{"id":989989,"date":"2024-03-09T07:05:14","date_gmt":"2024-03-09T07:05:14","guid":{"rendered":"https:\/\/belong2world.com\/pacifrus\/?page_id=989989"},"modified":"2024-03-30T06:03:00","modified_gmt":"2024-03-30T06:03:00","slug":"providers-join-us","status":"publish","type":"page","link":"https:\/\/pacifyr.ai\/us\/providers-join-us\/","title":{"rendered":"Providers join us"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"989989\" class=\"elementor elementor-989989\">\n\t\t\t\t<div class=\"elementor-element elementor-element-c8d04e7 e-flex e-con-boxed e-con e-parent\" data-id=\"c8d04e7\" data-element_type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ef2f5a1 elementor-widget elementor-widget-heading\" data-id=\"ef2f5a1\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Pacifyr Provider Registration<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eff1b04 elementor-widget elementor-widget-text-editor\" data-id=\"eff1b04\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Register to get started as a provider on Pacifyr<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7b0429e e-flex e-con-boxed e-con e-parent\" data-id=\"7b0429e\" data-element_type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9b0d129 filedsetr elementor-widget elementor-widget-shortcode\" data-id=\"9b0d129\" data-element_type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"frm_forms \" id=\"frm_form_8_container\" data-token=\"1e532a2385d07a5b725dde60452523f2\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_providers-join-us4\" data-token=\"1e532a2385d07a5b725dde60452523f2\">\n<div class=\"frm_form_fields  frm_page_num_1\">\n<fieldset>\n<legend class=\"frm_screen_reader\">Providers Join Us<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<div class=\"frm_rootline_group\" role=\"group\" tabindex=\"0\" aria-label=\"Page 1 of 5\" ><ul class=\"frm_page_bar frm_rootline_5 frm_rootline frm_rootline_line  frm_show_lines frm_show_titles\"><li class=\"frm_rootline_single frm_current_page\"><input type=\"button\" value=\"1\" data-page=\"\" class=\" frm_page_1\" aria-disabled=\"true\" data-field=\"0\" aria-label=\"Personal Information\"  \/><span class=\"frm_rootline_title\">Personal Information<\/span><\/li><li class=\"frm_rootline_single\"><input type=\"button\" value=\"2\" data-page=\"29\" class=\"frm_page_skip frm_page_2\" data-field=\"392\" aria-label=\"Partner Organization\"  \/><span class=\"frm_rootline_title\">Partner Organization<\/span><\/li><li class=\"frm_rootline_single\"><input type=\"button\" value=\"3\" data-page=\"42\" class=\"frm_page_skip frm_page_3\" data-field=\"399\" aria-label=\"Certification Details\"  \/><span class=\"frm_rootline_title\">Certification Details<\/span><\/li><li class=\"frm_rootline_single\"><input type=\"button\" value=\"4\" data-page=\"53\" class=\"frm_page_skip frm_page_4\" data-field=\"408\" aria-label=\"Insurance Details\"  \/><span class=\"frm_rootline_title\">Insurance Details<\/span><\/li>\t\t<li class=\"frm_rootline_single frm_rootline_show_hidden_steps_btn frm_hidden\">\n\t\t\t<input type=\"button\" class=\"frm_rootline_show_more_btn\" value=\"\u00b7\u00b7\u00b7\" \/>\n\t\t\t<ul class=\"frm_rootline_hidden_steps frm_hidden\"><\/ul>\n\t\t<\/li>\n\t\t<li class=\"frm_rootline_single\"><input type=\"button\" value=\"5\" data-page=\"63\" class=\"frm_page_skip frm_page_5\" data-field=\"475\" aria-label=\"Fees &amp; Submit\"  \/><span class=\"frm_rootline_title\">Fees & Submit<\/span><\/li><\/ul><div class=\"frm_clearfix\"><\/div><\/div><input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"8\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_8\" id=\"frm_hide_fields_8\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"providers-join-us4\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_8\" name=\"frm_submit_entry_8\" value=\"4c947e1359\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/us\/wp-json\/wp\/v2\/pages\/989989\" \/><div id=\"frm_field_385_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_iv40h6\" id=\"field_iv40h6_label\" class=\"frm_primary_label\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_iv40h6\" name=\"item_meta[385]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_443_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_1klxz\" id=\"field_1klxz_label\" class=\"frm_primary_label\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_1klxz\" name=\"item_meta[443]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_444_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_zj1dg\" id=\"field_zj1dg_label\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_zj1dg\" name=\"item_meta[444]\" value=\"\" autocomplete=\"email\" data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_445_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_qzumh\" id=\"field_qzumh_label\" class=\"frm_primary_label\">Date of Birth\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_qzumh\" name=\"item_meta[445]\" value=\"\"  maxlength=\"10\" data-reqmsg=\"Date of Birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of Birth is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_446_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_hsz3\" id=\"field_hsz3_label\" class=\"frm_primary_label\">Phone Number\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"tel\" id=\"field_hsz3\" name=\"item_meta[446]\" value=\"\"  data-reqmsg=\"Phone Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone Number is invalid\" aria-invalid=\"false\" pattern=\"((\\+\\d{1,3}(-|.| )?\\(?\\d\\)?(-| |.)?\\d{1,5})|(\\(?\\d{2,6}\\)?))(-|.| )?(\\d{3,4})(-|.| )?(\\d{4})(( x| ext)\\d{1,5}){0,1}$\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_381_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_ydin5\" id=\"field_ydin5_label\" class=\"frm_primary_label\">Bio\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ydin5\" name=\"item_meta[381]\" value=\"\"  data-reqmsg=\"Bio cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ydin5\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ydin5\">Provide a brief write-up about your work. This boosts the chances of more customers reaching out to you.<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_448_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_e9rqd\" id=\"field_e9rqd_label\" class=\"frm_primary_label\">Profile photo\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"hidden\" name=\"item_meta[448]\"  data-reqmsg=\"Profile photo cannot be blank.\"  value=\"\" data-frmfile=\"448\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file448_dropzone\" role=\"group\" >\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file448\" id=\"field_e9rqd\"\n\t\t\t data-reqmsg=\"Profile photo cannot be blank.\" data-invmsg=\"Profile photo is invalid\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"Profile photo. Drop a file here or click to upload. Maximum file size: 516MB\">Drop a file here or click to upload<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"Profile photo. Choose File. Maximum file size: 516MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 516MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_447_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_wr390\" id=\"field_wr390_label\" class=\"frm_primary_label\">Languages Known\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[447]\" id=\"field_wr390\"  data-frmval=\"All Languages\" data-reqmsg=\"Languages Known cannot be blank.\" aria-required=\"true\" data-invmsg=\"Languages Known is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"All Languages\" selected='selected'>All Languages<\/option><option  value=\"English\">English<\/option><option  value=\"French\">French<\/option><option  value=\"Hindi\">Hindi<\/option><option  value=\"Russian\">Russian<\/option><option  value=\"Spanish\">Spanish<\/option><option  value=\"German\">German<\/option><option  value=\"Arabic\">Arabic<\/option><option  value=\"Indonesian\">Indonesian<\/option><option  value=\"Japanese\">Japanese<\/option><option  value=\"Urdu\">Urdu<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_384_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Education<\/h3>\r\n\r\n\r\n<div id=\"frm_field_386_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_otxwc6\" id=\"field_otxwc6_label\" class=\"frm_primary_label\">Highest educational qualification achieved\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_otxwc6\" name=\"item_meta[386]\" value=\"\"  data-sectionid=\"384\" data-reqmsg=\"Highest educational qualification achieved cannot be blank.\" aria-required=\"true\" data-invmsg=\"Highest educational qualification achieved is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_otxwc6\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_otxwc6\">Degree\/diploma or any other highest qualification achieved.<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_449_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_lpdtx\" id=\"field_lpdtx_label\" class=\"frm_primary_label\">Name of educational institution\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_lpdtx\" name=\"item_meta[449]\" value=\"\"  data-sectionid=\"384\" data-reqmsg=\"Name of educational institution cannot be blank.\" aria-required=\"true\" data-invmsg=\"Name of educational institution is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_678_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first\">\n    <label for=\"field_xf8d7\" id=\"field_xf8d7_label\" class=\"frm_primary_label\">Country\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n    <\/label>\n    \t\t<select  name=\"item_meta[678]\" id=\"field_xf8d7\"  data-sectionid=\"384\" data-invmsg=\"Country is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t\t\t\t<option  value=\"\" class=\"frm-select-placeholder\">\n\t\t\t\t\t \t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Afghanistan\">\n\t\t\t\t\tAfghanistan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Aland\">\n\t\t\t\t\tAland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Albania\">\n\t\t\t\t\tAlbania\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Algeria\">\n\t\t\t\t\tAlgeria\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"American Samoa\">\n\t\t\t\t\tAmerican Samoa\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Andorra\">\n\t\t\t\t\tAndorra\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Angola\">\n\t\t\t\t\tAngola\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Anguilla\">\n\t\t\t\t\tAnguilla\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Antarctica\">\n\t\t\t\t\tAntarctica\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Antigua and Barbuda\">\n\t\t\t\t\tAntigua and Barbuda\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Argentina\">\n\t\t\t\t\tArgentina\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Armenia\">\n\t\t\t\t\tArmenia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Aruba\">\n\t\t\t\t\tAruba\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Ascension\">\n\t\t\t\t\tAscension\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Australia\">\n\t\t\t\t\tAustralia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Austria\">\n\t\t\t\t\tAustria\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Azerbaijan\">\n\t\t\t\t\tAzerbaijan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bahamas\">\n\t\t\t\t\tBahamas\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bahrain\">\n\t\t\t\t\tBahrain\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bangladesh\">\n\t\t\t\t\tBangladesh\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Barbados\">\n\t\t\t\t\tBarbados\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Belarus\">\n\t\t\t\t\tBelarus\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Belgium\">\n\t\t\t\t\tBelgium\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Belize\">\n\t\t\t\t\tBelize\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Benin\">\n\t\t\t\t\tBenin\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bermuda\">\n\t\t\t\t\tBermuda\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bhutan\">\n\t\t\t\t\tBhutan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bolivia\">\n\t\t\t\t\tBolivia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bosnia and Herzegovina\">\n\t\t\t\t\tBosnia and Herzegovina\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Botswana\">\n\t\t\t\t\tBotswana\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bouvet Island\">\n\t\t\t\t\tBouvet Island\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Brazil\">\n\t\t\t\t\tBrazil\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"British Indian Ocean Territory\">\n\t\t\t\t\tBritish Indian Ocean Territory\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"British Virgin Islands\">\n\t\t\t\t\tBritish Virgin Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Brunei\">\n\t\t\t\t\tBrunei\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Bulgaria\">\n\t\t\t\t\tBulgaria\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Burkina Faso\">\n\t\t\t\t\tBurkina Faso\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Burundi\">\n\t\t\t\t\tBurundi\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cambodia\">\n\t\t\t\t\tCambodia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cameroon\">\n\t\t\t\t\tCameroon\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Canada\">\n\t\t\t\t\tCanada\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cape Verde\">\n\t\t\t\t\tCape Verde\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cayman Islands\">\n\t\t\t\t\tCayman Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Central African Republic\">\n\t\t\t\t\tCentral African Republic\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Chad\">\n\t\t\t\t\tChad\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Chile\">\n\t\t\t\t\tChile\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"China\">\n\t\t\t\t\tChina\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Christmas Island\">\n\t\t\t\t\tChristmas Island\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cocos (Keeling) Islands\">\n\t\t\t\t\tCocos (Keeling) Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Colombia\">\n\t\t\t\t\tColombia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Comoros\">\n\t\t\t\t\tComoros\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Congo\">\n\t\t\t\t\tCongo\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Congo (DRC)\">\n\t\t\t\t\tCongo (DRC)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cook Islands\">\n\t\t\t\t\tCook Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Costa Rica\">\n\t\t\t\t\tCosta Rica\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cote d&#039;Ivoire\">\n\t\t\t\t\tCote d&#039;Ivoire\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Croatia\">\n\t\t\t\t\tCroatia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cuba\">\n\t\t\t\t\tCuba\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Cyprus\">\n\t\t\t\t\tCyprus\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Czech Republic\">\n\t\t\t\t\tCzech Republic\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Denmark\">\n\t\t\t\t\tDenmark\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Djibouti\">\n\t\t\t\t\tDjibouti\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Dominica\">\n\t\t\t\t\tDominica\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Dominican Republic\">\n\t\t\t\t\tDominican Republic\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Ecuador\">\n\t\t\t\t\tEcuador\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Egypt\">\n\t\t\t\t\tEgypt\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"El Salvador\">\n\t\t\t\t\tEl Salvador\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Equatorial Guinea\">\n\t\t\t\t\tEquatorial Guinea\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Eritrea\">\n\t\t\t\t\tEritrea\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Estonia\">\n\t\t\t\t\tEstonia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Ethiopia\">\n\t\t\t\t\tEthiopia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Falkland Islands (Islas Malvinas)\">\n\t\t\t\t\tFalkland Islands (Islas Malvinas)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Faroe Islands\">\n\t\t\t\t\tFaroe Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Fiji\">\n\t\t\t\t\tFiji\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Finland\">\n\t\t\t\t\tFinland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"France\">\n\t\t\t\t\tFrance\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"French Guiana\">\n\t\t\t\t\tFrench Guiana\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"French Polynesia\">\n\t\t\t\t\tFrench Polynesia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"French Southern and Antarctic Lands\">\n\t\t\t\t\tFrench Southern and Antarctic Lands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Gabon\">\n\t\t\t\t\tGabon\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Gambia\">\n\t\t\t\t\tGambia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Georgia\">\n\t\t\t\t\tGeorgia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Germany\">\n\t\t\t\t\tGermany\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Ghana\">\n\t\t\t\t\tGhana\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Gibraltar\">\n\t\t\t\t\tGibraltar\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Greece\">\n\t\t\t\t\tGreece\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Greenland\">\n\t\t\t\t\tGreenland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Grenada\">\n\t\t\t\t\tGrenada\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guadeloupe\">\n\t\t\t\t\tGuadeloupe\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guam\">\n\t\t\t\t\tGuam\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guatemala\">\n\t\t\t\t\tGuatemala\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guernsey\">\n\t\t\t\t\tGuernsey\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guinea\">\n\t\t\t\t\tGuinea\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guinea-Bissau\">\n\t\t\t\t\tGuinea-Bissau\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Guyana\">\n\t\t\t\t\tGuyana\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Haiti\">\n\t\t\t\t\tHaiti\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Heard Island and McDonald Islands\">\n\t\t\t\t\tHeard Island and McDonald Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Honduras\">\n\t\t\t\t\tHonduras\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Hong Kong\">\n\t\t\t\t\tHong Kong\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Hungary\">\n\t\t\t\t\tHungary\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Iceland\">\n\t\t\t\t\tIceland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"India\">\n\t\t\t\t\tIndia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Indonesia\">\n\t\t\t\t\tIndonesia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Iran\">\n\t\t\t\t\tIran\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Iraq\">\n\t\t\t\t\tIraq\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Ireland\">\n\t\t\t\t\tIreland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Isle of Man\">\n\t\t\t\t\tIsle of Man\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Israel\">\n\t\t\t\t\tIsrael\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Italy\">\n\t\t\t\t\tItaly\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Jamaica\">\n\t\t\t\t\tJamaica\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Japan\">\n\t\t\t\t\tJapan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Jersey\">\n\t\t\t\t\tJersey\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Jordan\">\n\t\t\t\t\tJordan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Kazakhstan\">\n\t\t\t\t\tKazakhstan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Kenya\">\n\t\t\t\t\tKenya\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Kiribati\">\n\t\t\t\t\tKiribati\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Korea (North Korea)\">\n\t\t\t\t\tKorea (North Korea)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Korea (South Korea)\">\n\t\t\t\t\tKorea (South Korea)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Kosovo\">\n\t\t\t\t\tKosovo\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Kuwait\">\n\t\t\t\t\tKuwait\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Kyrgyzstan\">\n\t\t\t\t\tKyrgyzstan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Laos\">\n\t\t\t\t\tLaos\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Latvia\">\n\t\t\t\t\tLatvia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Lebanon\">\n\t\t\t\t\tLebanon\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Lesotho\">\n\t\t\t\t\tLesotho\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Liberia\">\n\t\t\t\t\tLiberia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Libya\">\n\t\t\t\t\tLibya\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Liechtenstein\">\n\t\t\t\t\tLiechtenstein\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Lithuania\">\n\t\t\t\t\tLithuania\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Luxembourg\">\n\t\t\t\t\tLuxembourg\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Macau\">\n\t\t\t\t\tMacau\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Macedonia\">\n\t\t\t\t\tMacedonia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Madagascar\">\n\t\t\t\t\tMadagascar\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Malawi\">\n\t\t\t\t\tMalawi\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Malaysia\">\n\t\t\t\t\tMalaysia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Maldives\">\n\t\t\t\t\tMaldives\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mali\">\n\t\t\t\t\tMali\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Malta\">\n\t\t\t\t\tMalta\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Marshall Islands\">\n\t\t\t\t\tMarshall Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Martinique\">\n\t\t\t\t\tMartinique\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mauritania\">\n\t\t\t\t\tMauritania\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mauritius\">\n\t\t\t\t\tMauritius\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mayotte\">\n\t\t\t\t\tMayotte\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mexico\">\n\t\t\t\t\tMexico\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Micronesia\">\n\t\t\t\t\tMicronesia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Moldova\">\n\t\t\t\t\tMoldova\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Monaco\">\n\t\t\t\t\tMonaco\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mongolia\">\n\t\t\t\t\tMongolia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Montenegro\">\n\t\t\t\t\tMontenegro\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Montserrat\">\n\t\t\t\t\tMontserrat\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Morocco\">\n\t\t\t\t\tMorocco\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Mozambique\">\n\t\t\t\t\tMozambique\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Myanmar (Burma)\">\n\t\t\t\t\tMyanmar (Burma)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Namibia\">\n\t\t\t\t\tNamibia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Nauru\">\n\t\t\t\t\tNauru\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Nepal\">\n\t\t\t\t\tNepal\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Netherlands\">\n\t\t\t\t\tNetherlands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Netherlands Antilles\">\n\t\t\t\t\tNetherlands Antilles\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"New Caledonia\">\n\t\t\t\t\tNew Caledonia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"New Zealand\">\n\t\t\t\t\tNew Zealand\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Nicaragua\">\n\t\t\t\t\tNicaragua\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Niger\">\n\t\t\t\t\tNiger\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Nigeria\">\n\t\t\t\t\tNigeria\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Niue\">\n\t\t\t\t\tNiue\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Northern Mariana Islands\">\n\t\t\t\t\tNorthern Mariana Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Norway\">\n\t\t\t\t\tNorway\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Oman\">\n\t\t\t\t\tOman\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Pakistan\">\n\t\t\t\t\tPakistan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Palau\">\n\t\t\t\t\tPalau\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Palestinian Territories (Gaza Strip and West Bank)\">\n\t\t\t\t\tPalestinian Territories (Gaza Strip and West Bank)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Panama\">\n\t\t\t\t\tPanama\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Papua New Guinea\">\n\t\t\t\t\tPapua New Guinea\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Paraguay\">\n\t\t\t\t\tParaguay\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Peru\">\n\t\t\t\t\tPeru\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Philippines\">\n\t\t\t\t\tPhilippines\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Pitcairn Islands\">\n\t\t\t\t\tPitcairn Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Poland\">\n\t\t\t\t\tPoland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Portugal\">\n\t\t\t\t\tPortugal\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Puerto Rico\">\n\t\t\t\t\tPuerto Rico\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Qatar\">\n\t\t\t\t\tQatar\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Reunion\">\n\t\t\t\t\tReunion\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Romania\">\n\t\t\t\t\tRomania\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Russia\">\n\t\t\t\t\tRussia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Rwanda\">\n\t\t\t\t\tRwanda\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Saint Helena\">\n\t\t\t\t\tSaint Helena\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Saint Kitts and Nevis\">\n\t\t\t\t\tSaint Kitts and Nevis\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Saint Lucia\">\n\t\t\t\t\tSaint Lucia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Saint Pierre and Miquelon\">\n\t\t\t\t\tSaint Pierre and Miquelon\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Saint Vincent and the Grenadines\">\n\t\t\t\t\tSaint Vincent and the Grenadines\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Samoa\">\n\t\t\t\t\tSamoa\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"San Marino\">\n\t\t\t\t\tSan Marino\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Sao Tome and Principe\">\n\t\t\t\t\tSao Tome and Principe\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Saudi Arabia\">\n\t\t\t\t\tSaudi Arabia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Senegal\">\n\t\t\t\t\tSenegal\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Serbia\">\n\t\t\t\t\tSerbia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Seychelles\">\n\t\t\t\t\tSeychelles\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Sierra Leone\">\n\t\t\t\t\tSierra Leone\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Singapore\">\n\t\t\t\t\tSingapore\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Slovakia\">\n\t\t\t\t\tSlovakia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Slovenia\">\n\t\t\t\t\tSlovenia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Solomon Islands\">\n\t\t\t\t\tSolomon Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Somalia\">\n\t\t\t\t\tSomalia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"South Africa\">\n\t\t\t\t\tSouth Africa\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"South Georgia and the South Sandwich Islands\">\n\t\t\t\t\tSouth Georgia and the South Sandwich Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Spain\">\n\t\t\t\t\tSpain\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Sri Lanka\">\n\t\t\t\t\tSri Lanka\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Sudan\">\n\t\t\t\t\tSudan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Suriname\">\n\t\t\t\t\tSuriname\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Svalbard\">\n\t\t\t\t\tSvalbard\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Swaziland\">\n\t\t\t\t\tSwaziland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Sweden\">\n\t\t\t\t\tSweden\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Switzerland\">\n\t\t\t\t\tSwitzerland\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Syria\">\n\t\t\t\t\tSyria\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Taiwan\">\n\t\t\t\t\tTaiwan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tajikistan\">\n\t\t\t\t\tTajikistan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tanzania\">\n\t\t\t\t\tTanzania\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Thailand\">\n\t\t\t\t\tThailand\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Timor-Leste (East Timor)\">\n\t\t\t\t\tTimor-Leste (East Timor)\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Togo\">\n\t\t\t\t\tTogo\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tokelau\">\n\t\t\t\t\tTokelau\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tonga\">\n\t\t\t\t\tTonga\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Trinidad and Tobago\">\n\t\t\t\t\tTrinidad and Tobago\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tristan da Cunha\">\n\t\t\t\t\tTristan da Cunha\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tunisia\">\n\t\t\t\t\tTunisia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Turkey\">\n\t\t\t\t\tTurkey\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Turkmenistan\">\n\t\t\t\t\tTurkmenistan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Turks and Caicos Islands\">\n\t\t\t\t\tTurks and Caicos Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Tuvalu\">\n\t\t\t\t\tTuvalu\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"U.S. Virgin Islands\">\n\t\t\t\t\tU.S. Virgin Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Uganda\">\n\t\t\t\t\tUganda\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Ukraine\">\n\t\t\t\t\tUkraine\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"United Arab Emirates\">\n\t\t\t\t\tUnited Arab Emirates\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"United Kingdom\">\n\t\t\t\t\tUnited Kingdom\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"United States\">\n\t\t\t\t\tUnited States\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"United States Minor Outlying Islands\">\n\t\t\t\t\tUnited States Minor Outlying Islands\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Uruguay\">\n\t\t\t\t\tUruguay\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Uzbekistan\">\n\t\t\t\t\tUzbekistan\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Vanuatu\">\n\t\t\t\t\tVanuatu\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Vatican City\">\n\t\t\t\t\tVatican City\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Venezuela\">\n\t\t\t\t\tVenezuela\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Vietnam\">\n\t\t\t\t\tVietnam\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Wallis and Futuna\">\n\t\t\t\t\tWallis and Futuna\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Western Sahara\">\n\t\t\t\t\tWestern Sahara\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Yemen\">\n\t\t\t\t\tYemen\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Zambia\">\n\t\t\t\t\tZambia\t\t\t\t<\/option>\n\t\t\t\t\t\t\t\t<option  value=\"Zimbabwe\">\n\t\t\t\t\tZimbabwe\t\t\t\t<\/option>\n\t\t\t\t\t\t<\/select>\n\t\t\n    <div class=\"frm_description\" id=\"frm_desc_field_xf8d7\">Location of educational institution<\/div>\n    \n<\/div>\n<div id=\"frm_field_679_container\" class=\"frm_form_field form-field  frm_top_container frm6\">\n    <label for=\"field_zcicd\" id=\"field_zcicd_label\" class=\"frm_primary_label\">State\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n    <\/label>\n    \t\t<select  name=\"item_meta[679]\" id=\"field_zcicd\"  data-sectionid=\"384\" data-invmsg=\"State is invalid\" aria-invalid=\"false\"  >\n\t\t\t\t\t\t\t<option  value=\"\" class=\"frm-select-placeholder\">\n\t\t\t\t\t \t\t\t\t<\/option>\n\t\t\t\t\t\t<\/select>\n\t\t\n    \n    \n<\/div>\n<div id=\"frm_field_452_container\" class=\"frm_form_field form-field  frm_top_container frm6 frm_first vertical_radio\">\r\n    <div  id=\"field_qq361_label\" class=\"frm_primary_label\">Currently pursuing?\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" aria-labelledby=\"field_qq361_label\" role=\"radiogroup\">\t\t<div class=\"frm_radio\" id=\"frm_radio_452-384-0\">\t\t\t<label  for=\"field_qq361-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[452]\" id=\"field_qq361-0\" value=\"Yes\"\n\t\tchecked=\"checked\"   data-sectionid=\"384\" data-frmval=\"Yes\" data-invmsg=\"Currently pursuing? is invalid\" aria-invalid=\"false\"  \/> Yes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_452-384-1\">\t\t\t<label  for=\"field_qq361-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[452]\" id=\"field_qq361-1\" value=\"No\"\n\t\t   data-sectionid=\"384\" data-frmval=\"Yes\" data-invmsg=\"Currently pursuing? is invalid\" aria-invalid=\"false\"  \/> No<\/label><\/div>\n<\/div>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_qq361\">Click on Yes if currently pursuing the course<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_453_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_cji2f\" id=\"field_cji2f_label\" class=\"frm_primary_label\">Upload education documentThis question is required.\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"hidden\" name=\"item_meta[453]\"  data-reqmsg=\"Upload education documentThis question is required. cannot be blank.\"  value=\"\" data-frmfile=\"453\" \/>\n\n<div class=\"frm_dropzone frm_single_upload frm_clearfix\" id=\"file453_dropzone\" role=\"group\"  aria-describedby=\"frm_desc_field_cji2f\">\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file453\" id=\"field_cji2f\"\n\t\t\t data-sectionid=\"384\" data-reqmsg=\"Upload education documentThis question is required. cannot be blank.\" data-invmsg=\"Upload education documentThis question is required. is invalid\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"Upload education documentThis question is required.. Drop a file here or click to upload. Maximum file size: 516MB\">Drop a file here or click to upload<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"Upload education documentThis question is required.. Choose File. Maximum file size: 516MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 516MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\r\n    <div class=\"frm_description\" id=\"frm_desc_field_cji2f\">Upload relevant educational certificate. If currently pursuing, upload student ID<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_451_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label for=\"field_tqczt\" id=\"field_tqczt_label\" class=\"frm_primary_label\">Start date\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_tqczt\" name=\"item_meta[451]\" value=\"\"  data-sectionid=\"384\" maxlength=\"10\" data-reqmsg=\"Start date cannot be blank.\" aria-required=\"true\" data-invmsg=\"Start date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_tqczt\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_tqczt\">Start date of the course<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_454_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <label for=\"field_ai5ch\" id=\"field_ai5ch_label\" class=\"frm_primary_label\"> End date\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ai5ch\" name=\"item_meta[454]\" value=\"\"  data-sectionid=\"384\" maxlength=\"10\" data-reqmsg=\" End date cannot be blank.\" aria-required=\"true\" data-invmsg=\" End date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ai5ch\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ai5ch\">End date of the course<\/div>\r\n    \r\n<\/div>\n<\/div>\n<input type=\"hidden\" name=\"frm_page_order_8\" id=\"frm_page_order_8\" value=\"29\" \/><input type=\"hidden\" name=\"item_meta[393]\" id=\"field_bwy455\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[455]\" id=\"field_a2v6p\" value=\"\"  data-sectionid=\"393\"    \/>\n<input type=\"hidden\" name=\"item_meta[456]\" id=\"field_3lta8-0\" value=\"\"  data-sectionid=\"393\"    \/>\n<input type=\"hidden\" name=\"item_meta[457]\" id=\"field_mwg32-0\" value=\"Yes\"  data-sectionid=\"393\" data-frmval=\"Yes\"   \/>\n<input type=\"hidden\" name=\"item_meta[459]\" id=\"field_dsf96\" value=\"\"  data-sectionid=\"393\"    \/>\n<input type=\"hidden\" name=\"item_meta[460]\" id=\"field_4mn8w\" value=\"\"  data-sectionid=\"393\"    \/>\n<input type=\"hidden\" name=\"item_meta[398]\" id=\"field_y11k75\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[399]\" id=\"field_azrgv5\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[400]\" id=\"field_cql0m5\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[462]\" id=\"field_ehyfn\" value=\"\"  data-sectionid=\"400\"    \/>\n<input type=\"hidden\" name=\"item_meta[402]\" id=\"field_456kj5\" value=\"\"  data-sectionid=\"400\"    \/>\n<input type=\"hidden\" name=\"item_meta[463]\" id=\"field_t3ost\" value=\"\"  data-sectionid=\"400\"    \/>\n<input type=\"hidden\" name=\"item_meta[464]\" id=\"field_3f07c\" value=\"\"  data-sectionid=\"400\"    \/>\n<input type=\"hidden\" name=\"item_meta[407]\" id=\"field_81ddm5\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[408]\" id=\"field_x7xt45\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[476]\" id=\"field_psx4l\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[477]\" id=\"field_wp4ex\" value=\"\"  data-sectionid=\"476\"    \/>\n<input type=\"hidden\" name=\"item_meta[478]\" id=\"field_5kbxu\" value=\"\"  data-sectionid=\"476\"    \/>\n<input type=\"hidden\" name=\"item_meta[479]\" id=\"field_u3dgq\" value=\"\"  data-sectionid=\"476\"    \/>\n<input type=\"hidden\" name=\"item_meta[481]\" id=\"field_7ce25\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[475]\" id=\"field_s9q0e\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[409]\" id=\"field_zi72u5\" value=\"\"     \/>\n<input type=\"hidden\" name=\"item_meta[657]\" id=\"field_ot9r6\" value=\"\"  data-sectionid=\"409\"    \/>\n<input type=\"hidden\" name=\"item_meta[469]\" id=\"field_pbxr8\" value=\"\"  data-sectionid=\"409\"    \/>\n<input type=\"hidden\" name=\"item_meta[470]\" id=\"field_ihp77-0\" value=\"\"  data-sectionid=\"409\"    \/>\n<input type=\"hidden\" name=\"item_meta[417]\" id=\"field_7pcjx5\" value=\"\"     \/>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t\t<div class=\"frm__65ec09e83e7e4\">\n\t\t\t\t<label for=\"frm_email_8\" >\n\t\t\t\t\tIf you are human, leave this field blank.\t\t\t\t<\/label>\n\t\t\t\t<input  id=\"frm_email_8\" type=\"text\" class=\"frm_verify\" name=\"frm__65ec09e83e7e4\" value=\"\" autocomplete=\"off\"  \/>\n\t\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"c+sRUEdDnQHz6DXi\/Ttjm7jDYUUH9+gAlkHiG5d6mP0=\" \/><div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit\" type=\"submit\"  >Next<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Pacifyr Provider Registration Register to get started as a provider on Pacifyr<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-989989","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/pages\/989989","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/comments?post=989989"}],"version-history":[{"count":34,"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/pages\/989989\/revisions"}],"predecessor-version":[{"id":990361,"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/pages\/989989\/revisions\/990361"}],"wp:attachment":[{"href":"https:\/\/pacifyr.ai\/us\/wp-json\/wp\/v2\/media?parent=989989"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}