{"id":1027,"date":"2017-09-12T07:06:59","date_gmt":"2017-09-12T07:06:59","guid":{"rendered":"http:\/\/perakcheahclan.org\/?page_id=1027"},"modified":"2022-01-19T11:38:26","modified_gmt":"2022-01-19T03:38:26","slug":"join-members","status":"publish","type":"page","link":"https:\/\/perakcheahclan.org\/index.php\/join-members\/","title":{"rendered":"\u52a0\u5165\u4f1a\u5458"},"content":{"rendered":"<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_1' class='avia-section main_color avia-section-large avia-no-shadow avia-full-stretch av-section-color-overlay-active avia-bg-style-fixed  container_wrap sidebar_right' style = 'background-repeat: no-repeat; background-image: url(https:\/\/perakcheahclan.org\/wp-content\/uploads\/2017\/09\/join-members-1.jpg); background-attachment: fixed; background-position: bottom center; ' data-section-bg-repeat='stretch' ><div class='av-section-color-overlay-wrap'><div class='av-section-color-overlay' style='opacity: 0.3; background-color: #000000; '><\/div><div class='container' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1027'><div class='entry-content-wrapper clearfix'>\n<div style='padding-bottom:0px;color:#ffffff;font-size:50px;' class='av-special-heading av-special-heading-h3 custom-color-heading blockquote modern-quote modern-centered  av-inherit-size'><h3 class='av-special-heading-tag'  itemprop=\"headline\"  >\u52a0\u5165\u4f1a\u5458<\/h3><div class ='av-subheading av-subheading_below av_custom_color' style='font-size:15px;'><p>\u7533\u8bf7\u52a0\u5165\u9739\u96f3\u5b9d\u6811\u5802\u8c22\u6c0f\u5b97\u4eb2\u4f1a\u4f1a\u5458\u8868\u683c<\/p>\n<\/div><div class='special-heading-border'><div class='special-heading-inner-border' style='border-color:#ffffff'><\/div><\/div><\/div>\n<div style=' margin-top:30px; margin-bottom:30px;'  class='hr hr-custom hr-center hr-icon-yes '><span class='hr-inner   inner-border-av-border-thin' style=' width:20%; border-color:rgba(255,255,255,0.76);' ><span class='hr-inner-style'><\/span><\/span><span class='av-seperator-icon' style='color:#ffffff;' aria-hidden='true' data-av_icon='\ue8bf' data-av_iconfont='entypo-fontello'><\/span><span class='hr-inner   inner-border-av-border-thin' style=' width:20%; border-color:rgba(255,255,255,0.76);' ><span class='hr-inner-style'><\/span><\/span><\/div>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><\/div><div id='after_section_1' class='main_color av_default_container_wrap container_wrap sidebar_right'   ><div class='container' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1027'><div class='entry-content-wrapper clearfix'>\n<\/div><\/div><\/div><!-- close content main div --><\/div><\/div><div id='av_section_2' class='avia-section main_color avia-section-default avia-no-border-styling avia-bg-style-scroll  container_wrap sidebar_right'   ><div class='container' ><div class='template-page content  av-content-small alpha units'><div class='post-entry post-entry-type-page post-entry-1027'><div class='entry-content-wrapper clearfix'>\n<div class='flex_column_table av-equal-height-column-flextable' style='margin-top:-90px; margin-bottom:0px; '><div class=\"flex_column av_two_third  no_margin flex_column_table_cell av-equal-height-column av-align-top first  \" style='padding:30px; background-color:#ffffff; border-radius:0px; '><p><div style='padding-bottom:0px;' class='av-special-heading av-special-heading-h2  blockquote modern-quote  '><h2 class='av-special-heading-tag'  itemprop=\"headline\"  >\u52a0\u5165\u4f1a\u5458<\/h2><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n<section class=\"av_textblock_section\"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock '   itemprop=\"text\" ><p class=\"av-special-heading-tag\">\u6211\u4eec\u521b\u529e<strong>\u9739\u96f3\u5b9d\u6811\u5802\u8c22\u6c0f\u5b97\u4eb2\u4f1a<\/strong>\u7684\u76ee\u7684\u662f\u8981\u805a\u96c6\u5b97\u4eb2\u4eec\u56e2\u7ed3\u5728\u4e00\u8d77\uff0c\u53d1\u6325\u5b88\u671b\u76f8\u52a9\u7684\u7cbe\u795e\u3002 \u6b64\u5916\uff0c\u4e5f\u6559\u80b2\u5e74\u8f7b\u4e00\u4ee3\u7684\u5b97\u4eb2\u4eec\u65f6\u523b\u7262\u8bb0\u8c22\u6c0f\u7684\u5802\u53f7 \u201c<strong>\u5b9d\u6811\u5802<\/strong>\u201d\u3002<\/p>\n<p>\u201c<strong>\u6811\u7e41\u53f6\u8302<\/strong>\u201d \u662f\u5f62\u5bb9\u5b50\u5b59\u660c\u76db\u3002\u6211\u4eec\u7948\u671b\u9739\u96f3\u5dde\u5185\u7684\u5b97\u4eb2\u4eec\u80fd\u591f\u900f\u8fc7\u8c22\u6c0f\u5b97\u4eb2\u4f1a\u7684\u8fd9\u4e2a\u5e73\u53f0\uff0c\u5927\u5bb6\u4e92\u901a\u4fe1\u606f\u5f80\u6765\uff1b\u6bd5\u7adf\uff0c\u591a\u5e74\u4ee5\u524d\u6211\u4eec\u8c22\u59d3\u5b97\u4eb2\u672c\u662f\u4e00\u5bb6\u4eba\u3002<\/p>\n<p>\u6709\u610f\u52a0\u5165\u6210\u4e3a \u201c<strong>\u9739\u96f3\u5b9d\u6811\u5802\u8c22\u6c0f\u5b97\u4eb2\u4f1a<\/strong>\u201d \u4f1a\u5458\uff1f \u60a8\u53ef\u53d1\u7535\u90ae\u4e0e\u6211\u4eec\u8054\u7cfb\u3002<\/p>\n<p><strong><span id=\"result_box\" class=\"short_text\" lang=\"zh-CN\"><span class=\"\">\u7535\u8bdd<\/span><\/span>:<br \/>\n<\/strong>(+6) 05-255 1898<strong><br \/>\n<\/strong><\/p>\n<p><strong><span id=\"result_box\" class=\"short_text\" lang=\"zh-CN\"><span class=\"\">\u7535\u5b50\u90ae\u4ef6<\/span><\/span>:<br \/>\n<\/strong><a href=\"mailto:perakcheahclan@gmail.com\">perakcheahclan@gmail.com<\/a><\/p>\n<\/div><\/section><br \/>\n<div style=' margin-top:30px; margin-bottom:30px;'  class='hr hr-custom hr-center hr-icon-yes '><span class='hr-inner   inner-border-av-border-thin' style=' width:45%;' ><span class='hr-inner-style'><\/span><\/span><span class='av-seperator-icon'  aria-hidden='true' data-av_icon='\ue8bf' data-av_iconfont='entypo-fontello'><\/span><span class='hr-inner   inner-border-av-border-thin' style=' width:45%;' ><span class='hr-inner-style'><\/span><\/span><\/div><br \/>\n<form action=\"https:\/\/perakcheahclan.org\/index.php\/join-members\/\" method=\"post\"  class=\"avia_ajax_form av-form-labels-visible   \" data-avia-form-id=\"1\" data-avia-redirect=''><fieldset><h3>\u7533\u8bf7\u52a0\u5165\u9739\u96f3\u5b9d\u6811\u5802\u8c22\u6c0f\u5b97\u4eb2\u4f1a\u4f1a\u5458\u8868\u683c \/<br \/>\nApply to join Persatuan Keturunan Cheah Perak membership form<\/h3><p class=' first_form  form_element form_element_two_third' id='element_avia_1_1'><label for=\"avia_1_1\">\u7533\u8bf7\u4eba\u59d3\u540d (\u6839\u636e\u8eab\u4efd\u8bc1) \/ Applicant\u2019s Name as NRIC <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_1_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_1_1\" value=\"\" \/><\/p><p class=' form_element form_element_third' id='element_avia_2_1'><label for=\"avia_2_1\">\u4e2d\u6587\u540d \/ Chinese name<\/label> <input name=\"avia_2_1\" class=\"text_input \" type=\"text\" id=\"avia_2_1\" value=\"\" \/><\/p><p class=' first_form  form_element form_element_half' id='element_avia_3_1'><label for=\"avia_3_1\">\u8eab\u4efd\u8bc1\u53f7\u7801 \/ Malaysia NRIC No. <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_3_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_3_1\" value=\"\" \/><\/p><p class=' form_element form_element_fourth' id='element_avia_4_1'><label for=\"avia_4_1\">\u51fa\u751f\u65e5\u671f \/ D.O.B. <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_4_1\" class=\"avia_datepicker text_input is_empty\" type=\"text\" id=\"avia_4_1\" value=\"\" placeholder=\"DD \/ MM \/ YY\" \/><\/p><p class=' form_element form_element_fourth' id='element_avia_5_1'><label for=\"avia_5_1\">\u6027\u522b \/ Gender <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <select  name=\"avia_5_1\" class=\"select is_empty\" id=\"avia_5_1\"><option  value ='\u7537\u6027 \/ Male'>\u7537\u6027 \/ Male<\/option><option  value ='\u5973\u6027 \/ Female'>\u5973\u6027 \/ Female<\/option><option selected='selected' value =''><\/option><\/select><\/p><p class=' first_form  form_element form_element_half' id='element_avia_6_1'><label for=\"avia_6_1\">\u8054\u7edc\u7535\u8bdd \/ Tel <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_6_1\" class=\"text_input is_phone\" type=\"text\" id=\"avia_6_1\" value=\"\" \/><\/p><p class=' form_element form_element_half' id='element_avia_7_1'><label for=\"avia_7_1\">\u7535\u5b50\u90ae\u4ef6 \/ E-mail address <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_7_1\" class=\"text_input is_email\" type=\"text\" id=\"avia_7_1\" value=\"\" \/><\/p><p class=' first_form  form_element form_fullwidth' id='element_avia_8_1'><label for=\"avia_8_1\">\u8054\u7edc\u5730\u5740 \/ Mailing Address <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_8_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_8_1\" value=\"\" \/><\/p><p class=' first_form  form_element form_element_fourth' id='element_avia_9_1'><label for=\"avia_9_1\">\u90ae\u7f16 \/ Zip code <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_9_1\" class=\"text_input is_number\" type=\"text\" id=\"avia_9_1\" value=\"\" \/><\/p><p class=' form_element form_element_fourth' id='element_avia_10_1'><label for=\"avia_10_1\">\u57ce\u5e02 \/ City <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_10_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_10_1\" value=\"\" \/><\/p><p class=' form_element form_element_fourth' id='element_avia_11_1'><label for=\"avia_11_1\">\u5dde \/ State <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <input name=\"avia_11_1\" class=\"text_input is_empty\" type=\"text\" id=\"avia_11_1\" value=\"\" \/><\/p><p class=' form_element form_element_fourth' id='element_avia_12_1'><label for=\"avia_12_1\">\u56fd\u5bb6 \/ Country <abbr class=\"required\" title=\"required\">*<\/abbr><\/label> <select  name=\"avia_12_1\" class=\"select is_empty\" id=\"avia_12_1\"><option  value ='Malaysia'>Malaysia<\/option><option  value ='Afghanistan'>Afghanistan<\/option><option  value ='Albania'>Albania<\/option><option  value ='Algeria'>Algeria<\/option><option  value ='Andorra'>Andorra<\/option><option  value ='Angola'>Angola<\/option><option  value ='Antigua and Barbuda'>Antigua and Barbuda<\/option><option  value ='Argentina'>Argentina<\/option><option  value ='Armenia'>Armenia<\/option><option  value ='Aruba'>Aruba<\/option><option  value ='Australia'>Australia<\/option><option  value ='Austria'>Austria<\/option><option  value ='Azerbaijan'>Azerbaijan<\/option><option  value ='Bahamas'>Bahamas<\/option><option  value ='Bahrain'>Bahrain<\/option><option  value ='Bangladesh'>Bangladesh<\/option><option  value ='Barbados'>Barbados<\/option><option  value ='Belarus'>Belarus<\/option><option  value ='Belgium'>Belgium<\/option><option  value ='Belize'>Belize<\/option><option  value ='Benin'>Benin<\/option><option  value ='Bermuda'>Bermuda<\/option><option  value ='Bhutan'>Bhutan<\/option><option  value ='Bolivia'>Bolivia<\/option><option  value ='Bosnia and Herzegovina'>Bosnia and Herzegovina<\/option><option  value ='Botswana'>Botswana<\/option><option  value ='Brazil'>Brazil<\/option><option  value ='Brunei Darussalam'>Brunei Darussalam<\/option><option  value ='Bulgaria'>Bulgaria<\/option><option  value ='Burkina Faso'>Burkina Faso<\/option><option  value ='Burundi'>Burundi<\/option><option  value ='Cambodia'>Cambodia<\/option><option  value ='Cameroon'>Cameroon<\/option><option  value ='Canada'>Canada<\/option><option  value ='Cape Verde'>Cape Verde<\/option><option  value ='Cayman Islands'>Cayman Islands<\/option><option  value ='Central African Republic'>Central African Republic<\/option><option  value ='Chad'>Chad<\/option><option  value ='Chile'>Chile<\/option><option  value ='China'>China<\/option><option  value ='Christmas Island'>Christmas Island<\/option><option  value ='Cocos (Keeling) Islands'>Cocos (Keeling) Islands<\/option><option  value ='Colombia'>Colombia<\/option><option  value ='Comoros'>Comoros<\/option><option  value ='Democratic Republic of the Congo (Kinshasa)'>Democratic Republic of the Congo (Kinshasa)<\/option><option  value ='Congo'>Congo<\/option><option  value ='Republic of (Brazzaville)'>Republic of (Brazzaville)<\/option><option  value ='Cook Islands'>Cook Islands<\/option><option  value ='Costa Rica'>Costa Rica<\/option><option  value ='C\u00f4te D\u2019ivoire (Ivory Coast)'>C\u00f4te D\u2019ivoire (Ivory Coast)<\/option><option  value ='Croatia'>Croatia<\/option><option  value ='Cuba'>Cuba<\/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 ='East Timor (Timor-Leste)'>East Timor (Timor-Leste)<\/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 ='Great Britain'>Great Britain<\/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 ='Guinea'>Guinea<\/option><option  value ='Guinea-Bissau'>Guinea-Bissau<\/option><option  value ='Guyana'>Guyana<\/option><option  value ='Haiti'>Haiti<\/option><option  value ='Holy See'>Holy See<\/option><option  value ='Honduras'>Honduras<\/option><option  value ='Hong Kong'>Hong Kong<\/option><option  value ='Hungary'>Hungary<\/option><option  value ='Iceland'>Iceland<\/option><option  value ='India'>India<\/option><option  value ='Indonesia'>Indonesia<\/option><option  value ='Iran (Islamic Republic of)'>Iran (Islamic Republic of)<\/option><option  value ='Iraq'>Iraq<\/option><option  value ='Ireland'>Ireland<\/option><option  value ='Israel'>Israel<\/option><option  value ='Italy'>Italy<\/option><option  value ='Ivory Coast'>Ivory Coast<\/option><option  value ='Jamaica'>Jamaica<\/option><option  value ='Japan'>Japan<\/option><option  value ='Jordan'>Jordan<\/option><option  value ='Kazakhstan'>Kazakhstan<\/option><option  value ='Kenya'>Kenya<\/option><option  value ='Kiribati'>Kiribati<\/option><option  value ='Korea (North Korea)'>Korea (North Korea)<\/option><option  value ='Korea (South Korea)'>Korea (South Korea)<\/option><option  value ='Kosovo'>Kosovo<\/option><option  value ='Kuwait'>Kuwait<\/option><option  value ='Kyrgyzstan'>Kyrgyzstan<\/option><option  value ='Laos'>Laos<\/option><option  value ='Latvia'>Latvia<\/option><option  value ='Lebanon'>Lebanon<\/option><option  value ='Lesotho'>Lesotho<\/option><option  value ='Liberia'>Liberia<\/option><option  value ='Libya'>Libya<\/option><option  value ='Liechtenstein'>Liechtenstein<\/option><option  value ='Lithuania'>Lithuania<\/option><option  value ='Luxembourg'>Luxembourg<\/option><option  value ='Macau'>Macau<\/option><option  value ='Macedonia'>Macedonia<\/option><option  value ='Madagascar'>Madagascar<\/option><option  value ='Malawi'>Malawi<\/option><option  value ='Malaysia'>Malaysia<\/option><option  value ='Maldives'>Maldives<\/option><option  value ='Mali'>Mali<\/option><option  value ='Malta'>Malta<\/option><option  value ='Marshall Islands'>Marshall Islands<\/option><option  value ='Martinique'>Martinique<\/option><option  value ='Mauritania'>Mauritania<\/option><option  value ='Mauritius'>Mauritius<\/option><option  value ='Mayotte'>Mayotte<\/option><option  value ='Mexico'>Mexico<\/option><option  value ='Micronesia'>Micronesia<\/option><option  value ='Moldova'>Moldova<\/option><option  value ='Monaco'>Monaco<\/option><option  value ='Mongolia'>Mongolia<\/option><option  value ='Montenegro'>Montenegro<\/option><option  value ='Montserrat'>Montserrat<\/option><option  value ='Morocco'>Morocco<\/option><option  value ='Mozambique'>Mozambique<\/option><option  value ='Myanmar'>Myanmar<\/option><option  value ='Namibia'>Namibia<\/option><option  value ='Nauru'>Nauru<\/option><option  value ='Nepal'>Nepal<\/option><option  value ='Netherlands'>Netherlands<\/option><option  value ='Netherlands Antilles'>Netherlands Antilles<\/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 ='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 ='Palestinian territories'>Palestinian territories<\/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 Island'>Pitcairn Island<\/option><option  value ='Poland'>Poland<\/option><option  value ='Portugal'>Portugal<\/option><option  value ='Puerto Rico'>Puerto Rico<\/option><option  value ='Qatar'>Qatar<\/option><option  value ='Reunion Island'>Reunion Island<\/option><option  value ='Romania'>Romania<\/option><option  value ='Russian Federation'>Russian Federation<\/option><option  value ='Rwanda'>Rwanda<\/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 ='Samoa'>Samoa<\/option><option  value ='San Marino'>San Marino<\/option><option  value ='Sao Tome and Principe'>Sao Tome and Principe<\/option><option  value ='Saudi Arabia'>Saudi Arabia<\/option><option  value ='Senegal'>Senegal<\/option><option  value ='Serbia'>Serbia<\/option><option  value ='Seychelles'>Seychelles<\/option><option  value ='Sierra Leone'>Sierra Leone<\/option><option  value ='Singapore'>Singapore<\/option><option  value ='Sint Maarten'>Sint Maarten<\/option><option  value ='Slovakia'>Slovakia<\/option><option  value ='Slovenia'>Slovenia<\/option><option  value ='Solomon Islands'>Solomon Islands<\/option><option  value ='Somalia'>Somalia<\/option><option  value ='South Africa'>South Africa<\/option><option  value ='South Sudan'>South Sudan<\/option><option  value ='Spain'>Spain<\/option><option  value ='Sri Lanka'>Sri Lanka<\/option><option  value ='Sudan'>Sudan<\/option><option  value ='Suriname'>Suriname<\/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 ='Tibet'>Tibet<\/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 ='Uruguay'>Uruguay<\/option><option  value ='Uzbekistan'>Uzbekistan<\/option><option  value ='Vanuatu'>Vanuatu<\/option><option  value ='Vatican City State'>Vatican City State<\/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><\/select><\/p><p class=' first_form  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