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document.write("                    <option value=\"2018\">2018</option>"+"\n");
document.write("                    <option value=\"2019\">2019</option>"+"\n");
document.write("                    <option value=\"2020\">2020</option>"+"\n");
document.write("                    <option value=\"2021\">2021</option>"+"\n");
document.write("                    <option value=\"2022\">2022</option>"+"\n");
document.write("                    <option value=\"2023\">2023</option>"+"\n");
document.write("                    <option value=\"2024\">2024</option>"+"\n");
document.write("                    <option value=\"2025\">2025</option>"+"\n");
document.write("                    <option value=\"2026\">2026</option>"+"\n");
document.write("                </select>"+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    <input data-skip-validation type=\"text\" id=\"fsCalendar69336401Link\" class=\"fsCalendarPickerLink\" style=\"display:none;\" aria-hidden=\"true\" />"+"\n");
document.write("        <div id=\"fsCalendar69336401\" class=\"fsCalendar\" style=\" position:absolute\"></div>"+"\n");
document.write("        "+"\n");
document.write("        <span class=\"always-ltr\">"+"\n");
document.write("            <div class=\"hidden\"><label for=\"field69336401H\">Hour</label></div>"+"\n");
document.write("        <select id=\"field69336401H\" name=\"field69336401H\" class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"01\">01</option>"+"\n");
document.write("                    <option value=\"02\">02</option>"+"\n");
document.write("                    <option value=\"03\">03</option>"+"\n");
document.write("                    <option value=\"04\">04</option>"+"\n");
document.write("                    <option value=\"05\">05</option>"+"\n");
document.write("                    <option value=\"06\">06</option>"+"\n");
document.write("                    <option value=\"07\">07</option>"+"\n");
document.write("                    <option value=\"08\">08</option>"+"\n");
document.write("                    <option value=\"09\">09</option>"+"\n");
document.write("                    <option value=\"10\">10</option>"+"\n");
document.write("                    <option value=\"11\">11</option>"+"\n");
document.write("                    <option value=\"12\">12</option>"+"\n");
document.write("                </select>"+"\n");
document.write("        <div class=\"hidden\"><label for=\"field69336401I\">Minute</label></div>"+"\n");
document.write("        <span>:</span> <select id=\"field69336401I\" name=\"field69336401I\" class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"00\">00</option>"+"\n");
document.write("                    <option value=\"01\">01</option>"+"\n");
document.write("                    <option value=\"02\">02</option>"+"\n");
document.write("                    <option value=\"03\">03</option>"+"\n");
document.write("                    <option value=\"04\">04</option>"+"\n");
document.write("                    <option value=\"05\">05</option>"+"\n");
document.write("                    <option value=\"06\">06</option>"+"\n");
document.write("                    <option value=\"07\">07</option>"+"\n");
document.write("                    <option value=\"08\">08</option>"+"\n");
document.write("                    <option value=\"09\">09</option>"+"\n");
document.write("                    <option value=\"10\">10</option>"+"\n");
document.write("                    <option value=\"11\">11</option>"+"\n");
document.write("                    <option value=\"12\">12</option>"+"\n");
document.write("                    <option value=\"13\">13</option>"+"\n");
document.write("                    <option value=\"14\">14</option>"+"\n");
document.write("                    <option value=\"15\">15</option>"+"\n");
document.write("                    <option value=\"16\">16</option>"+"\n");
document.write("                    <option value=\"17\">17</option>"+"\n");
document.write("                    <option value=\"18\">18</option>"+"\n");
document.write("                    <option value=\"19\">19</option>"+"\n");
document.write("                    <option value=\"20\">20</option>"+"\n");
document.write("                    <option value=\"21\">21</option>"+"\n");
document.write("                    <option value=\"22\">22</option>"+"\n");
document.write("                    <option value=\"23\">23</option>"+"\n");
document.write("                    <option value=\"24\">24</option>"+"\n");
document.write("                    <option value=\"25\">25</option>"+"\n");
document.write("                    <option value=\"26\">26</option>"+"\n");
document.write("                    <option value=\"27\">27</option>"+"\n");
document.write("                    <option value=\"28\">28</option>"+"\n");
document.write("                    <option value=\"29\">29</option>"+"\n");
document.write("                    <option value=\"30\">30</option>"+"\n");
document.write("                    <option value=\"31\">31</option>"+"\n");
document.write("                    <option value=\"32\">32</option>"+"\n");
document.write("                    <option value=\"33\">33</option>"+"\n");
document.write("                    <option value=\"34\">34</option>"+"\n");
document.write("                    <option value=\"35\">35</option>"+"\n");
document.write("                    <option value=\"36\">36</option>"+"\n");
document.write("                    <option value=\"37\">37</option>"+"\n");
document.write("                    <option value=\"38\">38</option>"+"\n");
document.write("                    <option value=\"39\">39</option>"+"\n");
document.write("                    <option value=\"40\">40</option>"+"\n");
document.write("                    <option value=\"41\">41</option>"+"\n");
document.write("                    <option value=\"42\">42</option>"+"\n");
document.write("                    <option value=\"43\">43</option>"+"\n");
document.write("                    <option value=\"44\">44</option>"+"\n");
document.write("                    <option value=\"45\">45</option>"+"\n");
document.write("                    <option value=\"46\">46</option>"+"\n");
document.write("                    <option value=\"47\">47</option>"+"\n");
document.write("                    <option value=\"48\">48</option>"+"\n");
document.write("                    <option value=\"49\">49</option>"+"\n");
document.write("                    <option value=\"50\">50</option>"+"\n");
document.write("                    <option value=\"51\">51</option>"+"\n");
document.write("                    <option value=\"52\">52</option>"+"\n");
document.write("                    <option value=\"53\">53</option>"+"\n");
document.write("                    <option value=\"54\">54</option>"+"\n");
document.write("                    <option value=\"55\">55</option>"+"\n");
document.write("                    <option value=\"56\">56</option>"+"\n");
document.write("                    <option value=\"57\">57</option>"+"\n");
document.write("                    <option value=\"58\">58</option>"+"\n");
document.write("                    <option value=\"59\">59</option>"+"\n");
document.write("                </select>"+"\n");
document.write("        "+"\n");
document.write("                    &nbsp;"+"\n");
document.write("            <div class=\"hidden\"><label for=\"field69336401A\">AM/PM</label></div>"+"\n");
document.write("            <select id=\"field69336401A\" name=\"field69336401A\" class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                            <option value=\"\"> </option>"+"\n");
document.write("                            <option value=\"AM\">AM</option>"+"\n");
document.write("                            <option value=\"PM\">PM</option>"+"\n");
document.write("                        </select>"+"\n");
document.write("                <div class=\"fs-clear\">"+"\n");
document.write("        </div>"+"\n");
document.write("    </span>"+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3206353-8\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell69336435\" lang=\"en\" fs-field-type=\"datetime\" fs-field-validation-name=\"End Date & Time\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend69336435\" id=\"label69336435\">"+"\n");
document.write("                            <legend id=\"fsLegend69336435\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>End Date & Time<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                <!-- Used to pull in url for jquery -->"+"\n");
document.write("        <span aria-hidden=\"true\" style=\"display:none;\" id=\"fsCalendar69336435ImageUrl\">https://ncpgambling.formstack.com/forms/images/2/calendar.png</span>"+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    <input data-skip-validation data-date-format=\"M d, Y\" type=\"hidden\" id=\"field69336435Format\" name=\"field69336435Format\" value=\"MDY\" />"+"\n");
document.write("    "+"\n");
document.write("                    <div class=\"hidden\"><label for=\"field69336435M\">Month</label></div>"+"\n");
document.write("        <select id=\"field69336435M\" name=\"field69336435M\" class=\" fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"Jan\">Jan</option>"+"\n");
document.write("                    <option value=\"Feb\">Feb</option>"+"\n");
document.write("                    <option value=\"Mar\">Mar</option>"+"\n");
document.write("                    <option value=\"Apr\">Apr</option>"+"\n");
document.write("                    <option value=\"May\">May</option>"+"\n");
document.write("                    <option value=\"Jun\">Jun</option>"+"\n");
document.write("                    <option value=\"Jul\">Jul</option>"+"\n");
document.write("                    <option value=\"Aug\">Aug</option>"+"\n");
document.write("                    <option value=\"Sep\">Sep</option>"+"\n");
document.write("                    <option value=\"Oct\">Oct</option>"+"\n");
document.write("                    <option value=\"Nov\">Nov</option>"+"\n");
document.write("                    <option value=\"Dec\">Dec</option>"+"\n");
document.write("                </select>"+"\n");
document.write("             <div class=\"hidden\"><label for=\"field69336435D\">Day</label></div>"+"\n");
document.write("        <select id=\"field69336435D\" name=\"field69336435D\" class=\" fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"01\">01</option>"+"\n");
document.write("                    <option value=\"02\">02</option>"+"\n");
document.write("                    <option value=\"03\">03</option>"+"\n");
document.write("                    <option value=\"04\">04</option>"+"\n");
document.write("                    <option value=\"05\">05</option>"+"\n");
document.write("                    <option value=\"06\">06</option>"+"\n");
document.write("                    <option value=\"07\">07</option>"+"\n");
document.write("                    <option value=\"08\">08</option>"+"\n");
document.write("                    <option value=\"09\">09</option>"+"\n");
document.write("                    <option value=\"10\">10</option>"+"\n");
document.write("                    <option value=\"11\">11</option>"+"\n");
document.write("                    <option value=\"12\">12</option>"+"\n");
document.write("                    <option value=\"13\">13</option>"+"\n");
document.write("                    <option value=\"14\">14</option>"+"\n");
document.write("                    <option value=\"15\">15</option>"+"\n");
document.write("                    <option value=\"16\">16</option>"+"\n");
document.write("                    <option value=\"17\">17</option>"+"\n");
document.write("                    <option value=\"18\">18</option>"+"\n");
document.write("                    <option value=\"19\">19</option>"+"\n");
document.write("                    <option value=\"20\">20</option>"+"\n");
document.write("                    <option value=\"21\">21</option>"+"\n");
document.write("                    <option value=\"22\">22</option>"+"\n");
document.write("                    <option value=\"23\">23</option>"+"\n");
document.write("                    <option value=\"24\">24</option>"+"\n");
document.write("                    <option value=\"25\">25</option>"+"\n");
document.write("                    <option value=\"26\">26</option>"+"\n");
document.write("                    <option value=\"27\">27</option>"+"\n");
document.write("                    <option value=\"28\">28</option>"+"\n");
document.write("                    <option value=\"29\">29</option>"+"\n");
document.write("                    <option value=\"30\">30</option>"+"\n");
document.write("                    <option value=\"31\">31</option>"+"\n");
document.write("                </select>"+"\n");
document.write("             <div class=\"hidden\"><label for=\"field69336435Y\">Year</label></div>"+"\n");
document.write("        <select id=\"field69336435Y\" name=\"field69336435Y\" class=\" fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"2016\">2016</option>"+"\n");
document.write("                    <option value=\"2017\">2017</option>"+"\n");
document.write("                    <option value=\"2018\">2018</option>"+"\n");
document.write("                    <option value=\"2019\">2019</option>"+"\n");
document.write("                    <option value=\"2020\">2020</option>"+"\n");
document.write("                    <option value=\"2021\">2021</option>"+"\n");
document.write("                    <option value=\"2022\">2022</option>"+"\n");
document.write("                    <option value=\"2023\">2023</option>"+"\n");
document.write("                    <option value=\"2024\">2024</option>"+"\n");
document.write("                    <option value=\"2025\">2025</option>"+"\n");
document.write("                    <option value=\"2026\">2026</option>"+"\n");
document.write("                </select>"+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    "+"\n");
document.write("    <input data-skip-validation type=\"text\" id=\"fsCalendar69336435Link\" class=\"fsCalendarPickerLink\" style=\"display:none;\" aria-hidden=\"true\" />"+"\n");
document.write("        <div id=\"fsCalendar69336435\" class=\"fsCalendar\" style=\" position:absolute\"></div>"+"\n");
document.write("        "+"\n");
document.write("        <span class=\"always-ltr\">"+"\n");
document.write("            <div class=\"hidden\"><label for=\"field69336435H\">Hour</label></div>"+"\n");
document.write("        <select id=\"field69336435H\" name=\"field69336435H\" class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"01\">01</option>"+"\n");
document.write("                    <option value=\"02\">02</option>"+"\n");
document.write("                    <option value=\"03\">03</option>"+"\n");
document.write("                    <option value=\"04\">04</option>"+"\n");
document.write("                    <option value=\"05\">05</option>"+"\n");
document.write("                    <option value=\"06\">06</option>"+"\n");
document.write("                    <option value=\"07\">07</option>"+"\n");
document.write("                    <option value=\"08\">08</option>"+"\n");
document.write("                    <option value=\"09\">09</option>"+"\n");
document.write("                    <option value=\"10\">10</option>"+"\n");
document.write("                    <option value=\"11\">11</option>"+"\n");
document.write("                    <option value=\"12\">12</option>"+"\n");
document.write("                </select>"+"\n");
document.write("        <div class=\"hidden\"><label for=\"field69336435I\">Minute</label></div>"+"\n");
document.write("        <span>:</span> <select id=\"field69336435I\" name=\"field69336435I\" class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                    <option value=\"\"> </option>"+"\n");
document.write("                    <option value=\"00\">00</option>"+"\n");
document.write("                    <option value=\"01\">01</option>"+"\n");
document.write("                    <option value=\"02\">02</option>"+"\n");
document.write("                    <option value=\"03\">03</option>"+"\n");
document.write("                    <option value=\"04\">04</option>"+"\n");
document.write("                    <option value=\"05\">05</option>"+"\n");
document.write("                    <option value=\"06\">06</option>"+"\n");
document.write("                    <option value=\"07\">07</option>"+"\n");
document.write("                    <option value=\"08\">08</option>"+"\n");
document.write("                    <option value=\"09\">09</option>"+"\n");
document.write("                    <option value=\"10\">10</option>"+"\n");
document.write("                    <option value=\"11\">11</option>"+"\n");
document.write("                    <option value=\"12\">12</option>"+"\n");
document.write("                    <option value=\"13\">13</option>"+"\n");
document.write("                    <option value=\"14\">14</option>"+"\n");
document.write("                    <option value=\"15\">15</option>"+"\n");
document.write("                    <option value=\"16\">16</option>"+"\n");
document.write("                    <option value=\"17\">17</option>"+"\n");
document.write("                    <option value=\"18\">18</option>"+"\n");
document.write("                    <option value=\"19\">19</option>"+"\n");
document.write("                    <option value=\"20\">20</option>"+"\n");
document.write("                    <option value=\"21\">21</option>"+"\n");
document.write("                    <option value=\"22\">22</option>"+"\n");
document.write("                    <option value=\"23\">23</option>"+"\n");
document.write("                    <option value=\"24\">24</option>"+"\n");
document.write("                    <option value=\"25\">25</option>"+"\n");
document.write("                    <option value=\"26\">26</option>"+"\n");
document.write("                    <option value=\"27\">27</option>"+"\n");
document.write("                    <option value=\"28\">28</option>"+"\n");
document.write("                    <option value=\"29\">29</option>"+"\n");
document.write("                    <option value=\"30\">30</option>"+"\n");
document.write("                    <option value=\"31\">31</option>"+"\n");
document.write("                    <option value=\"32\">32</option>"+"\n");
document.write("                    <option value=\"33\">33</option>"+"\n");
document.write("                    <option value=\"34\">34</option>"+"\n");
document.write("                    <option value=\"35\">35</option>"+"\n");
document.write("                    <option value=\"36\">36</option>"+"\n");
document.write("                    <option value=\"37\">37</option>"+"\n");
document.write("                    <option value=\"38\">38</option>"+"\n");
document.write("                    <option value=\"39\">39</option>"+"\n");
document.write("                    <option value=\"40\">40</option>"+"\n");
document.write("                    <option value=\"41\">41</option>"+"\n");
document.write("                    <option value=\"42\">42</option>"+"\n");
document.write("                    <option value=\"43\">43</option>"+"\n");
document.write("                    <option value=\"44\">44</option>"+"\n");
document.write("                    <option value=\"45\">45</option>"+"\n");
document.write("                    <option value=\"46\">46</option>"+"\n");
document.write("                    <option value=\"47\">47</option>"+"\n");
document.write("                    <option value=\"48\">48</option>"+"\n");
document.write("                    <option value=\"49\">49</option>"+"\n");
document.write("                    <option value=\"50\">50</option>"+"\n");
document.write("                    <option value=\"51\">51</option>"+"\n");
document.write("                    <option value=\"52\">52</option>"+"\n");
document.write("                    <option value=\"53\">53</option>"+"\n");
document.write("                    <option value=\"54\">54</option>"+"\n");
document.write("                    <option value=\"55\">55</option>"+"\n");
document.write("                    <option value=\"56\">56</option>"+"\n");
document.write("                    <option value=\"57\">57</option>"+"\n");
document.write("                    <option value=\"58\">58</option>"+"\n");
document.write("                    <option value=\"59\">59</option>"+"\n");
document.write("                </select>"+"\n");
document.write("        "+"\n");
document.write("                    &nbsp;"+"\n");
document.write("            <div class=\"hidden\"><label for=\"field69336435A\">AM/PM</label></div>"+"\n");
document.write("            <select id=\"field69336435A\" name=\"field69336435A\" class=\"fsField fsRequired\" aria-required=\"true\">"+"\n");
document.write("                            <option value=\"\"> </option>"+"\n");
document.write("                            <option value=\"AM\">AM</option>"+"\n");
document.write("                            <option value=\"PM\">PM</option>"+"\n");
document.write("                        </select>"+"\n");
document.write("                <div class=\"fs-clear\">"+"\n");
document.write("        </div>"+"\n");
document.write("    </span>"+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3206353-9\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell69336450\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Time\">"+"\n");
document.write("                                                                                <fieldset role=\"group\" aria-labelledby=\"fsLegend69336450\" id=\"label69336450\">"+"\n");
document.write("                            <legend id=\"fsLegend69336450\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Time<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
document.write("                            <div class=\"fieldset-content\">"+"\n");
document.write("                    "+"\n");
document.write("                                        "+"\n");
document.write("                                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field69336450_1\"><input type=\"radio\" id=\"field69336450_1\" name=\"field69336450\" value=\"Event is at a specific time\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />Event is at a specific time</label>"+"\n");
document.write("            "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            <label class=\"fsOptionLabel vertical\" for=\"field69336450_2\"><input type=\"radio\" id=\"field69336450_2\" name=\"field69336450\" value=\"All day event\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />All day event</label>"+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("    "+"\n");
document.write("                                                                "+"\n");
document.write("                    "+"\n");
document.write("                                                </div></fieldset>"+"\n");
document.write("                    "+"\n");
document.write("                    "+"\n");
document.write("                                                </div>"+"\n");
document.write("                                    </div>"+"\n");
document.write("                        "+"\n");
document.write("                        "+"\n");
document.write("                "+"\n");
document.write("                    "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("            "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("                                        "+"\n");
document.write("            "+"\n");
document.write("                                                "+"\n");
document.write("                <div id=\"fsRow3206353-10\" class=\"fsRow fsFieldRow fsLastRow\">"+"\n");
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document.write("            "+"\n");
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document.write("            <div class=\"fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100\" id=\"fsCell69336522\" lang=\"en\" fs-field-type=\"radio\" fs-field-validation-name=\"Training / Event Location\">"+"\n");
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document.write("                            <legend id=\"fsLegend69336522\" class=\"fsLabel fsRequiredLabel fsLabelVertical\"><span>Training / Event Location<span class=\"fsRequiredMarker\">*</span></span></legend>"+"\n");
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document.write("            <label class=\"fsOptionLabel vertical\" for=\"field69336522_2\"><input type=\"radio\" id=\"field69336522_2\" name=\"field69336522\" value=\"Online\" class=\"fsField fsRequired vertical\" aria-required=\"true\" />Online</label>"+"\n");
document.write("            "+"\n");
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document.write("                                                                "+"\n");
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document.write("                                    <option value=\"DE\">Delaware</option>"+"\n");
document.write("                                    <option value=\"DC\">District of Columbia</option>"+"\n");
document.write("                                    <option value=\"FL\">Florida</option>"+"\n");
document.write("                                    <option value=\"GA\">Georgia</option>"+"\n");
document.write("                                    <option value=\"GU\">Guam</option>"+"\n");
document.write("                                    <option value=\"HI\">Hawaii</option>"+"\n");
document.write("                                    <option value=\"ID\">Idaho</option>"+"\n");
document.write("                                    <option value=\"IL\">Illinois</option>"+"\n");
document.write("                                    <option value=\"IN\">Indiana</option>"+"\n");
document.write("                                    <option value=\"IA\">Iowa</option>"+"\n");
document.write("                                    <option value=\"KS\">Kansas</option>"+"\n");
document.write("                                    <option value=\"KY\">Kentucky</option>"+"\n");
document.write("                                    <option value=\"LA\">Louisiana</option>"+"\n");
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document.write("                                    <option value=\"MI\">Michigan</option>"+"\n");
document.write("                                    <option value=\"MN\">Minnesota</option>"+"\n");
document.write("                                    <option value=\"MS\">Mississippi</option>"+"\n");
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document.write("                                    <option value=\"PR\">Puerto Rico</option>"+"\n");
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document.write("                                    <option value=\"TN\">Tennessee</option>"+"\n");
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document.write("                                    <option value=\"AA\">Armed Forces (the) Americas</option>"+"\n");
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