Formular inregistrare cursul 3 zile cel mai bun an

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Pentru participarea la programul de 3 zile ” CUM SA FACI DIN ANUL 2018 CEL MAI BUN AN DE PANA ACUM”
va rugam completati cu atentie formularul de participare.
La numarul de telefon completati fara primul zero din numar altfel o sa primiti eroare. Exemplu se va trece numarul de forma 722999999 si nu 0722999999

[headline style="1" font_size="33" font_font="Oswald" font_color="%23316694" align="center" line_height="45"]<span style="color: #d3a646;">Pentru participarea la programul de 3 zile " CUM SA FACI DIN ANUL 2018 CEL MAI BUN AN DE PANA ACUM"<br />
</span>va rugam completati cu atentie formularul de participare.<br />
La numarul de telefon completati fara primul zero din numar altfel o sa primiti eroare. Exemplu se va trece numarul de forma 722999999 si nu 0722999999[/headline]

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[custom_html]    <form class="preview-form" action="https://v2.textdeliver.com/handle-contact/595a3db925476" method="post"></p>
<p>                <div class="form-group required"><br />
                        <label class="small"><br />
                            <i class="fa fa-user"></i><br />
                            Nume</label><br />
                        <input class="form-control" type="text" name="name"/><br/><br />
</div></p>
<p>                <div class="form-group"><br />
                    <label class="small"><br />
                        <i class="fa fa-flag"></i><br />
                        Country<br />
                    </label><div id="country-dropdown"><br />
                        <input checked="checked" id="country-us" name="country-list" type="radio" value="+1"/><br />
                        <label class="flag-img us" for="country-us"><br />
                            United States<br />
                            <span class="dial-code">+1</span><br />
                        </label><br />
                        <input checked="checked" id="country-gb" name="country-list" type="radio" value="+44"/><br />
                        <label class="flag-img gb" for="country-gb"><br />
                            United Kingdom<br />
                            <span class="dial-code">+44</span><br />
                        </label><br />
                        <input checked="checked" id="country-af" name="country-list" type="radio" value="+93"/><br />
                        <label class="flag-img af" for="country-af"><br />
                            Afghanistan (‫افغانستان‬‎)<br />
                            <span class="dial-code">+93</span><br />
                        </label><br />
                        <input checked="checked" id="country-al" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img al" for="country-al"><br />
                            Albania (Shqipëri)<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-dz" name="country-list" type="radio" value="+21"/><br />
                        <label class="flag-img dz" for="country-dz"><br />
                            Algeria (‫الجزائر‬‎)<br />
                            <span class="dial-code">+21</span><br />
                        </label><br />
                        <input checked="checked" id="country-as" name="country-list" type="radio" value="+16"/><br />
                        <label class="flag-img as" for="country-as"><br />
                            American Samoa<br />
                            <span class="dial-code">+16</span><br />
                        </label><br />
                        <input checked="checked" id="country-ad" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img ad" for="country-ad"><br />
                            Andorra<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-ao" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img ao" for="country-ao"><br />
                            Angola<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-ai" name="country-list" type="radio" value="+12"/><br />
                        <label class="flag-img ai" for="country-ai"><br />
                            Anguilla<br />
                            <span class="dial-code">+12</span><br />
                        </label><br />
                        <input checked="checked" id="country-ag" name="country-list" type="radio" value="+12"/><br />
                        <label class="flag-img ag" for="country-ag"><br />
                            Antigua and Barbuda<br />
                            <span class="dial-code">+12</span><br />
                        </label><br />
                        <input checked="checked" id="country-ar" name="country-list" type="radio" value="+54"/><br />
                        <label class="flag-img ar" for="country-ar"><br />
                            Argentina<br />
                            <span class="dial-code">+54</span><br />
                        </label><br />
                        <input checked="checked" id="country-am" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img am" for="country-am"><br />
                            Armenia (Հայաստան)<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-aw" name="country-list" type="radio" value="+29"/><br />
                        <label class="flag-img aw" for="country-aw"><br />
                            Aruba<br />
                            <span class="dial-code">+29</span><br />
                        </label><br />
                        <input checked="checked" id="country-au" name="country-list" type="radio" value="+61"/><br />
                        <label class="flag-img au" for="country-au"><br />
                            Australia<br />
                            <span class="dial-code">+61</span><br />
                        </label><br />
                        <input checked="checked" id="country-at" name="country-list" type="radio" value="+43"/><br />
                        <label class="flag-img at" for="country-at"><br />
                            Austria (Österreich)<br />
                            <span class="dial-code">+43</span><br />
                        </label><br />
                        <input checked="checked" id="country-az" name="country-list" type="radio" value="+99"/><br />
                        <label class="flag-img az" for="country-az"><br />
                            Azerbaijan (Azərbaycan)<br />
                            <span class="dial-code">+99</span><br />
                        </label><br />
                        <input checked="checked" id="country-bs" name="country-list" type="radio" value="+12"/><br />
                        <label class="flag-img bs" for="country-bs"><br />
                            Bahamas<br />
                            <span class="dial-code">+12</span><br />
                        </label><br />
                        <input checked="checked" id="country-bh" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img bh" for="country-bh"><br />
                            Bahrain (‫البحرين‬‎)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-bd" name="country-list" type="radio" value="+88"/><br />
                        <label class="flag-img bd" for="country-bd"><br />
                            Bangladesh (বাংলাদেশ)<br />
                            <span class="dial-code">+88</span><br />
                        </label><br />
                        <input checked="checked" id="country-bb" name="country-list" type="radio" value="+12"/><br />
                        <label class="flag-img bb" for="country-bb"><br />
                            Barbados<br />
                            <span class="dial-code">+12</span><br />
                        </label><br />
                        <input checked="checked" id="country-by" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img by" for="country-by"><br />
                            Belarus (Беларусь)<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-be" name="country-list" type="radio" value="+32"/><br />
                        <label class="flag-img be" for="country-be"><br />
                            Belgium (België)<br />
                            <span class="dial-code">+32</span><br />
                        </label><br />
                        <input checked="checked" id="country-bz" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img bz" for="country-bz"><br />
                            Belize<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-bj" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img bj" for="country-bj"><br />
                            Benin (Bénin)<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-bm" name="country-list" type="radio" value="+14"/><br />
                        <label class="flag-img bm" for="country-bm"><br />
                            Bermuda<br />
                            <span class="dial-code">+14</span><br />
                        </label><br />
                        <input checked="checked" id="country-bt" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img bt" for="country-bt"><br />
                            Bhutan (འབྲུག)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-bo" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img bo" for="country-bo"><br />
                            Bolivia<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-ba" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img ba" for="country-ba"><br />
                            Bosnia and Herzegovina (Босна и Херцеговина)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-bw" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img bw" for="country-bw"><br />
                            Botswana<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-br" name="country-list" type="radio" value="+55"/><br />
                        <label class="flag-img br" for="country-br"><br />
                            Brazil (Brasil)<br />
                            <span class="dial-code">+55</span><br />
                        </label><br />
                        <input checked="checked" id="country-io" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img io" for="country-io"><br />
                            British Indian Ocean Territory<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-vg" name="country-list" type="radio" value="+12"/><br />
                        <label class="flag-img vg" for="country-vg"><br />
                            British Virgin Islands<br />
                            <span class="dial-code">+12</span><br />
                        </label><br />
                        <input checked="checked" id="country-bn" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img bn" for="country-bn"><br />
                            Brunei<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-bg" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img bg" for="country-bg"><br />
                            Bulgaria (България)<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-bf" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img bf" for="country-bf"><br />
                            Burkina Faso<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-bi" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img bi" for="country-bi"><br />
                            Burundi (Uburundi)<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-kh" name="country-list" type="radio" value="+85"/><br />
                        <label class="flag-img kh" for="country-kh"><br />
                            Cambodia (កម្ពុជា)<br />
                            <span class="dial-code">+85</span><br />
                        </label><br />
                        <input checked="checked" id="country-cm" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img cm" for="country-cm"><br />
                            Cameroon (Cameroun)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-ca" name="country-list" type="radio" value="+1"/><br />
                        <label class="flag-img ca" for="country-ca"><br />
                            Canada<br />
                            <span class="dial-code">+1</span><br />
                        </label><br />
                        <input checked="checked" id="country-cv" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img cv" for="country-cv"><br />
                            Cape Verde (Kabu Verdi)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-bq" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img bq" for="country-bq"><br />
                            Caribbean Netherlands<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-ky" name="country-list" type="radio" value="+13"/><br />
                        <label class="flag-img ky" for="country-ky"><br />
                            Cayman Islands<br />
                            <span class="dial-code">+13</span><br />
                        </label><br />
                        <input checked="checked" id="country-cf" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img cf" for="country-cf"><br />
                            Central African Republic (République centrafricaine)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-td" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img td" for="country-td"><br />
                            Chad (Tchad)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-cl" name="country-list" type="radio" value="+56"/><br />
                        <label class="flag-img cl" for="country-cl"><br />
                            Chile<br />
                            <span class="dial-code">+56</span><br />
                        </label><br />
                        <input checked="checked" id="country-cn" name="country-list" type="radio" value="+86"/><br />
                        <label class="flag-img cn" for="country-cn"><br />
                            China (中国)<br />
                            <span class="dial-code">+86</span><br />
                        </label><br />
                        <input checked="checked" id="country-cx" name="country-list" type="radio" value="+61"/><br />
                        <label class="flag-img cx" for="country-cx"><br />
                            Christmas Island<br />
                            <span class="dial-code">+61</span><br />
                        </label><br />
                        <input checked="checked" id="country-cc" name="country-list" type="radio" value="+61"/><br />
                        <label class="flag-img cc" for="country-cc"><br />
                            Cocos (Keeling) Islands<br />
                            <span class="dial-code">+61</span><br />
                        </label><br />
                        <input checked="checked" id="country-co" name="country-list" type="radio" value="+57"/><br />
                        <label class="flag-img co" for="country-co"><br />
                            Colombia<br />
                            <span class="dial-code">+57</span><br />
                        </label><br />
                        <input checked="checked" id="country-km" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img km" for="country-km"><br />
                            Comoros (‫جزر القمر‬‎)<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-cd" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img cd" for="country-cd"><br />
                            Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo)<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-cg" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img cg" for="country-cg"><br />
                            Congo (Republic) (Congo-Brazzaville)<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-ck" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img ck" for="country-ck"><br />
                            Cook Islands<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-cr" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img cr" for="country-cr"><br />
                            Costa Rica<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-ci" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img ci" for="country-ci"><br />
                            Côte d’Ivoire<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-hr" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img hr" for="country-hr"><br />
                            Croatia (Hrvatska)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-cu" name="country-list" type="radio" value="+53"/><br />
                        <label class="flag-img cu" for="country-cu"><br />
                            Cuba<br />
                            <span class="dial-code">+53</span><br />
                        </label><br />
                        <input checked="checked" id="country-cw" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img cw" for="country-cw"><br />
                            Curaçao<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-cy" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img cy" for="country-cy"><br />
                            Cyprus (Κύπρος)<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-cz" name="country-list" type="radio" value="+42"/><br />
                        <label class="flag-img cz" for="country-cz"><br />
                            Czech Republic (Česká republika)<br />
                            <span class="dial-code">+42</span><br />
                        </label><br />
                        <input checked="checked" id="country-dk" name="country-list" type="radio" value="+45"/><br />
                        <label class="flag-img dk" for="country-dk"><br />
                            Denmark (Danmark)<br />
                            <span class="dial-code">+45</span><br />
                        </label><br />
                        <input checked="checked" id="country-dj" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img dj" for="country-dj"><br />
                            Djibouti<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-dm" name="country-list" type="radio" value="+17"/><br />
                        <label class="flag-img dm" for="country-dm"><br />
                            Dominica<br />
                            <span class="dial-code">+17</span><br />
                        </label><br />
                        <input checked="checked" id="country-do" name="country-list" type="radio" value="+1"/><br />
                        <label class="flag-img do" for="country-do"><br />
                            Dominican Republic (República Dominicana)<br />
                            <span class="dial-code">+1</span><br />
                        </label><br />
                        <input checked="checked" id="country-ec" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img ec" for="country-ec"><br />
                            Ecuador<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-eg" name="country-list" type="radio" value="+20"/><br />
                        <label class="flag-img eg" for="country-eg"><br />
                            Egypt (‫مصر‬‎)<br />
                            <span class="dial-code">+20</span><br />
                        </label><br />
                        <input checked="checked" id="country-sv" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img sv" for="country-sv"><br />
                            El Salvador<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-gq" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img gq" for="country-gq"><br />
                            Equatorial Guinea (Guinea Ecuatorial)<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-er" name="country-list" type="radio" value="+29"/><br />
                        <label class="flag-img er" for="country-er"><br />
                            Eritrea<br />
                            <span class="dial-code">+29</span><br />
                        </label><br />
                        <input checked="checked" id="country-ee" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img ee" for="country-ee"><br />
                            Estonia (Eesti)<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-et" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img et" for="country-et"><br />
                            Ethiopia<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-fk" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img fk" for="country-fk"><br />
                            Falkland Islands (Islas Malvinas)<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-fo" name="country-list" type="radio" value="+29"/><br />
                        <label class="flag-img fo" for="country-fo"><br />
                            Faroe Islands (Føroyar)<br />
                            <span class="dial-code">+29</span><br />
                        </label><br />
                        <input checked="checked" id="country-fj" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img fj" for="country-fj"><br />
                            Fiji<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-fi" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img fi" for="country-fi"><br />
                            Finland (Suomi)<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-fr" name="country-list" type="radio" value="+33"/><br />
                        <label class="flag-img fr" for="country-fr"><br />
                            France<br />
                            <span class="dial-code">+33</span><br />
                        </label><br />
                        <input checked="checked" id="country-gf" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img gf" for="country-gf"><br />
                            French Guiana (Guyane française)<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-pf" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img pf" for="country-pf"><br />
                            French Polynesia (Polynésie française)<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-ga" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img ga" for="country-ga"><br />
                            Gabon<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-gm" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img gm" for="country-gm"><br />
                            Gambia<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-ge" name="country-list" type="radio" value="+99"/><br />
                        <label class="flag-img ge" for="country-ge"><br />
                            Georgia (საქართველო)<br />
                            <span class="dial-code">+99</span><br />
                        </label><br />
                        <input checked="checked" id="country-de" name="country-list" type="radio" value="+49"/><br />
                        <label class="flag-img de" for="country-de"><br />
                            Germany (Deutschland)<br />
                            <span class="dial-code">+49</span><br />
                        </label><br />
                        <input checked="checked" id="country-gh" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img gh" for="country-gh"><br />
                            Ghana (Gaana)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-gi" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img gi" for="country-gi"><br />
                            Gibraltar<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-gr" name="country-list" type="radio" value="+30"/><br />
                        <label class="flag-img gr" for="country-gr"><br />
                            Greece (Ελλάδα)<br />
                            <span class="dial-code">+30</span><br />
                        </label><br />
                        <input checked="checked" id="country-gl" name="country-list" type="radio" value="+29"/><br />
                        <label class="flag-img gl" for="country-gl"><br />
                            Greenland (Kalaallit Nunaat)<br />
                            <span class="dial-code">+29</span><br />
                        </label><br />
                        <input checked="checked" id="country-gd" name="country-list" type="radio" value="+14"/><br />
                        <label class="flag-img gd" for="country-gd"><br />
                            Grenada<br />
                            <span class="dial-code">+14</span><br />
                        </label><br />
                        <input checked="checked" id="country-gp" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img gp" for="country-gp"><br />
                            Guadeloupe<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-gu" name="country-list" type="radio" value="+16"/><br />
                        <label class="flag-img gu" for="country-gu"><br />
                            Guam<br />
                            <span class="dial-code">+16</span><br />
                        </label><br />
                        <input checked="checked" id="country-gt" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img gt" for="country-gt"><br />
                            Guatemala<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-gg" name="country-list" type="radio" value="+44"/><br />
                        <label class="flag-img gg" for="country-gg"><br />
                            Guernsey<br />
                            <span class="dial-code">+44</span><br />
                        </label><br />
                        <input checked="checked" id="country-gn" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img gn" for="country-gn"><br />
                            Guinea (Guinée)<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-gw" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img gw" for="country-gw"><br />
                            Guinea-Bissau (Guiné Bissau)<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-gy" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img gy" for="country-gy"><br />
                            Guyana<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-ht" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img ht" for="country-ht"><br />
                            Haiti<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-hn" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img hn" for="country-hn"><br />
                            Honduras<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-hk" name="country-list" type="radio" value="+85"/><br />
                        <label class="flag-img hk" for="country-hk"><br />
                            Hong Kong (香港)<br />
                            <span class="dial-code">+85</span><br />
                        </label><br />
                        <input checked="checked" id="country-hu" name="country-list" type="radio" value="+36"/><br />
                        <label class="flag-img hu" for="country-hu"><br />
                            Hungary (Magyarország)<br />
                            <span class="dial-code">+36</span><br />
                        </label><br />
                        <input checked="checked" id="country-is" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img is" for="country-is"><br />
                            Iceland (Ísland)<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-in" name="country-list" type="radio" value="+91"/><br />
                        <label class="flag-img in" for="country-in"><br />
                            India (भारत)<br />
                            <span class="dial-code">+91</span><br />
                        </label><br />
                        <input checked="checked" id="country-id" name="country-list" type="radio" value="+62"/><br />
                        <label class="flag-img id" for="country-id"><br />
                            Indonesia<br />
                            <span class="dial-code">+62</span><br />
                        </label><br />
                        <input checked="checked" id="country-ir" name="country-list" type="radio" value="+98"/><br />
                        <label class="flag-img ir" for="country-ir"><br />
                            Iran (‫ایران‬‎)<br />
                            <span class="dial-code">+98</span><br />
                        </label><br />
                        <input checked="checked" id="country-iq" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img iq" for="country-iq"><br />
                            Iraq (‫العراق‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-ie" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img ie" for="country-ie"><br />
                            Ireland<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-im" name="country-list" type="radio" value="+44"/><br />
                        <label class="flag-img im" for="country-im"><br />
                            Isle of Man<br />
                            <span class="dial-code">+44</span><br />
                        </label><br />
                        <input checked="checked" id="country-il" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img il" for="country-il"><br />
                            Israel (‫ישראל‬‎)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-it" name="country-list" type="radio" value="+39"/><br />
                        <label class="flag-img it" for="country-it"><br />
                            Italy (Italia)<br />
                            <span class="dial-code">+39</span><br />
                        </label><br />
                        <input checked="checked" id="country-jm" name="country-list" type="radio" value="+18"/><br />
                        <label class="flag-img jm" for="country-jm"><br />
                            Jamaica<br />
                            <span class="dial-code">+18</span><br />
                        </label><br />
                        <input checked="checked" id="country-jp" name="country-list" type="radio" value="+81"/><br />
                        <label class="flag-img jp" for="country-jp"><br />
                            Japan (日本)<br />
                            <span class="dial-code">+81</span><br />
                        </label><br />
                        <input checked="checked" id="country-je" name="country-list" type="radio" value="+44"/><br />
                        <label class="flag-img je" for="country-je"><br />
                            Jersey<br />
                            <span class="dial-code">+44</span><br />
                        </label><br />
                        <input checked="checked" id="country-jo" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img jo" for="country-jo"><br />
                            Jordan (‫الأردن‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-kz" name="country-list" type="radio" value="+7"/><br />
                        <label class="flag-img kz" for="country-kz"><br />
                            Kazakhstan (Казахстан)<br />
                            <span class="dial-code">+7</span><br />
                        </label><br />
                        <input checked="checked" id="country-ke" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img ke" for="country-ke"><br />
                            Kenya<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-ki" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img ki" for="country-ki"><br />
                            Kiribati<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-xk" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img xk" for="country-xk"><br />
                            Kosovo<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-kw" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img kw" for="country-kw"><br />
                            Kuwait (‫الكويت‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-kg" name="country-list" type="radio" value="+99"/><br />
                        <label class="flag-img kg" for="country-kg"><br />
                            Kyrgyzstan (Кыргызстан)<br />
                            <span class="dial-code">+99</span><br />
                        </label><br />
                        <input checked="checked" id="country-la" name="country-list" type="radio" value="+85"/><br />
                        <label class="flag-img la" for="country-la"><br />
                            Laos (ລາວ)<br />
                            <span class="dial-code">+85</span><br />
                        </label><br />
                        <input checked="checked" id="country-lv" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img lv" for="country-lv"><br />
                            Latvia (Latvija)<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-lb" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img lb" for="country-lb"><br />
                            Lebanon (‫لبنان‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-ls" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img ls" for="country-ls"><br />
                            Lesotho<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-lr" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img lr" for="country-lr"><br />
                            Liberia<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-ly" name="country-list" type="radio" value="+21"/><br />
                        <label class="flag-img ly" for="country-ly"><br />
                            Libya (‫ليبيا‬‎)<br />
                            <span class="dial-code">+21</span><br />
                        </label><br />
                        <input checked="checked" id="country-li" name="country-list" type="radio" value="+42"/><br />
                        <label class="flag-img li" for="country-li"><br />
                            Liechtenstein<br />
                            <span class="dial-code">+42</span><br />
                        </label><br />
                        <input checked="checked" id="country-lt" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img lt" for="country-lt"><br />
                            Lithuania (Lietuva)<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-lu" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img lu" for="country-lu"><br />
                            Luxembourg<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-mo" name="country-list" type="radio" value="+85"/><br />
                        <label class="flag-img mo" for="country-mo"><br />
                            Macau (澳門)<br />
                            <span class="dial-code">+85</span><br />
                        </label><br />
                        <input checked="checked" id="country-mk" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img mk" for="country-mk"><br />
                            Macedonia (FYROM) (Македонија)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-mg" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img mg" for="country-mg"><br />
                            Madagascar (Madagasikara)<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-mw" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img mw" for="country-mw"><br />
                            Malawi<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-my" name="country-list" type="radio" value="+60"/><br />
                        <label class="flag-img my" for="country-my"><br />
                            Malaysia<br />
                            <span class="dial-code">+60</span><br />
                        </label><br />
                        <input checked="checked" id="country-mv" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img mv" for="country-mv"><br />
                            Maldives<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-ml" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img ml" for="country-ml"><br />
                            Mali<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-mt" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img mt" for="country-mt"><br />
                            Malta<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-mh" name="country-list" type="radio" value="+69"/><br />
                        <label class="flag-img mh" for="country-mh"><br />
                            Marshall Islands<br />
                            <span class="dial-code">+69</span><br />
                        </label><br />
                        <input checked="checked" id="country-mq" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img mq" for="country-mq"><br />
                            Martinique<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-mr" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img mr" for="country-mr"><br />
                            Mauritania (‫موريتانيا‬‎)<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-mu" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img mu" for="country-mu"><br />
                            Mauritius (Moris)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-yt" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img yt" for="country-yt"><br />
                            Mayotte<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-mx" name="country-list" type="radio" value="+52"/><br />
                        <label class="flag-img mx" for="country-mx"><br />
                            Mexico (México)<br />
                            <span class="dial-code">+52</span><br />
                        </label><br />
                        <input checked="checked" id="country-fm" name="country-list" type="radio" value="+69"/><br />
                        <label class="flag-img fm" for="country-fm"><br />
                            Micronesia<br />
                            <span class="dial-code">+69</span><br />
                        </label><br />
                        <input checked="checked" id="country-md" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img md" for="country-md"><br />
                            Moldova (Republica Moldova)<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-mc" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img mc" for="country-mc"><br />
                            Monaco<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-mn" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img mn" for="country-mn"><br />
                            Mongolia (Монгол)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-me" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img me" for="country-me"><br />
                            Montenegro (Crna Gora)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-ms" name="country-list" type="radio" value="+16"/><br />
                        <label class="flag-img ms" for="country-ms"><br />
                            Montserrat<br />
                            <span class="dial-code">+16</span><br />
                        </label><br />
                        <input checked="checked" id="country-ma" name="country-list" type="radio" value="+21"/><br />
                        <label class="flag-img ma" for="country-ma"><br />
                            Morocco (‫المغرب‬‎)<br />
                            <span class="dial-code">+21</span><br />
                        </label><br />
                        <input checked="checked" id="country-mz" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img mz" for="country-mz"><br />
                            Mozambique (Moçambique)<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-mm" name="country-list" type="radio" value="+95"/><br />
                        <label class="flag-img mm" for="country-mm"><br />
                            Myanmar (Burma) (မြန်မာ)<br />
                            <span class="dial-code">+95</span><br />
                        </label><br />
                        <input checked="checked" id="country-na" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img na" for="country-na"><br />
                            Namibia (Namibië)<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-nr" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img nr" for="country-nr"><br />
                            Nauru<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-np" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img np" for="country-np"><br />
                            Nepal (नेपाल)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-nl" name="country-list" type="radio" value="+31"/><br />
                        <label class="flag-img nl" for="country-nl"><br />
                            Netherlands (Nederland)<br />
                            <span class="dial-code">+31</span><br />
                        </label><br />
                        <input checked="checked" id="country-nc" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img nc" for="country-nc"><br />
                            New Caledonia (Nouvelle-Calédonie)<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-nz" name="country-list" type="radio" value="+64"/><br />
                        <label class="flag-img nz" for="country-nz"><br />
                            New Zealand<br />
                            <span class="dial-code">+64</span><br />
                        </label><br />
                        <input checked="checked" id="country-ni" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img ni" for="country-ni"><br />
                            Nicaragua<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-ne" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img ne" for="country-ne"><br />
                            Niger (Nijar)<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-ng" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img ng" for="country-ng"><br />
                            Nigeria<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-nu" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img nu" for="country-nu"><br />
                            Niue<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-nf" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img nf" for="country-nf"><br />
                            Norfolk Island<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-kp" name="country-list" type="radio" value="+85"/><br />
                        <label class="flag-img kp" for="country-kp"><br />
                            North Korea (조선 민주주의 인민 공화국)<br />
                            <span class="dial-code">+85</span><br />
                        </label><br />
                        <input checked="checked" id="country-mp" name="country-list" type="radio" value="+16"/><br />
                        <label class="flag-img mp" for="country-mp"><br />
                            Northern Mariana Islands<br />
                            <span class="dial-code">+16</span><br />
                        </label><br />
                        <input checked="checked" id="country-no" name="country-list" type="radio" value="+47"/><br />
                        <label class="flag-img no" for="country-no"><br />
                            Norway (Norge)<br />
                            <span class="dial-code">+47</span><br />
                        </label><br />
                        <input checked="checked" id="country-om" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img om" for="country-om"><br />
                            Oman (‫عُمان‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-pk" name="country-list" type="radio" value="+92"/><br />
                        <label class="flag-img pk" for="country-pk"><br />
                            Pakistan (‫پاکستان‬‎)<br />
                            <span class="dial-code">+92</span><br />
                        </label><br />
                        <input checked="checked" id="country-pw" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img pw" for="country-pw"><br />
                            Palau<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-ps" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img ps" for="country-ps"><br />
                            Palestine (‫فلسطين‬‎)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-pa" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img pa" for="country-pa"><br />
                            Panama (Panamá)<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-pg" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img pg" for="country-pg"><br />
                            Papua New Guinea<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-py" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img py" for="country-py"><br />
                            Paraguay<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-pe" name="country-list" type="radio" value="+51"/><br />
                        <label class="flag-img pe" for="country-pe"><br />
                            Peru (Perú)<br />
                            <span class="dial-code">+51</span><br />
                        </label><br />
                        <input checked="checked" id="country-ph" name="country-list" type="radio" value="+63"/><br />
                        <label class="flag-img ph" for="country-ph"><br />
                            Philippines<br />
                            <span class="dial-code">+63</span><br />
                        </label><br />
                        <input checked="checked" id="country-pl" name="country-list" type="radio" value="+48"/><br />
                        <label class="flag-img pl" for="country-pl"><br />
                            Poland (Polska)<br />
                            <span class="dial-code">+48</span><br />
                        </label><br />
                        <input checked="checked" id="country-pt" name="country-list" type="radio" value="+35"/><br />
                        <label class="flag-img pt" for="country-pt"><br />
                            Portugal<br />
                            <span class="dial-code">+35</span><br />
                        </label><br />
                        <input checked="checked" id="country-pr" name="country-list" type="radio" value="+1"/><br />
                        <label class="flag-img pr" for="country-pr"><br />
                            Puerto Rico<br />
                            <span class="dial-code">+1</span><br />
                        </label><br />
                        <input checked="checked" id="country-qa" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img qa" for="country-qa"><br />
                            Qatar (‫قطر‬‎)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-re" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img re" for="country-re"><br />
                            Réunion (La Réunion)<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-ro" name="country-list" type="radio" value="+40"/><br />
                        <label class="flag-img ro" for="country-ro"><br />
                            Romania (România)<br />
                            <span class="dial-code">+40</span><br />
                        </label><br />
                        <input checked="checked" id="country-ru" name="country-list" type="radio" value="+7"/><br />
                        <label class="flag-img ru" for="country-ru"><br />
                            Russia (Россия)<br />
                            <span class="dial-code">+7</span><br />
                        </label><br />
                        <input checked="checked" id="country-rw" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img rw" for="country-rw"><br />
                            Rwanda<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-bl" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img bl" for="country-bl"><br />
                            Saint Barthélemy (Saint-Barthélemy)<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-sh" name="country-list" type="radio" value="+29"/><br />
                        <label class="flag-img sh" for="country-sh"><br />
                            Saint Helena<br />
                            <span class="dial-code">+29</span><br />
                        </label><br />
                        <input checked="checked" id="country-kn" name="country-list" type="radio" value="+18"/><br />
                        <label class="flag-img kn" for="country-kn"><br />
                            Saint Kitts and Nevis<br />
                            <span class="dial-code">+18</span><br />
                        </label><br />
                        <input checked="checked" id="country-lc" name="country-list" type="radio" value="+17"/><br />
                        <label class="flag-img lc" for="country-lc"><br />
                            Saint Lucia<br />
                            <span class="dial-code">+17</span><br />
                        </label><br />
                        <input checked="checked" id="country-mf" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img mf" for="country-mf"><br />
                            Saint Martin (Saint-Martin (partie française))<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-pm" name="country-list" type="radio" value="+50"/><br />
                        <label class="flag-img pm" for="country-pm"><br />
                            Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon)<br />
                            <span class="dial-code">+50</span><br />
                        </label><br />
                        <input checked="checked" id="country-vc" name="country-list" type="radio" value="+17"/><br />
                        <label class="flag-img vc" for="country-vc"><br />
                            Saint Vincent and the Grenadines<br />
                            <span class="dial-code">+17</span><br />
                        </label><br />
                        <input checked="checked" id="country-ws" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img ws" for="country-ws"><br />
                            Samoa<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-sm" name="country-list" type="radio" value="+37"/><br />
                        <label class="flag-img sm" for="country-sm"><br />
                            San Marino<br />
                            <span class="dial-code">+37</span><br />
                        </label><br />
                        <input checked="checked" id="country-st" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img st" for="country-st"><br />
                            São Tomé and Príncipe (São Tomé e Príncipe)<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-sa" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img sa" for="country-sa"><br />
                            Saudi Arabia (‫المملكة العربية السعودية‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-sn" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img sn" for="country-sn"><br />
                            Senegal (Sénégal)<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-rs" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img rs" for="country-rs"><br />
                            Serbia (Србија)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-sc" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img sc" for="country-sc"><br />
                            Seychelles<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-sl" name="country-list" type="radio" value="+23"/><br />
                        <label class="flag-img sl" for="country-sl"><br />
                            Sierra Leone<br />
                            <span class="dial-code">+23</span><br />
                        </label><br />
                        <input checked="checked" id="country-sg" name="country-list" type="radio" value="+65"/><br />
                        <label class="flag-img sg" for="country-sg"><br />
                            Singapore<br />
                            <span class="dial-code">+65</span><br />
                        </label><br />
                        <input checked="checked" id="country-sx" name="country-list" type="radio" value="+17"/><br />
                        <label class="flag-img sx" for="country-sx"><br />
                            Sint Maarten<br />
                            <span class="dial-code">+17</span><br />
                        </label><br />
                        <input checked="checked" id="country-sk" name="country-list" type="radio" value="+42"/><br />
                        <label class="flag-img sk" for="country-sk"><br />
                            Slovakia (Slovensko)<br />
                            <span class="dial-code">+42</span><br />
                        </label><br />
                        <input checked="checked" id="country-si" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img si" for="country-si"><br />
                            Slovenia (Slovenija)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-sb" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img sb" for="country-sb"><br />
                            Solomon Islands<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-so" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img so" for="country-so"><br />
                            Somalia (Soomaaliya)<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-za" name="country-list" type="radio" value="+27"/><br />
                        <label class="flag-img za" for="country-za"><br />
                            South Africa<br />
                            <span class="dial-code">+27</span><br />
                        </label><br />
                        <input checked="checked" id="country-kr" name="country-list" type="radio" value="+82"/><br />
                        <label class="flag-img kr" for="country-kr"><br />
                            South Korea (대한민국)<br />
                            <span class="dial-code">+82</span><br />
                        </label><br />
                        <input checked="checked" id="country-ss" name="country-list" type="radio" value="+21"/><br />
                        <label class="flag-img ss" for="country-ss"><br />
                            South Sudan (‫جنوب السودان‬‎)<br />
                            <span class="dial-code">+21</span><br />
                        </label><br />
                        <input checked="checked" id="country-es" name="country-list" type="radio" value="+34"/><br />
                        <label class="flag-img es" for="country-es"><br />
                            Spain (España)<br />
                            <span class="dial-code">+34</span><br />
                        </label><br />
                        <input checked="checked" id="country-lk" name="country-list" type="radio" value="+94"/><br />
                        <label class="flag-img lk" for="country-lk"><br />
                            Sri Lanka (ශ්‍රී ලංකාව)<br />
                            <span class="dial-code">+94</span><br />
                        </label><br />
                        <input checked="checked" id="country-sd" name="country-list" type="radio" value="+24"/><br />
                        <label class="flag-img sd" for="country-sd"><br />
                            Sudan (‫السودان‬‎)<br />
                            <span class="dial-code">+24</span><br />
                        </label><br />
                        <input checked="checked" id="country-sr" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img sr" for="country-sr"><br />
                            Suriname<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-sj" name="country-list" type="radio" value="+47"/><br />
                        <label class="flag-img sj" for="country-sj"><br />
                            Svalbard and Jan Mayen<br />
                            <span class="dial-code">+47</span><br />
                        </label><br />
                        <input checked="checked" id="country-sz" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img sz" for="country-sz"><br />
                            Swaziland<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-se" name="country-list" type="radio" value="+46"/><br />
                        <label class="flag-img se" for="country-se"><br />
                            Sweden (Sverige)<br />
                            <span class="dial-code">+46</span><br />
                        </label><br />
                        <input checked="checked" id="country-ch" name="country-list" type="radio" value="+41"/><br />
                        <label class="flag-img ch" for="country-ch"><br />
                            Switzerland (Schweiz)<br />
                            <span class="dial-code">+41</span><br />
                        </label><br />
                        <input checked="checked" id="country-sy" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img sy" for="country-sy"><br />
                            Syria (‫سوريا‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-tw" name="country-list" type="radio" value="+88"/><br />
                        <label class="flag-img tw" for="country-tw"><br />
                            Taiwan (台灣)<br />
                            <span class="dial-code">+88</span><br />
                        </label><br />
                        <input checked="checked" id="country-tj" name="country-list" type="radio" value="+99"/><br />
                        <label class="flag-img tj" for="country-tj"><br />
                            Tajikistan<br />
                            <span class="dial-code">+99</span><br />
                        </label><br />
                        <input checked="checked" id="country-tz" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img tz" for="country-tz"><br />
                            Tanzania<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-th" name="country-list" type="radio" value="+66"/><br />
                        <label class="flag-img th" for="country-th"><br />
                            Thailand (ไทย)<br />
                            <span class="dial-code">+66</span><br />
                        </label><br />
                        <input checked="checked" id="country-tl" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img tl" for="country-tl"><br />
                            Timor-Leste<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-tg" name="country-list" type="radio" value="+22"/><br />
                        <label class="flag-img tg" for="country-tg"><br />
                            Togo<br />
                            <span class="dial-code">+22</span><br />
                        </label><br />
                        <input checked="checked" id="country-tk" name="country-list" type="radio" value="+69"/><br />
                        <label class="flag-img tk" for="country-tk"><br />
                            Tokelau<br />
                            <span class="dial-code">+69</span><br />
                        </label><br />
                        <input checked="checked" id="country-to" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img to" for="country-to"><br />
                            Tonga<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-tt" name="country-list" type="radio" value="+18"/><br />
                        <label class="flag-img tt" for="country-tt"><br />
                            Trinidad and Tobago<br />
                            <span class="dial-code">+18</span><br />
                        </label><br />
                        <input checked="checked" id="country-tn" name="country-list" type="radio" value="+21"/><br />
                        <label class="flag-img tn" for="country-tn"><br />
                            Tunisia (‫تونس‬‎)<br />
                            <span class="dial-code">+21</span><br />
                        </label><br />
                        <input checked="checked" id="country-tr" name="country-list" type="radio" value="+90"/><br />
                        <label class="flag-img tr" for="country-tr"><br />
                            Turkey (Türkiye)<br />
                            <span class="dial-code">+90</span><br />
                        </label><br />
                        <input checked="checked" id="country-tm" name="country-list" type="radio" value="+99"/><br />
                        <label class="flag-img tm" for="country-tm"><br />
                            Turkmenistan<br />
                            <span class="dial-code">+99</span><br />
                        </label><br />
                        <input checked="checked" id="country-tc" name="country-list" type="radio" value="+16"/><br />
                        <label class="flag-img tc" for="country-tc"><br />
                            Turks and Caicos Islands<br />
                            <span class="dial-code">+16</span><br />
                        </label><br />
                        <input checked="checked" id="country-tv" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img tv" for="country-tv"><br />
                            Tuvalu<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-vi" name="country-list" type="radio" value="+13"/><br />
                        <label class="flag-img vi" for="country-vi"><br />
                            U.S. Virgin Islands<br />
                            <span class="dial-code">+13</span><br />
                        </label><br />
                        <input checked="checked" id="country-ug" name="country-list" type="radio" value="+25"/><br />
                        <label class="flag-img ug" for="country-ug"><br />
                            Uganda<br />
                            <span class="dial-code">+25</span><br />
                        </label><br />
                        <input checked="checked" id="country-ua" name="country-list" type="radio" value="+38"/><br />
                        <label class="flag-img ua" for="country-ua"><br />
                            Ukraine (Україна)<br />
                            <span class="dial-code">+38</span><br />
                        </label><br />
                        <input checked="checked" id="country-ae" name="country-list" type="radio" value="+97"/><br />
                        <label class="flag-img ae" for="country-ae"><br />
                            United Arab Emirates (‫الإمارات العربية المتحدة‬‎)<br />
                            <span class="dial-code">+97</span><br />
                        </label><br />
                        <input checked="checked" id="country-gb" name="country-list" type="radio" value="+44"/><br />
                        <label class="flag-img gb" for="country-gb"><br />
                            United Kingdom<br />
                            <span class="dial-code">+44</span><br />
                        </label><br />
                        <input checked="checked" id="country-us" name="country-list" type="radio" value="+1"/><br />
                        <label class="flag-img us" for="country-us"><br />
                            United States<br />
                            <span class="dial-code">+1</span><br />
                        </label><br />
                        <input checked="checked" id="country-uy" name="country-list" type="radio" value="+59"/><br />
                        <label class="flag-img uy" for="country-uy"><br />
                            Uruguay<br />
                            <span class="dial-code">+59</span><br />
                        </label><br />
                        <input checked="checked" id="country-uz" name="country-list" type="radio" value="+99"/><br />
                        <label class="flag-img uz" for="country-uz"><br />
                            Uzbekistan (Oʻzbekiston)<br />
                            <span class="dial-code">+99</span><br />
                        </label><br />
                        <input checked="checked" id="country-vu" name="country-list" type="radio" value="+67"/><br />
                        <label class="flag-img vu" for="country-vu"><br />
                            Vanuatu<br />
                            <span class="dial-code">+67</span><br />
                        </label><br />
                        <input checked="checked" id="country-va" name="country-list" type="radio" value="+39"/><br />
                        <label class="flag-img va" for="country-va"><br />
                            Vatican City (Città del Vaticano)<br />
                            <span class="dial-code">+39</span><br />
                        </label><br />
                        <input checked="checked" id="country-ve" name="country-list" type="radio" value="+58"/><br />
                        <label class="flag-img ve" for="country-ve"><br />
                            Venezuela<br />
                            <span class="dial-code">+58</span><br />
                        </label><br />
                        <input checked="checked" id="country-vn" name="country-list" type="radio" value="+84"/><br />
                        <label class="flag-img vn" for="country-vn"><br />
                            Vietnam (Việt Nam)<br />
                            <span class="dial-code">+84</span><br />
                        </label><br />
                        <input checked="checked" id="country-wf" name="country-list" type="radio" value="+68"/><br />
                        <label class="flag-img wf" for="country-wf"><br />
                            Wallis and Futuna<br />
                            <span class="dial-code">+68</span><br />
                        </label><br />
                        <input checked="checked" id="country-eh" name="country-list" type="radio" value="+21"/><br />
                        <label class="flag-img eh" for="country-eh"><br />
                            Western Sahara (‫الصحراء الغربية‬‎)<br />
                            <span class="dial-code">+21</span><br />
                        </label><br />
                        <input checked="checked" id="country-ye" name="country-list" type="radio" value="+96"/><br />
                        <label class="flag-img ye" for="country-ye"><br />
                            Yemen (‫اليمن‬‎)<br />
                            <span class="dial-code">+96</span><br />
                        </label><br />
                        <input checked="checked" id="country-zm" name="country-list" type="radio" value="+26"/><br />
                        <label class="flag-img zm" for="country-zm"><br />
                            Zambia<br />
                            <span class="dial-code">+26</span><br />
                        </label><br />
                        <input checked="checked" id="country-zw" name="country-list" type="radio" value="+263"/><br />
                        <label class="flag-img zw" for="country-zw"><br />
                            Zimbabwe<br />
                            <span class="dial-code">+263</span><br />
                        </label></p>
<p>                        <input checked="checked" id="country-ro" name="country-list" type="radio" value="+40"/><br />
                        <label class="flag-img ro" for="country-ro"><br />
                            Romania (România)<br />
                            <span class="dial-code">+40</span><br />
                        </label><br />
                    </div></div></p>
<p>                <div class="form-group required"><br />
                        <label class="small"><br />
                            <i class="fa fa-phone"></i><br />
                            Mobil</label><br />
                        <input class="form-control" type="text" name="phone"/><br/><br />
</div></p>
<p>                <div class="form-group required"><br />
                        <label class="small"><br />
                            <i class="fa fa-envelope"></i><br />
                            Email</label><br />
                        <input class="form-control" type="text" name="email"/><br/><br />
</div></p>
<p>        <input type="submit" value="SUBMIT"/><br />
    </form></p>
<p>    <!– Style and scripts code start here. Please paste it before </head> html tag. –><br />
    <script src="https://v2.textdeliver.com/build/embed-form/scripts.js" type="text/javascript"></script><br />
    <link rel="stylesheet" href="https://v2.textdeliver.com/build/embed-form/styles.css"/><br />
    <!– Style and scripts code finish here. –>[/custom_html]

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