{"id":3598,"date":"2016-05-24T09:29:39","date_gmt":"2016-05-24T09:29:39","guid":{"rendered":"https:\/\/urbandtox.com\/?page_id=3598"},"modified":"2018-10-19T16:45:24","modified_gmt":"2018-10-19T16:45:24","slug":"comprehensive-ha","status":"publish","type":"page","link":"https:\/\/urbandtox.com\/comprehensive-ha\/","title":{"rendered":"Comprehensive HA"},"content":{"rendered":"<p>[et_pb_section bb_built=\"1\" admin_label=\"section\" transparent_background=\"off\" background_color=\"#99ccff\" allow_player_pause=\"off\" inner_shadow=\"off\" parallax=\"off\" parallax_method=\"off\" padding_mobile=\"off\" make_fullwidth=\"off\" use_custom_width=\"off\" width_unit=\"on\" make_equal=\"off\" use_custom_gutter=\"off\" custom_padding_tablet=\"50px|0|50px|0\" custom_padding_last_edited=\"on|desktop\"][et_pb_row admin_label=\"row\" background_position=\"top_left\" background_repeat=\"repeat\" background_size=\"initial\"][et_pb_column type=\"4_4\"][et_pb_text background_layout=\"dark\" text_orientation=\"center\" use_border_color=\"off\" text_font=\"Open Sans Light||||\" background_position=\"top_left\" background_repeat=\"repeat\" background_size=\"initial\" module_alignment=\"center\" _builder_version=\"3.17\" custom_css_main_element=\"s2member-pro-stripe-form.s2member-pro-stripe-checkout-form {|| color: #000;|| font-family: helvetica;|| font-style: normal;|| font-weight: lighter;|| font-size: 14px;|| padding: 2rem;||}||||.s2member-pro-stripe-submit.s2member-pro-stripe-checkout-submit.btn.btn-primary {|| background: purple;|| color: white;|| padding: 1rem;||border-radius: 10px;||}||||.s2member-pro-stripe-submit.s2member-pro-stripe-checkout-submit.btn.btn-primary:hover {|| background: #D050D0 none repeat scroll 0 0;||cursor: pointer;||}||\"]<\/p>\n<p><span style=\"font-size: 30pt;\">Comprehensive Health Analysis<\/span><\/p>\n<p><span style=\"font-size: 16pt;\">1.Select your preferred option<\/span><br \/>\n<span style=\"font-size: 16pt;\">2.Fill in your profile<br \/>\n<\/span><span style=\"font-size: 16pt;\">3.Select add billing method<br \/>\n4.Complete payment<br \/>\n5.Submit form to complete the process<\/span><\/p>\n<div id=\"s2p-form\"><\/div><!-- This is for hash anchors; do NOT remove please. -->\n\n<form id=\"s2member-pro-stripe-checkout-form\" class=\"s2member-pro-stripe-form s2member-pro-stripe-checkout-form\" method=\"post\" action=\"\/wp-json\/wp\/v2\/pages\/3598\" autocomplete=\"off\">\n\n\t<!-- Response Section (this is auto-filled after form submission). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-response-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-response-section s2member-pro-stripe-checkout-form-response-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-response-div s2member-pro-stripe-checkout-form-response-div\">\n\t\t\t\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Options Section (this is filled by Shortcode options; when\/if specified). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-options-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-options-section s2member-pro-stripe-checkout-form-options-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-options-section-title s2member-pro-stripe-checkout-form-options-section-title\">\n\t\t\tCheckout Options\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-options-div s2member-pro-stripe-checkout-form-options-div\">\n\t\t\t<select name=\"s2p-option\" id=\"s2member-pro-stripe-checkout-options\" class=\"s2member-pro-stripe-options s2member-pro-stripe-checkout-options form-control\" tabindex=\"-1\">\n\t\t\t\t<option value=\"1\">Online Comprehensive Health Analysis \u00a3199<\/option><option value=\"2\">Visit Clinic Comprehensive Health Analysis \u00a3249<\/option>\n\t\t\t<\/select>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Checkout Description (this is the desc=\"\" attribute from your Shortcode). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-description-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-description-section s2member-pro-stripe-checkout-form-description-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-description-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-description-div s2member-pro-stripe-checkout-form-description-div\">\n\t\t\tOnline Comprehensive Health Analysis \u00a3199\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Coupon Code ( this will ONLY be displayed if your Shortcode has this attribute: accept_coupons=\"1\" ). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-coupon-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-coupon-section s2member-pro-stripe-checkout-form-coupon-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-response-div s2member-pro-stripe-checkout-form-coupon-response-div\">\n\t\t\t <!-- A Coupon response (w\/Discounts) will be displayed here; based on the Coupon Code that was entered. -->\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-div s2member-pro-stripe-checkout-form-coupon-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-coupon\" id=\"s2member-pro-stripe-checkout-form-coupon-label\" class=\"s2member-pro-stripe-form-coupon-label s2member-pro-stripe-checkout-form-coupon-label\">\n\t\t\t\t<span>Gift, Coupon, or Redemption Code?<\/span><br \/>\n\t\t\t\t<input type=\"text\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[coupon]\" id=\"s2member-pro-stripe-checkout-coupon\" class=\"s2member-pro-stripe-coupon s2member-pro-stripe-checkout-coupon form-control\" value=\" \" tabindex=\"1\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"button\" id=\"s2member-pro-stripe-checkout-coupon-apply\" class=\"s2member-pro-stripe-coupon-apply s2member-pro-stripe-checkout-coupon-apply btn btn-default\" value=\"Apply\" tabindex=\"-1\" \/>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Registration Details (Name, Email, Username, Password). -->\n\t<!-- Some of this information will be prefilled automatically when\/if a User\/Member is already logged-in. -->\n\t<!-- Name fields will NOT be hidden automatically here; even if your Registration\/Profile Field options dictate this behavior. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-registration-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-registration-section s2member-pro-stripe-checkout-form-registration-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-registration-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-registration-section-title s2member-pro-stripe-checkout-form-registration-section-title\">\n\t\t\tCreate Profile\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-first-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-first-name-div s2member-pro-stripe-checkout-form-first-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-first-name\" id=\"s2member-pro-stripe-checkout-form-first-name-label\" class=\"s2member-pro-stripe-form-first-name-label s2member-pro-stripe-checkout-form-first-name-label\">\n\t\t\t\t<span>First Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[first_name]\" id=\"s2member-pro-stripe-checkout-first-name\" class=\"s2member-pro-stripe-first-name s2member-pro-stripe-checkout-first-name form-control\" value=\"\" tabindex=\"10\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-last-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-last-name-div s2member-pro-stripe-checkout-form-last-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-last-name\" id=\"s2member-pro-stripe-checkout-form-last-name-label\" class=\"s2member-pro-stripe-form-last-name-label s2member-pro-stripe-checkout-form-last-name-label\">\n\t\t\t\t<span>Last Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[last_name]\" id=\"s2member-pro-stripe-checkout-last-name\" class=\"s2member-pro-stripe-last-name s2member-pro-stripe-checkout-last-name form-control\" value=\"\" tabindex=\"20\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-email-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-email-div s2member-pro-stripe-checkout-form-email-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-email\" id=\"s2member-pro-stripe-checkout-form-email-label\" class=\"s2member-pro-stripe-form-email-label s2member-pro-stripe-checkout-form-email-label\">\n\t\t\t\t<span>Email Address *<\/span><br \/>\n\t\t\t\t<input type=\"email\" aria-required=\"true\" data-expected=\"email\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[email]\" id=\"s2member-pro-stripe-checkout-email\" class=\"s2member-pro-stripe-email s2member-pro-stripe-checkout-email form-control\" value=\"\" tabindex=\"30\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-username-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-username-div s2member-pro-stripe-checkout-form-username-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-username\" id=\"s2member-pro-stripe-checkout-form-username-label\" class=\"s2member-pro-stripe-form-username-label s2member-pro-stripe-checkout-form-username-label\">\n\t\t\t\t<span>Username (lowercase alphanumeric) *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"60\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[username]\" id=\"s2member-pro-stripe-checkout-username\" class=\"s2member-pro-stripe-username s2member-pro-stripe-checkout-username form-control\" value=\"\" tabindex=\"40\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-password-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-password-div s2member-pro-stripe-checkout-form-password-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-password1\" id=\"s2member-pro-stripe-checkout-form-password-label\" class=\"s2member-pro-stripe-form-password-label s2member-pro-stripe-checkout-form-password-label\">\n\t\t\t\t<span>Password (type this twice please) *<\/span><br \/>\n\t\t\t\t<input type=\"password\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password1]\" id=\"s2member-pro-stripe-checkout-password1\" class=\"s2member-pro-stripe-password1 s2member-pro-stripe-checkout-password1 form-control\" value=\"\" tabindex=\"50\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"password\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password2]\" id=\"s2member-pro-stripe-checkout-password2\" class=\"s2member-pro-stripe-password2 s2member-pro-stripe-checkout-password2 form-control\" value=\"\" tabindex=\"60\" \/>\n\t\t\t<div id=\"s2member-pro-stripe-checkout-form-password-strength\" class=\"ws-plugin--s2member-password-strength s2member-pro-stripe-form-password-strength s2member-pro-stripe-checkout-form-password-strength\"><em>password strength indicator<\/em><\/div>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Custom Fields (Custom Registration\/Profile Fields will appear here, when\/if they've been configured). -->\n\t<!-- Custom Fields will NOT be displayed to existing Users\/Members that are already logged-in. s2Member assumes this information has already been collected in that case. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-custom-fields-section s2member-pro-stripe-checkout-form-custom-fields-section\">\n<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-custom-fields-section-title s2member-pro-stripe-checkout-form-custom-fields-section-title\">\nAdditional Info\n<\/div>\n<div id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-custom-reg-field-terms-div s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\">\n<label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\" class=\"s2member-pro-stripe-form-custom-reg-field-terms-label s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\">\n<span style=\"display:none;\">Yes, I Agree to Terms & Conditions *<\/span><\/label>\n<input type=\"checkbox\" value=\"1\" name=\"s2member_pro_stripe_checkout[custom_fields][terms]\" id=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" aria-required=\"true\" tabindex=\"100\" class=\"s2member-pro-stripe-custom-reg-field-terms s2member-pro-stripe-checkout-custom-reg-field-terms\" \/> <label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" style=\"display:inline !important; margin:0 !important;\">Yes, I Agree to Terms & Conditions<\/label><\/div>\n<\/div>\n\n\n\t<!-- Billing Method (powered by Stripe). -->\n\t\n\t<div id=\"s2member-pro-stripe-form-billing-method-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-form-billing-method-section\">\n\t\t<div id=\"s2member-pro-stripe-form-billing-method-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-form-billing-method-section-title\">\n\t\t\tBilling Method\t\t<\/div>\n\t\t<label for=\"s2member-pro-stripe-form-card-element\" id=\"s2member-pro-stripe-form-card-element-label\" class=\"s2member-pro-stripe-form-card-element-label\">\n\t\t\tCredit or debit card\t\t<\/label>\n\t\t<div id=\"s2member-pro-stripe-form-card-element\">\n\t\t\t<!-- A Stripe Element will be inserted here. -->\n\t\t<\/div>\n\n\t\t<!-- Used to display Element errors. -->\n\t\t<div id=\"s2member-pro-stripe-form-card-errors\" role=\"alert\"><\/div>\n\n\t\t<!-- Update with IDs -->\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pm-id\" name=\"stripe_pm_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-id\" name=\"stripe_pi_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-id\" name=\"stripe_seti_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-sub-id\" name=\"stripe_sub_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-secret\" name=\"stripe_pi_secret\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-secret\" name=\"stripe_seti_secret\" value=\"\" \/>\n\n\t\t<div id=\"s2member-pro-stripe-checkout-form-source-token-summary\" class=\"s2member-pro-stripe-form-source-token-summary s2member-pro-stripe-checkout-form-source-token-summary\">\n\t\t\t\t<!---->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<style>\n\t\t#s2member-pro-stripe-form-card-element {border: 1px solid #b6b6b3; border-radius: 4px; padding: 10px 13px;}\n\t\t#s2member-pro-stripe-form-card-errors {color: #eb1c26;}\n\t\t.s2member-pro-stripe-form-disabled {opacity: .5;}\n\t<\/style>\n\n\t<!-- Billing Address (hidden dynamically when\/if no tax details are necessary; and\/or when no billing info has been provided yet). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section\" class=\"s2member-pro-stripe-form-section  s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-billing-address-section s2member-pro-stripe-checkout-form-billing-address-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-billing-address-section-title s2member-pro-stripe-checkout-form-billing-address-section-title\">\n\t\t\tBilling Address\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-street-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-street-div s2member-pro-stripe-checkout-form-street-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-street\" id=\"s2member-pro-stripe-checkout-form-street-label\" class=\"s2member-pro-stripe-form-street-label s2member-pro-stripe-checkout-form-street-label\">\n\t\t\t\t<span>Street Address *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[street]\" id=\"s2member-pro-stripe-checkout-street\" class=\"s2member-pro-stripe-street s2member-pro-stripe-checkout-street form-control\" value=\"\" tabindex=\"300\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-city-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-city-div s2member-pro-stripe-checkout-form-city-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-city\" id=\"s2member-pro-stripe-checkout-form-city-label\" class=\"s2member-pro-stripe-form-city-label s2member-pro-stripe-checkout-form-city-label\">\n\t\t\t\t<span>City \/ Town *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[city]\" id=\"s2member-pro-stripe-checkout-city\" class=\"s2member-pro-stripe-city s2member-pro-stripe-checkout-city form-control\" value=\"\" tabindex=\"310\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-state-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-state-div s2member-pro-stripe-checkout-form-state-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-state\" id=\"s2member-pro-stripe-checkout-form-state-label\" class=\"s2member-pro-stripe-form-state-label s2member-pro-stripe-checkout-form-state-label\">\n\t\t\t\t<span>State \/ Province *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"40\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[state]\" id=\"s2member-pro-stripe-checkout-state\" class=\"s2member-pro-stripe-state s2member-pro-stripe-checkout-state form-control\" value=\"\" tabindex=\"320\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-zip-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-zip-div s2member-pro-stripe-checkout-form-zip-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-zip\" id=\"s2member-pro-stripe-checkout-form-zip-label\" class=\"s2member-pro-stripe-form-zip-label s2member-pro-stripe-checkout-form-zip-label\">\n\t\t\t\t<span>Postal \/ Zip Code *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"20\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[zip]\" id=\"s2member-pro-stripe-checkout-zip\" class=\"s2member-pro-stripe-zip s2member-pro-stripe-checkout-zip form-control\" value=\"\" tabindex=\"330\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-country-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-country-div s2member-pro-stripe-checkout-form-country-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-country\" id=\"s2member-pro-stripe-checkout-form-country-label\" class=\"s2member-pro-stripe-form-country-label s2member-pro-stripe-checkout-form-country-label\">\n\t\t\t\t<span>Country *<\/span><br \/>\n\t\t\t\t<select aria-required=\"true\" name=\"s2member_pro_stripe_checkout[country]\" id=\"s2member-pro-stripe-checkout-country\" class=\"s2member-pro-stripe-country s2member-pro-stripe-checkout-country form-control\" tabindex=\"340\">\n\t\t\t\t\t<option value=\"\"><\/option><option value=\"AF\">Afghanistan<\/option><option value=\"AX\">Aland Islands<\/option><option value=\"AL\">Albania<\/option><option value=\"DZ\">Algeria<\/option><option value=\"AS\">American Samoa<\/option><option value=\"AD\">Andorra<\/option><option value=\"AO\">Angola<\/option><option value=\"AI\">Anguilla<\/option><option value=\"AQ\">Antarctica<\/option><option value=\"AG\">Antigua And Barbuda<\/option><option value=\"AR\">Argentina<\/option><option value=\"AM\">Armenia<\/option><option value=\"AW\">Aruba<\/option><option value=\"AU\">Australia<\/option><option value=\"AT\">Austria<\/option><option value=\"AZ\">Azerbaijan<\/option><option value=\"BS\">Bahamas<\/option><option value=\"BH\">Bahrain<\/option><option value=\"BD\">Bangladesh<\/option><option value=\"BB\">Barbados<\/option><option value=\"BY\">Belarus<\/option><option value=\"BE\">Belgium<\/option><option value=\"BZ\">Belize<\/option><option value=\"BJ\">Benin<\/option><option value=\"BM\">Bermuda<\/option><option value=\"BT\">Bhutan<\/option><option value=\"BO\">Bolivia, Plurinational State Of<\/option><option value=\"BA\">Bosnia And Herzegovina<\/option><option value=\"BW\">Botswana<\/option><option value=\"BV\">Bouvet Island<\/option><option value=\"BR\">Brazil<\/option><option value=\"IO\">British Indian Ocean Territory<\/option><option value=\"BN\">Brunei Darussalam<\/option><option value=\"BG\">Bulgaria<\/option><option value=\"BF\">Burkina Faso<\/option><option value=\"BI\">Burundi<\/option><option value=\"KH\">Cambodia<\/option><option value=\"CM\">Cameroon<\/option><option value=\"CA\">Canada<\/option><option value=\"CV\">Cape Verde<\/option><option value=\"KY\">Cayman Islands<\/option><option value=\"CF\">Central African Republic<\/option><option value=\"TD\">Chad<\/option><option value=\"CL\">Chile<\/option><option value=\"CN\">China<\/option><option value=\"CX\">Christmas Island<\/option><option value=\"CC\">Cocos (keeling) Islands<\/option><option value=\"CO\">Colombia<\/option><option value=\"KM\">Comoros<\/option><option value=\"CG\">Congo<\/option><option value=\"CD\">Congo, The Democratic Republic Of The<\/option><option value=\"CK\">Cook Islands<\/option><option value=\"CR\">Costa Rica<\/option><option value=\"CI\">Cote D&#039;ivoire<\/option><option value=\"HR\">Croatia<\/option><option value=\"CU\">Cuba<\/option><option value=\"CY\">Cyprus<\/option><option value=\"CZ\">Czech Republic<\/option><option value=\"DK\">Denmark<\/option><option value=\"DJ\">Djibouti<\/option><option value=\"DM\">Dominica<\/option><option value=\"DO\">Dominican Republic<\/option><option value=\"EC\">Ecuador<\/option><option value=\"EG\">Egypt<\/option><option value=\"SV\">El Salvador<\/option><option value=\"GQ\">Equatorial Guinea<\/option><option value=\"ER\">Eritrea<\/option><option value=\"EE\">Estonia<\/option><option value=\"ET\">Ethiopia<\/option><option value=\"FK\">Falkland Islands (malvinas)<\/option><option value=\"FO\">Faroe Islands<\/option><option value=\"FJ\">Fiji<\/option><option value=\"FI\">Finland<\/option><option value=\"FR\">France<\/option><option value=\"GF\">French Guiana<\/option><option value=\"PF\">French Polynesia<\/option><option value=\"TF\">French Southern Territories<\/option><option value=\"GA\">Gabon<\/option><option value=\"GM\">Gambia<\/option><option value=\"GE\">Georgia<\/option><option value=\"DE\">Germany<\/option><option value=\"GH\">Ghana<\/option><option value=\"GI\">Gibraltar<\/option><option value=\"GR\">Greece<\/option><option value=\"GL\">Greenland<\/option><option value=\"GD\">Grenada<\/option><option value=\"GP\">Guadeloupe<\/option><option value=\"GU\">Guam<\/option><option value=\"GT\">Guatemala<\/option><option value=\"GG\">Guernsey<\/option><option value=\"GN\">Guinea<\/option><option value=\"GW\">Guinea-bissau<\/option><option value=\"GY\">Guyana<\/option><option value=\"HT\">Haiti<\/option><option value=\"HM\">Heard Island And Mcdonald Islands<\/option><option value=\"VA\">Holy See (vatican City State)<\/option><option value=\"HN\">Honduras<\/option><option value=\"HK\">Hong Kong<\/option><option value=\"HU\">Hungary<\/option><option value=\"IS\">Iceland<\/option><option value=\"IN\">India<\/option><option value=\"ID\">Indonesia<\/option><option value=\"IR\">Iran, Islamic Republic Of<\/option><option value=\"IQ\">Iraq<\/option><option value=\"IE\">Ireland<\/option><option value=\"IM\">Isle Of Man<\/option><option value=\"IL\">Israel<\/option><option value=\"IT\">Italy<\/option><option value=\"JM\">Jamaica<\/option><option value=\"JP\">Japan<\/option><option value=\"JE\">Jersey<\/option><option value=\"JO\">Jordan<\/option><option value=\"KZ\">Kazakhstan<\/option><option value=\"KE\">Kenya<\/option><option value=\"KI\">Kiribati<\/option><option value=\"KP\">Korea, Democratic People&#039;s Republic Of<\/option><option value=\"KR\">Korea, Republic Of<\/option><option value=\"KW\">Kuwait<\/option><option value=\"KG\">Kyrgyzstan<\/option><option value=\"LA\">Lao People&#039;s Democratic Republic<\/option><option value=\"LV\">Latvia<\/option><option value=\"LB\">Lebanon<\/option><option value=\"LS\">Lesotho<\/option><option value=\"LR\">Liberia<\/option><option value=\"LY\">Libyan Arab Jamahiriya<\/option><option value=\"LI\">Liechtenstein<\/option><option value=\"LT\">Lithuania<\/option><option value=\"LU\">Luxembourg<\/option><option value=\"MO\">Macao<\/option><option value=\"MK\">Macedonia, The Former Yugoslav Republic Of<\/option><option value=\"MG\">Madagascar<\/option><option value=\"MW\">Malawi<\/option><option value=\"MY\">Malaysia<\/option><option value=\"MV\">Maldives<\/option><option value=\"ML\">Mali<\/option><option value=\"MT\">Malta<\/option><option value=\"MH\">Marshall Islands<\/option><option value=\"MQ\">Martinique<\/option><option value=\"MR\">Mauritania<\/option><option value=\"MU\">Mauritius<\/option><option value=\"YT\">Mayotte<\/option><option value=\"MX\">Mexico<\/option><option value=\"FM\">Micronesia, Federated States Of<\/option><option value=\"MD\">Moldova, Republic Of<\/option><option value=\"MC\">Monaco<\/option><option value=\"MN\">Mongolia<\/option><option value=\"ME\">Montenegro<\/option><option value=\"MS\">Montserrat<\/option><option value=\"MA\">Morocco<\/option><option value=\"MZ\">Mozambique<\/option><option value=\"MM\">Myanmar<\/option><option value=\"NA\">Namibia<\/option><option value=\"NR\">Nauru<\/option><option value=\"NP\">Nepal<\/option><option value=\"NL\">Netherlands<\/option><option value=\"AN\">Netherlands Antilles<\/option><option value=\"NC\">New Caledonia<\/option><option value=\"NZ\">New Zealand<\/option><option value=\"NI\">Nicaragua<\/option><option value=\"NE\">Niger<\/option><option value=\"NG\">Nigeria<\/option><option value=\"NU\">Niue<\/option><option value=\"NF\">Norfolk Island<\/option><option value=\"MP\">Northern Mariana Islands<\/option><option value=\"NO\">Norway<\/option><option value=\"OM\">Oman<\/option><option value=\"PK\">Pakistan<\/option><option value=\"PW\">Palau<\/option><option value=\"PS\">Palestinian Territory, Occupied<\/option><option value=\"PA\">Panama<\/option><option value=\"PG\">Papua New Guinea<\/option><option value=\"PY\">Paraguay<\/option><option value=\"PE\">Peru<\/option><option value=\"PH\">Philippines<\/option><option value=\"PN\">Pitcairn<\/option><option value=\"PL\">Poland<\/option><option value=\"PT\">Portugal<\/option><option value=\"PR\">Puerto Rico<\/option><option value=\"QA\">Qatar<\/option><option value=\"RE\">Reunion<\/option><option value=\"RO\">Romania<\/option><option value=\"RU\">Russian Federation<\/option><option value=\"RW\">Rwanda<\/option><option value=\"BL\">Saint Barthelemy<\/option><option value=\"SH\">Saint Helena, Ascension And Tristan Da Cunha<\/option><option value=\"KN\">Saint Kitts And Nevis<\/option><option value=\"LC\">Saint Lucia<\/option><option value=\"MF\">Saint Martin<\/option><option value=\"PM\">Saint Pierre And Miquelon<\/option><option value=\"VC\">Saint Vincent And The Grenadines<\/option><option value=\"WS\">Samoa<\/option><option value=\"SM\">San Marino<\/option><option value=\"ST\">Sao Tome And Principe<\/option><option value=\"SA\">Saudi Arabia<\/option><option value=\"SN\">Senegal<\/option><option value=\"RS\">Serbia<\/option><option value=\"SC\">Seychelles<\/option><option value=\"SL\">Sierra Leone<\/option><option value=\"SG\">Singapore<\/option><option value=\"SK\">Slovakia<\/option><option value=\"SI\">Slovenia<\/option><option value=\"SB\">Solomon Islands<\/option><option value=\"SO\">Somalia<\/option><option value=\"ZA\">South Africa<\/option><option value=\"GS\">South Georgia And The South Sandwich Islands<\/option><option value=\"ES\">Spain<\/option><option value=\"LK\">Sri Lanka<\/option><option value=\"SD\">Sudan<\/option><option value=\"SR\">Suriname<\/option><option value=\"SJ\">Svalbard And Jan Mayen<\/option><option value=\"SZ\">Swaziland<\/option><option value=\"SE\">Sweden<\/option><option value=\"CH\">Switzerland<\/option><option value=\"SY\">Syrian Arab Republic<\/option><option value=\"TW\">Taiwan<\/option><option value=\"TJ\">Tajikistan<\/option><option value=\"TZ\">Tanzania, United Republic Of<\/option><option value=\"TH\">Thailand<\/option><option value=\"TL\">Timor-leste<\/option><option value=\"TG\">Togo<\/option><option value=\"TK\">Tokelau<\/option><option value=\"TO\">Tonga<\/option><option value=\"TT\">Trinidad And Tobago<\/option><option value=\"TN\">Tunisia<\/option><option value=\"TR\">Turkey<\/option><option value=\"TM\">Turkmenistan<\/option><option value=\"TC\">Turks And Caicos Islands<\/option><option value=\"TV\">Tuvalu<\/option><option value=\"UG\">Uganda<\/option><option value=\"UA\">Ukraine<\/option><option value=\"AE\">United Arab Emirates<\/option><option value=\"GB\">United Kingdom<\/option><option value=\"US\" selected=\"selected\">United States<\/option><option value=\"UM\">United States Minor Outlying Islands<\/option><option value=\"UY\">Uruguay<\/option><option value=\"UZ\">Uzbekistan<\/option><option value=\"VU\">Vanuatu<\/option><option value=\"VE\">Venezuela, Bolivarian Republic Of<\/option><option value=\"VN\">Viet Nam<\/option><option value=\"VG\">Virgin Islands, British<\/option><option value=\"VI\">Virgin Islands, U.s.<\/option><option value=\"WF\">Wallis And Futuna<\/option><option value=\"EH\">Western Sahara<\/option><option value=\"YE\">Yemen<\/option><option value=\"ZM\">Zambia<\/option><option value=\"ZW\">Zimbabwe<\/option>\n\t\t\t\t<\/select>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-ajax-tax-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-ajax-tax-div s2member-pro-stripe-checkout-form-ajax-tax-div\">\n\t\t\t<!-- Sales Tax will be displayed here via Ajax; based on state, country, and\/or zip code range. -->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Captcha ( A reCaptcha section, with a required security code will appear here; if captcha=\"1\" ). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-captcha-section\" 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value=\"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\" \/> <!-- Auto-filled by the s2Member software. Do NOT remove this under any circumstance. -->\n\t\t\t<button type=\"submit\" id=\"s2member-pro-stripe-checkout-submit\" class=\"s2member-pro-stripe-submit s2member-pro-stripe-checkout-submit btn btn-primary\" tabindex=\"600\">Submit Form<\/button>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n<\/form>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n<span class=\"et_bloom_bottom_trigger\"><\/span>","protected":false},"excerpt":{"rendered":"<p>Comprehensive Health Analysis 1.Select your preferred option 2.Fill in your profile 3.Select add billing method 4.Complete payment 5.Submit form to complete the process <div id=\"s2p-form\"><\/div><!-- This is for hash anchors; do NOT remove please. -->\n\n<form id=\"s2member-pro-stripe-checkout-form\" class=\"s2member-pro-stripe-form s2member-pro-stripe-checkout-form\" method=\"post\" action=\"\/wp-json\/wp\/v2\/pages\/3598\" autocomplete=\"off\">\n\n\t<!-- Response Section (this is auto-filled after form submission). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-response-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-response-section s2member-pro-stripe-checkout-form-response-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-response-div s2member-pro-stripe-checkout-form-response-div\">\n\t\t\t<div id=\"s2member-pro-stripe-form-response\" class=\"s2member-pro-stripe-form-response-error s2member-pro-stripe-checkout-form-response-error\">Invalid form configuration. Missing \"desc\" attribute. Please provide a Description for this form.<\/div>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Options Section (this is filled by Shortcode options; when\/if specified). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-options-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-options-section s2member-pro-stripe-checkout-form-options-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-options-section-title s2member-pro-stripe-checkout-form-options-section-title\">\n\t\t\tCheckout Options\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-options-div s2member-pro-stripe-checkout-form-options-div\">\n\t\t\t<select name=\"s2p-option\" id=\"s2member-pro-stripe-checkout-options\" class=\"s2member-pro-stripe-options s2member-pro-stripe-checkout-options form-control\" tabindex=\"-1\">\n\t\t\t\t\n\t\t\t<\/select>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Checkout Description (this is the desc=\"\" attribute from your Shortcode). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-description-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-description-section s2member-pro-stripe-checkout-form-description-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-description-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-description-div s2member-pro-stripe-checkout-form-description-div\">\n\t\t\t\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Coupon Code ( this will ONLY be displayed if your Shortcode has this attribute: accept_coupons=\"1\" ). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-coupon-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-coupon-section s2member-pro-stripe-checkout-form-coupon-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-response-div s2member-pro-stripe-checkout-form-coupon-response-div\">\n\t\t\t <!-- A Coupon response (w\/Discounts) will be displayed here; based on the Coupon Code that was entered. -->\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-div s2member-pro-stripe-checkout-form-coupon-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-coupon\" id=\"s2member-pro-stripe-checkout-form-coupon-label\" class=\"s2member-pro-stripe-form-coupon-label s2member-pro-stripe-checkout-form-coupon-label\">\n\t\t\t\t<span>Gift, Coupon, or Redemption Code?<\/span><br \/>\n\t\t\t\t<input type=\"text\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[coupon]\" id=\"s2member-pro-stripe-checkout-coupon\" class=\"s2member-pro-stripe-coupon s2member-pro-stripe-checkout-coupon form-control\" value=\"\" tabindex=\"1\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"button\" id=\"s2member-pro-stripe-checkout-coupon-apply\" class=\"s2member-pro-stripe-coupon-apply s2member-pro-stripe-checkout-coupon-apply btn btn-default\" value=\"Apply\" tabindex=\"-1\" \/>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Registration Details (Name, Email, Username, Password). -->\n\t<!-- Some of this information will be prefilled automatically when\/if a User\/Member is already logged-in. -->\n\t<!-- Name fields will NOT be hidden automatically here; even if your Registration\/Profile Field options dictate this behavior. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-registration-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-registration-section s2member-pro-stripe-checkout-form-registration-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-registration-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-registration-section-title s2member-pro-stripe-checkout-form-registration-section-title\">\n\t\t\tCreate Profile\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-first-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-first-name-div s2member-pro-stripe-checkout-form-first-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-first-name\" id=\"s2member-pro-stripe-checkout-form-first-name-label\" class=\"s2member-pro-stripe-form-first-name-label s2member-pro-stripe-checkout-form-first-name-label\">\n\t\t\t\t<span>First Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[first_name]\" id=\"s2member-pro-stripe-checkout-first-name\" class=\"s2member-pro-stripe-first-name s2member-pro-stripe-checkout-first-name form-control\" value=\"\" tabindex=\"10\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-last-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-last-name-div s2member-pro-stripe-checkout-form-last-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-last-name\" id=\"s2member-pro-stripe-checkout-form-last-name-label\" class=\"s2member-pro-stripe-form-last-name-label s2member-pro-stripe-checkout-form-last-name-label\">\n\t\t\t\t<span>Last Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[last_name]\" id=\"s2member-pro-stripe-checkout-last-name\" class=\"s2member-pro-stripe-last-name s2member-pro-stripe-checkout-last-name form-control\" value=\"\" tabindex=\"20\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-email-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-email-div s2member-pro-stripe-checkout-form-email-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-email\" id=\"s2member-pro-stripe-checkout-form-email-label\" class=\"s2member-pro-stripe-form-email-label s2member-pro-stripe-checkout-form-email-label\">\n\t\t\t\t<span>Email Address *<\/span><br \/>\n\t\t\t\t<input type=\"email\" aria-required=\"true\" data-expected=\"email\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[email]\" id=\"s2member-pro-stripe-checkout-email\" class=\"s2member-pro-stripe-email s2member-pro-stripe-checkout-email form-control\" value=\"\" tabindex=\"30\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-username-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-username-div s2member-pro-stripe-checkout-form-username-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-username\" id=\"s2member-pro-stripe-checkout-form-username-label\" class=\"s2member-pro-stripe-form-username-label s2member-pro-stripe-checkout-form-username-label\">\n\t\t\t\t<span>Username (lowercase alphanumeric) *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"60\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[username]\" id=\"s2member-pro-stripe-checkout-username\" class=\"s2member-pro-stripe-username s2member-pro-stripe-checkout-username form-control\" value=\"\" tabindex=\"40\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-password-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-password-div s2member-pro-stripe-checkout-form-password-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-password1\" id=\"s2member-pro-stripe-checkout-form-password-label\" class=\"s2member-pro-stripe-form-password-label s2member-pro-stripe-checkout-form-password-label\">\n\t\t\t\t<span>Password (type this twice please) *<\/span><br \/>\n\t\t\t\t<input type=\"password\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password1]\" id=\"s2member-pro-stripe-checkout-password1\" class=\"s2member-pro-stripe-password1 s2member-pro-stripe-checkout-password1 form-control\" value=\"\" tabindex=\"50\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"password\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password2]\" id=\"s2member-pro-stripe-checkout-password2\" class=\"s2member-pro-stripe-password2 s2member-pro-stripe-checkout-password2 form-control\" value=\"\" tabindex=\"60\" \/>\n\t\t\t<div id=\"s2member-pro-stripe-checkout-form-password-strength\" class=\"ws-plugin--s2member-password-strength s2member-pro-stripe-form-password-strength s2member-pro-stripe-checkout-form-password-strength\"><em>password strength indicator<\/em><\/div>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Custom Fields (Custom Registration\/Profile Fields will appear here, when\/if they've been configured). -->\n\t<!-- Custom Fields will NOT be displayed to existing Users\/Members that are already logged-in. s2Member assumes this information has already been collected in that case. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-custom-fields-section s2member-pro-stripe-checkout-form-custom-fields-section\">\n<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-custom-fields-section-title s2member-pro-stripe-checkout-form-custom-fields-section-title\">\nAdditional Info\n<\/div>\n<div id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-custom-reg-field-terms-div s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\">\n<label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\" class=\"s2member-pro-stripe-form-custom-reg-field-terms-label s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\">\n<span style=\"display:none;\">Yes, I Agree to Terms & Conditions *<\/span><\/label>\n<input type=\"checkbox\" value=\"1\" name=\"s2member_pro_stripe_checkout[custom_fields][terms]\" id=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" aria-required=\"true\" tabindex=\"100\" class=\"s2member-pro-stripe-custom-reg-field-terms s2member-pro-stripe-checkout-custom-reg-field-terms\" \/> <label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" style=\"display:inline !important; margin:0 !important;\">Yes, I Agree to Terms & Conditions<\/label><\/div>\n<\/div>\n\n\n\t<!-- Billing Method (powered by Stripe). -->\n\t\n\t<div id=\"s2member-pro-stripe-form-billing-method-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-form-billing-method-section\">\n\t\t<div id=\"s2member-pro-stripe-form-billing-method-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-form-billing-method-section-title\">\n\t\t\tBilling Method\t\t<\/div>\n\t\t<label for=\"s2member-pro-stripe-form-card-element\" id=\"s2member-pro-stripe-form-card-element-label\" class=\"s2member-pro-stripe-form-card-element-label\">\n\t\t\tCredit or debit card\t\t<\/label>\n\t\t<div id=\"s2member-pro-stripe-form-card-element\">\n\t\t\t<!-- A Stripe Element will be inserted here. -->\n\t\t<\/div>\n\n\t\t<!-- Used to display Element errors. -->\n\t\t<div id=\"s2member-pro-stripe-form-card-errors\" role=\"alert\"><\/div>\n\n\t\t<!-- Update with IDs -->\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pm-id\" name=\"stripe_pm_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-id\" name=\"stripe_pi_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-id\" name=\"stripe_seti_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-sub-id\" name=\"stripe_sub_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-secret\" name=\"stripe_pi_secret\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-secret\" name=\"stripe_seti_secret\" value=\"\" \/>\n\n\t\t<div id=\"s2member-pro-stripe-checkout-form-source-token-summary\" class=\"s2member-pro-stripe-form-source-token-summary s2member-pro-stripe-checkout-form-source-token-summary\">\n\t\t\t\t<!---->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<style>\n\t\t#s2member-pro-stripe-form-card-element {border: 1px solid #b6b6b3; border-radius: 4px; padding: 10px 13px;}\n\t\t#s2member-pro-stripe-form-card-errors {color: #eb1c26;}\n\t\t.s2member-pro-stripe-form-disabled {opacity: .5;}\n\t<\/style>\n\n\t<!-- Billing Address (hidden dynamically when\/if no tax details are necessary; and\/or when no billing info has been provided yet). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section\" class=\"s2member-pro-stripe-form-section  s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-billing-address-section s2member-pro-stripe-checkout-form-billing-address-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-billing-address-section-title s2member-pro-stripe-checkout-form-billing-address-section-title\">\n\t\t\tBilling Address\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-street-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-street-div s2member-pro-stripe-checkout-form-street-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-street\" id=\"s2member-pro-stripe-checkout-form-street-label\" class=\"s2member-pro-stripe-form-street-label s2member-pro-stripe-checkout-form-street-label\">\n\t\t\t\t<span>Street Address *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[street]\" id=\"s2member-pro-stripe-checkout-street\" class=\"s2member-pro-stripe-street s2member-pro-stripe-checkout-street form-control\" value=\"\" tabindex=\"300\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-city-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-city-div s2member-pro-stripe-checkout-form-city-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-city\" id=\"s2member-pro-stripe-checkout-form-city-label\" class=\"s2member-pro-stripe-form-city-label s2member-pro-stripe-checkout-form-city-label\">\n\t\t\t\t<span>City \/ Town *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[city]\" id=\"s2member-pro-stripe-checkout-city\" class=\"s2member-pro-stripe-city s2member-pro-stripe-checkout-city form-control\" value=\"\" tabindex=\"310\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-state-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-state-div s2member-pro-stripe-checkout-form-state-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-state\" id=\"s2member-pro-stripe-checkout-form-state-label\" class=\"s2member-pro-stripe-form-state-label s2member-pro-stripe-checkout-form-state-label\">\n\t\t\t\t<span>State \/ Province *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"40\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[state]\" id=\"s2member-pro-stripe-checkout-state\" class=\"s2member-pro-stripe-state s2member-pro-stripe-checkout-state form-control\" value=\"\" tabindex=\"320\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-zip-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-zip-div s2member-pro-stripe-checkout-form-zip-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-zip\" id=\"s2member-pro-stripe-checkout-form-zip-label\" class=\"s2member-pro-stripe-form-zip-label s2member-pro-stripe-checkout-form-zip-label\">\n\t\t\t\t<span>Postal \/ Zip Code *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"20\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[zip]\" id=\"s2member-pro-stripe-checkout-zip\" class=\"s2member-pro-stripe-zip s2member-pro-stripe-checkout-zip form-control\" value=\"\" tabindex=\"330\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-country-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-country-div s2member-pro-stripe-checkout-form-country-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-country\" id=\"s2member-pro-stripe-checkout-form-country-label\" class=\"s2member-pro-stripe-form-country-label s2member-pro-stripe-checkout-form-country-label\">\n\t\t\t\t<span>Country *<\/span><br \/>\n\t\t\t\t<select aria-required=\"true\" name=\"s2member_pro_stripe_checkout[country]\" id=\"s2member-pro-stripe-checkout-country\" class=\"s2member-pro-stripe-country s2member-pro-stripe-checkout-country form-control\" tabindex=\"340\">\n\t\t\t\t\t<option value=\"\"><\/option><option value=\"AF\">Afghanistan<\/option><option value=\"AX\">Aland Islands<\/option><option value=\"AL\">Albania<\/option><option value=\"DZ\">Algeria<\/option><option value=\"AS\">American Samoa<\/option><option value=\"AD\">Andorra<\/option><option value=\"AO\">Angola<\/option><option value=\"AI\">Anguilla<\/option><option value=\"AQ\">Antarctica<\/option><option value=\"AG\">Antigua And Barbuda<\/option><option value=\"AR\">Argentina<\/option><option value=\"AM\">Armenia<\/option><option value=\"AW\">Aruba<\/option><option value=\"AU\">Australia<\/option><option value=\"AT\">Austria<\/option><option value=\"AZ\">Azerbaijan<\/option><option value=\"BS\">Bahamas<\/option><option value=\"BH\">Bahrain<\/option><option value=\"BD\">Bangladesh<\/option><option value=\"BB\">Barbados<\/option><option value=\"BY\">Belarus<\/option><option value=\"BE\">Belgium<\/option><option value=\"BZ\">Belize<\/option><option value=\"BJ\">Benin<\/option><option value=\"BM\">Bermuda<\/option><option value=\"BT\">Bhutan<\/option><option value=\"BO\">Bolivia, Plurinational State Of<\/option><option value=\"BA\">Bosnia And Herzegovina<\/option><option value=\"BW\">Botswana<\/option><option value=\"BV\">Bouvet Island<\/option><option value=\"BR\">Brazil<\/option><option value=\"IO\">British Indian Ocean Territory<\/option><option value=\"BN\">Brunei Darussalam<\/option><option value=\"BG\">Bulgaria<\/option><option value=\"BF\">Burkina Faso<\/option><option value=\"BI\">Burundi<\/option><option value=\"KH\">Cambodia<\/option><option value=\"CM\">Cameroon<\/option><option value=\"CA\">Canada<\/option><option value=\"CV\">Cape Verde<\/option><option value=\"KY\">Cayman Islands<\/option><option value=\"CF\">Central African Republic<\/option><option value=\"TD\">Chad<\/option><option value=\"CL\">Chile<\/option><option value=\"CN\">China<\/option><option value=\"CX\">Christmas Island<\/option><option value=\"CC\">Cocos (keeling) Islands<\/option><option value=\"CO\">Colombia<\/option><option value=\"KM\">Comoros<\/option><option value=\"CG\">Congo<\/option><option value=\"CD\">Congo, The Democratic Republic Of The<\/option><option value=\"CK\">Cook Islands<\/option><option value=\"CR\">Costa Rica<\/option><option value=\"CI\">Cote D&#039;ivoire<\/option><option value=\"HR\">Croatia<\/option><option value=\"CU\">Cuba<\/option><option value=\"CY\">Cyprus<\/option><option value=\"CZ\">Czech Republic<\/option><option value=\"DK\">Denmark<\/option><option value=\"DJ\">Djibouti<\/option><option value=\"DM\">Dominica<\/option><option value=\"DO\">Dominican Republic<\/option><option value=\"EC\">Ecuador<\/option><option value=\"EG\">Egypt<\/option><option value=\"SV\">El Salvador<\/option><option value=\"GQ\">Equatorial Guinea<\/option><option value=\"ER\">Eritrea<\/option><option value=\"EE\">Estonia<\/option><option value=\"ET\">Ethiopia<\/option><option value=\"FK\">Falkland Islands (malvinas)<\/option><option value=\"FO\">Faroe Islands<\/option><option value=\"FJ\">Fiji<\/option><option value=\"FI\">Finland<\/option><option value=\"FR\">France<\/option><option value=\"GF\">French Guiana<\/option><option value=\"PF\">French Polynesia<\/option><option value=\"TF\">French Southern Territories<\/option><option value=\"GA\">Gabon<\/option><option value=\"GM\">Gambia<\/option><option value=\"GE\">Georgia<\/option><option value=\"DE\">Germany<\/option><option value=\"GH\">Ghana<\/option><option value=\"GI\">Gibraltar<\/option><option value=\"GR\">Greece<\/option><option value=\"GL\">Greenland<\/option><option value=\"GD\">Grenada<\/option><option value=\"GP\">Guadeloupe<\/option><option value=\"GU\">Guam<\/option><option value=\"GT\">Guatemala<\/option><option value=\"GG\">Guernsey<\/option><option value=\"GN\">Guinea<\/option><option value=\"GW\">Guinea-bissau<\/option><option value=\"GY\">Guyana<\/option><option value=\"HT\">Haiti<\/option><option value=\"HM\">Heard Island And Mcdonald Islands<\/option><option value=\"VA\">Holy See (vatican City State)<\/option><option value=\"HN\">Honduras<\/option><option value=\"HK\">Hong Kong<\/option><option value=\"HU\">Hungary<\/option><option value=\"IS\">Iceland<\/option><option value=\"IN\">India<\/option><option value=\"ID\">Indonesia<\/option><option value=\"IR\">Iran, Islamic Republic Of<\/option><option value=\"IQ\">Iraq<\/option><option value=\"IE\">Ireland<\/option><option value=\"IM\">Isle Of Man<\/option><option value=\"IL\">Israel<\/option><option value=\"IT\">Italy<\/option><option value=\"JM\">Jamaica<\/option><option value=\"JP\">Japan<\/option><option value=\"JE\">Jersey<\/option><option value=\"JO\">Jordan<\/option><option value=\"KZ\">Kazakhstan<\/option><option value=\"KE\">Kenya<\/option><option value=\"KI\">Kiribati<\/option><option value=\"KP\">Korea, Democratic People&#039;s Republic Of<\/option><option value=\"KR\">Korea, Republic Of<\/option><option value=\"KW\">Kuwait<\/option><option value=\"KG\">Kyrgyzstan<\/option><option value=\"LA\">Lao People&#039;s Democratic Republic<\/option><option value=\"LV\">Latvia<\/option><option value=\"LB\">Lebanon<\/option><option value=\"LS\">Lesotho<\/option><option value=\"LR\">Liberia<\/option><option value=\"LY\">Libyan Arab Jamahiriya<\/option><option value=\"LI\">Liechtenstein<\/option><option value=\"LT\">Lithuania<\/option><option value=\"LU\">Luxembourg<\/option><option value=\"MO\">Macao<\/option><option value=\"MK\">Macedonia, The Former Yugoslav Republic Of<\/option><option value=\"MG\">Madagascar<\/option><option value=\"MW\">Malawi<\/option><option value=\"MY\">Malaysia<\/option><option value=\"MV\">Maldives<\/option><option value=\"ML\">Mali<\/option><option value=\"MT\">Malta<\/option><option value=\"MH\">Marshall Islands<\/option><option value=\"MQ\">Martinique<\/option><option value=\"MR\">Mauritania<\/option><option value=\"MU\">Mauritius<\/option><option value=\"YT\">Mayotte<\/option><option value=\"MX\">Mexico<\/option><option value=\"FM\">Micronesia, Federated States Of<\/option><option value=\"MD\">Moldova, Republic Of<\/option><option value=\"MC\">Monaco<\/option><option value=\"MN\">Mongolia<\/option><option value=\"ME\">Montenegro<\/option><option value=\"MS\">Montserrat<\/option><option value=\"MA\">Morocco<\/option><option value=\"MZ\">Mozambique<\/option><option value=\"MM\">Myanmar<\/option><option value=\"NA\">Namibia<\/option><option value=\"NR\">Nauru<\/option><option value=\"NP\">Nepal<\/option><option value=\"NL\">Netherlands<\/option><option value=\"AN\">Netherlands Antilles<\/option><option value=\"NC\">New Caledonia<\/option><option value=\"NZ\">New Zealand<\/option><option value=\"NI\">Nicaragua<\/option><option value=\"NE\">Niger<\/option><option value=\"NG\">Nigeria<\/option><option value=\"NU\">Niue<\/option><option value=\"NF\">Norfolk Island<\/option><option value=\"MP\">Northern Mariana Islands<\/option><option value=\"NO\">Norway<\/option><option value=\"OM\">Oman<\/option><option value=\"PK\">Pakistan<\/option><option value=\"PW\">Palau<\/option><option value=\"PS\">Palestinian Territory, Occupied<\/option><option value=\"PA\">Panama<\/option><option value=\"PG\">Papua New Guinea<\/option><option value=\"PY\">Paraguay<\/option><option value=\"PE\">Peru<\/option><option value=\"PH\">Philippines<\/option><option value=\"PN\">Pitcairn<\/option><option value=\"PL\">Poland<\/option><option value=\"PT\">Portugal<\/option><option value=\"PR\">Puerto Rico<\/option><option value=\"QA\">Qatar<\/option><option value=\"RE\">Reunion<\/option><option value=\"RO\">Romania<\/option><option value=\"RU\">Russian Federation<\/option><option value=\"RW\">Rwanda<\/option><option value=\"BL\">Saint Barthelemy<\/option><option value=\"SH\">Saint Helena, Ascension And Tristan Da Cunha<\/option><option value=\"KN\">Saint Kitts And Nevis<\/option><option value=\"LC\">Saint Lucia<\/option><option value=\"MF\">Saint Martin<\/option><option value=\"PM\">Saint Pierre And Miquelon<\/option><option value=\"VC\">Saint Vincent And The Grenadines<\/option><option value=\"WS\">Samoa<\/option><option value=\"SM\">San Marino<\/option><option value=\"ST\">Sao Tome And Principe<\/option><option value=\"SA\">Saudi Arabia<\/option><option value=\"SN\">Senegal<\/option><option value=\"RS\">Serbia<\/option><option value=\"SC\">Seychelles<\/option><option value=\"SL\">Sierra Leone<\/option><option value=\"SG\">Singapore<\/option><option value=\"SK\">Slovakia<\/option><option value=\"SI\">Slovenia<\/option><option value=\"SB\">Solomon Islands<\/option><option value=\"SO\">Somalia<\/option><option value=\"ZA\">South Africa<\/option><option value=\"GS\">South Georgia And The South Sandwich Islands<\/option><option value=\"ES\">Spain<\/option><option value=\"LK\">Sri Lanka<\/option><option value=\"SD\">Sudan<\/option><option value=\"SR\">Suriname<\/option><option value=\"SJ\">Svalbard And Jan Mayen<\/option><option value=\"SZ\">Swaziland<\/option><option value=\"SE\">Sweden<\/option><option value=\"CH\">Switzerland<\/option><option value=\"SY\">Syrian Arab Republic<\/option><option value=\"TW\">Taiwan<\/option><option value=\"TJ\">Tajikistan<\/option><option value=\"TZ\">Tanzania, United Republic Of<\/option><option value=\"TH\">Thailand<\/option><option value=\"TL\">Timor-leste<\/option><option value=\"TG\">Togo<\/option><option value=\"TK\">Tokelau<\/option><option value=\"TO\">Tonga<\/option><option value=\"TT\">Trinidad And Tobago<\/option><option value=\"TN\">Tunisia<\/option><option value=\"TR\">Turkey<\/option><option value=\"TM\">Turkmenistan<\/option><option value=\"TC\">Turks And Caicos Islands<\/option><option value=\"TV\">Tuvalu<\/option><option value=\"UG\">Uganda<\/option><option value=\"UA\">Ukraine<\/option><option value=\"AE\">United Arab Emirates<\/option><option value=\"GB\">United Kingdom<\/option><option value=\"US\" selected=\"selected\">United States<\/option><option value=\"UM\">United States Minor Outlying Islands<\/option><option value=\"UY\">Uruguay<\/option><option value=\"UZ\">Uzbekistan<\/option><option value=\"VU\">Vanuatu<\/option><option value=\"VE\">Venezuela, Bolivarian Republic Of<\/option><option value=\"VN\">Viet Nam<\/option><option value=\"VG\">Virgin Islands, British<\/option><option value=\"VI\">Virgin Islands, U.s.<\/option><option value=\"WF\">Wallis And Futuna<\/option><option value=\"EH\">Western Sahara<\/option><option value=\"YE\">Yemen<\/option><option value=\"ZM\">Zambia<\/option><option value=\"ZW\">Zimbabwe<\/option>\n\t\t\t\t<\/select>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-ajax-tax-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-ajax-tax-div s2member-pro-stripe-checkout-form-ajax-tax-div\">\n\t\t\t<!-- Sales Tax will be displayed here via Ajax; based on state, country, and\/or zip code range. -->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Captcha ( A reCaptcha section, with a required security code will appear here; if captcha=\"1\" ). -->\n\t\n\n\t<!-- Checkout Now (this holds the submit button, and also some dynamic hidden input variables). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-submission-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-submission-section s2member-pro-stripe-checkout-form-submission-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-submission-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-checkout-form-submission-section-title\">\n\t\t\tCheckout Now\t\t<\/div>\n\t\t <!-- s2Member will fill this when\/if there are list servers integrated, and the Opt-In Box is turned on. -->\n\t\t<div id=\"s2member-pro-stripe-checkout-form-submit-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-submit-div s2member-pro-stripe-checkout-form-submit-div\">\n\t\t\t<input type=\"hidden\" name=\"s2member_pro_stripe_checkout[nonce]\" id=\"s2member-pro-stripe-checkout-nonce\" value=\"d2f8a3721e\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-coupons-not-required-or-not-possible\" value=\"1\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-password-not-required-or-not-possible\" value=\"1\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-tax-not-required-or-not-possible\" value=\"1\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-should-validate-zipcode\" value=\"0\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-should-collect-billing-address\" value=\"0\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-should-collect-shipping-address\" value=\"0\" \/><input type=\"hidden\" name=\"s2member_pro_stripe_checkout[attr]\" id=\"s2member-pro-stripe-checkout-attr\" value=\"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\" \/> <!-- Auto-filled by the s2Member software. Do NOT remove this under any circumstance. -->\n\t\t\t<button type=\"submit\" id=\"s2member-pro-stripe-checkout-submit\" class=\"s2member-pro-stripe-submit s2member-pro-stripe-checkout-submit btn btn-primary\" tabindex=\"600\">Submit Form<\/button>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n<\/form> <div id=\"s2p-form\"><\/div><!-- This is for hash anchors; do NOT remove please. -->\n\n<form id=\"s2member-pro-stripe-checkout-form\" class=\"s2member-pro-stripe-form s2member-pro-stripe-checkout-form\" method=\"post\" action=\"\/wp-json\/wp\/v2\/pages\/3598\" autocomplete=\"off\">\n\n\t<!-- Response Section (this is auto-filled after form submission). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-response-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-response-section s2member-pro-stripe-checkout-form-response-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-response-div s2member-pro-stripe-checkout-form-response-div\">\n\t\t\t\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Options Section (this is filled by Shortcode options; when\/if specified). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-options-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-options-section s2member-pro-stripe-checkout-form-options-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-options-section-title s2member-pro-stripe-checkout-form-options-section-title\">\n\t\t\tCheckout Options\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-options-div s2member-pro-stripe-checkout-form-options-div\">\n\t\t\t<select name=\"s2p-option\" id=\"s2member-pro-stripe-checkout-options\" class=\"s2member-pro-stripe-options s2member-pro-stripe-checkout-options form-control\" tabindex=\"-1\">\n\t\t\t\t\n\t\t\t<\/select>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Checkout Description (this is the desc=\"\" attribute from your Shortcode). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-description-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-description-section s2member-pro-stripe-checkout-form-description-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-description-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-description-div s2member-pro-stripe-checkout-form-description-div\">\n\t\t\tOnline Comprehensive Health Analysis \u00a3199\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Coupon Code ( this will ONLY be displayed if your Shortcode has this attribute: accept_coupons=\"1\" ). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-coupon-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-coupon-section s2member-pro-stripe-checkout-form-coupon-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-response-div s2member-pro-stripe-checkout-form-coupon-response-div\">\n\t\t\t <!-- A Coupon response (w\/Discounts) will be displayed here; based on the Coupon Code that was entered. -->\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-div s2member-pro-stripe-checkout-form-coupon-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-coupon\" id=\"s2member-pro-stripe-checkout-form-coupon-label\" class=\"s2member-pro-stripe-form-coupon-label s2member-pro-stripe-checkout-form-coupon-label\">\n\t\t\t\t<span>Gift, Coupon, or Redemption Code?<\/span><br \/>\n\t\t\t\t<input type=\"text\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[coupon]\" id=\"s2member-pro-stripe-checkout-coupon\" class=\"s2member-pro-stripe-coupon s2member-pro-stripe-checkout-coupon form-control\" value=\" \" tabindex=\"1\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"button\" id=\"s2member-pro-stripe-checkout-coupon-apply\" class=\"s2member-pro-stripe-coupon-apply s2member-pro-stripe-checkout-coupon-apply btn btn-default\" value=\"Apply\" tabindex=\"-1\" \/>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Registration Details (Name, Email, Username, Password). -->\n\t<!-- Some of this information will be prefilled automatically when\/if a User\/Member is already logged-in. -->\n\t<!-- Name fields will NOT be hidden automatically here; even if your Registration\/Profile Field options dictate this behavior. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-registration-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-registration-section s2member-pro-stripe-checkout-form-registration-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-registration-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-registration-section-title s2member-pro-stripe-checkout-form-registration-section-title\">\n\t\t\tCreate Profile\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-first-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-first-name-div s2member-pro-stripe-checkout-form-first-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-first-name\" id=\"s2member-pro-stripe-checkout-form-first-name-label\" class=\"s2member-pro-stripe-form-first-name-label s2member-pro-stripe-checkout-form-first-name-label\">\n\t\t\t\t<span>First Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[first_name]\" id=\"s2member-pro-stripe-checkout-first-name\" class=\"s2member-pro-stripe-first-name s2member-pro-stripe-checkout-first-name form-control\" value=\"\" tabindex=\"10\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-last-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-last-name-div s2member-pro-stripe-checkout-form-last-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-last-name\" id=\"s2member-pro-stripe-checkout-form-last-name-label\" class=\"s2member-pro-stripe-form-last-name-label s2member-pro-stripe-checkout-form-last-name-label\">\n\t\t\t\t<span>Last Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[last_name]\" id=\"s2member-pro-stripe-checkout-last-name\" class=\"s2member-pro-stripe-last-name s2member-pro-stripe-checkout-last-name form-control\" value=\"\" tabindex=\"20\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-email-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-email-div s2member-pro-stripe-checkout-form-email-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-email\" id=\"s2member-pro-stripe-checkout-form-email-label\" class=\"s2member-pro-stripe-form-email-label s2member-pro-stripe-checkout-form-email-label\">\n\t\t\t\t<span>Email Address *<\/span><br \/>\n\t\t\t\t<input type=\"email\" aria-required=\"true\" data-expected=\"email\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[email]\" id=\"s2member-pro-stripe-checkout-email\" class=\"s2member-pro-stripe-email s2member-pro-stripe-checkout-email form-control\" value=\"\" tabindex=\"30\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-username-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-username-div s2member-pro-stripe-checkout-form-username-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-username\" id=\"s2member-pro-stripe-checkout-form-username-label\" class=\"s2member-pro-stripe-form-username-label s2member-pro-stripe-checkout-form-username-label\">\n\t\t\t\t<span>Username (lowercase alphanumeric) *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"60\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[username]\" id=\"s2member-pro-stripe-checkout-username\" class=\"s2member-pro-stripe-username s2member-pro-stripe-checkout-username form-control\" value=\"\" tabindex=\"40\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-password-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-password-div s2member-pro-stripe-checkout-form-password-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-password1\" id=\"s2member-pro-stripe-checkout-form-password-label\" class=\"s2member-pro-stripe-form-password-label s2member-pro-stripe-checkout-form-password-label\">\n\t\t\t\t<span>Password (type this twice please) *<\/span><br \/>\n\t\t\t\t<input type=\"password\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password1]\" id=\"s2member-pro-stripe-checkout-password1\" class=\"s2member-pro-stripe-password1 s2member-pro-stripe-checkout-password1 form-control\" value=\"\" tabindex=\"50\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"password\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password2]\" id=\"s2member-pro-stripe-checkout-password2\" class=\"s2member-pro-stripe-password2 s2member-pro-stripe-checkout-password2 form-control\" value=\"\" tabindex=\"60\" \/>\n\t\t\t<div id=\"s2member-pro-stripe-checkout-form-password-strength\" class=\"ws-plugin--s2member-password-strength s2member-pro-stripe-form-password-strength s2member-pro-stripe-checkout-form-password-strength\"><em>password strength indicator<\/em><\/div>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Custom Fields (Custom Registration\/Profile Fields will appear here, when\/if they've been configured). -->\n\t<!-- Custom Fields will NOT be displayed to existing Users\/Members that are already logged-in. s2Member assumes this information has already been collected in that case. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-custom-fields-section s2member-pro-stripe-checkout-form-custom-fields-section\">\n<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-custom-fields-section-title s2member-pro-stripe-checkout-form-custom-fields-section-title\">\nAdditional Info\n<\/div>\n<div id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-custom-reg-field-terms-div s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\">\n<label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\" class=\"s2member-pro-stripe-form-custom-reg-field-terms-label s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\">\n<span style=\"display:none;\">Yes, I Agree to Terms & Conditions *<\/span><\/label>\n<input type=\"checkbox\" value=\"1\" name=\"s2member_pro_stripe_checkout[custom_fields][terms]\" id=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" aria-required=\"true\" tabindex=\"100\" class=\"s2member-pro-stripe-custom-reg-field-terms s2member-pro-stripe-checkout-custom-reg-field-terms\" \/> <label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" style=\"display:inline !important; margin:0 !important;\">Yes, I Agree to Terms & Conditions<\/label><\/div>\n<\/div>\n\n\n\t<!-- Billing Method (powered by Stripe). -->\n\t\n\t<div id=\"s2member-pro-stripe-form-billing-method-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-form-billing-method-section\">\n\t\t<div id=\"s2member-pro-stripe-form-billing-method-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-form-billing-method-section-title\">\n\t\t\tBilling Method\t\t<\/div>\n\t\t<label for=\"s2member-pro-stripe-form-card-element\" id=\"s2member-pro-stripe-form-card-element-label\" class=\"s2member-pro-stripe-form-card-element-label\">\n\t\t\tCredit or debit card\t\t<\/label>\n\t\t<div id=\"s2member-pro-stripe-form-card-element\">\n\t\t\t<!-- A Stripe Element will be inserted here. -->\n\t\t<\/div>\n\n\t\t<!-- Used to display Element errors. -->\n\t\t<div id=\"s2member-pro-stripe-form-card-errors\" role=\"alert\"><\/div>\n\n\t\t<!-- Update with IDs -->\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pm-id\" name=\"stripe_pm_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-id\" name=\"stripe_pi_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-id\" name=\"stripe_seti_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-sub-id\" name=\"stripe_sub_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-secret\" name=\"stripe_pi_secret\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-secret\" name=\"stripe_seti_secret\" value=\"\" \/>\n\n\t\t<div id=\"s2member-pro-stripe-checkout-form-source-token-summary\" class=\"s2member-pro-stripe-form-source-token-summary s2member-pro-stripe-checkout-form-source-token-summary\">\n\t\t\t\t<!---->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<style>\n\t\t#s2member-pro-stripe-form-card-element {border: 1px solid #b6b6b3; border-radius: 4px; padding: 10px 13px;}\n\t\t#s2member-pro-stripe-form-card-errors {color: #eb1c26;}\n\t\t.s2member-pro-stripe-form-disabled {opacity: .5;}\n\t<\/style>\n\n\t<!-- Billing Address (hidden dynamically when\/if no tax details are necessary; and\/or when no billing info has been provided yet). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section\" class=\"s2member-pro-stripe-form-section  s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-billing-address-section s2member-pro-stripe-checkout-form-billing-address-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-billing-address-section-title s2member-pro-stripe-checkout-form-billing-address-section-title\">\n\t\t\tBilling Address\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-street-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-street-div s2member-pro-stripe-checkout-form-street-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-street\" id=\"s2member-pro-stripe-checkout-form-street-label\" class=\"s2member-pro-stripe-form-street-label s2member-pro-stripe-checkout-form-street-label\">\n\t\t\t\t<span>Street Address *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[street]\" id=\"s2member-pro-stripe-checkout-street\" class=\"s2member-pro-stripe-street s2member-pro-stripe-checkout-street form-control\" value=\"\" tabindex=\"300\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-city-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-city-div s2member-pro-stripe-checkout-form-city-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-city\" id=\"s2member-pro-stripe-checkout-form-city-label\" class=\"s2member-pro-stripe-form-city-label s2member-pro-stripe-checkout-form-city-label\">\n\t\t\t\t<span>City \/ Town *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[city]\" id=\"s2member-pro-stripe-checkout-city\" class=\"s2member-pro-stripe-city s2member-pro-stripe-checkout-city form-control\" value=\"\" tabindex=\"310\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-state-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-state-div s2member-pro-stripe-checkout-form-state-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-state\" id=\"s2member-pro-stripe-checkout-form-state-label\" class=\"s2member-pro-stripe-form-state-label s2member-pro-stripe-checkout-form-state-label\">\n\t\t\t\t<span>State \/ Province *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"40\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[state]\" id=\"s2member-pro-stripe-checkout-state\" class=\"s2member-pro-stripe-state s2member-pro-stripe-checkout-state form-control\" value=\"\" tabindex=\"320\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-zip-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-zip-div s2member-pro-stripe-checkout-form-zip-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-zip\" id=\"s2member-pro-stripe-checkout-form-zip-label\" class=\"s2member-pro-stripe-form-zip-label s2member-pro-stripe-checkout-form-zip-label\">\n\t\t\t\t<span>Postal \/ Zip Code *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"20\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[zip]\" id=\"s2member-pro-stripe-checkout-zip\" class=\"s2member-pro-stripe-zip s2member-pro-stripe-checkout-zip form-control\" value=\"\" tabindex=\"330\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-country-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-country-div s2member-pro-stripe-checkout-form-country-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-country\" id=\"s2member-pro-stripe-checkout-form-country-label\" class=\"s2member-pro-stripe-form-country-label s2member-pro-stripe-checkout-form-country-label\">\n\t\t\t\t<span>Country *<\/span><br \/>\n\t\t\t\t<select aria-required=\"true\" name=\"s2member_pro_stripe_checkout[country]\" id=\"s2member-pro-stripe-checkout-country\" class=\"s2member-pro-stripe-country s2member-pro-stripe-checkout-country form-control\" tabindex=\"340\">\n\t\t\t\t\t<option value=\"\"><\/option><option value=\"AF\">Afghanistan<\/option><option value=\"AX\">Aland Islands<\/option><option value=\"AL\">Albania<\/option><option value=\"DZ\">Algeria<\/option><option value=\"AS\">American Samoa<\/option><option value=\"AD\">Andorra<\/option><option value=\"AO\">Angola<\/option><option value=\"AI\">Anguilla<\/option><option value=\"AQ\">Antarctica<\/option><option value=\"AG\">Antigua And Barbuda<\/option><option value=\"AR\">Argentina<\/option><option value=\"AM\">Armenia<\/option><option value=\"AW\">Aruba<\/option><option value=\"AU\">Australia<\/option><option value=\"AT\">Austria<\/option><option value=\"AZ\">Azerbaijan<\/option><option value=\"BS\">Bahamas<\/option><option value=\"BH\">Bahrain<\/option><option value=\"BD\">Bangladesh<\/option><option value=\"BB\">Barbados<\/option><option value=\"BY\">Belarus<\/option><option value=\"BE\">Belgium<\/option><option value=\"BZ\">Belize<\/option><option value=\"BJ\">Benin<\/option><option value=\"BM\">Bermuda<\/option><option value=\"BT\">Bhutan<\/option><option value=\"BO\">Bolivia, Plurinational State Of<\/option><option value=\"BA\">Bosnia And Herzegovina<\/option><option value=\"BW\">Botswana<\/option><option value=\"BV\">Bouvet Island<\/option><option value=\"BR\">Brazil<\/option><option value=\"IO\">British Indian Ocean Territory<\/option><option value=\"BN\">Brunei Darussalam<\/option><option value=\"BG\">Bulgaria<\/option><option value=\"BF\">Burkina Faso<\/option><option value=\"BI\">Burundi<\/option><option value=\"KH\">Cambodia<\/option><option value=\"CM\">Cameroon<\/option><option value=\"CA\">Canada<\/option><option value=\"CV\">Cape Verde<\/option><option value=\"KY\">Cayman Islands<\/option><option value=\"CF\">Central African Republic<\/option><option value=\"TD\">Chad<\/option><option value=\"CL\">Chile<\/option><option value=\"CN\">China<\/option><option value=\"CX\">Christmas Island<\/option><option value=\"CC\">Cocos (keeling) Islands<\/option><option value=\"CO\">Colombia<\/option><option value=\"KM\">Comoros<\/option><option value=\"CG\">Congo<\/option><option value=\"CD\">Congo, The Democratic Republic Of The<\/option><option value=\"CK\">Cook Islands<\/option><option value=\"CR\">Costa Rica<\/option><option value=\"CI\">Cote D&#039;ivoire<\/option><option value=\"HR\">Croatia<\/option><option value=\"CU\">Cuba<\/option><option value=\"CY\">Cyprus<\/option><option value=\"CZ\">Czech Republic<\/option><option value=\"DK\">Denmark<\/option><option value=\"DJ\">Djibouti<\/option><option value=\"DM\">Dominica<\/option><option value=\"DO\">Dominican Republic<\/option><option value=\"EC\">Ecuador<\/option><option value=\"EG\">Egypt<\/option><option value=\"SV\">El Salvador<\/option><option value=\"GQ\">Equatorial Guinea<\/option><option value=\"ER\">Eritrea<\/option><option value=\"EE\">Estonia<\/option><option value=\"ET\">Ethiopia<\/option><option value=\"FK\">Falkland Islands (malvinas)<\/option><option value=\"FO\">Faroe Islands<\/option><option value=\"FJ\">Fiji<\/option><option value=\"FI\">Finland<\/option><option value=\"FR\">France<\/option><option value=\"GF\">French Guiana<\/option><option value=\"PF\">French Polynesia<\/option><option value=\"TF\">French Southern Territories<\/option><option value=\"GA\">Gabon<\/option><option value=\"GM\">Gambia<\/option><option value=\"GE\">Georgia<\/option><option value=\"DE\">Germany<\/option><option value=\"GH\">Ghana<\/option><option value=\"GI\">Gibraltar<\/option><option value=\"GR\">Greece<\/option><option value=\"GL\">Greenland<\/option><option value=\"GD\">Grenada<\/option><option value=\"GP\">Guadeloupe<\/option><option value=\"GU\">Guam<\/option><option value=\"GT\">Guatemala<\/option><option value=\"GG\">Guernsey<\/option><option value=\"GN\">Guinea<\/option><option value=\"GW\">Guinea-bissau<\/option><option value=\"GY\">Guyana<\/option><option value=\"HT\">Haiti<\/option><option value=\"HM\">Heard Island And Mcdonald Islands<\/option><option value=\"VA\">Holy See (vatican City State)<\/option><option value=\"HN\">Honduras<\/option><option value=\"HK\">Hong Kong<\/option><option value=\"HU\">Hungary<\/option><option value=\"IS\">Iceland<\/option><option value=\"IN\">India<\/option><option value=\"ID\">Indonesia<\/option><option value=\"IR\">Iran, Islamic Republic Of<\/option><option value=\"IQ\">Iraq<\/option><option value=\"IE\">Ireland<\/option><option value=\"IM\">Isle Of Man<\/option><option value=\"IL\">Israel<\/option><option value=\"IT\">Italy<\/option><option value=\"JM\">Jamaica<\/option><option value=\"JP\">Japan<\/option><option value=\"JE\">Jersey<\/option><option value=\"JO\">Jordan<\/option><option value=\"KZ\">Kazakhstan<\/option><option value=\"KE\">Kenya<\/option><option value=\"KI\">Kiribati<\/option><option value=\"KP\">Korea, Democratic People&#039;s Republic Of<\/option><option value=\"KR\">Korea, Republic Of<\/option><option value=\"KW\">Kuwait<\/option><option value=\"KG\">Kyrgyzstan<\/option><option value=\"LA\">Lao People&#039;s Democratic Republic<\/option><option value=\"LV\">Latvia<\/option><option value=\"LB\">Lebanon<\/option><option value=\"LS\">Lesotho<\/option><option value=\"LR\">Liberia<\/option><option value=\"LY\">Libyan Arab Jamahiriya<\/option><option value=\"LI\">Liechtenstein<\/option><option value=\"LT\">Lithuania<\/option><option value=\"LU\">Luxembourg<\/option><option value=\"MO\">Macao<\/option><option value=\"MK\">Macedonia, The Former Yugoslav Republic Of<\/option><option value=\"MG\">Madagascar<\/option><option value=\"MW\">Malawi<\/option><option value=\"MY\">Malaysia<\/option><option value=\"MV\">Maldives<\/option><option value=\"ML\">Mali<\/option><option value=\"MT\">Malta<\/option><option value=\"MH\">Marshall Islands<\/option><option value=\"MQ\">Martinique<\/option><option value=\"MR\">Mauritania<\/option><option value=\"MU\">Mauritius<\/option><option value=\"YT\">Mayotte<\/option><option value=\"MX\">Mexico<\/option><option value=\"FM\">Micronesia, Federated States Of<\/option><option value=\"MD\">Moldova, Republic Of<\/option><option value=\"MC\">Monaco<\/option><option value=\"MN\">Mongolia<\/option><option value=\"ME\">Montenegro<\/option><option value=\"MS\">Montserrat<\/option><option value=\"MA\">Morocco<\/option><option value=\"MZ\">Mozambique<\/option><option value=\"MM\">Myanmar<\/option><option value=\"NA\">Namibia<\/option><option value=\"NR\">Nauru<\/option><option value=\"NP\">Nepal<\/option><option value=\"NL\">Netherlands<\/option><option value=\"AN\">Netherlands Antilles<\/option><option value=\"NC\">New Caledonia<\/option><option value=\"NZ\">New Zealand<\/option><option value=\"NI\">Nicaragua<\/option><option value=\"NE\">Niger<\/option><option value=\"NG\">Nigeria<\/option><option value=\"NU\">Niue<\/option><option value=\"NF\">Norfolk Island<\/option><option value=\"MP\">Northern Mariana Islands<\/option><option value=\"NO\">Norway<\/option><option value=\"OM\">Oman<\/option><option value=\"PK\">Pakistan<\/option><option value=\"PW\">Palau<\/option><option value=\"PS\">Palestinian Territory, Occupied<\/option><option value=\"PA\">Panama<\/option><option value=\"PG\">Papua New Guinea<\/option><option value=\"PY\">Paraguay<\/option><option value=\"PE\">Peru<\/option><option value=\"PH\">Philippines<\/option><option value=\"PN\">Pitcairn<\/option><option value=\"PL\">Poland<\/option><option value=\"PT\">Portugal<\/option><option value=\"PR\">Puerto Rico<\/option><option value=\"QA\">Qatar<\/option><option value=\"RE\">Reunion<\/option><option value=\"RO\">Romania<\/option><option value=\"RU\">Russian Federation<\/option><option value=\"RW\">Rwanda<\/option><option value=\"BL\">Saint Barthelemy<\/option><option value=\"SH\">Saint Helena, Ascension And Tristan Da Cunha<\/option><option value=\"KN\">Saint Kitts And Nevis<\/option><option value=\"LC\">Saint Lucia<\/option><option value=\"MF\">Saint Martin<\/option><option value=\"PM\">Saint Pierre And Miquelon<\/option><option value=\"VC\">Saint Vincent And The Grenadines<\/option><option value=\"WS\">Samoa<\/option><option value=\"SM\">San Marino<\/option><option value=\"ST\">Sao Tome And Principe<\/option><option value=\"SA\">Saudi Arabia<\/option><option value=\"SN\">Senegal<\/option><option value=\"RS\">Serbia<\/option><option value=\"SC\">Seychelles<\/option><option value=\"SL\">Sierra Leone<\/option><option value=\"SG\">Singapore<\/option><option value=\"SK\">Slovakia<\/option><option value=\"SI\">Slovenia<\/option><option value=\"SB\">Solomon Islands<\/option><option value=\"SO\">Somalia<\/option><option value=\"ZA\">South Africa<\/option><option value=\"GS\">South Georgia And The South Sandwich Islands<\/option><option value=\"ES\">Spain<\/option><option value=\"LK\">Sri Lanka<\/option><option value=\"SD\">Sudan<\/option><option value=\"SR\">Suriname<\/option><option value=\"SJ\">Svalbard And Jan Mayen<\/option><option value=\"SZ\">Swaziland<\/option><option value=\"SE\">Sweden<\/option><option value=\"CH\">Switzerland<\/option><option value=\"SY\">Syrian Arab Republic<\/option><option value=\"TW\">Taiwan<\/option><option value=\"TJ\">Tajikistan<\/option><option value=\"TZ\">Tanzania, United Republic Of<\/option><option value=\"TH\">Thailand<\/option><option value=\"TL\">Timor-leste<\/option><option value=\"TG\">Togo<\/option><option value=\"TK\">Tokelau<\/option><option value=\"TO\">Tonga<\/option><option value=\"TT\">Trinidad And Tobago<\/option><option value=\"TN\">Tunisia<\/option><option value=\"TR\">Turkey<\/option><option value=\"TM\">Turkmenistan<\/option><option value=\"TC\">Turks And Caicos Islands<\/option><option value=\"TV\">Tuvalu<\/option><option value=\"UG\">Uganda<\/option><option value=\"UA\">Ukraine<\/option><option value=\"AE\">United Arab Emirates<\/option><option value=\"GB\">United Kingdom<\/option><option value=\"US\" selected=\"selected\">United States<\/option><option value=\"UM\">United States Minor Outlying Islands<\/option><option value=\"UY\">Uruguay<\/option><option value=\"UZ\">Uzbekistan<\/option><option value=\"VU\">Vanuatu<\/option><option value=\"VE\">Venezuela, Bolivarian Republic Of<\/option><option value=\"VN\">Viet Nam<\/option><option value=\"VG\">Virgin Islands, British<\/option><option value=\"VI\">Virgin Islands, U.s.<\/option><option value=\"WF\">Wallis And Futuna<\/option><option value=\"EH\">Western Sahara<\/option><option value=\"YE\">Yemen<\/option><option value=\"ZM\">Zambia<\/option><option value=\"ZW\">Zimbabwe<\/option>\n\t\t\t\t<\/select>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-ajax-tax-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-ajax-tax-div s2member-pro-stripe-checkout-form-ajax-tax-div\">\n\t\t\t<!-- Sales Tax will be displayed here via Ajax; based on state, country, and\/or zip code range. -->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Captcha ( A reCaptcha section, with a required security code will appear here; if captcha=\"1\" ). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-captcha-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-captcha-section s2member-pro-stripe-checkout-form-captcha-section\">\n<div id=\"s2member-pro-stripe-checkout-form-captcha-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-captcha-section-title s2member-pro-stripe-checkout-form-captcha-section-title\">\nSecurity Verification\n<\/div>\n<div id=\"s2member-pro-stripe-checkout-form-captcha-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-captcha-div s2member-pro-stripe-checkout-form-captcha-div\">\n<label id=\"s2member-pro-stripe-checkout-form-captcha-label\" class=\"s2member-pro-stripe-form-captcha-label s2member-pro-stripe-checkout-form-captcha-label\">\n<div class=\"g-recaptcha\" data-sitekey=\"6LcAt1gUAAAAAFgHVROevNL6iCLxoKgZeWkLJrmV\" data-size=\"normal\" data-theme=\"light\" data-tabindex=\"400\"><\/div><script src=\"https:\/\/www.google.com\/recaptcha\/api.js\"><\/script>\n<\/label>\n<\/div>\n<\/div>\n\n\n\t<!-- Checkout Now (this holds the submit button, and also some dynamic hidden input variables). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-submission-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-submission-section s2member-pro-stripe-checkout-form-submission-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-submission-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-checkout-form-submission-section-title\">\n\t\t\tCheckout Now\t\t<\/div>\n\t\t <!-- s2Member will fill this when\/if there are list servers integrated, and the Opt-In Box is turned on. -->\n\t\t<div id=\"s2member-pro-stripe-checkout-form-submit-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-submit-div s2member-pro-stripe-checkout-form-submit-div\">\n\t\t\t<input type=\"hidden\" name=\"s2member_pro_stripe_checkout[nonce]\" id=\"s2member-pro-stripe-checkout-nonce\" value=\"d2f8a3721e\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-password-not-required-or-not-possible\" value=\"1\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-tax-not-required-or-not-possible\" value=\"1\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-is-buy-now-amount\" value=\"199.00\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-is-buy-now-amount-in-cents\" value=\"19900\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-is-buy-now-currency\" value=\"GBP\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-is-buy-now-desc\" value=\"Online Comprehensive Health Analysis \u00a3199\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-should-validate-zipcode\" value=\"0\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-should-collect-billing-address\" value=\"0\" \/><input type=\"hidden\" id=\"s2member-pro-stripe-checkout-should-collect-shipping-address\" value=\"0\" \/><input type=\"hidden\" name=\"s2member_pro_stripe_checkout[attr]\" id=\"s2member-pro-stripe-checkout-attr\" value=\"ZGVmNTAyMDAwNmEyZWUzZDMyM2JiMTg0NmNiMmE4ZmViMDlhNTQ4MDhjOTU0NWMyMTJhMThlZTNhOGQ0MTA4ZjQ5YjI3YTAzMzQ5YWVmOTg2YTA0MjkzZDA3OTdkZTFlMGExZDM5M2NkMGFmNWY0MjExNTI2ZWQwNWVlOWM3YTA0OTFkYzlkMmY3MmIwMWIzNzFlZTA4OTAwMGJkMTZjNjcyMDM4NTY4N2Y1OWJiZGVkOWE1MzlhY2QzMDE5Y2RiMmI0ZTQzZjBiNjEyZTI1ZWM1ZmIxNzRjZjkxY2JjZGE5MTAyZjM0MzY5ZmZiYTY5NTFjY2E1NGViNDBiNGJlOWYxZjQ1ZmZhNzg1NmNmNDU5YjFiMzJhOGUwYjczNTliNmZlNDdiMWMzOGRkYTFlNWZkZmJlNWJjYjk1MmZjMmU4NDY4YTI2NWM4ODdkNjg1YzVjMDlhMjQ2NTEzMDhkNGQxYmUxNzQ1MTg1MGZmMjQxMTFmYTVjODViNDNiNGI2YjcyYTI0MmU0YWMzNGNjODU3MGQzMzM1NDk2YmUzYTY2ZTA5M2MzYTdiODc3MTBkZjgyYTc2MjQ0MGU0NzI3ODcyODNkM2NhZWJlMzY3Mzc0N2I1MTlkODFiM2VkMjUyZjY0YTllMGM1NDhiM2U0OTZlNzI2MDdjMTUwYjUwZTQ0MzkwZGQ2ZDU5NmFhNzk5MjI4ZmE2NTIyYzA3NTE2M2VmYzMzNGI5YWZhMWMyYWY5MWYwOWQxNjc5MzQ1NTRhNTM2YzkwYWI3MjA5YzE3MGViMGFiZjQ3NWVmNjdlNzk1MmQzYzVhOWZkZDMxZDE5ZDc5MWQ3MThkNmUyMjk4ZjU0YWM1MTRlMmVjMDBmMzFjYWI4NTdlYTY2YzY5ZjdhNGM5OWU4MDk5ZTdjNzlmYzU0N2FkYmMxMDgxMzg0MWYwODcwNTA4OTI1M2IwMGE3NTQyYjVhNzM5YWFmMGE4ODhjMzVmNDUxNDg3ZWRmODU0ZmI1NjEzNmQwZDAzNWQ0YTA4ODJjOWY1MzVhNzY4Y2JjNWY4OGM3YWFmOTljOWJhNzczN2Q2NGU5ZjBlYTVhMjkzYmVhNWViNjgyZGFjNzY1MGY3YTdmMjdhMjg0ZWYyYWNmMzcwMjZlMzVmZDdhNDJiYjFmNDViM2U4MmE2ODdkYWUxYTljYzczZjcwZDkzMmY5ZjFiOGYzNmZmZWY1OTE4YjJiNmEwM2E3ZWRkY2MzOGI1MDg2Y2FkNjYwZjkzNjk0NGEyMjMwZTNjMDUxMzUyODQxMjQ2NDFiN2M3MzBmY2M0Y2IyNmE4ZDIzOGU5YjA4YTAzYzRjMzkyMmU2ODMyYzMwYzM1OGU4ODcxYjk1OWE4M2VlOTgyOTNmYjQ3OTY0ZTVkMTEyZmEwM2IwYzI3MTExZmFkMzJiZjE2MDk1ZGVhYjc0MDM1Mjc4NDE4M2Y0YmM4MTZlMjRlY2E3MWQyODE4ZDQ2NGNiYzU4YzM3OGU0NTJkZjM3YzE4MDgxYjkyMThjMDY0N2RjODdlNjA4YjJmYjhkYTM1MzM0OTRlNThjZmVkNWRiZWFlZjgxMjU2ZGQwMDkyMGFkZTkyMmM0Y2M2YjIwNmI2NjcyY2UzNmIyOTk4ZjQ3Yzc0ODZjZTFiOWU3ZjE0ZTdjNzhkMDc5MWRmYTQxN2UxMWE1YzNiYWFhZDVjYmVhMWUwODAzNjhhMjNjNjAxYzlkYmIzYmUyYzZmZDM3Y2FkOTMwOWJmNGFmYTA4M2JlYzc5NjQzMWYxY2FiNjVmMmExODU0OWRjZWRlZWRkNzQ3YTAzZDkwNzJmZmNmNGE0NDY4OTRlODMxMWQzOGY3ZWFlZGIzODg3YTQyZTdlNjc4OThjMWI4ODExMDlmZDhmOGQxMjAzOGMzZmQ0MjQxYzAyMzcyZTljNDgxYzE1NzM4MGJkYmU3MmVhOWRiZGRmOWM5YTQ2MzFkYjgyOWY3NWJkNjI5NDgzOGM1NjE0MGEwNDJhNzQ0OGUyYTdkZTNlYjgxZDQ5MWVhNWVlMjNlNDY3NDVkZjJlYzJlZmM0MjZkZTY3N2MxZThkMGY0ODcxMGVlMDMwMjUwMDAzNjdlNTFmZGY5ZWVjMTM3NGE1ZTRiZjg1OGFmNTFkNzkwMTAzM2JlYjQ4Yzk2MDM1NzlkNTcyMWFlM2YyOTE1ZjdlNDgwZjdhMTAyMThhNDc1NjA1NGQ3OGEwNWJkMmVmYWFjOGFjMzY5ODYxNWJiYzIyYWY0Y2JkMzZmYTViM2E0NTFmNzQxN2MzY2YzM2ExN2ExYWEwODBiMTE5ZGY3ZTAwNGEyNjFlN2VjNDVkNjk3ZmIzNjRhODdhNDBkYmYxOWUzMTEzOTI5NGQ1OTM4YzY3NzUxYzE3ODkwYjhjYmNmNDM1ZjI0ZDRjNWVlYTRiNWEwNzBiYmY5YjA1N2JlZmI4YWFmNGJkYTljYmRlZmVkOTkzNzM3NDkwMGUwM2RmMDViMWQzZDI1NGVjMmFmNGI4NTcyMzc1YjUwOGZkMDQxNDM2MjMzMmRlNGQyYWU1NWY0ZGI1MDIzODU\" \/> <!-- Auto-filled by the s2Member software. Do NOT remove this under any circumstance. -->\n\t\t\t<button type=\"submit\" id=\"s2member-pro-stripe-checkout-submit\" class=\"s2member-pro-stripe-submit s2member-pro-stripe-checkout-submit btn btn-primary\" tabindex=\"600\">Submit Form<\/button>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n<\/form> <div id=\"s2p-form\"><\/div><!-- This is for hash anchors; do NOT remove please. -->\n\n<form id=\"s2member-pro-stripe-checkout-form\" class=\"s2member-pro-stripe-form s2member-pro-stripe-checkout-form\" method=\"post\" action=\"\/wp-json\/wp\/v2\/pages\/3598\" autocomplete=\"off\">\n\n\t<!-- Response Section (this is auto-filled after form submission). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-response-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-response-section s2member-pro-stripe-checkout-form-response-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-response-div s2member-pro-stripe-checkout-form-response-div\">\n\t\t\t<div id=\"s2member-pro-stripe-form-response\" class=\"s2member-pro-stripe-form-response-error s2member-pro-stripe-checkout-form-response-error\">Invalid form configuration. Missing \"level\" attribute. Membership Level. Must be numeric [1-4], or an asterisk (*).<\/div>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Options Section (this is filled by Shortcode options; when\/if specified). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-options-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-options-section s2member-pro-stripe-checkout-form-options-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-options-section-title s2member-pro-stripe-checkout-form-options-section-title\">\n\t\t\tCheckout Options\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-options-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-options-div s2member-pro-stripe-checkout-form-options-div\">\n\t\t\t<select name=\"s2p-option\" id=\"s2member-pro-stripe-checkout-options\" class=\"s2member-pro-stripe-options s2member-pro-stripe-checkout-options form-control\" tabindex=\"-1\">\n\t\t\t\t\n\t\t\t<\/select>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Checkout Description (this is the desc=\"\" attribute from your Shortcode). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-description-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-description-section s2member-pro-stripe-checkout-form-description-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-description-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-description-div s2member-pro-stripe-checkout-form-description-div\">\n\t\t\tVisit\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Coupon Code ( this will ONLY be displayed if your Shortcode has this attribute: accept_coupons=\"1\" ). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-coupon-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-coupon-section s2member-pro-stripe-checkout-form-coupon-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-response-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-response-div s2member-pro-stripe-checkout-form-coupon-response-div\">\n\t\t\t <!-- A Coupon response (w\/Discounts) will be displayed here; based on the Coupon Code that was entered. -->\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-coupon-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-coupon-div s2member-pro-stripe-checkout-form-coupon-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-coupon\" id=\"s2member-pro-stripe-checkout-form-coupon-label\" class=\"s2member-pro-stripe-form-coupon-label s2member-pro-stripe-checkout-form-coupon-label\">\n\t\t\t\t<span>Gift, Coupon, or Redemption Code?<\/span><br \/>\n\t\t\t\t<input type=\"text\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[coupon]\" id=\"s2member-pro-stripe-checkout-coupon\" class=\"s2member-pro-stripe-coupon s2member-pro-stripe-checkout-coupon form-control\" value=\"\" tabindex=\"1\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"button\" id=\"s2member-pro-stripe-checkout-coupon-apply\" class=\"s2member-pro-stripe-coupon-apply s2member-pro-stripe-checkout-coupon-apply btn btn-default\" value=\"Apply\" tabindex=\"-1\" \/>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Registration Details (Name, Email, Username, Password). -->\n\t<!-- Some of this information will be prefilled automatically when\/if a User\/Member is already logged-in. -->\n\t<!-- Name fields will NOT be hidden automatically here; even if your Registration\/Profile Field options dictate this behavior. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-registration-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-registration-section s2member-pro-stripe-checkout-form-registration-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-registration-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-registration-section-title s2member-pro-stripe-checkout-form-registration-section-title\">\n\t\t\tCreate Profile\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-first-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-first-name-div s2member-pro-stripe-checkout-form-first-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-first-name\" id=\"s2member-pro-stripe-checkout-form-first-name-label\" class=\"s2member-pro-stripe-form-first-name-label s2member-pro-stripe-checkout-form-first-name-label\">\n\t\t\t\t<span>First Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[first_name]\" id=\"s2member-pro-stripe-checkout-first-name\" class=\"s2member-pro-stripe-first-name s2member-pro-stripe-checkout-first-name form-control\" value=\"\" tabindex=\"10\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-last-name-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-last-name-div s2member-pro-stripe-checkout-form-last-name-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-last-name\" id=\"s2member-pro-stripe-checkout-form-last-name-label\" class=\"s2member-pro-stripe-form-last-name-label s2member-pro-stripe-checkout-form-last-name-label\">\n\t\t\t\t<span>Last Name *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"50\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[last_name]\" id=\"s2member-pro-stripe-checkout-last-name\" class=\"s2member-pro-stripe-last-name s2member-pro-stripe-checkout-last-name form-control\" value=\"\" tabindex=\"20\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-email-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-email-div s2member-pro-stripe-checkout-form-email-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-email\" id=\"s2member-pro-stripe-checkout-form-email-label\" class=\"s2member-pro-stripe-form-email-label s2member-pro-stripe-checkout-form-email-label\">\n\t\t\t\t<span>Email Address *<\/span><br \/>\n\t\t\t\t<input type=\"email\" aria-required=\"true\" data-expected=\"email\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[email]\" id=\"s2member-pro-stripe-checkout-email\" class=\"s2member-pro-stripe-email s2member-pro-stripe-checkout-email form-control\" value=\"\" tabindex=\"30\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-username-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-username-div s2member-pro-stripe-checkout-form-username-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-username\" id=\"s2member-pro-stripe-checkout-form-username-label\" class=\"s2member-pro-stripe-form-username-label s2member-pro-stripe-checkout-form-username-label\">\n\t\t\t\t<span>Username (lowercase alphanumeric) *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"60\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[username]\" id=\"s2member-pro-stripe-checkout-username\" class=\"s2member-pro-stripe-username s2member-pro-stripe-checkout-username form-control\" value=\"\" tabindex=\"40\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-password-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-password-div s2member-pro-stripe-checkout-form-password-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-password1\" id=\"s2member-pro-stripe-checkout-form-password-label\" class=\"s2member-pro-stripe-form-password-label s2member-pro-stripe-checkout-form-password-label\">\n\t\t\t\t<span>Password (type this twice please) *<\/span><br \/>\n\t\t\t\t<input type=\"password\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password1]\" id=\"s2member-pro-stripe-checkout-password1\" class=\"s2member-pro-stripe-password1 s2member-pro-stripe-checkout-password1 form-control\" value=\"\" tabindex=\"50\" \/>\n\t\t\t<\/label>\n\t\t\t<input type=\"password\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[password2]\" id=\"s2member-pro-stripe-checkout-password2\" class=\"s2member-pro-stripe-password2 s2member-pro-stripe-checkout-password2 form-control\" value=\"\" tabindex=\"60\" \/>\n\t\t\t<div id=\"s2member-pro-stripe-checkout-form-password-strength\" class=\"ws-plugin--s2member-password-strength s2member-pro-stripe-form-password-strength s2member-pro-stripe-checkout-form-password-strength\"><em>password strength indicator<\/em><\/div>\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Custom Fields (Custom Registration\/Profile Fields will appear here, when\/if they've been configured). -->\n\t<!-- Custom Fields will NOT be displayed to existing Users\/Members that are already logged-in. s2Member assumes this information has already been collected in that case. -->\n\t<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-custom-fields-section s2member-pro-stripe-checkout-form-custom-fields-section\">\n<div id=\"s2member-pro-stripe-checkout-form-custom-fields-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-custom-fields-section-title s2member-pro-stripe-checkout-form-custom-fields-section-title\">\nAdditional Info\n<\/div>\n<div id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-custom-reg-field-terms-div s2member-pro-stripe-checkout-form-custom-reg-field-terms-div\">\n<label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" id=\"s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\" class=\"s2member-pro-stripe-form-custom-reg-field-terms-label s2member-pro-stripe-checkout-form-custom-reg-field-terms-label\">\n<span style=\"display:none;\">Yes, I Agree to Terms & Conditions *<\/span><\/label>\n<input type=\"checkbox\" value=\"1\" name=\"s2member_pro_stripe_checkout[custom_fields][terms]\" id=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" aria-required=\"true\" tabindex=\"100\" class=\"s2member-pro-stripe-custom-reg-field-terms s2member-pro-stripe-checkout-custom-reg-field-terms\" \/> <label for=\"s2member-pro-stripe-checkout-custom-reg-field-terms\" style=\"display:inline !important; margin:0 !important;\">Yes, I Agree to Terms & Conditions<\/label><\/div>\n<\/div>\n\n\n\t<!-- Billing Method (powered by Stripe). -->\n\t\n\t<div id=\"s2member-pro-stripe-form-billing-method-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-form-billing-method-section\">\n\t\t<div id=\"s2member-pro-stripe-form-billing-method-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-form-billing-method-section-title\">\n\t\t\tBilling Method\t\t<\/div>\n\t\t<label for=\"s2member-pro-stripe-form-card-element\" id=\"s2member-pro-stripe-form-card-element-label\" class=\"s2member-pro-stripe-form-card-element-label\">\n\t\t\tCredit or debit card\t\t<\/label>\n\t\t<div id=\"s2member-pro-stripe-form-card-element\">\n\t\t\t<!-- A Stripe Element will be inserted here. -->\n\t\t<\/div>\n\n\t\t<!-- Used to display Element errors. -->\n\t\t<div id=\"s2member-pro-stripe-form-card-errors\" role=\"alert\"><\/div>\n\n\t\t<!-- Update with IDs -->\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pm-id\" name=\"stripe_pm_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-id\" name=\"stripe_pi_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-id\" name=\"stripe_seti_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-sub-id\" name=\"stripe_sub_id\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-pi-secret\" name=\"stripe_pi_secret\" value=\"\" \/>\n\t\t<input type=\"hidden\" id=\"s2member-pro-stripe-form-seti-secret\" name=\"stripe_seti_secret\" value=\"\" \/>\n\n\t\t<div id=\"s2member-pro-stripe-checkout-form-source-token-summary\" class=\"s2member-pro-stripe-form-source-token-summary s2member-pro-stripe-checkout-form-source-token-summary\">\n\t\t\t\t<!---->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<style>\n\t\t#s2member-pro-stripe-form-card-element {border: 1px solid #b6b6b3; border-radius: 4px; padding: 10px 13px;}\n\t\t#s2member-pro-stripe-form-card-errors {color: #eb1c26;}\n\t\t.s2member-pro-stripe-form-disabled {opacity: .5;}\n\t<\/style>\n\n\t<!-- Billing Address (hidden dynamically when\/if no tax details are necessary; and\/or when no billing info has been provided yet). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section\" class=\"s2member-pro-stripe-form-section  s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-billing-address-section s2member-pro-stripe-checkout-form-billing-address-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-billing-address-section-title\" class=\"s2member-pro-stripe-form-section-title s2member-pro-stripe-checkout-form-section-title s2member-pro-stripe-form-billing-address-section-title s2member-pro-stripe-checkout-form-billing-address-section-title\">\n\t\t\tBilling Address\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-street-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-street-div s2member-pro-stripe-checkout-form-street-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-street\" id=\"s2member-pro-stripe-checkout-form-street-label\" class=\"s2member-pro-stripe-form-street-label s2member-pro-stripe-checkout-form-street-label\">\n\t\t\t\t<span>Street Address *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[street]\" id=\"s2member-pro-stripe-checkout-street\" class=\"s2member-pro-stripe-street s2member-pro-stripe-checkout-street form-control\" value=\"\" tabindex=\"300\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-city-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-city-div s2member-pro-stripe-checkout-form-city-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-city\" id=\"s2member-pro-stripe-checkout-form-city-label\" class=\"s2member-pro-stripe-form-city-label s2member-pro-stripe-checkout-form-city-label\">\n\t\t\t\t<span>City \/ Town *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"100\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[city]\" id=\"s2member-pro-stripe-checkout-city\" class=\"s2member-pro-stripe-city s2member-pro-stripe-checkout-city form-control\" value=\"\" tabindex=\"310\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-state-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-state-div s2member-pro-stripe-checkout-form-state-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-state\" id=\"s2member-pro-stripe-checkout-form-state-label\" class=\"s2member-pro-stripe-form-state-label s2member-pro-stripe-checkout-form-state-label\">\n\t\t\t\t<span>State \/ Province *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"40\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[state]\" id=\"s2member-pro-stripe-checkout-state\" class=\"s2member-pro-stripe-state s2member-pro-stripe-checkout-state form-control\" value=\"\" tabindex=\"320\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-zip-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-zip-div s2member-pro-stripe-checkout-form-zip-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-zip\" id=\"s2member-pro-stripe-checkout-form-zip-label\" class=\"s2member-pro-stripe-form-zip-label s2member-pro-stripe-checkout-form-zip-label\">\n\t\t\t\t<span>Postal \/ Zip Code *<\/span><br \/>\n\t\t\t\t<input type=\"text\" aria-required=\"true\" maxlength=\"20\" autocomplete=\"off\" name=\"s2member_pro_stripe_checkout[zip]\" id=\"s2member-pro-stripe-checkout-zip\" class=\"s2member-pro-stripe-zip s2member-pro-stripe-checkout-zip form-control\" value=\"\" tabindex=\"330\" \/>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-country-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-country-div s2member-pro-stripe-checkout-form-country-div\">\n\t\t\t<label for=\"s2member-pro-stripe-checkout-country\" id=\"s2member-pro-stripe-checkout-form-country-label\" class=\"s2member-pro-stripe-form-country-label s2member-pro-stripe-checkout-form-country-label\">\n\t\t\t\t<span>Country *<\/span><br \/>\n\t\t\t\t<select aria-required=\"true\" name=\"s2member_pro_stripe_checkout[country]\" id=\"s2member-pro-stripe-checkout-country\" class=\"s2member-pro-stripe-country s2member-pro-stripe-checkout-country form-control\" tabindex=\"340\">\n\t\t\t\t\t<option value=\"\"><\/option><option value=\"AF\">Afghanistan<\/option><option value=\"AX\">Aland Islands<\/option><option value=\"AL\">Albania<\/option><option value=\"DZ\">Algeria<\/option><option value=\"AS\">American Samoa<\/option><option value=\"AD\">Andorra<\/option><option value=\"AO\">Angola<\/option><option value=\"AI\">Anguilla<\/option><option value=\"AQ\">Antarctica<\/option><option value=\"AG\">Antigua And Barbuda<\/option><option value=\"AR\">Argentina<\/option><option value=\"AM\">Armenia<\/option><option value=\"AW\">Aruba<\/option><option value=\"AU\">Australia<\/option><option value=\"AT\">Austria<\/option><option value=\"AZ\">Azerbaijan<\/option><option value=\"BS\">Bahamas<\/option><option value=\"BH\">Bahrain<\/option><option value=\"BD\">Bangladesh<\/option><option value=\"BB\">Barbados<\/option><option value=\"BY\">Belarus<\/option><option value=\"BE\">Belgium<\/option><option value=\"BZ\">Belize<\/option><option value=\"BJ\">Benin<\/option><option value=\"BM\">Bermuda<\/option><option value=\"BT\">Bhutan<\/option><option value=\"BO\">Bolivia, Plurinational State Of<\/option><option value=\"BA\">Bosnia And Herzegovina<\/option><option value=\"BW\">Botswana<\/option><option value=\"BV\">Bouvet Island<\/option><option value=\"BR\">Brazil<\/option><option value=\"IO\">British Indian Ocean Territory<\/option><option value=\"BN\">Brunei Darussalam<\/option><option value=\"BG\">Bulgaria<\/option><option value=\"BF\">Burkina Faso<\/option><option value=\"BI\">Burundi<\/option><option value=\"KH\">Cambodia<\/option><option value=\"CM\">Cameroon<\/option><option value=\"CA\">Canada<\/option><option value=\"CV\">Cape Verde<\/option><option value=\"KY\">Cayman Islands<\/option><option value=\"CF\">Central African Republic<\/option><option value=\"TD\">Chad<\/option><option value=\"CL\">Chile<\/option><option value=\"CN\">China<\/option><option value=\"CX\">Christmas Island<\/option><option value=\"CC\">Cocos (keeling) Islands<\/option><option value=\"CO\">Colombia<\/option><option value=\"KM\">Comoros<\/option><option value=\"CG\">Congo<\/option><option value=\"CD\">Congo, The Democratic Republic Of The<\/option><option value=\"CK\">Cook Islands<\/option><option value=\"CR\">Costa Rica<\/option><option value=\"CI\">Cote D&#039;ivoire<\/option><option value=\"HR\">Croatia<\/option><option value=\"CU\">Cuba<\/option><option value=\"CY\">Cyprus<\/option><option value=\"CZ\">Czech Republic<\/option><option value=\"DK\">Denmark<\/option><option value=\"DJ\">Djibouti<\/option><option value=\"DM\">Dominica<\/option><option value=\"DO\">Dominican Republic<\/option><option value=\"EC\">Ecuador<\/option><option value=\"EG\">Egypt<\/option><option value=\"SV\">El Salvador<\/option><option value=\"GQ\">Equatorial Guinea<\/option><option value=\"ER\">Eritrea<\/option><option value=\"EE\">Estonia<\/option><option value=\"ET\">Ethiopia<\/option><option value=\"FK\">Falkland Islands (malvinas)<\/option><option value=\"FO\">Faroe Islands<\/option><option value=\"FJ\">Fiji<\/option><option value=\"FI\">Finland<\/option><option value=\"FR\">France<\/option><option value=\"GF\">French Guiana<\/option><option value=\"PF\">French Polynesia<\/option><option value=\"TF\">French Southern Territories<\/option><option value=\"GA\">Gabon<\/option><option value=\"GM\">Gambia<\/option><option value=\"GE\">Georgia<\/option><option value=\"DE\">Germany<\/option><option value=\"GH\">Ghana<\/option><option value=\"GI\">Gibraltar<\/option><option value=\"GR\">Greece<\/option><option value=\"GL\">Greenland<\/option><option value=\"GD\">Grenada<\/option><option value=\"GP\">Guadeloupe<\/option><option value=\"GU\">Guam<\/option><option value=\"GT\">Guatemala<\/option><option value=\"GG\">Guernsey<\/option><option value=\"GN\">Guinea<\/option><option value=\"GW\">Guinea-bissau<\/option><option value=\"GY\">Guyana<\/option><option value=\"HT\">Haiti<\/option><option value=\"HM\">Heard Island And Mcdonald Islands<\/option><option value=\"VA\">Holy See (vatican City State)<\/option><option value=\"HN\">Honduras<\/option><option value=\"HK\">Hong Kong<\/option><option value=\"HU\">Hungary<\/option><option value=\"IS\">Iceland<\/option><option value=\"IN\">India<\/option><option value=\"ID\">Indonesia<\/option><option value=\"IR\">Iran, Islamic Republic Of<\/option><option value=\"IQ\">Iraq<\/option><option value=\"IE\">Ireland<\/option><option value=\"IM\">Isle Of Man<\/option><option value=\"IL\">Israel<\/option><option value=\"IT\">Italy<\/option><option value=\"JM\">Jamaica<\/option><option value=\"JP\">Japan<\/option><option value=\"JE\">Jersey<\/option><option value=\"JO\">Jordan<\/option><option value=\"KZ\">Kazakhstan<\/option><option value=\"KE\">Kenya<\/option><option value=\"KI\">Kiribati<\/option><option value=\"KP\">Korea, Democratic People&#039;s Republic Of<\/option><option value=\"KR\">Korea, Republic Of<\/option><option value=\"KW\">Kuwait<\/option><option value=\"KG\">Kyrgyzstan<\/option><option value=\"LA\">Lao People&#039;s Democratic Republic<\/option><option value=\"LV\">Latvia<\/option><option value=\"LB\">Lebanon<\/option><option value=\"LS\">Lesotho<\/option><option value=\"LR\">Liberia<\/option><option value=\"LY\">Libyan Arab Jamahiriya<\/option><option value=\"LI\">Liechtenstein<\/option><option value=\"LT\">Lithuania<\/option><option value=\"LU\">Luxembourg<\/option><option value=\"MO\">Macao<\/option><option value=\"MK\">Macedonia, The Former Yugoslav Republic Of<\/option><option value=\"MG\">Madagascar<\/option><option value=\"MW\">Malawi<\/option><option value=\"MY\">Malaysia<\/option><option value=\"MV\">Maldives<\/option><option value=\"ML\">Mali<\/option><option value=\"MT\">Malta<\/option><option value=\"MH\">Marshall Islands<\/option><option value=\"MQ\">Martinique<\/option><option value=\"MR\">Mauritania<\/option><option value=\"MU\">Mauritius<\/option><option value=\"YT\">Mayotte<\/option><option value=\"MX\">Mexico<\/option><option value=\"FM\">Micronesia, Federated States Of<\/option><option value=\"MD\">Moldova, Republic Of<\/option><option value=\"MC\">Monaco<\/option><option value=\"MN\">Mongolia<\/option><option value=\"ME\">Montenegro<\/option><option value=\"MS\">Montserrat<\/option><option value=\"MA\">Morocco<\/option><option value=\"MZ\">Mozambique<\/option><option value=\"MM\">Myanmar<\/option><option value=\"NA\">Namibia<\/option><option value=\"NR\">Nauru<\/option><option value=\"NP\">Nepal<\/option><option value=\"NL\">Netherlands<\/option><option value=\"AN\">Netherlands Antilles<\/option><option value=\"NC\">New Caledonia<\/option><option value=\"NZ\">New Zealand<\/option><option value=\"NI\">Nicaragua<\/option><option value=\"NE\">Niger<\/option><option value=\"NG\">Nigeria<\/option><option value=\"NU\">Niue<\/option><option value=\"NF\">Norfolk Island<\/option><option value=\"MP\">Northern Mariana Islands<\/option><option value=\"NO\">Norway<\/option><option value=\"OM\">Oman<\/option><option value=\"PK\">Pakistan<\/option><option value=\"PW\">Palau<\/option><option value=\"PS\">Palestinian Territory, Occupied<\/option><option value=\"PA\">Panama<\/option><option value=\"PG\">Papua New Guinea<\/option><option value=\"PY\">Paraguay<\/option><option value=\"PE\">Peru<\/option><option value=\"PH\">Philippines<\/option><option value=\"PN\">Pitcairn<\/option><option value=\"PL\">Poland<\/option><option value=\"PT\">Portugal<\/option><option value=\"PR\">Puerto Rico<\/option><option value=\"QA\">Qatar<\/option><option value=\"RE\">Reunion<\/option><option value=\"RO\">Romania<\/option><option value=\"RU\">Russian Federation<\/option><option value=\"RW\">Rwanda<\/option><option value=\"BL\">Saint Barthelemy<\/option><option value=\"SH\">Saint Helena, Ascension And Tristan Da Cunha<\/option><option value=\"KN\">Saint Kitts And Nevis<\/option><option value=\"LC\">Saint Lucia<\/option><option value=\"MF\">Saint Martin<\/option><option value=\"PM\">Saint Pierre And Miquelon<\/option><option value=\"VC\">Saint Vincent And The Grenadines<\/option><option value=\"WS\">Samoa<\/option><option value=\"SM\">San Marino<\/option><option value=\"ST\">Sao Tome And Principe<\/option><option value=\"SA\">Saudi Arabia<\/option><option value=\"SN\">Senegal<\/option><option value=\"RS\">Serbia<\/option><option value=\"SC\">Seychelles<\/option><option value=\"SL\">Sierra Leone<\/option><option value=\"SG\">Singapore<\/option><option value=\"SK\">Slovakia<\/option><option value=\"SI\">Slovenia<\/option><option value=\"SB\">Solomon Islands<\/option><option value=\"SO\">Somalia<\/option><option value=\"ZA\">South Africa<\/option><option value=\"GS\">South Georgia And The South Sandwich Islands<\/option><option value=\"ES\">Spain<\/option><option value=\"LK\">Sri Lanka<\/option><option value=\"SD\">Sudan<\/option><option value=\"SR\">Suriname<\/option><option value=\"SJ\">Svalbard And Jan Mayen<\/option><option value=\"SZ\">Swaziland<\/option><option value=\"SE\">Sweden<\/option><option value=\"CH\">Switzerland<\/option><option value=\"SY\">Syrian Arab Republic<\/option><option value=\"TW\">Taiwan<\/option><option value=\"TJ\">Tajikistan<\/option><option value=\"TZ\">Tanzania, United Republic Of<\/option><option value=\"TH\">Thailand<\/option><option value=\"TL\">Timor-leste<\/option><option value=\"TG\">Togo<\/option><option value=\"TK\">Tokelau<\/option><option value=\"TO\">Tonga<\/option><option value=\"TT\">Trinidad And Tobago<\/option><option value=\"TN\">Tunisia<\/option><option value=\"TR\">Turkey<\/option><option value=\"TM\">Turkmenistan<\/option><option value=\"TC\">Turks And Caicos Islands<\/option><option value=\"TV\">Tuvalu<\/option><option value=\"UG\">Uganda<\/option><option value=\"UA\">Ukraine<\/option><option value=\"AE\">United Arab Emirates<\/option><option value=\"GB\">United Kingdom<\/option><option value=\"US\" selected=\"selected\">United States<\/option><option value=\"UM\">United States Minor Outlying Islands<\/option><option value=\"UY\">Uruguay<\/option><option value=\"UZ\">Uzbekistan<\/option><option value=\"VU\">Vanuatu<\/option><option value=\"VE\">Venezuela, Bolivarian Republic Of<\/option><option value=\"VN\">Viet Nam<\/option><option value=\"VG\">Virgin Islands, British<\/option><option value=\"VI\">Virgin Islands, U.s.<\/option><option value=\"WF\">Wallis And Futuna<\/option><option value=\"EH\">Western Sahara<\/option><option value=\"YE\">Yemen<\/option><option value=\"ZM\">Zambia<\/option><option value=\"ZW\">Zimbabwe<\/option>\n\t\t\t\t<\/select>\n\t\t\t<\/label>\n\t\t<\/div>\n\t\t<div id=\"s2member-pro-stripe-checkout-form-ajax-tax-div\" class=\"s2member-pro-stripe-form-div s2member-pro-stripe-checkout-form-div s2member-pro-stripe-form-ajax-tax-div s2member-pro-stripe-checkout-form-ajax-tax-div\">\n\t\t\t<!-- Sales Tax will be displayed here via Ajax; based on state, country, and\/or zip code range. -->\n\t\t<\/div>\n\t\t<div style=\"clear:both;\"><\/div>\n\t<\/div>\n\n\t<!-- Captcha ( A reCaptcha section, with a required security code will appear here; if captcha=\"1\" ). -->\n\t\n\n\t<!-- Checkout Now (this holds the submit button, and also some dynamic hidden input variables). -->\n\t<div id=\"s2member-pro-stripe-checkout-form-submission-section\" class=\"s2member-pro-stripe-form-section s2member-pro-stripe-checkout-form-section s2member-pro-stripe-form-submission-section s2member-pro-stripe-checkout-form-submission-section\">\n\t\t<div id=\"s2member-pro-stripe-checkout-form-submission-section-title\" class=\"s2member-pro-stripe-form-section-title 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