<style type="text/css">
.hdn { visibility:hidden; }
.jpn {}
.us {}
.canada {}
</style>
<form id="stepShippingForm" name="stepShippingForm">
<label for="shipPersonTitle">Title <i>(optional)</i></label>
<select name="personTitle" id="shipPersonTitle">
<option value="">Please select:</option>
<option value="Mr.">Mr.</option>
<option value="Mrs.">Mrs.</option>
<option value="Ms.">Ms.</option>
<option value="Dr.">Dr.</option>
<option value="Sir">Sir</option>
</select>
<div>
<label for="shipFirstName">First Name</label>
<input id="shipFirstName" name="firstName" value="" type="text" maxlength="20">
</div>
<div>
<label for="shipMiddleName">Middle Name<i>(optional)</i></label>
<input id="shipMiddleName" name="middleName" type="text" maxlength="20">
</div>
<div>
<label for="shipLastName">Last Name</label>
<input id="shipLastName" name="lastName" type="text" maxlength="20">
</div>
<div>
<label id="shipGenderLabel">Gender <i>(optional)</i></label>
<label><input type="radio" value="M" id="shipMale" name="gender">Male</label>
<label><input type="radio" value="F" id="shipFemale" name="gender">Female</label>
</div>
<div id="shippingAddress">
<label for="shipCountry">Country</label>
<select name="country" id="shipCountry" size="0" title="Country">
<option value="">Select</option>
<option value="" disabled="disabled">----------</option>
<option value="USA" selected="selected">USA & Territories</option>
<option value="CAN">Canada</option>
<option value="JPN">jpn</option>
<option value="ALB">Albania</option>
<option value="DZA">Algeria</option>
<option value="AND">Andorra</option>
<option value="AGO">Angola</option>
<option value="AIA">Anguilla</option>
</select>
</div>
<div>
<div class="jpn hdn">
<label for="shipJPNPostal">Postal Code</label>
<div>
<input id="shipJPNPostal" name="JPNPostal" type="text" maxlength="10">
</div>
</div>
<div class="jpn hdn">
<label for="shipJPNPrefecture">Prefecture</label>
<div>
<input id="shipJPNPrefecture" name="JPNPrefecture" type="text" maxlength="20">
</div>
</div>
</div>
<div class="jpn hdn">
<label for="shipJPNCity">City</label>
<input id="shipJPNCity" name="JPNCity" type="text">
</div>
<div class="hdn">
<div>
<label for="secondaryName">Business, Attention, or In Care of Name <i>(optional)</i></label>
<div>
<input id="secondaryName" name="organizationName" type="text" value="" maxlength="40">
</div>
</div>
<div>
<label for="businessName"> <input value="BUS" id="businessName" name="orgNameInd" type="radio">Business</label>
<label for="inCareOfName"> <input value="C/O" id="inCareOfName" name="orgNameInd" type="radio">In care of</label>
<label for="attentionName"> <input value="ATTN" id="attentionName" name="orgNameInd" type="radio">Attention</label>
</div>
</div>
<div>
<label for="shipAddress1">Address</label>
<input id="shipAddress1" name="address1" type="text" maxlength="35">
</div>
<div>
<label for="shipAddress2">Address Line 2 <i>(optional)</i></label>
<input id="shipAddress2" name="address2" type="text" maxlength="35">
</div>
<div class="hdn">
<label for="shipAddress3">Address Line 3 <i>(optional)</i></label>
<input id="shipAddress3" name="address3" type="text" maxlength="35">
</div>
<div class="us">
<div>
<label for="shipZipCode">Zip Code</label>
<div>
<input id="shipZipCode" name="zipCode" type="tel" maxlength="10">
</div>
<input id="shipZipCodeFull" name="zipCodeFull" type="hidden" value="">
</div>
<div>
<label> </label><p>Enter Zip for City and State</p>
</div>
</div>
<div>
<div class="us">
<label for="shipCity">City</label>
<div>
<input id="shipCity" name="city" type="text">
</div>
</div>
<div class="us">
<label for="shipState">State</label>
<div>
<select name="state" id="shipState" title="State">
<option value="">Please Select:</option>
<option value="AL">Alabama (AL)</option>
<option value="AK">Alaska (AK)</option>
<option value="AS">American Samoa (AS)</option>
<option value="AA">APO/FPO Address (AA)</option>
<option value="AE">APO/FPO Address (AE)</option>
<option value="AP">APO/FPO Address (AP)</option>
<option value="AZ">Arizona (AZ)</option>
<option value="AR">Arkansas (AR)</option>
<option value="CA">California (CA)</option>
<option value="CO">Colorado (CO)</option>
<option value="CT">Connecticut (CT)</option>
<option value="DE">Delaware (DE)</option>
<option value="DC">District of Columbia (DC)</option>
<option value="FM">Federation of Micronesia (FM)</option>
<option value="FL">Florida (FL)</option>
<option value="GA">Georgia (GA)</option>
<option value="GU">Guam (GU)</option>
<option value="HI">Hawaii (HI)</option>
<option value="ID">Idaho (ID)</option>
<option value="IL">Illinois (IL)</option>
<option value="IN">Indiana (IN)</option>
<option value="IA">Iowa (IA)</option>
<option value="KS">Kansas (KS)</option>
<option value="KY">Kentucky (KY)</option>
<option value="LA">Louisiana (LA)</option>
<option value="ME">Maine (ME)</option>
<option value="MH">Marshall Islands (MH)</option>
<option value="MD">Maryland (MD)</option>
<option value="MA">Massachusetts (MA)</option>
<option value="MI">Michigan (MI)</option>
<option value="MN">Minnesota (MN)</option>
<option value="MS">Mississippi (MS)</option>
<option value="MO">Missouri (MO)</option>
<option value="MT">Montana (MT)</option>
<option value="NE">Nebraska (NE)</option>
<option value="NV">Nevada (NV)</option>
<option value="NH">New Hampshire (NH)</option>
<option value="NJ">New Jersey (NJ)</option>
<option value="NM">New Mexico (NM)</option>
<option value="NY">New York (NY)</option>
<option value="NC">North Carolina (NC)</option>
<option value="ND">North Dakota (ND)</option>
<option value="MP">Northern Mariana Islands (MP)</option>
<option value="OH">Ohio (OH)</option>
<option value="OK">Oklahoma (OK)</option>
<option value="OR">Oregon (OR)</option>
<option value="PW">Palau (PW)</option>
<option value="PA">Pennsylvania (PA)</option>
<option value="PR">Puerto Rico (PR)</option>
<option value="RI">Rhode Island (RI)</option>
<option value="SC">South Carolina (SC)</option>
<option value="SD">South Dakota (SD)</option>
<option value="TN">Tennessee (TN)</option>
<option value="TX">Texas (TX)</option>
<option value="UT">Utah (UT)</option>
<option value="VT">Vermont (VT)</option>
<option value="VI">Virgin Islands (VI)</option>
<option value="VA">Virginia (VA)</option>
<option value="WA">Washington (WA)</option>
<option value="WV">West Virginia (WV)</option>
<option value="WI">Wisconsin (WI)</option>
<option value="WY">Wyoming (WY)</option>
</select>
</div>
</div>
</div>
<div class="canada hdn">
<label for="shipCAPostal">Postal Code</label>
<input id="shipCAPostal" name="CAPostal" type="text" maxlength="7">
</div>
<div>
<div class="hdn">
<label for="shipCACity">City</label>
<div>
<input id="shipCACity" name="CACity" type="text" maxlength="25">
</div>
</div>
<div class="canada hdn">
<label for="shipCAProvince">Province</label>
<div>
<select id="shipCAProvince" title="Province (required)" name="CAProvince">
<option value=""> Please Select:</option>
<option value="AB">Alberta (AB)</option>
<option value="BC">British Columbia (BC)</option>
<option value="MB">Manitoba (MB)</option>
<option value="NB">New Brunswick (NB)</option>
<option value="NL">Newfoundland (NL)</option>
<option value="NT">Northwest Territories (NT)</option>
<option value="NS">Nova Scotia (NS)</option>
<option value="NU">Nunavut (NU)</option>
<option value="ON">Ontario (ON)</option>
<option value="PE">Prince Edward Island (PE)</option>
<option value="QC">Quebec (QC)</option>
<option value="SK">Saskatchewan (SK)</option>
<option value="YT">Yukon Territory (YT)</option>
</select>
</div>
</div>
</div>
<div>
<div class="hdn">
<label for="shipINTLCity">City</label>
<div>
<input id="shipINTLCity" name="INTLCity" type="text" maxlength="25">
</div>
</div>
<div class="intl hdn">
<label for="shipINTLCounty">County</label>
<div>
<input id="shipINTLCounty" name="INTLCounty" type="text" maxlength="20">
</div>
</div>
<div>
<div class="intl hdn">
<label for="shipINTLPostal">Postal Code</label>
<div>
<input id="shipINTLPostal" name="INTLPostal" type="text" maxlength="10">
</div>
</div>
</div>
<div>
<div class="us canada">
<label for="shipDaytimePhone">Daytime Phone Number <i class="hdn">(optional)</i></label>
<div>
<input id="shipDaytimePhone" name="phone1" type="tel" maxlength="20">
</div>
</div>
<div class="intl jpn hdn">
<label for="shipIntlPhonePrefix">International Country Code</label>
<label for="shipIntlPhone">Daytime Phone Number</label>
<div>
<input id="shipIntlPhonePrefix" name="intlPhone1Prefix" type="tel" maxlength="4">
<input id="shipIntlPhone" name="intlPhone1" type="tel" maxlength="20">
</div>
</div>
<div>
<label for="shipHomePhone">
<input type="radio" value="H" id="shipHomePhone" name="phone1_Loc" checked="">Home
</label>
<label for="shipWorkPhone">
<input type="radio" value="B" id="shipWorkPhone" name="phone1_Loc">Work
</label>
<label for="shipMobilePhone">
<input type="radio" value="M" id="shipMobilePhone" name="phone1_Loc">Mobile
</label>
</div>
</div>
<div class="us canada" id="shipIncludePhoneBlk">
<label for="shipCkoutShippingCheck">
<input id="shipCkoutShippingCheck" type="checkbox" value="ckoutShippingCheck" name="ckoutShippingCheck" checked="checked">
Include phone number
</label>
</div>
<div>
<label for="shipModeId">Shipping</label>
<div>
<label for="shipMode10">
<input type="radio" name="shipModeId" id="shipMode10" value="10" checked="checked">Fast
</label>
<label for="shipMode11">
<input type="radio" name="shipModeId" id="shipMode11" value="11">Slow
</label>
</div>
</div>
<div id="shipLiabilityBlock">
<label for="shipLiability">
<input id="shipLiability" type="checkbox" value="on" name="shipLiability">Liability
</label>
</div>
<div id="shipGiftChkBlk">
<label for="shipAddGiftMsg">
<input type="checkbox" value="addGiftMsg" id="shipAddGiftMsg">Message
</label>
</div>
<div id="shipGiftMsgBlk" class="hdn">
<label for="shipGiftMsg">Message</label>
<textarea id="shipGiftMsg" name="giftMsg" rows="3" cols="30" maxlength="90"></textarea>
</div>
</form>
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