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Thursday, November 06, Friday, November 07, 75 74
<form method="post" action="http://www.change.gov/" >

<form method="post" action="http://change.gov/" >

<input type="hidden" name="XID" value="69458da8c867d6a82280cc57ba6f62b862191052" />

<input type="hidden" name="XID" value="fcf20fc952c11061b272e70b5472a8a9713cbeb5" />
Country:
</label>
<br />
<select id="country" name="country">
<option value="AF">
Afghanistan
</option>
<option value="AL">
Albania
</option>
<option value="DZ">
Algeria
</option>
<option value="AS">
American Samoa
</option>
<option value="AD">
Andorra
</option>
<option value="AO">
Angola
</option>
<option value="AI">
Anguilla
</option>
<option value="AG">
Antigua and Barbuda
</option>
<option value="AR">
Argentina
</option>
<option value="AM">
Armenia
</option>
<option value="AW">
Aruba
</option>
<option value="AU">
Australia
</option>
<option value="AT">
Austria
</option>
<option value="AZ">
Azerbaijan
</option>
<option value="BS">
Bahamas
</option>
<option value="BH">
Bahrain
</option>
<option value="BD">
Bangladesh
</option>
<option value="BB">
Barbados
</option>
<option value="BY">
Belarus
</option>
<option value="BE">
Belgium
</option>
<option value="BZ">
Belize
</option>
<option value="BJ">
Benin
</option>
<option value="BM">
Bermuda
</option>
<option value="BT">
Bhutan
</option>
<option value="BO">
Bolivia
</option>
<option value="BA">
Bosnia and Herzegovina
</option>
<option value="BW">
Botswana
</option>
<option value="BR">
Brazil
</option>
<option value="VG">
British Virgin Islands
</option>
<option value="IO">
British Indian Ocean Territory
</option>
<option value="BN">
Brunei
</option>
<option value="BG">
Bulgaria
</option>
<option value="BF">
Burkina Faso
</option>
<option value="BI">
Burundi
</option>
<option value="KH">
Cambodia
</option>
<option value="CM">
Cameroon
</option>
<option value="CA">
Canada
</option>
<option value="CV">
Cape Verde
</option>
<option value="KY">
Cayman Islands
</option>
<option value="CF">
Central African Republic
</option>
<option value="TD">
Chad
</option>
<option value="CL">
Chile
</option>
<option value="CN">
China
</option>
<option value="CX">
Christmas Island
</option>
<option value="CO">
Colombia
</option>
<option value="KM">
Comoros Islands
</option>
<option value="CG">
Congo
</option>
<option value="CK">
Cook Islands
</option>
<option value="CR">
Costa Rica
</option>
<option value="CI">
Cote D'ivoire
</option>
<option value="HR">
Croatia
</option>
<option value="CU">
Cuba
</option>
<option value="CY">
Cyprus
</option>
<option value="CZ">
Czech Republic
</option>
<option value="DK">
Denmark
</option>
<option value="DJ">
Djibouti
</option>
<option value="DM">
Dominica
</option>
<option value="DO">
Dominican Republic
</option>
<option value="TP">
East Timor
</option>
<option value="EC">
Ecuador
</option>
<option value="EG">
Egypt
</option>
<option value="SV">
El Salvador
</option>
<option value="GQ">
Equatorial Guinea
</option>
<option value="ER">
Eritrea
</option>
<option value="EE">
Estonia
</option>
<option value="ET">
Ethiopia
</option>
<option value="FK">
Falkland Islands (Malvinas)
</option>
<option value="FO">
Faroe Islands
</option>
<option value="FJ">
Fiji
</option>
<option value="FI">
Finland
</option>
<option value="FR">
France
</option>
<option value="GF">
French Guiana
</option>
<option value="PF">
French Polynesia
</option>
<option value="TF">
French Southern Territories
</option>
<option value="GA">
Gabon
</option>
<option value="GM">
Gambia
</option>
<option value="GE">
Georgia
</option>
<option value="DE">
Germany
</option>
<option value="GH">
Ghana
</option>
<option value="GI">
Gibraltar
</option>
<option value="GR">
Greece
</option>
<option value="GL">
Greenland
</option>
<option value="GD">
Grenada
</option>
<option value="GP">
Guadeloupe
</option>
<option value="GU">
Guam
</option>
<option value="GT">
Guatemala
</option>
<option value="GN">
Guinea
</option>
<option value="GW">
Guinea-Bissau
</option>
<option value="GY">
Guyana
</option>
<option value="HT">
Haiti
</option>
<option value="VA">
Holy See (Vatican City State)
</option>
<option value="HN">
Honduras
</option>
<option value="HK">
Hong Kong
</option>
<option value="HU">
Hungary
</option>
<option value="IS">
Iceland
</option>
<option value="IN">
India
</option>
<option value="ID">
Indonesia
</option>
<option value="IR">
Iran
</option>
<option value="IQ">
Iraq
</option>
<option value="IE">
Ireland
</option>
<option value="IL">
Israel
</option>
<option value="IT">
Italy
</option>
<option value="JM">
Jamaica
</option>
<option value="JP">
Japan
</option>
<option value="JO">
Jordan
</option>
<option value="KZ">
Kazakhstan
</option>
<option value="KE">
Kenya
</option>
<option value="KI">
Kiribati
</option>
<option value="KR">
South Korea
</option>
<option value="KW">
Kuwait
</option>
<option value="KG">
Kyrgyzstan
</option>
<option value="LA">
Laos
</option>
<option value="LV">
Latvia
</option>
<option value="LB">
Lebanon
</option>
<option value="LS">
Lesotho
</option>
<option value="LR">
Liberia
</option>
<option value="LI">
Liechtenstein
</option>
<option value="LT">
Lithuania
</option>
<option value="LU">
Luxembourg
</option>
<option value="MO">
Macau
</option>
<option value="MK">
Macedonia
</option>
<option value="MG">
Madagascar
</option>
<option value="MW">
Malawi
</option>
<option value="MY">
Malaysia
</option>
<option value="MV">
Maldives
</option>
<option value="ML">
Mali
</option>
<option value="MT">
Malta
</option>
<option value="MH">
Marshall Islands
</option>
<option value="MQ">
Martinique
</option>
<option value="MR">
Mauritania
</option>
<option value="MU">
Mauritius
</option>
<option value="YT">
Mayotte
</option>
<option value="MX">
Mexico
</option>
<option value="FM">
Micronesia
</option>
<option value="MD">
Moldova, Republic of
</option>
<option value="MC">
Monaco
</option>
<option value="MN">
Mongolia
</option>
<option value="MS">
Montserrat
</option>
<option value="MA">
Morocco
</option>
<option value="MZ">
Mozambique
</option>
<option value="MM">
Myanmar
</option>
<option value="NA">
Namibia
</option>
<option value="NR">
Nauru
</option>
<option value="NP">
Nepal
</option>
<option value="NL">
Netherlands
</option>
<option value="AN">
Netherlands Antilles
</option>
<option value="NC">
New Caledonia
</option>
<option value="NZ">
New Zealand
</option>
<option value="NI">
Nicaragua
</option>
<option value="NE">
Niger
</option>
<option value="NG">
Nigeria
</option>
<option value="NU">
Niue
</option>
<option value="NF">
Norfolk Island
</option>
<option value="MP">
Northern Mariana Islands
</option>
<option value="NO">
Norway
</option>
<option value="OM">
Oman
</option>
<option value="PK">
Pakistan
</option>
<option value="PW">
Palau
</option>
<option value="PA">
Panama
</option>
<option value="PG">
Papua New Guinea
</option>
<option value="PY">
Paraguay
</option>
<option value="PE">
Peru
</option>
<option value="PH">
Philippines
</option>
<option value="PN">
Pitcairn Island
</option>
<option value="PL">
Poland
</option>
<option value="PT">
Portugal
</option>
<option value="PR">
Puerto Rico
</option>
<option value="QA">
Qatar
</option>
<option value="RE">
Reunion
</option>
<option value="RO">
Romania
</option>
<option value="RU">
Russian Federation
</option>
<option value="RW">
Rwanda
</option>
<option value="KN">
Saint Kitts and Nevis
</option>
<option value="LC">
Saint Lucia
</option>
<option value="VC">
Saint Vincent and the Grenadines
</option>
<option value="WS">
Samoa
</option>
<option value="SM">
San Marino
</option>
<option value="ST">
Sao Tome and Principe
</option>
<option value="SA">
Saudi Arabia
</option>
<option value="SN">
Senegal
</option>
<option value="CS">
Serbia and Montenegro
</option>
<option value="SC">
Seychelles
</option>
<option value="SL">
Sierra Leone
</option>
<option value="SG">
Singapore
</option>
<option value="SK">
Slovakia
</option>
<option value="SI">
Slovenia
</option>
<option value="SB">
Solomon Islands
</option>
<option value="SO">
Somalia
</option>
<option value="ZA">
South Africa
</option>
<option value="ES">
Spain
</option>
<option value="LK">
Sri Lanka
</option>
<option value="SH">
St. Helena
</option>
<option value="PM">
St. Pierre and Miquelon
</option>
<option value="SD">
Sudan
</option>
<option value="SR">
Suriname
</option>
<option value="SZ">
Swaziland
</option>
<option value="SE">
Sweden
</option>
<option value="CH">
Switzerland
</option>
<option value="TW">
Taiwan
</option>
<option value="TJ">
Tajikistan
</option>
<option value="TZ">
Tanzania
</option>
<option value="TH">
Thailand
</option>
<option value="TG">
Togo
</option>
<option value="TK">
Tokelau
</option>
<option value="TO">
Tonga
</option>
<option value="TT">
Trinidad and Tobago
</option>
<option value="TN">
Tunisia
</option>
<option value="TR">
Turkey
</option>
<option value="TM">
Turkmenistan
</option>
<option value="TC">
Turks and Caicos Islands
</option>
<option value="TV">
Tuvalu
</option>
<option value="UG">
Uganda
</option>
<option value="UA">
Ukraine
</option>
<option value="AE">
United Arab Emirates
</option>
<option value="GB">
United Kingdom
</option>
<option value="US" selected="selected">
United States
</option>
<option value="UY">
Uruguay
</option>
<option value="UZ">
Uzbekistan
</option>
<option value="VU">
Vanuatu
</option>
<option value="VE">
Venezuela
</option>
<option value="VN">
Viet Nam
</option>
<option value="VI">
Virgin Islands (U.S.)
</option>
<option value="WF">
Wallis and Futuna Islands
</option>
<option value="EH">
Western Sahara
</option>
<option value="YE">
Yemen
</option>
<option value="ZM">
Zambia
</option>
<option value="ZW">
Zimbabwe
</option>
</select>
</td>
<td valign="top">
<label class="field">

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