitts and Nevis</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="187">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Lucia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="188">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint Vincent and the Grenadines</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="189">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saint-Martin (France)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="190"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Samoa</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="191">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">San Marino</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="192">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sao Tome and Principe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="193">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Saudi Arabia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="194">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Senegal</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="195">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Serbia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="196">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Seychelles</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="197">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sierra Leone</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="198">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Singapore</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="199">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sint Maarten (Dutch part)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="200">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Slovakia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="201">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Slovenia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="202">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Solomon Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="203">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Somalia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="204">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Africa</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="205">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Georgia and the South Sandwich Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="206">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Korea</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="207">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">South Sudan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="208"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Spain</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="209">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sri Lanka</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="210">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">St. Pierre and Miquelon</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="211"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sudan</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="212">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Suriname</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="213">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Svalbard and Jan Mayen Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="214">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Swaziland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="215">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Sweden</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="216">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Switzerland</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="217"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Syria</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="218">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Taiwan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="219">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tajikistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="220">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tanzania</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="221">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Thailand</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="222">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">The Netherlands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="223">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Timor-Leste</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="224"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Togo</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="225">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tokelau</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="226"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tonga</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="227">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Trinidad and Tobago</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="228">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tunisia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="229">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turkey</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="230">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turkmenistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="231">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Turks and Caicos Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="232">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Tuvalu</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="233">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uganda</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="234">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Ukraine</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="235">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Arab Emirates</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="236">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United Kingdom</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="237">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="238">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">United States Minor Outlying Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="239">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uruguay</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="240">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Uzbekistan</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="241">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vanuatu</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="242">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vatican</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="243">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Venezuela</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="244">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Vietnam</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="245">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Virgin Islands (British)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="246">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Virgin Islands (U.S.)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="247">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Wallis and Futuna Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="248">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Western Sahara</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="249"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Yemen</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="250">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Zambia</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="251">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Zimbabwe</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="252">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Åland Islands</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
</ul>
</div><select name="d_address_country" id="d_address_country" class="form-control selectpicker g_address_country" data-stripe="address_country" autocomplete="country" data-size="8" tabindex="-98">
<option value="Australia">Australia</option>
<option value="United States">United States</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" selected="selected">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="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="Caribbean Netherlands ">Caribbean Netherlands </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">Congo</option>
<option value="Congo, Democratic Republic of">Congo, Democratic Republic of</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Côte d'Ivoire">Côte d'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</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="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 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="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's Democratic Republic">Lao People'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, Federated States of">Micronesia, Federated States of</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="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="Réunion">Réunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Barthélemy">Saint Barthélemy</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 Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
<option value="Saint-Martin (France)">Saint-Martin (France)</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 (Dutch part)">Sint Maarten (Dutch part)</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 and the South Sandwich Islands">South Georgia and the 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. Pierre and Miquelon">St. Pierre and Miquelon</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="Swaziland">Swaziland</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="The Netherlands">The Netherlands</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="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="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican">Vatican</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 Islands">Wallis and Futuna Islands</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>
<input type="hidden" name="d_address_dpid" id="d_address_dpid" value="" tabindex="-1">
<script>
$(document).ready(function() {
$('#d_address_state').autocomplete({
source: "/funraisin/getstatesjson/",
minLength: 2,
select: function(event, ui) {
setTimeout(function() {
$("#d_address_state").val(ui.item.state_code);
}, 700);
}
});
});
</script>
<div class="col-xs-12 col-12 sponsor-comments">
<div class="row">
<div class="height-10"></div>
<div class="col-xs-12 col-12">
<div class="form-group d_comment">
<label class="col-xs-12 col-12">Leave your message</label>
<div class="col-xs-12 col-12">
<textarea class="form-control" name="d_comments" id="d_comments" rows="4" cols="30" placeholder="Leave a message"></textarea>
</div>
</div>
</div>
<div class="col-xs-12 col-12">
<div class="form-group">
<div class="col-xs-12 col-12">
<div class="vertical-align checkbox-wrapper">
<input type="checkbox" name="d_anonymous" value="Y" id="d_anonymous" tabindex="-1">
<span class="checkbox-text">I'd like to remain anonymous</span>
</div>
</div>
</div>
</div>
<script>
$('#DonationForm_6433 #d_anonymous').on('click', function() {
if ($(this).is(":checked")) {
$('#DonationForm_6433 .display_name').addClass('hidden');
} else {
$('#DonationForm_6433 .display_name').removeClass('hidden');
}
});
</script>
<div class="col-xs-12 col-12 display_name">
<div class="form-group d_comment">
<label class="col-xs-12 col-12">Name to appear</label>
<div class="col-xs-12 col-12">
<input class="form-control" type="text" name="d_display_name" id="d_display_name" tabindex="-1">
</div>
</div>
</div>
</div>
</div>
<div class="col-12 col-xs-12">
<input type="hidden" name="form_key" value="38958L" tabindex="-1">
<div class="lump-form form-horizontal" id="DIV43">
<div class="row">
<div class="col-md-12 ">
<p style="font-size: 14px; text-align: center;" class="col-sm-12 mb0 mt10"><span style="font-size: 14px;">By submitting these details you confirm that you have read and agree to Wayside Chapel's
<a href="https://www.waysidechapel.org.au/privacy" target="_blank" rel="noopener noreferrer" tabindex="-1"><span style="color: #ee0000;"><u>Privacy Policy</u></span></a></span>.</p>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<div class="row pt10">
<div class="vertical-align width-full buttons-block">
<div class="text-center btn-back-block">
<a class="btn btn-back btn-xl" tabindex="-1"><span class="material-icons">chevron_left</span></a>
</div>
<div class="text-center btn-action-block">
<button type="button" class="btn btn-primary btn-block btn-xl btn-next" rel="personaldetails" tabindex="-1"><span>Payment Options</span></button>
</div>
</div>
</div>
<div class="height-20"></div>
</div>
</section>
<section class="section slick-slide" id="paymentdetails" data-slick-index="2" aria-hidden="true" style="width: 400px; position: relative; left: -800px; top: 0px; z-index: 998; opacity: 0;" tabindex="-1">
<div class="container">
<div class="row">
<h3 class="text-center col-xs-12 col-12">Payment Details</h3>
<p id="error" class="text-center error" style="display:none">
<b></b>
</p>
<div class="buttons-block col-xs-12">
<a href="javascript:void(0);" data-rel="credit card" class="btn btn-payment-element btn-pay-creditcard active" id="elements_credit_card" style="display: none;" tabindex="-1"><img src="https://d1p2vuwzdwq826.cloudfront.net/cacd2a43ec8cb767ea934456b7916b4f.svg" alt="Credit Card">Credit Card</a>
</div>
<input type="hidden" name="payment_method" id="payment_method" value="credit card" tabindex="-1">
<script>
$('.btn-payment-element').on('click', function() {
$('#payment_method').val($(this).data('rel'));
$('.btn-payment-element').addClass('fadeout');
$(this).removeClass('fadeout');
if ($(this).data('rel') == 'paypal') {
$('.creditcard,.eft').addClass('hidden');
$('.paypal').removeClass('hidden');
} else if ($(this).data('rel') == 'eft') {
$('.creditcard,.paypal').addClass('hidden');
$('.eft').removeClass('hidden');
} else {
$('.creditcard').removeClass('hidden');
$('.paypal,.eft').addClass('hidden');
}
});
</script>
<div class="height-20"></div>
<div class="col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-sm-12" for="card_name"> Name on Card * </label>
<div class="col-sm-12">
<input type="text" class="form-control " name="card_name" id="card_name" value="" required="" data-stripe="name" x-autocompletetype="cc-name" tabindex="-1">
</div>
</div>
</div>
<div class="col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-sm-12" for="card_number"> Card Number * </label>
<div class="col-sm-12">
<input type="text" class="form-control" name="card_number" id="card_number" value="" required="" data-stripe="number" data-eway-encrypt-name="EWAY_CARDNUMBER" data-braintree="number" tabindex="-1">
</div>
</div>
</div>
<div class="clear"></div>
<div class="col-sm-6 col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-xs-12 col-12 " for="card_expiry_month">Card Expiry *</label>
<div class="col-sm-6 col-xs-6 col-6">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle bs-placeholder form-control" data-toggle="dropdown" role="button" data-id="card_expiry_month" tabindex="-1" title="MM"><span
class="filter-option pull-left">MM</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">MM</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">01</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">02</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">03</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">04</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">05</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">06</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="7"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">07</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">08</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">09</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="10"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">10</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="11"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">11</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="12"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">12</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
</ul>
</div><select class="form-control selectpicker" id="card_expiry_month" name="card_expiry_month" data-braintree-name="expiration_month" data-stripe="exp_month" tabindex="-98">
<option value="">MM</option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select>
</div>
</div>
<div class="col-sm-6 col-xs-6 col-6">
<div class="btn-group bootstrap-select form-control"><button type="button" class="dropdown-toggle bs-placeholder form-control" data-toggle="dropdown" role="button" data-id="card_expiry_year" tabindex="-1" title="YY"><span
class="filter-option pull-left">YY</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0" class="selected">
<a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">YY</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="1"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2024</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="2"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2025</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="3"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2026</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2027</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2028</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="6"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2029</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="7"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2030</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="8"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2031</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="9"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2032</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="10"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2033</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="11"><a tabindex="0" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">2034</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
</ul>
</div><select class="form-control selectpicker" id="card_expiry_year" name="card_expiry_year" data-braintree-name="expiration_year" data-stripe="exp_year" aria-label="Expiry year (YY)" tabindex="-98">
<option value="">YY</option>
<option value="24">2024</option>
<option value="25">2025</option>
<option value="26">2026</option>
<option value="27">2027</option>
<option value="28">2028</option>
<option value="29">2029</option>
<option value="30">2030</option>
<option value="31">2031</option>
<option value="32">2032</option>
<option value="33">2033</option>
<option value="34">2034</option>
</select>
</div>
</div>
</div>
</div>
<div class="col-sm-6 col-xs-12 col-12 creditcard">
<div class="form-group">
<label class="col-xs-12 col-12 " for="card_cvv">CVV *</label>
<div class="col-sm-6 col-xs-6 col-6">
<input class="form-control" type="text" size="5" id="card_cvv" name="card_cvv" value="" maxlength="4" data-eway-encrypt-name="EWAY_CARDCVN" data-braintree-name="cvv" data-stripe="cvc" autocomplete="off" tabindex="-1">
</div>
<div class="col-sm-6 col-xs-6 col-6">
<img src="https://4e14afa0f2e33fe0acb7-65ce87aea9ade6f30f5e307f425e6c8a.ssl.cf5.rackcdn.com/cvv.png" style="width:55px;margin-top:-10px;">
</div>
</div>
</div>
<div class="clearfix"></div>
<div class="col-sm-6 col-xs-12 col-12 donation-amount-display hidden">
<div class="form-group">
<label class="col-xs-12 col-12 pt10 pb0">Donation Amount</label>
<div class="col-sm-4">
<span id="amountdonating">$96</span> <span id="donatingfrequency"></span>
</div>
</div>
</div>
</div>
<style>
.funraisin-fee-bordered .funraisin-fee-box {
border: 1px solid #ee0000;
}
.funraisin-fee-box {
padding: 5px 20px 20px;
border-radius: 5px;
}
.funraisin-fee-box i,
.funraisin-fee-box .hoverlink {
color: #f17330;
}
.optincheckbox:not(.funraisin-fee-bordered) .funraisin-fee-box {
background: #f1733010;
}
</style>
<input type="hidden" name="optin_fees_rate" id="optin_fees_rate" value="5.5" tabindex="-1">
<input type="hidden" name="d_optin_fees" id="d_optin_fees" value="Y" tabindex="-1">
<div class="row optincheckbox funraisin-fee-bordered funraisin-no-bg">
<div class="col-xs-12 col-12">
<div class="funraisin-fee-box funraisin-no-bg">
<label class="fee-box-header">Cover platform costs <span class="funraisin-fee-heart"><img class="static" src="https://d1gotx1r5o7hbd.cloudfront.net/e27154d713bcc89ca73cade1b4cd8e33.png"></span></label>
<p class="funraisin-fee-text hidden"><i class="only-default fa fa-heart"></i> Add a little to cover fees. <span class="hoverlink" data-toggle="tooltip" data-bs-container=".funraisin-fee-box" data-container=".funraisin-fee-box"
data-bs-toggle="tooltip" data-placement="top" data-bs-placement="top" title="" data-original-title="By helping cover our costs, you keep our donations platform free so we can help more people in crisis "><span
class="only-default">Why?</span><i class="material-icons-outlined only-bordered">info</i></span></p>
<div>
<div class="btn-group bootstrap-select form-control dropup"><button type="button" class="dropdown-toggle form-control" data-toggle="dropdown" role="button" data-id="d_fee_multiple" title="$5.28" tabindex="-1"><span
class="filter-option pull-left">$5.28</span> <span class="bs-caret"><span class="caret"></span></span></button>
<div class="dropdown-menu open" role="combobox">
<ul class="dropdown-menu inner" role="listbox" aria-expanded="false">
<li data-original-index="0"><a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">$7.68</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="1"><a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">$7.20</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="2"><a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">$6.24</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
<li data-original-index="3" class="selected">
<a tabindex="-1" class="" data-tokens="null" role="option" aria-disabled="false" aria-selected="true"><span class="text">$5.28</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="4">
<a tabindex="-1" class="only-default" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">Other (or $0)</span><span class="glyphicon glyphicon-ok check-mark"></span></a></li>
<li data-original-index="5">
<a tabindex="-1" class="only-bordered" data-tokens="null" role="option" aria-disabled="false" aria-selected="false"><span class="text">I don't wish to help cover costs</span><span class="glyphicon glyphicon-ok check-mark"></span></a>
</li>
</ul>
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<option value="7.20" data-percentage="7.5" data-amount="">$7.20</option>
<option value="6.24" data-percentage="6.5" data-amount="">$6.24</option>
<option value="5.28" data-percentage="5.5" data-amount="" selected="" data-default="true">$5.28</option>
<option class="only-default" value="other">Other (or $0)</option>
<option class="only-bordered" value="0">I don't wish to help cover costs</option>
</select>
</div>
</div>
<div class="fee-other hidden">
<p>Your contribution helps cover the costs of fundraising.</p>
<div class="input-group float-center">
<span class="input-group-addon border-radius-left white color-primary size-125"> $ </span>
<input type="number" class="form-control" name="d_fee_other" id="d_fee_other" value="1" min="0" autocomplete="off" tabindex="-1">
</div>
</div>
<p class="funraisin-fee-text optout-box only-bordered hidden">By helping cover our costs, you keep our donations platform free so we can help more people in crisis</p>
</div>
<div class="optout-box only-default hidden">
<img src="https://d1p2vuwzdwq826.cloudfront.net/1fb80280a4829cb2bc66f82295789c05.png">
<p> By helping cover our costs, you keep our donations platform free so we can help more people in crisis </p>
</div>
<div class="only-bordered funraisin-fee-total">
<span>Total amount <span class="donation-amount-incfee">$101.28</span></span>
</div>
</div>
</div>
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<div class="text-center btn-back-block">
<a class="btn btn-back btn-xl" tabindex="-1"><span class="material-icons">chevron_left</span></a>
</div>
<div class="text-center btn-action-block">
<button type="submit" class="btn btn-primary btn-block btn-donate-display btn-xl" tabindex="-1"><span>Donate Now</span></button>
</div>
</div>
</div>
<div class="height-20"></div>
</div>
</section>
</div>
</div>
</div>
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</script>
</form>Text Content
* Home * * * * Create a Fundraising page * Donate * Wall of Love * Resources Login * * * Create a Fundraising page * Donate * Resources * Wall of Love * * Create a Fundraising page * Donate * Login * * Resources * Wall of Love Login SAY 'I LOVE YOU' WITH UNDIES! This Valentine's Day, we're asking you to share your love and help bring dignity and support to people experiencing homelessness or in crisis. Stand with Wayside Chapel and help us raise $300,000 by Valentine's Day to provide a clean pair of undies, a hot shower and toiletries to someone doing it tough. During the most romantic day of the year, you can say 'I love you' and show Sydney's most vulnerable people that they are loved, and not forgotten. DONATE NOW $77,326 $77,326 RAISED raised of goal $300,000 $300,000 GOAL $77,326 RAISED raised of goal $300,000 $300,000 GOAL Thank you for your ongoing commitment to provide unconditional love, care and support to people doing it tough during the holiday season. So far, you have personally sponsored meals to feed [if:PeopleHelped=1] a person living on and around our streets. [else] [PeopleHelped] people living on and around our streets. [endif] Today, we’re asking you to stand with us again to make your personal impact even bigger this year, and to help us reach our goal to raise $1,100,000 by 25 December to make sure the vulnerable members of our community are fed and supported this Christmas. Please 'Donate a Plate' now to sponsor a meal with all the trimmings, and ensure that people doing it tough during the holiday season receive the love, care and support they deserve. Because no one should go hungry or be alone at Christmas. NOTHING SAYS 'I YOU' LIKE A CLEAN PAIR OF UNDIES! Donate now to provide a clean pair of undies, a hot shower and toiletries to someone sleeping rough on our streets. * attach_money * person * credit_card PLEASE SELECT A DONATION AMOUNT $32 $32 can send love to a person sleeping rough on our streets. X + – $64 $64 can send love to 2 people sleeping rough on our streets. X + – $96 $96 can send love to 3 people sleeping rough on our streets. X + – $192 $192 can send love to 6 people sleeping rough on our streets. X + – $448 $448 can send love to 14 people sleeping rough on our streets. X + – $ Donate $96 YOUR DETAILS Individual Organisation Organisation Name * First Name * Last Name * Email Address * Mobile +61 +0 +1 +1242 +1246 +1264 +1268 +1345 +1441 +1473 +1649 +1664 +1670 +1671 +1684 +1758 +1767 +1784 +1787 +1809 +1868 +1869 +1876 +20 +212 +213 +216 +220 +221 +222 +223 +224 +225 +226 +227 +228 +229 +230 +231 +232 +233 +234 +235 +236 +237 +238 +239 +240 +241 +242 +244 +245 +246 +248 +249 +250 +251 +252 +253 +254 +256 +257 +258 +260 +261 +262 +263 +264 +265 +266 +267 +268 +269 +27 +290 +291 +297 +298 +299 +30 +31 +32 +33 +34 +350 +351 +352 +353 +354 +355 +356 +357 +358 +359 +36 +370 +371 +372 +374 +375 +376 +377 +378 +380 +385 +386 +387 +39 +40 +41 +420 +421 +423 +43 +44 +45 +46 +47 +48 +49 +501 +502 +503 +504 +505 +506 +507 +509 +51 +52 +53 +54 +55 +56 +57 +58 +590 +591 +592 +593 +594 +595 +596 +597 +598 +60 +61 +62 +63 +64 +65 +66 +670 +672 +673 +674 +675 +676 +677 +678 +679 +680 +682 +683 +684 +686 +687 +688 +689 +690 +691 +692 +7 +70 +7370 +81 +82 +84 +852 +855 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Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Saint-Martin (France) Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Sri Lanka St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Netherlands Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Zambia Zimbabwe Åland Islands Leave your message I'd like to remain anonymous Name to appear By submitting these details you confirm that you have read and agree to Wayside Chapel's Privacy Policy. chevron_left Payment Options PAYMENT DETAILS Credit Card Name on Card * Card Number * Card Expiry * MM * MM * 01 * 02 * 03 * 04 * 05 * 06 * 07 * 08 * 09 * 10 * 11 * 12 MM 01 02 03 04 05 06 07 08 09 10 11 12 YY * YY * 2024 * 2025 * 2026 * 2027 * 2028 * 2029 * 2030 * 2031 * 2032 * 2033 * 2034 YY 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 CVV * Donation Amount $96 Cover platform costs Add a little to cover fees. Why?info $5.28 * $7.68 * $7.20 * $6.24 * $5.28 * Other (or $0) * I don't wish to help cover costs $7.68 $7.20 $6.24 $5.28 Other (or $0) I don't wish to help cover costs Your contribution helps cover the costs of fundraising. $ By helping cover our costs, you keep our donations platform free so we can help more people in crisis By helping cover our costs, you keep our donations platform free so we can help more people in crisis Total amount $101.28 chevron_left Donate Now * * Anonymous just donated $96 * Anonymous just donated $96 * Anonymous just donated $32 * Zena Morellini just donated $64 * Anonymous just donated $101.28 * Anonymous just donated $105.50 * David Cox just donated $96 * Anonymous just donated $32 * Karin just donated $64 * Jennifer Ruhno just donated $448 * Caryl Timm just donated $64 * Linda just donated $32 * Anonymous just donated $32 * Anonymous just donated $64 * Lloyd Powys just donated $64 * Elizabeth just donated $192 * Cooper family just donated $96 * Anonymous just donated $96 * Megan Bridge just donated $96 * Roy Morgan just donated $20 * THE PROBLEM Right now, there are 35,011 people experiencing homelessness in NSW alone. When people walk through the doors of Wayside, they're often in the middle of a crisis. They may be struggling with homelessness, addiction and mental health issues, or they might be feeling lonely, and looking for connection. When the world feels like it's crashing down around you, little things can make a big difference – and that includes undies! This Valentine's Day, we are determined to bring dignity, love and support to people who need us most by providing a clean pair of undies, a hot shower and toiletries to people sleeping rough on our streets. But we need your help... Together, we need to show the most vulnerable people in our community that they are loved, and not forgotten. THE SOLUTION We're asking YOU to share your love this Valentine's Day by making a donation to provide clean pairs of undies, hot showers and toiletries to people who need it most. Your kind gift will ensure Wayside Chapel will always be there to deliver love, care and connection to support Sydney's most vulnerable people. After all, nothing says 'I love you' like a clean pair of undies! DONATE NOW "IF IT WASN'T FOR WAYSIDE, I WOULD BE DEAD, USING DRUGS, BACK ON THE STREET, OR IN JAIL... WAYSIDE SAVED MY LIFE." - TONY, WAYSIDE VISITOR A BIG THANK YOU TO OUR 818 SUPPORTERS FOR SHARING THEIR LOVE THIS VALENTINE'S DAY Together, we choose love over hate to support people sleeping rough on our streets. ANONYMOUS Have a good day - fresh duds are always a good way to start 🙂 41m ago $96 ANONYMOUS 53m ago $96 ANONYMOUS 1h ago $32 ZENA MORELLINI 1h ago $64 ANONYMOUS 1h ago $101 ANONYMOUS 1h ago $106 DAVID COX 1h ago $96 ANONYMOUS Blessings ❤️🙏🏻 1h ago $32 KARIN Take care 1h ago $64 JENNIFER RUHNO Thank-you Wayside Chapel xxxx 1h ago $448 CARYL TIMM God bless you 🙏 1h ago $64 LINDA 1h ago $32 ANONYMOUS Sending love and little sparkles✨ 1h ago $32 ANONYMOUS 1h ago $64 LLOYD POWYS happy valentines day 1h ago $64 ELIZABETH STEWART Thank you for helping people have a shower and get some clean clothes 1h ago $192 COOPER FAMILY 1h ago $96 ANONYMOUS 1h ago $96 MEGAN BRIDGE Thank you for your generosity. 2h ago $96 ROY MORGAN 2h ago $20 ANONYMOUS 3h ago $96 ANONYMOUS 3h ago $26 LAURA QUINTANILLA Enjoy 3h ago $34 DEB All the best for the future xx 4h ago $32 ANONYMOUS Thank you for all your good work - keep it up - no matter what 4h ago $64 V TAYLOR 4h ago $32 ANONYMOUS 4h ago $101 BARRY DIETRICH 4h ago $192 ANONYMOUS 4h ago $96 ROSEMARY GAYNOR 4h ago $96 KERRI BRICKLEY 5h ago $106 ANONYMOUS Thinking of you with love 5h ago $96 ERIN JAGGERS 5h ago $96 JASMINE LANGDON 5h ago $21 ANONYMOUS 5h ago $96 MALCOLM HINGSTON Happy wedding day to Brad & Greg from Jaye and Mal 5h ago $520 JENNY RUSHFORTH Happy Valentines Day 6h ago $32 ALLISON WINMILL 6h ago $96 LORRAINE BRADSHAW 7h ago $32 JULIE BARNES Happy to help a little 7h ago $21 VIEW ALL DONORS All donations over $2 to Wayside Chapel are tax-deductible. *Statistics from Homelessness NSW Donations made to Wayside Chapel's "Donate a Plate" will help provide meals over the festive season, alongside providing the support needed to deliver these services and support programs. Any additional funds raised will be distributed to Wayside Chapel's programs and services that need it most. * CHRISTMAS CHEER WALL * LEADERBOARDS * RESOURCES * DONATE * CREATE A CHRISTMAS PAGE * LOGIN © 2024 Wayside Chapel | ABN 77 406 918 553 | (02) 9581 9101 | www.waysidechapel.org.au | Privacy Policy Charity donations of $2 or more to Wayside Chapel are tax deductible in Australia. Wayside Chapel acknowledges and pays our respects to the Aboriginal and Torres Strait Islander Custodians across this country, and to Elders, past, present and emerging.