- Scan-ID:
- 8a85ab47-6d08-4953-b3c1-9e8e67818241Beendet
- Eingereichte URL:
- https://jsdimmigrations.in/ethiopia-visa/application
- Bericht beendet:
Links · 0 gefunden
Die von der Seite ausgehenden identifizierten Links
JavaScript-Variablen · 73 gefunden
Globale JavaScript-Variablen, die in das Window Object einer Seite geladen werden, sind Variablen, die außerhalb von Funktionen deklariert werden und von jeder Stelle des Codes innerhalb des aktuellen Bereichs zugänglich sind
| Name | Typ |
|---|---|
| onbeforetoggle | object |
| documentPictureInPicture | object |
| onscrollend | object |
| $ | function |
| jQuery | function |
| WSDEBUG | boolean |
| webshims | object |
| webshim | object |
| WOW | function |
| Waypoint | function |
Konsolenprotokoll-Meldungen · 0 gefunden
In der Web-Konsole protokollierte Meldungen
HTML
Der HTML-Rohtext der Seite
<!DOCTYPE html><html class="no-js" lang=""><head>
<meta charset="gb18030">
<meta http-equiv="x-ua-compatible" content="ie=edge">
<title> Ethiopia Evisa </title>
<meta name="description" content="">
<meta name="viewport" content="width=device-width, initial-scale=1">
<meta charset="utf-8">
<meta name="yandex-verification" content="8511df3a898f5b5d">
<meta name="keywords" content="ethiopia visa, ethiopia eVisa, jsdvisa.com ">
<meta http-equiv="x-ua-compatible" content="ie=edge">
<title> JSDIMMIGRATIONS.COM | APPLY Ethiopia eVISA </title>
<meta name="description" content="Effortlessly secure your ethiopia eVisa online at JSDVISA.COM. Experience a seamless application process and receive prompt visa approvals for your journey.">
<meta name="viewport" content="width=device-width, initial-scale=1">
<link rel="stylesheet" href="https://cdnjs.cloudflare.com/ajax/libs/webshim/1.16.0/dev/shims/styles/shim.css"><link rel="canonical" href="https://www.jsdvisa.com/ethiopia-visa/application">
<meta name="robots" content="index,follow">
<meta name="generator" content="jsdvisa 4.18.5, jsdvisa.com">
<!--------------------------------------------------New Added----------------------------------------------->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/normalize.css">
<!-- Main CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/main.css">
<!-- Owl Caousel CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/vendor/OwlCarousel/owl.carousel.min.css">
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/vendor/OwlCarousel/owl.theme.default.min.css">
<!-- nivo slider CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/vendor/slider/css/nivo-slider.css" type="text/css">
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/vendor/slider/css/preview.css" type="text/css" media="screen">
<!-- Magic popup CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/magnific-popup.css">
<!-- Switch Style CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/hover-min.css">
<!-- ReImageGrid CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/reImageGrid.css">
<!-- Custom CSS -->
<!--------------------------------------------------New Added Ends----------------------------------------------->
<link rel="shortcut icon" type="image/x-icon" href="https://cdn.jsdimmigrations.in/ethiopia/img/favicon.png">
<script src="https://code.jquery.com/jquery-3.5.1.min.js"></script>
<!-- Bootstrap CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/bootstrap.min.css">
<!-- Animate CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/animate.min.css">
<!-- Font-awesome CSS-->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/font-awesome.min.css">
<!-- Owl Caousel CSS -->
<!-- Main Menu CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/meanmenu.min.css">
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/style.css">
<!-- Custom CSS -->
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/style.css">
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/main_step.css">
<style>
body{
background-color:#f5f5f5!important;
}
#wrapper {
background-color:#f5f5f5!important;
}
</style>
<script src="https://cdnjs.cloudflare.com/ajax/libs/webshim/1.16.0/dev/polyfiller.js"></script>
<script>
webshim.activeLang('en');
webshim.polyfill('forms');
if (webshims.cfg) {
webshims.cfg.no$Switch = true;
}
</script>
<link rel="stylesheet" href="https://cdn.jsdimmigrations.in/asset/css/jquery.datetimepicker.css">
<script src="https://jsdvisa.b-cdn.net/bootstrap-datepicker.js"></script>
<!--link rel="apple-touch-icon" sizes="180x180"
href="https://cdn.jsdimmigrations.in/online-visa/favicon/ethiopia/apple-touch-icon.png"-->
<!--link rel="icon" type="image/png" sizes="32x32"
href="https://cdn.jsdimmigrations.in/online-visa/favicon/ethiopia/favicon-32x32.png"-->
<!--link rel="icon" type="image/png" sizes="16x16"
href="https://cdn.jsdimmigrations.in/online-visa/favicon/ethiopia/favicon-16x16.png"-->
<!--link rel="manifest" href="https://cdn.jsdimmigrations.in/online-visa/favicon/ethiopia/site.webmanifest"-->
<link rel="apple-touch-icon" sizes="180x180" href="https://cdn.jsdimmigrations.in/favicon/apple-touch-icon.png">
<link rel="icon" type="image/png" sizes="32x32" href="https://cdn.jsdimmigrations.in/favicon/favicon-32x32.png">
<link rel="icon" type="image/png" sizes="16x16" href="https://cdn.jsdimmigrations.in/favicon/favicon-16x16.png">
<link rel="manifest" href="https://cdn.jsdimmigrations.in/favicon/site.webmanifest">
</head>
<body>
<!-- Header Area Start Here -->
<style>
.mean-container .mean-nav ul li a {
background-color: white;
/* border: blanchedalmond; */
font-size: 20px;
}
</style>
<div id="wrapper">
<header>
<div id="header2" class="header2-area">
<div class="header-top-area">
<div class="container">
<div class="row">
<div class="col-lg-8 col-md-8 col-sm-8 col-xs-12">
<div class="header-top-left">
<ul>
<li><img title="United States" alt="United States" src="https://cdn.jsdimmigrations.com/images/usflag.png"> <a href="Tel: +1 888 369 3111"> +1 888 369 3111 </a></li>
<li><img title="United Kingdom" alt="United Kingdom" src="https://cdn.jsdimmigrations.com/images/ukflag.png"> <a href="Tel: +44 203 608 4671"> +44 203 608 4671 </a></li>
<li><i class="fa fa-envelope" aria-hidden="true"></i><a href="mailto:[email protected]">[email protected]</a></li>
</ul>
</div>
</div>
<div class="col-lg-4 col-md-4 col-sm-4 col-xs-12">
<div class="header-top-right">
<ul>
<li>
<a class="login-btn-area" href="https://jsdimmigrations.in/contact-us" target="_blank">Contact Us</a>
</li>
<li>
<div class="apply-btn-area">
<a href="https://jsdimmigrations.in/ethiopia-visa/application" class="apply-now-btn">APPLY VISA</a>
</div>
</li>
</ul>
</div>
</div>
</div>
</div>
</div>
<div class="main-menu-area bg-textPrimary" id="sticker">
<div class="container">
<div class="row">
<div class="col-lg-3 col-md-3 col-sm-3">
<div class="logo-area">
<a href=""><img class="img-responsive" src="https://cdn.jsdimmigrations.com/online-visa/images/ethiopia-logo.png" alt="logo"></a>
<!--a href="https://jsdimmigrations.in/ethiopia-visa/"><img class="img-responsive" src="https://cdn.jsdimmigrations.in/images/logo.png" alt="logo"></a-->
</div>
</div>
<div class="col-lg-8 col-md-8 col-sm-8">
<nav id="desktop-nav">
<ul>
<li><a href="https://jsdimmigrations.in/ethiopia-visa">Home</a>
</li>
<li><a href="https://jsdimmigrations.in/ethiopia-visa/application">APPLY VISA</a> </li>
<li><a href="https://jsdimmigrations.in/ethiopia-visa/application">RUSH VISA</a> </li>
<li><a href="https://jsdimmigrations.in/ethiopia-visa/check-status">Ongoing Application</a> </li>
</ul>
</nav>
</div>
<div class="col-lg-1 col-md-1 hidden-sm">
<div class="header-search">
<form action="search" method="GET" novalidate="novalidate">
<input type="text" name="ref" class="search-form" placeholder="Enter Your Application Number...." required="required" aria-required="true">
<a href="#" class="search-button" id="search-button"><i class="fa fa-search" aria-hidden="true"></i></a>
</form>
</div>
</div>
</div>
</div>
</div>
</div>
<!-- Mobile Menu Area Start -->
<div class="mobile-menu-area">
<div class="container">
<div class="row">
<div class="col-md-12">
<div class="mobile-menu">
<nav id="dropdown" style="display: block;">
<ul>
<li><a href="https://jsdimmigrations.in/ethiopia-visa">Home</a>
</li>
<li><a href="application">APPLY VISA</a> </li>
<li>
<a href="https://jsdimmigrations.in/contact-us">Contact Us</a>
</li>
</ul>
</nav>
</div>
</div>
</div>
</div>
</div>
<!-- Mobile Menu Area End -->
</header>
<!-- Header Area End Here -->
<!-- Inner Page Banner Area Start Here -->
<form action="modules/submitstep3.php" method="POST" name="application_form" id="application_form" xmlns=" http://www.w3.org/1999/html" class="m-form-application" data-parsley-validate="" novalidate="">
<input type="hidden" name="_token" value="MZo4GULU2bWeZGbjVnWHF3D7D4e3fIFoq4yDC6nH">
<input type="hidden" id="countrycode" name="countrycode" value="">
<div class="container m-form-container">
<ol class="m-steps__classic m-steps__classic--progress">
<li class="current ">
<div class="m-steps-textcontainer">1. Submit Application Online</div>
<span></span>
</li>
<li>
<div class="m-steps-textcontainer">2. Review and Confirm Payment</div>
<span></span>
</li>
<li>
<div class="m-steps-textcontainer">
3. Receive Approved Visa </div>
<span></span>
</li>
</ol>
<div class="hide j-tittle-section clearfix">
<dir class="row">
<h3 class="text-center u-pad--b10 m-txt--color3">
<strong>
Online Application for Citizens from <span class="countryFrom"></span>
</strong>
</h3>
</dir>
</div>
<div class="u-marg--t20">
<div>
</div>
<div class="m-form-application-container u-pad--t0">
<section class="m-form-application-category-container active">
<div class="m-form-application-title">
<h2 style="color: #fff;">
Personal Details </h2>
</div>
<div class="m-form-application-inputs-container">
<div class="row">
<div id="form-country_of_citizenship" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="country_of_citizenship">
Number of Visa <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class="country_citizenship" name="No_of_visa" id="No_of_visa" autocomplete="off" required="required" data-parsley-trigger="change" data-parsley-group="block-0" aria-required="true">
<option selected="" value="1">Only 1 applicant</option>
<option value="2">Group of 2 applicants</option>
<option value="3">Group of 3 applicants</option>
<option value="4">Group of 4 applicants</option>
<option value="5">Group of 5 applicants</option>
<option value="6">Group of 6 applicants</option>
<option value="7">Group of 7 applicants</option>
<option value="8">Group of 8 applicants</option>
<option value="9">Group of 9 applicants</option>
<option value="10">Group of 10 applicants</option>
<option value="11">Group of 11 applicants</option>
<option value="12">Group of 12 applicants</option>
<option value="13">Group of 13 applicants</option>
<option value="14">Group of 14 applicants</option>
<option value="15">Group of 15 applicants</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" style="color:white" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-arrival_date" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="arrival_date">
Intended Arrival Date <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<div class="form-inline j-date-form container-datepicker">
<input id="arrival_date_id" class="datepicker picker__input" name="" type="text" value="" data-value="" data-field-name="Intended Date of Entry" data-min-year="" data-max-year="2026" required="required" data-parsley-errors-container="#errorarrival_date" data-parsley-trigger="change" readonly="" aria-haspopup="true" aria-expanded="false" aria-readonly="false" aria-owns="arrival_date_id_root" data-parsley-group="block-0" aria-required="true"><input type="hidden" class="j-form-hiden" value="" required="required" name="arrivaldate" id="arrivaldate" data-parsley-group="block-0" aria-required="true">
<i class="fa fa-calendar" aria-hidden="true"></i>
<div class="calendarContainer"><div class="picker" id="arrival_date_id_root" aria-hidden="true"><div class="picker__holder" tabindex="-1"><div class="picker__frame"><div class="picker__wrap"><div class="picker__box"><h5>Intended Date of Entry</h5><div class="picker__header"><select class="picker__select--month" aria-controls="arrival_date_id_table" title="Select a month" data-parsley-group="block-0"><option value="0" disabled="">January</option><option value="1" disabled="">February</option><option value="2" disabled="">March</option><option value="3" disabled="">April</option><option value="4" disabled="">May</option><option value="5" disabled="">June</option><option value="6" disabled="">July</option><option value="7" disabled="">August</option><option value="8" disabled="">September</option><option value="9" disabled="">October</option><option value="10" selected="">November</option><option value="11">December</option></select><select class="picker__select--year" aria-controls="arrival_date_id_table" title="Select a year" data-parsley-group="block-0"><option value="2024" selected="">2024</option><option value="2025">2025</option><option value="2026">2026</option></select><div class="picker__nav--prev picker__nav--disabled" data-nav="-1" role="button" aria-controls="arrival_date_id_table" title="Previous month"> </div><div class="picker__nav--next" data-nav="1" role="button" aria-controls="arrival_date_id_table" title="Next month"> </div></div><table class="picker__table" id="arrival_date_id_table" role="grid" aria-controls="arrival_date_id" aria-readonly="true"><thead><tr><th class="picker__weekday" scope="col" title="Monday">Mon</th><th class="picker__weekday" scope="col" title="Tuesday">Tue</th><th class="picker__weekday" scope="col" title="Wednesday">Wed</th><th class="picker__weekday" scope="col" title="Thursday">Thu</th><th class="picker__weekday" scope="col" title="Friday">Fri</th><th class="picker__weekday" scope="col" title="Saturday">Sat</th><th class="picker__weekday" scope="col" title="Sunday">Sun</th></tr></thead><tbody><tr><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730073600000" role="gridcell" aria-label="28 October, 2024" aria-disabled="true">28</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730160000000" role="gridcell" aria-label="29 October, 2024" aria-disabled="true">29</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730246400000" role="gridcell" aria-label="30 October, 2024" aria-disabled="true">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730332800000" role="gridcell" aria-label="31 October, 2024" aria-disabled="true">31</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730419200000" role="gridcell" aria-label="1 November, 2024" aria-disabled="true">1</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730505600000" role="gridcell" aria-label="2 November, 2024" aria-disabled="true">2</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730592000000" role="gridcell" aria-label="3 November, 2024" aria-disabled="true">3</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730678400000" role="gridcell" aria-label="4 November, 2024" aria-disabled="true">4</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730764800000" role="gridcell" aria-label="5 November, 2024" aria-disabled="true">5</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--today picker__day--highlighted" data-pick="1730851200000" role="gridcell" aria-label="6 November, 2024" aria-activedescendant="true">6</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730937600000" role="gridcell" aria-label="7 November, 2024">7</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731024000000" role="gridcell" aria-label="8 November, 2024">8</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731110400000" role="gridcell" aria-label="9 November, 2024">9</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731196800000" role="gridcell" aria-label="10 November, 2024">10</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731283200000" role="gridcell" aria-label="11 November, 2024">11</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731369600000" role="gridcell" aria-label="12 November, 2024">12</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731456000000" role="gridcell" aria-label="13 November, 2024">13</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731542400000" role="gridcell" aria-label="14 November, 2024">14</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731628800000" role="gridcell" aria-label="15 November, 2024">15</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731715200000" role="gridcell" aria-label="16 November, 2024">16</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731801600000" role="gridcell" aria-label="17 November, 2024">17</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731888000000" role="gridcell" aria-label="18 November, 2024">18</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731974400000" role="gridcell" aria-label="19 November, 2024">19</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732060800000" role="gridcell" aria-label="20 November, 2024">20</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732147200000" role="gridcell" aria-label="21 November, 2024">21</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732233600000" role="gridcell" aria-label="22 November, 2024">22</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732320000000" role="gridcell" aria-label="23 November, 2024">23</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732406400000" role="gridcell" aria-label="24 November, 2024">24</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732492800000" role="gridcell" aria-label="25 November, 2024">25</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732579200000" role="gridcell" aria-label="26 November, 2024">26</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732665600000" role="gridcell" aria-label="27 November, 2024">27</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732752000000" role="gridcell" aria-label="28 November, 2024">28</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732838400000" role="gridcell" aria-label="29 November, 2024">29</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732924800000" role="gridcell" aria-label="30 November, 2024">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733011200000" role="gridcell" aria-label="1 December, 2024">1</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733097600000" role="gridcell" aria-label="2 December, 2024">2</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733184000000" role="gridcell" aria-label="3 December, 2024">3</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733270400000" role="gridcell" aria-label="4 December, 2024">4</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733356800000" role="gridcell" aria-label="5 December, 2024">5</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733443200000" role="gridcell" aria-label="6 December, 2024">6</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733529600000" role="gridcell" aria-label="7 December, 2024">7</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733616000000" role="gridcell" aria-label="8 December, 2024">8</div></td></tr></tbody></table><div class="picker__footer"><button class="picker__button--today" type="button" data-pick="1730851200000" disabled="" aria-controls="arrival_date_id" data-parsley-group="block-0">Today</button><button class="picker__button--clear" type="button" data-clear="1" disabled="" aria-controls="arrival_date_id" data-parsley-group="block-0">Clear</button><button class="picker__button--close" type="button" data-close="true" disabled="" aria-controls="arrival_date_id" data-parsley-group="block-0">Close</button></div></div></div></div></div></div></div>
<div id="errorarrival_date" class="multi-error"></div>
</div>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
<i class="fa fa-info-circle" aria-hidden="true"></i> If Date of Entry is
Unknown, enter estimated date.
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please indicate an estimated date of entry to
Ethiopia. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field arrival_date "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<div class="row">
<div id="form-last_name" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="last_name">
Surname <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="last_name" name="family_name" required="required" class=" " maxlength="80" data-parsley-errors-container="#errorlast_name" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-0" aria-required="true">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
<i class="fa fa-info-circle" aria-hidden="true"></i> Enter your Surname
exactly as shown in your passport
</div>
<div class="m-help j-help hide">
<ul>
<li>
Surname is also known as Last name or Family name. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field last_name "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-first_name" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="first_name">
First/Given Names <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="first_name" name="first_name" class=" " maxlength="80" required="required" data-parsley-errors-container="#errorfirst_name" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-0" aria-required="true">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
<i class="fa fa-info-circle" aria-hidden="true"></i> Enter your First/Given
Name(s) exactly as shown in your passport
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please provide your first name(s) (also known as "given name")
exactly as shown on your passport or identity document. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field first_name "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-gender" class="col-xs-12 col-sm-6 j-form-container u-marg--b20">
<div class="col-sm-12">
<label>
Gender<span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-sm-12 m-form-radio">
<label class="radio-inline">
<input type="radio" id="radio-gender-male" class="radio-gender" name="gender" value="Male" data-parsley-multiple="gender-multiple" required="required" data-parsley-errors-container="#errorgender" data-required="true" checked="" data-parsley-group="block-0" aria-required="true">
Male
</label>
<label class="radio-inline">
<input type="radio" id="radio-gender-female" class="radio-gender" name="gender" value="Female" data-parsley-multiple="gender-multiple" required="required" data-parsley-errors-container="#errorgender" data-required="true" data-parsley-group="block-0" aria-required="true">
Female
</label>
<span class="u-alert-field gender "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
<div id="errorgender"></div>
<div class="m-help j-help hide">
</div>
<label class="error ">
<p>
</p>
</label>
</div>
</div>
<div id="form-date_of_birth" class="birthday j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="date_of_birth">
Date of Birth <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<div class="form-inline j-date-form container-datepicker">
<input id="date_of_birth_id" class="datepicker picker__input" name="" type="text" value="" data-value="" data-field-name="Date of Birth" data-min-year="1919" data-max-year="" required="required" data-parsley-errors-container="#errordate_of_birth" data-parsley-trigger="change" readonly="" aria-haspopup="true" aria-expanded="false" aria-readonly="false" aria-owns="date_of_birth_id_root" data-parsley-group="block-0" aria-required="true"><input type="hidden" class="j-form-hiden" value="" required="required" name="dob" id="dob" data-parsley-group="block-0" aria-required="true">
<i class="fa fa-calendar" aria-hidden="true"></i>
<div class="calendarContainer"><div class="picker" id="date_of_birth_id_root" aria-hidden="true"><div class="picker__holder" tabindex="-1"><div class="picker__frame"><div class="picker__wrap"><div class="picker__box"><h5>Date of Birth</h5><div class="picker__header"><select class="picker__select--month" aria-controls="date_of_birth_id_table" title="Select a month" data-parsley-group="block-0"><option value="0">January</option><option value="1">February</option><option value="2">March</option><option value="3">April</option><option value="4">May</option><option value="5">June</option><option value="6">July</option><option value="7">August</option><option value="8">September</option><option value="9">October</option><option value="10" selected="">November</option><option value="11" disabled="">December</option></select><select class="picker__select--year" aria-controls="date_of_birth_id_table" title="Select a year" data-parsley-group="block-0"><option value="1919">1919</option><option value="1920">1920</option><option value="1921">1921</option><option value="1922">1922</option><option value="1923">1923</option><option value="1924">1924</option><option value="1925">1925</option><option value="1926">1926</option><option value="1927">1927</option><option value="1928">1928</option><option value="1929">1929</option><option value="1930">1930</option><option value="1931">1931</option><option value="1932">1932</option><option value="1933">1933</option><option value="1934">1934</option><option value="1935">1935</option><option value="1936">1936</option><option value="1937">1937</option><option value="1938">1938</option><option value="1939">1939</option><option value="1940">1940</option><option value="1941">1941</option><option value="1942">1942</option><option value="1943">1943</option><option value="1944">1944</option><option value="1945">1945</option><option value="1946">1946</option><option value="1947">1947</option><option value="1948">1948</option><option value="1949">1949</option><option value="1950">1950</option><option value="1951">1951</option><option value="1952">1952</option><option value="1953">1953</option><option value="1954">1954</option><option value="1955">1955</option><option value="1956">1956</option><option value="1957">1957</option><option value="1958">1958</option><option value="1959">1959</option><option value="1960">1960</option><option value="1961">1961</option><option value="1962">1962</option><option value="1963">1963</option><option value="1964">1964</option><option value="1965">1965</option><option value="1966">1966</option><option value="1967">1967</option><option value="1968">1968</option><option value="1969">1969</option><option value="1970">1970</option><option value="1971">1971</option><option value="1972">1972</option><option value="1973">1973</option><option value="1974">1974</option><option value="1975">1975</option><option value="1976">1976</option><option value="1977">1977</option><option value="1978">1978</option><option value="1979">1979</option><option value="1980">1980</option><option value="1981">1981</option><option value="1982">1982</option><option value="1983">1983</option><option value="1984">1984</option><option value="1985">1985</option><option value="1986">1986</option><option value="1987">1987</option><option value="1988">1988</option><option value="1989">1989</option><option value="1990">1990</option><option value="1991">1991</option><option value="1992">1992</option><option value="1993">1993</option><option value="1994">1994</option><option value="1995">1995</option><option value="1996">1996</option><option value="1997">1997</option><option value="1998">1998</option><option value="1999">1999</option><option value="2000">2000</option><option value="2001">2001</option><option value="2002">2002</option><option value="2003">2003</option><option value="2004">2004</option><option value="2005">2005</option><option value="2006">2006</option><option value="2007">2007</option><option value="2008">2008</option><option value="2009">2009</option><option value="2010">2010</option><option value="2011">2011</option><option value="2012">2012</option><option value="2013">2013</option><option value="2014">2014</option><option value="2015">2015</option><option value="2016">2016</option><option value="2017">2017</option><option value="2018">2018</option><option value="2019">2019</option><option value="2020">2020</option><option value="2021">2021</option><option value="2022">2022</option><option value="2023">2023</option><option value="2024" selected="">2024</option></select><div class="picker__nav--prev" data-nav="-1" role="button" aria-controls="date_of_birth_id_table" title="Previous month"> </div><div class="picker__nav--next picker__nav--disabled" data-nav="1" role="button" aria-controls="date_of_birth_id_table" title="Next month"> </div></div><table class="picker__table" id="date_of_birth_id_table" role="grid" aria-controls="date_of_birth_id" aria-readonly="true"><thead><tr><th class="picker__weekday" scope="col" title="Monday">Mon</th><th class="picker__weekday" scope="col" title="Tuesday">Tue</th><th class="picker__weekday" scope="col" title="Wednesday">Wed</th><th class="picker__weekday" scope="col" title="Thursday">Thu</th><th class="picker__weekday" scope="col" title="Friday">Fri</th><th class="picker__weekday" scope="col" title="Saturday">Sat</th><th class="picker__weekday" scope="col" title="Sunday">Sun</th></tr></thead><tbody><tr><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730073600000" role="gridcell" aria-label="28 October, 2024">28</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730160000000" role="gridcell" aria-label="29 October, 2024">29</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730246400000" role="gridcell" aria-label="30 October, 2024">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730332800000" role="gridcell" aria-label="31 October, 2024">31</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730419200000" role="gridcell" aria-label="1 November, 2024">1</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730505600000" role="gridcell" aria-label="2 November, 2024">2</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730592000000" role="gridcell" aria-label="3 November, 2024">3</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730678400000" role="gridcell" aria-label="4 November, 2024">4</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730764800000" role="gridcell" aria-label="5 November, 2024">5</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--today picker__day--highlighted" data-pick="1730851200000" role="gridcell" aria-label="6 November, 2024" aria-activedescendant="true">6</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730937600000" role="gridcell" aria-label="7 November, 2024" aria-disabled="true">7</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731024000000" role="gridcell" aria-label="8 November, 2024" aria-disabled="true">8</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731110400000" role="gridcell" aria-label="9 November, 2024" aria-disabled="true">9</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731196800000" role="gridcell" aria-label="10 November, 2024" aria-disabled="true">10</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731283200000" role="gridcell" aria-label="11 November, 2024" aria-disabled="true">11</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731369600000" role="gridcell" aria-label="12 November, 2024" aria-disabled="true">12</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731456000000" role="gridcell" aria-label="13 November, 2024" aria-disabled="true">13</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731542400000" role="gridcell" aria-label="14 November, 2024" aria-disabled="true">14</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731628800000" role="gridcell" aria-label="15 November, 2024" aria-disabled="true">15</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731715200000" role="gridcell" aria-label="16 November, 2024" aria-disabled="true">16</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731801600000" role="gridcell" aria-label="17 November, 2024" aria-disabled="true">17</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731888000000" role="gridcell" aria-label="18 November, 2024" aria-disabled="true">18</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731974400000" role="gridcell" aria-label="19 November, 2024" aria-disabled="true">19</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732060800000" role="gridcell" aria-label="20 November, 2024" aria-disabled="true">20</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732147200000" role="gridcell" aria-label="21 November, 2024" aria-disabled="true">21</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732233600000" role="gridcell" aria-label="22 November, 2024" aria-disabled="true">22</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732320000000" role="gridcell" aria-label="23 November, 2024" aria-disabled="true">23</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732406400000" role="gridcell" aria-label="24 November, 2024" aria-disabled="true">24</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732492800000" role="gridcell" aria-label="25 November, 2024" aria-disabled="true">25</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732579200000" role="gridcell" aria-label="26 November, 2024" aria-disabled="true">26</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732665600000" role="gridcell" aria-label="27 November, 2024" aria-disabled="true">27</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732752000000" role="gridcell" aria-label="28 November, 2024" aria-disabled="true">28</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732838400000" role="gridcell" aria-label="29 November, 2024" aria-disabled="true">29</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732924800000" role="gridcell" aria-label="30 November, 2024" aria-disabled="true">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733011200000" role="gridcell" aria-label="1 December, 2024" aria-disabled="true">1</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733097600000" role="gridcell" aria-label="2 December, 2024" aria-disabled="true">2</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733184000000" role="gridcell" aria-label="3 December, 2024" aria-disabled="true">3</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733270400000" role="gridcell" aria-label="4 December, 2024" aria-disabled="true">4</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733356800000" role="gridcell" aria-label="5 December, 2024" aria-disabled="true">5</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733443200000" role="gridcell" aria-label="6 December, 2024" aria-disabled="true">6</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733529600000" role="gridcell" aria-label="7 December, 2024" aria-disabled="true">7</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733616000000" role="gridcell" aria-label="8 December, 2024" aria-disabled="true">8</div></td></tr></tbody></table><div class="picker__footer"><button class="picker__button--today" type="button" data-pick="1730851200000" disabled="" aria-controls="date_of_birth_id" data-parsley-group="block-0">Today</button><button class="picker__button--clear" type="button" data-clear="1" disabled="" aria-controls="date_of_birth_id" data-parsley-group="block-0">Clear</button><button class="picker__button--close" type="button" data-close="true" disabled="" aria-controls="date_of_birth_id" data-parsley-group="block-0">Close</button></div></div></div></div></div></div></div>
<div id="errordate_of_birth" class="multi-error"></div>
</div>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Select your date of birth, as it appears on your passport. </li>
<li>
If you do not know your exact date of birth, give as much
information as possible. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field date_of_birth "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<div class="row">
<div id="form-country_of_citizenship" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="country_of_citizenship">
Nationality/Country of Citizenship <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class="select-countries" name="country_citizenship" id="country_of_citizenship" autocomplete="off" required="required" data-parsley-trigger="change" data-parsley-group="block-0" tabindex="-1" aria-hidden="true" aria-required="true">
<option value="">[Nationality]</option>
<option>Afghanistan</option>
<option>Aland Islands</option>
<option>Albania</option>
<option>Algeria</option>
<option>American Samoa</option>
<option>Andorra</option>
<option>Angola</option>
<option>Anguilla</option>
<option>Antarctica</option>
<option>Antigua and Barbuda</option>
<option>Argentina</option>
<option>Armenia</option>
<option>Aruba</option>
<option>Australia</option>
<option>Austria</option>
<option>Azerbaijan</option>
<option>Bahamas</option>
<option>Bahrain</option>
<option>Bangladesh</option>
<option>Barbados</option>
<option>Belarus</option>
<option>Belgium</option>
<option>Belize</option>
<option>Benin</option>
<option>Bermuda</option>
<option>Bhutan</option>
<option>Bolivia</option>
<option>Bonaire</option>
<option>Bosnia and Herzegovina</option>
<option>Botswana</option>
<option>Brazil</option>
<option>British Indian Ocean Territory</option>
<option>British Virgin Islands</option>
<option>Brunei Darussalam</option>
<option>Bulgaria</option>
<option>Burkina Faso</option>
<option>Burundi</option>
<option>Canada</option>
<option>Cape Verde</option>
<option>Cayman Islands</option>
<option>Central African Republic</option>
<option>Chad</option>
<option>Chile</option>
<option>China</option>
<option>Christmas Island</option>
<option>Cocos Islands</option>
<option>Colombia</option>
<option>Comoros</option>
<option>Congo</option>
<option>Cook Islands</option>
<option>Costa Rica</option>
<option>Croatia</option>
<option>Cuba</option>
<option>Curacao</option>
<option>Czech Republic</option>
<option>Democratic Republic of the Congo</option>
<option>Denmark</option>
<option>Dominica</option>
<option>Dominican Republic</option>
<option>Ecuador</option>
<!--option>Egypt</option-->
<option>El Salvador</option>
<option>Equatorial Guinea</option>
<!--option>Eritrea</option-->
<option>Estonia</option>
<option>Falkland Islands</option>
<option>Faroe Islands</option>
<option>Federated States of Micronesia</option>
<option>Fiji</option>
<option>Finland</option>
<option>France</option>
<option>French Guiana</option>
<option>French Polynesia</option>
<option>Gabon</option>
<option>Gambia</option>
<option>Georgia</option>
<option>Germany</option>
<option>Ghana</option>
<option>Gibraltar</option>
<option>Greece</option>
<option>Greenland</option>
<option>Grenada</option>
<option>Guadeloupe</option>
<option>Guam</option>
<option>Guatemala</option>
<option>Guinea</option>
<option>Guinea-Bissau</option>
<option>Guyana</option>
<option>Haiti</option>
<option>Honduras</option>
<option>Hungary</option>
<option>Iceland</option>
<option>India</option>
<option>Indonesia</option>
<option>Iran</option>
<!--option>Iraq</option-->
<option>Ireland</option>
<option>Israel</option>
<option>Italy</option>
<option>Jamaica</option>
<option>Japan</option>
<option>Jersey</option>
<option>Jordan</option>
<option>Kazakhstan</option>
<option>Kiribati</option>
<option>Kuwait</option>
<option>Kyrgyzstan</option>
<option>Laos</option>
<option>Latvia</option>
<option>Lebanon</option>
<option>Lesotho</option>
<option>Liberia</option>
<option>Libya</option>
<option>Liechtenstein</option>
<option>Lithuania</option>
<option>Luxembourg</option>
<option>Macau</option>
<option>Macedonia</option>
<option>Madagascar</option>
<option>Malawi</option>
<option>Malaysia</option>
<option>Maldives</option>
<option>Mali</option>
<option>Malta</option>
<option>Marshall Islands</option>
<option>Martinique</option>
<option>Mauritania</option>
<option>Mauritius</option>
<option>Mayotte</option>
<option>Mexico</option>
<option>Moldova</option>
<option>Monaco</option>
<option>Mongolia</option>
<option>Montenegro</option>
<option>Montserrat</option>
<option>Morocco</option>
<option>Mozambique</option>
<option>Myanmar</option>
<option>Namibia</option>
<option>Nauru</option>
<option>Nepal</option>
<option>Netherlands</option>
<option>New Caledonia</option>
<option>New Zealand</option>
<option>Nicaragua</option>
<!--option>Niger</option-->
<!--option>Nigeria</option-->
<option>Niue</option>
<option>Norfolk Island</option>
<option>North Korea</option>
<option>Northern Mariana Islands</option>
<option>Norway</option>
<option>Oman</option>
<option>Pakistan</option>
<option>Palau</option>
<option>Palestinian Territory</option>
<option>Panama</option>
<option>Papua New Guinea</option>
<option>Paraguay</option>
<option>Peru</option>
<option>Philippines</option>
<option>Pitcairn Islands</option>
<option>Poland</option>
<option>Portugal</option>
<option>Puerto Rico</option>
<option>Qatar</option>
<option>Republic of Cyprus</option>
<option>Reunion</option>
<option>Romania</option>
<option>Russian Federation</option>
<option>Rwanda</option>
<option>Saint Barthelemy</option>
<option>Saint Helena</option>
<option>Saint Kitts and Nevis</option>
<option>Saint Lucia</option>
<option>Saint Pierre and Miquelon</option>
<option>Saint Vincent and the Grenadines</option>
<option>Samoa</option>
<option>San Marino</option>
<option>Sao Tome and Principe</option>
<option>Saudi Arabia</option>
<option>Senegal</option>
<option>Serbia</option>
<option>Seychelles</option>
<option>Sierra Leone</option>
<option>Singapore</option>
<option>Sint Maarten</option>
<option>Slovakia</option>
<option>Slovenia</option>
<option>Solomon Islands</option>
<option>Somalia</option>
<option>South Africa</option>
<option>South Georgia and the South Sandwich Islands</option>
<option>South Korea</option>
<option>South Sudan</option>
<option>Spain</option>
<option>Sri Lanka</option>
<option>Sudan</option>
<option>Suriname</option>
<option>Svalbard and Jan Mayen</option>
<option>Swaziland</option>
<option>Sweden</option>
<option>Switzerland</option>
<option>Tajikistan</option>
<option>Tanzania</option>
<option>Thailand</option>
<option>Timor-Leste</option>
<option>Togo</option>
<option>Tokelau</option>
<option>Tonga</option>
<option>Trinidad and Tobago</option>
<option>Tunisia</option>
<option>Turkey</option>
<option>Turkmenistan</option>
<option>Turks and Caicos Islands</option>
<option>Tuvalu</option>
<option>Uganda</option>
<option>Ukraine</option>
<option>United Arab Emirates</option>
<option>United Kingdom</option>
<option>United States</option>
<option>United States Virgin Islands</option>
<option>Uruguay</option>
<option>Uzbekistan</option>
<option>Vanuatu</option>
<option>Vatican City</option>
<option>Venezuela</option>
<option>Vietnam</option>
<option>Wallis and Futuna</option>
<!--option>Yemen</option-->
<option>Zambia</option>
<option>Zimbabwe</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please indicate the country of your citizenship, the country of the
passport you will use to travel. If you do not find your country in
this list, it means that your country is not eligible to apply for
an online visa. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-country_of_citizenship" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="country_of_citizenship">
Country of Birth <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class=" select-countries" name="country_birth" id="country_birth" autocomplete="off" required="required" data-parsley-trigger="change" data-parsley-group="block-0" aria-required="true">
<option selected="selected" value="">[Country of Birth]</option>
<option>Aaland Islands</option>
<option>Afghanistan</option>
<option>Albania</option>
<option>Algeria</option>
<option>American Samoa</option>
<option>Andorra</option>
<option>Angola</option>
<option>Anguilla</option>
<option>Antarctica</option>
<option>Antigua and Barbuda</option>
<option>Arab Saudi</option>
<option>Argentina</option>
<option>Armenia</option>
<option>Aruba</option>
<option>Ascension Island (British)</option>
<option>Australia</option>
<option>Austria</option>
<option>Azerbaijan</option>
<option>Bahamas</option>
<option>Bahrain</option>
<option>Bangladesh</option>
<option>Barbados</option>
<option>Belarus</option>
<option>Belgium</option>
<option>Belize</option>
<option>Benin</option>
<option>Bermuda</option>
<option>Bhutan</option>
<option>Bolivia</option>
<option>Bonaire Sint Eustatius and Saba</option>
<option>Bosnia and Herzegovina</option>
<option>Botswana</option>
<option>Brazil</option>
<option>British Indian Ocean Territory</option>
<option>Brunei Darussalam</option>
<option>Bulgaria</option>
<option>Burkina Faso</option>
<option>Burundi</option>
<option>Cambodia</option>
<option>Cameroon</option>
<option>Canada</option>
<option>Canary Islands</option>
<option>Cape Verde</option>
<option>Cayman Islands</option>
<option>Central African</option>
<option>Chad</option>
<option>Chile</option>
<option>China</option>
<option>Colombia</option>
<option>Comoros</option>
<option>Congo</option>
<option>Cook Islands</option>
<option>Costa Rica</option>
<option value="Cote DIvoire">Cote D'Ivoire</option>
<option>Croatia</option>
<option>Cuba</option>
<option>Curacao</option>
<option>Cyprus</option>
<option>Czech</option>
<option>Democratic Republic of the Congo</option>
<option>Denmark</option>
<option>Djibouti</option>
<option>Dominica</option>
<option>Dominican</option>
<option>East Timor</option>
<option>Ecuador</option>
<option>Egypt</option>
<option>El Salvador</option>
<option>England</option>
<option>Equatorial Guinea</option>
<option>Eritrea</option>
<option>Estonia</option>
<option>Ethiopia</option>
<option>Falkland Islands (Malvinas)</option>
<option>Faroe Islands</option>
<option>Fiji</option>
<option>Finland</option>
<option>France</option>
<option>FYROM</option>
<option>Gabon</option>
<option>Gambia</option>
<option>Georgia</option>
<option>Germany</option>
<option>Ghana</option>
<option>Gibraltar</option>
<option>Greece</option>
<option>Greenland</option>
<option>Grenada</option>
<option>Guadeloupe</option>
<option>Guam</option>
<option>Guatemala</option>
<option>Guernsey</option>
<option>Guinea</option>
<option>Guinea-Bissau</option>
<option>Guyana</option>
<option>Haiti</option>
<option>Honduras</option>
<option>Hong Kong (China)</option>
<option>Hungary</option>
<option>Iceland</option>
<option>India</option>
<option>Indonesia</option>
<option>Iran</option>
<option>Iraq</option>
<option>Ireland</option>
<option>Isle of Man</option>
<option>Israel</option>
<option>Italy</option>
<option>Jamaica</option>
<option>Japan</option>
<option>Jersey</option>
<option>Jordan</option>
<option>Kazakhstan</option>
<option>Kenya</option>
<option>Kiribati</option>
<option>Kuwait</option>
<option>Kyrgyzstan</option>
<option>Lao People s Democratic Kingdom</option>
<option>Latvia</option>
<option>Lebanon</option>
<option>Lesotho</option>
<option>Liberia</option>
<option>Libyan Arab Jamahiriya</option>
<option>Liechtenstein</option>
<option>Lithuania</option>
<option>Luxembourg</option>
<option>Macau (China)</option>
<option>Macedonia</option>
<option>Madagascar</option>
<option>Malawi</option>
<option>Malaysia</option>
<option>Maldives</option>
<option>Mali</option>
<option>Malta</option>
<option>Marshall Islands</option>
<option>Martinique</option>
<option>Mauritania</option>
<option>Mauritius</option>
<option>Mayotte</option>
<option>Mexico</option>
<option>Micronesia</option>
<option>Moldova</option>
<option>Monaco</option>
<option>Mongolia</option>
<option>Montenegro</option>
<option>Montserrat</option>
<option>Morocco</option>
<option>Mozambique</option>
<option>Myanmar</option>
<option>Namibia</option>
<option>Nauru</option>
<option>Nepal</option>
<option>Netherlands</option>
<option>Netherlands Antilles</option>
<option>New Caledonia</option>
<option>New Zealand</option>
<option>Nicaragua</option>
<option>Niger</option>
<option>Nigeria</option>
<option>Niue</option>
<option>Norfolk Island</option>
<option>North Korea</option>
<option>Northern Mariana Islands</option>
<option>Norway</option>
<option>Oman</option>
<option>Pakistan</option>
<option>Palau</option>
<option>Palestine</option>
<option>Panama</option>
<option>Papua New Guinea</option>
<option>Paraguay</option>
<option>Peru</option>
<option>Philippines</option>
<option>Pitcairn</option>
<option>Poland</option>
<option>Portugal</option>
<option>Puerto Rico</option>
<option>Qatar</option>
<option>Reunion</option>
<option>Romania</option>
<option>Russian Federation</option>
<option>Rwanda</option>
<option>Saint Kitts and Nevis</option>
<option>Saint Lucia</option>
<option>Saint Vincent and the Grenadines</option>
<option>Samoa</option>
<option>San Marino</option>
<option>Sao Tome and Principe</option>
<option>Saudi Arabia</option>
<option>Scotland</option>
<option>Senegal</option>
<option>Serbia</option>
<option>Seychelles</option>
<option>Sierra Leone</option>
<option>Singapore</option>
<option>Slovakia</option>
<option>Slovenia</option>
<option>Solomon Islands</option>
<option>Somalia</option>
<option>South Africa</option>
<option>South Georgia & South Sandwich Islands</option>
<option>South Korea</option>
<option>South Sudan</option>
<option>Spain</option>
<option>Sri Lanka</option>
<option>St. Barthelemy</option>
<option>St. Helena</option>
<option>St. Martin (French part)</option>
<option>St. Pierre and Miquelon</option>
<option>Sudan</option>
<option>Suriname</option>
<option>Svalbard and Jan Mayen Islands</option>
<option>Swaziland</option>
<option>Sweden</option>
<option>Switzerland</option>
<option>Syrian Arab Kingdom</option>
<option>Taiwan (China)</option>
<option>Tajikistan</option>
<option>Tanzania</option>
<option>Thailand</option>
<option>Togo</option>
<option>Tokelau</option>
<option>Tonga</option>
<option>Trinidad and Tobago</option>
<option>Tristan da Cunha</option>
<option>Tunisia</option>
<option>Cambodia</option>
<option>Turkey</option>
<option>Turkmenistan</option>
<option>Turks and Caicos Islands</option>
<option>Tuvalu</option>
<option>Uganda</option>
<option>Ukraine</option>
<option>United Arab Emirates</option>
<option>United Kingdom</option>
<option>United States</option>
<option>United States Minor Outlying Islands</option>
<option>Uruguay</option>
<option>Uzbekistan</option>
<option>Vanuatu</option>
<option>Vatican City State (Holy See)</option>
<option>Venezuela</option>
<option>VietNam</option>
<option>Virgin Islands (British)</option>
<option>Virgin Islands (U.S.)</option>
<option>Wales</option>
<option>Wallis and Futuna Islands</option>
<option>Western Sahara</option>
<option>Yemen</option>
<option>Zambia</option>
<option>Zimbabwe</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Select the Country where you born.
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<div class="row">
<div id="form-marital_status" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="marital_status">
Martial Status <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class="country_citizenship" name="marital_status" id="marital_status" autocomplete="off" required="required" data-parsley-trigger="change" data-parsley-group="block-0" aria-required="true">
<option value="">Select</option>
<option value="Single">Single</option>
<option value="Married">Married</option>
<option value="Widower">Widower</option>
<option value="Divorce">Divorce</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" style="color:white" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-occupationofuser" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="occupationofuser">
Occupation <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="occupationofuser" name="occupationofuser" class="" maxlength="80" required="required" data-parsley-errors-container="#erroroccupationofuser" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-0" aria-required="true">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
<i class="fa fa-info-circle" aria-hidden="true"></i> Enter your Occupation
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please provide your occupation. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field occupationofuser "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<div class="actions next">
<a class="btnNext btn m-button-primary" id="btnNext0" href="#next0">
Next </a>
</div>
</div>
</section>
<section class="m-form-application-category-container">
<div class="m-form-application-title">
<h2 style="color:#fff;" class="s2-m-txt--duotone s1-m-title--t3">
Travel And Passport Information </h2>
</div>
<div class="m-form-application-inputs-container">
<p class="m-form-application-inputs-container-titledescription">
Provide details of the passport that you will use to enter
Ethiopia. Enter these details exactly as they appear in your passport. </p>
<div class="row">
<div id="form-passport_country" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="passport_country">
Country of Passport <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class=" select-countries" name="passport_country" id="passport_country" autocomplete="off" data-parsley-trigger="change" data-parsley-group="block-1" disabled="disabled">
<option value=""> [Country of Passport]</option>
<option>Afghanistan</option>
<option>Aland Islands</option>
<option>Albania</option>
<option>Algeria</option>
<option>American Samoa</option>
<option>Andorra</option>
<option>Angola</option>
<option>Anguilla</option>
<option>Antarctica</option>
<option>Antigua and Barbuda</option>
<option>Argentina</option>
<option>Armenia</option>
<option>Aruba</option>
<option>Australia</option>
<option>Austria</option>
<option>Azerbaijan</option>
<option>Bahamas</option>
<option>Bahrain</option>
<option>Bangladesh</option>
<option>Barbados</option>
<option>Belarus</option>
<option>Belgium</option>
<option>Belize</option>
<option>Benin</option>
<option>Bermuda</option>
<option>Bhutan</option>
<option>Bolivia</option>
<option>Bonaire</option>
<option>Bosnia and Herzegovina</option>
<option>Botswana</option>
<option>Brazil</option>
<option>British Indian Ocean Territory</option>
<option>British Virgin Islands</option>
<option>Brunei Darussalam</option>
<option>Bulgaria</option>
<option>Burkina Faso</option>
<option>Burundi</option>
<option>Canada</option>
<option>Cape Verde</option>
<option>Cayman Islands</option>
<option>Central African Republic</option>
<option>Chad</option>
<option>Chile</option>
<option>China</option>
<option>Christmas Island</option>
<option>Cocos Islands</option>
<option>Colombia</option>
<option>Comoros</option>
<option>Congo</option>
<option>Cook Islands</option>
<option>Costa Rica</option>
<option>Croatia</option>
<option>Cuba</option>
<option>Curacao</option>
<option>Czech Republic</option>
<option>Democratic Republic of the Congo</option>
<option>Denmark</option>
<option>Dominica</option>
<option>Dominican Republic</option>
<option>Ecuador</option>
<option>Egypt</option>
<option>Ethiopia</option>
<option>El Salvador</option>
<option>Equatorial Guinea</option>
<option>Eritrea</option>
<option>Estonia</option>
<option>Falkland Islands</option>
<option>Faroe Islands</option>
<option>Federated States of Micronesia</option>
<option>Fiji</option>
<option>Finland</option>
<option>France</option>
<option>French Guiana</option>
<option>French Polynesia</option>
<option>Gabon</option>
<option>Gambia</option>
<option>Georgia</option>
<option>Germany</option>
<option>Ghana</option>
<option>Gibraltar</option>
<option>Greece</option>
<option>Greenland</option>
<option>Grenada</option>
<option>Guadeloupe</option>
<option>Guam</option>
<option>Guatemala</option>
<option>Guinea</option>
<option>Guinea-Bissau</option>
<option>Guyana</option>
<option>Haiti</option>
<option>Honduras</option>
<option>Hungary</option>
<option>Iceland</option>
<option>India</option>
<option>Indonesia</option>
<option>Iran</option>
<option>Iraq</option>
<option>Ireland</option>
<option>Israel</option>
<option>Italy</option>
<option>Jamaica</option>
<option>Japan</option>
<option>Jersey</option>
<option>Jordan</option>
<option>Kazakhstan</option>
<option>Kiribati</option>
<option>Kuwait</option>
<option>Kyrgyzstan</option>
<option>Laos</option>
<option>Latvia</option>
<option>Lebanon</option>
<option>Lesotho</option>
<option>Liberia</option>
<option>Libya</option>
<option>Liechtenstein</option>
<option>Lithuania</option>
<option>Luxembourg</option>
<option>Macau</option>
<option>Macedonia</option>
<option>Madagascar</option>
<option>Malawi</option>
<option>Malaysia</option>
<option>Maldives</option>
<option>Mali</option>
<option>Malta</option>
<option>Marshall Islands</option>
<option>Martinique</option>
<option>Mauritania</option>
<option>Mauritius</option>
<option>Mayotte</option>
<option>Mexico</option>
<option>Moldova</option>
<option>Monaco</option>
<option>Mongolia</option>
<option>Montenegro</option>
<option>Montserrat</option>
<option>Morocco</option>
<option>Mozambique</option>
<option>Myanmar</option>
<option>Namibia</option>
<option>Nauru</option>
<option>Nepal</option>
<option>Netherlands</option>
<option>New Caledonia</option>
<option>New Zealand</option>
<option>Nicaragua</option>
<option>Niger</option>
<option>Nigeria</option>
<option>Niue</option>
<option>Norfolk Island</option>
<option>North Korea</option>
<option>Northern Mariana Islands</option>
<option>Norway</option>
<option>Oman</option>
<option>Pakistan</option>
<option>Palau</option>
<option>Palestinian Territory</option>
<option>Panama</option>
<option>Papua New Guinea</option>
<option>Paraguay</option>
<option>Peru</option>
<option>Philippines</option>
<option>Pitcairn Islands</option>
<option>Poland</option>
<option>Portugal</option>
<option>Puerto Rico</option>
<option>Qatar</option>
<option>Republic of Cyprus</option>
<option>Reunion</option>
<option>Romania</option>
<option>Russian Federation</option>
<option>Rwanda</option>
<option>Saint Barthelemy</option>
<option>Saint Helena</option>
<option>Saint Kitts and Nevis</option>
<option>Saint Lucia</option>
<option>Saint Pierre and Miquelon</option>
<option>Saint Vincent and the Grenadines</option>
<option>Samoa</option>
<option>San Marino</option>
<option>Sao Tome and Principe</option>
<option>Saudi Arabia</option>
<option>Senegal</option>
<option>Serbia</option>
<option>Seychelles</option>
<option>Sierra Leone</option>
<option>Singapore</option>
<option>Sint Maarten</option>
<option>Slovakia</option>
<option>Slovenia</option>
<option>Solomon Islands</option>
<option>Somalia</option>
<option>South Africa</option>
<option>South Georgia and the South Sandwich Islands</option>
<option>South Korea</option>
<option>South Sudan</option>
<option>Spain</option>
<option>Sri Lanka</option>
<option>Sudan</option>
<option>Suriname</option>
<option>Svalbard and Jan Mayen</option>
<option>Swaziland</option>
<option>Sweden</option>
<option>Switzerland</option>
<option>Tajikistan</option>
<option>Tanzania</option>
<option>Thailand</option>
<option>Timor-Leste</option>
<option>Togo</option>
<option>Tokelau</option>
<option>Tonga</option>
<option>Trinidad and Tobago</option>
<option>Tunisia</option>
<option>Turkey</option>
<option>Turkmenistan</option>
<option>Turks and Caicos Islands</option>
<option>Tuvalu</option>
<option>Uganda</option>
<option>Ukraine</option>
<option>United Arab Emirates</option>
<option>United Kingdom</option>
<option>United States</option>
<option>United States Virgin Islands</option>
<option>Uruguay</option>
<option>Uzbekistan</option>
<option>Vanuatu</option>
<option>Vatican City</option>
<option>Venezuela</option>
<option>Vietnam</option>
<option>Wallis and Futuna</option>
<option>Yemen</option>
<option>Zambia</option>
<option>Zimbabwe</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please indicate the country of your citizenship, the country of the
passport you will use to travel. If you do not find your country in
this list, it means that your country is not eligible to apply for
an online visa. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field passport_country "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-passport_number" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="passport_number">
Passport Number <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="passport_number" name="passport_number" class=" " maxlength="50" required="required" data-parsley-errors-container="#errorpassport_number" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-1" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter the passport number exactly as it appears on the biographic
information page. Pay particular attention to the letter O and the
number 0; and the letter I and the number 1. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field passport_number "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-passport_issue" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="passport_issue">
Passport Date of Issue <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<div class="form-inline j-date-form container-datepicker">
<input id="passport_issue_id" class="datepicker picker__input" name="" type="text" value="" data-value="" data-field-name="Passport Date of Issue" data-min-year="1999" data-max-year="" required="required" data-parsley-errors-container="#errorpassport_issue" data-parsley-trigger="change" readonly="" aria-haspopup="true" aria-expanded="false" aria-readonly="false" aria-owns="passport_issue_id_root" data-parsley-group="block-1" aria-required="true" disabled="disabled"><input type="hidden" class="j-form-hiden" value="" required="required" name="pissuedate" id="pissuedate" data-parsley-group="block-1" aria-required="true" disabled="disabled">
<i class="fa fa-calendar" aria-hidden="true"></i>
<div class="calendarContainer"><div class="picker" id="passport_issue_id_root" aria-hidden="true"><div class="picker__holder" tabindex="-1"><div class="picker__frame"><div class="picker__wrap"><div class="picker__box"><h5>Passport Date of Issue</h5><div class="picker__header"><select class="picker__select--month" disabled="disabled" aria-controls="passport_issue_id_table" title="Select a month" data-parsley-group="block-1"><option value="0">January</option><option value="1">February</option><option value="2">March</option><option value="3">April</option><option value="4">May</option><option value="5">June</option><option value="6">July</option><option value="7">August</option><option value="8">September</option><option value="9">October</option><option value="10" selected="">November</option><option value="11" disabled="">December</option></select><select class="picker__select--year" disabled="disabled" aria-controls="passport_issue_id_table" title="Select a year" data-parsley-group="block-1"><option value="1999">1999</option><option value="2000">2000</option><option value="2001">2001</option><option value="2002">2002</option><option value="2003">2003</option><option value="2004">2004</option><option value="2005">2005</option><option value="2006">2006</option><option value="2007">2007</option><option value="2008">2008</option><option value="2009">2009</option><option value="2010">2010</option><option value="2011">2011</option><option value="2012">2012</option><option value="2013">2013</option><option value="2014">2014</option><option value="2015">2015</option><option value="2016">2016</option><option value="2017">2017</option><option value="2018">2018</option><option value="2019">2019</option><option value="2020">2020</option><option value="2021">2021</option><option value="2022">2022</option><option value="2023">2023</option><option value="2024" selected="">2024</option></select><div class="picker__nav--prev" data-nav="-1" role="button" aria-controls="passport_issue_id_table" title="Previous month"> </div><div class="picker__nav--next picker__nav--disabled" data-nav="1" role="button" aria-controls="passport_issue_id_table" title="Next month"> </div></div><table class="picker__table" id="passport_issue_id_table" role="grid" aria-controls="passport_issue_id" aria-readonly="true"><thead><tr><th class="picker__weekday" scope="col" title="Monday">Mon</th><th class="picker__weekday" scope="col" title="Tuesday">Tue</th><th class="picker__weekday" scope="col" title="Wednesday">Wed</th><th class="picker__weekday" scope="col" title="Thursday">Thu</th><th class="picker__weekday" scope="col" title="Friday">Fri</th><th class="picker__weekday" scope="col" title="Saturday">Sat</th><th class="picker__weekday" scope="col" title="Sunday">Sun</th></tr></thead><tbody><tr><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730073600000" role="gridcell" aria-label="28 October, 2024">28</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730160000000" role="gridcell" aria-label="29 October, 2024">29</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730246400000" role="gridcell" aria-label="30 October, 2024">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1730332800000" role="gridcell" aria-label="31 October, 2024">31</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730419200000" role="gridcell" aria-label="1 November, 2024">1</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730505600000" role="gridcell" aria-label="2 November, 2024">2</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730592000000" role="gridcell" aria-label="3 November, 2024">3</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730678400000" role="gridcell" aria-label="4 November, 2024">4</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730764800000" role="gridcell" aria-label="5 November, 2024">5</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--today picker__day--highlighted" data-pick="1730851200000" role="gridcell" aria-label="6 November, 2024" aria-activedescendant="true">6</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730937600000" role="gridcell" aria-label="7 November, 2024" aria-disabled="true">7</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731024000000" role="gridcell" aria-label="8 November, 2024" aria-disabled="true">8</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731110400000" role="gridcell" aria-label="9 November, 2024" aria-disabled="true">9</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731196800000" role="gridcell" aria-label="10 November, 2024" aria-disabled="true">10</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731283200000" role="gridcell" aria-label="11 November, 2024" aria-disabled="true">11</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731369600000" role="gridcell" aria-label="12 November, 2024" aria-disabled="true">12</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731456000000" role="gridcell" aria-label="13 November, 2024" aria-disabled="true">13</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731542400000" role="gridcell" aria-label="14 November, 2024" aria-disabled="true">14</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731628800000" role="gridcell" aria-label="15 November, 2024" aria-disabled="true">15</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731715200000" role="gridcell" aria-label="16 November, 2024" aria-disabled="true">16</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731801600000" role="gridcell" aria-label="17 November, 2024" aria-disabled="true">17</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731888000000" role="gridcell" aria-label="18 November, 2024" aria-disabled="true">18</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1731974400000" role="gridcell" aria-label="19 November, 2024" aria-disabled="true">19</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732060800000" role="gridcell" aria-label="20 November, 2024" aria-disabled="true">20</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732147200000" role="gridcell" aria-label="21 November, 2024" aria-disabled="true">21</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732233600000" role="gridcell" aria-label="22 November, 2024" aria-disabled="true">22</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732320000000" role="gridcell" aria-label="23 November, 2024" aria-disabled="true">23</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732406400000" role="gridcell" aria-label="24 November, 2024" aria-disabled="true">24</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732492800000" role="gridcell" aria-label="25 November, 2024" aria-disabled="true">25</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732579200000" role="gridcell" aria-label="26 November, 2024" aria-disabled="true">26</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732665600000" role="gridcell" aria-label="27 November, 2024" aria-disabled="true">27</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732752000000" role="gridcell" aria-label="28 November, 2024" aria-disabled="true">28</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732838400000" role="gridcell" aria-label="29 November, 2024" aria-disabled="true">29</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1732924800000" role="gridcell" aria-label="30 November, 2024" aria-disabled="true">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733011200000" role="gridcell" aria-label="1 December, 2024" aria-disabled="true">1</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733097600000" role="gridcell" aria-label="2 December, 2024" aria-disabled="true">2</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733184000000" role="gridcell" aria-label="3 December, 2024" aria-disabled="true">3</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733270400000" role="gridcell" aria-label="4 December, 2024" aria-disabled="true">4</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733356800000" role="gridcell" aria-label="5 December, 2024" aria-disabled="true">5</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733443200000" role="gridcell" aria-label="6 December, 2024" aria-disabled="true">6</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733529600000" role="gridcell" aria-label="7 December, 2024" aria-disabled="true">7</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1733616000000" role="gridcell" aria-label="8 December, 2024" aria-disabled="true">8</div></td></tr></tbody></table><div class="picker__footer"><button class="picker__button--today" type="button" data-pick="1730851200000" disabled="" aria-controls="passport_issue_id" data-parsley-group="block-1">Today</button><button class="picker__button--clear" type="button" data-clear="1" disabled="" aria-controls="passport_issue_id" data-parsley-group="block-1">Clear</button><button class="picker__button--close" type="button" data-close="true" disabled="" aria-controls="passport_issue_id" data-parsley-group="block-1">Close</button></div></div></div></div></div></div></div>
<div id="errorpassport_issue" class="multi-error"></div>
</div>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Issue date can be found on your passport or travel document. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field passport_issue "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-passport_expiry" class="js-passportExpire j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="passport_expiry">
Passport Expiry Date <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<div class="form-inline j-date-form container-datepicker">
<input id="passport_expiry_id" class="datepicker picker__input" name="" type="text" value="" data-value="" data-field-name="Passport Expiry Date" data-min-year="" data-max-year="2041" required="required" data-parsley-errors-container="#errorpassport_expiry" data-parsley-trigger="change" readonly="" aria-haspopup="true" aria-expanded="false" aria-readonly="false" aria-owns="passport_expiry_id_root" data-parsley-group="block-1" aria-required="true" disabled="disabled"><input type="hidden" class="j-form-hiden" value="" required="required" name="pexpirydate" id="pexpirydate" data-parsley-group="block-1" aria-required="true" disabled="disabled">
<i class="fa fa-calendar" aria-hidden="true"></i>
<div class="calendarContainer"><div class="picker" id="passport_expiry_id_root" aria-hidden="true"><div class="picker__holder" tabindex="-1"><div class="picker__frame"><div class="picker__wrap"><div class="picker__box"><h5>Passport Expiry Date</h5><div class="picker__header"><select class="picker__select--month" disabled="disabled" aria-controls="passport_expiry_id_table" title="Select a month" data-parsley-group="block-1"><option value="0" disabled="">January</option><option value="1" disabled="">February</option><option value="2" disabled="">March</option><option value="3" disabled="">April</option><option value="4" disabled="">May</option><option value="5" disabled="">June</option><option value="6" disabled="">July</option><option value="7" disabled="">August</option><option value="8" disabled="">September</option><option value="9" disabled="">October</option><option value="10" selected="">November</option><option value="11">December</option></select><select class="picker__select--year" disabled="disabled" aria-controls="passport_expiry_id_table" title="Select a year" data-parsley-group="block-1"><option value="2024" selected="">2024</option><option value="2025">2025</option><option value="2026">2026</option><option value="2027">2027</option><option value="2028">2028</option><option value="2029">2029</option><option value="2030">2030</option><option value="2031">2031</option><option value="2032">2032</option><option value="2033">2033</option><option value="2034">2034</option><option value="2035">2035</option><option value="2036">2036</option><option value="2037">2037</option><option value="2038">2038</option><option value="2039">2039</option><option value="2040">2040</option><option value="2041">2041</option></select><div class="picker__nav--prev picker__nav--disabled" data-nav="-1" role="button" aria-controls="passport_expiry_id_table" title="Previous month"> </div><div class="picker__nav--next" data-nav="1" role="button" aria-controls="passport_expiry_id_table" title="Next month"> </div></div><table class="picker__table" id="passport_expiry_id_table" role="grid" aria-controls="passport_expiry_id" aria-readonly="true"><thead><tr><th class="picker__weekday" scope="col" title="Monday">Mon</th><th class="picker__weekday" scope="col" title="Tuesday">Tue</th><th class="picker__weekday" scope="col" title="Wednesday">Wed</th><th class="picker__weekday" scope="col" title="Thursday">Thu</th><th class="picker__weekday" scope="col" title="Friday">Fri</th><th class="picker__weekday" scope="col" title="Saturday">Sat</th><th class="picker__weekday" scope="col" title="Sunday">Sun</th></tr></thead><tbody><tr><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730073600000" role="gridcell" aria-label="28 October, 2024" aria-disabled="true">28</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730160000000" role="gridcell" aria-label="29 October, 2024" aria-disabled="true">29</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730246400000" role="gridcell" aria-label="30 October, 2024" aria-disabled="true">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus picker__day--disabled" data-pick="1730332800000" role="gridcell" aria-label="31 October, 2024" aria-disabled="true">31</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730419200000" role="gridcell" aria-label="1 November, 2024" aria-disabled="true">1</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730505600000" role="gridcell" aria-label="2 November, 2024" aria-disabled="true">2</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730592000000" role="gridcell" aria-label="3 November, 2024" aria-disabled="true">3</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730678400000" role="gridcell" aria-label="4 November, 2024" aria-disabled="true">4</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--disabled" data-pick="1730764800000" role="gridcell" aria-label="5 November, 2024" aria-disabled="true">5</div></td><td role="presentation"><div class="picker__day picker__day--infocus picker__day--today picker__day--highlighted" data-pick="1730851200000" role="gridcell" aria-label="6 November, 2024" aria-activedescendant="true">6</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1730937600000" role="gridcell" aria-label="7 November, 2024">7</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731024000000" role="gridcell" aria-label="8 November, 2024">8</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731110400000" role="gridcell" aria-label="9 November, 2024">9</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731196800000" role="gridcell" aria-label="10 November, 2024">10</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731283200000" role="gridcell" aria-label="11 November, 2024">11</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731369600000" role="gridcell" aria-label="12 November, 2024">12</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731456000000" role="gridcell" aria-label="13 November, 2024">13</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731542400000" role="gridcell" aria-label="14 November, 2024">14</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731628800000" role="gridcell" aria-label="15 November, 2024">15</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731715200000" role="gridcell" aria-label="16 November, 2024">16</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731801600000" role="gridcell" aria-label="17 November, 2024">17</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731888000000" role="gridcell" aria-label="18 November, 2024">18</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1731974400000" role="gridcell" aria-label="19 November, 2024">19</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732060800000" role="gridcell" aria-label="20 November, 2024">20</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732147200000" role="gridcell" aria-label="21 November, 2024">21</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732233600000" role="gridcell" aria-label="22 November, 2024">22</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732320000000" role="gridcell" aria-label="23 November, 2024">23</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732406400000" role="gridcell" aria-label="24 November, 2024">24</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732492800000" role="gridcell" aria-label="25 November, 2024">25</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732579200000" role="gridcell" aria-label="26 November, 2024">26</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732665600000" role="gridcell" aria-label="27 November, 2024">27</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732752000000" role="gridcell" aria-label="28 November, 2024">28</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732838400000" role="gridcell" aria-label="29 November, 2024">29</div></td><td role="presentation"><div class="picker__day picker__day--infocus" data-pick="1732924800000" role="gridcell" aria-label="30 November, 2024">30</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733011200000" role="gridcell" aria-label="1 December, 2024">1</div></td></tr><tr><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733097600000" role="gridcell" aria-label="2 December, 2024">2</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733184000000" role="gridcell" aria-label="3 December, 2024">3</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733270400000" role="gridcell" aria-label="4 December, 2024">4</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733356800000" role="gridcell" aria-label="5 December, 2024">5</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733443200000" role="gridcell" aria-label="6 December, 2024">6</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733529600000" role="gridcell" aria-label="7 December, 2024">7</div></td><td role="presentation"><div class="picker__day picker__day--outfocus" data-pick="1733616000000" role="gridcell" aria-label="8 December, 2024">8</div></td></tr></tbody></table><div class="picker__footer"><button class="picker__button--today" type="button" data-pick="1730851200000" disabled="" aria-controls="passport_expiry_id" data-parsley-group="block-1">Today</button><button class="picker__button--clear" type="button" data-clear="1" disabled="" aria-controls="passport_expiry_id" data-parsley-group="block-1">Clear</button><button class="picker__button--close" type="button" data-close="true" disabled="" aria-controls="passport_expiry_id" data-parsley-group="block-1">Close</button></div></div></div></div></div></div></div>
<div id="errorpassport_expiry" class="multi-error"></div>
</div>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Expiry date can be found on your passport or travel document. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field passport_expiry "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<!--div id="form-country_of_citizenship" class=" j-form-container col-xs-12 col-sm-6"-->
<div id="form-departurecity" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="country_of_citizenship">
Visa Type <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class="select-countries" name="visa_type" id="visa_type" autocomplete="off" required="required" onchange="visatype(this)" data-parsley-group="block-1" aria-required="true" disabled="disabled">
<option value="">
Select </option>
<option value="Tourist Visa Single Entry - 30 Days">Tourist Visa Single Entry - 30 Days</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please select the visa type for your trip to
Ethiopia.
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<!--div id="form.purpose_of_visit" class=" j-form-container col-xs-12 col-sm-6"-->
<div id="form-" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="country_of_citizenship">
Purpose of Visit <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class="select-countries" name="purpose_of_visit" id="purpose_of_visit" autocomplete="off" required="required" data-parsley-trigger="change" data-parsley-group="block-1" aria-required="true" disabled="disabled">
<option value="">
Select </option>
<!--?php include_once('../includes/purpose-of-visit.php'); ?-->
<!---------------------check visa.js file for purpose of visit------------------>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please select the purpose of your trip to Ethiopia.
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<!-------------------------start visa purpose ----------------------------------------------------->
<div id="form-intend_stay" style="display:none" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="intend_stay">
Intended stay in days <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class="select-countries" name="intend_stay" id="intend_stay" autocomplete="off" data-parsley-trigger="change" data-parsley-group="block-1" disabled="disabled">
<option value="">
Select </option>
<option value="1 days">1 days
</option>
<option value="2 days">2 days
</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please specify the number of days intended to stay
in Ethiopia.
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<!-------------purpose of visit ----------------->
<div id="form-purpose_description" style="display:none" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="intend_stay">
Purpose Description </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="purpose_description" name="purpose_description" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please specify the purpose of Business visit.
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field country_of_citizenship "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<!--------------purpose of visit -------------------->
</div>
<div class="row">
<div id="form-final_destionation" style="display:none" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Final Destination <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="final_destionation" name="final_destionation" class="" data-parsley-errors-container="#final_destionation" data-parsley-trigger="change" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please specify the endpoint you are reaching at. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<!-----------------------------end visa purpose ------------------------------------------------->
<!----------------------------- Business required field ------------------------------------------------->
<div id="business_required" style="display:none">
<div class="m-form-application-title">
<h2 style="color:#fff;">
Contact Details of the Applicant's Company </h2>
</div>
<br>
<div class="row">
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Company Name <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="acompany_name" name="acompany_name" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company name. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="aaddress" name="aaddress" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
City <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="acity " name="acity" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address city. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
State <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="astate " name="astate" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address State. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Country <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="acountry " name="acountry" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address Country. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Zip/Postal Code <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="azipcode " name="azipcode" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address Zip/Postal Code. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Contact Number <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="aphone " name="aphone" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Contact Number. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Email Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="aemail" name="aemail" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Email Address . </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<!--------------------------------------------------------------------------------------------------------->
<div class="m-form-application-title">
<h2 style="color:#fff;">
Contact Details of the company in Ethiopia. </h2>
</div>
<br>
<div class="row">
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Company Name <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="scompany_name" name="scompany_name" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company name. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="saddress" name="saddress" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
City <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="scity " name="scity" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address city. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
State <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="sstate " name="sstate" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address State. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Zip/Postal Code <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="szipcode " name="szipcode" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Address Zip/Postal Code. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Contact Number <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="sphone " name="sphone" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Contact Number. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-business_required" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
Email Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="semail" name="semail" class="" data-parsley-group="block-1" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Please enter your company Email Address . </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is
required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
</div>
<!----------------------------- Business required field ------------------------------------------------->
<div class="actions next">
<a class="btnNext btn m-button-primary" id="btnNext2" href="#next2">
Next </a>
</div>
</div>
</section>
<section class="m-form-application-category-container">
<div class="m-form-application-title">
<h2 style="color:#fff;">
Contact Details </h2>
</div>
<div class="m-form-application-inputs-container">
<div class="row">
<div id="form-email" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="email">
Email Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="email" id="email" name="email" class="" maxlength="40" required="required" data-parsley-errors-container="#erroremail" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
You will receive an e-mail that confirms the receipt of your
Application at the e-mail address you provide. You will also receive
updates on the status of your Application. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field email "><i class="fa fa-exclamation-circle"></i> This
field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-confirm_email" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="confirm_email">
Confirm Email Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="email" id="confirm_email" name="confirm_email" class="" maxlength="40" required="required" data-parsley-equalto="#email" data-parsley-error-message="The confirm email and email must match. This field is required." data-parsley-errors-container="#errorconfirm_email" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon invisible"><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field confirm_email "><i class="fa fa-exclamation-circle"></i> This
field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<div class="row">
<div id="form-phone" class="col-sm-6 col-xs-12 j-form-container">
<div class="col-sm-12 col-xs-12">
<label for="phone">
Mobile/Cell Telephone <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-sm-4 col-xs-4">
<select name="callingcode" id="phone-prefix" required="required" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<option value="">Select Prefix</option>
<option value="93">
Afghanistan (+93)
</option>
<option value="358">
Aland Islands (+358)
</option>
<option value="355">
Albania (+355)
</option>
<option value="213">
Algeria (+213)
</option>
<option value="1684">
American Samoa (+1684)
</option>
<option value="376">
Andorra (+376)
</option>
<option value="244">
Angola (+244)
</option>
<option value="1264">
Anguilla (+1264)
</option>
<option value="672">
Antarctica (+672)
</option>
<option value="1268">
Antigua and Barbuda (+1268)
</option>
<option value="54">
Argentina (+54)
</option>
<option value="374">
Armenia (+374)
</option>
<option value="297">
Aruba (+297)
</option>
<option value="61">
Australia (+61)
</option>
<option value="43">
Austria (+43)
</option>
<option value="994">
Azerbaijan (+994)
</option>
<option value="1242">
Bahamas (+1242)
</option>
<option value="973">
Bahrain (+973)
</option>
<option value="880">
Bangladesh (+880)
</option>
<option value="1246">
Barbados (+1246)
</option>
<option value="375">
Belarus (+375)
</option>
<option value="32">
Belgium (+32)
</option>
<option value="501">
Belize (+501)
</option>
<option value="229">
Benin (+229)
</option>
<option value="1441">
Bermuda (+1441)
</option>
<option value="975">
Bhutan (+975)
</option>
<option value="591">
Bolivia (+591)
</option>
<option value="599">
Bonaire, Saint Eustatius and Saba (+599)
</option>
<option value="387">
Bosnia and Herzegovina (+387)
</option>
<option value="267">
Botswana (+267)
</option>
<option value="55">
Brazil (+55)
</option>
<option value="246">
British Indian Ocean Territory (+246)
</option>
<option value="673">
Brunei Darussalam (+673)
</option>
<option value="359">
Bulgaria (+359)
</option>
<option value="226">
Burkina Faso (+226)
</option>
<option value="257">
Burundi (+257)
</option>
<option value="855">
Cambodia (+855)
</option>
<option value="237">
Cameroon (+237)
</option>
<option value="1">
Canada (+1)
</option>
<option value="238">
Cape Verde (+238)
</option>
<option value="1345">
Cayman Islands (+1345)
</option>
<option value="236">
Central African Republic (+236)
</option>
<option value="235">
Chad (+235)
</option>
<option value="56">
Chile (+56)
</option>
<option value="86">
China (+86)
</option>
<option value="61">
Christmas Island (+61)
</option>
<option value="61">
Cocos (Keeling) Islands (+61)
</option>
<option value="57">
Colombia (+57)
</option>
<option value="269">
Comoros (+269)
</option>
<option value="243">
Congo (+243)
</option>
<option value="243">
Congo, The Democratic Republic of the (+243)
</option>
<option value="682">
Cook Islands (+682)
</option>
<option value="506">
Costa Rica (+506)
</option>
<option value="225">
Cote D'Ivoire (+225)
</option>
<option value="385">
Croatia (+385)
</option>
<option value="53">
Cuba (+53)
</option>
<option value="599">
Curacao (+599)
</option>
<option value="420">
Czech Republic (+420)
</option>
<option value="45">
Denmark (+45)
</option>
<option value="253">
Djibouti (+253)
</option>
<option value="1767">
Dominica (+1767)
</option>
<option value="1767">
Dominican Republic (+1767)
</option>
<option value="593">
Ecuador (+593)
</option>
<option value="20">
Egypt (+20)
</option>
<option value="503">
El Salvador (+503)
</option>
<option value="240">
Equatorial Guinea (+240)
</option>
<option value="291">
Eritrea (+291)
</option>
<option value="372">
Estonia (+372)
</option>
<option value="251">
Ethiopia (+251)
</option>
<option value="500">
Falkland Islands (Malvinas) (+500)
</option>
<option value="298">
Faroe Islands (+298)
</option>
<option value="679">
Fiji (+679)
</option>
<option value="358">
Finland (+358)
</option>
<option value="33">
France (+33)
</option>
<option value="592">
French Guiana (+592)
</option>
<option value="689">
French Polynesia (+689)
</option>
<option value="241">
Gabon (+241)
</option>
<option value="220">
Gambia (+220)
</option>
<option value="995">
Georgia (+995)
</option>
<option value="49">
Germany (+49)
</option>
<option value="233">
Ghana (+233)
</option>
<option value="350">
Gibraltar (+350)
</option>
<option value="30">
Greece (+30)
</option>
<option value="299">
Greenland (+299)
</option>
<option value="1473">
Grenada (+1473)
</option>
<option value="590">
Guadeloupe (+590)
</option>
<option value="1671">
Guam (+1671)
</option>
<option value="502">
Guatemala (+502)
</option>
<option value="441481">
Guernsey (+441481)
</option>
<option value="224">
Guinea (+224)
</option>
<option value="245">
Guinea-Bissau (+245)
</option>
<option value="592">
Guyana (+592)
</option>
<option value="509">
Haiti (+509)
</option>
<option value="504">
Honduras (+504)
</option>
<option value="852">
Hong Kong (+852)
</option>
<option value="36">
Hungary (+36)
</option>
<option value="354">
Iceland (+354)
</option>
<option value="91">
India (+91)
</option>
<option value="62">
Indonesia (+62)
</option>
<option value="98">
Iran, Islamic Republic of (+98)
</option>
<option value="964">
Iraq (+964)
</option>
<option value="353">
Ireland (+353)
</option>
<option value="441624">
Isle of Man (+441624)
</option>
<option value="972">
Israel (+972)
</option>
<option value="39">
Italy (+39)
</option>
<option value="1876">
Jamaica (+1876)
</option>
<option value="81">
Japan (+81)
</option>
<option value="441534">
Jersey (+441534)
</option>
<option value="962">
Jordan (+962)
</option>
<option value="7">
Kazakhstan (+7)
</option>
<option value="254">
Kenya (+254)
</option>
<option value="686">
Kiribati (+686)
</option>
<option value="850">
Korea North (+850)
</option>
<option value="82">
Korea South (+82)
</option>
<option value="965">
Kuwait (+965)
</option>
<option value="996">
Kyrgyzstan (+996)
</option>
<option value="856">
Lao People's Democratic Republic (+856)
</option>
<option value="371">
Latvia (+371)
</option>
<option value="961">
Lebanon (+961)
</option>
<option value="266">
Lesotho (+266)
</option>
<option value="231">
Liberia (+231)
</option>
<option value="218">
Libya (+218)
</option>
<option value="423">
Liechtenstein (+423)
</option>
<option value="370">
Lithuania (+370)
</option>
<option value="352">
Luxembourg (+352)
</option>
<option value="853">
Macau (+853)
</option>
<option value="389">
Macedonia (+389)
</option>
<option value="261">
Madagascar (+261)
</option>
<option value="265">
Malawi (+265)
</option>
<option value="60">
Malaysia (+60)
</option>
<option value="960">
Maldives (+960)
</option>
<option value="223">
Mali (+223)
</option>
<option value="356">
Malta (+356)
</option>
<option value="692">
Marshall Islands (+692)
</option>
<option value="596">
Martinique (+596)
</option>
<option value="222">
Mauritania (+222)
</option>
<option value="230">
Mauritius (+230)
</option>
<option value="262">
Mayotte (+262)
</option>
<option value="52">
Mexico (+52)
</option>
<option value="691">
Micronesia, Federated States of (+691)
</option>
<option value="373">
Moldova, Republic of (+373)
</option>
<option value="377">
Monaco (+377)
</option>
<option value="976">
Mongolia (+976)
</option>
<option value="382">
Montenegro (+382)
</option>
<option value="1664">
Montserrat (+1664)
</option>
<option value="212">
Morocco (+212)
</option>
<option value="258">
Mozambique (+258)
</option>
<option value="95">
Myanmar (+95)
</option>
<option value="264">
Namibia (+264)
</option>
<option value="674">
Nauru (+674)
</option>
<option value="977">
Nepal (+977)
</option>
<option value="31">
Netherlands (+31)
</option>
<option value="687">
New Caledonia (+687)
</option>
<option value="64">
New Zealand (+64)
</option>
<option value="505">
Nicaragua (+505)
</option>
<option value="227">
Niger (+227)
</option>
<option value="234">
Nigeria (+234)
</option>
<option value="683">
Niue (+683)
</option>
<option value="672">
Norfolk Island (+672)
</option>
<option value="1670">
Northern Mariana Islands (+1670)
</option>
<option value="47">
Norway (+47)
</option>
<option value="968">
Oman (+968)
</option>
<option value="92">
Pakistan (+92)
</option>
<option value="680">
Palau (+680)
</option>
<option value="970">
Palestinian Territory (+970)
</option>
<option value="507">
Panama (+507)
</option>
<option value="675">
Papua New Guinea (+675)
</option>
<option value="595">
Paraguay (+595)
</option>
<option value="51">
Peru (+51)
</option>
<option value="63">
Philippines (+63)
</option>
<option value="64">
Pitcairn Islands (+64)
</option>
<option value="48">
Poland (+48)
</option>
<option value="351">
Portugal (+351)
</option>
<option value="1">
Puerto Rico (+1)
</option>
<option value="974">
Qatar (+974)
</option>
<option value="357">
Republic of Cyprus (+357)
</option>
<option value="262">
Reunion (+262)
</option>
<option value="40">
Romania (+40)
</option>
<option value="7">
Russian Federation (+7)
</option>
<option value="250">
Rwanda (+250)
</option>
<option value="590">
Saint Barthelemy (+590)
</option>
<option value="290">
Saint Helena (+290)
</option>
<option value="1869">
Saint Kitts and Nevis (+1869)
</option>
<option value="1758">
Saint Lucia (+1758)
</option>
<option value="590">
Saint Martin (+590)
</option>
<option value="508">
Saint Pierre and Miquelon (+508)
</option>
<option value="1784">
Saint Vincent and the Grenadines (+1784)
</option>
<option value="685">
Samoa (+685)
</option>
<option value="378">
San Marino (+378)
</option>
<option value="239">
Sao Tome and Principe (+239)
</option>
<option value="966">
Saudi Arabia (+966)
</option>
<option value="221">
Senegal (+221)
</option>
<option value="381">
Serbia (+381)
</option>
<option value="248">
Seychelles (+248)
</option>
<option value="232">
Sierra Leone (+232)
</option>
<option value="65">
Singapore (+65)
</option>
<option value="1721">
Sint Maarten (Dutch part) (+1721)
</option>
<option value="421">
Slovakia (+421)
</option>
<option value="386">
Slovenia (+386)
</option>
<option value="677">
Solomon Islands (+677)
</option>
<option value="252">
Somalia (+252)
</option>
<option value="27">
South Africa (+27)
</option>
<option value="500">
South Georgia and the South Sandwich Islands (+500)
</option>
<option value="211">
South Sudan (+211)
</option>
<option value="34">
Spain (+34)
</option>
<option value="94">
Sri Lanka (+94)
</option>
<option value="249">
Sudan (+249)
</option>
<option value="597">
Suriname (+597)
</option>
<option value="47">
Svalbard and Jan Mayen (+47)
</option>
<option value="268">
Swaziland (+268)
</option>
<option value="46">
Sweden (+46)
</option>
<option value="41">
Switzerland (+41)
</option>
<option value="963">
Syrian Arab Republic (+963)
</option>
<option value="886">
Taiwan (+886)
</option>
<option value="992">
Tajikistan (+992)
</option>
<option value="255">
Tanzania, United Republic of (+255)
</option>
<option value="66">
Thailand (+66)
</option>
<option value="670">
Timor-Leste (+670)
</option>
<option value="228">
Togo (+228)
</option>
<option value="690">
Tokelau (+690)
</option>
<option value="676">
Tonga (+676)
</option>
<option value="1868">
Trinidad and Tobago (+1868)
</option>
<option value="216">
Tunisia (+216)
</option>
<option value="90">
Turkey (+90)
</option>
<option value="993">
Turkmenistan (+993)
</option>
<option value="1649">
Turks and Caicos Islands (+1649)
</option>
<option value="688">
Tuvalu (+688)
</option>
<option value="256">
Uganda (+256)
</option>
<option value="380">
Ukraine (+380)
</option>
<option value="971">
United Arab Emirates (+971)
</option>
<option value="44">
United Kingdom (+44)
</option>
<option value="1">
United States (+1)
</option>
<option value="598">
Uruguay (+598)
</option>
<option value="998">
Uzbekistan (+998)
</option>
<option value="678">
Vanuatu (+678)
</option>
<option value="379">
Vatican City (+379)
</option>
<option value="58">
Venezuela (+58)
</option>
<option value="84">
Vietnam (+84)
</option>
<option value="1284">
Virgin Islands, British (+1284)
</option>
<option value="1340">
Virgin Islands, U.S. (+1340)
</option>
<option value="681">
Wallis and Futuna (+681)
</option>
<option value="967">
Yemen (+967)
</option>
<option value="260">
Zambia (+260)
</option>
<option value="263">
Zimbabwe (+263)
</option></select>
<span class="u-alert-field phone alert-phone-with-prefix-select "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="col-sm-8 col-xs-8">
<div class="input-group">
<input name="phone" type="text" id="phone" placeholder="" data-parsley-errors-container="#errors-phone" value="" maxlength="15" required="required" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon"><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
</div>
<div class="m-help j-help hide col-sm-12 col-xs-12 clearfix">
<ul>
<li>
Please indicate a mobile/cell telephone. It is important to indicate a
correct phone number, since you may receive updates on the status of
your Application. If you do not have a telephone number, you may provide
an alternative third-party telephone number belonging to a point of
contact. </li>
</ul>
</div>
<div class="clearfix"></div>
</div>
<div id="form-phone" class="col-sm-6 col-xs-12 j-form-container">
<div class="col-sm-12 col-xs-12">
<label for="home_address_line_one">
Address <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="home_address_line_one" name="addressline1" class="" required="required" data-parsley-errors-container="#errorhome_address_line_one" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter the number, street and apartment number of your home address
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_one "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<!--------------------------address ----------------------->
<div class="row">
<div id="form-passport_issue" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
City <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="home_address_line_city" name="addresslinecity" class="" required="required" data-parsley-errors-container="#errorhome_address_line_city" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter city </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_city "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-passport_issue" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_city">
State/Province <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="home_address_line_state" name="addresslinestate" class="" required="required" data-parsley-errors-container="#home_address_line_state" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter State/Province </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_state "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<!--------------------------address ----------------------->
<!--------------------------address ----------------------->
<div class="row">
<div id="form-passport_issue" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="home_address_line_country">
Country of Residence <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<select class=" select-countries" name="addresslinecountry" id="home_address_line_country" autocomplete="off" required="required" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<option value="">Select a Country</option>
<option name="93" value="Afghanistan" data-iso="AFG" data-country="Afghanistan">
Afghanistan</option>
<option name="358" value="Aland Islands" data-iso="ALA" data-country="Aland Islands">
Aland Islands</option>
<option name="355" value="Albania" data-iso="ALB" data-country="Albania">
Albania</option>
<option name="213" value="Algeria" data-iso="DZA" data-country="Algeria">
Algeria</option>
<option name="1684" value="American Samoa" data-iso="ASM" data-country="American Samoa">
American Samoa</option>
<option name="376" value="Andorra" data-iso="AND" data-country="Andorra">
Andorra</option>
<option name="244" value="Angola" data-iso="AGO" data-country="Angola">
Angola</option>
<option name="1264" value="Anguilla" data-iso="AIA" data-country="Anguilla">
Anguilla</option>
<option name="672" value="Antarctica" data-iso="AQ" data-country="Antarctica">
Antarctica</option>
<option name="1268" value="Antigua and Barbuda" data-iso="ATG" data-country="Antigua and Barbuda">
Antigua and Barbuda</option>
<option name="54" value="Argentina" data-iso="ARG" data-country="Argentina">
Argentina</option>
<option name="374" value="Armenia" data-iso="ARM" data-country="Armenia">
Armenia</option>
<option name="297" value="Aruba" data-iso="AWB" data-country="Aruba">
Aruba</option>
<option name="61" value="Australia" data-iso="AUS" data-country="Australia">
Australia</option>
<option name="43" value="Austria" data-iso="AUT" data-country="Austria">
Austria</option>
<option name="994" value="Azerbaijan" data-iso="AZE" data-country="Azerbaijan">
Azerbaijan</option>
<option name="1242" value="Bahamas" data-iso="BHS" data-country="Bahamas">
Bahamas</option>
<option name="973" value="Bahrain" data-iso="BHR" data-country="Bahrain">
Bahrain</option>
<option name="880" value="Bangladesh" data-iso="BGD" data-country="Bangladesh">
Bangladesh</option>
<option name="1246" value="Barbados" data-iso="BRB" data-country="Barbados">
Barbados</option>
<option name="1246" value="Barbuda" data-iso="BEL" data-country="Barbados">
Barbuda</option>
<option name="375" value="Belarus" data-iso="BLR" data-country="Belarus">
Belarus</option>
<option name="32" value="Belgium" data-iso="BEL" data-country="Belgium">
Belgium</option>
<option name="501" value="Belize" data-iso="BLZ" data-country="Belize">
Belize</option>
<option name="229" value="Benin" data-iso="BEN" data-country="Benin">
Benin</option>
<option name="1441" value="Bermuda" data-iso="BMU" data-country="Bermuda">
Bermuda</option>
<option name="975" value="Bhutan" data-iso="BTN" data-country="Bhutan">
Bhutan</option>
<option name="591" value="Bolivia" data-iso="BOL" data-country="Bolivia">
Bolivia</option>
<option name="599" value="Bonaire Saint Eustatius and Saba" data-iso="BES" data-country="Bonaire, Saint Eustatius and Saba">
Bonaire, Saint Eustatius and Saba</option>
<option name="387" value="Bosnia and Herzegovina" data-iso="BIH" data-country="Bosnia and Herzegovina">
Bosnia and Herzegovina</option>
<option name="267" value="Botswana" data-iso="BWA" data-country="Botswana">
Botswana</option>
<option name="55" value="Brazil" data-iso="BRA" data-country="Brazil">
Brazil</option>
<option name="246" value="British Indian Ocean Territory" data-iso="IOT" data-country="British Indian Ocean Territory">
British Indian Ocean Territory</option>
<option name="673" value="Brunei Darussalam" data-iso="BRM" data-country="Brunei Darussalam">
Brunei Darussalam</option>
<option name="359" value="Bulgaria" data-iso="BGR" data-country="Bulgaria">
Bulgaria</option>
<option name="226" value="Burkina Faso" data-iso="BFA" data-country="Burkina Faso">
Burkina Faso</option>
<option name="257" value="Burundi" data-iso="BDI" data-country="Burundi">
Burundi</option>
<option name="855" value="Cambodia" data-iso="KHM" data-country="Cambodia">
Cambodia</option>
<option name="237" value="Cameroon" data-iso="CMR" data-country="Cameroon">
Cameroon</option>
<option name="1" value="Canada" data-iso="CAN" data-country="Canada">
Canada</option>
<option name="238" value="Cape Verde" data-iso="CPV" data-country="Cape Verde">
Cape Verde</option>
<option name="1345" value="Cayman Islands" data-iso="CYM" data-country="Cayman Islands">
Cayman Islands</option>
<option name="236" value="Central African Kingdom" data-iso="CAF" data-country="Central African Kingdom">
Central African Kingdom</option>
<option name="235" value="Chad" data-iso="TCD" data-country="Chad">
Chad</option>
<option name="56" value="Chile" data-iso="CHL" data-country="Chile">
Chile</option>
<option name="86" value="China" data-iso="CHN" data-country="China">
China</option>
<option name="61" value="Christmas Island" data-iso="CXR" data-country="Christmas Island">
Christmas Island</option>
<option name="61" value="Cocos (Keeling) Islands" data-iso="CCK" data-country="Cocos (Keeling) Islands">
Cocos (Keeling) Islands</option>
<option name="57" value="Colombia" data-iso="COL" data-country="Colombia">
Colombia</option>
<option name="269" value="Comoros" data-iso="COM" data-country="Comoros">
Comoros</option>
<option name="243" value="Congo" data-iso="COD" data-country="Congo">
Congo</option>
<option name="243" value="Congo The Democratic Kingdom of the" data-iso="ZAR" data-country="Congo, The Democratic Kingdom of the">
Congo, The Democratic Kingdom of the</option>
<option name="682" value="Cook Islands" data-iso="COK" data-country="Cook Islands">
Cook Islands</option>
<option name="506" value="Costa Rica" data-iso="CRI" data-country="Costa Rica">
Costa Rica</option>
<option name="225" value="Cote DIvoire" data-iso="CIV" data-country="Cote D'Ivoire">
Cote D'Ivoire</option>
<option name="385" value="Croatia" data-iso="HRV" data-country="Croatia">
Croatia</option>
<option name="53" value="Cuba" data-iso="CUB" data-country="Cuba">
Cuba</option>
<option name="599" value="Curacao" data-iso="CUW" data-country="Curacao">
Curacao</option>
<option name="420" value="Czech Kingdom" data-iso="CZE" data-country="Czech Kingdom">
Czech Kingdom</option>
<option name="45" value="Denmark" data-iso="DNK" data-country="Denmark">
Denmark</option>
<option name="253" value="Diego Garcia" data-iso="DGA " data-country="Djibouti">
Diego Garcia</option>
<option name="253" value="Djibouti" data-iso="DJI" data-country="Djibouti">
Djibouti</option>
<option name="1767" value="Dominica" data-iso="DMA" data-country="Dominica">
Dominica</option>
<option name="1767" value="Dominican Kingdom" data-iso="DMA" data-country="Dominican Kingdom">
Dominican Kingdom</option>
<option name="593" value="Ecuador" data-iso="ECU" data-country="Ecuador">
Ecuador</option>
<option name="20" value="Egypt" data-iso="EGY" data-country="Egypt">
Egypt</option>
<option name="503" value="El Salvador" data-iso="SLV" data-country="El Salvador">
El Salvador</option>
<option name="240" value="Equatorial Guinea" data-iso="GNQ" data-country="Equatorial Guinea">
Equatorial Guinea</option>
<option name="291" value="Eritrea" data-iso="ERI" data-country="Eritrea">
Eritrea</option>
<option name="372" value="Estonia" data-iso="EST" data-country="Estonia">
Estonia</option>
<option name="251" value="Ethiopia" data-iso="ETH" data-country="Ethiopia">
Ethiopia</option>
<option name="500" value="Falkland Islands (Malvinas)" data-iso="FLK" data-country="Falkland Islands (Malvinas)">
Falkland Islands (Malvinas)</option>
<option name="298" value="Faroe Islands" data-iso="FRO" data-country="Faroe Islands">
Faroe Islands</option>
<option name="679" value="Fiji" data-iso="FJI" data-country="Fiji">
Fiji</option>
<option name="358" value="Finland" data-iso="FIN" data-country="Finland">
Finland</option>
<option name="33" value="France" data-iso="FRA" data-country="France">
France</option>
<option name="592" value="French Antilles" data-iso="ATF" data-country="French Antilles">
French Antilles</option>
<option name="592" value="French Guiana" data-iso="GUF" data-country="French Guiana">
French Guiana</option>
<option name="689" value="French Polynesia" data-iso="PYF" data-country="French Polynesia">
French Polynesia</option>
<option name="241" value="Gabon" data-iso="GAB" data-country="Gabon">
Gabon</option>
<option name="220" value="Gambia" data-iso="GMB" data-country="Gambia">
Gambia</option>
<option name="995" value="Georgia" data-iso="GEO" data-country="Georgia">
Georgia</option>
<option name="49" value="Germany" data-iso="DEU" data-country="Germany">
Germany</option>
<option name="233" value="Ghana" data-iso="GHA" data-country="Ghana">
Ghana</option>
<option name="350" value="Gibraltar" data-iso="GIB" data-country="Gibraltar">
Gibraltar</option>
<option name="30" value="Greece" data-iso="GRC" data-country="Greece">
Greece</option>
<option name="299" value="Greenland" data-iso="GRL" data-country="Greenland">
Greenland</option>
<option name="1473" value="Grenada" data-iso="GRD" data-country="Grenada">
Grenada</option>
<option name="590" value="Guadeloupe" data-iso="GLP" data-country="Guadeloupe">
Guadeloupe</option>
<option name="1671" value="Guam" data-iso="GUM" data-country="Guam">
Guam</option>
<option name="502" value="Guatemala" data-iso="GTM" data-country="Guatemala">
Guatemala</option>
<option name="441481" value="Guernsey" data-iso="GGY" data-country="Guernsey">
Guernsey</option>
<option name="224" value="Guinea" data-iso="GIN" data-country="Guinea">
Guinea</option>
<option name="245" value="Guinea-Bissau" data-iso="GNB" data-country="Guinea-Bissau">
Guinea-Bissau</option>
<option name="592" value="Guyana" data-iso="GUY" data-country="Guyana">
Guyana</option>
<option name="509" value="Haiti" data-iso="HTI" data-country="Haiti">
Haiti</option>
<option name="504" value="Honduras" data-iso="HND" data-country="Honduras">
Honduras</option>
<option name="852" value="Hong Kong" data-iso="HKG" data-country="Hong Kong">
Hong Kong</option>
<option name="36" value="Hungary" data-iso="HUN" data-country="Hungary">
Hungary</option>
<option name="354" value="Iceland" data-iso="ISL" data-country="Iceland">
Iceland</option>
<option name="91" value="India" data-iso="IND" data-country="India">
India</option>
<option name="62" value="Indonesia" data-iso="IDN" data-country="Indonesia">
Indonesia</option>
<option name="98" value="Iran Islamic Kingdom of" data-iso="IRN" data-country="Iran, Islamic Kingdom of">
Iran, Islamic Kingdom of</option>
<option name="964" value="Iraq" data-iso="IRQ" data-country="Iraq">
Iraq</option>
<option name="353" value="Ireland" data-iso="IRL" data-country="Ireland">
Ireland</option>
<option name="441624" value="Isle of Man" data-iso="IMN" data-country="Isle of Man">
Isle of Man</option>
<option name="972" value="Israel" data-iso="ISR" data-country="Israel">
Israel</option>
<option name="39" value="Italy" data-iso="ITA" data-country="Italy">
Italy</option>
<option name="1876" value="Jamaica" data-iso="JAM" data-country="Jamaica">
Jamaica</option>
<option name="81" value="Japan" data-iso="JPN" data-country="Japan">
Japan</option>
<option name="441534" value="Jersey" data-iso="JEY" data-country="Jersey">
Jersey</option>
<option name="962" value="Jordan" data-iso="JOR" data-country="Jordan">
Jordan</option>
<option name="7" value="Kazakhstan" data-iso="KAZ" data-country="Kazakhstan">
Kazakhstan</option>
<option name="254" value="Kenya" data-iso="KEN" data-country="Kenya">
Kenya</option>
<option name="686" value="Kiribati" data-iso="KIR" data-country="Kiribati">
Kiribati</option>
<option name="850" value="Korea North" data-iso="PRK" data-country="Korea North">
Korea North</option>
<option name="82" value="Korea South" data-iso="KOR" data-country="Korea South">
Korea South</option>
<option name="965" value="Kuwait" data-iso="KWT" data-country="Kuwait">
Kuwait</option>
<option name="996" value="Kyrgyzstan" data-iso="KGZ" data-country="Kyrgyzstan">
Kyrgyzstan</option>
<option name="856" value="Lao Peoples Democratic Kingdom" data-iso="LAO" data-country="Lao People's Democratic Kingdom">
Lao People's Democratic Kingdom</option>
<option name="371" value="Latvia" data-iso="LBA" data-country="Latvia">
Latvia</option>
<option name="961" value="Lebanon" data-iso="LBN" data-country="Lebanon">
Lebanon</option>
<option name="266" value="Lesotho" data-iso="LSO" data-country="Lesotho">
Lesotho</option>
<option name="231" value="Liberia" data-iso="LBR" data-country="Liberia">
Liberia</option>
<option name="218" value="Libya" data-iso="LBY" data-country="Libya">
Libya</option>
<option name="423" value="Liechtenstein" data-iso="LIE" data-country="Liechtenstein">
Liechtenstein</option>
<option name="370" value="Lithuania" data-iso="LTU" data-country="Lithuania">
Lithuania</option>
<option name="352" value="Luxembourg" data-iso="LUX" data-country="Luxembourg">
Luxembourg</option>
<option name="853" value="Macau" data-iso="MAC" data-country="Macau">
Macau</option>
<option name="389" value="Macedonia" data-iso="MKD" data-country="Macedonia">
Macedonia</option>
<option name="261" value="Madagascar" data-iso="MDG" data-country="Madagascar">
Madagascar</option>
<option name="265" value="Malawi" data-iso="MWI" data-country="Malawi">
Malawi</option>
<option name="60" value="Malaysia" data-iso="MYS" data-country="Malaysia">
Malaysia</option>
<option name="960" value="Maldives" data-iso="MDV" data-country="Maldives">
Maldives</option>
<option name="223" value="Mali" data-iso="MLI" data-country="Mali">
Mali</option>
<option name="356" value="Malta" data-iso="MLT" data-country="Malta">
Malta</option>
<option name="692" value="Marshall Islands" data-iso="MHL" data-country="Marshall Islands">
Marshall Islands</option>
<option name="596" value="Martinique" data-iso="MTQ" data-country="Martinique">
Martinique</option>
<option name="222" value="Mauritania" data-iso="MRT" data-country="Mauritania">
Mauritania</option>
<option name="230" value="Mauritius" data-iso="MUS" data-country="Mauritius">
Mauritius</option>
<option name="262" value="Mayotte" data-iso="MYT" data-country="Mayotte">
Mayotte</option>
<option name="52" value="Mexico" data-iso="MEX" data-country="Mexico">
Mexico</option>
<option name="691" value="Micronesia Federated States of" data-iso="FSM" data-country="Micronesia, Federated States of">
Micronesia, Federated States of</option>
<option name="1808" value="Midway Island" data-iso="UMI" data-country="Midway Island">
Midway Island</option>
<option name="373" value="Moldova Kingdom of" data-iso="MDA" data-country="Moldova, Kingdom of">
Moldova, Kingdom of</option>
<option name="377" value="Monaco" data-iso="MCO" data-country="Monaco">
Monaco</option>
<option name="976" value="Mongolia" data-iso="MNG" data-country="Mongolia">
Mongolia</option>
<option name="382" value="Montenegro" data-iso="MNE" data-country="Montenegro">
Montenegro</option>
<option name="1664" value="Montserrat" data-iso="MSR" data-country="Montserrat">
Montserrat</option>
<option name="212" value="Morocco" data-iso="MAR" data-country="Morocco">
Morocco</option>
<option name="258" value="Mozambique" data-iso="MOZ" data-country="Mozambique">
Mozambique</option>
<option name="95" value="Myanmar" data-iso="MMR" data-country="Myanmar">
Myanmar</option>
<option name="264" value="Namibia" data-iso="NAM" data-country="Namibia">
Namibia</option>
<option name="674" value="Nauru" data-iso="NRU" data-country="Nauru">
Nauru</option>
<option name="977" value="Nepal" data-iso="NPL" data-country="Nepal">
Nepal</option>
<option name="31" value="Netherlands" data-iso="NLD" data-country="Netherlands">
Netherlands</option>
<option name="1869" value="Nevis" data-iso="KNA" data-country="Nevis">
Nevis</option>
<option name="687" value="New Caledonia" data-iso="NCL" data-country="New Caledonia">
New Caledonia</option>
<option name="64" value="New Zealand" data-iso="NZL" data-country="New Zealand">
New Zealand</option>
<option name="505" value="Nicaragua" data-iso="NIC" data-country="Nicaragua">
Nicaragua</option>
<option name="227" value="Niger" data-iso="NER" data-country="Niger">
Niger</option>
<option name="234" value="Nigeria" data-iso="NGA" data-country="Nigeria">
Nigeria</option>
<option name="683" value="Niue" data-iso="NIU" data-country="Niue">
Niue</option>
<option name="672" value="Norfolk Island" data-iso="NFK" data-country="Norfolk Island">
Norfolk Island</option>
<option name="1670" value="Northern Mariana Islands" data-iso="MNP" data-country="Northern Mariana Islands">
Northern Mariana Islands</option>
<option name="47" value="Norway" data-iso="NOR" data-country="Norway">
Norway</option>
<option name="968" value="Oman" data-iso="OMN" data-country="Oman">
Oman</option>
<option name="92" value="Pakistan" data-iso="PAK" data-country="Pakistan">
Pakistan</option>
<option name="680" value="Palau" data-iso="PLW" data-country="Palau">
Palau</option>
<option name="970" value="Palestinian Territory" data-iso="PSE" data-country="Palestinian Territory">
Palestinian Territory</option>
<option name="507" value="Panama" data-iso="PAN" data-country="Panama">
Panama</option>
<option name="675" value="Papua New Guinea" data-iso="PNG" data-country="Papua New Guinea">
Papua New Guinea</option>
<option name="595" value="Paraguay" data-iso="PRY" data-country="Paraguay">
Paraguay</option>
<option name="51" value="Peru" data-iso="PER" data-country="Peru">
Peru</option>
<option name="63" value="Philippines" data-iso="PHL" data-country="Philippines">
Philippines</option>
<option name="64" value="Pitcairn Islands" data-iso="PCN" data-country="Pitcairn Islands">
Pitcairn Islands</option>
<option name="48" value="Poland" data-iso="POL" data-country="Poland">
Poland</option>
<option name="351" value="Portugal" data-iso="PRT" data-country="Portugal">
Portugal</option>
<option name="1" value="Puerto Rico" data-iso="PRI" data-country="Puerto Rico">
Puerto Rico</option>
<option name="974" value="Qatar" data-iso="QAT" data-country="Qatar">
Qatar</option>
<option name="357" value="Kingdom of Cyprus" data-iso="CYP" data-country="Kingdom of Cyprus">
Kingdom of Cyprus</option>
<option name="262" value="Reunion" data-iso="REU" data-country="Reunion">
Reunion</option>
<option name="40" value="Romania" data-iso="ROU" data-country="Romania">
Romania</option>
<option name="7" value="Russian Federation" data-iso="RUS" data-country="Russian Federation">
Russian Federation</option>
<option name="250" value="Rwanda" data-iso="RWA" data-country="Rwanda">
Rwanda</option>
<option name="590" value="Saint Barthelemy" data-iso="BLM" data-country="Saint Barthelemy">
Saint Barthelemy</option>
<option name="290" value="Saint Helena" data-iso="SHN" data-country="Saint Helena">
Saint Helena</option>
<option name="1869" value="Saint Kitts and Nevis" data-iso="KNA" data-country="Saint Kitts and Nevis">
Saint Kitts and Nevis</option>
<option name="1758" value="Saint Lucia" data-iso="KNA" data-country="Saint Lucia">
Saint Lucia</option>
<option name="590" value="Saint Martin" data-iso="MAF" data-country="Saint Martin">
Saint Martin</option>
<option name="508" value="Saint Pierre and Miquelon" data-iso="SPM" data-country="Saint Pierre and Miquelon">
Saint Pierre and Miquelon</option>
<option name="1784" value="Saint Vincent and the Grenadines" data-iso="VCT" data-country="Saint Vincent and the Grenadines">
Saint Vincent and the Grenadines</option>
<option name="685" value="Samoa" data-iso="WSM" data-country="Samoa">
Samoa</option>
<option name="378" value="San Marino" data-iso="SMR" data-country="San Marino">
San Marino</option>
<option name="239" value="Sao Tome and Principe" data-iso="STP" data-country="Sao Tome and Principe">
Sao Tome and Principe</option>
<option name="966" value="Saudi Arabia" data-iso="SAU" data-country="Saudi Arabia">
Saudi Arabia</option>
<option name="221" value="Senegal" data-iso="SEN" data-country="Senegal">
Senegal</option>
<option name="381" value="Serbia" data-iso="SRB" data-country="Serbia">
Serbia</option>
<option name="248" value="Seychelles" data-iso="SYC" data-country="Seychelles">
Seychelles</option>
<option name="232" value="Sierra Leone" data-iso="SLE" data-country="Sierra Leone">
Sierra Leone</option>
<option name="65" value="Singapore" data-iso="SGP" data-country="Singapore">
Singapore</option>
<option name="1721" value="Sint Maarten (Dutch part)" data-iso="MAF" data-country="Sint Maarten (Dutch part)">
Sint Maarten (Dutch part)</option>
<option name="421" value="Slovakia" data-iso="SVK" data-country="Slovakia">
Slovakia</option>
<option name="386" value="Slovenia" data-iso="SVN" data-country="Slovenia">
Slovenia</option>
<option name="677" value="Solomon Islands" data-iso="SLB" data-country="Solomon Islands">
Solomon Islands</option>
<option name="252" value="Somalia" data-iso="SOM" data-country="Somalia">
Somalia</option>
<option name="27" value="South Africa" data-iso="ZAF" data-country="South Africa">
South Africa</option>
<option name="500" value="South Georgia and the South Sandwich Islands" data-iso="SGS" data-country="South Georgia and the South Sandwich Islands">
South Georgia and the South Sandwich Islands</option>
<option name="211" value="South Sudan" data-iso="SDN" data-country="South Sudan">
South Sudan</option>
<option name="34" value="Spain" data-iso="ESP" data-country="Spain">
Spain</option>
<option name="94" value="Sri Lanka" data-iso="LKA" data-country="Sri Lanka">
Sri Lanka</option>
<option name="249" value="Sudan" data-iso="SDN" data-country="Sudan">
Sudan</option>
<option name="597" value="Suriname" data-iso="SUR" data-country="Suriname">
Suriname</option>
<option name="47" value="Svalbard and Jan Mayen" data-iso="SJM" data-country="Svalbard and Jan Mayen">
Svalbard and Jan Mayen</option>
<option name="268" value="Swaziland" data-iso="SWZ" data-country="Swaziland">
Swaziland</option>
<option name="46" value="Sweden" data-iso="SWE" data-country="Sweden">
Sweden</option>
<option name="41" value="Switzerland" data-iso="CHE" data-country="Switzerland">
Switzerland</option>
<option name="963" value="Syrian Arab Kingdom" data-iso="SYR" data-country="Syrian Arab Kingdom">
Syrian Arab Kingdom</option>
<option name="886" value="Taiwan" data-iso="TWN" data-country="Taiwan">
Taiwan</option>
<option name="992" value="Tajikistan" data-iso="TJK" data-country="Tajikistan">
Tajikistan</option>
<option name="255" value="Tanzania, United Kingdom of" data-iso="TZA" data-country="Tanzania, United Kingdom of">
Tanzania, United Kingdom of</option>
<option name="66" value="Thailand" data-iso="THA" data-country="Thailand">
Thailand</option>
<option name="670" value="Timor-Leste" data-iso="TLS" data-country="Timor-Leste">
Timor-Leste</option>
<option name="228" value="Togo" data-iso="TGO" data-country="Togo">
Togo</option>
<option name="690" value="Tokelau" data-iso="TKL" data-country="Tokelau">
Tokelau</option>
<option name="676" value="Tonga" data-iso="TON" data-country="Tonga">
Tonga</option>
<option name="1868" value="Trinidad and Tobago" data-iso="TTO" data-country="Trinidad and Tobago">
Trinidad and Tobago</option>
<option name="216" value="Tunisia" data-iso="TUN" data-country="Tunisia">
Tunisia</option>
<option name="90" value="Turkey" data-iso="TUN" data-country="Turkey">
Turkey</option>
<option name="993" value="Turkmenistan" data-iso="TKM" data-country="Turkmenistan">
Turkmenistan</option>
<option name="1649" value="Turks and Caicos Islands" data-iso="TCA" data-country="Turks and Caicos Islands">
Turks and Caicos Islands</option>
<option name="688" value="Tuvalu" data-iso="TUV" data-country="Tuvalu">
Tuvalu</option>
<option name="256" value="Uganda" data-iso="UGA" data-country="Uganda">
Uganda</option>
<option name="380" value="Ukraine" data-iso="UKR" data-country="Ukraine">
Ukraine</option>
<option name="971" value="United Arab Emirates" data-iso="ARE" data-country="United Arab Emirates">
United Arab Emirates</option>
<option name="44" value="United Kingdom" data-iso="GBR" data-country="United Kingdom">
United Kingdom</option>
<option name="1" value="United States" data-iso="USA" data-country="United States">
United States</option>
<option name="598" value="Uruguay" data-iso="URY" data-country="Uruguay">
Uruguay</option>
<option name="998" value="Uzbekistan" data-iso="UZB" data-country="Uzbekistan">
Uzbekistan</option>
<option name="678" value="Vanuatu" data-iso="VUT" data-country="Vanuatu">
Vanuatu</option>
<option name="379" value="Vatican City" data-iso="VAT" data-country="Vatican City">
Vatican City</option>
<option name="58" value="Venezuela" data-iso="VEN" data-country="Venezuela">
Venezuela</option>
<option name="84" value="Vietnam" data-iso="VNM" data-country="Vietnam">
Vietnam</option>
<option name="1284" value="Virgin Islands, British" data-iso="VGB" data-country="Virgin Islands, British">
Virgin Islands, British</option>
<option name="1340" value="Virgin Islands, U.S." data-iso="VIR" data-country="Virgin Islands, U.S.">
Virgin Islands, U.S.</option>
<option name="808" value="Wake Island" data-iso="WAK" data-country="Wake Island">
Wake Island</option>
<option name="681" value="Wallis and Futuna" data-iso="WLF" data-country="Wallis and Futuna">
Wallis and Futuna</option>
<option name="967" value="Yemen" data-iso="YEM" data-country="Yemen">
Yemen</option>
<option name="381" value="Yugoslavia" data-iso="SCG" data-country="Yugoslavia">
Yugoslavia</option>
<option name="260" value="Zambia" data-iso="ZMB" data-country="Zambia">
Zambia</option>
<option name="255" value="Zanzibar" data-iso="TZA" data-country="Zanzibar">
Zanzibar</option>
<option name="263" value="Zimbabwe" data-iso="ZWE" data-country="Zimbabwe">
Zimbabwe</option>
</select>
<div class="input-group-addon m-help--sign j-help-icon invisible"><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field home_address_line_country "><i class="fa fa-exclamation-circle"></i> This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-passport_issue" class="js-passportIssue j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="pincode">
Zipcode/Pincode <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="pincode" name="pincode" class="" required="required" data-parsley-errors-container="#errorpincode" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter Zipcode </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field pincode "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<div class="row">
<div class="m-form-application-title">
<h2 style="color:#fff;">
Address in Ethiopia </h2>
</div>
<br>
<div id="form-accomtype" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="accomtype">
Address in Ethiopia <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="accomtype" name="accomtype" class=" " maxlength="50" placeholder="Mention NA if not applicable" required="required" data-parsley-errors-container="#erroraccomtype" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter address in Ethiopia where you will stay.
</li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field accomtype "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-accomname" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="accomname">
Host Name <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="accomname" name="accomname" class=" " maxlength="50" required="required" data-parsley-errors-container="#erroraccomname" placeholder="Mention NA if not applicable" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter host name. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field accomname "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-accomstreet" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="accomstreet">
Accommodation Street Address* <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="accomstreet" name="accomstreet" class=" " maxlength="50" placeholder="Mention NA if not applicable" required="required" data-parsley-errors-container="#erroraccomstreet" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter address of your accomodation. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field accomstreet "><i class="fa fa-exclamation-circle"></i> This field
is required!</span>
</div>
<div class="clearfix"></div>
</div>
<div id="form-accomcity" class=" j-form-container col-xs-12 col-sm-6">
<div class="col-xs-12 col-sm-12">
<label for="accomcity">
Select City/Province <span class="m-txt--color-15">*</span> </label>
</div>
<div class="col-xs-12 col-sm-12">
<div class="input-group">
<input type="text" id="accomcity" name="accomcity" class="" maxlength="50" placeholder="Mention NA if not applicable" required="required" data-parsley-errors-container="#erroraccomcity" data-parsley-reguex="" data-parsley-trigger="change" data-parsley-group="block-2" aria-required="true" disabled="disabled">
<div class="input-group-addon m-help--sign j-help-icon "><i class="fa fa-question-circle" aria-hidden="true"></i></div>
</div>
<div class="m-txt--descriptionform">
</div>
<div class="m-help j-help hide">
<ul>
<li>
Enter accomodation city. </li>
</ul>
</div>
<label class="error ">
<p>
</p>
</label>
<span class="u-alert-field accomcity "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
</div>
<div class="clearfix"></div>
</div>
</div>
<!--------------------------address ----------------------->
<div class="actions next">
<a class="btnNext btn m-button-primary" id="btnNext3" href="#next3">
Next </a>
</div>
</div>
</section>
<!------------------------------check conditions ----------------------->
<section class="m-form-application-category-container ">
<div class="m-form-application-title">
<h2 style="color:#fff;" class="a-subtitle">
Please confirm the responses to the following mandatory questions: </h2>
</div>
<div class="m-form-application-inputs-container">
<div class="row">
<div id="form-question1" class="m-form j-form-container question1">
<div class="col-sm-9">
<label>
Do you have a valid residence visa to Ethiopia? <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-sm-3 m-form-radio">
<label class="radio-inline parsley-success">
<input type="radio" id="radio-question1-1" class="radio-question1" name="question1" value="1" data-parsley-multiple="question1-multiple" required="required" data-parsley-errors-container="#errorquestion1" data-required="true" data-parsley-group="block-3" data-parsley-id="56" aria-required="true" disabled="disabled">
Yes
</label>
<label class="radio-inline">
<input type="radio" id="radio-question1-0" class="radio-question1" name="question1" value="0" data-parsley-multiple="question1-multiple" required="required" data-parsley-errors-container="#errorquestion1" data-required="true" checked="" data-parsley-group="block-3" aria-required="true" disabled="disabled">
No
</label>
<span class="u-alert-field question1 "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
<div id="errorquestion1"></div>
<div class="m-help j-help hide">
</div>
<label class="error ">
<p>
</p>
</label>
</div>
</div>
<div id="form-question2" class="m-form j-form-container question2">
<div class="col-sm-9">
<label>
Are you currently in Ethiopia with a valid ETA or obtained an
extension of visa? <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-sm-3 m-form-radio">
<label class="radio-inline parsley-success">
<input type="radio" id="radio-question2-1" class="radio-question2" name="question2" value="1" data-parsley-multiple="question2-multiple" required="required" data-parsley-errors-container="#errorquestion2" data-required="true" data-parsley-group="block-3" data-parsley-id="61" aria-required="true" disabled="disabled">
Yes
</label>
<label class="radio-inline">
<input type="radio" id="radio-question2-0" class="radio-question2" name="question2" value="0" data-parsley-multiple="question2-multiple" required="required" data-parsley-errors-container="#errorquestion2" data-required="true" checked="" data-parsley-group="block-3" aria-required="true" disabled="disabled">
No
</label>
<span class="u-alert-field question2 "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
<div id="errorquestion2"></div>
<div class="m-help j-help hide">
</div>
<label class="error ">
<p>
</p>
</label>
</div>
</div>
<div id="form-question3" class="m-form j-form-container question3">
<div class="col-sm-9">
<label>
Do you have a multiple entry visa to Ethiopia? <span class="m-txt--color-15">*</span>
</label>
</div>
<div class="col-sm-3 m-form-radio">
<label class="radio-inline parsley-success">
<input type="radio" id="radio-question3-1" class="radio-question3" name="question3" value="1" data-parsley-multiple="question3-multiple" required="required" data-parsley-errors-container="#errorquestion3" data-required="true" data-parsley-group="block-3" data-parsley-id="66" aria-required="true" disabled="disabled">
Yes
</label>
<label class="radio-inline">
<input type="radio" id="radio-question3-0" class="radio-question3" name="question3" value="0" data-parsley-multiple="question3-multiple" required="required" data-parsley-errors-container="#errorquestion3" data-required="true" checked="" data-parsley-group="block-3" aria-required="true" disabled="disabled">
No
</label>
<span class="u-alert-field question3 "><i class="fa fa-exclamation-circle"></i>
This field is required!</span>
<div id="errorquestion3"></div>
<div class="m-help j-help hide">
</div>
<label class="error ">
<p>
</p>
</label>
</div>
</div>
</div>
<div class="actions next">
<a class="btnNext btn m-button-primary" id="btnNext4" href="#next4">
Next </a>
</div>
</div>
</section>
<!-----------------------------------check conditions --------------------------->
<section class="m-form-application-category-container checkboxes">
<div class="m-form-application-title">
<h2 style="color:#fff;">
Declaration of Applicant </h2>
</div>
<div class="m-form-application-inputs-container">
<div class="m-form declaration2 ">
<div class="col-sm-12">
<label class="checkbox-inline">
<input type="checkbox" class="" name="declaration2" value="1" data-parsley-multiple="multipledeclaration2" required="required" data-parsley-group="block-4" aria-required="true" disabled="disabled">
I declare that the information I have given in this application is truthful,
complete and correct.
</label>
</div>
<label class="error ">
<p>
</p>
</label>
</div>
<div class="m-form declaration1 accept">
<div class="col-sm-12">
<label class="checkbox-inline">
<input type="checkbox" class="" name="declaration1" value="1" data-parsley-multiple="multipledeclaration1" required="required" data-parsley-group="block-4" aria-required="true" disabled="disabled">
I have read and understood the <a href="/terms-and-conditions" target="_blank">terms and conditions</a> and <a href="/refund" target="_blank">refund policy</a>
</label>
</div>
<label class="error ">
<p>
</p>
</label>
</div>
<div class="actions">
<input id="submit-button" type="submit" class="js-buttonLoading submitHide btn m-button-primary" value="Continue" name="sum_continue" data-parsley-group="block-4" disabled="disabled">
<button class="js-buttonLoading btn-loading hide btn m-button-primary" disabled="" data-parsley-group="block-4">
Continue <i id="spinner-loader" class="fa fa-spinner fa-spin m-button-spiner"></i>
</button>
</div>
</div>
</section>
</div>
</div>
<!-- Modal terms -->
</div>
</form>
</div>
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<footer>
<div class="footer-area-top">
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<div class="footer-about">
<p>Ethiopia eVisa system allows foreign nationals from certain countries to travel for tourism & business business purpose to Ethiopia.</p>
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<div class="footer-box">
<h3>Featured Links</h3>
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<li>
<ul>
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<h3></h3><br>
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<h3>Evisa Service</h3>
<ul class="featured-links">
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<li><a target="_blank" href="https://jsdimmigrations.in/ethiopia-visa/application">Apply For Tourist eVisa</a></li>
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