PDA

View Full Version : State DDL won't populate depending on Country DDL



llckll
02-02-2011, 03:23 PM
Please help. I'm not sure why it's not populating.


<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN">
<html>
<head>
<title>Blood Control</title>
<meta name="keywords" content="">
<meta name="description" content="">
<META HTTP-EQUIV="Expires" CONTENT="0">
<META HTTP-EQUIV="Pragma" CONTENT="no-cache">
<!--- global javascript functions --->
<script language="JavaScript" type="text/javascript" src="https://www.bd.com/includes/global.js"></script>
<!--- global style sheet --->
<LINK rel="stylesheet" type="text/css" href="https://www.bd.com/includes/styles.css" media="screen">
<!--- print style sheet --->
<LINK rel="stylesheet" type="text/css" href="https://www.bd.com/includes/print.css" media="print">
<!--- browser specific style sheets --->
<STYLE TYPE="text/css">
BODY {
font-size: 75%;
font-family : Verdana, Arial, Helvetica;
color: #333333;
}
TD {
font-size: 75%;
font-family : Verdana, Arial, Helvetica;
color: #333333;
}
</STYLE>
<!----- HBX Include ----->
<!-- HBX INCLUDE DATA HERE www.bd.com -->
<!--WEBSIDESTORY CODE HBX1.0 (Universal)-->
<!--COPYRIGHT 1997-2005 WEBSIDESTORY,INC. ALL RIGHTS RESERVED. U.S.PATENT No. 6,393,479B1. MORE INFO:http://websidestory.com/privacy-->
<script language="javascript">
var _hbEC=0,_hbE=new Array;function _hbEvent(a,b){b=_hbE[_hbEC++]=new Object();b._N=a;b._C=0;return b;}
var hbx=_hbEvent("pv");hbx.vpc="HBX0100u";hbx.gn="aa.bd.com";

//BEGIN EDITABLE SECTION
//CONFIGURATION VARIABLES
hbx.acct="DM531126I7FB72EN3";//ACCOUNT NUMBER(S)
hbx.pn="PUT+PAGE+NAME+HERE";//PAGE NAME(S)
hbx.mlc="CONTENT+CATEGORY";//MULTI-LEVEL CONTENT CATEGORY
hbx.pndef="index.asp";//DEFAULT PAGE NAME
hbx.ctdef="full";//DEFAULT CONTENT CATEGORY

//OPTIONAL PAGE VARIABLES
//ACTION SETTINGS
hbx.fv="";//FORM VALIDATION MINIMUM ELEMENTS OR SUBMIT FUNCTION NAME
hbx.lt="auto";//LINK TRACKING
hbx.dlf="n";//DOWNLOAD FILTER
hbx.dft="n";//DOWNLOAD FILE NAMING
hbx.elf="n";//EXIT LINK FILTER
hbx.lc="y";//FORCE LOWERCASE

//SEGMENTS AND FUNNELS
hbx.seg="";//VISITOR SEGMENTATION
hbx.fnl="";//FUNNELS

//CAMPAIGNS
hbx.cmp="";//CAMPAIGN ID
hbx.cmpn="";//CAMPAIGN ID IN QUERY
hbx.dcmp="";//DYNAMIC CAMPAIGN ID
hbx.dcmpn="";//DYNAMIC CAMPAIGN ID IN QUERY
hbx.dcmpe="";//DYNAMIC CAMPAIGN EXPIRATION
hbx.dcmpre="";//DYNAMIC CAMPAIGN RESPONSE EXPIRATION
hbx.hra="";//RESPONSE ATTRIBUTE
hbx.hqsr="";//RESPONSE ATTRIBUTE IN REFERRAL QUERY
hbx.hqsp="";//RESPONSE ATTRIBUTE IN QUERY
hbx.hlt="";//LEAD TRACKING
hbx.hla="";//LEAD ATTRIBUTE
hbx.gp="";//CAMPAIGN GOAL
hbx.gpn="";//CAMPAIGN GOAL IN QUERY
hbx.hcn="";//CONVERSION ATTRIBUTE
hbx.hcv="";//CONVERSION VALUE
hbx.cp="";//LEGACY CAMPAIGN
hbx.cpd="";//CAMPAIGN DOMAIN

//CUSTOM VARIABLES
hbx.ci="";//CUSTOMER ID
hbx.hc1="";//CUSTOM 1
hbx.hc2="";//CUSTOM 2
hbx.hc3="";//CUSTOM 3
hbx.hc4="";//CUSTOM 4
hbx.hrf="";//CUSTOM REFERRER
hbx.pec="";//ERROR CODES

//INSERT CUSTOM EVENTS

//END EDITABLE SECTION

//REQUIRED SECTION. CHANGE "YOURSERVER" TO VALID LOCATION ON YOUR WEB SERVER (HTTPS IF FROM SECURE SERVER)
</script>
<script language="javascript1.1" src="https://www.bd.com/includes/hbx.js"></script>
<!--END WEBSIDESTORY CODE-->
<!----- WT Include ----->
<meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1">
<script language="javascript">

var rand_no = Math.floor(Math.random()*999999);

// Declaring required variables
var digits = "0123456789";
// non-digit characters which are allowed in phone numbers
var phoneNumberDelimiters = "()#- .";
// characters which are allowed in international phone numbers
// (a leading + is OK)
var validWorldPhoneChars = phoneNumberDelimiters + "+";
// Minimum no of digits in an international phone no.
var minDigitsInIPhoneNumber = 0;

function form_action(form)
{
if (form.Share_Story.checked)
{
document.getElementById('share_story_enabled').style.display = 'block';

}
else
{
document.getElementById('share_story_enabled').style.display = 'none';
}

if (form.Share_Comment.checked)
{
document.getElementById('share_comment_enabled').style.display = 'block';

}
else
{
document.getElementById('share_comment_enabled').style.display = 'none';
}

if (form.Sign_Up.checked)
{
document.getElementById('sign_up_enabled').style.display = 'block';

}
else
{
document.getElementById('sign_up_enabled').style.display = 'none';
}

}
</script>
<script language="javascript">

function clearselect()
{
document.myform.State.options.length = 0;
}

function changeStates()
{
var indx=document.myform.Country.selectedIndex
var Country=document.myform.Country.options[indx].value

if (Country=="United States")
{
clearselect();
document.myform.State.options[0] = new Option('----- Select One -----','');
document.myform.State.options[1] = new Option('Alabama','AB');
document.myform.State.options[2] = new Option('Alaska','AK');
document.myform.State.options[3] = new Option('Arizona','AZ');
document.myform.State.options[4] = new Option('Arkansas','AR');
document.myform.State.options[5] = new Option('California','CA');
document.myform.State.options[6] = new Option('Colorado','CO');
document.myform.State.options[7] = new Option('Connecticut','CT');
document.myform.State.options[8] = new Option('Delaware','DE');
document.myform.State.options[9] = new Option('District of Columbia','DC');
document.myform.State.options[10] = new Option('Florida','FL');
document.myform.State.options[11] = new Option('Georgia','GA');
document.myform.State.options[12] = new Option('Hawaii','HI');
document.myform.State.options[13] = new Option('Idaho','ID');
document.myform.State.options[14] = new Option('Illinois','IL');
document.myform.State.options[15] = new Option('Indiana','IN');
document.myform.State.options[16] = new Option('Iowa','IA');
document.myform.State.options[17] = new Option('Kansas','KS');
document.myform.State.options[18] = new Option('Kentucky','KY');
document.myform.State.options[19] = new Option('Louisiana','LA');
document.myform.State.options[20] = new Option('Maine','ME');
document.myform.State.options[21] = new Option('Maryland','MD');
document.myform.State.options[22] = new Option('Massachusetts','MA');
document.myform.State.options[23] = new Option('Michigan','MI');
document.myform.State.options[24] = new Option('Minnesota','MN');
document.myform.State.options[25] = new Option('Mississippi','MS');
document.myform.State.options[26] = new Option('Missouri','MO');
document.myform.State.options[27] = new Option('Montana','MT');
document.myform.State.options[28] = new Option('Nebraska','NE');
document.myform.State.options[29] = new Option('Nevada','NV');
document.myform.State.options[30] = new Option('New Hampshire','NH');
document.myform.State.options[31] = new Option('New Jersey','NJ');
document.myform.State.options[32] = new Option('New Mexico','NM');
document.myform.State.options[33] = new Option('New York','NY');
document.myform.State.options[34] = new Option('North Carolina','NC');
document.myform.State.options[35] = new Option('North Dakota','ND');
document.myform.State.options[36] = new Option('Ohio','OH');
document.myform.State.options[37] = new Option('Oklahoma','OK');
document.myform.State.options[38] = new Option('Oregon','OR');
document.myform.State.options[39] = new Option('Pennsylvania','PA');
document.myform.State.options[40] = new Option('Puerto Rico','PR');
document.myform.State.options[41] = new Option('Rhode Island','RI');
document.myform.State.options[42] = new Option('South Carolina','SC');
document.myform.State.options[43] = new Option('South Dakota','SD');
document.myform.State.options[44] = new Option('Tennessee','TN');
document.myform.State.options[45] = new Option('Texas','TX');
document.myform.State.options[46] = new Option('Utah','UT');
document.myform.State.options[47] = new Option('Vermont','VT');
document.myform.State.options[48] = new Option('Virginia','VA');
document.myform.State.options[49] = new Option('Washington','WA');
document.myform.State.options[50] = new Option('West Virginia','WV');
document.myform.State.options[51] = new Option('Wisconsin','WI');
document.myform.State.options[52] = new Option('Wyoming','WY');
}
else if (Country=="Canada")
{
clearselect();
document.myform.State.options[0] = new Option('---------------Select One-------------','');
document.myform.State.options[1] = new Option('Alberta','AB');
document.myform.State.options[2] = new Option('British Columbia','BC');
document.myform.State.options[3] = new Option('Manitoba','MB');
document.myform.State.options[4] = new Option('New Brunswick','NB');
document.myform.State.options[5] = new Option('New Foundland','NL');
document.myform.State.options[6] = new Option('NorthWest Territories','NT');
document.myform.State.options[7] = new Option('Nova Scotia','NS');
document.myform.State.options[8] = new Option('Ontario','ON');
document.myform.State.options[9] = new Option('Prince Edward Island','PE');
document.myform.State.options[10] = new Option('Quebec','QC');
document.myform.State.options[11] = new Option('Saskatchewan','SK');
document.myform.State.options[12] = new Option('Yukon','YT');
}


else if (Country!="Canada" && Country!="United States")
{
clearselect();
document.myform.State.options[0] = new Option('Not Applicable','Not Applicable');
}
}


</script>
</head>
<body bgcolor="#ECF3FB" link="#2F61BD" vlink="#2F61BD" alink="#FF6600" marginheight="0" marginwidth="0" topmargin="0" leftmargin="0" onLoad="pageLoaded();">
<table border=0 cellpadding=0 cellspacing=0 width=768 align="center" bgcolor="#FFFFFF">
<tr>
<td width=4 height=7 background="https://www.bd.com/images/shadow_left.gif" valign=top><img src="https://www.bd.com/images/shadow_top_left.gif" alt="[spacer image]" width="4" height="7" hspace="0" vspace="0" border="0"></td>
<td width=760 rowspan=2 valign=top><!--- Global Header Include --->
<script type="text/javascript" src="https://www.bd.com/includes/anylink.js">
/***********************************************
* AnyLink CSS Menu script- © Dynamic Drive DHTML code library (www.dynamicdrive.com)
* This notice MUST stay intact for legal use
* Visit Dynamic Drive at http://www.dynamicdrive.com/ for full source code
***********************************************/
</script>

llckll
02-02-2011, 03:24 PM
Continuation


<style>
.anylinkcss{
position:absolute;
visibility: hidden;
border:1px solid #172E62;
font-family: verdana;
font-size: 90%;
line-height: 90%;
border-bottom-width: 0;
background-color: #e6eefb;
width: 85px;
}
.anylinkcss a{
width: 85px;
display: block;
border-bottom: 1px solid black;
color: #575757;
background: #e6eefb;
padding: 4px 4px 5px 6px;
text-decoration: none;
}
.anylinkcss a:hover{ /*hover background color*/
background-color: #fff;
color: #f60;
}
</style>
<table border=0 cellpadding=0 cellspacing=0 width=760 background="https://www.bd.com/images/header_bg.jpg" class="hd-table">
<tr>
<FORM NAME="SrchInput" ACTION="http://search.bd.com/query.html" METHOD="POST" enctype="multipart/form-data">
<INPUT TYPE="HIDDEN" NAME="col" VALUE="all">
<input type=hidden name=lowercase_query value="1">
<input type=hidden name=charset value="iso-8859-1">
<td valign=top><a href="http://www.bd.com/support/bdlogo.asp?site=bloodcontrol&title=Blood+Control&country=&ctitle="><img src="https://www.bd.com/images/bd_logo.gif" alt="BD" width="106" height="66" hspace="0" vspace="0" border="0"></a></td>
<td align=right valign=top><table border=0 cellpadding=0 cellspacing=0 class="banner-table" width="20%">
<tr>
<td rowspan=3 valign=top style="padding-top:3px;" nowrap><table border=0 cellpadding=0 cellspacing=0 width=425>
<tr>
<td align=center><a href="http://www.bd.com/aboutbd/" class="white-link-bold">About BD</a></td>
<td align=center><a href="http://www.bd.com/support/contact/" class="white-link-bold">Contact BD</a></td>
<td align=center><a href="http://www.bd.com/careers/" class="white-link-bold">Careers</a></td>
<td align=center><a href="http://www.bd.com/products/" class="white-link-bold">Products</a></td>
<td align=center><a href="http://www.bd.com/investors/" class="white-link-bold">Investors</a></td>
<td align=center><a href="http://www.bd.com/press/" class="white-link-bold">Press</a></td>
</tr>
</table>
<td width="8" rowspan=2>&nbsp;&nbsp;</td>
<td height=19 valign=top class="white-link" style="padding-top:1px;"><!--- this is for France b/c their phrases were so long, it wouldn't fit within the normal template --->
<!--- end france code --->
<table border=0 cellpadding=0 cellspacing=0 width="165">
<tr>
<td align="left"><a href="http://www.bd.com/legal/privacy_policy.asp" class="white-link">Privacy</a>&nbsp;</td>
<td align="right" nowrap><a href="http://www.bd.com/legal/terms.asp" class="white-link">Terms &amp; Conditions</a></td>
</tr>
</table></td>
<td width="6" rowspan=2>&nbsp;</td>
<td width="1" rowspan=2><img src="https://www.bd.com/images/spacer.gif" alt="[spacer image]" width="1" height="1" hspace="0" vspace="32" border="0"></td>
</tr>
<tr align="left">
<td align="right" valign="top"><table border="0" cellpadding="0" cellspacing="0" width="134">
<tr align="right" valign="top">
<td colspan="2" nowrap><input type="text" name="qt" width="10" style="width:112px; height:18px;" id=inputbox>
<input type=image value="submit" src="https://www.bd.com/images/search.gif" alt="Search" width="49" height="22" hspace="0" vspace="0" border="0" align="absmiddle"></td>
</tr>
<tr>
<td align="left" nowrap><a href="http://www.bd.com/site_map.asp#bloodcontrol" class="white-link">Site Map</a></td>
<td align="right" nowrap><a href="http://search.bd.com/" class="white-link">Advanced Search</a></td>
</tr>
</table></td>
</tr>
</table></td>
</form>
</tr>
</table>
<!--- Local Header Include --->
<table border=0 cellpadding=0 cellspacing=0 width=758 height=87 align=center background="https://www.bd.com/images/headers/bg/bloodcontrol_bg.jpg" class="banner-table">
<tr>
<td width="140" height="60" valign="top" class="country-cell"><a href="http://www.bd.com/" class="country">BD - Worldwide</a><br>
<a href="http://www.bd.com/support/locations.asp">Select a BD Location</a></td>
<td height="60" align="left" valign="top" cellpadding="0" cellspacing="0"><script type="text/javascript" src="https://www.bd.com/includes/swfobject.js"></script>
<div id="flashcontent" align="left"><img src="https://www.bd.com/includes/flash/tagline.gif" width="215" height="60" border=0></div>
<SCRIPT type="text/javascript">
var so = new SWFObject("https://www.bd.com/includes/flash/tagline4.swf", "tagline4", "215", "60", "6", "#ffffff");
so.addParam("quality", "high");
so.addParam("wmode", "transparent");
so.write("flashcontent");
</script></td>
</tr>
<tr>
<td colspan="2"><a href="http://www.bd.com/bloodcontrol/" class="section-hd-org">Blood Control</a></td>
</tr>
</table>
<img src="https://www.bd.com/images/spacer.gif" alt="[spacer image]" width="1" height="1" hspace="0" vspace="0" border="0"><br>
<table border=0 cellpadding=0 cellspacing=0 width=756 align=center>
<tr>
<!--- Sidenav Cell --->
<td width=139 bgcolor="#E6ECF7" valign=top class="sidenav-bg" background="https://www.bd.com/images/sidenav_bg.gif"><!--- Sidenav Include --->
<br>
<!--- Did You Know Include --->
<br></td>
<!--- left gutter --->
<td width=9><img src="https://www.bd.com/images/spacer.gif" alt="" width="1" height="1" hspace="4" vspace="0" border="0"></td>
<!--- content cell --->
<form action="https://bd.recp.rm02.net/servlet/UserSignUp?f=210130&postMethod=HTML&m=0&j=MAS2" method="post" name="myform" id="myform" onSubmit="return valid()">
<td width=608 valign=top><table border=0 cellpadding=0 cellspacing=0 width=608 class="hd-table">
<tr>
<td width=597 class="intro-text" style="padding-top: 20px; padding-bottom: 20px;"><table width="585" border="0">
<tr>
<td colspan="3">Check all that apply:</td>
</tr>
<tr>
<td width="18">&nbsp;</td>
<td width="247">&nbsp;</td>
<td width="306">&nbsp;</td>
</tr>
<!-- SHARE MY BLOOD EXPOSURE STORY SECTION -->
<tr>
<td colspan="3"><input type="checkbox" value="Share My Blood Exposure Story" name="Share_Story" onClick="form_action(this.form)" />
&nbsp;&nbsp;Share My Blood Exposure Story</td>
</tr>
<tr>
<td>&nbsp;&nbsp;&nbsp;</td>
<td colspan="2"><div id="share_story_enabled" style="display: none;">
<table width="0" border="0">
<tr>
<td width="2">&nbsp;</td>
<td colspan="2"><input type="radio" checked="checked" value="Share Story" name="Share Story" />
&nbsp;&nbsp;Information:</td>
</tr>
<tr>
<td>&nbsp;</td>
<td width="107">&nbsp;</td>
<td width="434">&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Name:&nbsp;</div></td>
<td><input type="text" name="Share Story Name" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Country:&nbsp;</div></td>
<td><select name="Country" onChange="return changeStates()">
<option value="" selected>---------------Select One-------------</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua and Barbuda">Antigua and Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="Brunei Darussalam">Brunei Darussalam</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Congo, The Democratic Republic of The">Congo, The Democratic Republic of The</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote D'ivoire">Cote D'ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-bissau">Guinea-bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard Island and Mcdonald Islands">Heard Island and Mcdonald Islands</option>
<option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran, Islamic Republic of">Iran, Islamic Republic of</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Israel">Israel</option>

llckll
02-02-2011, 03:24 PM
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea, Democratic People's Republic of">Korea, Democratic People's Republic of</option>
<option value="Korea, Republic of">Korea, Republic of</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao">Macao</option>
<option value="Macedonia, The Former Yugoslav Republic of">Macedonia, The Former Yugoslav Republic of</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia, Federated States of">Micronesia, Federated States of</option>
<option value="Moldova, Republic of">Moldova, Republic of</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territory, Occupied">Palestinian Territory, Occupied</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn">Pitcairn</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russian Federation">Russian Federation</option>
<option value="Rwanda">Rwanda</option>
<option value="Saint Helena">Saint Helena</option>
<option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
<option value="Saint Lucia">Saint Lucia</option>
<option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
<option value="Saint Vincent and The Grenadines">Saint Vincent and The Grenadines</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome and Principe">Sao Tome and Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia and Montenegro">Serbia and Montenegro</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia and The South Sandwich Islands">South Georgia and The South Sandwich Islands</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard and Jan Mayen">Svalbard and Jan Mayen</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syrian Arab Republic">Syrian Arab Republic</option>
<option value="Taiwan, Province of China">Taiwan, Province of China</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
<option value="Thailand">Thailand</option>
<option value="Timor-leste">Timor-leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad and Tobago">Trinidad and Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="United States Minor Outlying Islands">United States Minor Outlying Islands</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Venezuela">Venezuela</option>
<option value="Viet Nam">Viet Nam</option>
<option value="Virgin Islands, British">Virgin Islands, British</option>
<option value="Virgin Islands, U.S.">Virgin Islands, U.S.</option>
<option value="Wallis and Futuna">Wallis and Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>State:&nbsp;</div></td>
<td><select name="State">

</select></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Email:&nbsp;</div></td>
<td><input type="text" name="Email" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Phone:&nbsp;</div></td>
<td><input type="text" name="Share Story Phone" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2"><input type="radio" value="Share Story Anonymously" name="Share Story" />
&nbsp;&nbsp;Anonymous</td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td colspan="3">&nbsp;&nbsp;Input your story here</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2"><textarea name="Story" cols="50" rows="10"></textarea></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2" style="font-family:Verdana, Geneva, sans-serif; font-size:10px;">I hereby authorize Becton, Dickinson and Company ("BD") and its affiliates, representatives and agents to use any submitted images or story content as BD ("Media") on this site. My permission is performed freely and without any expectation of compensation. I also agree that BD is to be the sole owner of all rights and copyright holder of the Media of myself for all uses set forth herein. Any information I provide to BD shall be on a non-confidential basis and is disclosed freely and without any expectation of confidentiality following internal legal review. I agree not to include facility or product names in my story content and provide BD with full consent to remove this information if overlooked in my submission. I understand that BD has no control over the subsequent use of the Media by other parties, after they have been used by BD. I hereby release BD and its affiliates, representatives and agents from any and all claims based on the use of the Media. This agreement constitutes the sole, complete and exclusive agreement regarding the Media, and I am not relying on any other representation, whether oral or written.</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2" style="font-family:Verdana, Geneva, sans-serif; font-size:10px;"><input type="checkbox" value="Yes" name="Story Agreement" />
&nbsp;&nbsp;I agree</td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
</table>
</div></td>
</tr>
<tr>
<td colspan="3"><input type="checkbox" value="Share My Blood Exposure Story" name="Share_Comment" onClick="form_action(this.form)" />
&nbsp;&nbsp;Comment</td>
</tr>
<tr>
<td>&nbsp;&nbsp;&nbsp;</td>
<td colspan="2"><div id="share_comment_enabled" style="display: none;">
<table width="0" border="0">
<tr>
<td width="2">&nbsp;</td>
<td colspan="2">&nbsp;&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2"><input type="checkbox" value="Share Story" name="Share Story" />
&nbsp;Comment on a story&nbsp;&nbsp;
<input type="checkbox" value="Share Story" name="Share Story" />
&nbsp;General comment</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2">&nbsp;&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2"><input type="radio" checked="checked" value="Share Story" name="Share Story" />
&nbsp;&nbsp;Information:</td>
</tr>
<tr>
<td>&nbsp;</td>
<td width="107">&nbsp;</td>
<td width="434">&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Title of Story:&nbsp;</div></td>
<td><input type="text" name="Share Story Name" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Name:&nbsp;</div></td>
<td><input type="text" name="Share Story Name" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>State:&nbsp;</div></td>
<td><select name="State">
<option selected>-------- Select One --------</option>
<option value=AL>Alabama</option>
<option value=AK>Alaska</option>
<option value=AZ>Arizona</option>
<option value=AR>Arkansas</option>
<option value=CA>California</option>

llckll
02-02-2011, 03:25 PM
<option value=CO>Colorado</option>
<option value=CT>Connecticut</option>
<option value=DE>Delaware</option>
<option value=DC>District of Columbia</option>
<option value=FL>Florida</option>
<option value=GA>Georgia</option>
<option value=GU>Guam</option>
<option value=HI>Hawaii</option>
<option value=ID>Idaho</option>
<option value=IL>Illinois</option>
<option value=IN>Indiana</option>
<option value=IA>Iowa</option>
<option value=KS>Kansas</option>
<option value=KY>Kentucky</option>
<option value=LA>Louisiana</option>
<option value=ME>Maine</option>
<option value=MD>Maryland</option>
<option value=MA>Massachusetts</option>
<option value=MI>Michigan</option>
<option value=MN>Minnesota</option>
<option value=MS>Mississippi</option>
<option value=MO>Missouri</option>
<option value=MT>Montana</option>
<option value=NE>Nebraska</option>
<option value=NV>Nevada</option>
<option value=NH>New Hampshire</option>
<option value=NJ>New Jersey</option>
<option value=NM>New Mexico</option>
<option value=NY>New York</option>
<option value=NC>North Carolina</option>
<option value=ND>North Dakota</option>
<option value=OH>Ohio</option>
<option value=OK>Oklahoma</option>
<option value=OR>Oregon</option>
<option value=PA>Pennsylvania</option>
<option value=PR>Puerto Rico</option>
<option value=RI>Rhode Island</option>
<option value=SC>South Carolina</option>
<option value=SD>South Dakota</option>
<option value=TN>Tennessee</option>
<option value=TX>Texas</option>
<option value=UT>Utah</option>
<option value=VT>Vermont</option>
<option value=VI>Virgin Islands</option>
<option value=VA>Virginia</option>
<option value=WA>Washington</option>
<option value=WV>West Virginia</option>
<option value=WI>Wisconsin</option>
<option value=WY>Wyoming</option>
</select></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Email:&nbsp;</div></td>
<td><input type="text" name="Email" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>Phone:&nbsp;</div></td>
<td><input type="text" name="Share Story Phone" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2"><input type="radio" value="Share Story Anonymously" name="Share Story" />
&nbsp;&nbsp;Anonymous</td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td colspan="3">&nbsp;&nbsp;Input your comments here</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2"><textarea name="Story" cols="50" rows="10"></textarea></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2" style="font-family:Verdana, Geneva, sans-serif; font-size:10px;">I hereby authorize Becton, Dickinson and Company ("BD") and its affiliates, representatives and agents to use any submitted images or story content as BD ("Media") on this site. My permission is performed freely and without any expectation of compensation. I also agree that BD is to be the sole owner of all rights and copyright holder of the Media of myself for all uses set forth herein. Any information I provide to BD shall be on a non-confidential basis and is disclosed freely and without any expectation of confidentiality following internal legal review. I agree not to include facility or product names in my story content and provide BD with full consent to remove this information if overlooked in my submission. I understand that BD has no control over the subsequent use of the Media by other parties, after they have been used by BD. I hereby release BD and its affiliates, representatives and agents from any and all claims based on the use of the Media. This agreement constitutes the sole, complete and exclusive agreement regarding the Media, and I am not relying on any other representation, whether oral or written.</td>
</tr>
<tr>
<td>&nbsp;</td>
<td colspan="2" style="font-family:Verdana, Geneva, sans-serif; font-size:10px;"><input type="checkbox" value="Yes" name="Story Agreement" />
&nbsp;&nbsp;I agree</td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
</table>
</div></td>
</tr>
<tr>
<td colspan="3"><input type="checkbox" value="Yes" name="Sign_Up" onClick="form_action(this.form)" />
&nbsp;&nbsp;Contact Us</td>
</tr>
<tr>
<td>&nbsp;&nbsp;&nbsp;</td>
<td colspan="2"><div id="sign_up_enabled" style="display: none;">
<table width="0" border="0" cellpadding="3" cellspacing="3">
<tr>
<td width="20" valign="top"><input type="checkbox" value="Yes" name="Comment - General Comment" /></td>
<td colspan="2">Please keep me updated on general information regarding Peripheral IV Blood Exposure</td>
</tr>
<tr>
<td valign="top"><input type="checkbox" value="Yes" name="Comment - Comment on Story" /></td>
<td colspan="2">Please keep me updated on news regarding Peripheral IV Blood Exposure</td>
</tr>
<tr>
<td valign="top"><input type="checkbox" value="Yes" name="Comment - Comment on Story" /></td>
<td colspan="2">Please keep me updated on solutions to Peripheral IV Blood Exposure</td>
</tr>
<tr>
<td valign="top"><input type="checkbox" value="Yes" name="Comment - Comment on Story" /></td>
<td colspan="2">Please have a BD sales rep contact me</td>
</tr>
<tr>
<td>&nbsp;</td>
<td width="97">&nbsp;</td>
<td width="391">&nbsp;</td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>&nbsp;Name:&nbsp;</div></td>
<td>&nbsp;
<input type="text" name="Name" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right"><font color="#ff6600">*</font>&nbsp;Email:&nbsp;</div></td>
<td>&nbsp;
<input type="text" name="Email" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td><div align="right">Phone:&nbsp;</div></td>
<td>&nbsp;
<input type="text" name="Phone" size="30" /></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
</table>
</div></td>
</tr>
<tr>
<td colspan="3">Before submitting personal information to us, we encourage you to read our <a href="http://www.bd.com/legal/privacy_policy..asp">Privacy Statement and Consent to Use of Data</a>. This Statement contains important information about how we will handle and use your personal information. After you have had a chance to review the Statement, please acknowledge your acceptance of terms by selecting the box below. If you choose not to accept, the information you just completed will not be submitted to BD.</td>
</tr>
<tr>
<td valign="top" colspan="3"><font color="ff6600">*</font>
<input type="checkbox" name="accept" value="on">
&nbsp;I accept the terms of the Privacy Statement.</td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
<tr>
<td colspan="3" align="center"><input type="Submit" name="Submit" value="Submit" onClick="javascript:return valid();">
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
<input type="reset" value="Clear" name="reset"></td>
</tr>
<tr>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
</tr>
</table></td>
<td width=9><img src="https://www.bd.com/images/spacer.gif" alt="" width="1" height="1" hspace="4" vspace="0" border="0"></td>
</tr>
</table>
<!---------- Load Content ----------></td>
</form>
</tr>
</table></td>
<td width=4 height=7 valign=top background="https://www.bd.com/images/shadow_right.gif" class="shadow-cell"><img src="https://www.bd.com/images/shadow_top_right.gif" alt="[spacer image]" width="4" height="7" hspace="0" vspace="0" border="0"></td>
</tr>
<tr>
<td background="https://www.bd.com/images/shadow_left.gif"><img src="https://www.bd.com/images/spacer.gif" alt="" width="4" height="1" hspace="0" vspace="200" border="0"></td>
<td background="https://www.bd.com/images/shadow_right.gif" class="shadow-cell"><img src="https://www.bd.com/images/spacer.gif" alt="" width="4" height="1" hspace="0" vspace="200" border="0"></td>
</tr>
<tr>
<td background="https://www.bd.com/images/shadow_left.gif"><img src="https://www.bd.com/images/shadow_left.gif" alt="[spacer image]" width="4" height="1" hspace="0" vspace="0" border="0"></td>
<td class="hd-table"><img src="https://www.bd.com/images/spacer_blue.gif" alt="[spacer image]" width="758" height="5" hspace="1" vspace="1" border="0" class="hd-table"></td>
<td background="https://www.bd.com/images/shadow_right.gif" class="shadow-cell"><img src="https://www.bd.com/images/shadow_right.gif" alt="[spacer image]" width="4" height="1" hspace="0" vspace="0" border="0"></td>
</tr>
<tr>
<td valign=top><img src="https://www.bd.com/images/shadow_bottom_left.gif" alt="[spacer image]" width="4" height="8" hspace="0" vspace="0" border="0"></td>
<td height=8 bgcolor="#ECF3FB" background="https://www.bd.com/images/shadow_bottom.gif" class="shadow-bg"><img src="https://www.bd.com/images/shadow_bottom.gif" alt="[spacer image]" width="760" height="8" hspace="0" vspace="0" border="0" class="hd-table"></td>
<td valign=top><img src="https://www.bd.com/images/shadow_bottom_right.gif" alt="[spacer image]" width="4" height="8" hspace="0" vspace="0" border="0"></td>
</tr>
</table>
<!--- Footer Include --->
<img src="https://www.bd.com/images/spacer.gif" alt="[spacer image]" width="1" height="1" hspace="0" vspace="3" border="0"><br>
<table border=0 cellpadding=0 cellspacing=0 width=720 align=center class="hd-table">
<tr>
<td align=center class="footer-links" colspan="2"><a href="http://www.bd.com/site_map.asp#bloodcontrol">Site Map</a> <br>
<!--Setting the privacy policy to the default country-->
<a href="http://www.bd.com/legal/privacy_policy.asp" class="white-link">Privacy</a> | <a href="http://www.bd.com/legal/terms.asp">Terms &amp; Conditions</a> | <a href="http://www.bd.com/legal/permission.asp">Permission Request</a> | <a href="http://www.bd.com/legal/trademark_usage.asp">Trademarks</a><br>
<a href="http://www.bd.com/">BD Worldwide</a><br>
<br></td>
</tr>
<tr>
<td class="footer-text" width="40%" valign="top">BD<br>
1 Becton Drive<br>
Franklin Lakes, NJ USA 07417<br>
201.847.6800<br>
<br>
<td class="footer-text" width="60%" valign="top" align="right"><br>
</font></td>
</tr>
<tr>
<td class="footer-text" colspan="2"> Unless otherwise noted, BD, BD Logo and all other <a href="http://www.bd.com/legal/trademark_usage.asp">trademarks</a> are property of Becton, Dickinson and Company. &copy; 2011 BD<br>
<br></td>
</tr>
</table>
</body>
</html>

Philip M
02-02-2011, 03:56 PM
It would be more helpful if you posted only the relevant code - see

http://www.codingforums.com/showthread.php?t=2090 Item #3

People may well want to help you, but do not want to wade through umpteen countries and 50 states top get there, plus all the CSS which simply controls the display.

It is your responsibility to die() if necessary.. - PHP Manual