/*jslint nomen:false, debug:true, evil:true, vars:false, browser:true, forin:true, undef:false, white:false */
/**
 * Includes a Form with javascript
 * @param {Object} formId
 * @param {Object} initialHeight
 * @param {Object} iframeCode
 */
function FrameBuilder (formId, appendTo, initialHeight, iframeCode){
    this.formId = formId;
    this.initialHeight = initialHeight;
    this.iframeCode = iframeCode;
    this.frame = null;
    this.timeInterval= 200;
    this.appendTo = appendTo || false;
    
    // initialize function for object
    this.init = function(){
        this.createFrame();
        this.addFrameContent(this.iframeCode);
    };
    
    // Create the frame
    this.createFrame = function(){
        var htmlCode = "<"+"iframe src=\"\" allowtransparency=\"true\" frameborder=\"0\" name=\""+this.formId+"\" id=\""+this.formId+"\" style=\"width:100%; height:"+this.initialHeight+"px; border:none;\" scrolling=\"no\"></if"+"rame>";
        if(this.appendTo === false){
            document.write(htmlCode);
        }else{
            var tmp = document.createElement('div');
            tmp.innerHTML = htmlCode;
            var a = this.appendTo;
            document.getElementById(a).appendChild(tmp.firstChild);            
        }
        // also get the frame for future use.
        this.frame = document.getElementById(this.formId);
        // set the time on the on load event of the frame
        this.addEvent(this.frame, 'load', this.bindMethod(this.setTimer, this));
    };
    
    // add event function for different browsers
    this.addEvent = function( obj, type, fn ) {
        if ( obj.attachEvent ) {
            obj["e"+type+fn] = fn;
            obj[type+fn] = function() { obj["e"+type+fn]( window.event ); };
            obj.attachEvent( "on"+type, obj[type+fn] );
        }
        else{
            obj.addEventListener( type, fn, false );   
        }
    };
    
    this.addFrameContent = function (string){
        string = string.replace(new RegExp('src\\=\\"[^"]*captcha.php\"><\/scr'+'ipt>', 'gim'), 'src="http://api.recaptcha.net/js/recaptcha_ajax.js"></scr'+'ipt><'+'div id="recaptcha_div"><'+'/div>'+
                '<'+'style>#recaptcha_logo{ display:none;} #recaptcha_tagline{display:none;} #recaptcha_table{border:none !important;} .recaptchatable .recaptcha_image_cell, #recaptcha_table{ background-color:transparent !important; } <'+'/style>'+
                '<'+'script defer="defer"> window.onload = function(){ Recaptcha.create("6Ld9UAgAAAAAAMon8zjt30tEZiGQZ4IIuWXLt1ky", "recaptcha_div", {theme: "clean",tabindex: 0,callback: function (){'+
                'if (document.getElementById("uword")) { document.getElementById("uword").parentNode.removeChild(document.getElementById("uword")); } if (window["validate"] !== undefined) { if (document.getElementById("recaptcha_response_field")){ document.getElementById("recaptcha_response_field").onblur = function(){ validate(document.getElementById("recaptcha_response_field"), "Required"); } } } if (document.getElementById("recaptcha_response_field")){ document.getElementsByName("recaptcha_challenge_field")[0].setAttribute("name", "anum"); } if (document.getElementById("recaptcha_response_field")){ document.getElementsByName("recaptcha_response_field")[0].setAttribute("name", "qCap"); }}})'+
                ' }<'+'/script>');
        string = string.replace(/(type="text\/javascript">)\s+(validate\(\"[^"]*"\);)/, '$1 jTime = setInterval(function(){if("validate" in window){$2clearTimeout(jTime);}}, 1000);');
        var frameDocument = (this.frame.contentWindow) ? this.frame.contentWindow : (this.frame.contentDocument.document) ? this.frame.contentDocument.document : this.frame.contentDocument;
        frameDocument.document.open();
        frameDocument.document.write(string);
        setTimeout( function(){
            frameDocument.document.close();
            try{
                if('JotFormFrameLoaded' in window){
                    JotFormFrameLoaded();
                }
            }catch(e){}
        },200);
    };
    
    this.setTimer = function(){
        var self = this;
        this.interval = setTimeout(function(){self.changeHeight();},this.timeInterval);
    };
    
    this.changeHeight = function (){
        var actualHeight = this.getBodyHeight();
        var currentHeight = this.getViewPortHeight();
        if(actualHeight === undefined){
            this.frame.style.height = "100%";
            if(!this.frame.style.minHeight){
                this.frame.style.minHeight = "300px";
            }
        }else if  (Math.abs(actualHeight - currentHeight) > 18){
            this.frame.style.height = (actualHeight)+"px";
        }
        this.setTimer();
    };
    
    this.bindMethod = function(method, scope) {
        return function() {
            method.apply(scope,arguments);
        };
    };
    
    this.getBodyHeight = function (){
        var height;
        var scrollHeight;
        var offsetHeight;
        try{  // Prevent IE from throw errors
            if (this.frame.contentWindow.document.height){
                
                height = this.frame.contentWindow.document.height;
                //Emre: to prevent "iframe height"  problem (61059)
                if (this.frame.contentWindow.document.body.scrollHeight){
                    height = scrollHeight = this.frame.contentWindow.document.body.scrollHeight;
                }
                
                if (this.frame.contentWindow.document.body.offsetHeight){
                    height = offsetHeight = this.frame.contentWindow.document.body.offsetHeight;
                }
                
            } else if (this.frame.contentWindow.document.body){
                
                if (this.frame.contentWindow.document.body.scrollHeight){
                    height = scrollHeight = this.frame.contentWindow.document.body.scrollHeight;
                }
                
                if (this.frame.contentWindow.document.body.offsetHeight){
                    height = offsetHeight = this.frame.contentWindow.document.body.offsetHeight;
                }
                
                if (scrollHeight && offsetHeight){
                    height = Math.max(scrollHeight, offsetHeight);
                }
            }            
        }catch(e){ }
        return height;
    };
    
    this.getViewPortHeight = function(){
        var height = 0;
        try{ // Prevent IE from throw errors
            if (this.frame.contentWindow.window.innerHeight)
            {
                height = this.frame.contentWindow.window.innerHeight - 18;
            }
            else if ((this.frame.contentWindow.document.documentElement) &&
                     (this.frame.contentWindow.document.documentElement.clientHeight))
            {
                height = this.frame.contentWindow.document.documentElement.clientHeight;
            }
            else if ((this.frame.contentWindow.document.body) &&
                     (this.frame.contentWindow.document.body.clientHeight))
            {
                height = this.frame.contentWindow.document.body.clientHeight;
            }            
        }catch(e){ }
        return height;
    };
    
    this.init();
}
FrameBuilder.get = [];
var i1084103596 = new FrameBuilder("1084103596", false, "", "<!DOCTYPE HTML PUBLIC \"-\/\/W3C\/\/DTD HTML 4.01\/\/EN\" \"http:\/\/www.w3.org\/TR\/html4\/strict.dtd\">\n<html><head>\n<meta http-equiv=\"Content-Type\" content=\"text\/html; charset=utf-8\" \/>\n<meta name=\"viewport\" content=\"width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=0\" \/>\n<meta name=\"HandheldFriendly\" content=\"true\" \/>\n<title>Form<\/title>\n<link href=\"http:\/\/max.jotfor.ms\/min\/g=formCss?3.0.2435\" rel=\"stylesheet\" type=\"text\/css\" \/>\n<style type=\"text\/css\">\n    .form-label{\n        width:162px !important;\n    }\n    .form-label-left{\n        width:162px !important;\n    }\n    .form-line{\n        padding:10px;\n    }\n    .form-label-right{\n        width:162px !important;\n    }\n    body, html{\n        margin:0;\n        padding:0;\n        background:false;\n    }\n\n    .form-all{\n        margin:0px auto;\n        padding-top:0px;\n        width:575px;\n        color:Black !important;\n        font-family:Verdana;\n        font-size:12px;\n    }\n    \/* Injected CSS Code *\/\n.form-header-group {border-bottom: 1px dotted #000000;\nfont-size: 12px;\nfont-style: italic;\nfont-weight: lighter;\nmargin: 10px 0px 20px 0;\npadding-bottom: 3px;background: transparent;}\n.form-subHeader {border-top: none;}\n    \/* Injected CSS Code *\/\n<\/style>\n\n<script src=\"http:\/\/max.jotfor.ms\/min\/g=jotform?3.0.2435\" type=\"text\/javascript\"><\/script>\n<script type=\"text\/javascript\">\n var jsTime = setInterval(function(){try{\n   JotForm.jsForm = true;\n\n   JotForm.setConditions([{\"action\":{\"field\":\"107\",\"visibility\":\"Show\"},\"link\":\"Any\",\"terms\":[{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"requested\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Requested\"}],\"type\":\"field\"},{\"action\":{\"field\":\"108\",\"visibility\":\"Show\"},\"link\":\"Any\",\"terms\":[{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"requested\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Requested\"}],\"type\":\"field\"},{\"action\":{\"field\":\"110\",\"visibility\":\"Show\"},\"link\":\"Any\",\"terms\":[{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"requested\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Requested\"}],\"type\":\"field\"},{\"action\":{\"field\":\"111\",\"visibility\":\"Show\"},\"link\":\"Any\",\"terms\":[{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"requested\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Assessed\"},{\"field\":\"104\",\"operator\":\"contains\",\"value\":\"Requested\"}],\"type\":\"field\"}]);\n   JotForm.init(function(){\n      $('input_62').hint('300 words max');\n      $('input_19').hint('Please nominate the style or genre that best describes the play, eg naturalistic drama, surrealist, black comedy etc');\n      $('input_20').hint('Please list up to five keywords that someone might use to find your script through our online search facility, e.g. politics, history, war) ');\n      $('input_22').hint('minutes');\n      $('input_25').hint('XX Males, XX Females, XX TOTAL');\n      $('input_26').hint('XX Males, XX Females, XX TOTAL');\n      $('input_30').hint('Please list company, cast (if possible) director and performance dates.');\n      $('input_31').hint('Please list the year and name of any playwriting awards won for this script.');\n      $('input_41').hint('ex: myname@example.com');\n      $('input_61').hint('250 words max');\n      $('input_49').hint('ex: myname@example.com');\n      JotForm.description('input_63', 'Formats allowed: PDF, Microsoft Word or Pages');\n   });\n\n   clearInterval(jsTime);\n }catch(e){}}, 1000);\n<\/script>\n<\/head>\n<body>\n<form class=\"jotform-form\" action=\"http:\/\/submit.jotform.com\/submit.php\" method=\"post\" enctype=\"multipart\/form-data\" name=\"form_1084103596\" id=\"1084103596\" accept-charset=\"utf-8\">\n  <input type=\"hidden\" name=\"formID\" value=\"1084103596\" \/>\n  <div class=\"form-all\">\n    <ul class=\"form-section\">\n      <li id=\"cid_112\" class=\"form-input-wide\">\n        <div class=\"form-header-group\">\n          <h1 id=\"header_112\" class=\"form-header\">\n            Script Submissions\n          <\/h1>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_84\">\n        <div id=\"cid_84\" class=\"form-input-wide\">\n          <div id=\"text_84\" class=\"form-html\">\n            <p>\n              <strong>\n                Tips for using this form:\n              <\/strong>\n              <br \/>\n              <br \/>\n            <\/p>\n            <ul>\n              <li>\n                Fields\/sections marked * are required.\n              <\/li>\n              <li>\n                Some instructions within fields will disappear when you start typing. Click away from the field if you would like to review the instruction.\n              <\/li>\n              <li>\n                Once you begin completing this form you cannot save it part way through and return to it later.\n              <\/li>\n              <li>\n                Information can be copied and pasted into fields, which may particularly useful for the Synopsis and Playwright Bio sections.\n              <\/li>\n              <li>\n                Only one script can be submitted at a time. Return to this page and complete for each subsequent script you wish to submit.\n              <\/li>\n            <\/ul>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_93\">\n        <div id=\"cid_93\" class=\"form-input-wide\">\n          <div id=\"text_93\" class=\"form-html\">\n            &nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column\" id=\"id_1\">\n        <label class=\"form-label-right\" id=\"label_1\" for=\"input_1\">\n          PLAY TITLE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_1\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_1\" name=\"q1_playTitle\" size=\"32\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_7\">\n        <label class=\"form-label-right\" id=\"label_7\" for=\"input_7\">\n          PLAYWRIGHT:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_7\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"text\" size=\"10\" name=\"q7_playwright[first]\" id=\"first_7\" \/>\n            <label class=\"form-sub-label\" for=\"first_7\" id=\"sublabel_first\"> First Name <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"text\" size=\"15\" name=\"q7_playwright[last]\" id=\"last_7\" \/>\n            <label class=\"form-sub-label\" for=\"last_7\" id=\"sublabel_last\"> Last Name <\/label><\/span>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_94\">\n        <div id=\"cid_94\" class=\"form-input-wide\">\n          <div id=\"text_94\" class=\"form-html\">\n            &nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_12\" class=\"form-input-wide\">\n        <div class=\"form-header-group\">\n          <h1 id=\"header_12\" class=\"form-header\">\n            Eligibility\n          <\/h1>\n          <div id=\"subHeader_12\" class=\"form-subHeader\">\n            All scripts included in the ASC catalogue MUST be production ready.\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_92\">\n        <label class=\"form-label-top\" id=\"label_92\" for=\"input_92\">\n          Please tick at least one of the following eligibility criteria:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_92\" class=\"form-input-wide\">\n          <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_92_0\" name=\"q92_pleaseTick92[]\" value=\"The script has received a professional production and\/or an independent production. (Production history is set out below in the space provided. Please also attach reviews if available.)\" \/>\n              <label for=\"input_92_0\"> The script has received a professional production and\/or an independent production. (Production history is set out below in the space provided. Please also attach reviews if available.) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_92_1\" name=\"q92_pleaseTick92[]\" value=\"The script has been through a professional script development workshop. (Details are set out below in the space provided.)\" \/>\n              <label for=\"input_92_1\"> The script has been through a professional script development workshop. (Details are set out below in the space provided.) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_92_2\" name=\"q92_pleaseTick92[]\" value=\"The script has received a favourable written assessment by an industry-recognised professional (attach below in the space provided).\" \/>\n              <label for=\"input_92_2\"> The script has received a favourable written assessment by an industry-recognised professional (attach below in the space provided). <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_92_3\" name=\"q92_pleaseTick92[]\" value=\"The writer has a letter of support from an industry-recognised professional (attach below in the space provided).\" \/>\n              <label for=\"input_92_3\"> The writer has a letter of support from an industry-recognised professional (attach below in the space provided). <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_92_4\" name=\"q92_pleaseTick92[]\" value=\"The script has won or been shortlisted for a major Australian prize. (Details are set out below in the space provided.)\" \/>\n              <label for=\"input_92_4\"> The script has won or been shortlisted for a major Australian prize. (Details are set out below in the space provided.) <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_92_5\" name=\"q92_pleaseTick92[]\" value=\"I am a playwright, or a theatrical agent representing a playwright, who has three or more works already available on AustralianPlays.org\" \/>\n              <label for=\"input_92_5\"> I am a playwright, or a theatrical agent representing a playwright, who has three or more works already available on AustralianPlays.org <\/label><\/span><span class=\"clearfix\"><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_79\">\n        <div id=\"cid_79\" class=\"form-input-wide\">\n          <div id=\"text_79\" class=\"form-html\">\n            &nbsp;&nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_17\" class=\"form-input-wide\">\n        <div class=\"form-header-group\">\n          <h1 id=\"header_17\" class=\"form-header\">\n            About the Play\n          <\/h1>\n          <div id=\"subHeader_17\" class=\"form-subHeader\">\n            Most of the information collected on this form will be published on our websites if your script is accepted into the ASC catalogue. Ensuring that the information provided is accurate helps us to promote your script.\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_62\">\n        <label class=\"form-label-right\" id=\"label_62\" for=\"input_62\">\n          SYNOPSIS:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_62\" class=\"form-input\">\n          <div class=\"form-textarea-limit\"><span><textarea id=\"input_62\" class=\"form-textarea validate[required]\" name=\"q62_synopsis62\" cols=\"40\" rows=\"12\"><\/textarea>\n              <div class=\"form-textarea-limit-indicator\"><span type=\"Words\" limit=\"300\" id=\"input_62-limit\">0\/300<\/span>\n              <\/div><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_19\">\n        <label class=\"form-label-right\" id=\"label_19\" for=\"input_19\">\n          STYLE \/ GENRE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_19\" class=\"form-input\">\n          <textarea id=\"input_19\" class=\"form-textarea validate[required]\" name=\"q19_style19\" cols=\"40\" rows=\"3\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_20\">\n        <label class=\"form-label-right\" id=\"label_20\" for=\"input_20\">\n          SUBJECT KEYWORDS:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_20\" class=\"form-input\">\n          <textarea id=\"input_20\" class=\"form-textarea validate[required]\" name=\"q20_subjectKeywords20\" cols=\"40\" rows=\"3\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_32\">\n        <label class=\"form-label-right\" id=\"label_32\" for=\"input_32\">\n          FORMAT:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_32\" class=\"form-input\">\n          <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_32_0\" name=\"q32_format[]\" value=\"One-act play\" \/>\n              <label for=\"input_32_0\"> One-act play <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_32_1\" name=\"q32_format[]\" value=\"Two-act play\" \/>\n              <label for=\"input_32_1\"> Two-act play <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_32_2\" name=\"q32_format[]\" value=\"Three-acts plus\" \/>\n              <label for=\"input_32_2\"> Three-acts plus <\/label><\/span><span class=\"clearfix\"><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_22\">\n        <label class=\"form-label-right\" id=\"label_22\" for=\"input_22\">\n          PLAY DURATION:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_22\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_22\" name=\"q22_playDuration\" size=\"20\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_23\">\n        <label class=\"form-label-right\" id=\"label_23\" for=\"input_23\">\n          NO. OF PAGES:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_23\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_23\" name=\"q23_noOf\" size=\"20\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_24\">\n        <label class=\"form-label-right\" id=\"label_24\" for=\"input_24\">\n          COPYRIGHT YEAR:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_24\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_24\" name=\"q24_copyrightYear24\" size=\"20\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_25\">\n        <label class=\"form-label-right\" id=\"label_25\" for=\"input_25\">\n          PREFERRED CAST SIZE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_25\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_25\" name=\"q25_preferredCast25\" size=\"46\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_26\">\n        <label class=\"form-label-right\" id=\"label_26\" for=\"input_26\"> NUMBER OF ROLES: (specify if different from above) <\/label>\n        <div id=\"cid_26\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_26\" name=\"q26_numberOf26\" size=\"46\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_28\">\n        <label class=\"form-label-right\" id=\"label_28\" for=\"input_28\">\n          CAST AGE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_28\" class=\"form-input\">\n          <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_28_0\" name=\"q28_castAge28[]\" value=\"3-8 years\" \/>\n              <label for=\"input_28_0\"> 3-8 years <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_28_1\" name=\"q28_castAge28[]\" value=\"8-11 years\" \/>\n              <label for=\"input_28_1\"> 8-11 years <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_28_2\" name=\"q28_castAge28[]\" value=\"12-15 years\" \/>\n              <label for=\"input_28_2\"> 12-15 years <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_28_3\" name=\"q28_castAge28[]\" value=\"16-18 years\" \/>\n              <label for=\"input_28_3\"> 16-18 years <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_28_4\" name=\"q28_castAge28[]\" value=\"18+ years\" \/>\n              <label for=\"input_28_4\"> 18+ years <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_28_5\" name=\"q28_castAge28[]\" value=\"Any\" \/>\n              <label for=\"input_28_5\"> Any <\/label><\/span><span class=\"clearfix\"><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_29\">\n        <label class=\"form-label-right\" id=\"label_29\" for=\"input_29\">\n          AUDIENCE AGE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_29\" class=\"form-input\">\n          <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_29_0\" name=\"q29_audienceAge[]\" value=\"Family\" \/>\n              <label for=\"input_29_0\"> Family <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_29_1\" name=\"q29_audienceAge[]\" value=\"Children\" \/>\n              <label for=\"input_29_1\"> Children <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_29_2\" name=\"q29_audienceAge[]\" value=\"Teen\" \/>\n              <label for=\"input_29_2\"> Teen <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_29_3\" name=\"q29_audienceAge[]\" value=\"Young adult\" \/>\n              <label for=\"input_29_3\"> Young adult <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_29_4\" name=\"q29_audienceAge[]\" value=\"Adult\" \/>\n              <label for=\"input_29_4\"> Adult <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_29_5\" name=\"q29_audienceAge[]\" value=\"Any\" \/>\n              <label for=\"input_29_5\"> Any <\/label><\/span><span class=\"clearfix\"><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_30\">\n        <label class=\"form-label-right\" id=\"label_30\" for=\"input_30\"> WORKSHOP and\/or PRODUCTION HISTORY: <\/label>\n        <div id=\"cid_30\" class=\"form-input\">\n          <textarea id=\"input_30\" class=\"form-textarea\" name=\"q30_workshopAndor\" cols=\"40\" rows=\"6\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_31\">\n        <label class=\"form-label-right\" id=\"label_31\" for=\"input_31\"> AWARDS: <\/label>\n        <div id=\"cid_31\" class=\"form-input\">\n          <textarea id=\"input_31\" class=\"form-textarea\" name=\"q31_awards\" cols=\"40\" rows=\"6\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_96\">\n        <label class=\"form-label-right\" id=\"label_96\" for=\"input_96\">\n          CATEGORY: (Please tick at least one and no more than four of the categories listed)<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_96\" class=\"form-input\">\n          <div class=\"form-single-column\"><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_0\" name=\"q96_categoryplease32[]\" value=\"Drama\" \/>\n              <label for=\"input_96_0\"> Drama <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_1\" name=\"q96_categoryplease32[]\" value=\"Audition piece\" \/>\n              <label for=\"input_96_1\"> Audition piece <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_2\" name=\"q96_categoryplease32[]\" value=\"Solo Performer\" \/>\n              <label for=\"input_96_2\"> Solo Performer <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_3\" name=\"q96_categoryplease32[]\" value=\"Two-hander\" \/>\n              <label for=\"input_96_3\"> Two-hander <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_4\" name=\"q96_categoryplease32[]\" value=\"Australian history\" \/>\n              <label for=\"input_96_4\"> Australian history <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_5\" name=\"q96_categoryplease32[]\" value=\"Indigenous themes\" \/>\n              <label for=\"input_96_5\"> Indigenous themes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_6\" name=\"q96_categoryplease32[]\" value=\"Indigenous playwright\" \/>\n              <label for=\"input_96_6\"> Indigenous playwright <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_7\" name=\"q96_categoryplease32[]\" value=\"Multicultural themes\" \/>\n              <label for=\"input_96_7\"> Multicultural themes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_8\" name=\"q96_categoryplease32[]\" value=\"Political\/social themes\" \/>\n              <label for=\"input_96_8\"> Political\/social themes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_9\" name=\"q96_categoryplease32[]\" value=\"Gay\/Lesbian themes\" \/>\n              <label for=\"input_96_9\"> Gay\/Lesbian themes <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_10\" name=\"q96_categoryplease32[]\" value=\"Poetic\" \/>\n              <label for=\"input_96_10\"> Poetic <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_11\" name=\"q96_categoryplease32[]\" value=\"Epic\" \/>\n              <label for=\"input_96_11\"> Epic <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_12\" name=\"q96_categoryplease32[]\" value=\"Black comedy\" \/>\n              <label for=\"input_96_12\"> Black comedy <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_13\" name=\"q96_categoryplease32[]\" value=\"Comedy\" \/>\n              <label for=\"input_96_13\"> Comedy <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_14\" name=\"q96_categoryplease32[]\" value=\"Farce\" \/>\n              <label for=\"input_96_14\"> Farce <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_15\" name=\"q96_categoryplease32[]\" value=\"Satire\" \/>\n              <label for=\"input_96_15\"> Satire <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_16\" name=\"q96_categoryplease32[]\" value=\"Pantomime\" \/>\n              <label for=\"input_96_16\"> Pantomime <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_17\" name=\"q96_categoryplease32[]\" value=\"Mystery\" \/>\n              <label for=\"input_96_17\"> Mystery <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_18\" name=\"q96_categoryplease32[]\" value=\"Musical\/Play with music\" \/>\n              <label for=\"input_96_18\"> Musical\/Play with music <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_19\" name=\"q96_categoryplease32[]\" value=\"Physical theatre\" \/>\n              <label for=\"input_96_19\"> Physical theatre <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_20\" name=\"q96_categoryplease32[]\" value=\"Cross-artform\" \/>\n              <label for=\"input_96_20\"> Cross-artform <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_21\" name=\"q96_categoryplease32[]\" value=\"Puppetry\" \/>\n              <label for=\"input_96_21\"> Puppetry <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_22\" name=\"q96_categoryplease32[]\" value=\"Radio play\" \/>\n              <label for=\"input_96_22\"> Radio play <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_23\" name=\"q96_categoryplease32[]\" value=\"Verbatim theatre\" \/>\n              <label for=\"input_96_23\"> Verbatim theatre <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_24\" name=\"q96_categoryplease32[]\" value=\"Adaptation\" \/>\n              <label for=\"input_96_24\"> Adaptation <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-checkbox-item\" style=\"clear:left;\"><input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_96_25\" name=\"q96_categoryplease32[]\" value=\"Internationally produced\" \/>\n              <label for=\"input_96_25\"> Internationally produced <\/label><\/span><span class=\"clearfix\"><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_80\">\n        <div id=\"cid_80\" class=\"form-input-wide\">\n          <div id=\"text_80\" class=\"form-html\">\n            &nbsp;&nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_34\" class=\"form-input-wide\">\n        <div class=\"form-header-group\">\n          <h1 id=\"header_34\" class=\"form-header\">\n            About the Playwright\n          <\/h1>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_37\">\n        <div id=\"cid_37\" class=\"form-input-wide\">\n          <div id=\"text_37\" class=\"form-html\">\n            <font size=\"2\">\n              <i>\n                Personal contact details are kept confidential unless you authorise otherwise.\n              <\/i>\n              <br>\n            <\/font>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column form-line-column-clear\" id=\"id_46\">\n        <label class=\"form-label-right\" id=\"label_46\" for=\"input_46\">\n          PLAYWRIGHT NAME:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_46\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"text\" size=\"10\" name=\"q46_playwrightName46[first]\" id=\"first_46\" \/>\n            <label class=\"form-sub-label\" for=\"first_46\" id=\"sublabel_first\"> First Name <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox validate[required]\" type=\"text\" size=\"15\" name=\"q46_playwrightName46[last]\" id=\"last_46\" \/>\n            <label class=\"form-sub-label\" for=\"last_46\" id=\"sublabel_last\"> Last Name <\/label><\/span>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_86\">\n        <label class=\"form-label-right\" id=\"label_86\" for=\"input_86\">\n          STREET ADDRESS:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_86\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_86\" name=\"q86_streetAddress86\" size=\"29\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_87\">\n        <label class=\"form-label-right\" id=\"label_87\" for=\"input_87\">\n          CITY \/ SUBURB:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_87\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_87\" name=\"q87_city87\" size=\"29\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_88\">\n        <label class=\"form-label-right\" id=\"label_88\" for=\"input_88\">\n          STATE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_88\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_88\" name=\"q88_state\" size=\"10\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_89\">\n        <label class=\"form-label-right\" id=\"label_89\" for=\"input_89\">\n          POSTCODE:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_89\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox validate[required]\" id=\"input_89\" name=\"q89_postcode\" size=\"10\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_90\">\n        <label class=\"form-label-right\" id=\"label_90\" for=\"input_90\">\n          COUNTRY:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_90\" class=\"form-input\">\n          <select class=\"form-dropdown validate[required]\" style=\"width:150px\" id=\"input_90\" name=\"q90_country\">\n            <option>  <\/option>\n            <option value=\"United States\"> United States <\/option>\n            <option value=\"Abkhazia\"> Abkhazia <\/option>\n            <option value=\"Afghanistan\"> Afghanistan <\/option>\n            <option value=\"Albania\"> Albania <\/option>\n            <option value=\"Algeria\"> Algeria <\/option>\n            <option value=\"American Samoa\"> American Samoa <\/option>\n            <option value=\"Andorra\"> Andorra <\/option>\n            <option value=\"Angola\"> Angola <\/option>\n            <option value=\"Anguilla\"> Anguilla <\/option>\n            <option value=\"Antigua and Barbuda\"> Antigua and Barbuda <\/option>\n            <option value=\"Argentina\"> Argentina <\/option>\n            <option value=\"Armenia\"> Armenia <\/option>\n            <option value=\"Aruba\"> Aruba <\/option>\n            <option selected=\"selected\" value=\"Australia\"> Australia <\/option>\n            <option value=\"Austria\"> Austria <\/option>\n            <option value=\"Azerbaijan\"> Azerbaijan <\/option>\n            <option value=\"The Bahamas\"> The Bahamas <\/option>\n            <option value=\"Bahrain\"> Bahrain <\/option>\n            <option value=\"Bangladesh\"> Bangladesh <\/option>\n            <option value=\"Barbados\"> Barbados <\/option>\n            <option value=\"Belarus\"> Belarus <\/option>\n            <option value=\"Belgium\"> Belgium <\/option>\n            <option value=\"Belize\"> Belize <\/option>\n            <option value=\"Benin\"> Benin <\/option>\n            <option value=\"Bermuda\"> Bermuda <\/option>\n            <option value=\"Bhutan\"> Bhutan <\/option>\n            <option value=\"Bolivia\"> Bolivia <\/option>\n            <option value=\"Bosnia and Herzegovina\"> Bosnia and Herzegovina <\/option>\n            <option value=\"Botswana\"> Botswana <\/option>\n            <option value=\"Brazil\"> Brazil <\/option>\n            <option value=\"Brunei\"> Brunei <\/option>\n            <option value=\"Bulgaria\"> Bulgaria <\/option>\n            <option value=\"Burkina Faso\"> Burkina Faso <\/option>\n            <option value=\"Burundi\"> Burundi <\/option>\n            <option value=\"Cambodia\"> Cambodia <\/option>\n            <option value=\"Cameroon\"> Cameroon <\/option>\n            <option value=\"Canada\"> Canada <\/option>\n            <option value=\"Cape Verde\"> Cape Verde <\/option>\n            <option value=\"Cayman Islands\"> Cayman Islands <\/option>\n            <option value=\"Central African Republic\"> Central African Republic <\/option>\n            <option value=\"Chad\"> Chad <\/option>\n            <option value=\"Chile\"> Chile <\/option>\n            <option value=\"People's Republic of China\"> People's Republic of China <\/option>\n            <option value=\"Republic of China\"> Republic of China <\/option>\n            <option value=\"Christmas Island\"> Christmas Island <\/option>\n            <option value=\"Cocos (Keeling) Islands\"> Cocos (Keeling) Islands <\/option>\n            <option value=\"Colombia\"> Colombia <\/option>\n            <option value=\"Comoros\"> Comoros <\/option>\n            <option value=\"Congo\"> Congo <\/option>\n            <option value=\"Cook Islands\"> Cook Islands <\/option>\n            <option value=\"Costa Rica\"> Costa Rica <\/option>\n            <option value=\"Cote d'Ivoire\"> Cote d'Ivoire <\/option>\n            <option value=\"Croatia\"> Croatia <\/option>\n            <option value=\"Cuba\"> Cuba <\/option>\n            <option value=\"Cyprus\"> Cyprus <\/option>\n            <option value=\"Czech Republic\"> Czech Republic <\/option>\n            <option value=\"Denmark\"> Denmark <\/option>\n            <option value=\"Djibouti\"> Djibouti <\/option>\n            <option value=\"Dominica\"> Dominica <\/option>\n            <option value=\"Dominican Republic\"> Dominican Republic <\/option>\n            <option value=\"Ecuador\"> Ecuador <\/option>\n            <option value=\"Egypt\"> Egypt <\/option>\n            <option value=\"El Salvador\"> El Salvador <\/option>\n            <option value=\"Equatorial Guinea\"> Equatorial Guinea <\/option>\n            <option value=\"Eritrea\"> Eritrea <\/option>\n            <option value=\"Estonia\"> Estonia <\/option>\n            <option value=\"Ethiopia\"> Ethiopia <\/option>\n            <option value=\"Falkland Islands\"> Falkland Islands <\/option>\n            <option value=\"Faroe Islands\"> Faroe Islands <\/option>\n            <option value=\"Fiji\"> Fiji <\/option>\n            <option value=\"Finland\"> Finland <\/option>\n            <option value=\"France\"> France <\/option>\n            <option value=\"French Polynesia\"> French Polynesia <\/option>\n            <option value=\"Gabon\"> Gabon <\/option>\n            <option value=\"The Gambia\"> The Gambia <\/option>\n            <option value=\"Georgia\"> Georgia <\/option>\n            <option value=\"Germany\"> Germany <\/option>\n            <option value=\"Ghana\"> Ghana <\/option>\n            <option value=\"Gibraltar\"> Gibraltar <\/option>\n            <option value=\"Greece\"> Greece <\/option>\n            <option value=\"Greenland\"> Greenland <\/option>\n            <option value=\"Grenada\"> Grenada <\/option>\n            <option value=\"Guadeloupe\"> Guadeloupe <\/option>\n            <option value=\"Guam\"> Guam <\/option>\n            <option value=\"Guatemala\"> Guatemala <\/option>\n            <option value=\"Guernsey\"> Guernsey <\/option>\n            <option value=\"Guinea\"> Guinea <\/option>\n            <option value=\"Guinea-Bissau\"> Guinea-Bissau <\/option>\n            <option value=\"Guyana\"> Guyana <\/option>\n            <option value=\"Haiti\"> Haiti <\/option>\n            <option value=\"Honduras\"> Honduras <\/option>\n            <option value=\"Hong Kong\"> Hong Kong <\/option>\n            <option value=\"Hungary\"> Hungary <\/option>\n            <option value=\"Iceland\"> Iceland <\/option>\n            <option value=\"India\"> India <\/option>\n            <option value=\"Indonesia\"> Indonesia <\/option>\n            <option value=\"Iran\"> Iran <\/option>\n            <option value=\"Iraq\"> Iraq <\/option>\n            <option value=\"Ireland\"> Ireland <\/option>\n            <option value=\"Israel\"> Israel <\/option>\n            <option value=\"Italy\"> Italy <\/option>\n            <option value=\"Jamaica\"> Jamaica <\/option>\n            <option value=\"Japan\"> Japan <\/option>\n            <option value=\"Jersey\"> Jersey <\/option>\n            <option value=\"Jordan\"> Jordan <\/option>\n            <option value=\"Kazakhstan\"> Kazakhstan <\/option>\n            <option value=\"Kenya\"> Kenya <\/option>\n            <option value=\"Kiribati\"> Kiribati <\/option>\n            <option value=\"North Korea\"> North Korea <\/option>\n            <option value=\"South Korea\"> South Korea <\/option>\n            <option value=\"Kosovo\"> Kosovo <\/option>\n            <option value=\"Kuwait\"> Kuwait <\/option>\n            <option value=\"Kyrgyzstan\"> Kyrgyzstan <\/option>\n            <option value=\"Laos\"> Laos <\/option>\n            <option value=\"Latvia\"> Latvia <\/option>\n            <option value=\"Lebanon\"> Lebanon <\/option>\n            <option value=\"Lesotho\"> Lesotho <\/option>\n            <option value=\"Liberia\"> Liberia <\/option>\n            <option value=\"Libya\"> Libya <\/option>\n            <option value=\"Liechtenstein\"> Liechtenstein <\/option>\n            <option value=\"Lithuania\"> Lithuania <\/option>\n            <option value=\"Luxembourg\"> Luxembourg <\/option>\n            <option value=\"Macau\"> Macau <\/option>\n            <option value=\"Macedonia\"> Macedonia <\/option>\n            <option value=\"Madagascar\"> Madagascar <\/option>\n            <option value=\"Malawi\"> Malawi <\/option>\n            <option value=\"Malaysia\"> Malaysia <\/option>\n            <option value=\"Maldives\"> Maldives <\/option>\n            <option value=\"Mali\"> Mali <\/option>\n            <option value=\"Malta\"> Malta <\/option>\n            <option value=\"Marshall Islands\"> Marshall Islands <\/option>\n            <option value=\"Martinique\"> Martinique <\/option>\n            <option value=\"Mauritania\"> Mauritania <\/option>\n            <option value=\"Mauritius\"> Mauritius <\/option>\n            <option value=\"Mayotte\"> Mayotte <\/option>\n            <option value=\"Mexico\"> Mexico <\/option>\n            <option value=\"Micronesia\"> Micronesia <\/option>\n            <option value=\"Moldova\"> Moldova <\/option>\n            <option value=\"Monaco\"> Monaco <\/option>\n            <option value=\"Mongolia\"> Mongolia <\/option>\n            <option value=\"Montenegro\"> Montenegro <\/option>\n            <option value=\"Montserrat\"> Montserrat <\/option>\n            <option value=\"Morocco\"> Morocco <\/option>\n            <option value=\"Mozambique\"> Mozambique <\/option>\n            <option value=\"Myanmar\"> Myanmar <\/option>\n            <option value=\"Nagorno-Karabakh\"> Nagorno-Karabakh <\/option>\n            <option value=\"Namibia\"> Namibia <\/option>\n            <option value=\"Nauru\"> Nauru <\/option>\n            <option value=\"Nepal\"> Nepal <\/option>\n            <option value=\"Netherlands\"> Netherlands <\/option>\n            <option value=\"Netherlands Antilles\"> Netherlands Antilles <\/option>\n            <option value=\"New Caledonia\"> New Caledonia <\/option>\n            <option value=\"New Zealand\"> New Zealand <\/option>\n            <option value=\"Nicaragua\"> Nicaragua <\/option>\n            <option value=\"Niger\"> Niger <\/option>\n            <option value=\"Nigeria\"> Nigeria <\/option>\n            <option value=\"Niue\"> Niue <\/option>\n            <option value=\"Norfolk Island\"> Norfolk Island <\/option>\n            <option value=\"Turkish Republic of Northern Cyprus\"> Turkish Republic of Northern Cyprus <\/option>\n            <option value=\"Northern Mariana\"> Northern Mariana <\/option>\n            <option value=\"Norway\"> Norway <\/option>\n            <option value=\"Oman\"> Oman <\/option>\n            <option value=\"Pakistan\"> Pakistan <\/option>\n            <option value=\"Palau\"> Palau <\/option>\n            <option value=\"Palestine\"> Palestine <\/option>\n            <option value=\"Panama\"> Panama <\/option>\n            <option value=\"Papua New Guinea\"> Papua New Guinea <\/option>\n            <option value=\"Paraguay\"> Paraguay <\/option>\n            <option value=\"Peru\"> Peru <\/option>\n            <option value=\"Philippines\"> Philippines <\/option>\n            <option value=\"Pitcairn Islands\"> Pitcairn Islands <\/option>\n            <option value=\"Poland\"> Poland <\/option>\n            <option value=\"Portugal\"> Portugal <\/option>\n            <option value=\"Puerto Rico\"> Puerto Rico <\/option>\n            <option value=\"Qatar\"> Qatar <\/option>\n            <option value=\"Romania\"> Romania <\/option>\n            <option value=\"Russia\"> Russia <\/option>\n            <option value=\"Rwanda\"> Rwanda <\/option>\n            <option value=\"Saint Barthelemy\"> Saint Barthelemy <\/option>\n            <option value=\"Saint Helena\"> Saint Helena <\/option>\n            <option value=\"Saint Kitts and Nevis\"> Saint Kitts and Nevis <\/option>\n            <option value=\"Saint Lucia\"> Saint Lucia <\/option>\n            <option value=\"Saint Martin\"> Saint Martin <\/option>\n            <option value=\"Saint Pierre and Miquelon\"> Saint Pierre and Miquelon <\/option>\n            <option value=\"Saint Vincent and the Grenadines\"> Saint Vincent and the Grenadines <\/option>\n            <option value=\"Samoa\"> Samoa <\/option>\n            <option value=\"San Marino\"> San Marino <\/option>\n            <option value=\"Sao Tome and Principe\"> Sao Tome and Principe <\/option>\n            <option value=\"Saudi Arabia\"> Saudi Arabia <\/option>\n            <option value=\"Senegal\"> Senegal <\/option>\n            <option value=\"Serbia\"> Serbia <\/option>\n            <option value=\"Seychelles\"> Seychelles <\/option>\n            <option value=\"Sierra Leone\"> Sierra Leone <\/option>\n            <option value=\"Singapore\"> Singapore <\/option>\n            <option value=\"Slovakia\"> Slovakia <\/option>\n            <option value=\"Slovenia\"> Slovenia <\/option>\n            <option value=\"Solomon Islands\"> Solomon Islands <\/option>\n            <option value=\"Somalia\"> Somalia <\/option>\n            <option value=\"Somaliland\"> Somaliland <\/option>\n            <option value=\"South Africa\"> South Africa <\/option>\n            <option value=\"South Ossetia\"> South Ossetia <\/option>\n            <option value=\"Spain\"> Spain <\/option>\n            <option value=\"Sri Lanka\"> Sri Lanka <\/option>\n            <option value=\"Sudan\"> Sudan <\/option>\n            <option value=\"Suriname\"> Suriname <\/option>\n            <option value=\"Svalbard\"> Svalbard <\/option>\n            <option value=\"Swaziland\"> Swaziland <\/option>\n            <option value=\"Sweden\"> Sweden <\/option>\n            <option value=\"Switzerland\"> Switzerland <\/option>\n            <option value=\"Syria\"> Syria <\/option>\n            <option value=\"Taiwan\"> Taiwan <\/option>\n            <option value=\"Tajikistan\"> Tajikistan <\/option>\n            <option value=\"Tanzania\"> Tanzania <\/option>\n            <option value=\"Thailand\"> Thailand <\/option>\n            <option value=\"Timor-Leste\"> Timor-Leste <\/option>\n            <option value=\"Togo\"> Togo <\/option>\n            <option value=\"Tokelau\"> Tokelau <\/option>\n            <option value=\"Tonga\"> Tonga <\/option>\n            <option value=\"Transnistria Pridnestrovie\"> Transnistria Pridnestrovie <\/option>\n            <option value=\"Trinidad and Tobago\"> Trinidad and Tobago <\/option>\n            <option value=\"Tristan da Cunha\"> Tristan da Cunha <\/option>\n            <option value=\"Tunisia\"> Tunisia <\/option>\n            <option value=\"Turkey\"> Turkey <\/option>\n            <option value=\"Turkmenistan\"> Turkmenistan <\/option>\n            <option value=\"Turks and Caicos Islands\"> Turks and Caicos Islands <\/option>\n            <option value=\"Tuvalu\"> Tuvalu <\/option>\n            <option value=\"Uganda\"> Uganda <\/option>\n            <option value=\"Ukraine\"> Ukraine <\/option>\n            <option value=\"United Arab Emirates\"> United Arab Emirates <\/option>\n            <option value=\"United Kingdom\"> United Kingdom <\/option>\n            <option value=\"Uruguay\"> Uruguay <\/option>\n            <option value=\"Uzbekistan\"> Uzbekistan <\/option>\n            <option value=\"Vanuatu\"> Vanuatu <\/option>\n            <option value=\"Vatican City\"> Vatican City <\/option>\n            <option value=\"Venezuela\"> Venezuela <\/option>\n            <option value=\"Vietnam\"> Vietnam <\/option>\n            <option value=\"British Virgin Islands\"> British Virgin Islands <\/option>\n            <option value=\"US Virgin Islands\"> US Virgin Islands <\/option>\n            <option value=\"Wallis and Futuna\"> Wallis and Futuna <\/option>\n            <option value=\"Western Sahara\"> Western Sahara <\/option>\n            <option value=\"Yemen\"> Yemen <\/option>\n            <option value=\"Zambia\"> Zambia <\/option>\n            <option value=\"Zimbabwe\"> Zimbabwe <\/option>\n          <\/select>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_53\">\n        <label class=\"form-label-right\" id=\"label_53\" for=\"input_53\"> PHONE: <\/label>\n        <div id=\"cid_53\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_53\" name=\"q53_phone\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_42\">\n        <label class=\"form-label-right\" id=\"label_42\" for=\"input_42\"> MOBILE: <\/label>\n        <div id=\"cid_42\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_42\" name=\"q42_mobile\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_41\">\n        <label class=\"form-label-right\" id=\"label_41\" for=\"input_41\">\n          EMAIL:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_41\" class=\"form-input\">\n          <input type=\"email\" class=\"form-textbox validate[required, Email]\" id=\"input_41\" name=\"q41_email\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_45\">\n        <label class=\"form-label-right\" id=\"label_45\" for=\"input_45\"> PLAYWRIGHT WEBSITE: <\/label>\n        <div id=\"cid_45\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_45\" name=\"q45_playwrightWebsite45\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_61\">\n        <label class=\"form-label-right\" id=\"label_61\" for=\"input_61\">\n          PLAYWRIGHT'S BIO:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_61\" class=\"form-input\">\n          <div class=\"form-textarea-limit\"><span><textarea id=\"input_61\" class=\"form-textarea validate[required]\" name=\"q61_playwrightsBio61\" cols=\"40\" rows=\"15\"><\/textarea>\n              <div class=\"form-textarea-limit-indicator\"><span type=\"Words\" limit=\"250\" id=\"input_61-limit\">0\/250<\/span>\n              <\/div><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_77\">\n        <div id=\"cid_77\" class=\"form-input-wide\">\n          <div id=\"text_77\" class=\"form-html\">\n            <hr>\n            &nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_75\">\n        <div id=\"cid_75\" class=\"form-input-wide\">\n          <div id=\"text_75\" class=\"form-html\">\n            &nbsp;\n            <b>\n              AGENT DETAILS\n            <\/b>\n            (if applicable)\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column form-line-column-clear\" id=\"id_39\">\n        <label class=\"form-label-right\" id=\"label_39\" for=\"input_39\"> AGENT'S NAME: <\/label>\n        <div id=\"cid_39\" class=\"form-input\"><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"text\" size=\"10\" name=\"q39_agentsName[first]\" id=\"first_39\" \/>\n            <label class=\"form-sub-label\" for=\"first_39\" id=\"sublabel_first\"> First Name <\/label><\/span><span class=\"form-sub-label-container\"><input class=\"form-textbox\" type=\"text\" size=\"15\" name=\"q39_agentsName[last]\" id=\"last_39\" \/>\n            <label class=\"form-sub-label\" for=\"last_39\" id=\"sublabel_last\"> Last Name <\/label><\/span>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_52\">\n        <label class=\"form-label-right\" id=\"label_52\" for=\"input_52\"> AGENCY: <\/label>\n        <div id=\"cid_52\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_52\" name=\"q52_agency\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_49\">\n        <label class=\"form-label-right\" id=\"label_49\" for=\"input_49\"> AGENT'S EMAIL: <\/label>\n        <div id=\"cid_49\" class=\"form-input\">\n          <input type=\"email\" class=\"form-textbox validate[Email]\" id=\"input_49\" name=\"q49_agentsEmail\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_51\">\n        <label class=\"form-label-right\" id=\"label_51\" for=\"input_51\"> AGENT'S WEBSITE: <\/label>\n        <div id=\"cid_51\" class=\"form-input\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_51\" name=\"q51_agentsWebsite\" size=\"30\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_55\">\n        <div id=\"cid_55\" class=\"form-input-wide\">\n          <div id=\"text_55\" class=\"form-html\">\n            <font size=\"2\">\n              I prefer communications from the Australian Script Centre (including newsletters, updates and royalty statements) to be made:\n              <br>\n            <\/font>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_56\">\n        <label class=\"form-label-right\" id=\"label_56\" for=\"input_56\">\n          MAIN CONTACT:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_56\" class=\"form-input\">\n          <div class=\"form-single-column\"><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_56_0\" name=\"q56_mainContact56\" value=\"Directly to playwright\" \/>\n              <label for=\"input_56_0\"> Directly to playwright <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_56_1\" name=\"q56_mainContact56\" value=\"Only through agent\" \/>\n              <label for=\"input_56_1\"> Only through agent <\/label><\/span><span class=\"clearfix\"><\/span><span class=\"form-radio-item\" style=\"clear:left;\"><input type=\"radio\" class=\"form-radio validate[required]\" id=\"input_56_2\" name=\"q56_mainContact56\" value=\"To both agent and playwright\" \/>\n              <label for=\"input_56_2\"> To both agent and playwright <\/label><\/span><span class=\"clearfix\"><\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_78\">\n        <div id=\"cid_78\" class=\"form-input-wide\">\n          <div id=\"text_78\" class=\"form-html\">\n            <br>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_57\" class=\"form-input-wide\">\n        <div class=\"form-header-group\">\n          <h1 id=\"header_57\" class=\"form-header\">\n            About Your Submission\n          <\/h1>\n          <div id=\"subHeader_57\" class=\"form-subHeader\">\n            Please note that submissions are only accepted electronically. If you can not upload your script (below) and\/or any other support materials, please contact the Script Centre to arrange an alternative.\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_74\">\n        <div id=\"cid_74\" class=\"form-input-wide\">\n          <div id=\"text_74\" class=\"form-html\">\n            <p>\n              SUBMISSION FEE:\n            <\/p>\n            <p>\n              For unsolicited submissions, a one-off fee of $33 (incl. GST) is payable per\n              <strong>\n                accepted\n              <\/strong>\n              script. This goes towards the costs involved in formatting, uploading and managing access to, and sales of the script.\n              <strong>\n                Please do not send payment now\n              <\/strong>\n              . Payment will be requested upon advice of acceptance.\n            <\/p>\n            <p>\n              The submission fee is waived for solicited plays and those which have won a major playwriting award (eg the Griffin Award, Patrick White Playwrights' Award, an AWGIE etc) and in other certain circumstances at the sole discretion of the Script Centre.\n            <\/p>\n            <br>\n            <\/br>\n            <p>\n              UPLOADING YOUR FILES:\n            <\/p>\n            <p>\n              Use the 'Browse' button next to the upload fields below to locate the files on your computer.\n            <\/p>\n            <p>\n              If you need to include any additional files (eg. a letter of support or a review), you can attach them here also. If you have more than two additional files you can email them to admin@ozscript.org. (Please ensure they are clearly labeled so they can be matched to your online submission.) We will contact you for a bio photo and any available production shots if your script is accepted.\n            <\/p>\n            <p>\n              Click 'Submit Form' once all your files are attached and all information is complete.\n            <\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_103\">\n        <div id=\"cid_103\" class=\"form-input-wide\">\n          <div id=\"text_103\" class=\"form-html\">\n            &nbsp;&nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_63\">\n        <label class=\"form-label-right\" id=\"label_63\" for=\"input_63\">\n          ATTACH YOUR SCRIPT:<span class=\"form-required\">*<\/span>\n        <\/label>\n        <div id=\"cid_63\" class=\"form-input\">\n          <input class=\"form-upload validate[required]\" type=\"file\" id=\"input_63\" name=\"q63_attachYour\" file-accept=\"pdf, doc, docx, pages\" file-maxsize=\"4000\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_98\">\n        <label class=\"form-label-right\" id=\"label_98\" for=\"input_98\"> ATTACH SUPPORT MATERIALS: <\/label>\n        <div id=\"cid_98\" class=\"form-input\"><span class=\"form-sub-label-container\"><div class=\"qq-uploader-buttonText-value\">\n              Choose Files\n            <\/div>\n            <input class=\"form-upload-multiple\" type=\"file\" id=\"input_98\" name=\"q98_attachSupport98[]\" multiple=\"multiple\" file-accept=\"pdf, doc, docx, mp3, wma, mpg, flv, jpg, png, gif, tiff, tif, jpeg\" file-maxsize=\"3000\" \/>\n            <label class=\"form-sub-label\" for=\"input_98\"> Optional <\/label><\/span>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_83\">\n        <div id=\"cid_83\" class=\"form-input-wide\">\n          <div id=\"text_83\" class=\"form-html\">\n            <p style=\"text-align: center;\">\n              When you submit this form, please allow a few moments for your information to send. Once completed, a message will display that confirms receipt and a copy of your submisison will be automatically forwarded to your email address.\n            <\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_95\">\n        <div id=\"cid_95\" class=\"form-input-wide\">\n          <div style=\"text-align:center\" class=\"form-buttons-wrapper\">\n            <button id=\"input_95\" type=\"submit\" class=\"form-submit-button\">\n              Submit Form\n            <\/button>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_109\">\n        <div id=\"cid_109\" class=\"form-input-wide\">\n          <div id=\"text_109\" class=\"form-html\">\n            <hr>\n            &nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_104\">\n        <label class=\"form-label-top\" id=\"label_104\" for=\"input_104\"> Office use only: <\/label>\n        <div id=\"cid_104\" class=\"form-input-wide\">\n          <input type=\"text\" class=\"form-textbox\" id=\"input_104\" name=\"q104_officeUse\" size=\"20\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_111\">\n        <label class=\"form-label-top\" id=\"label_111\" for=\"input_111\"> Date Assessed: <\/label>\n        <div id=\"cid_111\" class=\"form-input-wide\"><span class=\"form-sub-label-container\"><select class=\"form-dropdown\" name=\"q111_dateAssessed111[month]\" id=\"input_111_month\">\n              <option>  <\/option>\n              <option value=\"January\"> January <\/option>\n              <option value=\"February\"> February <\/option>\n              <option value=\"March\"> March <\/option>\n              <option value=\"April\"> April <\/option>\n              <option value=\"May\"> May <\/option>\n              <option value=\"June\"> June <\/option>\n              <option value=\"July\"> July <\/option>\n              <option value=\"August\"> August <\/option>\n              <option value=\"September\"> September <\/option>\n              <option value=\"October\"> October <\/option>\n              <option value=\"November\"> November <\/option>\n              <option value=\"December\"> December <\/option>\n            <\/select>\n            <label class=\"form-sub-label\" for=\"input_111_month\" id=\"sublabel_month\"> Month <\/label><\/span><span class=\"form-sub-label-container\"><select class=\"form-dropdown\" name=\"q111_dateAssessed111[day]\" id=\"input_111_day\">\n              <option>  <\/option>\n              <option value=\"1\"> 1 <\/option>\n              <option value=\"2\"> 2 <\/option>\n              <option value=\"3\"> 3 <\/option>\n              <option value=\"4\"> 4 <\/option>\n              <option value=\"5\"> 5 <\/option>\n              <option value=\"6\"> 6 <\/option>\n              <option value=\"7\"> 7 <\/option>\n              <option value=\"8\"> 8 <\/option>\n              <option value=\"9\"> 9 <\/option>\n              <option value=\"10\"> 10 <\/option>\n              <option value=\"11\"> 11 <\/option>\n              <option value=\"12\"> 12 <\/option>\n              <option value=\"13\"> 13 <\/option>\n              <option value=\"14\"> 14 <\/option>\n              <option value=\"15\"> 15 <\/option>\n              <option value=\"16\"> 16 <\/option>\n              <option value=\"17\"> 17 <\/option>\n              <option value=\"18\"> 18 <\/option>\n              <option value=\"19\"> 19 <\/option>\n              <option value=\"20\"> 20 <\/option>\n              <option value=\"21\"> 21 <\/option>\n              <option value=\"22\"> 22 <\/option>\n              <option value=\"23\"> 23 <\/option>\n              <option value=\"24\"> 24 <\/option>\n              <option value=\"25\"> 25 <\/option>\n              <option value=\"26\"> 26 <\/option>\n              <option value=\"27\"> 27 <\/option>\n              <option value=\"28\"> 28 <\/option>\n              <option value=\"29\"> 29 <\/option>\n              <option value=\"30\"> 30 <\/option>\n              <option value=\"31\"> 31 <\/option>\n            <\/select>\n            <label class=\"form-sub-label\" for=\"input_111_day\" id=\"sublabel_day\"> Day <\/label><\/span><span class=\"form-sub-label-container\"><select class=\"form-dropdown\" name=\"q111_dateAssessed111[year]\" id=\"input_111_year\">\n              <option>  <\/option>\n              <option value=\"2016\"> 2016 <\/option>\n              <option value=\"2015\"> 2015 <\/option>\n              <option value=\"2014\"> 2014 <\/option>\n              <option value=\"2013\"> 2013 <\/option>\n              <option value=\"2012\"> 2012 <\/option>\n              <option value=\"2011\"> 2011 <\/option>\n              <option value=\"2010\"> 2010 <\/option>\n              <option value=\"2009\"> 2009 <\/option>\n              <option value=\"2008\"> 2008 <\/option>\n              <option value=\"2007\"> 2007 <\/option>\n              <option value=\"2006\"> 2006 <\/option>\n              <option value=\"2005\"> 2005 <\/option>\n              <option value=\"2004\"> 2004 <\/option>\n              <option value=\"2003\"> 2003 <\/option>\n              <option value=\"2002\"> 2002 <\/option>\n              <option value=\"2001\"> 2001 <\/option>\n              <option value=\"2000\"> 2000 <\/option>\n              <option value=\"1999\"> 1999 <\/option>\n              <option value=\"1998\"> 1998 <\/option>\n              <option value=\"1997\"> 1997 <\/option>\n              <option value=\"1996\"> 1996 <\/option>\n              <option value=\"1995\"> 1995 <\/option>\n              <option value=\"1994\"> 1994 <\/option>\n              <option value=\"1993\"> 1993 <\/option>\n              <option value=\"1992\"> 1992 <\/option>\n              <option value=\"1991\"> 1991 <\/option>\n              <option value=\"1990\"> 1990 <\/option>\n              <option value=\"1989\"> 1989 <\/option>\n              <option value=\"1988\"> 1988 <\/option>\n              <option value=\"1987\"> 1987 <\/option>\n              <option value=\"1986\"> 1986 <\/option>\n              <option value=\"1985\"> 1985 <\/option>\n              <option value=\"1984\"> 1984 <\/option>\n              <option value=\"1983\"> 1983 <\/option>\n              <option value=\"1982\"> 1982 <\/option>\n              <option value=\"1981\"> 1981 <\/option>\n              <option value=\"1980\"> 1980 <\/option>\n              <option value=\"1979\"> 1979 <\/option>\n              <option value=\"1978\"> 1978 <\/option>\n              <option value=\"1977\"> 1977 <\/option>\n              <option value=\"1976\"> 1976 <\/option>\n              <option value=\"1975\"> 1975 <\/option>\n              <option value=\"1974\"> 1974 <\/option>\n              <option value=\"1973\"> 1973 <\/option>\n              <option value=\"1972\"> 1972 <\/option>\n              <option value=\"1971\"> 1971 <\/option>\n              <option value=\"1970\"> 1970 <\/option>\n              <option value=\"1969\"> 1969 <\/option>\n              <option value=\"1968\"> 1968 <\/option>\n              <option value=\"1967\"> 1967 <\/option>\n              <option value=\"1966\"> 1966 <\/option>\n              <option value=\"1965\"> 1965 <\/option>\n              <option value=\"1964\"> 1964 <\/option>\n              <option value=\"1963\"> 1963 <\/option>\n              <option value=\"1962\"> 1962 <\/option>\n              <option value=\"1961\"> 1961 <\/option>\n              <option value=\"1960\"> 1960 <\/option>\n              <option value=\"1959\"> 1959 <\/option>\n              <option value=\"1958\"> 1958 <\/option>\n              <option value=\"1957\"> 1957 <\/option>\n              <option value=\"1956\"> 1956 <\/option>\n              <option value=\"1955\"> 1955 <\/option>\n              <option value=\"1954\"> 1954 <\/option>\n              <option value=\"1953\"> 1953 <\/option>\n              <option value=\"1952\"> 1952 <\/option>\n              <option value=\"1951\"> 1951 <\/option>\n              <option value=\"1950\"> 1950 <\/option>\n              <option value=\"1949\"> 1949 <\/option>\n              <option value=\"1948\"> 1948 <\/option>\n              <option value=\"1947\"> 1947 <\/option>\n              <option value=\"1946\"> 1946 <\/option>\n              <option value=\"1945\"> 1945 <\/option>\n              <option value=\"1944\"> 1944 <\/option>\n              <option value=\"1943\"> 1943 <\/option>\n              <option value=\"1942\"> 1942 <\/option>\n              <option value=\"1941\"> 1941 <\/option>\n              <option value=\"1940\"> 1940 <\/option>\n              <option value=\"1939\"> 1939 <\/option>\n              <option value=\"1938\"> 1938 <\/option>\n              <option value=\"1937\"> 1937 <\/option>\n              <option value=\"1936\"> 1936 <\/option>\n              <option value=\"1935\"> 1935 <\/option>\n              <option value=\"1934\"> 1934 <\/option>\n              <option value=\"1933\"> 1933 <\/option>\n              <option value=\"1932\"> 1932 <\/option>\n              <option value=\"1931\"> 1931 <\/option>\n              <option value=\"1930\"> 1930 <\/option>\n              <option value=\"1929\"> 1929 <\/option>\n              <option value=\"1928\"> 1928 <\/option>\n              <option value=\"1927\"> 1927 <\/option>\n              <option value=\"1926\"> 1926 <\/option>\n              <option value=\"1925\"> 1925 <\/option>\n              <option value=\"1924\"> 1924 <\/option>\n              <option value=\"1923\"> 1923 <\/option>\n              <option value=\"1922\"> 1922 <\/option>\n              <option value=\"1921\"> 1921 <\/option>\n              <option value=\"1920\"> 1920 <\/option>\n            <\/select>\n            <label class=\"form-sub-label\" for=\"input_111_year\" id=\"sublabel_year\"> Year <\/label><\/span>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_107\">\n        <label class=\"form-label-top\" id=\"label_107\" for=\"input_107\"> Status: <\/label>\n        <div id=\"cid_107\" class=\"form-input-wide\">\n          <select class=\"form-dropdown\" style=\"width:150px\" id=\"input_107\" name=\"q107_status\">\n            <option>  <\/option>\n            <option value=\"accepted\"> accepted <\/option>\n            <option value=\"declined\"> declined <\/option>\n            <option value=\"ready to upload\"> ready to upload <\/option>\n            <option value=\"complete\"> complete <\/option>\n          <\/select>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_110\">\n        <label class=\"form-label-top\" id=\"label_110\" for=\"input_110\"> Notes: <\/label>\n        <div id=\"cid_110\" class=\"form-input-wide\">\n          <textarea id=\"input_110\" class=\"form-textarea\" name=\"q110_notes110\" cols=\"75\" rows=\"6\"><\/textarea>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_108\">\n        <div id=\"cid_108\" class=\"form-input-wide\">\n          <div style=\"text-align:left\" class=\"form-buttons-wrapper\">\n            <button id=\"input_108\" type=\"submit\" class=\"form-submit-button\">\n              Update Status\n            <\/button>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" id=\"id_106\">\n        <div id=\"cid_106\" class=\"form-input-wide\">\n          <div id=\"text_106\" class=\"form-html\">\n            &nbsp;&nbsp;\n          <\/div>\n        <\/div>\n      <\/li>\n      <li style=\"display:none\">\n        Should be Empty:\n        <input type=\"text\" name=\"website\" value=\"\" \/>\n      <\/li>\n    <\/ul>\n  <\/div>\n  <input type=\"hidden\" id=\"simple_spc\" name=\"simple_spc\" value=\"1084103596\" \/>\n  <script type=\"text\/javascript\">\n  document.getElementById(\"si\" + \"mple\" + \"_spc\").value = \"1084103596-1084103596\";\n  <\/script>\n<\/form><\/body>\n<\/html>\n");

