<div class="tabs-contain" >

    <div id="" class="form-section current" >

        <h2>Personal Information</h2>

        <ul class="row" >

            <li>
                <label for="First-Name" >First/given name*</label>
                [text First-Name id:First-Name " "]
            </li>
            <li>
                <label for="Last-Name" >Last/Family/Surname*</label>
                [text Last-Name id:Last-Name " "]
            </li>
            <li>
                <label for="Middle-Name" >Middle name</label>
                [text Middle-Name id:Middle-Name " "]
            </li>
            <li>
                <label for="Preferred-Name" >Preferred name</label>
                [text Preferred-Name id:Preferred-Name " "]
            </li>
            <li>
                <ul class="input-row" >
                    <li>
                        <label for="Sex" >Sex*</label>
                        [select* Sex id:Sex class:nice "Female" "Male"]
                    </li>
                    <li>
                        <label for="Birthday" >Date of Birth*</label>
                        [text* Birthday id:Birthday class:ui-datepick date-format:mm/dd/yy]
                    </li>
                </ul>
            <li>                
                <ul class="input-row" >
                    <li>
                        <label for="Phone-Type" >Phone type*</label>
        [select* Phone-Type id:Phone-Type class:nice "Home" "Mobile"]
                    </li>
                    <li>
                        <label for="Phone" >Phone number*</label>
                        [text Phone class:nice id:Phone " "]
                    </li>
                </ul>
            <li>
                <label for="Email" >Email address*</label>
                [text Email class:nice id:Email " "]
            </li>

        </ul>

    </div>

    <div id="" class="form-section current" >

        <h2>Home Address</h2>

        <ul class="row" >

            <li class="full-span" >
                <label for="Country" >Home country*</label>
                [select* Country class:nice id:Country "Afghanistan"
                    "Akrotiri"
                    "Albania"
                    "Algeria"
                    "American Samoa"
                    "Andorra"
                    "Angola"
                    "Anguilla"
                    "Antarctica"
                    "Antigua and Barbuda"
                    "Argentina"
                    "Armenia"
                    "Aruba"
                    "Ashmore And Cartier Is"
                    "Australia"
                    "Austria"
                    "Azerbaijan"
                    "Bahamas The"
                    "Bahrain"
                    "Baker Island"
                    "Bangladesh"
                    "Barbados"
                    "Bassas Da India"
                    "Belarus"
                    "Belgium"
                    "Belize"
                    "Benin"
                    "Bermuda"
                    "Bhutan"
                    "Bolivia"
                    "Bosnia and Herzegovina"
                    "Botswana"
                    "Bouvet Island"
                    "Brazil"
                    "British Indian Ocean Ter"
                    "British Virgin Islands"
                    "Brunei"
                    "Bulgaria"
                    "Burkina Faso"
                    "Burma"
                    "Burundi"
                    "Cambodia"
                    "Cameroon"
                    "Canada"
                    "Canal Zone"
                    "Canton And Enderbury"
                    "Cape Verde"
                    "Cayman Islands"
                    "Central African Republic"
                    "Central And S Line Isl"
                    "Chad"
                    "Chile"
                    "China"
                    "Christmas Island"
                    "Clipperton Island"
                    "Cocos (Keeling) Islands"
                    "Colombia"
                    "Comoros"
                    "Congo"
                    "Congo Democratic Republic Of"
                    "Cook Islands"
                    "Coral Sea Islands"
                    "Costa Rica"
                    "Cote D Ivoire"
                    "Croatia"
                    "Cuba"
                    "Curacao"
                    "Cyprus"
                    "Czech Republic"
                    "Czechoslovakia"
                    "Dem Republic Of Viet-Nam"
                    "Denmark"
                    "Dhekelia"
                    "Djibouti"
                    "Dominica"
                    "Dominican Republic"
                    "Ecuador"
                    "Egypt"
                    "El Salvador"
                    "Equatorial Guinea"
                    "Eritrea"
                    "Estonia"
                    "Ethiopia"
                    "Etorofu Habomai Kunashiri and Shikotan Islands"
                    "Europa Island"
                    "Falkland Isl (Malvinas)"
                    "Faroe Islands"
                    "Federal Republic Of Germany"
                    "Fiji"
                    "Finland"
                    "France"
                    "French Afars And Issas"
                    "French Guiana"
                    "French Polynesia"
                    "French S And Ant Lands"
                    "Gabon"
                    "Gambia The"
                    "Gaza Strip"
                    "Georgia"
                    "German Democratic Republic"
                    "Germany"
                    "Germany Berlin"
                    "Ghana"
                    "Gibraltar"
                    "Gilbert And Ellice Islands"
                    "Gilbert Islands"
                    "Glorioso Islands"
                    "Greece"
                    "Greenland"
                    "Grenada"
                    "Guadeloupe"
                    "Guam"
                    "Guatemala"
                    "Guernsey"
                    "Guinea"
                    "Guinea-Bissau"
                    "Guyana"
                    "Haiti"
                    "Heard Is & Mcdonald Slands"
                    "Honduras"
                    "Hong Kong"
                    "Howland Island"
                    "Hungary"
                    "Iceland"
                    "India"
                    "Indonesia"
                    "Iran"
                    "Iraq"
                    "Iraq-Saudi Arabia Neut Zone"
                    "Ireland"
                    "Isle Of Man"
                    "Israel"
                    "Israel-Jordan Demil Zone"
                    "Israel-Syria Demil Zone"
                    "Italy"
                    "Jamaica"
                    "Jan Mayen"
                    "Japan"
                    "Jarvis Island"
                    "Jersey"
                    "Johnston Atoll"
                    "Jordan"
                    "Juan De Nova Island"
                    "Kazakhstan"
                    "Kenya"
                    "Kingman Reef"
                    "Kiribati"
                    "Kosovo"
                    "Kuwait"
                    "Kyrgyzstan"
                    "Laos"
                    "Latvia"
                    "Lebanon"
                    "Lesotho"
                    "Liberia"
                    "Libya"
                    "Liechtenstein"
                    "Lithuania"
                    "Luxembourg"
                    "Macau"
                    "Macedonia"
                    "Madagascar"
                    "Malawi"
                    "Malaysia"
                    "Maldives"
                    "Mali"
                    "Malta"
                    "Marshall Islands"
                    "Martinique"
                    "Mauritania"
                    "Mauritius"
                    "Mayotte"
                    "Mexico"
                    "Micronesia Fed States Of"
                    "Midway Islands"
                    "Moldova"
                    "Monaco"
                    "Mongolia"
                    "Montenegro"
                    "Montenegro"
                    "Montserrat"
                    "Morocco"
                    "Mozambique"
                    "Namibia"
                    "Nauru"
                    "Navassa Island"
                    "Nepal"
                    "Netherlands"
                    "Netherlands Antilles"
                    "Neutral Zone"
                    "New Caledonia"
                    "New Zealand"
                    "Nicaragua"
                    "Niger"
                    "Nigeria"
                    "Niue"
                    "Norfolk Island"
                    "North Korea"
                    "Northern Mariana Islands"
                    "Norway"
                    "Oman"
                    "Pakistan"
                    "Palau"
                    "Palmyra Atoll"
                    "Panama"
                    "Papua New Guinea"
                    "Paracel Islands"
                    "Paraguay"
                    "Peru"
                    "Philippines"
                    "Pitcairn Islands"
                    "Poland"
                    "Portugal"
                    "Portuguese Timor"
                    "Puerto Rico"
                    "Qatar"
                    "Republic Of Viet-Nam"
                    "Reunion"
                    "Romania"
                    "Russia"
                    "Rwanda"
                    "S Georgia & S Sandwich"
                    "S Vincent & The Grenadines"
                    "Saint Barthelemy"
                    "Saint Helena"
                    "Saint Kitts And Nevis"
                    "Saint Lucia"
                    "Saint Martin"
                    "Saint Pierre And Miquelon"
                    "Samoa"
                    "San Marino"
                    "Sao Tome and Principe"
                    "Saudi Arabia"
                    "Senegal"
                    "Serbia"
                    "Serbia"
                    "Serbia"
                    "Serbia And Montenegro"
                    "Seychelles"
                    "Sierra Leone"
                    "Sikkim"
                    "Singapore"
                    "Sint Maarten"
                    "Sint Maarten"
                    "Slovakia"
                    "Slovenia"
                    "Solomon Islands"
                    "Somalia"
                    "South Africa"
                    "South Korea"
                    "Southern Rhodesia"
                    "Southern Ryukyu Islands"
                    "Spain"
                    "Spanish North Africa"
                    "Spanish Sahara"
                    "Spratly Islands"
                    "Sri Lanka"
                    "Stateless"
                    "Sudan"
                    "Suriname"
                    "Svalbard"
                    "Svalbard And Jan Mayen"
                    "Swan Islands"
                    "Swaziland"
                    "Sweden"
                    "Switzerland"
                    "Syria"
                    "Taiwan"
                    "Tajikistan"
                    "Tanzania"
                    "Thailand"
                    "Timor-Leste"
                    "Togo"
                    "Tokelau"
                    "Tonga"
                    "Trinidad and Tobago"
                    "Tromelin Island"
                    "Trust Terr Of Pacific Isl"
                    "Tunisia"
                    "Turkey"
                    "Turkmenistan"
                    "Turks and Caicos Islands"
                    "Tuvalu"
                    "US Misc Pacific Islands"
                    "Uganda"
                    "Ukraine"
                    "Union Of Sov Soc Republics"
                    "United Arab Emirates"
                    "United Kingdom"
                    "United States"
                    "Unknown"
                    "Uruguay"
                    "Uzbekistan"
                    "Vanuatu"
                    "Vatican City"
                    "Venezuela"
                    "Vietnam"
                    "Virgin Islands"
                    "Wake Atoll"
                    "Wallis And Futuna"
                    "West Bank"
                    "Western Sahara"
                    "Yeman (Sanaa)"
                    "Yemen"
                    "Yemen (Aden)"
                    "Yugoslavia"
                    "Zambia"
                    "Zimbabwe" ]
        </li>
        <li>
            <label for="Address-Line-1" >Address Line 1*</label>
            [text Address-Line-1 id:Address-Line-1 " "]
        </li>
        <li>
            <label for="Address-Line-2" >Address Line 2</label>
            [text Address-Line-2 id:Address-Line-2 " "]
        </li>
        <li>
            <label for="City" >City*</label>
            [text City id:City " "]
        </li>
        <li>
            <label for="State-Province" >State/Province</label>
            [text State-Province id:State-Province " "]
        </li>

        <li>
            <label for="" >Is your home address different than your current Mailing address? </label>
            [select Different-Mailing-Address id:mailing class:form-toggle class:nice "No" "Yes" ]
        </li>

    </ul>

</div>

<div id="mailing" class="form-section hidden-fields" >

    <h2>Mailing Address</h2>

    <ul class="row" >

        <li>
            <label for="Mailing-Address-Country" >Mailing address country</label>
            [text Mailing-Address-Country id:Mailing-Address-Country " "]
        </li>
        <li>
            <label for="Mailing-Address-Line-1" >Mailing address Line 1</label>
            [text Mailing-Address-Line-1 id:Mailing-Address-Line-1 " "]
        </li>
        <li>
            <label for="Mailing-Address-Line-2" >Mailing adress Line 2</label>
            [text Mailing-Address-Line-2 id:Mailing-Address-Line-2 " "]
        </li>
        <li>
            <label for="Mailing-Address-City" >Mailling Address City</label>
            [text Mailing-Address-City id:Mailing-Address-City " "]
        </li>
        <li>
            <label for="Mailing-State" >Mailing Address State/ Province</label>
            [text Mailing-State id:Mailing-State " "]
        </li>

    </ul>

</div>

<div id="" class="form-section " >

    <h2>Citizenship</h2>

    <ul class="row" >
            <li>
                <label for="Country-Of-Citizenship" >Country of citizenship*</label>
                [select* Country-Of-Citizenship id:Country-Of-Citizenship class:nice "Afghanistan"
                "Akrotiri"
                "Albania"
                "Algeria"
                "American Samoa"
                "Andorra"
                "Angola"
                "Anguilla"
                "Antarctica"
                "Antigua and Barbuda"
                "Argentina"
                "Armenia"
                "Aruba"
                "Ashmore And Cartier Is"
                "Australia"
                "Austria"
                "Azerbaijan"
                "Bahamas The"
                "Bahrain"
                "Baker Island"
                "Bangladesh"
                "Barbados"
                "Bassas Da India"
                "Belarus"
                "Belgium"
                "Belize"
                "Benin"
                "Bermuda"
                "Bhutan"
                "Bolivia"
                "Bosnia and Herzegovina"
                "Botswana"
                "Bouvet Island"
                "Brazil"
                "British Indian Ocean Ter"
                "British Virgin Islands"
                "Brunei"
                "Bulgaria"
                "Burkina Faso"
                "Burma"
                "Burundi"
                "Cambodia"
                "Cameroon"
                "Canada"
                "Canal Zone"
                "Canton And Enderbury"
                "Cape Verde"
                "Cayman Islands"
                "Central African Republic"
                "Central And S Line Isl"
                "Chad"
                "Chile"
                "China"
                "Christmas Island"
                "Clipperton Island"
                "Cocos (Keeling) Islands"
                "Colombia"
                "Comoros"
                "Congo"
                "Congo Democratic Republic Of"
                "Cook Islands"
                "Coral Sea Islands"
                "Costa Rica"
                "Cote D Ivoire"
                "Croatia"
                "Cuba"
                "Curacao"
                "Cyprus"
                "Czech Republic"
                "Czechoslovakia"
                "Dem Republic Of Viet-Nam"
                "Denmark"
                "Dhekelia"
                "Djibouti"
                "Dominica"
                "Dominican Republic"
                "Ecuador"
                "Egypt"
                "El Salvador"
                "Equatorial Guinea"
                "Eritrea"
                "Estonia"
                "Ethiopia"
                "Etorofu Habomai Kunashiri and Shikotan Islands"
                "Europa Island"
                "Falkland Isl (Malvinas)"
                "Faroe Islands"
                "Federal Republic Of Germany"
                "Fiji"
                "Finland"
                "France"
                "French Afars And Issas"
                "French Guiana"
                "French Polynesia"
                "French S And Ant Lands"
                "Gabon"
                "Gambia The"
                "Gaza Strip"
                "Georgia"
                "German Democratic Republic"
                "Germany"
                "Germany Berlin"
                "Ghana"
                "Gibraltar"
                "Gilbert And Ellice Islands"
                "Gilbert Islands"
                "Glorioso Islands"
                "Greece"
                "Greenland"
                "Grenada"
                "Guadeloupe"
                "Guam"
                "Guatemala"
                "Guernsey"
                "Guinea"
                "Guinea-Bissau"
                "Guyana"
                "Haiti"
                "Heard Is & Mcdonald Slands"
                "Honduras"
                "Hong Kong"
                "Howland Island"
                "Hungary"
                "Iceland"
                "India"
                "Indonesia"
                "Iran"
                "Iraq"
                "Iraq-Saudi Arabia Neut Zone"
                "Ireland"
                "Isle Of Man"
                "Israel"
                "Israel-Jordan Demil Zone"
                "Israel-Syria Demil Zone"
                "Italy"
                "Jamaica"
                "Jan Mayen"
                "Japan"
                "Jarvis Island"
                "Jersey"
                "Johnston Atoll"
                "Jordan"
                "Juan De Nova Island"
                "Kazakhstan"
                "Kenya"
                "Kingman Reef"
                "Kiribati"
                "Kosovo"
                "Kuwait"
                "Kyrgyzstan"
                "Laos"
                "Latvia"
                "Lebanon"
                "Lesotho"
                "Liberia"
                "Libya"
                "Liechtenstein"
                "Lithuania"
                "Luxembourg"
                "Macau"
                "Macedonia"
                "Madagascar"
                "Malawi"
                "Malaysia"
                "Maldives"
                "Mali"
                "Malta"
                "Marshall Islands"
                "Martinique"
                "Mauritania"
                "Mauritius"
                "Mayotte"
                "Mexico"
                "Micronesia Fed States Of"
                "Midway Islands"
                "Moldova"
                "Monaco"
                "Mongolia"
                "Montenegro"
                "Montenegro"
                "Montserrat"
                "Morocco"
                "Mozambique"
                "Namibia"
                "Nauru"
                "Navassa Island"
                "Nepal"
                "Netherlands"
                "Netherlands Antilles"
                "Neutral Zone"
                "New Caledonia"
                "New Zealand"
                "Nicaragua"
                "Niger"
                "Nigeria"
                "Niue"
                "Norfolk Island"
                "North Korea"
                "Northern Mariana Islands"
                "Norway"
                "Oman"
                "Pakistan"
                "Palau"
                "Palmyra Atoll"
                "Panama"
                "Papua New Guinea"
                "Paracel Islands"
                "Paraguay"
                "Peru"
                "Philippines"
                "Pitcairn Islands"
                "Poland"
                "Portugal"
                "Portuguese Timor"
                "Puerto Rico"
                "Qatar"
                "Republic Of Viet-Nam"
                "Reunion"
                "Romania"
                "Russia"
                "Rwanda"
                "S Georgia & S Sandwich"
                "S Vincent & The Grenadines"
                "Saint Barthelemy"
                "Saint Helena"
                "Saint Kitts And Nevis"
                "Saint Lucia"
                "Saint Martin"
                "Saint Pierre And Miquelon"
                "Samoa"
                "San Marino"
                "Sao Tome and Principe"
                "Saudi Arabia"
                "Senegal"
                "Serbia"
                "Serbia"
                "Serbia"
                "Serbia And Montenegro"
                "Seychelles"
                "Sierra Leone"
                "Sikkim"
                "Singapore"
                "Sint Maarten"
                "Sint Maarten"
                "Slovakia"
                "Slovenia"
                "Solomon Islands"
                "Somalia"
                "South Africa"
                "South Korea"
                "Southern Rhodesia"
                "Southern Ryukyu Islands"
                "Spain"
                "Spanish North Africa"
                "Spanish Sahara"
                "Spratly Islands"
                "Sri Lanka"
                "Stateless"
                "Sudan"
                "Suriname"
                "Svalbard"
                "Svalbard And Jan Mayen"
                "Swan Islands"
                "Swaziland"
                "Sweden"
                "Switzerland"
                "Syria"
                "Taiwan"
                "Tajikistan"
                "Tanzania"
                "Thailand"
                "Timor-Leste"
                "Togo"
                "Tokelau"
                "Tonga"
                "Trinidad and Tobago"
                "Tromelin Island"
                "Trust Terr Of Pacific Isl"
                "Tunisia"
                "Turkey"
                "Turkmenistan"
                "Turks and Caicos Islands"
                "Tuvalu"
                "US Misc Pacific Islands"
                "Uganda"
                "Ukraine"
                "Union Of Sov Soc Republics"
                "United Arab Emirates"
                "United Kingdom"
                "United States"
                "Unknown"
                "Uruguay"
                "Uzbekistan"
                "Vanuatu"
                "Vatican City"
                "Venezuela"
                "Vietnam"
                "Virgin Islands"
                "Wake Atoll"
                "Wallis And Futuna"
                "West Bank"
                "Western Sahara"
                "Yeman (Sanaa)"
                "Yemen"
                "Yemen (Aden)"
                "Yugoslavia"
                "Zambia"
                "Zimbabwe"]
            </li>
            <li>
                <label for="Birth-Country" >Country of birth*</label>
                [select* Birth-Country id:Birth-Country class:nice "Afghanistan"
                    "Akrotiri"
                    "Albania"
                    "Algeria"
                    "American Samoa"
                    "Andorra"
                    "Angola"
                    "Anguilla"
                    "Antarctica"
                    "Antigua and Barbuda"
                    "Argentina"
                    "Armenia"
                    "Aruba"
                    "Ashmore And Cartier Is"
                    "Australia"
                    "Austria"
                    "Azerbaijan"
                    "Bahamas The"
                    "Bahrain"
                    "Baker Island"
                    "Bangladesh"
                    "Barbados"
                    "Bassas Da India"
                    "Belarus"
                    "Belgium"
                    "Belize"
                    "Benin"
                    "Bermuda"
                    "Bhutan"
                    "Bolivia"
                    "Bosnia and Herzegovina"
                    "Botswana"
                    "Bouvet Island"
                    "Brazil"
                    "British Indian Ocean Ter"
                    "British Virgin Islands"
                    "Brunei"
                    "Bulgaria"
                    "Burkina Faso"
                    "Burma"
                    "Burundi"
                    "Cambodia"
                    "Cameroon"
                    "Canada"
                    "Canal Zone"
                    "Canton And Enderbury"
                    "Cape Verde"
                    "Cayman Islands"
                    "Central African Republic"
                    "Central And S Line Isl"
                    "Chad"
                    "Chile"
                    "China"
                    "Christmas Island"
                    "Clipperton Island"
                    "Cocos (Keeling) Islands"
                    "Colombia"
                    "Comoros"
                    "Congo"
                    "Congo Democratic Republic Of"
                    "Cook Islands"
                    "Coral Sea Islands"
                    "Costa Rica"
                    "Cote D Ivoire"
                    "Croatia"
                    "Cuba"
                    "Curacao"
                    "Cyprus"
                    "Czech Republic"
                    "Czechoslovakia"
                    "Dem Republic Of Viet-Nam"
                    "Denmark"
                    "Dhekelia"
                    "Djibouti"
                    "Dominica"
                    "Dominican Republic"
                    "Ecuador"
                    "Egypt"
                    "El Salvador"
                    "Equatorial Guinea"
                    "Eritrea"
                    "Estonia"
                    "Ethiopia"
                    "Etorofu Habomai Kunashiri and Shikotan Islands"
                    "Europa Island"
                    "Falkland Isl (Malvinas)"
                    "Faroe Islands"
                    "Federal Republic Of Germany"
                    "Fiji"
                    "Finland"
                    "France"
                    "French Afars And Issas"
                    "French Guiana"
                    "French Polynesia"
                    "French S And Ant Lands"
                    "Gabon"
                    "Gambia The"
                    "Gaza Strip"
                    "Georgia"
                    "German Democratic Republic"
                    "Germany"
                    "Germany Berlin"
                    "Ghana"
                    "Gibraltar"
                    "Gilbert And Ellice Islands"
                    "Gilbert Islands"
                    "Glorioso Islands"
                    "Greece"
                    "Greenland"
                    "Grenada"
                    "Guadeloupe"
                    "Guam"
                    "Guatemala"
                    "Guernsey"
                    "Guinea"
                    "Guinea-Bissau"
                    "Guyana"
                    "Haiti"
                    "Heard Is & Mcdonald Slands"
                    "Honduras"
                    "Hong Kong"
                    "Howland Island"
                    "Hungary"
                    "Iceland"
                    "India"
                    "Indonesia"
                    "Iran"
                    "Iraq"
                    "Iraq-Saudi Arabia Neut Zone"
                    "Ireland"
                    "Isle Of Man"
                    "Israel"
                    "Israel-Jordan Demil Zone"
                    "Israel-Syria Demil Zone"
                    "Italy"
                    "Jamaica"
                    "Jan Mayen"
                    "Japan"
                    "Jarvis Island"
                    "Jersey"
                    "Johnston Atoll"
                    "Jordan"
                    "Juan De Nova Island"
                    "Kazakhstan"
                    "Kenya"
                    "Kingman Reef"
                    "Kiribati"
                    "Kosovo"
                    "Kuwait"
                    "Kyrgyzstan"
                    "Laos"
                    "Latvia"
                    "Lebanon"
                    "Lesotho"
                    "Liberia"
                    "Libya"
                    "Liechtenstein"
                    "Lithuania"
                    "Luxembourg"
                    "Macau"
                    "Macedonia"
                    "Madagascar"
                    "Malawi"
                    "Malaysia"
                    "Maldives"
                    "Mali"
                    "Malta"
                    "Marshall Islands"
                    "Martinique"
                    "Mauritania"
                    "Mauritius"
                    "Mayotte"
                    "Mexico"
                    "Micronesia Fed States Of"
                    "Midway Islands"
                    "Moldova"
                    "Monaco"
                    "Mongolia"
                    "Montenegro"
                    "Montenegro"
                    "Montserrat"
                    "Morocco"
                    "Mozambique"
                    "Namibia"
                    "Nauru"
                    "Navassa Island"
                    "Nepal"
                    "Netherlands"
                    "Netherlands Antilles"
                    "Neutral Zone"
                    "New Caledonia"
                    "New Zealand"
                    "Nicaragua"
                    "Niger"
                    "Nigeria"
                    "Niue"
                    "Norfolk Island"
                    "North Korea"
                    "Northern Mariana Islands"
                    "Norway"
                    "Oman"
                    "Pakistan"
                    "Palau"
                    "Palmyra Atoll"
                    "Panama"
                    "Papua New Guinea"
                    "Paracel Islands"
                    "Paraguay"
                    "Peru"
                    "Philippines"
                    "Pitcairn Islands"
                    "Poland"
                    "Portugal"
                    "Portuguese Timor"
                    "Puerto Rico"
                    "Qatar"
                    "Republic Of Viet-Nam"
                    "Reunion"
                    "Romania"
                    "Russia"
                    "Rwanda"
                    "S Georgia & S Sandwich"
                    "S Vincent & The Grenadines"
                    "Saint Barthelemy"
                    "Saint Helena"
                    "Saint Kitts And Nevis"
                    "Saint Lucia"
                    "Saint Martin"
                    "Saint Pierre And Miquelon"
                    "Samoa"
                    "San Marino"
                    "Sao Tome and Principe"
                    "Saudi Arabia"
                    "Senegal"
                    "Serbia"
                    "Serbia"
                    "Serbia"
                    "Serbia And Montenegro"
                    "Seychelles"
                    "Sierra Leone"
                    "Sikkim"
                    "Singapore"
                    "Sint Maarten"
                    "Sint Maarten"
                    "Slovakia"
                    "Slovenia"
                    "Solomon Islands"
                    "Somalia"
                    "South Africa"
                    "South Korea"
                    "Southern Rhodesia"
                    "Southern Ryukyu Islands"
                    "Spain"
                    "Spanish North Africa"
                    "Spanish Sahara"
                    "Spratly Islands"
                    "Sri Lanka"
                    "Stateless"
                    "Sudan"
                    "Suriname"
                    "Svalbard"
                    "Svalbard And Jan Mayen"
                    "Swan Islands"
                    "Swaziland"
                    "Sweden"
                    "Switzerland"
                    "Syria"
                    "Taiwan"
                    "Tajikistan"
                    "Tanzania"
                    "Thailand"
                    "Timor-Leste"
                    "Togo"
                    "Tokelau"
                    "Tonga"
                    "Trinidad and Tobago"
                    "Tromelin Island"
                    "Trust Terr Of Pacific Isl"
                    "Tunisia"
                    "Turkey"
                    "Turkmenistan"
                    "Turks and Caicos Islands"
                    "Tuvalu"
                    "US Misc Pacific Islands"
                    "Uganda"
                    "Ukraine"
                    "Union Of Sov Soc Republics"
                    "United Arab Emirates"
                    "United Kingdom"
                    "United States"
                    "Unknown"
                    "Uruguay"
                    "Uzbekistan"
                    "Vanuatu"
                    "Vatican City"
                    "Venezuela"
                    "Vietnam"
                    "Virgin Islands"
                    "Wake Atoll"
                    "Wallis And Futuna"
                    "West Bank"
                    "Western Sahara"
                    "Yeman (Sanaa)"
                    "Yemen"
                    "Yemen (Aden)"
                    "Yugoslavia"
                    "Zambia"
                    "Zimbabwe"]
            </li>
            <li>
                <label for="Birth-City" > City of birth*</label>
                [text* Birth-City id:Birth-City maxlength:40]
            </li>
            <li class="full-span" >
                <label for="Language-Proficiency" >Are you proficient in a language other than English?</label>
[select* Language-Proficiency id:proficient class:form-toggle class:nice "No" "Yes" ]
            </li>
            <li id="proficient" class="hidden-fields full-span" >
                <label for="Proficient-In" >If Yes, select Language:</label>
                [select Proficient-In id:Proficient-In class:nice " " "Spanish"
                "Aceh"
                "Afrikaans"
                "Akan"
                "Albanian"
                "Amharic"
                "Arabic"
                "Armenian"
                "Assamese"
                "Awadhi"
                "Azerbaijani"
                "Bagheli"
                "Bali"
                "Baluchi"
                "Banjar"
                "Bavarian"
                "Belarusan"
                "Bemba"
                "Bengali"
                "Bhojpuri"
                "Bikol"
                "Bosnian"
                "Bugis"
                "Bulgarian"
                "Burmese"
                "Catalan-Valencian-Balear"
                "Cebuano"
                "Chhattisgarhi"
                "Chinese"
                "Chittagonian"
                "Czech"
                "Danish"
                "Deccan"
                "Dholuo"
                "Dogri"
                "Domari"
                "Dutch"
                "Estonian"
                "Éwé"
                "Filipino"
                "Finnish"
                "French"
                "Fulah"
                "Galician"
                "Ganda"
                "Georgian"
                "German, Standard"
                "German, Swiss"
                "Gikuyu"
                "Gilaki"
                "Godwari"
                "Greek"
                "Guarani"
                "Gujarati"
                "Haitian"
                "Haryanvi"
                "Hassaniyya"
                "Hausa"
                "Hebrew"
                "Hiligaynon"
                "Hindi"
                "Hmong"
                "Hungarian"
                "Hunsrik"
                "Igbo"
                "Ilocano"
                "Indonesian"
                "Italian"
                "Jamaican Creole English"
                "Japanese"
                "Javanese"
                "Kabyle"
                "Kamba"
                "Kanauji"
                "Kannada"
                "Kanuri"
                "Kashmiri"
                "Kazakh"
                "Khmer"
                "Kimbundu"
                "Kituba"
                "Kongo"
                "Konkani"
                "Korean"
                "Kurdish"
                "Lahnda"
                "Lambadi"
                "Lao"
                "Latvian"
                "Lithuanian"
                "Lombard"
                "Luba-Kasai"
                "Madura"
                "Magahi"
                "Mainfrankisch"
                "Maithili"
                "Makhuwa"
                "Malagasy"
                "Malay"
                "Malayalam"
                "Mandingo"
                "Marathi"
                "Marwari"
                "Mazanderani"
                "Mewati"
                "Mina"
                "Minangkabau"
                "Mongolian"
                "Moore"
                "Musi"
                "Napoletano-Calabrese"
                "Nepali"
                "Norwegian"
                "Nyanja"
                "Oriya"
                "Oromo"
                "Panjabi, Eastern"
                "Persian"
                "Piemontese"
                "Polish"
                "Portuguese"
                "Pushto"
                "Quechua"
                "Rajasthani"
                "Rangpuri"
                "Romanian"
                "Rundi"
                "Russian"
                "Rwanda"
                "Santali"
                "Serbo-Croatian"
                "Shan"
                "Shona"
                "Sicilian"
                "Sindhi"
                "Sinhala"
                "Slovak"
                "Slovene"
                "Somali"
                "Sotho, Northern"
                "Sotho, Southern"
                "Sukuma"
                "Sunda"
                "Swedish"
                "Sylheti"
                "Tachelhit"
                "Tagalog"
                "Tajiki"
                "Tamazight, Central Atlas"
                "Tamil"
                "Tatar"
                "Telugu"
                "Thai"
                "Thai, Northeastern"
                "Thai, Northern"
                "Thai, Southern"
                "Tigrigna"
                "Tsonga"
                "Tswana"
                "Turkish"
                "Turkmen"
                "Ukrainian"
                "Umbundu"
                "Urdu"
                "Uyghur"
                "Uzbek"
                "Varhadi-Nagpuri"
                "Venetian"
                "Vietnamese"
                "Vlaams"
                "Wolof"
                "Xhosa"
                "Yoruba"
                "Zhuang"
                "Zulu"
                "Other" ]
            </li>
            <li class="full-span" >
                <label for="Race-Ethnicity" >Race, ethnicity</label>
                [checkbox* Race-Ethnicity id:Race-Ethnicity  "American Indian or Alaskan Native" "Asian" "Black or African American" "Native Hawaiian or Pacific Islander"
                "White"]
            </li>
            <li>
                <label for="Visa-Type" >Current U.S. visa type, if any </label>
                [select* Visa-Type id:Visa-Type class:nice "I do not hold a currently valid U.S. non-immigrant Visa"
                "I am a U.S. permanent resident"
                "A-1 Foreign Diplomatic Personnel"
                "A-2 Dependent Foreign Diplomatic Personnel"
                "A-3 Employee of Foreign Gov Office"
                "B-2 Tourist"
                "E-2 Dependent of Treaty Investor"
                "F-1 Student"
                "F-2 Dependent of F-1 Student"
                "G-1 Representative of Intl. Org."
                "G-2 Dependent of Representative of Intl. Org."
                "G-3 Dependent of Representative of Intl. Org."
                "G-4 Dependent of Representative of Intl. Org."
                "H-1 Work Visa"
                "H-4 Dependent of H Visa Holder"
                "J-1 Exchange Visitor"
                "J-2 Dependent of J-1 Visa Holder"
                "L-2 Dependent of L-1 Visa Holder"
                "R-2 Dependent of R-1 Visa Holder"]
            </li>

        </ul>

</div>

<div id="" class="form-section " >

    <h2>Academic History</h2>

    <ul class="row" >

        <li>
            <label for="High-School" >High School name*</label>
            [text High-School id:High-School " "]
        </li>
        <li class="full-span" >
            <label for="Taken-Courses" >Have you taken any college/university courses?*</label>
            [select* Taken-Courses id:Taken-Courses class:form-toggle class:nice "No" "Yes" ]  
        </li>
    </ul>
    <ul id="Taken-Courses" class="row hidden-fields" >
        <li class="full-span" >
            <label for="College-Name" >College name </label>
            [text College-Name id:College-Name " "]
        </li>
        <li>
            <label for="Attended-From" >Attended from: (mm/yyyy)</label>
            [text Attended-From id:Attended-From class:ui-datepick-month " "]
        </li>
        <li>
            <label for="Attended-To" >Attended to: (mm/yyyy)</label>
            [text Attended-To id:Attended-To class:ui-datepick-month " "]
        </li>

    </ul>

</div>

<div id="" class="form-section " >

    <h2>University Preferences</h2>

    <ul class="row" >
        <li>
            <label for="On-Campus-Housing" >Do you plan to live in on-campus housing?*</label>
            [select* On-Campus-Housing id:On-Campus-Housing class:nice "Yes" "No"]
        </li>
        <li>
            <label for="major" >Major/Area of Interest*</label>
            [select* major id:major class:nice first_as_label "Please Choose One"
            "Actuarial Science"
            "Art History"
            "Biochemistry"
            "Biology"
            "Biology of Global Health"
            "Business Administration - Accounting"
            "Business Administration - Business Communication"
            "Business Administration - Entrepreneurship"
            "Business Administration - Financial Management"
            "Business Administration - General Business Management"
            "Business Administration - Human Resources Management"
            "Business Administration - International Business"
            "Business Administration - Law and Compliance"
            "Business Administration - Leadership & Management"
            "Business Administration - Marketing Management"
            "Business Administration - Operations and Supply Chain Management"
            "Business Administration - Real Estate Studies"
            "Catholic Studies"
            "Chemistry"
            "Classical Civilization"
            "Classical Languages"
            "Communication and Journalism"
            "Computer Science"
            "Criminal Justice"
            "Data Analytics"
            "Economics"
            "Education-Elementary Education"
            "Education-Secondary Education"
            "Engineering-Civil"
            "Engineering-Computer"
            "Engineering-Electrical"
            "Engineering-Mechanical"
            "English"
            "English-Creative Writing"
            "English-Professional Writing"
            "Environmental Science"
            "Environmental Studies"
            "Exercise Science"
            "Family Studies"
            "French"
            "Geographic Information Systems"
            "Geography"
            "Geology"
            "German"
            "Health Promotion"
            "History"
            "International Studies"
            "Justice & Peace Studies"
            "Latin"
            "Mathematics"
            "Music"
            "Music - Business"
            "Music Education-Instrumental (K-12)"
            "Music Education-Vocal (K-12)"
            "Music - Performance"
            "Neuroscience"
            "Philosophy"
            "Physics"
            "Political Science"
            "Psychology"
            "Public Health"
            "Social Work"
            "Sociology"
            "Spanish"
            "Statistics"
            "Theology"
            "Women's Studies" ]
    </li>
    <li class="full-span" >
            <label for="Professional-Program-Interest" >Are you interested in a pre-professional program?</label>
            [select Professional-Program-Interest id:program-interest class:form-toggle class:nice "No" "Yes" ]  
    </li>
    <li id="program-interest" class="hidden-fields" >
        <label for="PreProfessional-Program-Interest" >If so, please select the program:</label>
        [select* PreProfessional-Program-Interest id:PreProfessional-Program-Interest class:nice  "None"
        "Pre-Chiropractic"
        "Pre-Dentistry"
        "Pre-Law"
        "Pre-Medicine"
        "Pre-Occupational Therapy"
        "Pre-Optometry"
        "Pre-Pharmacy"
        "Pre-Physician Assistant"
        "Pre-Physical Therapy"]
    </li>

    </ul>

</div>

<div id="" class="form-section" >

    <h2>Additional Information</h2>

    <ul class="row" >

        <li>
            <label for="Religious-Preference" >What is your religious preference?</label>
            [select* Religious-Preference id:Religious-Preference class:nice "Baptist"
                "Buddhist"
                "Chinese Religions"
                "Episcopal"
                "Ev. Lutheran Church/America"
                "Hinduism"
                "Jewish"
                "Methodist"
                "Muslim"
                "Native American"
                "Orthodox"
                "Other Christian"
                "Other Lutheran"
                "Other Non-Christian"
                "Presbyterian"
                "Roman Catholic"
                "Prefer not to Respond"
                "None" ]
        </li>
        <li>
            <label for="First-Generation-Student" >Are you a first-generation college student? </label>
            [select* First-Generation-Student id:First-Generation-Student class:nice "Yes" "No"]
        </li>
        <li>
            <label for="Shirt-Size" >What is your T-shirt size?</label>
            [select* Shirt-Size id:Shirt-Size class:nice "S" "M" "L" "XL"]
        </li>

    </ul>

    </div> <!-- END TAB CONTENT -->

    <div id="" class="form-section" >

        <h2>Documents</h2>

        <ul class="row" >

            <li>
                <label for="High-School-Transcript" >High School Transcript</label>
                [file High-School-Transcript id:High-School-Transcript " "]
            </li>

            <li>
                <label for="College-Transcript" >College Transcript</label>
                [file College-Transcript id:College-Transcript " "]
            </li>

            <li>
                <label for="Recommendation-Letter" >Letter of Recommendation</label>
                [file Recommendation-Letter id:Recommendation-Letter " "]
            </li>

            <li>
                <label for="Passport" >Passport copy</label>
                [file Passport id:Passport " "]
            </li>

            <li>
                <label for="Bank-Statement" >Bank Statement</label>
                [file Bank-Statement id:Bank-Statement " "]
            </li>

            <li>
                <label for="Financial-Statement" >Financial Statement (Affidavit of Support)</label>
                [file Financial-Statement id:Financial-Statement " "]
            </li>

            <li>
                <label for="Other" >Other</label>
                [file Other id:Other " "]
            </li>

        </ul>

    </div>

    [submit "Submit Form"]

</div> <!-- END TAB CONTAIN -->