How do i attach files to a form using ASP

Hi all i have got  a form and a script that collects all the informational for the form and sends it to a address i was hoping someone can help me make it so the attachments from the form get sent as well, the first first of code is the form and the 2nd is the script that collects the data
<!-- 
  Adby Designs
  By Adam Wolarczuk
  July 2011
-->

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" 
  "http://www.w3.org/TR/html4/loose.dtd">

<html lang="en">


	<head>
		<title>Tenancy Application Form</title>
	
		<meta http-equiv="content-script-type" content="text/javascript">
		<meta http-equiv="content-type" content="text/html;charset=iso-8859-1">
		<link href ="settings.css" rel="stylesheet"  >
			<style type="text/css">
			#midcon1		{position:absolute;	height:5330px;width:800px; background-color:white;left:29px;	top:218px;border: #01466f solid 1px}   /*White pageground in the middle */
			#footer1		{position:absolute; top: 4398px; width: 800px; left:-29px}
			#bottom1 {  width:800px;height:120px;background-color: #236e9a;}  /* layout bottom*/

				ul.a {list-style-type:none;}			.auto-style1 {
				border-width: 0px;
			}			</style>			
	</head>

<body>
		<div id="container" >			
	
            <a href="home.asp"><map id="ImgMap0" name="ImgMap0">
			<area alt="" coords="5, 30, 188, 125" href="home.asp" shape="rect">
			</map>
	
          <img src="images/title.png"  alt=""  id="timage" class="auto-style1" usemap="#ImgMap0" ></a>
           	
			<div id="topl"><img src="images/topline.png"  alt="tline" width="800px"></div>
			<div id="midcon1"> 
    <table border="0" cellspacing="1" cellpadding="2"  width="800">
      <tr> 
        <td class="navytext" colspan="2"><h2><b>Tenancy Application</b></h2><span class="redstar">*</span> = Required fields<br><br></td>
      </tr>      

      <form method="post" action="process_mail.aspx">
        <input type="hidden" name="mode" value="R">
       <input type="hidden" name="u" value=180112>
    	<tr> 
        <td class="navytext" colspan="2"><strong>CREATE A NEW APPLICATION:</strong></td>
      </tr>     

       <tr> 
        <td class="navytext" colspan="2"><strong>PROPERTY APPLIED FOR: <span class="redstar">*</span> </strong></td>
      </tr>

	  <tr> 
        <td align="left" width="171">Type of Residence</td>
        <td valign="Bottom" align="left"><select name="Type_of_Residence" onChange=				"if((this.value=='')||(this.value=='')){document.getElementById('Property_Flat_Number').style.display='none';document.getElementById('lblPropertyFlatNo').style.display='none';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPropertyStreetNo.focus()};}else{document.getElementById('chPropertyFlatNo').style.display='inline';document.getElementById('lblPropertyFlatNo').style.display='inline';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPropertyFlatNo.focus()};};if(this.value=='-----'){this.value='';document.getElementById('chPropertyFlatNo').style.display='none';document.getElementById('lblPropertyFlatNo').style.display='none';}" style="width:113px;">

       		    <option value="null">(Select)</option>
                <option value="">HOUSE</option>
                <option value="UNIT">UNIT</option>
                <option value="APARTMENT">APARTMENT</option>
                <option value="FLAT">FLAT</option>
                <option value="STUDIO">STUDIO</option>
				<option value="-----" >-----</option>

				<option value="BLOCK" >BLOCK</option>
				<option value="CABIN" >CABIN</option>
				<option value="COTTAGE" >COTTAGE</option>
				<option value="DUPLEX" >DUPLEX</option>
				<option value="FACTORY" >FACTORY</option>
				<option value="FLOOR" >FLOOR</option>
				<option value="LOT" >LOT</option>
				<option value="PIER" >PIER</option>
				<option value="ROOFTOP" >ROOFTOP</option>
				<option value="ROOM" >ROOM</option>
				<option value="SHOP" >SHOP</option>
				<option value="SUITE" >SUITE</option>
				<option value="TOWNHOUSE" >TOWNHOUSE</option>
				<option value="VILLA" >VILLA</option>
				<option value="WAREHOUSE" >WAREHOUSE</option>
              </select><div id="lblPropertyFlatNo" style="display:none">&nbsp;&nbsp;No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</div><input name="chPropertyFlatNo" id="chPropertyFlatNo" type="Text" size="4" style="display:none" onBlur="checkAlphaNumeric(this,1,'','.','');"> Str. No. <input name="Property_Street_Number" type="Text" size="4" onBlur="checkAlphaNumeric(this,1,'','','-')"></td>

              </tr>   

   <tr>        
        <td align="left" >Street Name</td>

        <td valign="Bottom" align="left" ><input name="Property_Street_Name" type="Text" size="16"><img src="images/spacer.gif" width="46" height="1" border="0"><select name="Property_Street_Type" onChange="if(this.value=='-----'){this.value='';};if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPropertySuburb.focus()};">

                <option value="">(Street Type)</option>
					<option value="STREET">STREET</option>
					<option value="ROAD">ROAD</option>
					<option value="AVENUE">AVENUE</option>
					<option value="PLACE">PLACE</option>
					<option value="CRESCENT">CRESCENT</option>
					<option value="DRIVE">DRIVE</option>
					<option value="PARADE">PARADE</option>
					<option value="CLOSE">CLOSE</option>
					<option value="-----">-----</option>

					<option value="ACCESS">ACCESS</option>
					<option value="ALLEY">ALLEY</option>
					<option value="ALLEYWAY">ALLEYWAY</option>
					<option value="AMBLE">AMBLE</option>
					<option value="ANCHORAGE">ANCHORAGE</option>
					<option value="APPROACH">APPROACH</option>
					<option value="ARCADE">ARCADE</option>
					<option value="ARTERY">ARTERY</option>
					<option value="BASIN">BASIN</option>
					<option value="BEACH">BEACH</option>
					<option value="BEND">BEND</option>
					<option value="BLOCK">BLOCK</option>
					<option value="BOULEVARD">BOULEVARD</option>
					<option value="BOULEVARDE">BOULEVARDE</option>
					<option value="BRACE">BRACE</option>
					<option value="BRAE">BRAE</option>
					<option value="BREAK">BREAK</option>
					<option value="BRIDGE">BRIDGE</option>
					<option value="BROADWAY">BROADWAY</option>
					<option value="BROW">BROW</option>
					<option value="BYPASS">BYPASS</option>
					<option value="BYWAY">BYWAY</option>
					<option value="CAUSEWAY">CAUSEWAY</option>
					<option value="CENTRAL">CENTRAL</option>
					<option value="CENTRE">CENTRE</option>
					<option value="CENTREWAY">CENTREWAY</option>
					<option value="CHASE">CHASE</option>
					<option value="CIRCLE">CIRCLE</option>
					<option value="CIRCLET">CIRCLET</option>
					<option value="CIRCUIT">CIRCUIT</option>
					<option value="CIRCUS">CIRCUS</option>
					<option value="COLONNADE">COLONNADE</option>
					<option value="COMMON">COMMON</option>
					<option value="CONCOURSE">CONCOURSE</option>
					<option value="COPSE">COPSE</option>
					<option value="CORNER">CORNER</option>
					<option value="CORSO">CORSO</option>
					<option value="COURT">COURT</option>
					<option value="COURTYARD">COURTYARD</option>
					<option value="COVE">COVE</option>
					<option value="CREST">CREST</option>
					<option value="CROSS">CROSS</option>
					<option value="CROSSING">CROSSING</option>
					<option value="CROSSROAD">CROSSROAD</option>
					<option value="CROSSWAY">CROSSWAY</option>
					<option value="CRUISEWAY">CRUISEWAY</option>
					<option value="CUL-DE-SAC">CUL-DE-SAC</option>
					<option value="CUTTING">CUTTING</option>
					<option value="DALE">DALE</option>
					<option value="DELL">DELL</option>
					<option value="DEVIATION">DEVIATION</option>
					<option value="DIP">DIP</option>
					<option value="DISTRIBUTOR">DISTRIBUTOR</option>
					<option value="DRIVEWAY">DRIVEWAY</option>
					<option value="EAST">EAST</option>
					<option value="EDGE">EDGE</option>
					<option value="ELBOW">ELBOW</option>
					<option value="END">END</option>
					<option value="ENTRANCE">ENTRANCE</option>
					<option value="ESPLANADE">ESPLANADE</option>
					<option value="ESTATE">ESTATE</option>
					<option value="EXPRESSWAY">EXPRESSWAY</option>
					<option value="EXTENSION">EXTENSION</option>
					<option value="EXTENSION">EXTENSION</option>
					<option value="FAIRWAY">FAIRWAY</option>
					<option value="FIRE TRACK">FIRE TRACK</option>
					<option value="FIRETRAIL">FIRETRAIL</option>
					<option value="FLAT">FLAT</option>
					<option value="FOLLOW">FOLLOW</option>
					<option value="FOOTWAY">FOOTWAY</option>
					<option value="FORESHORE">FORESHORE</option>
					<option value="FORMATION">FORMATION</option>
					<option value="FREEWAY">FREEWAY</option>
					<option value="FRONT">FRONT</option>
					<option value="FRONTAGE">FRONTAGE</option>
					<option value="GAP">GAP</option>
					<option value="GARDEN">GARDEN</option>
					<option value="GARDENS">GARDENS</option>
					<option value="GATE">GATE</option>
					<option value="GATES">GATES</option>
					<option value="GLADE">GLADE</option>
					<option value="GLEN">GLEN</option>
					<option value="GRANGE">GRANGE</option>
					<option value="GREEN">GREEN</option>
					<option value="GROUND">GROUND</option>
					<option value="GROVE">GROVE</option>
					<option value="GULLY">GULLY</option>
					<option value="HEIGHTS">HEIGHTS</option>
					<option value="HIGHROAD">HIGHROAD</option>
					<option value="HIGHWAY">HIGHWAY</option>
					<option value="HILL">HILL</option>
					<option value="INTERCHANGE">INTERCHANGE</option>
					<option value="INTERSECTION">INTERSECTION</option>
					<option value="JUNCTION">JUNCTION</option>
					<option value="KEY">KEY</option>
					<option value="LANDING">LANDING</option>
					<option value="LANE">LANE</option>
					<option value="LANEWAY">LANEWAY</option>
					<option value="LEES">LEES</option>
					<option value="LINE">LINE</option>
					<option value="LINK">LINK</option>
					<option value="LITTLE">LITTLE</option>
					<option value="LOOKOUT">LOOKOUT</option>
					<option value="LOOP">LOOP</option>
					<option value="LOWER">LOWER</option>
					<option value="LOWER">LOWER</option>
					<option value="MALL">MALL</option>
					<option value="MEANDER">MEANDER</option>
					<option value="MEW">MEW</option>
					<option value="MEWS">MEWS</option>
					<option value="MOTORWAY">MOTORWAY</option>
					<option value="MOUNT">MOUNT</option>
					<option value="NOOK">NOOK</option>
					<option value="NORTH">NORTH</option>
					<option value="NORTH EAST">NORTH EAST</option>
					<option value="NORTH WEST">NORTH WEST</option>
					<option value="OUTLOOK">OUTLOOK</option>
					<option value="PARK">PARK</option>
					<option value="PARKLANDS">PARKLANDS</option>
					<option value="PARKWAY">PARKWAY</option>
					<option value="PART">PART</option>
					<option value="PASS">PASS</option>
					<option value="PATH">PATH</option>
					<option value="PATHWAY">PATHWAY</option>
					<option value="PIAZZA">PIAZZA</option>
					<option value="PLATEAU">PLATEAU</option>
					<option value="PLAZA">PLAZA</option>
					<option value="POCKET">POCKET</option>
					<option value="POINT">POINT</option>
					<option value="PORT">PORT</option>
					<option value="PROMENADE">PROMENADE</option>
					<option value="QUAD">QUAD</option>
					<option value="QUADRANGLE">QUADRANGLE</option>
					<option value="QUADRANT">QUADRANT</option>
					<option value="QUAY">QUAY</option>
					<option value="QUAYS">QUAYS</option>
					<option value="RAMBLE">RAMBLE</option>
					<option value="RAMP">RAMP</option>
					<option value="RANGE">RANGE</option>
					<option value="REACH">REACH</option>
					<option value="RESERVE">RESERVE</option>
					<option value="REST">REST</option>
					<option value="RETREAT">RETREAT</option>
					<option value="RIDE">RIDE</option>
					<option value="RIDGE">RIDGE</option>
					<option value="RIDGEWAY">RIDGEWAY</option>
					<option value="RIGHT OF WAY">RIGHT OF WAY</option>
					<option value="RING">RING</option>
					<option value="RISE">RISE</option>
					<option value="RIVER">RIVER</option>
					<option value="RIVERWAY">RIVERWAY</option>
					<option value="RIVIERA">RIVIERA</option>
					<option value="ROADS">ROADS</option>
					<option value="ROADSIDE">ROADSIDE</option>
					<option value="ROADWAY">ROADWAY</option>
					<option value="RONDE">RONDE</option>
					<option value="ROSEBOWL">ROSEBOWL</option>
					<option value="ROTARY">ROTARY</option>
					<option value="ROUND">ROUND</option>
					<option value="ROUTE">ROUTE</option>
					<option value="ROW">ROW</option>
					<option value="RUE">RUE</option>
					<option value="RUN">RUN</option>
					<option value="SERVICE WAY">SERVICE WAY</option>
					<option value="SIDING">SIDING</option>
					<option value="SLOPE">SLOPE</option>
					<option value="SOUND">SOUND</option>
					<option value="SOUTH">SOUTH</option>
					<option value="SOUTH EAST">SOUTH EAST</option>
					<option value="SOUTH WEST">SOUTH WEST</option>
					<option value="SPUR">SPUR</option>
					<option value="SQUARE">SQUARE</option>
					<option value="STAIRS">STAIRS</option>
					<option value="STATE HIGHWAY">STATE HIGHWA</option>
					<option value="STEPS">STEPS</option>
					<option value="STEYNE">STEYNE</option>
					<option value="STRAND">STRAND</option>
					<option value="STRIP">STRIP</option>
					<option value="SUBWAY">SUBWAY</option>
					<option value="TARN">TARN</option>
					<option value="TERRACE">TERRACE</option>
					<option value="THOROUGHFARE">THOROUGHFARE</option>
					<option value="TOLLWAY">TOLLWAY</option>
					<option value="TOP">TOP</option>
					<option value="TOR">TOR</option>
					<option value="TOWERS">TOWERS</option>
					<option value="TRACK">TRACK</option>
					<option value="TRAIL">TRAIL</option>
					<option value="TRAILER">TRAILER</option>
					<option value="TRIANGLE">TRIANGLE</option>
					<option value="TRUNKWAY">TRUNKWAY</option>
					<option value="TURN">TURN</option>
					<option value="UNDERPASS">UNDERPASS</option>
					<option value="UPPER">UPPER</option>
					<option value="UPPER">UPPER</option>
					<option value="VALE">VALE</option>
					<option value="VIADUCT">VIADUCT</option>
					<option value="VIEW">VIEW</option>
					<option value="VILLAS">VILLAS</option>
					<option value="VISTA">VISTA</option>
					<option value="WADE">WADE</option>
					<option value="WALK">WALK</option>
					<option value="WALKWAY">WALKWAY</option>
					<option value="WAY">WAY</option>
					<option value="WEST">WEST</option>
					<option value="WHARF">WHARF</option>
					<option value="WYND">WYND</option>
					<option value="YARD">YARD</option>
          </select></td>
     </tr>	 	

     <tr> 
        <td align="left" >Suburb</td>
        <td align="left" ><input name="Property_Suburb" type="Text" size="16"> State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="Property_State" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPropertyPostcode.focus()};">

					<option value=""></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>

          </select> Postcode<img src="images/spacer.gif" width="10" height="1" border="0"><input name="Property_Postcode" type="Text" size="4" maxlength="4">&nbsp;</td>
      </tr>	  

       <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td> 
	  </tr>

       <tr>
	  	<td align="left" width="171">Have you viewed the property?</td>
        <td  width="568">
		<input name="Property_Viewed" type="Radio" class="formcheckbox" value="Yes" checked="true" > 
		Yes<img src="images/spacer.gif" width="62" height="1" border="0"><input class="formcheckbox" name="isPropertyViewed" type="Radio" value="No" > No</td>
	  </tr>	  

 <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

        <tr>
	  	<td align="left" width="171" class="navytext"><strong>TENANCY REQUIREMENTS: <span class="redstar">*</span> </strong></td>
        <td  width="568">&nbsp;</td>
	  </tr>  
       
       <tr>
	  	<td align="left" width="171">Commencement of lease</td>
        <td  width="568"><input name="Commencement_Of_Lease"  type="text" size="16" maxlength="50"> Rent $&nbsp;&nbsp;&nbsp;<input name="Rent" type="Text" size="4" maxlength="4"> 
        pw<img src="images/spacer.gif" width="11" height="1" border="0">Length of lease 
          <input name="Length_of_Lease" type="Text" size="16" maxlength="50"></td>
	  </tr>           	  

	 <tr>
	  	<td align="left" width="171" class="navytext"><strong>APPLICANT'S NAME: <span class="redstar">*</span> </strong></td>
        <td  width="568"><select name="chTitle" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chFName.focus()};">
            <option value="null" SELECTED>(Title)</option>
            <option value="MR" >Mr</option> 
			<option value="MRS" >Mrs</option>
			<option value="MS" >Ms</option>
			<option value="MISS" >Miss</option>
            <option value="DR" >Dr</option>

          </select><img src="images/spacer.gif" width="42" height="1" border="0"><input name="First_Name" onfocus="if(this.value=='First name'){this.value=''};" onblur="if(this.value==''){this.value='First name'};" value="First name" type="Text" size="16"> <input name="Middle_Name"  value="Middle name" onfocus="if(this.value=='Middle name'){this.value=''};" onblur="if(this.value==''){this.value='Middle name'};" type="Text" size="16"> <input name="Surname" value="Surname" onfocus="if(this.value=='Surname'){this.value=''};" onblur="if(this.value==''){this.value='Surname'};checkSurname(this);" type="Text" size="16"></td>

	  </tr>
      
      <tr> 
         <td align="left">Maiden name</td>
        <td ><input name="Maiden_Name" type="Text" size="16" value="" maxlength="50">
          <input name="Gender"  class="formcheckbox"    type="Radio" value="Male" checked="true"> Male 
		<input  class="formcheckbox" name="chGender"    type="Radio" value="Female" > 
          Female<img src="images/spacer.gif" width="44" height="1" border="0">DOB 
                    
           <select name="DOB_DAY" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtDOB_mm.focus()};">
                <option value="null" SELECTED>

				<option value="1" >1<option value="2" >2<option value="3" >3<option value="4" >4<option value="5" >5<option value="6" >6<option value="7" >7<option value="8" >8<option value="9" >9<option value="10" >10<option value="11" >11<option value="12" >12<option value="13" >13<option value="14" >14<option value="15" >15<option value="16" >16<option value="17" >17<option value="18" >18<option value="19" >19<option value="20" >20<option value="21" >21<option value="22" >22<option value="23" >23<option value="24" >24<option value="25" >25<option value="26" >26<option value="27" >27<option value="28" >28<option value="29" >29<option value="30" >30<option value="31" >31
           </select>         

           <select name="DOB_MONTH" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtDOB_yyyy.focus()};">
                <option value="null" SELECTED>
				<option value="1" >Jan<option value="2" >Feb<option value="3" >Mar<option value="4" >Apr<option value="5" >May<option value="6" >Jun<option value="7" >Jul<option value="8" >Aug<option value="9" >Sep<option value="10" >Oct<option value="11" >Nov<option value="12" >Dec
           </select>

           <select name="DOB_YEAR" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chNumberOfAdults.focus()};">

                <option value="null" SELECTED>
                <option value="1994" >1994<option value="1993" >1993<option value="1992" >1992<option value="1991" >1991<option value="1990" >1990<option value="1989" >1989<option value="1988" >1988<option value="1987" >1987<option value="1986" >1986<option value="1985" >1985<option value="1984" >1984<option value="1983" >1983<option value="1982" >1982<option value="1981" >1981<option value="1980" >1980<option value="1979" >1979<option value="1978" >1978<option value="1977" >1977<option value="1976" >1976<option value="1975" >1975<option value="1974" >1974<option value="1973" >1973<option value="1972" >1972<option value="1971" >1971<option value="1970" >1970<option value="1969" >1969<option value="1968" >1968<option value="1967" >1967<option value="1966" >1966<option value="1965" >1965<option value="1964" >1964<option value="1963" >1963<option value="1962" >1962<option value="1961" >1961<option value="1960" >1960<option value="1959" >1959<option value="1958" >1958<option value="1957" >1957<option value="1956" >1956<option value="1955" >1955<option value="1954" >1954<option value="1953" >1953<option value="1952" >1952<option value="1951" >1951<option value="1950" >1950<option value="1949" >1949<option value="1948" >1948<option value="1947" >1947<option value="1946" >1946<option value="1945" >1945<option value="1944" >1944<option value="1943" >1943<option value="1942" >1942<option value="1941" >1941<option value="1940" >1940<option value="1939" >1939<option value="1938" >1938<option value="1937" >1937<option value="1936" >1936<option value="1935" >1935<option value="1934" >1934<option value="1933" >1933<option value="1932" >1932<option value="1931" >1931<option value="1930" >1930<option value="1929" >1929<option value="1928" >1928<option value="1927" >1927<option value="1926" >1926<option value="1925" >1925<option value="1924" >1924<option value="1923" >1923<option value="1922" >1922<option value="1921" >1921<option value="1920" >1920<option value="1919" >1919<option value="1918" >1918<option value="1917" >1917<option value="1916" >1916<option value="1915" >1915<option value="1914" >1914<option value="1913" >1913<option value="1912" >1912<option value="1911" >1911
                </select>
           </td>
      </tr>
      
       <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

        <tr>
	  	<td align="left" width="171" class="navytext"><strong>OCCUPANCY DETAILS: <span class="redstar">*</span> </strong></td>
        <td  width="568">&nbsp;</td>
	  </tr>  
       
       <tr>
	  	<td align="left" width="171">No. of Adults</td>
        <td  width="568"> <select name="Number_Of_Adults" style="width:74px" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chNumberOfChildren.focus()};">
            <option value="null" SELECTED>(Select)</option>
            <option value="1" >1</option> 
			<option value="2" >2</option>
            <option value="3" >3</option>
            <option value="4" >4</option>
            <option value="5" >5</option>
            <option value="6" >6</option>
            <option value="6+" >6+</option>
          </select>

        No. of Children 
          <select name="Number_Of_Children" style="width:74px" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgesOfChildren.focus()};">
            <option value="null" SELECTED>(Select)</option>
            <option value="0" >0</option> 
            <option value="1" >1</option> 
			<option value="2" >2</option>
            <option value="3" >3</option>
            <option value="4" >4</option>
            <option value="5" >5</option>
            <option value="6" >6</option>
            <option value="6+" >6+</option>

          </select> Ages of Children 
          <input name="Ages_Of_Children" type="Text" size="16"  value=""  maxlength="30"></td>
	  </tr>
    
      <tr>
	  	<td align="left" width="171">Name of Adult 1</td>
        <td  width="568"><input name="Name_of_Adult_1"  value=""  type="text" size="16" maxlength="100"> 
         <img src="images/spacer.gif" width="122" height="1" border="0">Name of Adult 2) <input name="Name_of_Adult_2" type="Text" size="16"  value=""  maxlength="100"> 
         </td>
	  </tr>
      
       <tr>
	  	<td align="left" width="171">Name of Adult 3</td>
        <td  width="568"><input name="Name_of_Adult_3"  value=""  type="text" size="16" maxlength="100"> 
         <img src="images/spacer.gif" width="122" height="1" border="0">Name of Adult 4) <input name="Name_of_Adult_4" type="Text" size="16"  value=""  maxlength="100"> 
         </td>
	  </tr>
       
       <tr>
	  	<td align="left" width="171" style="height: 34px">Name of Adult 5</td>
        <td  width="568" style="height: 34px"><input name="Name_of_Adult_5"  value=""  type="text" size="16" maxlength="100"> 
         <img src="images/spacer.gif" width="122" height="1" border="0">Name of Adult 6) <input name="Name_of_Adult_6" type="Text" size="16"  value=""  maxlength="100"> 
         </td>
	  </tr>
	  
      <tr>
	  	<td align="left" width="171">Do you smoke?</td>        
        <td  width="568">
		<input name="Do_You_Smoke" class="formcheckbox"  type="Radio" value="Yes" checked="true"> Yes<img src="images/spacer.gif" width="62" height="1" border="0"><input class="formcheckbox" name="chDoYouSmoke"    type="Radio" value="No"> 
        No <img src="images/spacer.gif" width="89" height="1" border="0">
        Inside or outside?&nbsp;
        <input name="Smoking_Inside_or_Outside" type="Text" size="16" maxlength="10"></td>
	  </tr>
     
      <tr>
	  	<td align="left" width="171">Do you have any pets?</td>        
        <td  width="568">
		<input name="Do_You_Have_Pets" class="formcheckbox"  type="Radio" value="Yes" checked="true"> Yes<img src="images/spacer.gif" width="62" height="1" border="0"><input class="formcheckbox" name="chDoYouHavePets"    type="Radio" value="No"> 
        No </td>
	  </tr>
      
      <tr>
	  	<td align="left" width="171">Number /   Type / Breed of pets</td>
        <td  width="568"><input name="Pet_Description"  type="text" style="width:441px;" maxlength="50" ></td>
	  </tr>
     
	  <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

	  <tr> 
        <td class="navytext"><b>PRESENT ADDRESS: <span class="redstar">*</span> </b></td>
		<td class="searchgreentext">
		<input name="International" onClick="setInternationalPresentAddressNode(0)"  class="formcheckbox" checked="true" type="Radio" value="AUSTRALIAN"><span class="navytext"> AUSTRALIAN</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input  class="formcheckbox"  onClick="setInternationalPresentAddressNode(1)" name="chInternational" type="Radio" value="INTERNATIONAL" ><span class="navytext"> INTERNATIONAL</span></td>
      </tr>
      
	   <tr> 
         <td align="left">Type of residence</td>
        <td valign="Bottom" align="left" ><select name="chPrefix" onChange=				"if((this.value=='')||(this.value=='null')){document.getElementById('chFlatNo').style.display='none';document.getElementById('lblFlatNo').style.display='none';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chStreetNo.focus()};}else{document.getElementById('chFlatNo').style.display='inline';document.getElementById('lblFlatNo').style.display='inline';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chFlatNo.focus()}};if(this.value=='-----'){this.value='';document.getElementById('chFlatNo').style.display='none';document.getElementById('lblFlatNo').style.display='none';};" style="width:113px;">
                    <option value="null">(Select)</option>
                    <option value="" SELECTED>HOUSE</option>
                    <option value="UNIT" >UNIT</option>
                    <option value="APARTMENT" >APARTMENT</option>
                    <option value="FLAT" >FLAT</option>
                    <option value="STUDIO" >STUDIO</option>                    
                    <option value="-----" >

                        -----</option>

                    <option value="BLOCK" >
                        BLOCK</option>
                    <option value="CABIN" >
                        CABIN</option>
                    <option value="COTTAGE" >
                        COTTAGE</option>
                    <option value="DUPLEX" >
                        DUPLEX</option>
                    <option value="FACTORY" >
                        FACTORY</option>
                    <option value="FLOOR" >
                        FLOOR</option>
                    <option value="LOT" >
                        LOT</option>
                    <option value="PIER" >
                        PIER</option>
                    <option value="ROOFTOP" >
                        ROOFTOP</option>
                    <option value="ROOM" >
                        ROOM</option>
                    <option value="SHOP" >
                        SHOP</option>
                    <option value="SUITE" >
                        SUITE</option>
                    <option value="TOWNHOUSE" >
                        TOWNHOUSE</option>
                    <option value="VILLA" >
                        VILLA</option>
                    <option value="WAREHOUSE" >
                        WAREHOUSE</option>
              </select><div id="lblFlatNo" style="display:none">&nbsp;&nbsp;No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<img src="images/spacer.gif" width="2" border="0"></div><input name="Flat_Number" id="chFlatNo" value="" type="Text" size="4" style="display:none" onBlur="checkAlphaNumeric(this,1,'','.','');"><img src="images/spacer.gif" width="2" border="0">Str. No.&nbsp;<input name="Street_Number" value=""  type="Text" size="4" onBlur="checkAlphaNumeric(this,1,'','','-')"></td>
      </tr>
	   <tr>
        <td align="left" >Street Name</td>
        <td valign="Bottom" align="left" ><input name="Street_Name" value=""  type="Text" size="16" maxlength="50"><img src="images/spacer.gif" width="46" height="1" border="0"><select
                        name="Street_Type" onchange="if(this.value=='-----'){this.value='';};if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chSuburb.focus()};"><option
                            value="">(Street Type)</option>
                        <option value="STREET" >
                            STREET</option>
                        <option value="ROAD" >
                            ROAD</option>
                        <option value="AVENUE" >
                            AVENUE</option>
                        <option value="PLACE" >
                            PLACE</option>
                        <option value="CRESCENT" >
                            CRESCENT</option>
                        <option value="DRIVE" >
                            DRIVE</option>
                        <option value="PARADE" >
                            PARADE</option>
                        <option value="CLOSE" >
                            CLOSE</option>
                        <option value="-----" >
                            -----</option>

                        <option value="ACCESS" >
                            ACCESS</option>
                        <option value="ALLEY" >
                            ALLEY</option>
                        <option value="ALLEYWAY" >
                            ALLEYWAY</option>
                        <option value="AMBLE" >
                            AMBLE</option>
                        <option value="ANCHORAGE" >
                            ANCHORAGE</option>
                        <option value="APPROACH" >
                            APPROACH</option>
                        <option value="ARCADE" >
                            ARCADE</option>
                        <option value="ARTERY" >
                            ARTERY</option>
                        <option value="BASIN" >
                            BASIN</option>
                        <option value="BEACH" >
                            BEACH</option>
                        <option value="BEND" >
                            BEND</option>
                        <option value="BLOCK" >
                            BLOCK</option>
                        <option value="BOULEVARD" >
                            BOULEVARD</option>
                        <option value="BOULEVARDE" >
                            BOULEVARDE</option>
                        <option value="BRACE" >
                            BRACE</option>
                        <option value="BRAE" >
                            BRAE</option>
                        <option value="BREAK" >
                            BREAK</option>
                        <option value="BRIDGE" >
                            BRIDGE</option>
                        <option value="BROADWAY" >
                            BROADWAY</option>
                        <option value="BROW" >
                            BROW</option>
                        <option value="BYPASS" >
                            BYPASS</option>
                        <option value="BYWAY" >
                            BYWAY</option>
                        <option value="CAUSEWAY" >
                            CAUSEWAY</option>
                        <option value="CENTRAL" >
                            CENTRAL</option>
                        <option value="CENTRE" >
                            CENTRE</option>
                        <option value="CENTREWAY" >
                            CENTREWAY</option>
                        <option value="CHASE" >
                            CHASE</option>
                        <option value="CIRCLE" >
                            CIRCLE</option>
                        <option value="CIRCLET" >
                            CIRCLET</option>
                        <option value="CIRCUIT" >
                            CIRCUIT</option>
                        <option value="CIRCUS" >
                            CIRCUS</option>
                        <option value="COLONNADE" >
                            COLONNADE</option>
                        <option value="COMMON" >
                            COMMON</option>
                        <option value="CONCOURSE" >
                            CONCOURSE</option>
                        <option value="COPSE" >
                            COPSE</option>
                        <option value="CORNER" >
                            CORNER</option>
                        <option value="CORSO" >
                            CORSO</option>
                        <option value="COURT" >
                            COURT</option>
                        <option value="COURTYARD" >
                            COURTYARD</option>
                        <option value="COVE" >
                            COVE</option>
                        <option value="CREST" >
                            CREST</option>
                        <option value="CROSS" >
                            CROSS</option>
                        <option value="CROSSING" >
                            CROSSING</option>
                        <option value="CROSSROAD" >
                            CROSSROAD</option>
                        <option value="CROSSWAY" >
                            CROSSWAY</option>
                        <option value="CRUISEWAY" >
                            CRUISEWAY</option>
                        <option value="CUL-DE-SAC" >
                            CUL-DE-SAC</option>
                        <option value="CUTTING" >
                            CUTTING</option>
                        <option value="DALE" >
                            DALE</option>
                        <option value="DELL" >
                            DELL</option>
                        <option value="DEVIATION" >
                            DEVIATION</option>
                        <option value="DIP" >
                            DIP</option>
                        <option value="DISTRIBUTOR" >
                            DISTRIBUTOR</option>
                        <option value="DRIVEWAY" >
                            DRIVEWAY</option>
                        <option value="EAST" >
                            EAST</option>
                        <option value="EDGE" >
                            EDGE</option>
                        <option value="ELBOW" >
                            ELBOW</option>
                        <option value="END" >
                            END</option>
                        <option value="ENTRANCE" >
                            ENTRANCE</option>
                        <option value="ESPLANADE" >
                            ESPLANADE</option>
                        <option value="ESTATE" >
                            ESTATE</option>
                        <option value="EXPRESSWAY" >
                            EXPRESSWAY</option>
                        <option value="EXTENSION" >
                            EXTENSION</option>
                        <option value="EXTENSION" >
                            EXTENSION</option>
                        <option value="FAIRWAY" >
                            FAIRWAY</option>
                        <option value="FIRE TRACK" >
                            FIRE TRACK</option>
                        <option value="FIRETRAIL" >
                            FIRETRAIL</option>
                        <option value="FLAT" >
                            FLAT</option>
                        <option value="FOLLOW" >
                            FOLLOW</option>
                        <option value="FOOTWAY" >
                            FOOTWAY</option>
                        <option value="FORESHORE" >
                            FORESHORE</option>
                        <option value="FORMATION" >
                            FORMATION</option>
                        <option value="FREEWAY" >
                            FREEWAY</option>
                        <option value="FRONT" >
                            FRONT</option>
                        <option value="FRONTAGE" >
                            FRONTAGE</option>
                        <option value="GAP" >
                            GAP</option>
                        <option value="GARDEN" >
                            GARDEN</option>
                        <option value="GARDENS" >
                            GARDENS</option>
                        <option value="GATE" >
                            GATE</option>
                        <option value="GATES" >
                            GATES</option>
                        <option value="GLADE" >
                            GLADE</option>
                        <option value="GLEN" >
                            GLEN</option>
                        <option value="GRANGE" >
                            GRANGE</option>
                        <option value="GREEN" >
                            GREEN</option>
                        <option value="GROUND" >
                            GROUND</option>
                        <option value="GROVE" >
                            GROVE</option>
                        <option value="GULLY" >
                            GULLY</option>
                        <option value="HEIGHTS" >
                            HEIGHTS</option>
                        <option value="HIGHROAD" >
                            HIGHROAD</option>
                        <option value="HIGHWAY" >
                            HIGHWAY</option>
                        <option value="HILL" >
                            HILL</option>
                        <option value="INTERCHANGE" >
                            INTERCHANGE</option>
                        <option value="INTERSECTION" >
                            INTERSECTION</option>
                        <option value="JUNCTION" >
                            JUNCTION</option>
                        <option value="KEY" >
                            KEY</option>
                        <option value="LANDING" >
                            LANDING</option>
                        <option value="LANE" >
                            LANE</option>
                        <option value="LANEWAY" >
                            LANEWAY</option>
                        <option value="LEES" >
                            LEES</option>
                        <option value="LINE" >
                            LINE</option>
                        <option value="LINK" >
                            LINK</option>
                        <option value="LITTLE" >
                            LITTLE</option>
                        <option value="LOOKOUT" >
                            LOOKOUT</option>
                        <option value="LOOP" >
                            LOOP</option>
                        <option value="LOWER" >
                            LOWER</option>
                        <option value="LOWER" >
                            LOWER</option>
                        <option value="MALL" >
                            MALL</option>
                        <option value="MEANDER" >
                            MEANDER</option>
                        <option value="MEW" >
                            MEW</option>
                        <option value="MEWS" >
                            MEWS</option>
                        <option value="MOTORWAY" >
                            MOTORWAY</option>
                        <option value="MOUNT" >
                            MOUNT</option>
                        <option value="NOOK" >
                            NOOK</option>
                        <option value="NORTH" >
                            NORTH</option>
                        <option value="NORTH EAST" >
                            NORTH EAST</option>
                        <option value="NORTH WEST" >
                            NORTH WEST</option>
                        <option value="OUTLOOK" >
                            OUTLOOK</option>
                        <option value="PARK" >
                            PARK</option>
                        <option value="PARKLANDS" >
                            PARKLANDS</option>
                        <option value="PARKWAY" >
                            PARKWAY</option>
                        <option value="PART" >
                            PART</option>
                        <option value="PASS" >
                            PASS</option>
                        <option value="PATH" >
                            PATH</option>
                        <option value="PATHWAY" >
                            PATHWAY</option>
                        <option value="PIAZZA" >
                            PIAZZA</option>
                        <option value="PLATEAU" >
                            PLATEAU</option>
                        <option value="PLAZA" >
                            PLAZA</option>
                        <option value="POCKET" >
                            POCKET</option>
                        <option value="POINT" >
                            POINT</option>
                        <option value="PORT" >
                            PORT</option>
                        <option value="PROMENADE" >
                            PROMENADE</option>
                        <option value="QUAD" >
                            QUAD</option>
                        <option value="QUADRANGLE" >
                            QUADRANGLE</option>
                        <option value="QUADRANT" >
                            QUADRANT</option>
                        <option value="QUAY" >
                            QUAY</option>
                        <option value="QUAYS" >
                            QUAYS</option>
                        <option value="RAMBLE" >
                            RAMBLE</option>
                        <option value="RAMP" >
                            RAMP</option>
                        <option value="RANGE" >
                            RANGE</option>
                        <option value="REACH" >
                            REACH</option>
                        <option value="RESERVE" >
                            RESERVE</option>
                        <option value="REST" >
                            REST</option>
                        <option value="RETREAT" >
                            RETREAT</option>
                        <option value="RIDE" >
                            RIDE</option>
                        <option value="RIDGE" >
                            RIDGE</option>
                        <option value="RIDGEWAY" >
                            RIDGEWAY</option>
                        <option value="RIGHT OF WAY" >
                            RIGHT OF WAY</option>
                        <option value="RING" >
                            RING</option>
                        <option value="RISE" >
                            RISE</option>
                        <option value="RIVER" >
                            RIVER</option>
                        <option value="RIVERWAY" >
                            RIVERWAY</option>
                        <option value="RIVIERA" >
                            RIVIERA</option>
                        <option value="ROADS" >
                            ROADS</option>
                        <option value="ROADSIDE" >
                            ROADSIDE</option>
                        <option value="ROADWAY" >
                            ROADWAY</option>
                        <option value="RONDE" >
                            RONDE</option>
                        <option value="ROSEBOWL" >
                            ROSEBOWL</option>
                        <option value="ROTARY" >
                            ROTARY</option>
                        <option value="ROUND" >
                            ROUND</option>
                        <option value="ROUTE" >
                            ROUTE</option>
                        <option value="ROW" >
                            ROW</option>
                        <option value="RUE" >
                            RUE</option>
                        <option value="RUN" >
                            RUN</option>
                        <option value="SERVICE WAY" >
                            SERVICE WAY</option>
                        <option value="SIDING" >
                            SIDING</option>
                        <option value="SLOPE" >
                            SLOPE</option>
                        <option value="SOUND" >
                            SOUND</option>
                        <option value="SOUTH" >
                            SOUTH</option>
                        <option value="SOUTH EAST" >
                            SOUTH EAST</option>
                        <option value="SOUTH WEST" >
                            SOUTH WEST</option>
                        <option value="SPUR" >
                            SPUR</option>
                        <option value="SQUARE" >
                            SQUARE</option>
                        <option value="STAIRS" >
                            STAIRS</option>
                        <option value="STATE HIGHWAY" >
                            STATE HIGHWA</option>
                        <option value="STEPS" >
                            STEPS</option>
                        <option value="STEYNE" >
                            STEYNE</option>
                        <option value="STRAND" >
                            STRAND</option>
                        <option value="STRIP" >
                            STRIP</option>
                        <option value="SUBWAY" >
                            SUBWAY</option>
                        <option value="TARN" >
                            TARN</option>
                        <option value="TERRACE" >
                            TERRACE</option>
                        <option value="THOROUGHFARE" >
                            THOROUGHFARE</option>
                        <option value="TOLLWAY" >
                            TOLLWAY</option>
                        <option value="TOP" >
                            TOP</option>
                        <option value="TOR" >
                            TOR</option>
                        <option value="TOWERS" >
                            TOWERS</option>
                        <option value="TRACK" >
                            TRACK</option>
                        <option value="TRAIL" >
                            TRAIL</option>
                        <option value="TRAILER" >
                            TRAILER</option>
                        <option value="TRIANGLE" >
                            TRIANGLE</option>
                        <option value="TRUNKWAY" >
                            TRUNKWAY</option>
                        <option value="TURN" >
                            TURN</option>
                        <option value="UNDERPASS" >
                            UNDERPASS</option>
                        <option value="UPPER" >
                            UPPER</option>
                        <option value="UPPER" >
                            UPPER</option>
                        <option value="VALE" >
                            VALE</option>
                        <option value="VIADUCT" >
                            VIADUCT</option>
                        <option value="VIEW" >
                            VIEW</option>
                        <option value="VILLAS" >
                            VILLAS</option>
                        <option value="VISTA" >
                            VISTA</option>
                        <option value="WADE" >
                            WADE</option>
                        <option value="WALK" >
                            WALK</option>
                        <option value="WALKWAY" >
                            WALKWAY</option>
                        <option value="WAY" >
                            WAY</option>
                        <option value="WEST" >
                            WEST</option>
                        <option value="WHARF" >
                            WHARF</option>
                        <option value="WYND" >
                            WYND</option>
                        <option value="YARD" >
                            YARD</option>
                    </select></td>
      </tr>

     <tr> 
        <td align="left"><div id="objPresentAddressAus1">Suburb</div></td>
        <td align="left"><div id="objPresentAddressAus2"><input name="Suburb" value="" type="Text" size="16"> 
        State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="chState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPostcode.focus()};">
					<option value=""></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>
          </select> Postcode<img src="images/spacer.gif" width="10" height="1" border="0"><input name="Postcode"value="" type="Text" size="4" maxlength="4">  </div></td>
      </tr>    

      <!-- INT ADDRESS STUFF --->
      
      <tr> 
        <td align="left" ><div id="objPresentAddressInt1" style="display:none">Suburb</div></td>
        <td align="left" ><div id="objPresentAddressInt2" style="display:none"><input name="Int_Suburb" type="Text" size="16"> City&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input name="Int_City" type="Text" size="16"> State/County <input name="Int_State" type="Text" size="16"></div></td>
      </tr>  

     <tr> 
        <td height="3" align="left"><div id="objPresentAddressInt3"  style="display:none">PostCode/ZIP</div></td>
        <td height="3"><div id="objPresentAddressInt4"  style="display:none"><input name="Int_Postcode" type="Text" size="16"> Country <select name="chIntCountry"><option value="">(Select Country)</option>
            <option value="Afghanistan">Afghanistan</option>
            <option value="Albania">Albania</option>
            <option value="Algeria">Algeria</option>
            <option value="American Samoa">American Samoa</option>
            <option value="Andorra">Andorra</option>
            <option value="Angola">Angola</option>
            <option value="Anguilla">Anguilla</option>
            <option value="Antarctica">Antarctica</option>
            <option value="Antigua and Barbuda">Antigua and Barbuda</option>
            <option value="Argentina">Argentina</option>
            <option value="Armenia">Armenia</option>
            <option value="Aruba">Aruba</option>
            <option value="Austria">Austria</option>
            <option value="Azerbaijan">Azerbaijan</option>
            <option value="Bahamas">Bahamas</option>
            <option value="Bahrain">Bahrain</option>
            <option value="Bangladesh">Bangladesh</option>
            <option value="Barbados">Barbados</option>
            <option value="Belarus">Belarus</option>
            <option value="Belgium">Belgium</option>
            <option value="Belize">Belize</option>
            <option value="Benin">Benin</option>
            <option value="Bermuda">Bermuda</option>
            <option value="Bhutan">Bhutan</option>
            <option value="Bolivia">Bolivia</option>
            <option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
            <option value="Botswana">Botswana</option>
            <option value="Bouvet Island">Bouvet Island</option>
            <option value="Brazil">Brazil</option>
            <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
            <option value="Brunei Darussalam">Brunei Darussalam</option>
            <option value="Bulgaria">Bulgaria</option>
            <option value="Burkina Faso">Burkina Faso</option>
            <option value="Burundi">Burundi</option>
            <option value="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman islands">Cayman islands</option>
            <option value="Central African Republic">Central African Republic</option>
            <option value="Chad">Chad</option>
            <option value="Chile">Chile</option>
            <option value="China">China</option>
            <option value="Christmas Island">Christmas Island</option>
            <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
            <option value="Colombia">Colombia</option>
            <option value="Comoros">Comoros</option>
            <option value="Congo">Congo</option>
            <option value="Congo, Democratic Republic">Congo, Democratic Republic</option>
            <option value="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Cote d'ivoire">Cote d'ivoire</option>
            <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option>
            <option value="Cuba">Cuba</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</option>
            <option value="Denmark">Denmark</option>
            <option value="Djibouti">Djibouti</option>
            <option value="Dominica">Dominica</option>
            <option value="Dominican Republic">Dominican Republic</option>
            <option value="East Timor">East Timor</option>
            <option value="Ecuador">Ecuador</option>
            <option value="Egypt">Egypt</option>
            <option value="El Salvador">El Salvador</option>
            <option value="Equatorial Guinea">Equatorial Guinea</option>
            <option value="Eritrea">Eritrea</option>
            <option value="Estonia">Estonia</option>
            <option value="Ethiopia">Ethiopia</option>
            <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
            <option value="Faroe islands">Faroe islands</option>
            <option value="Fiji">Fiji</option>
            <option value="Finland">Finland</option>
            <option value="France">France</option>
            <option value="France, Metropolitan">France, Metropolitan</option>
            <option value="French Guiana">French Guiana</option>
            <option value="French Polynesia">French Polynesia</option>
            <option value="French Southern Territories">French Southern Territories</option>
            <option value="Gabon">Gabon</option>
            <option value="Gambia">Gambia</option>
            <option value="Georgia">Georgia</option>
            <option value="Germany">Germany</option>
            <option value="Ghana">Ghana</option>
            <option value="Gibraltar">Gibraltar</option>
            <option value="Greece">Greece</option>
            <option value="Greenland">Greenland</option>
            <option value="Grenada">Grenada</option>
            <option value="Guadeloupe">Guadeloupe</option>
            <option value="Guam">Guam</option>
            <option value="Guatemala">Guatemala</option>
            <option value="Guinea">Guinea</option>
           <option value="Guinea-Bissau">Guinea-Bissau</option>
            <option value="Guyana">Guyana</option>
            <option value="Haiti">Haiti</option>
            <option value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option>
            <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
            <option value="Honduras">Honduras</option>
            <option value="Hong Kong">Hong Kong</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="India">India</option>
            <option value="Indonesia">Indonesia</option>
            <option value="Iran (Islamic Republic of)">Iran (Islamic Republic of)</option>
            <option value="Iraq">Iraq</option>
            <option value="Ireland">Ireland</option>
            <option value="Israel">Israel</option>
            <option value="Italy">Italy</option>
            <option value="Jamaica">Jamaica</option>
            <option value="Japan">Japan</option>
            <option value="Jordan">Jordan</option>
            <option value="Kazakhstan">Kazakhstan</option>
            <option value="Kenya">Kenya</option>
            <option value="Kiribati">Kiribati</option>
            <option value="Korea, Democratic People's Republic">Korea, Democratic People's Republic</option>
            <option value="Korea, Republic of">Korea, Republic of</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
            <option value="Latvia">Latvia</option>
            <option value="Lebanon">Lebanon</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macau">Macau</option>
            <option value="Macedonia (Yugoslav Republic)">Macedonia (Yugoslav Republic)</option>
            <option value="Madagascar">Madagascar</option>
            <option value="Malawi">Malawi</option>
            <option value="Malaysia">Malaysia</option>
            <option value="Maldives">Maldives</option>
            <option value="Mali">Mali</option>
            <option value="Malta">Malta</option>
            <option value="Marshall Islands">Marshall Islands</option>
            <option value="Martinique">Martinique</option>
            <option value="Mauritania">Mauritania</option>
            <option value="Mauritius">Mauritius</option>
            <option value="Mayotte">Mayotte</option>
            <option value="Mexico">Mexico</option>
            <option value="Micronesia">Micronesia</option>
            <option value="Moldova">Moldova</option>
            <option value="Monaco">Monaco</option>
            <option value="Mongolia">Mongolia</option>
            <option value="Montserrat">Montserrat</option>
            <option value="Morocco">Morocco</option>
            <option value="Mozambique">Mozambique</option>
            <option value="Myanmar">Myanmar</option>
            <option value="Namibia">Namibia</option>
            <option value="Nauru">Nauru</option>
            <option value="Nepal">Nepal</option>
            <option value="Netherlands">Netherlands</option>
            <option value="Netherlands Antilles">Netherlands Antilles</option>
            <option value="New Caledonia">New Caledonia</option>
            <option value="New Zealand">New Zealand</option>
            <option value="Nicaragua">Nicaragua</option>
            <option value="Niger">Niger</option>
            <option value="Nigeria">Nigeria</option>
            <option value="Niue">Niue</option>
            <option value="Norfolk island">Norfolk island</option>
            <option value="Northern Mariana Islands">Northern Mariana Islands</option>
            <option value="Norway">Norway</option>
            <option value="Oman">Oman</option>
            <option value="Pakistan">Pakistan</option>
            <option value="Palau">Palau</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Peru">Peru</option>
            <option value="Philippines">Philippines</option>
            <option value="Pitcairn">Pitcairn</option>
            <option value="Poland">Poland</option>
            <option value="Portugal">Portugal</option>
            <option value="Puerto Rico">Puerto Rico</option>
            <option value="Qatar">Qatar</option>
            <option value="Reunion">Reunion</option>
            <option value="Romania">Romania</option>
            <option value="Russian Federation">Russian Federation</option>
            <option value="Rwanda">Rwanda</option>
            <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
            <option value="Saint Lucia">Saint Lucia</option>
            <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
            <option value="Samoa">Samoa</option>
            <option value="San Marino">San Marino</option>
            <option value="Sao Tome and Principe">Sao Tome and Principe</option>
            <option value="Saudi Arabia">Saudi Arabia</option>
            <option value="Senegal">Senegal</option>
            <option value="Seychelles">Seychelles</option>
            <option value="Sierra Leone">Sierra Leone</option>
            <option value="Singapore">Singapore</option>
            <option value="Slovakia (Slovak Republic)">Slovakia (Slovak Republic)</option>
            <option value="Slovenia">Slovenia</option>
            <option value="Solomon Islands">Solomon Islands</option>
            <option value="Somalia">Somalia</option>
            <option value="South Africa">South Africa</option>
            <option value="South Georgia">South Georgia</option>
            <option value="Spain">Spain</option>
            <option value="Sri Lanka">Sri Lanka</option>
            <option value="St Helena">St Helena</option>
            <option value="St Pierre and Miquelon">St Pierre and Miquelon</option>
            <option value="Sudan">Sudan</option>
            <option value="Suriname">Suriname</option>
            <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
            <option value="Swaziland">Swaziland</option>
            <option value="Sweden">Sweden</option>
            <option value="Switzerland">Switzerland</option>
            <option value="Syrian Arab Republic">Syrian Arab Republic</option>
            <option value="Taiwan">Taiwan</option>
            <option value="Tajikistan">Tajikistan</option>
            <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
            <option value="Thailand">Thailand</option>
            <option value="Togo">Togo</option>
            <option value="Tokelau">Tokelau</option>
            <option value="Tonga">Tonga</option>
            <option value="Trinidad and Tobago">Trinidad and Tobago</option>
            <option value="Tunisia">Tunisia</option>
            <option value="Turkey">Turkey</option>
            <option value="Turkmenistan">Turkmenistan</option>
            <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
            <option value="Tuvalu">Tuvalu</option>
            <option value="Uganda">Uganda</option>
            <option value="Ukraine">Ukraine</option>
            <option value="United Arab Emirates">United Arab Emirates</option>
            <option value="United Kingdom">United Kingdom</option>
            <option value="United States">United States</option>
            <option value="Uruguay">Uruguay</option>
            <option value="Uzbekistan">Uzbekistan</option>
            <option value="Vanuatu">Vanuatu</option>
            <option value="Venezuela">Venezuela</option>
            <option value="Vietnam">Vietnam</option>
            <option value="Virgin Islands (British)">Virgin Islands (British)</option>
            <option value="Virgin Islands (US)">Virgin Islands (US)</option>
            <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
            <option value="Western Sahara">Western Sahara</option>
            <option value="Yemen">Yemen</option>
            <option value="Yugoslavia">Yugoslavia</option>
            <option value="Zambia">Zambia</option>
            <option value="Zimbabwe">Zimbabwe</option>
          </select></div></td>
      </tr>

     <!--- END INT ADDRESS STUFF -->
       <tr>
	  	<td align="left" width="171"><table cellpadding="0" width="100%" cellspacing="0" border="0"><tr>
	  	      <td>Current Rent</td><td align="right">$ </td></tr></table></td>
        <td  width="568"><input name="Current_Rent" value=""  type="text" size="4" maxlength="10"> 
        pw
        <img src="images/spacer.gif" height="1" width="29" border="0">Length of tenancy at current address<img src="images/spacer.gif" height="1" width="28" border="0">
        <input name="Time_At_Current_Address"  value=""  type="Text" size="16" maxlength="16"> 
	  </tr>

      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 
      <tr>
	  	<td align="left" width="171" class="navytext"><strong>IDENTIFIERS:</strong></td>
        <td>&nbsp;</td>
	  </tr>      

      <tr> 
         <td align="left" >Driver's Licence No.</td>
        <td ><input name="License"  value=""  type="Text" size="16"> State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="License_State_Issue" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chLicenseCardNumber.focus()};">
					<option value=" " ></option>

            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>
          </select> 
        License Card No.<img src="images/spacer.gif" width="18" height="1" border="0">
        <input name="License_Card_Number" value=""  type="Text" size="16"> </td>
      </tr>

      <tr> 
         <td align="left" >Vehicle Registration</td>
        <td ><input name="Vehicle" value=""  type="Text" size="16" onBlur="checkRego(this);"> State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="Vehicle_State_Issue" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chCentrelink.focus()};"><option value=" " ></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>
          </select></td>
      </tr>

     <tr><td align="left"  valign="baseline">Centrelink No.</td>
        <td ><input name="Centrelink" value=""  type="Text" size="16" maxlength="10"><img src="images/spacer.gif" width="100" height="1" border="0">Proof of Age Card No. <input name="Proof_of_Age" value=""  type="Text" size="16" maxlength="10">        
        </td>
      </tr>

        <tr><td align="left"  valign="baseline">Pension No.</td>
        <td ><input name="Pension_Number" value=""  type="Text" size="16" maxlength="10"><img src="images/spacer.gif" width="100" height="1" border="0">Pension Type<img src="images/spacer.gif" width="46" height="1" border="0"><input name="Pension_Type" value=""  type="Text" size="16" maxlength="20">       
        </td>
      </tr>

      <tr><td align="left"  valign="baseline">Working Visa</td>
        <td ><input name="Working_Visa" value=""  type="Text" size="16" maxlength="10"><img src="images/spacer.gif" width="100" height="1" border="0">Date of expiry<img src="images/spacer.gif" width="48" height="1" border="0"><input name="Work_Visa_Expiry" value=""  type="Text" size="16" maxlength="20">       
        </td>
      </tr>

     <tr>
        <td   align="left" valign="baseline">Australian Passport No.</td>
        <td ><input name="Aus_Passport" value=""  type="Text" size="16"><img src="images/spacer.gif" width="100" height="1" border="0">Medicare No.<img src="images/spacer.gif" width="49" height="1" border="0"><input name="Medicare" value=""  type="Text" size="16" maxlength="10"></td>
      </tr>

      <tr>
        <td   align="left" valign="baseline">International Passport No.</td>
        <td ><input name="Passport" value=""  type="Text" size="16"><img src="images/spacer.gif" width="57" height="1" border="0">Country <select name="chPassportCountry"  onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chIntLicense.focus()};">

            <option value=""></option>
             <option value="Afghanistan" >
                        Afghanistan</option>
             <option value="Albania" >
                        Albania</option>
             <option value="Algeria" >
                        Algeria</option>
             <option value="American Samoa" >
                        American Samoa</option>
             <option value="Andorra" >
                        Andorra</option>
             <option value="Angola" >
                        Angola</option>
             <option value="Anguilla" >
                        Anguilla</option>
             <option value="Antarctica" >
                        Antarctica</option>
             <option value="Antigua and Barbuda" >
                        Antigua and Barbuda</option>
             <option value="Argentina" >
                        Argentina</option>
             <option value="Armenia" >
                        Armenia</option>
             <option value="Aruba" >
                        Aruba</option>
             <option value="Austria" >
                        Austria</option>
             <option value="Azerbaijan" >
                        Azerbaijan</option>
             <option value="Bahamas" >
                        Bahamas</option>
             <option value="Bahrain" >
                        Bahrain</option>
             <option value="Bangladesh" >
                        Bangladesh</option>
             <option value="Barbados" >
                        Barbados</option>
             <option value="Belarus" >
                        Belarus</option>
             <option value="Belgium" >
                        Belgium</option>
             <option value="Belize" >
                        Belize</option>
             <option value="Benin" >
                        Benin</option>
             <option value="Bermuda" >
                        Bermuda</option>
             <option value="Bhutan" >
                        Bhutan</option>
             <option value="Bolivia" >
                        Bolivia</option>
             <option value="Bosnia and Herzegowina" >
                        Bosnia and Herzegowina</option>
             <option value="Botswana" >
                        Botswana</option>
             <option value="Bouvet Island" >
                        Bouvet Island</option>
             <option value="Brazil" >
                        Brazil</option>
             <option value="British Indian Ocean Territory" >
                        British Indian Ocean Territory</option>
             <option value="Brunei Darussalam" >
                        Brunei Darussalam</option>
             <option value="Bulgaria" >
                        Bulgaria</option>
             <option value="Burkina Faso" >
                        Burkina Faso</option>
             <option value="Burundi" >
                        Burundi</option>
             <option value="Cambodia" >
                        Cambodia</option>
             <option value="Cameroon" >
                        Cameroon</option>
             <option value="Canada" >
                        Canada</option>
             <option value="Cape Verde" >
                        Cape Verde</option>
             <option value="Cayman islands" >
                        Cayman islands</option>
             <option value="Central African Republic" >
                        Central African Republic</option>
             <option value="Chad" >
                        Chad</option>
             <option value="Chile" >
                        Chile</option>
             <option value="China" >
                        China</option>
             <option value="Christmas Island" >
                        Christmas Island</option>
             <option value="Cocos (Keeling) Islands" >
                        Cocos (Keeling) Islands</option>
             <option value="Colombia" >
                        Colombia</option>
             <option value="Comoros" >
                        Comoros</option>
             <option value="Congo" >
                        Congo</option>
             <option value="Congo, Democratic Republic" >
                        Congo, Democratic Republic</option>
             <option value="Cook Islands" >
                        Cook Islands</option>
             <option value="Costa Rica" >
                        Costa Rica</option>
             <option value="Cote d'ivoire" >
                        Cote d'ivoire</option>
             <option value="Croatia (Hrvatska)" >
                        Croatia (Hrvatska)</option>
             <option value="Cuba" >
                        Cuba</option>
             <option value="Cyprus" >
                        Cyprus</option>
             <option value="Czech Republic" >
                        Czech Republic</option>
             <option value="Denmark" >
                        Denmark</option>
             <option value="Djibouti" >
                        Djibouti</option>
             <option value="Dominica" >
                        Dominica</option>
             <option value="Dominican Republic" >
                        Dominican Republic</option>
             <option value="East Timor" >
                        East Timor</option>
             <option value="Ecuador" >
                        Ecuador</option>
             <option value="Egypt" >
                        Egypt</option>
             <option value="El Salvador" >
                        El Salvador</option>
             <option value="Equatorial Guinea" >
                        Equatorial Guinea</option>
             <option value="Eritrea" >
                        Eritrea</option>
             <option value="Estonia" >
                        Estonia</option>
             <option value="Ethiopia" >
                        Ethiopia</option>
             <option value="Falkland Islands (Malvinas)" >
                        Falkland Islands (Malvinas)</option>
             <option value="Faroe islands" >
                        Faroe islands</option>
             <option value="Fiji" >
                        Fiji</option>
             <option value="Finland" >
                        Finland</option>
             <option value="France" >
                        France</option>
             <option value="France, Metropolitan" >
                        France, Metropolitan</option>
             <option value="French Guiana" >
                        French Guiana</option>
             <option value="French Polynesia" >
                        French Polynesia</option>
             <option value="French Southern Territories" >
                        French Southern Territories</option>
             <option value="Gabon" >
                        Gabon</option>
             <option value="Gambia" >
                        Gambia</option>
             <option value="Georgia" >
                        Georgia</option>
             <option value="Germany" >
                        Germany</option>
             <option value="Ghana" >
                        Ghana</option>
             <option value="Gibraltar" >
                        Gibraltar</option>
             <option value="Greece" >
                        Greece</option>
             <option value="Greenland" >
                        Greenland</option>
             <option value="Grenada" >
                        Grenada</option>
             <option value="Guadeloupe" >
                        Guadeloupe</option>
             <option value="Guam" >
                        Guam</option>
             <option value="Guatemala" >
                        Guatemala</option>
             <option value="Guinea" >
                        Guinea</option>
             <option value="Guinea-Bissau" >
                        Guinea-Bissau</option>
             <option value="Guyana" >
                        Guyana</option>
             <option value="Haiti" >
                        Haiti</option>
             <option value="Heard and Mc Donald Islands" >
                        Heard and Mc Donald Islands</option>
             <option value="Holy See (Vatican City State)" >
                        Holy See (Vatican City State)</option>
             <option value="Honduras" >
                        Honduras</option>
             <option value="Hong Kong" >
                        Hong Kong</option>
             <option value="Hungary" >
                        Hungary</option>
             <option value="Iceland" >
                        Iceland</option>
             <option value="India" >
                        India</option>
             <option value="Indonesia" >
                        Indonesia</option>
             <option value="Iran (Islamic Republic of)" >
                        Iran (Islamic Republic of)</option>
             <option value="Iraq" >
                        Iraq</option>
             <option value="Ireland" >
                        Ireland</option>
             <option value="Israel" >
                        Israel</option>
             <option value="Italy" >
                        Italy</option>
             <option value="Jamaica" >
                        Jamaica</option>
             <option value="Japan" >
                        Japan</option>
             <option value="Jordan" >
                        Jordan</option>
             <option value="Kazakhstan" >
                        Kazakhstan</option>
             <option value="Kenya" >
                        Kenya</option>
             <option value="Kiribati" >
                        Kiribati</option>
             <option value="Korea, Democratic People's Republic" >
                        Korea, Democratic People's Republic</option>
             <option value="Korea, Republic of" >
                        Korea, Republic of</option>
             <option value="Kuwait" >
                        Kuwait</option>
             <option value="Kyrgyzstan" >
                        Kyrgyzstan</option>
             <option value="Lao People's Democratic Republic" >
                        Lao People's Democratic Republic</option>
             <option value="Latvia" >
                        Latvia</option>
             <option value="Lebanon" >
                        Lebanon</option>
             <option value="Lesotho" >
                        Lesotho</option>
             <option value="Liberia" >
                        Liberia</option>
             <option value="Libyan Arab Jamahiriya" >
                        Libyan Arab Jamahiriya</option>
             <option value="Liechtenstein" >
                        Liechtenstein</option>
             <option value="Lithuania" >
                        Lithuania</option>
             <option value="Luxembourg" >
                        Luxembourg</option>
             <option value="Macau" >
                        Macau</option>
             <option value="Macedonia (Yugoslav Republic)" >
                        Macedonia (Yugoslav Republic)</option>
             <option value="Madagascar" >
                        Madagascar</option>
             <option value="Malawi" >
                        Malawi</option>
             <option value="Malaysia" >
                       Malaysia</option>
             <option value="Maldives" >
                        Maldives</option>
             <option value="Mali" >
                        Mali</option>
             <option value="Malta" >
                        Malta</option>
             <option value="Marshall Islands" >
                        Marshall Islands</option>
             <option value="Martinique" >
                        Martinique</option>
             <option value="Mauritania" >
                        Mauritania</option>
             <option value="Mauritius" >
                        Mauritius</option>
             <option value="Mayotte" >
                        Mayotte</option>
             <option value="Mexico" >
                        Mexico</option>
             <option value="Micronesia" >
                        Micronesia</option>
             <option value="Moldova" >
                        Moldova</option>
             <option value="Monaco" >
                        Monaco</option>
             <option value="Mongolia" >
                        Mongolia</option>
             <option value="Montserrat" >
                        Montserrat</option>
             <option value="Morocco" >
                        Morocco</option>
             <option value="Mozambique" >
                        Mozambique</option>
             <option value="Myanmar" >
                        Myanmar</option>
             <option value="Namibia" >
                        Namibia</option>
             <option value="Nauru" >
                        Nauru</option>
             <option value="Nepal" >
                        Nepal</option>
             <option value="Netherlands" >
                        Netherlands</option>
             <option value="Netherlands Antilles" >
                        Netherlands Antilles</option>
             <option value="New Caledonia" >
                        New Caledonia</option>
             <option value="New Zealand" >
                        New Zealand</option>
             <option value="Nicaragua" >
                        Nicaragua</option>
             <option value="Niger" >
                        Niger</option>
             <option value="Nigeria" >
                        Nigeria</option>
             <option value="Niue" >
                        Niue</option>
             <option value="Norfolk island" >
                        Norfolk island</option>
             <option value="Northern Mariana Islands" >
                        Northern Mariana Islands</option>
             <option value="Norway" >
                        Norway</option>
             <option value="Oman" >
                        Oman</option>
             <option value="Pakistan" >
                        Pakistan</option>
             <option value="Palau" >
                        Palau</option>
             <option value="Panama" >
                        Panama</option>
             <option value="Papua New Guinea" >
                        Papua New Guinea</option>
             <option value="Paraguay" >
                        Paraguay</option>
             <option value="Peru" >
                        Peru</option>
             <option value="Philippines" >
                        Philippines</option>
             <option value="Pitcairn" >
                        Pitcairn</option>
             <option value="Poland" >
                        Poland</option>
             <option value="Portugal" >
                        Portugal</option>
             <option value="Puerto Rico" >
                        Puerto Rico</option>
             <option value="Qatar" >
                        Qatar</option>
             <option value="Reunion" >
                        Reunion</option>
             <option value="Romania" >
                        Romania</option>
             <option value="Russian Federation" >
                        Russian Federation</option>
             <option value="Rwanda" >
                        Rwanda</option>
             <option value="Saint Kitts and Nevis" >
                        Saint Kitts and Nevis</option>
             <option value="Saint Lucia" >
                        Saint Lucia</option>
             <option value="Saint Vincent and the Grenadines" >
                        Saint Vincent and the Grenadines</option>
             <option value="Samoa" >
                        Samoa</option>
             <option value="San Marino" >
                        San Marino</option>
             <option value="Sao Tome and Principe" >
                        Sao Tome and Principe</option>
             <option value="Saudi Arabia" >
                        Saudi Arabia</option>
             <option value="Senegal" >
                        Senegal</option>
             <option value="Seychelles" >
                        Seychelles</option>
             <option value="Sierra Leone" >
                        Sierra Leone</option>
             <option value="Singapore" >
                        Singapore</option>
             <option value="Slovakia (Slovak Republic)" >
                        Slovakia (Slovak Republic)</option>
             <option value="Slovenia" >
                        Slovenia</option>
             <option value="Solomon Islands" >
                        Solomon Islands</option>
             <option value="Somalia" >
                        Somalia</option>
             <option value="South Africa" >
                        South Africa</option>
             <option value="South Georgia" >
                        South Georgia</option>
             <option value="Spain" >
                        Spain</option>
             <option value="Sri Lanka" >
                        Sri Lanka</option>
             <option value="St Helena" >
                        St Helena</option>
             <option value="St Pierre and Miquelon" >
                        St Pierre and Miquelon</option>
             <option value="Sudan" >
                        Sudan</option>
             <option value="Suriname" >
                        Suriname</option>
             <option value="Svalbard and Jan Mayen Islands" >
                        Svalbard and Jan Mayen Islands</option>
             <option value="Swaziland" >
                        Swaziland</option>
             <option value="Sweden" >
                        Sweden</option>
             <option value="Switzerland" >
                        Switzerland</option>
             <option value="Syrian Arab Republic" >
                        Syrian Arab Republic</option>
             <option value="Taiwan" >
                        Taiwan</option>
             <option value="Tajikistan" >
                        Tajikistan</option>
             <option value="Tanzania, United Republic of" >
                        Tanzania, United Republic of</option>
             <option value="Thailand" >
                        Thailand</option>
             <option value="Togo" >
                        Togo</option>
             <option value="Tokelau" >
                        Tokelau</option>
             <option value="Tonga" >
                        Tonga</option>
             <option value="Trinidad and Tobago" >
                        Trinidad and Tobago</option>
             <option value="Tunisia" >
                        Tunisia</option>
             <option value="Turkey" >
                        Turkey</option>
             <option value="Turkmenistan" >
                        Turkmenistan</option>
             <option value="Turks and Caicos Islands" >
                        Turks and Caicos Islands</option>
             <option value="Tuvalu" >
                        Tuvalu</option>
             <option value="Uganda" >
                        Uganda</option>
             <option value="Ukraine" >
                        Ukraine</option>
             <option value="United Arab Emirates" >
                        United Arab Emirates</option>
             <option value="United Kingdom" >
                        United Kingdom</option>
             <option value="United States" >
                        United States</option>
             <option value="Uruguay" >
                        Uruguay</option>
             <option value="Uzbekistan" >
                        Uzbekistan</option>
             <option value="Vanuatu" >
                        Vanuatu</option>
             <option value="Venezuela" >
                        Venezuela</option>
             <option value="Vietnam" >
                        Vietnam</option>
             <option value="Virgin Islands (British)" >
                        Virgin Islands (British)</option>
             <option value="Virgin Islands (US)" >
                        Virgin Islands (US)</option>
             <option value="Wallis and Futuna Islands" >
                        Wallis and Futuna Islands</option>
             <option value="Western Sahara" >
                        Western Sahara</option>
             <option value="Yemen" >
                        Yemen</option>
             <option value="Yugoslavia" >
                        Yugoslavia</option>
             <option value="Zambia" >
                        Zambia</option>
             <option value="Zimbabwe" >
                        Zimbabwe</option>
            </select></td>
      </tr>
      
	  <tr><td  align="left" valign="baseline">Inter Driver's Licence No.</td>
        <td ><input name="Int_License" value="" type="Text" size="16"><img src="images/spacer.gif" width="57" height="1" border="0">Country 
          <select name="Int_License_Country_Issue"  onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chHomePhone1.focus()};"><option value=""></option>
            <option value="Afghanistan" >
                        Afghanistan</option>
<option value="Albania" >
                        Albania</option>
<option value="Algeria" >
                        Algeria</option>
<option value="American Samoa" >
                        American Samoa</option>
<option value="Andorra" >
                        Andorra</option>
<option value="Angola" >
                        Angola</option>
<option value="Anguilla" >
                        Anguilla</option>
<option value="Antarctica" >
                        Antarctica</option>
<option value="Antigua and Barbuda" >
                        Antigua and Barbuda</option>
<option value="Argentina" >
                        Argentina</option>
<option value="Armenia" >
                        Armenia</option>
<option value="Aruba" >
                        Aruba</option>
<option value="Austria" >
                        Austria</option>
<option value="Azerbaijan" >
                        Azerbaijan</option>
<option value="Bahamas" >
                        Bahamas</option>
<option value="Bahrain" >
                        Bahrain</option>
<option value="Bangladesh" >
                        Bangladesh</option>
<option value="Barbados" >
                        Barbados</option>
<option value="Belarus" >
                        Belarus</option>
<option value="Belgium" >
                        Belgium</option>
<option value="Belize" >
                        Belize</option>
<option value="Benin" >
                        Benin</option>
<option value="Bermuda" >
                        Bermuda</option>
<option value="Bhutan" >
                        Bhutan</option>
<option value="Bolivia" >
                        Bolivia</option>
<option value="Bosnia and Herzegowina" >
                        Bosnia and Herzegowina</option>
<option value="Botswana" >
                        Botswana</option>
<option value="Bouvet Island" >
                        Bouvet Island</option>
<option value="Brazil" >
                        Brazil</option>
<option value="British Indian Ocean Territory" >
                        British Indian Ocean Territory</option>
<option value="Brunei Darussalam" >
                        Brunei Darussalam</option>
<option value="Bulgaria" >
                        Bulgaria</option>
<option value="Burkina Faso" >
                        Burkina Faso</option>
<option value="Burundi" >
                        Burundi</option>
<option value="Cambodia" >
                        Cambodia</option>
<option value="Cameroon" >
                        Cameroon</option>
<option value="Canada" >
                        Canada</option>
<option value="Cape Verde" >
                        Cape Verde</option>
<option value="Cayman islands" >
                        Cayman islands</option>
<option value="Central African Republic" >
                        Central African Republic</option>
<option value="Chad" >
                        Chad</option>
<option value="Chile" >
                        Chile</option>
<option value="China" >
                        China</option>
<option value="Christmas Island" >
                        Christmas Island</option>
<option value="Cocos (Keeling) Islands" >
                        Cocos (Keeling) Islands</option>
<option value="Colombia" >
                        Colombia</option>
<option value="Comoros" >
                        Comoros</option>
<option value="Congo" >
                        Congo</option>
<option value="Congo, Democratic Republic" >
                        Congo, Democratic Republic</option>
<option value="Cook Islands" >
                        Cook Islands</option>
<option value="Costa Rica" >
                        Costa Rica</option>
<option value="Cote d'ivoire" >
                        Cote d'ivoire</option>
<option value="Croatia (Hrvatska)" >
                        Croatia (Hrvatska)</option>
<option value="Cuba" >
                        Cuba</option>
<option value="Cyprus" >
                        Cyprus</option>
<option value="Czech Republic" >
                        Czech Republic</option>
<option value="Denmark" >
                        Denmark</option>
<option value="Djibouti" >
                        Djibouti</option>
<option value="Dominica" >
                        Dominica</option>
<option value="Dominican Republic" >
                        Dominican Republic</option>
<option value="East Timor" >
                        East Timor</option>
<option value="Ecuador" >
                        Ecuador</option>
<option value="Egypt" >
                        Egypt</option>
<option value="El Salvador" >
                        El Salvador</option>
<option value="Equatorial Guinea" >
                        Equatorial Guinea</option>
<option value="Eritrea" >
                        Eritrea</option>
<option value="Estonia" >
                        Estonia</option>
<option value="Ethiopia" >
                        Ethiopia</option>
<option value="Falkland Islands (Malvinas)" >
                        Falkland Islands (Malvinas)</option>
<option value="Faroe islands" >
                        Faroe islands</option>
<option value="Fiji" >
                        Fiji</option>
<option value="Finland" >
                        Finland</option>
<option value="France" >
                        France</option>
<option value="France, Metropolitan" >
                        France, Metropolitan</option>
<option value="French Guiana" >
                        French Guiana</option>
<option value="French Polynesia" >
                        French Polynesia</option>
<option value="French Southern Territories" >
                        French Southern Territories</option>
<option value="Gabon" >
                        Gabon</option>
<option value="Gambia" >
                        Gambia</option>
<option value="Georgia" >
                        Georgia</option>
<option value="Germany" >
                        Germany</option>
<option value="Ghana" >
                        Ghana</option>
<option value="Gibraltar" >
                        Gibraltar</option>
<option value="Greece" >
                        Greece</option>
<option value="Greenland" >
                        Greenland</option>
<option value="Grenada" >
                        Grenada</option>
<option value="Guadeloupe" >
                        Guadeloupe</option>
<option value="Guam" >
                        Guam</option>
<option value="Guatemala" >
                        Guatemala</option>
<option value="Guinea" >
                        Guinea</option>
<option value="Guinea-Bissau" >
                        Guinea-Bissau</option>
<option value="Guyana" >
                        Guyana</option>
<option value="Haiti" >
                        Haiti</option>
<option value="Heard and Mc Donald Islands" >
                        Heard and Mc Donald Islands</option>
<option value="Holy See (Vatican City State)" >
                        Holy See (Vatican City State)</option>
<option value="Honduras" >
                        Honduras</option>
<option value="Hong Kong" >
                        Hong Kong</option>
<option value="Hungary" >
                        Hungary</option>
<option value="Iceland" >
                        Iceland</option>
<option value="India" >
                        India</option>
<option value="Indonesia" >
                        Indonesia</option>
<option value="Iran (Islamic Republic of)" >
                        Iran (Islamic Republic of)</option>
<option value="Iraq" >
                        Iraq</option>
<option value="Ireland" >
                        Ireland</option>
<option value="Israel" >
                        Israel</option>
<option value="Italy" >
                        Italy</option>
<option value="Jamaica" >
                        Jamaica</option>
<option value="Japan" >
                        Japan</option>
<option value="Jordan" >
                        Jordan</option>
<option value="Kazakhstan" >
                        Kazakhstan</option>
<option value="Kenya" >
                        Kenya</option>
<option value="Kiribati" >
                        Kiribati</option>
<option value="Korea, Democratic People's Republic" >
                        Korea, Democratic People's Republic</option>
<option value="Korea, Republic of" >
                        Korea, Republic of</option>
<option value="Kuwait" >
                        Kuwait</option>
<option value="Kyrgyzstan" >
                        Kyrgyzstan</option>
<option value="Lao People's Democratic Republic" >
                        Lao People's Democratic Republic</option>
<option value="Latvia" >
                        Latvia</option>
<option value="Lebanon" >
                        Lebanon</option>
<option value="Lesotho" >
                        Lesotho</option>
<option value="Liberia" >
                        Liberia</option>
<option value="Libyan Arab Jamahiriya" >
                        Libyan Arab Jamahiriya</option>
<option value="Liechtenstein" >
                        Liechtenstein</option>
<option value="Lithuania" >
                        Lithuania</option>
<option value="Luxembourg" >
                        Luxembourg</option>
<option value="Macau" >
                        Macau</option>
<option value="Macedonia (Yugoslav Republic)" >
                        Macedonia (Yugoslav Republic)</option>
<option value="Madagascar" >
                        Madagascar</option>
<option value="Malawi" >
                        Malawi</option>
<option value="Malaysia" >
                        Malaysia</option>
<option value="Maldives" >
                        Maldives</option>
<option value="Mali" >
                        Mali</option>
<option value="Malta" >
                        Malta</option>
<option value="Marshall Islands" >
                        Marshall Islands</option>
<option value="Martinique" >
                        Martinique</option>
<option value="Mauritania" >
                        Mauritania</option>
<option value="Mauritius" >
                        Mauritius</option>
<option value="Mayotte" >
                        Mayotte</option>
<option value="Mexico" >
                        Mexico</option>
<option value="Micronesia" >
                        Micronesia</option>
<option value="Moldova" >
                        Moldova</option>
<option value="Monaco" >
                        Monaco</option>
<option value="Mongolia" >
                        Mongolia</option>
<option value="Montserrat" >
                        Montserrat</option>
<option value="Morocco" >
                        Morocco</option>
<option value="Mozambique" >
                        Mozambique</option>
<option value="Myanmar" >
                        Myanmar</option>
<option value="Namibia" >
                        Namibia</option>
<option value="Nauru" >
                        Nauru</option>
<option value="Nepal" >
                        Nepal</option>
<option value="Netherlands" >
                        Netherlands</option>
<option value="Netherlands Antilles" >
                        Netherlands Antilles</option>
<option value="New Caledonia" >
                        New Caledonia</option>
<option value="New Zealand" >
                        New Zealand</option>
<option value="Nicaragua" >
                        Nicaragua</option>
<option value="Niger" >
                        Niger</option>
<option value="Nigeria" >
                        Nigeria</option>
<option value="Niue" >
                        Niue</option>
<option value="Norfolk island" >
                        Norfolk island</option>
<option value="Northern Mariana Islands" >
                        Northern Mariana Islands</option>
<option value="Norway" >
                       Norway</option>
<option value="Oman" >
                        Oman</option>
<option value="Pakistan" >
                        Pakistan</option>
<option value="Palau" >
                        Palau</option>
<option value="Panama" >
                        Panama</option>
<option value="Papua New Guinea" >
                        Papua New Guinea</option>
<option value="Paraguay" >
                        Paraguay</option>
<option value="Peru" >
                        Peru</option>
<option value="Philippines" >
                        Philippines</option>
<option value="Pitcairn" >
                        Pitcairn</option>
<option value="Poland" >
                        Poland</option>
<option value="Portugal" >
                        Portugal</option>
<option value="Puerto Rico" >
                        Puerto Rico</option>
<option value="Qatar" >
                        Qatar</option>
<option value="Reunion" >
                        Reunion</option>
<option value="Romania" >
                        Romania</option>
<option value="Russian Federation" >
                        Russian Federation</option>
<option value="Rwanda" >
                        Rwanda</option>
<option value="Saint Kitts and Nevis" >
                        Saint Kitts and Nevis</option>
<option value="Saint Lucia" >
                        Saint Lucia</option>
<option value="Saint Vincent and the Grenadines" >
                        Saint Vincent and the Grenadines</option>
<option value="Samoa" >
                        Samoa</option>
<option value="San Marino" >
                        San Marino</option>
<option value="Sao Tome and Principe" >
                        Sao Tome and Principe</option>
<option value="Saudi Arabia" >
                        Saudi Arabia</option>
<option value="Senegal" >
                        Senegal</option>
<option value="Seychelles" >
                        Seychelles</option>
<option value="Sierra Leone" >
                        Sierra Leone</option>
<option value="Singapore" >
                        Singapore</option>
<option value="Slovakia (Slovak Republic)" >
                        Slovakia (Slovak Republic)</option>
<option value="Slovenia" >
                        Slovenia</option>
<option value="Solomon Islands" >
                        Solomon Islands</option>
<option value="Somalia" >
                        Somalia</option>
<option value="South Africa" >
                        South Africa</option>
<option value="South Georgia" >
                        South Georgia</option>
<option value="Spain" >
                        Spain</option>
<option value="Sri Lanka" >
                        Sri Lanka</option>
<option value="St Helena" >
                        St Helena</option>
<option value="St Pierre and Miquelon" >
                        St Pierre and Miquelon</option>
<option value="Sudan" >
                        Sudan</option>
<option value="Suriname" >
                        Suriname</option>
<option value="Svalbard and Jan Mayen Islands" >
                        Svalbard and Jan Mayen Islands</option>
<option value="Swaziland" >
                        Swaziland</option>
<option value="Sweden" >
                        Sweden</option>
<option value="Switzerland" >
                        Switzerland</option>
<option value="Syrian Arab Republic" >
                        Syrian Arab Republic</option>
<option value="Taiwan" >
                        Taiwan</option>
<option value="Tajikistan" >
                        Tajikistan</option>
<option value="Tanzania, United Republic of" >
                        Tanzania, United Republic of</option>
<option value="Thailand" >
                        Thailand</option>
<option value="Togo" >
                        Togo</option>
<option value="Tokelau" >
                        Tokelau</option>
<option value="Tonga" >
                        Tonga</option>
<option value="Trinidad and Tobago" >
                        Trinidad and Tobago</option>
<option value="Tunisia" >
                        Tunisia</option>
<option value="Turkey" >
                        Turkey</option>
<option value="Turkmenistan" >
                        Turkmenistan</option>
<option value="Turks and Caicos Islands" >
                        Turks and Caicos Islands</option>
<option value="Tuvalu" >
                        Tuvalu</option>
<option value="Uganda" >
                        Uganda</option>
<option value="Ukraine" >
                        Ukraine</option>
<option value="United Arab Emirates" >
                        United Arab Emirates</option>
<option value="United Kingdom" >
                        United Kingdom</option>
<option value="United States" >
                        United States</option>
<option value="Uruguay" >
                        Uruguay</option>
<option value="Uzbekistan" >
                        Uzbekistan</option>
<option value="Vanuatu" >
                        Vanuatu</option>
<option value="Venezuela" >
                        Venezuela</option>
<option value="Vietnam" >
                        Vietnam</option>
<option value="Virgin Islands (British)" >
                        Virgin Islands (British)</option>
<option value="Virgin Islands (US)" >
                        Virgin Islands (US)</option>
<option value="Wallis and Futuna Islands" >
                        Wallis and Futuna Islands</option>
<option value="Western Sahara" >
                        Western Sahara</option>
<option value="Yemen" >
                        Yemen</option>
<option value="Yugoslavia" >
                        Yugoslavia</option>
<option value="Zambia" >
                        Zambia</option>
<option value="Zimbabwe" >
                        Zimbabwe</option>
</select></td>
      </tr>
      
      <tr> 
         <td align="left">Home Phone</td>
        <td ><select name="Home_Phone_One" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){Home_Phone_Two.focus()};" id="chHomePhone1">
		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>		
		  </select>
			  <input type="text" name="Home_Phone_Two" value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){Home_Phone_Three.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			  <input type="text" name="Home_Phone_Three" value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){Mobile_Phone_One.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			 <img src="images/spacer.gif" width="45" height="1" border="0">Mobile 
			 <input type="text" name="Mobile_Phone_One" value=""  size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){Mobile_Phone_Two.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	

		  <input type="text" name="Mobile_Phone_Two" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){Mobile_Phone_Three.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="Mobile_Phone_Three" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chEmail.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

	  &nbsp;         
		</td>
      </tr>
    
     <tr> 
         <td align="left">Email</td>
        <td ><input name="Email" value="" maxlength="50"  type="Text" style="width:199px;" onBlur="checkEmail(this);">         
		</td>
      </tr>
  
      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 
        <tr>
	  	<td align="left" width="171" class="navytext"><strong>PERSONAL DETAILS:</strong></td>
        <td>&nbsp;</td>
	  </tr> 
      
      <tr>
	  	<td align="left" width="171">Bank Name</td>
        <td  width="568"><input name="Bank_Name"  value=""  type="text" size="16" maxlength="50">&nbsp;&nbsp;&nbsp;BSB <input name="Bank_BSB" value=""  type="Text" size="4" maxlength="6">&nbsp;&nbsp;&nbsp;Acc No <input name="Bank_Acc_No" value=""  type="Text" size="6" maxlength="10"></td>
	  </tr>
      
       <tr>
	  	<td align="left" width="171">Bankrupt</td>
        <td  width="568">
		<input name="Bankrupt" class="formcheckbox" type="Radio"  value="Yes" maxlength="50" checked="true" > Yes<img src="images/spacer.gif" width="62" height="1" border="0"><input class="formcheckbox" name="isBankrupt" type="Radio"  value="No" checked="true"> No</td>
	  </tr>
      
        <tr>
	  	<td align="left" width="171">Preferred payment of rent</td>
        <td  width="568">
		<input name="Rent_Payment_Period" maxlength="50" checked="true" class="formcheckbox" type="Radio" value="Weekly"> Weekly<img src="images/spacer.gif" width="44" height="1" border="0"><input name="chRentPaymentPeriod" class="formcheckbox" type="Radio" value="Fortnightly" > Fortnightly<img src="images/spacer.gif" width="44" height="1" border="0"><input  class="formcheckbox" name="chRentPaymentPeriod" type="Radio" value="Monthly" > Monthly</td>
	  </tr>
      
      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr>   
       <tr><td class="navytext"><strong>EMPLOYMENT HISTORY:</strong></td>
		 <td valign="Bottom" >&nbsp;</td>
      </tr> 
       <tr>
		 <td class="navytext"><strong>Current Employment: <span class="redstar">*</span> </strong></td>
		 <td valign="Bottom" ><input type="checkbox" name="isUnemployed"  class="formcheckbox" value="1" onClick="setEmploymentNode(this.checked)"><span class="searchgreentext"> Tick the box if the applicant is unemployed</span></td>
      </tr>   
     
	   <tr> 
         <td align="left"  width="171"><div id="objEmploymentNode">Job Title</div></td>
         <td valign="Bottom"   width="568"> <div id="objEmploymentNode2"><input name="Employer_Job_Title" value=""  type="Text" size="34" maxlength="50">
         Employment Type<img src="images/spacer.gif" width="58" height="1" border="0"> <select name="Employment_Type" style="width:80px" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chEmployerCompany.focus()};">
            <option value="null" SELECTED>(Select)</option>
            <option value="Full time" >Full time</option> 
			<option value="Part time" >Part time</option>
			<option value="Casual" >Casual</option>
          </select>
         </div></td>
      </tr>
      
      <tr> 
        <td align="left"  width="171"><div id="objEmploymentNode3">Employer's Company Name</div></td>
        <td valign="Bottom"   width="568"><div id="objEmploymentNode4"><input name="Employer_Company" value="" type="Text" size="34" maxlength="128"> Employer's Phone No. <input name="Employer_Phone_Number" value="" type="Text" size="16" maxlength="50"></div></td>
      </tr>
	 
       <tr> 
         <td align="left"><div id="objEmploymentNode15">Manager's Name</div></td>
        <td><div id="objEmploymentNode16"><input name="Managers_Name" value="" type="Text" maxlength="100" size="34"></div></td>
      </tr> 
       
      <tr> 
         <td align="left"  width="171"><div id="objEmploymentNode5">Employer's Address</div></td>
        <td valign="Bottom"  width="568"><div id="objEmploymentNode6"><input name="Employer_Address" value=""  type="Text" size="34"></div></td>
      </tr>
      
      <tr> 
         <td align="left"  width="171"><div id="objEmploymentNode7">Suburb</div></td>
        <td  width="568"><div id="objEmploymentNode8"><input name="Employer_Suburb" value=""  type="Text" size="16"> State<img src="images/spacer.gif" width="4" height="1" border="0"><select name="chEmployerState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chEmployerPostcode.focus()};"><option value="null" ></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>
          </select> 
        Postcode<img src="images/spacer.gif" width="18" height="1" border="0"><input name="Employer_Postcode" value=""  type="Text" size="4" maxlength="4">&nbsp;</div></td>
      </tr>
      	 
      <tr> 
         <td align="left"><div id="objEmploymentNode9">Work Phone</div></td>
        <td ><div id="objEmploymentNode10"><select name="chWorkPhone1" id="chWorkPhone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chWorkPhone2.focus()};">
		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>			
		  </select>

			  <input type="text" name="chWorkPhone2" value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chWorkPhone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">
			  <input type="text" name="chWorkPhone3" value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chWorkMobilePhone1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			 Work Mobile<img src="images/spacer.gif" height="1" width="10" border="0"><input type="text" name="chWorkMobilePhone1" value="" size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chWorkMobilePhone2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	

		  <input type="text" name="chWorkMobilePhone2" value=""  size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chWorkMobilePhone3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="chWorkMobilePhone3" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chWorkEmail.focus()};" onBlur="checkNumeric(this,1,'','','','','');"></div>
		</td>
      </tr>
      	 
      <tr> 
         <td align="left"><div id="objEmploymentNode11">Work Email</div></td>
        <td><div id="objEmploymentNode12"><input name="Work_Email" type="Text"  value="" style="width:199px;" onBlur="checkEmail(this);">
           Net income<img src="images/spacer.gif" height="1" width="60" border="0"><input name="Net_Income" maxlength="50"  value=""  type="Text" size="16">
          </div>
		</td>
      </tr>
      	 
        <tr> 
         <td align="left"><div id="objEmploymentNode13">Length of Employment</div></td>
        <td><div id="objEmploymentNode14"><input name="Length_Of_Employment" value="" type="Text" maxlength="50" style="width:199px;" > Commenced<img src="images/spacer.gif" height="1" width="11" border="0">
            <select name="dtEmploymentDateCommenced_dd" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtEmploymentDateCommenced_mm.focus()};">
                <option value="null" >
				<option value="1" >1<option value="2" >2<option value="3" >3<option value="4" >4<option value="5" >5<option value="6" >6<option value="7" >7<option value="8" >8<option value="9" >9<option value="10" >10<option value="11" >11<option value="12" >12<option value="13" >13<option value="14" >14<option value="15" >15<option value="16" >16<option value="17" >17<option value="18" >18<option value="19" >19<option value="20" >20<option value="21" >21<option value="22" >22<option value="23" >23<option value="24" >24<option value="25" >25<option value="26" >26<option value="27" >27<option value="28" >28<option value="29" >29<option value="30" >30<option value="31" >31
           </select>         
           <select name="dtEmploymentDateCommenced_mm" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtEmploymentDateCommenced_yyyy.focus()};">
                <option value="null" >
				<option value="1" >Jan<option value="2" >Feb<option value="3" >Mar<option value="4" >Apr<option value="5" >May<option value="6" >Jun<option value="7" >Jul<option value="8" >Aug<option value="9" >Sep<option value="10" >Oct<option value="11" >Nov<option value="12" >Dec
           </select>

           <select name="dtEmploymentDateCommenced_yyyy" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousEmployerJobTitle.focus()};">
                <option value="null" >
                <option value="2011" >2011<option value="2010" >2010<option value="2009" >2009<option value="2008" >2008<option value="2007" >2007<option value="2006" >2006<option value="2005" >2005<option value="2004" >2004<option value="2003" >2003<option value="2002" >2002<option value="2001" >2001<option value="2000" >2000<option value="1999" >1999<option value="1998" >1998<option value="1997" >1997<option value="1996" >1996<option value="1995" >1995<option value="1994" >1994<option value="1993" >1993<option value="1992" >1992<option value="1991" >1991<option value="1990" >1990<option value="1989" >1989<option value="1988" >1988<option value="1987" >1987<option value="1986" >1986<option value="1985" >1985<option value="1984" >1984<option value="1983" >1983<option value="1982" >1982<option value="1981" >1981<option value="1980" >1980<option value="1979" >1979<option value="1978" >1978<option value="1977" >1977<option value="1976" >1976<option value="1975" >1975<option value="1974" >1974<option value="1973" >1973<option value="1972" >1972<option value="1971" >1971<option value="1970" >1970<option value="1969" >1969<option value="1968" >1968<option value="1967" >1967<option value="1966" >1966<option value="1965" >1965<option value="1964" >1964<option value="1963" >1963<option value="1962" >1962<option value="1961" >1961<option value="1960" >1960<option value="1959" >1959<option value="1958" >1958<option value="1957" >1957<option value="1956" >1956<option value="1955" >1955<option value="1954" >1954<option value="1953" >1953<option value="1952" >1952<option value="1951" >1951<option value="1950" >1950<option value="1949" >1949<option value="1948" >1948<option value="1947" >1947<option value="1946" >1946<option value="1945" >1945<option value="1944" >1944<option value="1943" >1943<option value="1942" >1942<option value="1941" >1941<option value="1940" >1940<option value="1939" >1939<option value="1938" >1938<option value="1937" >1937<option value="1936" >1936<option value="1935" >1935<option value="1934" >1934<option value="1933" >1933<option value="1932" >1932<option value="1931" >1931<option value="1930" >1930<option value="1929" >1929<option value="1928" >1928<option value="1927" >1927<option value="1926" >1926<option value="1925" >1925<option value="1924" >1924<option value="1923" >1923<option value="1922" >1922<option value="1921" >1921<option value="1920" >1920<option value="1919" >1919<option value="1918" >1918<option value="1917" >1917<option value="1916" >1916<option value="1915" >1915<option value="1914" >1914<option value="1913" >1913<option value="1912" >1912<option value="1911" >1911
                </select></div>
		</td>
      </tr>
      
       <tr>
         <td class="navytext" colspan="2"><strong>Previous Employment if less than 3 years:</strong></td>
       </tr>   

   <tr> 
         <td align="left"  width="171">Job Title</td>
         <td valign="Bottom" width="568"><input name="Previous_Employer_JobTitle" value=""  type="Text" size="34" maxlength="50"></td>
      </tr>
     	 
      <tr> 
        <td align="left"  width="171">Employer's Company Name</td>
        <td valign="Bottom"   width="568"><input name="Previous_Employer_Company" value=""  type="Text" size="34" maxlength="50"></td>
      </tr>
      	 
      <tr> 
         <td align="left"  width="171">Employer's Address</td>
        <td valign="Bottom"  width="568"><input name="Previous_Employer_Address" value=""  type="Text" size="34" maxlength="50"></td>
      </tr>
   	 
      <tr> 
         <td align="left"  width="171">Suburb</td>
        <td  width="568"><input name="Previous_Employer_Suburb" value=""  type="Text" size="16" maxlength="50"> State<img src="images/spacer.gif" width="4" height="1" border="0"><select name="chPreviousEmployerState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousEmployerPostcode.focus()};"><option value="null" ></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>
          </select> 

        Postcode<img src="images/spacer.gif" width="18" height="1" border="0"><input name="Previous_Employer_Postcode" value="" type="Text" size="4" maxlength="4">&nbsp;</td>
      </tr>
      	 
            <tr> 
         <td align="left">Work Phone</td>
        <td ><select name="chPreviousWorkPhone1" id="chPreviousWorkPhone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousWorkPhone2.focus()};">

		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>			
		  </select>

			  <input type="text" name="chPreviousWorkPhone2" value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousWorkPhone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			  <input type="text" name="chPreviousWorkPhone3" value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousWorkMobilePhone1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			 Work Mobile<img src="images/spacer.gif" height="1" width="11" border="0"><input type="text" name="chPreviousWorkMobilePhone1" value=""  size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousWorkMobilePhone2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	

		  <input type="text" name="chPreviousWorkMobilePhone2" value=""  size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousWorkMobilePhone3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="chPreviousWorkMobilePhone3" value=""  size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousWorkEmail.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		</td>
      </tr>
     	 
         <tr> 
         <td align="left">Work Email</td>
        <td><input name="Previous_Work_Email" type="Text" value="" style="width:199px;" onBlur="checkEmail(this);" maxlength="50"> 
		</td>
      </tr>

       <tr> 
         <td align="left">Commenced </td>
        <td><select name="dtPreviousEmploymentDateCommenced_dd" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtPreviousEmploymentDateCommenced_mm.focus()};">

                <option value="null" >

				<option value="1" >1<option value="2" >2<option value="3" >3<option value="4" >4<option value="5" >5<option value="6" >6<option value="7" >7<option value="8" >8<option value="9" >9<option value="10" >10<option value="11" >11<option value="12" >12<option value="13" >13<option value="14" >14<option value="15" >15<option value="16" >16<option value="17" >17<option value="18" >18<option value="19" >19<option value="20" >20<option value="21" >21<option value="22" >22<option value="23" >23<option value="24" >24<option value="25" >25<option value="26" >26<option value="27" >27<option value="28" >28<option value="29" >29<option value="30" >30<option value="31" >31
           </select>         

           <select name="dtPreviousEmploymentDateCommenced_mm" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtPreviousEmploymentDateCommenced_yyyy.focus()};">
                <option value="null" >

				<option value="1" >Jan<option value="2" >Feb<option value="3" >Mar<option value="4" >Apr<option value="5" >May<option value="6" >Jun<option value="7" >Jul<option value="8" >Aug<option value="9" >Sep<option value="10" >Oct<option value="11" >Nov<option value="12" >Dec
           </select>

           <select name="dtPreviousEmploymentDateCommenced_yyyy" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtPreviousEmploymentDateTerminated_dd.focus()};">
                <option value="null" >
                <option value="2011" >2011<option value="2010" >2010<option value="2009" >2009<option value="2008" >2008<option value="2007" >2007<option value="2006" >2006<option value="2005" >2005<option value="2004" >2004<option value="2003" >2003<option value="2002" >2002<option value="2001" >2001<option value="2000" >2000<option value="1999" >1999<option value="1998" >1998<option value="1997" >1997<option value="1996" >1996<option value="1995" >1995<option value="1994" >1994<option value="1993" >1993<option value="1992" >1992<option value="1991" >1991<option value="1990" >1990<option value="1989" >1989<option value="1988" >1988<option value="1987" >1987<option value="1986" >1986<option value="1985" >1985<option value="1984" >1984<option value="1983" >1983<option value="1982" >1982<option value="1981" >1981<option value="1980" >1980<option value="1979" >1979<option value="1978" >1978<option value="1977" >1977<option value="1976" >1976<option value="1975" >1975<option value="1974" >1974<option value="1973" >1973<option value="1972" >1972<option value="1971" >1971<option value="1970" >1970<option value="1969" >1969<option value="1968" >1968<option value="1967" >1967<option value="1966" >1966<option value="1965" >1965<option value="1964" >1964<option value="1963" >1963<option value="1962" >1962<option value="1961" >1961<option value="1960" >1960<option value="1959" >1959<option value="1958" >1958<option value="1957" >1957<option value="1956" >1956<option value="1955" >1955<option value="1954" >1954<option value="1953" >1953<option value="1952" >1952<option value="1951" >1951<option value="1950" >1950<option value="1949" >1949<option value="1948" >1948<option value="1947" >1947<option value="1946" >1946<option value="1945" >1945<option value="1944" >1944<option value="1943" >1943<option value="1942" >1942<option value="1941" >1941<option value="1940" >1940<option value="1939" >1939<option value="1938" >1938<option value="1937" >1937<option value="1936" >1936<option value="1935" >1935<option value="1934" >1934<option value="1933" >1933<option value="1932" >1932<option value="1931" >1931<option value="1930" >1930<option value="1929" >1929<option value="1928" >1928<option value="1927" >1927<option value="1926" >1926<option value="1925" >1925<option value="1924" >1924<option value="1923" >1923<option value="1922" >1922<option value="1921" >1921<option value="1920" >1920<option value="1919" >1919<option value="1918" >1918<option value="1917" >1917<option value="1916" >1916<option value="1915" >1915<option value="1914" >1914<option value="1913" >1913<option value="1912" >1912<option value="1911" >1911
          </select> <img src="images/spacer.gif" height="1" width="56" border="0">Terminated<img src="images/spacer.gif" height="1" width="18" border="0">

<select name="dtPreviousEmploymentDateTerminated_dd" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtPreviousEmploymentDateTerminated_mm.focus()};">
                <option value="null" >

				<option value="1" >1<option value="2" >2<option value="3" >3<option value="4" >4<option value="5" >5<option value="6" >6<option value="7" >7<option value="8" >8<option value="9" >9<option value="10" >10<option value="11" >11<option value="12" >12<option value="13" >13<option value="14" >14<option value="15" >15<option value="16" >16<option value="17" >17<option value="18" >18<option value="19" >19<option value="20" >20<option value="21" >21<option value="22" >22<option value="23" >23<option value="24" >24<option value="25" >25<option value="26" >26<option value="27" >27<option value="28" >28<option value="29" >29<option value="30" >30<option value="31" >31
           </select>         

           <select name="dtPreviousEmploymentDateTerminated_mm" size="1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){dtPreviousEmploymentDateTerminated_yyyy.focus()};">
                <option value="null" >

				<option value="1" >Jan<option value="2" >Feb<option value="3" >Mar<option value="4" >Apr<option value="5" >May<option value="6" >Jun<option value="7" >Jul<option value="8" >Aug<option value="9" >Sep<option value="10" >Oct<option value="11" >Nov<option value="12" >Dec
           </select>

           <select name="dtPreviousEmploymentDateTerminated_yyyy" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgencyName.focus()};">
                <option value="null" >

                <option value="2011" >2011<option value="2010" >2010<option value="2009" >2009<option value="2008" >2008<option value="2007" >2007<option value="2006" >2006<option value="2005" >2005<option value="2004" >2004<option value="2003" >2003<option value="2002" >2002<option value="2001" >2001<option value="2000" >2000<option value="1999" >1999<option value="1998" >1998<option value="1997" >1997<option value="1996" >1996<option value="1995" >1995<option value="1994" >1994<option value="1993" >1993<option value="1992" >1992<option value="1991" >1991<option value="1990" >1990<option value="1989" >1989<option value="1988" >1988<option value="1987" >1987<option value="1986" >1986<option value="1985" >1985<option value="1984" >1984<option value="1983" >1983<option value="1982" >1982<option value="1981" >1981<option value="1980" >1980<option value="1979" >1979<option value="1978" >1978<option value="1977" >1977<option value="1976" >1976<option value="1975" >1975<option value="1974" >1974<option value="1973" >1973<option value="1972" >1972<option value="1971" >1971<option value="1970" >1970<option value="1969" >1969<option value="1968" >1968<option value="1967" >1967<option value="1966" >1966<option value="1965" >1965<option value="1964" >1964<option value="1963" >1963<option value="1962" >1962<option value="1961" >1961<option value="1960" >1960<option value="1959" >1959<option value="1958" >1958<option value="1957" >1957<option value="1956" >1956<option value="1955" >1955<option value="1954" >1954<option value="1953" >1953<option value="1952" >1952<option value="1951" >1951<option value="1950" >1950<option value="1949" >1949<option value="1948" >1948<option value="1947" >1947<option value="1946" >1946<option value="1945" >1945<option value="1944" >1944<option value="1943" >1943<option value="1942" >1942<option value="1941" >1941<option value="1940" >1940<option value="1939" >1939<option value="1938" >1938<option value="1937" >1937<option value="1936" >1936<option value="1935" >1935<option value="1934" >1934<option value="1933" >1933<option value="1932" >1932<option value="1931" >1931<option value="1930" >1930<option value="1929" >1929<option value="1928" >1928<option value="1927" >1927<option value="1926" >1926<option value="1925" >1925<option value="1924" >1924<option value="1923" >1923<option value="1922" >1922<option value="1921" >1921<option value="1920" >1920<option value="1919" >1919<option value="1918" >1918<option value="1917" >1917<option value="1916" >1916<option value="1915" >1915<option value="1914" >1914<option value="1913" >1913<option value="1912" >1912<option value="1911" >1911
          </select>  
		</td>
      </tr>
      	 
	<tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

      <tr><td class="navytext"><strong>TENANT HISTORY:</strong></td>
		 <td valign="Bottom" >&nbsp;</td>
      </tr> 

      <tr>
        <td class="navytext" colspan="2"><strong>Contact Details of Current Landlord or Agent: <span class="redstar">*</span> </strong></td>
      </tr> 
      	 
        <tr> 
         <td align="left">Agency Name</td>
        <td><input name="Agency_Name" value="" type="Text" maxlength="100" style="width:436px;"></td>
      </tr> 
      	 
          <tr> 
         <td align="left">Property Manager's Name</td>
        <td><input name="Property_Managers_Name" value="" type="Text" maxlength="100"  style="width:199px;"></td>
      </tr> 

       <tr><td class="navytext" colspan="2"><strong>Or</strong></td>
      </tr>  

        <tr> 
         <td align="left">Landlord's Name</td>
        <td><input name="Land_lord_FirstName"  value="" maxlength="50" type="Text" size="16"> 
        <input name="Land_lord_Surname"  value="" type="Text" maxlength="50" size="16">
		</td>
      </tr> 
     	   
      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr>      
        <tr> 
        <td class="navytext"><b>Address of agent/landlord: <span class="redstar">*</span> </b></td>
		<td class="searchgreentext">
		<input name="Agent_International1"  onClick="setAgentInternationalPresentAddressNode(0)"  class="formcheckbox" checked="true" type="Radio" value="V1"><span class="navytext"> AUSTRALIAN</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input  class="formcheckbox"  onClick="setAgentInternationalPresentAddressNode(1)" name="chAgentInternational" type="Radio" value="V1" checked="true"><span class="navytext"> INTERNATIONAL</span></td>
      </tr>
      
      <tr> 
         <td align="left">Type of Residence</td>
        <td valign="Bottom" align="left" ><select name="chAgentPrefix" onChange=				"if((this.value=='')||(this.value=='null')){document.getElementById('chAgentFlatNo').style.display='none';document.getElementById('lblAgentFlatNo').style.display='none';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentStreetNo.focus()};}else{document.getElementById('chAgentFlatNo').style.display='inline';document.getElementById('lblAgentFlatNo').style.display='inline';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentFlatNo.focus()}};if(this.value=='-----'){this.value='';document.getElementById('chAgentFlatNo').style.display='none';document.getElementById('lblAgentFlatNo').style.display='none';};" style="width:113px;">

                    <option value="null">(Select)</option>
                    <option value="" SELECTED>HOUSE</option>
                    <option value="UNIT" >UNIT</option>
                    <option value="APARTMENT" >APARTMENT</option>
                    <option value="FLAT" >FLAT</option>
                    <option value="STUDIO" >STUDIO</option>
				<option value="-----" >-----</option>
				<option value="BLOCK" >BLOCK</option>
				<option value="CABIN" >CABIN</option>
				<option value="COTTAGE" >COTTAGE</option>
				<option value="DUPLEX" >DUPLEX</option>
				<option value="FACTORY" >FACTORY</option>
				<option value="FLOOR" >FLOOR</option>
				<option value="LOT" >LOT</option>
				<option value="PIER" >PIER</option>
				<option value="ROOFTOP" >ROOFTOP</option>
				<option value="ROOM" >ROOM</option>
				<option value="SHOP" >SHOP</option>
				<option value="SUITE" >SUITE</option>
				<option value="TOWNHOUSE" >TOWNHOUSE</option>
				<option value="VILLA" >VILLA</option>
				<option value="WAREHOUSE" >WAREHOUSE</option>
              </select><div id="lblAgentFlatNo" style="display:none">&nbsp;&nbsp;No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<img src="images/spacer.gif" width="2" border="0"></div><input name="Agent_Flat_Number" id="chAgentFlatNo" value="" type="Text" size="4" style="display:none" onBlur="checkAlphaNumeric(this,1,'','.','');"><img src="images/spacer.gif" width="2" border="0">Str. No.&nbsp;<input name="Agent_Street_Number" value=""  type="Text" size="4" onBlur="checkAlphaNumeric(this,1,'','','-')"></td>
     </tr>
   	  
   <tr>
        <td align="left" >Street Name</td>
        <td valign="Bottom" align="left" ><input name="Agent_Street_Name" value="" type="Text" size="16"><img src="images/spacer.gif" width="46" height="1" border="0"><select name="chAgentStreetType" onChange="if(this.value=='-----'){this.value='';};if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentSuburb.focus()};"><option value="">(Street Type)</option>
                
					  <option value="STREET" >
                            STREET</option>
					  <option value="ROAD" >
                            ROAD</option>
					  <option value="AVENUE" >
                            AVENUE</option>
					  <option value="PLACE" >
                            PLACE</option>
					  <option value="CRESCENT" >
                            CRESCENT</option>
					  <option value="DRIVE" >
                            DRIVE</option>
					  <option value="PARADE" >
                            PARADE</option>
					  <option value="CLOSE" >
                            CLOSE</option>
					  <option value="-----" >
                            -----</option>

					  <option value="ACCESS" >
                            ACCESS</option>
					  <option value="ALLEY" >
                            ALLEY</option>
					  <option value="ALLEYWAY" >
                            ALLEYWAY</option>
					  <option value="AMBLE" >
                            AMBLE</option>
					  <option value="ANCHORAGE" >
                            ANCHORAGE</option>
					  <option value="APPROACH" >
                            APPROACH</option>
					  <option value="ARCADE" >
                            ARCADE</option>
					  <option value="ARTERY" >
                            ARTERY</option>
					  <option value="BASIN" >
                            BASIN</option>
					  <option value="BEACH" >
                            BEACH</option>
					  <option value="BEND" >
                            BEND</option>
					  <option value="BLOCK" >
                            BLOCK</option>
					  <option value="BOULEVARD" >
                            BOULEVARD</option>
					  <option value="BOULEVARDE" >
                            BOULEVARDE</option>
					  <option value="BRACE" >
                            BRACE</option>
					  <option value="BRAE" >
                            BRAE</option>
					  <option value="BREAK" >
                            BREAK</option>
					  <option value="BRIDGE" >
                            BRIDGE</option>
					  <option value="BROADWAY" >
                            BROADWAY</option>
					  <option value="BROW" >
                            BROW</option>
					  <option value="BYPASS" >
                            BYPASS</option>
					  <option value="BYWAY" >
                            BYWAY</option>
					  <option value="CAUSEWAY" >
                            CAUSEWAY</option>
					  <option value="CENTRAL" >
                            CENTRAL</option>
					  <option value="CENTRE" >
                            CENTRE</option>
					  <option value="CENTREWAY" >
                            CENTREWAY</option>
					  <option value="CHASE" >
                            CHASE</option>
					  <option value="CIRCLE" >
                            CIRCLE</option>
					  <option value="CIRCLET" >
                            CIRCLET</option>
					  <option value="CIRCUIT" >
                            CIRCUIT</option>
					  <option value="CIRCUS" >
                            CIRCUS</option>
					  <option value="COLONNADE" >
                            COLONNADE</option>
					  <option value="COMMON" >
                            COMMON</option>
					  <option value="CONCOURSE" >
                            CONCOURSE</option>
					  <option value="COPSE" >
                            COPSE</option>
					  <option value="CORNER" >
                            CORNER</option>
					  <option value="CORSO" >
                            CORSO</option>
					  <option value="COURT" >
                            COURT</option>
					  <option value="COURTYARD" >
                            COURTYARD</option>
					  <option value="COVE" >
                            COVE</option>
					  <option value="CREST" >
                            CREST</option>
					  <option value="CROSS" >
                            CROSS</option>
					  <option value="CROSSING" >
                            CROSSING</option>
					  <option value="CROSSROAD" >
                            CROSSROAD</option>
					  <option value="CROSSWAY" >
                            CROSSWAY</option>
					  <option value="CRUISEWAY" >
                            CRUISEWAY</option>
					  <option value="CUL-DE-SAC" >
                            CUL-DE-SAC</option>
					  <option value="CUTTING" >
                            CUTTING</option>
					  <option value="DALE" >
                            DALE</option>
					  <option value="DELL" >
                            DELL</option>
					  <option value="DEVIATION" >
                            DEVIATION</option>
					  <option value="DIP" >
                            DIP</option>
					  <option value="DISTRIBUTOR" >
                            DISTRIBUTOR</option>
					  <option value="DRIVEWAY" >
                            DRIVEWAY</option>
					  <option value="EAST" >
                            EAST</option>
					  <option value="EDGE" >
                            EDGE</option>
					  <option value="ELBOW" >
                            ELBOW</option>
					  <option value="END" >
                            END</option>
					  <option value="ENTRANCE" >
                            ENTRANCE</option>
					  <option value="ESPLANADE" >
                            ESPLANADE</option>
					  <option value="ESTATE" >
                            ESTATE</option>
					  <option value="EXPRESSWAY" >
                            EXPRESSWAY</option>
					  <option value="EXTENSION" >
                            EXTENSION</option>
					  <option value="EXTENSION" >
                            EXTENSION</option>
					  <option value="FAIRWAY" >
                            FAIRWAY</option>
					  <option value="FIRE TRACK" >
                            FIRE TRACK</option>
					  <option value="FIRETRAIL" >
                            FIRETRAIL</option>
					  <option value="FLAT" >
                            FLAT</option>
					  <option value="FOLLOW" >
                            FOLLOW</option>
					  <option value="FOOTWAY" >
                            FOOTWAY</option>
					  <option value="FORESHORE" >
                            FORESHORE</option>
					  <option value="FORMATION" >
                            FORMATION</option>
					  <option value="FREEWAY" >
                            FREEWAY</option>
					  <option value="FRONT" >
                            FRONT</option>
					  <option value="FRONTAGE" >
                            FRONTAGE</option>
					  <option value="GAP" >
                            GAP</option>
					  <option value="GARDEN" >
                            GARDEN</option>
					  <option value="GARDENS" >
                            GARDENS</option>
					  <option value="GATE" >
                            GATE</option>
					  <option value="GATES" >
                            GATES</option>
					  <option value="GLADE" >
                            GLADE</option>
					  <option value="GLEN" >
                            GLEN</option>
					  <option value="GRANGE" >
                            GRANGE</option>
					  <option value="GREEN" >
                            GREEN</option>
					  <option value="GROUND" >
                            GROUND</option>
					  <option value="GROVE" >
                            GROVE</option>
					  <option value="GULLY" >
                            GULLY</option>
					  <option value="HEIGHTS" >
                            HEIGHTS</option>
					  <option value="HIGHROAD" >
                            HIGHROAD</option>
					  <option value="HIGHWAY" >
                            HIGHWAY</option>
					  <option value="HILL" >
                            HILL</option>
					  <option value="INTERCHANGE" >
                            INTERCHANGE</option>
					  <option value="INTERSECTION" >
                            INTERSECTION</option>
					  <option value="JUNCTION" >
                            JUNCTION</option>
					  <option value="KEY" >
                            KEY</option>
					  <option value="LANDING" >
                            LANDING</option>
					  <option value="LANE" >
                            LANE</option>
					  <option value="LANEWAY" >
                            LANEWAY</option>
					  <option value="LEES" >
                            LEES</option>
					  <option value="LINE" >
                            LINE</option>
					  <option value="LINK" >
                            LINK</option>
					  <option value="LITTLE" >
                            LITTLE</option>
					  <option value="LOOKOUT" >
                            LOOKOUT</option>
					  <option value="LOOP" >
                            LOOP</option>
					  <option value="LOWER" >
                            LOWER</option>
					  <option value="LOWER" >
                            LOWER</option>
					  <option value="MALL" >
                            MALL</option>
					  <option value="MEANDER" >
                            MEANDER</option>
					  <option value="MEW" >
                            MEW</option>
					  <option value="MEWS" >
                            MEWS</option>
					  <option value="MOTORWAY" >
                            MOTORWAY</option>
					  <option value="MOUNT" >
                            MOUNT</option>
					  <option value="NOOK" >
                            NOOK</option>
					  <option value="NORTH" >
                            NORTH</option>
					  <option value="NORTH EAST" >
                            NORTH EAST</option>
					  <option value="NORTH WEST" >
                            NORTH WEST</option>
					  <option value="OUTLOOK" >
                            OUTLOOK</option>
					  <option value="PARK" >
                            PARK</option>
					  <option value="PARKLANDS" >
                            PARKLANDS</option>
					  <option value="PARKWAY" >
                            PARKWAY</option>
					  <option value="PART" >
                            PART</option>
					  <option value="PASS" >
                            PASS</option>
					  <option value="PATH" >
                            PATH</option>
					  <option value="PATHWAY" >
                            PATHWAY</option>
					  <option value="PIAZZA" >
                            PIAZZA</option>
					  <option value="PLATEAU" >
                            PLATEAU</option>
					  <option value="PLAZA" >
                            PLAZA</option>
					  <option value="POCKET" >
                            POCKET</option>
					  <option value="POINT" >
                            POINT</option>
					  <option value="PORT" >
                            PORT</option>
					  <option value="PROMENADE" >
                            PROMENADE</option>
					  <option value="QUAD" >
                            QUAD</option>
					  <option value="QUADRANGLE" >
                            QUADRANGLE</option>
					  <option value="QUADRANT" >
                            QUADRANT</option>
					  <option value="QUAY" >
                            QUAY</option>
					  <option value="QUAYS" >
                            QUAYS</option>
					  <option value="RAMBLE" >
                            RAMBLE</option>
					  <option value="RAMP" >
                            RAMP</option>
					  <option value="RANGE" >
                            RANGE</option>
					  <option value="REACH" >
                            REACH</option>
					  <option value="RESERVE" >
                            RESERVE</option>
					  <option value="REST" >
                            REST</option>
					  <option value="RETREAT" >
                            RETREAT</option>
					  <option value="RIDE" >
                            RIDE</option>
					  <option value="RIDGE" >
                            RIDGE</option>
					  <option value="RIDGEWAY" >
                            RIDGEWAY</option>
					  <option value="RIGHT OF WAY" >
                            RIGHT OF WAY</option>
					  <option value="RING" >
                            RING</option>
					  <option value="RISE" >
                            RISE</option>
					  <option value="RIVER" >
                            RIVER</option>
					  <option value="RIVERWAY" >
                            RIVERWAY</option>
					  <option value="RIVIERA" >
                            RIVIERA</option>
					  <option value="ROADS" >
                            ROADS</option>
					  <option value="ROADSIDE" >
                            ROADSIDE</option>
					  <option value="ROADWAY" >
                            ROADWAY</option>
					  <option value="RONDE" >
                            RONDE</option>
					  <option value="ROSEBOWL" >
                            ROSEBOWL</option>
					  <option value="ROTARY" >
                            ROTARY</option>
					  <option value="ROUND" >
                            ROUND</option>
					  <option value="ROUTE" >
                            ROUTE</option>
					  <option value="ROW" >
                            ROW</option>
					  <option value="RUE" >
                            RUE</option>
					  <option value="RUN" >
                            RUN</option>
					  <option value="SERVICE WAY" >
                            SERVICE WAY</option>
					  <option value="SIDING" >
                            SIDING</option>
					  <option value="SLOPE" >
                            SLOPE</option>
					  <option value="SOUND" >
                            SOUND</option>
					  <option value="SOUTH" >
                            SOUTH</option>
					  <option value="SOUTH EAST" >
                            SOUTH EAST</option>
					  <option value="SOUTH WEST" >
                            SOUTH WEST</option>
					  <option value="SPUR" >
                            SPUR</option>
					  <option value="SQUARE" >
                            SQUARE</option>
					  <option value="STAIRS" >
                            STAIRS</option>
					  <option value="STATE HIGHWAY" >
                            STATE HIGHWA</option>
					  <option value="STEPS" >
                            STEPS</option>
					  <option value="STEYNE" >
                            STEYNE</option>
					  <option value="STRAND" >
                            STRAND</option>
					  <option value="STRIP" >
                            STRIP</option>
					  <option value="SUBWAY" >
                            SUBWAY</option>
					  <option value="TARN" >
                            TARN</option>
					  <option value="TERRACE" >
                            TERRACE</option>
					  <option value="THOROUGHFARE" >
                            THOROUGHFARE</option>
					  <option value="TOLLWAY" >
                            TOLLWAY</option>
					  <option value="TOP" >
                            TOP</option>
					  <option value="TOR" >
                            TOR</option>
					  <option value="TOWERS" >
                            TOWERS</option>
					  <option value="TRACK" >
                            TRACK</option>
					  <option value="TRAIL" >
                            TRAIL</option>
					  <option value="TRAILER" >
                            TRAILER</option>
					  <option value="TRIANGLE" >
                            TRIANGLE</option>
					  <option value="TRUNKWAY" >
                            TRUNKWAY</option>
					  <option value="TURN" >
                            TURN</option>
					  <option value="UNDERPASS" >
                            UNDERPASS</option>
					  <option value="UPPER" >
                            UPPER</option>
					  <option value="UPPER" >
                            UPPER</option>
					  <option value="VALE" >
                            VALE</option>
					  <option value="VIADUCT" >
                            VIADUCT</option>
					  <option value="VIEW" >
                            VIEW</option>
					  <option value="VILLAS" >
                            VILLAS</option>
					  <option value="VISTA" >
                            VISTA</option>
					  <option value="WADE" >
                            WADE</option>
					  <option value="WALK" >
                            WALK</option>
					  <option value="WALKWAY" >
                            WALKWAY</option>
					  <option value="WAY" >
                            WAY</option>
					  <option value="WEST" >
                            WEST</option>
					  <option value="WHARF" >
                            WHARF</option>
					  <option value="WYND" >
                            WYND</option>
					  <option value="YARD" >
                            YARD</option>
              </select></td>
      </tr>
      <tr> 
        <td align="left"><div id="objAgentPresentAddressAus1">Suburb</div></td>
        <td align="left"><div id="objAgentPresentAddressAus2"><input name="Agent_Suburb" value=""   type="Text" size="16"> 
        State<img src="images/spacer.gif" width="15" height="1" border="0"><select name="chAgentState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentPostcode.focus()};">

					<option value=""></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>
          </select> Postcode<img src="images/spacer.gif" width="10" height="1" border="0"><input name="Agent_Postcode" value=""  type="Text" size="4" maxlength="4">  </div></td>
      </tr>  
      
     <tr> 
        <td align="left" ><div id="objAgentPresentAddressInt1" style="display:none">Suburb</div></td>
        <td align="left" ><div id="objAgentPresentAddressInt2" style="display:none"><input name="Agent_Int_Suburb" type="Text" size="16"> City&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input name="chAgentIntCity" type="Text" size="16"> State/County <input name="Agent_Int_State" type="Text" size="16"></div></td>
      </tr>  
      
       <tr> 
        <td height="3" align="left"><div id="objAgentPresentAddressInt3"  style="display:none">PostCode/ZIP</div></td>
        <td height="3"><div id="objAgentPresentAddressInt4"  style="display:none"><input name="Agent_Int_Postcode" type="Text" size="16"> Country <select name="chAgentIntCountry"><option value="">(Select Country)</option>
           <option value="Afghanistan">Afghanistan</option>
            <option value="Albania">Albania</option>
            <option value="Algeria">Algeria</option>
            <option value="American Samoa">American Samoa</option>
            <option value="Andorra">Andorra</option>
            <option value="Angola">Angola</option>
            <option value="Anguilla">Anguilla</option>
            <option value="Antarctica">Antarctica</option>
            <option value="Antigua and Barbuda">Antigua and Barbuda</option>
            <option value="Argentina">Argentina</option>
            <option value="Armenia">Armenia</option>
            <option value="Aruba">Aruba</option>
            <option value="Austria">Austria</option>
            <option value="Azerbaijan">Azerbaijan</option>
            <option value="Bahamas">Bahamas</option>
            <option value="Bahrain">Bahrain</option>
            <option value="Bangladesh">Bangladesh</option>
            <option value="Barbados">Barbados</option>
            <option value="Belarus">Belarus</option>
            <option value="Belgium">Belgium</option>
            <option value="Belize">Belize</option>
            <option value="Benin">Benin</option>
            <option value="Bermuda">Bermuda</option>
            <option value="Bhutan">Bhutan</option>
            <option value="Bolivia">Bolivia</option>
            <option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
            <option value="Botswana">Botswana</option>
            <option value="Bouvet Island">Bouvet Island</option>
            <option value="Brazil">Brazil</option>
            <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
            <option value="Brunei Darussalam">Brunei Darussalam</option>
            <option value="Bulgaria">Bulgaria</option>
            <option value="Burkina Faso">Burkina Faso</option>
            <option value="Burundi">Burundi</option>
            <option value="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman islands">Cayman islands</option>
            <option value="Central African Republic">Central African Republic</option>
            <option value="Chad">Chad</option>
            <option value="Chile">Chile</option>
            <option value="China">China</option>
            <option value="Christmas Island">Christmas Island</option>
            <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
            <option value="Colombia">Colombia</option>
            <option value="Comoros">Comoros</option>
            <option value="Congo">Congo</option>
            <option value="Congo, Democratic Republic">Congo, Democratic Republic</option>
            <option value="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Cote d'ivoire">Cote d'ivoire</option>
           <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option>
            <option value="Cuba">Cuba</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</option>
            <option value="Denmark">Denmark</option>
            <option value="Djibouti">Djibouti</option>
            <option value="Dominica">Dominica</option>
            <option value="Dominican Republic">Dominican Republic</option>
            <option value="East Timor">East Timor</option>
            <option value="Ecuador">Ecuador</option>
            <option value="Egypt">Egypt</option>
            <option value="El Salvador">El Salvador</option>
            <option value="Equatorial Guinea">Equatorial Guinea</option>
            <option value="Eritrea">Eritrea</option>
            <option value="Estonia">Estonia</option>
            <option value="Ethiopia">Ethiopia</option>
            <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
            <option value="Faroe islands">Faroe islands</option>
            <option value="Fiji">Fiji</option>
            <option value="Finland">Finland</option>
            <option value="France">France</option>
            <option value="France, Metropolitan">France, Metropolitan</option>
            <option value="French Guiana">French Guiana</option>
            <option value="French Polynesia">French Polynesia</option>
            <option value="French Southern Territories">French Southern Territories</option>
            <option value="Gabon">Gabon</option>
            <option value="Gambia">Gambia</option>
            <option value="Georgia">Georgia</option>
            <option value="Germany">Germany</option>
            <option value="Ghana">Ghana</option>
            <option value="Gibraltar">Gibraltar</option>
            <option value="Greece">Greece</option>
            <option value="Greenland">Greenland</option>
            <option value="Grenada">Grenada</option>
            <option value="Guadeloupe">Guadeloupe</option>
            <option value="Guam">Guam</option>
            <option value="Guatemala">Guatemala</option>
            <option value="Guinea">Guinea</option>
            <option value="Guinea-Bissau">Guinea-Bissau</option>
            <option value="Guyana">Guyana</option>
            <option value="Haiti">Haiti</option>
            <option value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option>
            <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
            <option value="Honduras">Honduras</option>
            <option value="Hong Kong">Hong Kong</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="India">India</option>
            <option value="Indonesia">Indonesia</option>
            <option value="Iran (Islamic Republic of)">Iran (Islamic Republic of)</option>
            <option value="Iraq">Iraq</option>
            <option value="Ireland">Ireland</option>
            <option value="Israel">Israel</option>
            <option value="Italy">Italy</option>
            <option value="Jamaica">Jamaica</option>
            <option value="Japan">Japan</option>
            <option value="Jordan">Jordan</option>
            <option value="Kazakhstan">Kazakhstan</option>
            <option value="Kenya">Kenya</option>
            <option value="Kiribati">Kiribati</option>
           <option value="Korea, Democratic People's Republic">Korea, Democratic People's Republic</option>
            <option value="Korea, Republic of">Korea, Republic of</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
            <option value="Latvia">Latvia</option>
            <option value="Lebanon">Lebanon</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macau">Macau</option>
            <option value="Macedonia (Yugoslav Republic)">Macedonia (Yugoslav Republic)</option>
            <option value="Madagascar">Madagascar</option>
            <option value="Malawi">Malawi</option>
            <option value="Malaysia">Malaysia</option>
            <option value="Maldives">Maldives</option>
            <option value="Mali">Mali</option>
            <option value="Malta">Malta</option>
           <option value="Marshall Islands">Marshall Islands</option>
            <option value="Martinique">Martinique</option>
            <option value="Mauritania">Mauritania</option>
            <option value="Mauritius">Mauritius</option>
            <option value="Mayotte">Mayotte</option>
            <option value="Mexico">Mexico</option>
            <option value="Micronesia">Micronesia</option>
            <option value="Moldova">Moldova</option>
            <option value="Monaco">Monaco</option>
            <option value="Mongolia">Mongolia</option>
            <option value="Montserrat">Montserrat</option>
            <option value="Morocco">Morocco</option>
           <option value="Mozambique">Mozambique</option>
            <option value="Myanmar">Myanmar</option>
            <option value="Namibia">Namibia</option>
            <option value="Nauru">Nauru</option>
            <option value="Nepal">Nepal</option>
            <option value="Netherlands">Netherlands</option>
            <option value="Netherlands Antilles">Netherlands Antilles</option>
            <option value="New Caledonia">New Caledonia</option>
            <option value="New Zealand">New Zealand</option>
            <option value="Nicaragua">Nicaragua</option>
            <option value="Niger">Niger</option>
            <option value="Nigeria">Nigeria</option>
            <option value="Niue">Niue</option>
            <option value="Norfolk island">Norfolk island</option>
            <option value="Northern Mariana Islands">Northern Mariana Islands</option>
            <option value="Norway">Norway</option>
            <option value="Oman">Oman</option>
            <option value="Pakistan">Pakistan</option>
            <option value="Palau">Palau</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Peru">Peru</option>
            <option value="Philippines">Philippines</option>
            <option value="Pitcairn">Pitcairn</option>
            <option value="Poland">Poland</option>
            <option value="Portugal">Portugal</option>
            <option value="Puerto Rico">Puerto Rico</option>
            <option value="Qatar">Qatar</option>
            <option value="Reunion">Reunion</option>
            <option value="Romania">Romania</option>
            <option value="Russian Federation">Russian Federation</option>
            <option value="Rwanda">Rwanda</option>
            <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
            <option value="Saint Lucia">Saint Lucia</option>
            <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
            <option value="Samoa">Samoa</option>
            <option value="San Marino">San Marino</option>
            <option value="Sao Tome and Principe">Sao Tome and Principe</option>
            <option value="Saudi Arabia">Saudi Arabia</option>
            <option value="Senegal">Senegal</option>
            <option value="Seychelles">Seychelles</option>
            <option value="Sierra Leone">Sierra Leone</option>
            <option value="Singapore">Singapore</option>
            <option value="Slovakia (Slovak Republic)">Slovakia (Slovak Republic)</option>
            <option value="Slovenia">Slovenia</option>
            <option value="Solomon Islands">Solomon Islands</option>
            <option value="Somalia">Somalia</option>
            <option value="South Africa">South Africa</option>
            <option value="South Georgia">South Georgia</option>
            <option value="Spain">Spain</option>
            <option value="Sri Lanka">Sri Lanka</option>
            <option value="St Helena">St Helena</option>
            <option value="St Pierre and Miquelon">St Pierre and Miquelon</option>
            <option value="Sudan">Sudan</option>
            <option value="Suriname">Suriname</option>
            <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
            <option value="Swaziland">Swaziland</option>
            <option value="Sweden">Sweden</option>
            <option value="Switzerland">Switzerland</option>
            <option value="Syrian Arab Republic">Syrian Arab Republic</option>
            <option value="Taiwan">Taiwan</option>
            <option value="Tajikistan">Tajikistan</option>
            <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
            <option value="Thailand">Thailand</option>
            <option value="Togo">Togo</option>
            <option value="Tokelau">Tokelau</option>
            <option value="Tonga">Tonga</option>
            <option value="Trinidad and Tobago">Trinidad and Tobago</option>
            <option value="Tunisia">Tunisia</option>
            <option value="Turkey">Turkey</option>
            <option value="Turkmenistan">Turkmenistan</option>
            <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
            <option value="Tuvalu">Tuvalu</option>
            <option value="Uganda">Uganda</option>
            <option value="Ukraine">Ukraine</option>
            <option value="United Arab Emirates">United Arab Emirates</option>
            <option value="United Kingdom">United Kingdom</option>
            <option value="United States">United States</option>
            <option value="Uruguay">Uruguay</option>
            <option value="Uzbekistan">Uzbekistan</option>
            <option value="Vanuatu">Vanuatu</option>
            <option value="Venezuela">Venezuela</option>
            <option value="Vietnam">Vietnam</option>
            <option value="Virgin Islands (British)">Virgin Islands (British)</option>
            <option value="Virgin Islands (US)">Virgin Islands (US)</option>
            <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
            <option value="Western Sahara">Western Sahara</option>
            <option value="Yemen">Yemen</option>
            <option value="Yugoslavia">Yugoslavia</option>
            <option value="Zambia">Zambia</option>
            <option value="Zimbabwe">Zimbabwe</option>
          </select></div></td>
      </tr>
      
      <tr> 
         <td align="left">Phone</td>
        <td ><select name="chAgentPhone1" id="chAgentPhone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentPhone2.focus()};">
		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>			
		  </select>
			  <input type="text" name="chAgentPhone2"  value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentPhone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			  <input type="text" name="chAgentPhone3"  value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentMobilePhone1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');"><img src="images/spacer.gif" width="10" height="1" border="0"> Mobile<img src="images/spacer.gif" width="36" height="1" border="0"><input type="text" name="chAgentMobilePhone1" value="" size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentMobilePhone2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="chAgentMobilePhone2"  value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentMobilePhone3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="chAgentMobilePhone3"  value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chAgentEmail.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		</td>
      </tr>
      	 
       <tr> 
         <td align="left">Email</td>
        <td><input name="Agent_Email" type="Text"   value=""  style="width:199px;" onBlur="checkEmail(this);" maxlength="50">
		</td>
      </tr>
      
      <tr> 
        <td class="navytext"><b>Previous Address:</b></td>
		<td class="searchgreentext">
		<input name="Previous_International_1" onClick="setPreviousInternationalNode(0)"  class="formcheckbox" checked="true" type="Radio" value="V1">
		  <span class="navytext"> AUSTRALIAN</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
		  <input  class="formcheckbox"  onClick="setPreviousInternationalNode(1)" name="chPreviousInternational" type="Radio" value="V1" checked="true">
	    <span class="navytext"> INTERNATIONAL</span></td>
      </tr>
      
      <tr> 
         <td align="left">Type of Residence</td>
        <td valign="Bottom" align="left" ><select name="chPreviousPrefix" onChange=				"if((this.value=='')||(this.value=='null')){document.getElementById('chPreviousFlatNo').style.display='none';document.getElementById('lblPreviousFlatNo').style.display='none';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousStreetNo.focus()};}else{document.getElementById('chPreviousFlatNo').style.display='inline';document.getElementById('lblPreviousFlatNo').style.display='inline';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousFlatNo.focus()}};if(this.value=='-----'){this.value='';document.getElementById('chPreviousFlatNo').style.display='none';document.getElementById('lblPreviousFlatNo').style.display='none';};" style="width:113px;">
                    <option value="null">(Select)</option>
                    <option value="" SELECTED>HOUSE</option>
                    <option value="UNIT" >UNIT</option>
                    <option value="APARTMENT" >APARTMENT</option>
                    <option value="FLAT" >FLAT</option>
                    <option value="STUDIO" >STUDIO</option>
                
				    <option value="-----" >
                        -----</option>
				    <option value="BLOCK" >
                        BLOCK</option>
				    <option value="CABIN" >
                        CABIN</option>
				    <option value="COTTAGE" >
                        COTTAGE</option>
				    <option value="DUPLEX" >
                        DUPLEX</option>
				    <option value="FACTORY" >
                        FACTORY</option>
				    <option value="FLOOR" >
                        FLOOR</option>
				    <option value="LOT" >
                        LOT</option>
				    <option value="PIER" >
                        PIER</option>
				    <option value="ROOFTOP" >
                        ROOFTOP</option>
				    <option value="ROOM" >
                        ROOM</option>
				    <option value="SHOP" >
                        SHOP</option>
				    <option value="SUITE" >
                        SUITE</option>
				    <option value="TOWNHOUSE" >
                        TOWNHOUSE</option>
				    <option value="VILLA" >
                        VILLA</option>
				    <option value="WAREHOUSE" >
                        WAREHOUSE</option>
              </select><div id="lblPreviousFlatNo" style="display:none">&nbsp;&nbsp;No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<img src="images/spacer.gif" width="2" border="0"></div><input name="Previous_Flat_Number" id="chPreviousFlatNo"  value="" type="Text" size="4" style="display:none" onBlur="checkAlphaNumeric(this,1,'','.','');"><img src="images/spacer.gif" width="2" border="0">Str. No.&nbsp;<input name="Previous_Street_Number"  value=""  type="Text" size="4" onBlur="checkAlphaNumeric(this,1,'','','-')"></td>
      </tr>  

	   <tr>
        <td align="left" >Street Name</td>
        <td valign="Bottom" align="left" ><input name="Previous_Street_Name" value="" type="Text" size="16"><img src="images/spacer.gif" width="46" height="1" border="0"><select name="chPreviousStreetType" onChange="if(this.value=='-----'){this.value='';};if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousSuburb.focus()};"><option value="">(Street Type)</option>
                
					 <option value="STREET" >
                            STREET</option>
					 <option value="ROAD" >
                            ROAD</option>
					 <option value="AVENUE" >
                            AVENUE</option>
					 <option value="PLACE" >
                            PLACE</option>
					 <option value="CRESCENT" >
                            CRESCENT</option>
					 <option value="DRIVE" >
                            DRIVE</option>
					 <option value="PARADE" >
                            PARADE</option>
					 <option value="CLOSE" >
                            CLOSE</option>
					 <option value="-----" >
                            -----</option>
					 <option value="ACCESS" >
                            ACCESS</option>
					 <option value="ALLEY" >
                            ALLEY</option>
					 <option value="ALLEYWAY" >
                            ALLEYWAY</option>
					 <option value="AMBLE" >
                            AMBLE</option>
					 <option value="ANCHORAGE" >
                            ANCHORAGE</option>
					 <option value="APPROACH" >
                            APPROACH</option>
					 <option value="ARCADE" >
                            ARCADE</option>
					 <option value="ARTERY" >
                            ARTERY</option>
					 <option value="BASIN" >
                            BASIN</option>
					 <option value="BEACH" >
                            BEACH</option>
					 <option value="BEND" >
                            BEND</option>
					 <option value="BLOCK" >
                            BLOCK</option>
					 <option value="BOULEVARD" >
                            BOULEVARD</option>
					 <option value="BOULEVARDE" >
                            BOULEVARDE</option>
					 <option value="BRACE" >
                            BRACE</option>
					 <option value="BRAE" >
                            BRAE</option>
					 <option value="BREAK" >
                            BREAK</option>
					 <option value="BRIDGE" >
                            BRIDGE</option>
					 <option value="BROADWAY" >
                            BROADWAY</option>
					 <option value="BROW" >
                            BROW</option>
					 <option value="BYPASS" >
                            BYPASS</option>
					 <option value="BYWAY" >
                            BYWAY</option>
					 <option value="CAUSEWAY" >
                            CAUSEWAY</option>
					 <option value="CENTRAL" >
                            CENTRAL</option>
					 <option value="CENTRE" >
                            CENTRE</option>
					 <option value="CENTREWAY" >
                            CENTREWAY</option>
					 <option value="CHASE" >
                            CHASE</option>
					 <option value="CIRCLE" >
                            CIRCLE</option>
					 <option value="CIRCLET" >
                            CIRCLET</option>
					 <option value="CIRCUIT" >
                            CIRCUIT</option>
					 <option value="CIRCUS" >
                            CIRCUS</option>
					 <option value="COLONNADE" >
                            COLONNADE</option>
					 <option value="COMMON" >
                            COMMON</option>
					 <option value="CONCOURSE" >
                            CONCOURSE</option>
					 <option value="COPSE" >
                            COPSE</option>
					 <option value="CORNER" >
                            CORNER</option>
					 <option value="CORSO" >
                            CORSO</option>
					 <option value="COURT" >
                            COURT</option>
					 <option value="COURTYARD" >
                            COURTYARD</option>
					 <option value="COVE" >
                            COVE</option>
					 <option value="CREST" >
                            CREST</option>
					 <option value="CROSS" >
                            CROSS</option>
					 <option value="CROSSING" >
                            CROSSING</option>
					 <option value="CROSSROAD" >
                            CROSSROAD</option>
					 <option value="CROSSWAY" >
                            CROSSWAY</option>
					 <option value="CRUISEWAY" >
                            CRUISEWAY</option>
					 <option value="CUL-DE-SAC" >
                            CUL-DE-SAC</option>
					 <option value="CUTTING" >
                            CUTTING</option>
					 <option value="DALE" >
                            DALE</option>
					 <option value="DELL" >
                            DELL</option>
					 <option value="DEVIATION" >
                            DEVIATION</option>
					 <option value="DIP" >
                            DIP</option>
					 <option value="DISTRIBUTOR" >
                            DISTRIBUTOR</option>
					 <option value="DRIVEWAY" >
                            DRIVEWAY</option>
					 <option value="EAST" >
                            EAST</option>
					 <option value="EDGE" >
                            EDGE</option>
					 <option value="ELBOW" >
                            ELBOW</option>
					 <option value="END" >
                            END</option>
					 <option value="ENTRANCE" >
                            ENTRANCE</option>
					 <option value="ESPLANADE" >
                            ESPLANADE</option>
					 <option value="ESTATE" >
                            ESTATE</option>
					 <option value="EXPRESSWAY" >
                            EXPRESSWAY</option>
					 <option value="EXTENSION" >
                            EXTENSION</option>
				 <option value="EXTENSION" >
                            EXTENSION</option>
					 <option value="FAIRWAY" >
                            FAIRWAY</option>
					 <option value="FIRE TRACK" >
                            FIRE TRACK</option>
					 <option value="FIRETRAIL" >
                            FIRETRAIL</option>
					 <option value="FLAT" >
                            FLAT</option>
					 <option value="FOLLOW" >
                            FOLLOW</option>
					 <option value="FOOTWAY" >
                            FOOTWAY</option>
					 <option value="FORESHORE" >
                            FORESHORE</option>
					 <option value="FORMATION" >
                            FORMATION</option>
					 <option value="FREEWAY" >
                            FREEWAY</option>
					 <option value="FRONT" >
                            FRONT</option>
					 <option value="FRONTAGE" >
                            FRONTAGE</option>
					 <option value="GAP" >
                            GAP</option>
					 <option value="GARDEN" >
                            GARDEN</option>
					 <option value="GARDENS" >
                            GARDENS</option>
					 <option value="GATE" >
                            GATE</option>
					 <option value="GATES" >
                            GATES</option>
					 <option value="GLADE" >
                            GLADE</option>
					 <option value="GLEN" >
                            GLEN</option>
					 <option value="GRANGE" >
                            GRANGE</option>
					 <option value="GREEN" >
                            GREEN</option>
					 <option value="GROUND" >
                            GROUND</option>
					 <option value="GROVE" >
                            GROVE</option>
					 <option value="GULLY" >
                            GULLY</option>
					 <option value="HEIGHTS" >
                            HEIGHTS</option>
				 <option value="HIGHROAD" >
                            HIGHROAD</option>
					 <option value="HIGHWAY" >
                            HIGHWAY</option>
					 <option value="HILL" >
                            HILL</option>
					 <option value="INTERCHANGE" >
                            INTERCHANGE</option>
					 <option value="INTERSECTION" >
                            INTERSECTION</option>
					 <option value="JUNCTION" >
                            JUNCTION</option>
					 <option value="KEY" >
                            KEY</option>
					 <option value="LANDING" >
                           LANDING</option>
					 <option value="LANE" >
                            LANE</option>
					 <option value="LANEWAY" >
                            LANEWAY</option>
					 <option value="LEES" >
                            LEES</option>
					 <option value="LINE" >
                            LINE</option>
					 <option value="LINK" >
                            LINK</option>
					 <option value="LITTLE" >
                            LITTLE</option>
					 <option value="LOOKOUT" >
                            LOOKOUT</option>
					 <option value="LOOP" >
                            LOOP</option>
					 <option value="LOWER" >
                            LOWER</option>
					 <option value="LOWER" >
                            LOWER</option>
					 <option value="MALL" >
                            MALL</option>
					 <option value="MEANDER" >
                            MEANDER</option>
					 <option value="MEW" >
                            MEW</option>
					 <option value="MEWS" >
                            MEWS</option>
					 <option value="MOTORWAY" >
                            MOTORWAY</option>
					 <option value="MOUNT" >
                            MOUNT</option>
					 <option value="NOOK" >
                            NOOK</option>
					 <option value="NORTH" >
                            NORTH</option>
					 <option value="NORTH EAST" >
                            NORTH EAST</option>
					 <option value="NORTH WEST" >
                            NORTH WEST</option>
					 <option value="OUTLOOK" >
                            OUTLOOK</option>
					 <option value="PARK" >
                            PARK</option>
					 <option value="PARKLANDS" >
                            PARKLANDS</option>
					 <option value="PARKWAY" >
                            PARKWAY</option>
					 <option value="PART" >
                            PART</option>
					 <option value="PASS" >
                            PASS</option>
					 <option value="PATH" >
                            PATH</option>
					 <option value="PATHWAY" >
                            PATHWAY</option>
					 <option value="PIAZZA" >
                            PIAZZA</option>
					 <option value="PLATEAU" >
                            PLATEAU</option>
					 <option value="PLAZA" >
                            PLAZA</option>
					 <option value="POCKET" >
                            POCKET</option>
					 <option value="POINT" >
                            POINT</option>
					 <option value="PORT" >
                            PORT</option>
					 <option value="PROMENADE" >
                            PROMENADE</option>
					 <option value="QUAD" >
                            QUAD</option>
					 <option value="QUADRANGLE" >
                            QUADRANGLE</option>
					 <option value="QUADRANT" >
                            QUADRANT</option>
					 <option value="QUAY" >
                            QUAY</option>
					 <option value="QUAYS" >
                            QUAYS</option>
					 <option value="RAMBLE" >
                            RAMBLE</option>
					 <option value="RAMP" >
                            RAMP</option>
					 <option value="RANGE" >
                            RANGE</option>
					 <option value="REACH" >
                            REACH</option>
					 <option value="RESERVE" >
                            RESERVE</option>
					 <option value="REST" >
                            REST</option>
					 <option value="RETREAT" >
                            RETREAT</option>
					 <option value="RIDE" >
                            RIDE</option>
					 <option value="RIDGE" >
                            RIDGE</option>
					 <option value="RIDGEWAY" >
                            RIDGEWAY</option>
					 <option value="RIGHT OF WAY" >
                            RIGHT OF WAY</option>
					 <option value="RING" >
                            RING</option>
					 <option value="RISE" >
                            RISE</option>
					 <option value="RIVER" >
                            RIVER</option>
					 <option value="RIVERWAY" >
                            RIVERWAY</option>
					 <option value="RIVIERA" >
                            RIVIERA</option>
					 <option value="ROADS" >
                            ROADS</option>
					 <option value="ROADSIDE" >
                            ROADSIDE</option>
					 <option value="ROADWAY" >
                            ROADWAY</option>
					 <option value="RONDE" >
                            RONDE</option>
					 <option value="ROSEBOWL" >
                            ROSEBOWL</option>
					 <option value="ROTARY" >
                            ROTARY</option>
					 <option value="ROUND" >
                            ROUND</option>
					 <option value="ROUTE" >
                            ROUTE</option>
					 <option value="ROW" >
                            ROW</option>
					 <option value="RUE" >
                            RUE</option>
					 <option value="RUN" >
                            RUN</option>
					 <option value="SERVICE WAY" >
                            SERVICE WAY</option>
					 <option value="SIDING" >
                            SIDING</option>
					 <option value="SLOPE" >
                            SLOPE</option>
					 <option value="SOUND" >
                            SOUND</option>
					 <option value="SOUTH" >
                            SOUTH</option>
					 <option value="SOUTH EAST" >
                            SOUTH EAST</option>
					 <option value="SOUTH WEST" >
                            SOUTH WEST</option>
					 <option value="SPUR" >
                            SPUR</option>
					 <option value="SQUARE" >
                            SQUARE</option>
					 <option value="STAIRS" >
                            STAIRS</option>
					 <option value="STATE HIGHWAY" >
                            STATE HIGHWA</option>
					 <option value="STEPS" >
                            STEPS</option>
					 <option value="STEYNE" >
                            STEYNE</option>
					 <option value="STRAND" >
                            STRAND</option>
					 <option value="STRIP" >
                            STRIP</option>
					 <option value="SUBWAY" >
                            SUBWAY</option>
					 <option value="TARN" >
                            TARN</option>
					 <option value="TERRACE" >
                            TERRACE</option>
					 <option value="THOROUGHFARE" >
                            THOROUGHFARE</option>
					 <option value="TOLLWAY" >
                            TOLLWAY</option>
					 <option value="TOP" >
                            TOP</option>
					 <option value="TOR" >
                            TOR</option>
					 <option value="TOWERS" >
                            TOWERS</option>
					 <option value="TRACK" >
                            TRACK</option>
					 <option value="TRAIL" >
                            TRAIL</option>
					 <option value="TRAILER" >
                            TRAILER</option>
					 <option value="TRIANGLE" >
                            TRIANGLE</option>
					 <option value="TRUNKWAY" >
                            TRUNKWAY</option>
					 <option value="TURN" >
                            TURN</option>
					 <option value="UNDERPASS" >
                            UNDERPASS</option>
					 <option value="UPPER" >
                            UPPER</option>
					 <option value="UPPER" >
                            UPPER</option>
					 <option value="VALE" >
                            VALE</option>
					 <option value="VIADUCT" >
                            VIADUCT</option>
					 <option value="VIEW" >
                            VIEW</option>
					 <option value="VILLAS" >
                            VILLAS</option>
					 <option value="VISTA" >
                            VISTA</option>
					 <option value="WADE" >
                            WADE</option>
					 <option value="WALK" >
                            WALK</option>
					 <option value="WALKWAY" >
                            WALKWAY</option>
					 <option value="WAY" >
                            WAY</option>
					 <option value="WEST" >
                            WEST</option>
					 <option value="WHARF" >
                            WHARF</option>
					 <option value="WYND" >
                            WYND</option>
					 <option value="YARD" >
                            YARD</option>
              </select></td>
      </tr>
      <tr> 
        <td align="left"><div id="objPreviousAddressAus1">Suburb</div></td>
        <td align="left"><div id="objPreviousAddressAus2"><input name="Previous_Suburb"  value="" type="Text" size="16"> 
        State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="chPreviousState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousPostcode.focus()};">

					<option value=""></option>
              <option value="ACT" >
                            ACT</option>
              <option value="NSW" >
                            NSW</option>
              <option value="NT" >
                            NT</option>
              <option value="QLD" >
                            QLD</option>
              <option value="SA" >
                            SA</option>
              <option value="TAS" >
                            TAS</option>
              <option value="VIC" >
                            VIC</option>
              <option value="WA " >
                            WA </option>

          </select> Postcode<img src="images/spacer.gif" width="10" height="1" border="0"><input name="Previous_Postcode" value=""  type="Text" size="4" maxlength="4">  </div></td>
      </tr> 
     
      <tr> 
        <td align="left" ><div id="objPreviousAddressInt1" style="display:none">Suburb</div></td>
        <td align="left" ><div id="objPreviousAddressInt2" style="display:none"><input name="Previous_Int_Suburb" type="Text" size="16"> City&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input name="chPreviousIntCity" type="Text" size="16"> State/County <input name="Previous_Int_State" type="Text" size="16"></div></td>
      </tr>  
             
      <tr> 
        <td height="3" align="left"><div id="objPreviousAddressInt3"  style="display:none">PostCode/ZIP</div></td>
        <td height="3"><div id="objPreviousAddressInt4"  style="display:none"><input name="Previous_Int_Postcode" type="Text" size="16"> Country <select name="chPreviousIntCountry"><option value="">(Select Country)</option>

            <option value="Afghanistan">Afghanistan</option>
            <option value="Albania">Albania</option>
            <option value="Algeria">Algeria</option>
            <option value="American Samoa">American Samoa</option>
            <option value="Andorra">Andorra</option>
            <option value="Angola">Angola</option>
            <option value="Anguilla">Anguilla</option>
            <option value="Antarctica">Antarctica</option>
            <option value="Antigua and Barbuda">Antigua and Barbuda</option>
            <option value="Argentina">Argentina</option>
            <option value="Armenia">Armenia</option>
            <option value="Aruba">Aruba</option>
            <option value="Austria">Austria</option>
            <option value="Azerbaijan">Azerbaijan</option>
            <option value="Bahamas">Bahamas</option>
            <option value="Bahrain">Bahrain</option>
            <option value="Bangladesh">Bangladesh</option>
            <option value="Barbados">Barbados</option>
            <option value="Belarus">Belarus</option>
            <option value="Belgium">Belgium</option>
            <option value="Belize">Belize</option>
            <option value="Benin">Benin</option>
            <option value="Bermuda">Bermuda</option>
            <option value="Bhutan">Bhutan</option>
            <option value="Bolivia">Bolivia</option>
            <option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
            <option value="Botswana">Botswana</option>
            <option value="Bouvet Island">Bouvet Island</option>
            <option value="Brazil">Brazil</option>
            <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
            <option value="Brunei Darussalam">Brunei Darussalam</option>
            <option value="Bulgaria">Bulgaria</option>
            <option value="Burkina Faso">Burkina Faso</option>
            <option value="Burundi">Burundi</option>
            <option value="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman islands">Cayman islands</option>
            <option value="Central African Republic">Central African Republic</option>
            <option value="Chad">Chad</option>
            <option value="Chile">Chile</option>
            <option value="China">China</option>
            <option value="Christmas Island">Christmas Island</option>
            <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
            <option value="Colombia">Colombia</option>
            <option value="Comoros">Comoros</option>
            <option value="Congo">Congo</option>
            <option value="Congo, Democratic Republic">Congo, Democratic Republic</option>
            <option value="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Cote d'ivoire">Cote d'ivoire</option>
            <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option>
            <option value="Cuba">Cuba</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</option>
            <option value="Denmark">Denmark</option>
            <option value="Djibouti">Djibouti</option>
            <option value="Dominica">Dominica</option>
            <option value="Dominican Republic">Dominican Republic</option>
            <option value="East Timor">East Timor</option>
            <option value="Ecuador">Ecuador</option>
            <option value="Egypt">Egypt</option>
            <option value="El Salvador">El Salvador</option>
            <option value="Equatorial Guinea">Equatorial Guinea</option>
            <option value="Eritrea">Eritrea</option>
            <option value="Estonia">Estonia</option>
            <option value="Ethiopia">Ethiopia</option>
            <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
            <option value="Faroe islands">Faroe islands</option>
            <option value="Fiji">Fiji</option>
            <option value="Finland">Finland</option>
            <option value="France">France</option>
            <option value="France, Metropolitan">France, Metropolitan</option>
            <option value="French Guiana">French Guiana</option>
            <option value="French Polynesia">French Polynesia</option>
            <option value="French Southern Territories">French Southern Territories</option>
            <option value="Gabon">Gabon</option>
            <option value="Gambia">Gambia</option>
            <option value="Georgia">Georgia</option>
            <option value="Germany">Germany</option>
            <option value="Ghana">Ghana</option>
            <option value="Gibraltar">Gibraltar</option>
            <option value="Greece">Greece</option>
            <option value="Greenland">Greenland</option>
            <option value="Grenada">Grenada</option>
            <option value="Guadeloupe">Guadeloupe</option>
            <option value="Guam">Guam</option>
            <option value="Guatemala">Guatemala</option>
            <option value="Guinea">Guinea</option>
            <option value="Guinea-Bissau">Guinea-Bissau</option>
            <option value="Guyana">Guyana</option>
            <option value="Haiti">Haiti</option>
            <option value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option>
            <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
            <option value="Honduras">Honduras</option>
            <option value="Hong Kong">Hong Kong</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="India">India</option>
            <option value="Indonesia">Indonesia</option>
            <option value="Iran (Islamic Republic of)">Iran (Islamic Republic of)</option>
            <option value="Iraq">Iraq</option>
            <option value="Ireland">Ireland</option>
            <option value="Israel">Israel</option>
            <option value="Italy">Italy</option>
            <option value="Jamaica">Jamaica</option>
            <option value="Japan">Japan</option>
            <option value="Jordan">Jordan</option>
            <option value="Kazakhstan">Kazakhstan</option>
            <option value="Kenya">Kenya</option>
            <option value="Kiribati">Kiribati</option>
            <option value="Korea, Democratic People's Republic">Korea, Democratic People's Republic</option>
            <option value="Korea, Republic of">Korea, Republic of</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
            <option value="Latvia">Latvia</option>
            <option value="Lebanon">Lebanon</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macau">Macau</option>
            <option value="Macedonia (Yugoslav Republic)">Macedonia (Yugoslav Republic)</option>
            <option value="Madagascar">Madagascar</option>
            <option value="Malawi">Malawi</option>
            <option value="Malaysia">Malaysia</option>
            <option value="Maldives">Maldives</option>
            <option value="Mali">Mali</option>
            <option value="Malta">Malta</option>
            <option value="Marshall Islands">Marshall Islands</option>
            <option value="Martinique">Martinique</option>
            <option value="Mauritania">Mauritania</option>
            <option value="Mauritius">Mauritius</option>
            <option value="Mayotte">Mayotte</option>
            <option value="Mexico">Mexico</option>
            <option value="Micronesia">Micronesia</option>
            <option value="Moldova">Moldova</option>
            <option value="Monaco">Monaco</option>
            <option value="Mongolia">Mongolia</option>
            <option value="Montserrat">Montserrat</option>
            <option value="Morocco">Morocco</option>
            <option value="Mozambique">Mozambique</option>
            <option value="Myanmar">Myanmar</option>
            <option value="Namibia">Namibia</option>
            <option value="Nauru">Nauru</option>
            <option value="Nepal">Nepal</option>
            <option value="Netherlands">Netherlands</option>
            <option value="Netherlands Antilles">Netherlands Antilles</option>
            <option value="New Caledonia">New Caledonia</option>
            <option value="New Zealand">New Zealand</option>
            <option value="Nicaragua">Nicaragua</option>
            <option value="Niger">Niger</option>
            <option value="Nigeria">Nigeria</option>
            <option value="Niue">Niue</option>
            <option value="Norfolk island">Norfolk island</option>
            <option value="Northern Mariana Islands">Northern Mariana Islands</option>
            <option value="Norway">Norway</option>
            <option value="Oman">Oman</option>
            <option value="Pakistan">Pakistan</option>
            <option value="Palau">Palau</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Peru">Peru</option>
            <option value="Philippines">Philippines</option>
            <option value="Pitcairn">Pitcairn</option>
            <option value="Poland">Poland</option>
            <option value="Portugal">Portugal</option>
            <option value="Puerto Rico">Puerto Rico</option>
            <option value="Qatar">Qatar</option>
            <option value="Reunion">Reunion</option>
            <option value="Romania">Romania</option>
            <option value="Russian Federation">Russian Federation</option>
            <option value="Rwanda">Rwanda</option>
            <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
            <option value="Saint Lucia">Saint Lucia</option>
            <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
            <option value="Samoa">Samoa</option>
            <option value="San Marino">San Marino</option>
            <option value="Sao Tome and Principe">Sao Tome and Principe</option>
            <option value="Saudi Arabia">Saudi Arabia</option>
            <option value="Senegal">Senegal</option>
            <option value="Seychelles">Seychelles</option>
            <option value="Sierra Leone">Sierra Leone</option>
            <option value="Singapore">Singapore</option>
            <option value="Slovakia (Slovak Republic)">Slovakia (Slovak Republic)</option>
            <option value="Slovenia">Slovenia</option>
            <option value="Solomon Islands">Solomon Islands</option>
            <option value="Somalia">Somalia</option>
            <option value="South Africa">South Africa</option>
            <option value="South Georgia">South Georgia</option>
            <option value="Spain">Spain</option>
            <option value="Sri Lanka">Sri Lanka</option>
            <option value="St Helena">St Helena</option>
            <option value="St Pierre and Miquelon">St Pierre and Miquelon</option>
            <option value="Sudan">Sudan</option>
            <option value="Suriname">Suriname</option>
            <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
            <option value="Swaziland">Swaziland</option>
            <option value="Sweden">Sweden</option>
            <option value="Switzerland">Switzerland</option>
            <option value="Syrian Arab Republic">Syrian Arab Republic</option>
            <option value="Taiwan">Taiwan</option>
            <option value="Tajikistan">Tajikistan</option>
            <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
            <option value="Thailand">Thailand</option>
            <option value="Togo">Togo</option>
            <option value="Tokelau">Tokelau</option>
            <option value="Tonga">Tonga</option>
            <option value="Trinidad and Tobago">Trinidad and Tobago</option>
            <option value="Tunisia">Tunisia</option>
            <option value="Turkey">Turkey</option>
            <option value="Turkmenistan">Turkmenistan</option>
            <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
            <option value="Tuvalu">Tuvalu</option>
            <option value="Uganda">Uganda</option>
            <option value="Ukraine">Ukraine</option>
            <option value="United Arab Emirates">United Arab Emirates</option>
            <option value="United Kingdom">United Kingdom</option>
            <option value="United States">United States</option>
            <option value="Uruguay">Uruguay</option>
            <option value="Uzbekistan">Uzbekistan</option>
            <option value="Vanuatu">Vanuatu</option>
            <option value="Venezuela">Venezuela</option>
            <option value="Vietnam">Vietnam</option>
            <option value="Virgin Islands (British)">Virgin Islands (British)</option>
            <option value="Virgin Islands (US)">Virgin Islands (US)</option>
            <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
            <option value="Western Sahara">Western Sahara</option>
            <option value="Yemen">Yemen</option>
            <option value="Yugoslavia">Yugoslavia</option>
            <option value="Zambia">Zambia</option>
            <option value="Zimbabwe">Zimbabwe</option>
          </select></div></td>
      </tr>      
    
        <tr>
	  	<td align="left" width="171"><table cellpadding="0" width="100%" cellspacing="0" border="0"><tr>
	  	      <td>Rent</td><td align="right">$ </td></tr></table></td>
        <td  width="568"><input name="Previous_Rent" value=""   type="text" size="4" maxlength="50"> 
        pw
        <img src="images/spacer.gif" height="1" width="42" border="0">Length of tenancy<img src="images/spacer.gif" height="1" width="22" border="0">
        <input name="Previous_Time_At_Address" value="" type="Text" size="16" maxlength="20"> 
	  </tr>
             
      <tr>
	  	<td align="left" width="171">Was bond refunded in full?</td>
        <td  width="568"><input name="Previous_Bond_Refund"  value="" type="text" size="4" maxlength="10"> 
        <img src="images/spacer.gif" width="62" height="1" border="0">If not, why not? 
         <img src="images/spacer.gif" width="37" height="1" border="0"><input name="Previous_Bond_Refund_Excuse"  value=""  type="Text" style="width:199px" maxlength="50">
	  </tr>
      
      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 
      
      <tr>
        <td class="navytext" colspan="2"><strong>Contact Details of Previous Landlord or Agent if less than 3 years:</strong></td>
      </tr> 
      	 
      <tr> 
             <td align="left">Agency Name</td>
            <td><input name="Previous_Agency_Name" value="" maxlength="100"  type="Text" style="width:436px;"></td>
          </tr> 

          <tr><td class="navytext" colspan="2"><strong>Or</strong></td>
          </tr> 
          <tr> 
         <td align="left">Landlord's Name</td>
        <td><input name="Previous_Landlord_FirstName" value="" maxlength="50"  type="Text" size="16"> 
        <input name="Previous_Landlord_Surname" value="" maxlength="50"  type="Text" size="16">
		</td>
      </tr>  
      
      <tr> 
        <td class="navytext"><b>Address of agent/landlord:</b></td>
		<td class="searchgreentext">
		<input name="Previous_Agent_International1" onClick="setPreviousAgentInternationalNode(0)"  class="formcheckbox" checked="true" type="Radio" value="V1">

		  <span class="navytext"> AUSTRALIAN</span>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

		  <input  class="formcheckbox"  onClick="setPreviousAgentInternationalNode(1)" name="chPreviousAgentInternational" type="Radio" value="V1" checked="true">
	    <span class="navytext"> INTERNATIONAL</span></td>
      </tr>
      
       <tr> 
         <td align="left">Type of Residence</td>

        <td valign="Bottom" align="left" ><select name="chPreviousAgentPrefix" onChange=				"if((this.value=='')||(this.value=='null')){document.getElementById('chPreviousAgentFlatNo').style.display='none';document.getElementById('lblPreviousAgentFlatNo').style.display='none';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentStreetNo.focus()};}else{document.getElementById('chPreviousAgentFlatNo').style.display='inline';document.getElementById('lblPreviousAgentFlatNo').style.display='inline';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentFlatNo.focus()}};if(this.value=='-----'){this.value='';document.getElementById('chPreviousAgentFlatNo').style.display='none';document.getElementById('lblPreviousAgentFlatNo').style.display='none';};" style="width:113px;">
                    <option value="null">(Select)</option>
                    <option value="" SELECTED>HOUSE</option>
                    <option value="UNIT" >UNIT</option>
                    <option value="APARTMENT" >APARTMENT</option>
                    <option value="FLAT" >FLAT</option>
                    <option value="STUDIO" >STUDIO</option>
			<option value="-----" >
                        -----</option>
				<option value="BLOCK" >
                        BLOCK</option>
				<option value="CABIN" >
                        CABIN</option>
				<option value="COTTAGE" >
                        COTTAGE</option>
				<option value="DUPLEX" >
                        DUPLEX</option>
				<option value="FACTORY" >
                        FACTORY</option>
				<option value="FLOOR" >
                        FLOOR</option>
				<option value="LOT" >
                        LOT</option>
				<option value="PIER" >
                        PIER</option>
				<option value="ROOFTOP" >
                        ROOFTOP</option>
				<option value="ROOM" >
                        ROOM</option>
				<option value="SHOP" >
                        SHOP</option>
				<option value="SUITE" >
                        SUITE</option>
				<option value="TOWNHOUSE" >
                        TOWNHOUSE</option>
				<option value="VILLA" >
                        VILLA</option>
				<option value="WAREHOUSE" >
                        WAREHOUSE</option>
              </select><div id="lblPreviousAgentFlatNo" style="display:none">&nbsp;&nbsp;No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<img src="images/spacer.gif" width="2" border="0"></div><input name="Previous_Agent_FlatNo"  value="" id="chPreviousAgentFlatNo" type="Text" size="4" style="display:none" onBlur="checkAlphaNumeric(this,1,'','.','');"><img src="images/spacer.gif" width="2" border="0">Str. No.&nbsp;<input name="Previous_Agent_Street_Number" value=""  type="Text" size="4" onBlur="checkAlphaNumeric(this,1,'','','-')"></td>
      </tr>
         <tr>

        <td align="left" >Street Name</td>
        <td valign="Bottom" align="left" ><input name="Previous_Agent_Street_Name" value=""  type="Text" size="16"><img src="images/spacer.gif" width="46" height="1" border="0"><select name="chPreviousAgentStreetType" onChange="if(this.value=='-----'){this.value='';};if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentSuburb.focus()};"><option value="">(Street Type)</option>
                
					 <option value="STREET" >
                            STREET</option>
					 <option value="ROAD" >
                            ROAD</option>
					 <option value="AVENUE" >
                            AVENUE</option>
					 <option value="PLACE" >
                            PLACE</option>
					 <option value="CRESCENT" >
                            CRESCENT</option>
					 <option value="DRIVE" >
                            DRIVE</option>
					 <option value="PARADE" >
                            PARADE</option>
					 <option value="CLOSE" >
                            CLOSE</option>

					 <option value="-----" >
                            -----</option>
					 <option value="ACCESS" >
                            ACCESS</option>
					 <option value="ALLEY" >
                            ALLEY</option>
					 <option value="ALLEYWAY" >
                            ALLEYWAY</option>
					 <option value="AMBLE" >
                            AMBLE</option>
					 <option value="ANCHORAGE" >
                            ANCHORAGE</option>
					 <option value="APPROACH" >
                            APPROACH</option>
					 <option value="ARCADE" >
                            ARCADE</option>
					 <option value="ARTERY" >
                            ARTERY</option>
					 <option value="BASIN" >
                            BASIN</option>
					 <option value="BEACH" >
                            BEACH</option>
					 <option value="BEND" >
                            BEND</option>
					 <option value="BLOCK" >
                            BLOCK</option>
					 <option value="BOULEVARD" >
                            BOULEVARD</option>
					 <option value="BOULEVARDE" >
                            BOULEVARDE</option>
					 <option value="BRACE" >
                            BRACE</option>
					 <option value="BRAE" >
                            BRAE</option>
					 <option value="BREAK" >
                            BREAK</option>
					 <option value="BRIDGE" >
                            BRIDGE</option>
					 <option value="BROADWAY" >
                            BROADWAY</option>
					 <option value="BROW" >
                            BROW</option>
					 <option value="BYPASS" >
                            BYPASS</option>
					 <option value="BYWAY" >
                            BYWAY</option>
					 <option value="CAUSEWAY" >
                            CAUSEWAY</option>
					 <option value="CENTRAL" >
                            CENTRAL</option>
					 <option value="CENTRE" >
                            CENTRE</option>
					 <option value="CENTREWAY" >
                            CENTREWAY</option>
					 <option value="CHASE" >
                            CHASE</option>
					 <option value="CIRCLE" >
                            CIRCLE</option>
					 <option value="CIRCLET" >
                            CIRCLET</option>
					 <option value="CIRCUIT" >
                            CIRCUIT</option>
					 <option value="CIRCUS" >
                            CIRCUS</option>
					 <option value="COLONNADE" >
                            COLONNADE</option>
					 <option value="COMMON" >
                            COMMON</option>
					 <option value="CONCOURSE" >
                            CONCOURSE</option>
					 <option value="COPSE" >
                            COPSE</option>
					 <option value="CORNER" >
                            CORNER</option>
					 <option value="CORSO" >
                            CORSO</option>
					 <option value="COURT" >
                            COURT</option>
					 <option value="COURTYARD" >
                            COURTYARD</option>
					 <option value="COVE" >
                            COVE</option>
					 <option value="CREST" >
                            CREST</option>
					 <option value="CROSS" >
                            CROSS</option>
					 <option value="CROSSING" >
                            CROSSING</option>
					 <option value="CROSSROAD" >
                            CROSSROAD</option>
					 <option value="CROSSWAY" >
                            CROSSWAY</option>
					 <option value="CRUISEWAY" >
                            CRUISEWAY</option>
					 <option value="CUL-DE-SAC" >
                            CUL-DE-SAC</option>
					 <option value="CUTTING" >
                            CUTTING</option>
					 <option value="DALE" >
                            DALE</option>
					 <option value="DELL" >
                            DELL</option>
					 <option value="DEVIATION" >
                            DEVIATION</option>
					 <option value="DIP" >
                            DIP</option>
					 <option value="DISTRIBUTOR" >
                            DISTRIBUTOR</option>
					 <option value="DRIVEWAY" >
                            DRIVEWAY</option>
					 <option value="EAST" >
                            EAST</option>
					 <option value="EDGE" >
                            EDGE</option>
					 <option value="ELBOW" >
                            ELBOW</option>
					 <option value="END" >
                            END</option>
					 <option value="ENTRANCE" >
                            ENTRANCE</option>
					 <option value="ESPLANADE" >
                            ESPLANADE</option>
					 <option value="ESTATE" >
                            ESTATE</option>
					 <option value="EXPRESSWAY" >
                            EXPRESSWAY</option>
					 <option value="EXTENSION" >
                            EXTENSION</option>
					 <option value="EXTENSION" >
                            EXTENSION</option>
					 <option value="FAIRWAY" >
                            FAIRWAY</option>
					 <option value="FIRE TRACK" >
                            FIRE TRACK</option>
					 <option value="FIRETRAIL" >
                            FIRETRAIL</option>
					 <option value="FLAT" >
                            FLAT</option>
					 <option value="FOLLOW" >
                            FOLLOW</option>
					 <option value="FOOTWAY" >
                            FOOTWAY</option>
					 <option value="FORESHORE" >
                            FORESHORE</option>
					 <option value="FORMATION" >
                            FORMATION</option>
					 <option value="FREEWAY" >
                            FREEWAY</option>
					 <option value="FRONT" >
                            FRONT</option>
					 <option value="FRONTAGE" >
                            FRONTAGE</option>
					 <option value="GAP" >
                            GAP</option>
					 <option value="GARDEN" >
                            GARDEN</option>
					 <option value="GARDENS" >
                            GARDENS</option>
					 <option value="GATE" >
                            GATE</option>
					 <option value="GATES" >
                            GATES</option>
					 <option value="GLADE" >
                            GLADE</option>
					 <option value="GLEN" >
                            GLEN</option>
					 <option value="GRANGE" >
                            GRANGE</option>
					 <option value="GREEN" >
                            GREEN</option>
					 <option value="GROUND" >
                            GROUND</option>
					 <option value="GROVE" >
                            GROVE</option>
					 <option value="GULLY" >
                            GULLY</option>
					 <option value="HEIGHTS" >
                            HEIGHTS</option>
					 <option value="HIGHROAD" >
                            HIGHROAD</option>
					 <option value="HIGHWAY" >
                            HIGHWAY</option>
					 <option value="HILL" >
                            HILL</option>
					 <option value="INTERCHANGE" >
                            INTERCHANGE</option>
					 <option value="INTERSECTION" >
                            INTERSECTION</option>
					 <option value="JUNCTION" >
                            JUNCTION</option>
					 <option value="KEY" >
                            KEY</option>
					 <option value="LANDING" >
                            LANDING</option>
					 <option value="LANE" >
                            LANE</option>
					 <option value="LANEWAY" >
                            LANEWAY</option>
					 <option value="LEES" >
                            LEES</option>
					 <option value="LINE" >
                            LINE</option>
					 <option value="LINK" >
                            LINK</option>
					 <option value="LITTLE" >
                            LITTLE</option>
					 <option value="LOOKOUT" >
                            LOOKOUT</option>
					 <option value="LOOP" >
                            LOOP</option>
					 <option value="LOWER" >
                            LOWER</option>
					 <option value="LOWER" >
                            LOWER</option>
					 <option value="MALL" >
                            MALL</option>
					 <option value="MEANDER" >
                            MEANDER</option>
					 <option value="MEW" >
                            MEW</option>
					 <option value="MEWS" >
                            MEWS</option>
					 <option value="MOTORWAY" >
                            MOTORWAY</option>
					 <option value="MOUNT" >
                            MOUNT</option>
					 <option value="NOOK" >
                            NOOK</option>
					 <option value="NORTH" >
                            NORTH</option>
					 <option value="NORTH EAST" >
                            NORTH EAST</option>
					 <option value="NORTH WEST" >
                            NORTH WEST</option>
					 <option value="OUTLOOK" >
                            OUTLOOK</option>
					 <option value="PARK" >
                            PARK</option>
					 <option value="PARKLANDS" >
                            PARKLANDS</option>
					 <option value="PARKWAY" >
                            PARKWAY</option>
					 <option value="PART" >
                            PART</option>
					 <option value="PASS" >
                            PASS</option>
					 <option value="PATH" >
                            PATH</option>
					 <option value="PATHWAY" >
                            PATHWAY</option>
					 <option value="PIAZZA" >
                            PIAZZA</option>
					 <option value="PLATEAU" >
                            PLATEAU</option>
					 <option value="PLAZA" >
                            PLAZA</option>
					 <option value="POCKET" >
                            POCKET</option>
					 <option value="POINT" >
                            POINT</option>
					 <option value="PORT" >
                            PORT</option>
					 <option value="PROMENADE" >
                            PROMENADE</option>
					 <option value="QUAD" >
                            QUAD</option>
					 <option value="QUADRANGLE" >
                            QUADRANGLE</option>
					 <option value="QUADRANT" >
                            QUADRANT</option>
					 <option value="QUAY" >
                            QUAY</option>
					 <option value="QUAYS" >
                            QUAYS</option>
					 <option value="RAMBLE" >
                            RAMBLE</option>
					 <option value="RAMP" >
                            RAMP</option>
					 <option value="RANGE" >
                            RANGE</option>
					 <option value="REACH" >
                            REACH</option>
					 <option value="RESERVE" >
                            RESERVE</option>
					 <option value="REST" >
                            REST</option>
					 <option value="RETREAT" >
                            RETREAT</option>
					 <option value="RIDE" >
                            RIDE</option>
					 <option value="RIDGE" >
                            RIDGE</option>
					 <option value="RIDGEWAY" >
                            RIDGEWAY</option>
					 <option value="RIGHT OF WAY" >
                            RIGHT OF WAY</option>
					 <option value="RING" >
                            RING</option>
					 <option value="RISE" >
                            RISE</option>
					 <option value="RIVER" >
                            RIVER</option>
					 <option value="RIVERWAY" >
                            RIVERWAY</option>
					 <option value="RIVIERA" >
                            RIVIERA</option>
					 <option value="ROADS" >
                            ROADS</option>
					 <option value="ROADSIDE" >
                            ROADSIDE</option>
					 <option value="ROADWAY" >
                            ROADWAY</option>
					 <option value="RONDE" >
                            RONDE</option>
					 <option value="ROSEBOWL" >
                            ROSEBOWL</option>
					 <option value="ROTARY" >
                            ROTARY</option>
					 <option value="ROUND" >
                            ROUND</option>
					 <option value="ROUTE" >
                            ROUTE</option>
					 <option value="ROW" >
                            ROW</option>
					 <option value="RUE" >
                            RUE</option>
					 <option value="RUN" >
                            RUN</option>
					 <option value="SERVICE WAY" >
                            SERVICE WAY</option>
					 <option value="SIDING" >
                            SIDING</option>
					 <option value="SLOPE" >
                            SLOPE</option>
					 <option value="SOUND" >
                            SOUND</option>
					 <option value="SOUTH" >
                            SOUTH</option>
					 <option value="SOUTH EAST" >
                            SOUTH EAST</option>
					 <option value="SOUTH WEST" >
                            SOUTH WEST</option>
					 <option value="SPUR" >
                            SPUR</option>
					 <option value="SQUARE" >
                            SQUARE</option>
					 <option value="STAIRS" >
                            STAIRS</option>
					 <option value="STATE HIGHWAY" >
                            STATE HIGHWA</option>
					 <option value="STEPS" >
                            STEPS</option>
					 <option value="STEYNE" >
                            STEYNE</option>
					 <option value="STRAND" >
                            STRAND</option>
					 <option value="STRIP" >
                            STRIP</option>
					 <option value="SUBWAY" >
                            SUBWAY</option>
					 <option value="TARN" >
                            TARN</option>
					 <option value="TERRACE" >
                            TERRACE</option>
					 <option value="THOROUGHFARE" >
                            THOROUGHFARE</option>
					 <option value="TOLLWAY" >
                            TOLLWAY</option>
					 <option value="TOP" >
                            TOP</option>
					 <option value="TOR" >
                            TOR</option>
					 <option value="TOWERS" >
                            TOWERS</option>
					 <option value="TRACK" >
                            TRACK</option>
					 <option value="TRAIL" >
                            TRAIL</option>
					 <option value="TRAILER" >
                            TRAILER</option>
					 <option value="TRIANGLE" >
                            TRIANGLE</option>
					 <option value="TRUNKWAY" >
                            TRUNKWAY</option>
					 <option value="TURN" >
                            TURN</option>
					 <option value="UNDERPASS" >
                            UNDERPASS</option>
					 <option value="UPPER" >
                            UPPER</option>
					 <option value="UPPER" >
                            UPPER</option>
					 <option value="VALE" >
                            VALE</option>
					 <option value="VIADUCT" >
                            VIADUCT</option>
					 <option value="VIEW" >
                            VIEW</option>
					 <option value="VILLAS" >
                            VILLAS</option>
					 <option value="VISTA" >
                            VISTA</option>
					 <option value="WADE" >
                            WADE</option>
					 <option value="WALK" >
                            WALK</option>
					 <option value="WALKWAY" >
                            WALKWAY</option>
					 <option value="WAY" >
                            WAY</option>
					 <option value="WEST" >
                            WEST</option>
					 <option value="WHARF" >
                            WHARF</option>
					 <option value="WYND" >
                            WYND</option>
					 <option value="YARD" >
                            YARD</option>
              </select></td>
      </tr>

      <tr> 
        <td align="left"><div id="objPreviousAgentAus1">Suburb</div></td>
        <td align="left"><div id="objPreviousAgentAus2"><input name="Previous_Agent_Suburb"  value="" type="Text" size="16"> 

        State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="chPreviousAgentState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentPostcode.focus()};">

					<option value=""></option>
             <option value="ACT" >
                            ACT</option>
             <option value="NSW" >
                            NSW</option>
             <option value="NT" >
                            NT</option>
             <option value="QLD" >
                            QLD</option>
             <option value="SA" >
                            SA</option>
             <option value="TAS" >
                            TAS</option>
             <option value="VIC" >
                            VIC</option>
             <option value="WA " >
                            WA </option>

          </select> Postcode<img src="images/spacer.gif" width="10" height="1" border="0"><input name="Previous_Agent_Postcode" value="" type="Text" size="4" maxlength="4">  </div></td>

      </tr> 
      <tr> 
        <td align="left" ><div id="objPreviousAgentInt1" style="display:none">Suburb</div></td>
        <td align="left" ><div id="objPreviousAgentInt2" style="display:none"><input name="Previous_AgentIntSuburb" type="Text" size="16"> City&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input name="Previous_Agent_Int_City" type="Text" size="16"> State/County <input name="Previous_Agent_Int_State" type="Text" size="16"></div></td>

      </tr>  
       <tr> 

        <td height="3" align="left"><div id="objPreviousAgentInt3"  style="display:none">PostCode/ZIP</div></td>

        <td height="3"><div id="objPreviousAgentInt4"  style="display:none"><input name="Previous_Agent_Int_Postcode" type="Text" size="16"> Country <select name="chPreviousAgentIntCountry"><option value="">(Select Country)</option>
            <option value="Afghanistan">Afghanistan</option>
            <option value="Albania">Albania</option>
            <option value="Algeria">Algeria</option>
            <option value="American Samoa">American Samoa</option>
            <option value="Andorra">Andorra</option>
            <option value="Angola">Angola</option>
            <option value="Anguilla">Anguilla</option>
            <option value="Antarctica">Antarctica</option>
            <option value="Antigua and Barbuda">Antigua and Barbuda</option>
            <option value="Argentina">Argentina</option>
            <option value="Armenia">Armenia</option>
            <option value="Aruba">Aruba</option>
            <option value="Austria">Austria</option>
            <option value="Azerbaijan">Azerbaijan</option>
            <option value="Bahamas">Bahamas</option>
            <option value="Bahrain">Bahrain</option>
            <option value="Bangladesh">Bangladesh</option>
            <option value="Barbados">Barbados</option>
            <option value="Belarus">Belarus</option>
            <option value="Belgium">Belgium</option>
            <option value="Belize">Belize</option>
            <option value="Benin">Benin</option>
            <option value="Bermuda">Bermuda</option>
            <option value="Bhutan">Bhutan</option>
            <option value="Bolivia">Bolivia</option>
            <option value="Bosnia and Herzegowina">Bosnia and Herzegowina</option>
            <option value="Botswana">Botswana</option>
            <option value="Bouvet Island">Bouvet Island</option>
            <option value="Brazil">Brazil</option>
            <option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
            <option value="Brunei Darussalam">Brunei Darussalam</option>
            <option value="Bulgaria">Bulgaria</option>
            <option value="Burkina Faso">Burkina Faso</option>
            <option value="Burundi">Burundi</option>
            <option value="Cambodia">Cambodia</option>
            <option value="Cameroon">Cameroon</option>
            <option value="Canada">Canada</option>
            <option value="Cape Verde">Cape Verde</option>
            <option value="Cayman islands">Cayman islands</option>
            <option value="Central African Republic">Central African Republic</option>
            <option value="Chad">Chad</option>
            <option value="Chile">Chile</option>
            <option value="China">China</option>
            <option value="Christmas Island">Christmas Island</option>
            <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
            <option value="Colombia">Colombia</option>
            <option value="Comoros">Comoros</option>
            <option value="Congo">Congo</option>
            <option value="Congo, Democratic Republic">Congo, Democratic Republic</option>
            <option value="Cook Islands">Cook Islands</option>
            <option value="Costa Rica">Costa Rica</option>
            <option value="Cote d'ivoire">Cote d'ivoire</option>
            <option value="Croatia (Hrvatska)">Croatia (Hrvatska)</option>
            <option value="Cuba">Cuba</option>
            <option value="Cyprus">Cyprus</option>
            <option value="Czech Republic">Czech Republic</option>
            <option value="Denmark">Denmark</option>
            <option value="Djibouti">Djibouti</option>
            <option value="Dominica">Dominica</option>
            <option value="Dominican Republic">Dominican Republic</option>
            <option value="East Timor">East Timor</option>
            <option value="Ecuador">Ecuador</option>
            <option value="Egypt">Egypt</option>
            <option value="El Salvador">El Salvador</option>
            <option value="Equatorial Guinea">Equatorial Guinea</option>
            <option value="Eritrea">Eritrea</option>
            <option value="Estonia">Estonia</option>
            <option value="Ethiopia">Ethiopia</option>
            <option value="Falkland Islands (Malvinas)">Falkland Islands (Malvinas)</option>
            <option value="Faroe islands">Faroe islands</option>
            <option value="Fiji">Fiji</option>
            <option value="Finland">Finland</option>
            <option value="France">France</option>
            <option value="France, Metropolitan">France, Metropolitan</option>
            <option value="French Guiana">French Guiana</option>
            <option value="French Polynesia">French Polynesia</option>
            <option value="French Southern Territories">French Southern Territories</option>
            <option value="Gabon">Gabon</option>
            <option value="Gambia">Gambia</option>
            <option value="Georgia">Georgia</option>
            <option value="Germany">Germany</option>
            <option value="Ghana">Ghana</option>
            <option value="Gibraltar">Gibraltar</option>
            <option value="Greece">Greece</option>
            <option value="Greenland">Greenland</option>
            <option value="Grenada">Grenada</option>
            <option value="Guadeloupe">Guadeloupe</option>
            <option value="Guam">Guam</option>
            <option value="Guatemala">Guatemala</option>
            <option value="Guinea">Guinea</option>
            <option value="Guinea-Bissau">Guinea-Bissau</option>
            <option value="Guyana">Guyana</option>
            <option value="Haiti">Haiti</option>
            <option value="Heard and Mc Donald Islands">Heard and Mc Donald Islands</option>
            <option value="Holy See (Vatican City State)">Holy See (Vatican City State)</option>
            <option value="Honduras">Honduras</option>
            <option value="Hong Kong">Hong Kong</option>
            <option value="Hungary">Hungary</option>
            <option value="Iceland">Iceland</option>
            <option value="India">India</option>
            <option value="Indonesia">Indonesia</option>
            <option value="Iran (Islamic Republic of)">Iran (Islamic Republic of)</option>
            <option value="Iraq">Iraq</option>
            <option value="Ireland">Ireland</option>
            <option value="Israel">Israel</option>
            <option value="Italy">Italy</option>
            <option value="Jamaica">Jamaica</option>
            <option value="Japan">Japan</option>
            <option value="Jordan">Jordan</option>
            <option value="Kazakhstan">Kazakhstan</option>
            <option value="Kenya">Kenya</option>
            <option value="Kiribati">Kiribati</option>
            <option value="Korea, Democratic People's Republic">Korea, Democratic People's Republic</option>
            <option value="Korea, Republic of">Korea, Republic of</option>
            <option value="Kuwait">Kuwait</option>
            <option value="Kyrgyzstan">Kyrgyzstan</option>
            <option value="Lao People's Democratic Republic">Lao People's Democratic Republic</option>
            <option value="Latvia">Latvia</option>
            <option value="Lebanon">Lebanon</option>
            <option value="Lesotho">Lesotho</option>
            <option value="Liberia">Liberia</option>
            <option value="Libyan Arab Jamahiriya">Libyan Arab Jamahiriya</option>
            <option value="Liechtenstein">Liechtenstein</option>
            <option value="Lithuania">Lithuania</option>
            <option value="Luxembourg">Luxembourg</option>
            <option value="Macau">Macau</option>
            <option value="Macedonia (Yugoslav Republic)">Macedonia (Yugoslav Republic)</option>
            <option value="Madagascar">Madagascar</option>
            <option value="Malawi">Malawi</option>
            <option value="Malaysia">Malaysia</option>
            <option value="Maldives">Maldives</option>
            <option value="Mali">Mali</option>
            <option value="Malta">Malta</option>
            <option value="Marshall Islands">Marshall Islands</option>
            <option value="Martinique">Martinique</option>
            <option value="Mauritania">Mauritania</option>
            <option value="Mauritius">Mauritius</option>
            <option value="Mayotte">Mayotte</option>
            <option value="Mexico">Mexico</option>
            <option value="Micronesia">Micronesia</option>
            <option value="Moldova">Moldova</option>
            <option value="Monaco">Monaco</option>
            <option value="Mongolia">Mongolia</option>
            <option value="Montserrat">Montserrat</option>
            <option value="Morocco">Morocco</option>
            <option value="Mozambique">Mozambique</option>
            <option value="Myanmar">Myanmar</option>
            <option value="Namibia">Namibia</option>
            <option value="Nauru">Nauru</option>
            <option value="Nepal">Nepal</option>
            <option value="Netherlands">Netherlands</option>
            <option value="Netherlands Antilles">Netherlands Antilles</option>
            <option value="New Caledonia">New Caledonia</option>
            <option value="New Zealand">New Zealand</option>
            <option value="Nicaragua">Nicaragua</option>
            <option value="Niger">Niger</option>
            <option value="Nigeria">Nigeria</option>
            <option value="Niue">Niue</option>
            <option value="Norfolk island">Norfolk island</option>
            <option value="Northern Mariana Islands">Northern Mariana Islands</option>
            <option value="Norway">Norway</option>
            <option value="Oman">Oman</option>
            <option value="Pakistan">Pakistan</option>
            <option value="Palau">Palau</option>
            <option value="Panama">Panama</option>
            <option value="Papua New Guinea">Papua New Guinea</option>
            <option value="Paraguay">Paraguay</option>
            <option value="Peru">Peru</option>
            <option value="Philippines">Philippines</option>
            <option value="Pitcairn">Pitcairn</option>
            <option value="Poland">Poland</option>
            <option value="Portugal">Portugal</option>
            <option value="Puerto Rico">Puerto Rico</option>
            <option value="Qatar">Qatar</option>
            <option value="Reunion">Reunion</option>
            <option value="Romania">Romania</option>
            <option value="Russian Federation">Russian Federation</option>
            <option value="Rwanda">Rwanda</option>
            <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
            <option value="Saint Lucia">Saint Lucia</option>
            <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
            <option value="Samoa">Samoa</option>
            <option value="San Marino">San Marino</option>
            <option value="Sao Tome and Principe">Sao Tome and Principe</option>
            <option value="Saudi Arabia">Saudi Arabia</option>
            <option value="Senegal">Senegal</option>
            <option value="Seychelles">Seychelles</option>
            <option value="Sierra Leone">Sierra Leone</option>
            <option value="Singapore">Singapore</option>
            <option value="Slovakia (Slovak Republic)">Slovakia (Slovak Republic)</option>
            <option value="Slovenia">Slovenia</option>
            <option value="Solomon Islands">Solomon Islands</option>
            <option value="Somalia">Somalia</option>
            <option value="South Africa">South Africa</option>
            <option value="South Georgia">South Georgia</option>
            <option value="Spain">Spain</option>
            <option value="Sri Lanka">Sri Lanka</option>
            <option value="St Helena">St Helena</option>
            <option value="St Pierre and Miquelon">St Pierre and Miquelon</option>
            <option value="Sudan">Sudan</option>
            <option value="Suriname">Suriname</option>
            <option value="Svalbard and Jan Mayen Islands">Svalbard and Jan Mayen Islands</option>
            <option value="Swaziland">Swaziland</option>
            <option value="Sweden">Sweden</option>
            <option value="Switzerland">Switzerland</option>
            <option value="Syrian Arab Republic">Syrian Arab Republic</option>
            <option value="Taiwan">Taiwan</option>
            <option value="Tajikistan">Tajikistan</option>
            <option value="Tanzania, United Republic of">Tanzania, United Republic of</option>
            <option value="Thailand">Thailand</option>
            <option value="Togo">Togo</option>
            <option value="Tokelau">Tokelau</option>
            <option value="Tonga">Tonga</option>
            <option value="Trinidad and Tobago">Trinidad and Tobago</option>
            <option value="Tunisia">Tunisia</option>
            <option value="Turkey">Turkey</option>
            <option value="Turkmenistan">Turkmenistan</option>
            <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
            <option value="Tuvalu">Tuvalu</option>
            <option value="Uganda">Uganda</option>
            <option value="Ukraine">Ukraine</option>
            <option value="United Arab Emirates">United Arab Emirates</option>
            <option value="United Kingdom">United Kingdom</option>
            <option value="United States">United States</option>
            <option value="Uruguay">Uruguay</option>
            <option value="Uzbekistan">Uzbekistan</option>
            <option value="Vanuatu">Vanuatu</option>
            <option value="Venezuela">Venezuela</option>
            <option value="Vietnam">Vietnam</option>
            <option value="Virgin Islands (British)">Virgin Islands (British)</option>
            <option value="Virgin Islands (US)">Virgin Islands (US)</option>
            <option value="Wallis and Futuna Islands">Wallis and Futuna Islands</option>
            <option value="Western Sahara">Western Sahara</option>
            <option value="Yemen">Yemen</option>
            <option value="Yugoslavia">Yugoslavia</option>
            <option value="Zambia">Zambia</option>
            <option value="Zimbabwe">Zimbabwe</option>          </select></div></td>
      </tr>
       <tr> 

         <td align="left">Phone</td>

        <td ><select name="chPreviousAgentPhone1" id="chPreviousAgentPhone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentPhone2.focus()};">

		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>				

		  </select>

			  <input type="text" name="chPreviousAgentPhone2"  value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentPhone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			  <input type="text" name="chPreviousAgentPhone3" value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentMobilePhone1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			<img src="images/spacer.gif" width="6" height="1" border="0"> Mobile<img src="images/spacer.gif" width="37" height="1" border="0"><input type="text" name="chPreviousAgentMobilePhone1" value=""  size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentMobilePhone2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	

		  <input type="text" name="chPreviousAgentMobilePhone2" value=""  size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentMobilePhone3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="chPreviousAgentMobilePhone3" value=""  size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chPreviousAgentEmail.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		</td>
      </tr>

      <tr> 
         <td align="left">Email</td>
        <td><input name="Previous_Agent_Email" value="" type="Text" style="width:199px;" onBlur="checkEmail(this);" maxlength="50">
		</td>
      </tr>
      
      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

      <tr>
	  	<td align="left" width="171" class="navytext"><strong>EMERGENCY CONTACT: <span class="redstar">*</span> </strong></td>
        <td  width="568">&nbsp;</td>
	  </tr>

      <tr>

	  	<td align="left" width="171">Name</td>

        <td  width="568"><input name="Contact_FirstName" value=""  type="Text" size="16"> <input name="Contact_Surname" value=""  type="Text" size="16"></td>

	  </tr>

       <tr> 

         <td align="left">Type of Residence</td>

        <td valign="Bottom" align="left" ><select name="chContactPrefix" onChange=				"if((this.value=='')||(this.value=='null')){document.getElementById('chContactFlatNo').style.display='none';document.getElementById('lblContactFlatNo').style.display='none';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactStreetNo.focus()};}else{document.getElementById('chContactFlatNo').style.display='inline';document.getElementById('lblContactFlatNo').style.display='inline';if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactFlatNo.focus()}};if(this.value=='-----'){this.value='';document.getElementById('chContactFlatNo').style.display='none';document.getElementById('lblContactFlatNo').style.display='none';};" style="width:113px;">
                    <option value="null">(Select)</option>
                    <option value="" SELECTED>HOUSE</option>
                    <option value="UNIT" >UNIT</option>
                    <option value="APARTMENT" >APARTMENT</option>
                    <option value="FLAT" >FLAT</option>
                    <option value="STUDIO" >STUDIO</option>

			    <option value="-----" >

                        -----</option>
			    <option value="BLOCK" >
                        BLOCK</option>
			    <option value="CABIN" >
                        CABIN</option>
			    <option value="COTTAGE" >
                        COTTAGE</option>
			    <option value="DUPLEX" >
                        DUPLEX</option>
			    <option value="FACTORY" >
                        FACTORY</option>
			    <option value="FLOOR" >
                        FLOOR</option>
			    <option value="LOT" >
                        LOT</option>
			    <option value="PIER" >
                        PIER</option>
			    <option value="ROOFTOP" >
                        ROOFTOP</option>
			    <option value="ROOM" >
                        ROOM</option>
			    <option value="SHOP" >
                        SHOP</option>
			    <option value="SUITE" >
                        SUITE</option>
			    <option value="TOWNHOUSE" >
                        TOWNHOUSE</option>
			    <option value="VILLA" >
                        VILLA</option>
			    <option value="WAREHOUSE" >
                        WAREHOUSE</option>

              </select><div id="lblContactFlatNo" style="display:none">&nbsp;&nbsp;No.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<img src="images/spacer.gif" width="2" border="0"></div><input name="Contact_Flat_Number" id="chContactFlatNo" value=""  type="Text" size="4" style="display:none" onBlur="checkAlphaNumeric(this,1,'','.','');"><img src="images/spacer.gif" width="2" border="0">Str. No.&nbsp;<input name="Contact_Street_Number"  value=""  type="Text" size="4" onBlur="checkAlphaNumeric(this,1,'','','-')"></td>

      </tr>
         <tr>

        <td align="left" >Street Name</td>

        <td valign="Bottom" align="left" ><input name="Contact_Street_Name" value="" type="Text" size="16"><img src="images/spacer.gif" width="46" height="1" border="0"><select name="chContactStreetType" onChange="if(this.value=='-----'){this.value='';};if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactSuburb.focus()};"><option value="">(Street Type)</option>
                
					  <option value="STREET" >
                            STREET</option>
					  <option value="ROAD" >
                            ROAD</option>
					  <option value="AVENUE" >
                            AVENUE</option>
					  <option value="PLACE" >
                            PLACE</option>
					  <option value="CRESCENT" >
                            CRESCENT</option>
					  <option value="DRIVE" >
                            DRIVE</option>
					  <option value="PARADE" >
                            PARADE</option>

					  <option value="CLOSE" >

                            CLOSE</option>

					  <option value="-----" >
                            -----</option>
					  <option value="ACCESS" >
                            ACCESS</option>
					  <option value="ALLEY" >
                            ALLEY</option>
					  <option value="ALLEYWAY" >
                            ALLEYWAY</option>
					  <option value="AMBLE" >
                            AMBLE</option>
					  <option value="ANCHORAGE" >
                            ANCHORAGE</option>
					  <option value="APPROACH" >
                            APPROACH</option>
					  <option value="ARCADE" >
                            ARCADE</option>
					  <option value="ARTERY" >
                            ARTERY</option>
					  <option value="BASIN" >
                            BASIN</option>
					  <option value="BEACH" >
                            BEACH</option>
					  <option value="BEND" >
                            BEND</option>
					  <option value="BLOCK" >
                            BLOCK</option>
					  <option value="BOULEVARD" >
                            BOULEVARD</option>
					  <option value="BOULEVARDE" >
                            BOULEVARDE</option>
					  <option value="BRACE" >
                            BRACE</option>
					  <option value="BRAE" >
                            BRAE</option>
					  <option value="BREAK" >
                            BREAK</option>
					  <option value="BRIDGE" >
                            BRIDGE</option>
					  <option value="BROADWAY" >
                            BROADWAY</option>
					  <option value="BROW" >
                            BROW</option>
					  <option value="BYPASS" >
                            BYPASS</option>
					  <option value="BYWAY" >
                            BYWAY</option>
					  <option value="CAUSEWAY" >
                            CAUSEWAY</option>
					  <option value="CENTRAL" >
                            CENTRAL</option>
					  <option value="CENTRE" >
                            CENTRE</option>
					  <option value="CENTREWAY" >
                            CENTREWAY</option>
					  <option value="CHASE" >
                            CHASE</option>
					  <option value="CIRCLE" >
                            CIRCLE</option>
					  <option value="CIRCLET" >
                            CIRCLET</option>
					  <option value="CIRCUIT" >
                            CIRCUIT</option>
					  <option value="CIRCUS" >
                            CIRCUS</option>
					  <option value="COLONNADE" >
                            COLONNADE</option>
					  <option value="COMMON" >
                            COMMON</option>
					  <option value="CONCOURSE" >
                            CONCOURSE</option>
					  <option value="COPSE" >
                            COPSE</option>
					  <option value="CORNER" >
                            CORNER</option>
					  <option value="CORSO" >
                            CORSO</option>
					  <option value="COURT" >
                            COURT</option>
					  <option value="COURTYARD" >
                            COURTYARD</option>
					  <option value="COVE" >
                            COVE</option>
					  <option value="CREST" >
                            CREST</option>
					  <option value="CROSS" >
                            CROSS</option>
					  <option value="CROSSING" >
                            CROSSING</option>
					  <option value="CROSSROAD" >
                            CROSSROAD</option>
					  <option value="CROSSWAY" >
                            CROSSWAY</option>
					  <option value="CRUISEWAY" >
                            CRUISEWAY</option>
					  <option value="CUL-DE-SAC" >
                            CUL-DE-SAC</option>
					  <option value="CUTTING" >
                            CUTTING</option>
					  <option value="DALE" >
                            DALE</option>
					  <option value="DELL" >
                            DELL</option>
					  <option value="DEVIATION" >
                            DEVIATION</option>
					  <option value="DIP" >
                            DIP</option>
					  <option value="DISTRIBUTOR" >
                            DISTRIBUTOR</option>
					  <option value="DRIVEWAY" >
                            DRIVEWAY</option>
					  <option value="EAST" >
                            EAST</option>
					  <option value="EDGE" >
                            EDGE</option>
					  <option value="ELBOW" >
                            ELBOW</option>
					  <option value="END" >
                            END</option>
					  <option value="ENTRANCE" >
                            ENTRANCE</option>
					  <option value="ESPLANADE" >
                            ESPLANADE</option>
					  <option value="ESTATE" >
                            ESTATE</option>
					  <option value="EXPRESSWAY" >
                            EXPRESSWAY</option>
					  <option value="EXTENSION" >
                            EXTENSION</option>
					  <option value="EXTENSION" >
                            EXTENSION</option>
					  <option value="FAIRWAY" >
                            FAIRWAY</option>
					  <option value="FIRE TRACK" >
                            FIRE TRACK</option>
					  <option value="FIRETRAIL" >
                            FIRETRAIL</option>
					  <option value="FLAT" >
                            FLAT</option>
					  <option value="FOLLOW" >
                            FOLLOW</option>
					  <option value="FOOTWAY" >
                            FOOTWAY</option>
					  <option value="FORESHORE" >
                            FORESHORE</option>
					  <option value="FORMATION" >
                            FORMATION</option>
					  <option value="FREEWAY" >
                            FREEWAY</option>
					  <option value="FRONT" >
                            FRONT</option>
					  <option value="FRONTAGE" >
                            FRONTAGE</option>
					  <option value="GAP" >
                            GAP</option>
					  <option value="GARDEN" >
                            GARDEN</option>
					  <option value="GARDENS" >
                            GARDENS</option>
					  <option value="GATE" >
                            GATE</option>
					  <option value="GATES" >
                            GATES</option>
					  <option value="GLADE" >
                            GLADE</option>
					  <option value="GLEN" >
                            GLEN</option>
					  <option value="GRANGE" >
                            GRANGE</option>
					  <option value="GREEN" >
                            GREEN</option>
					  <option value="GROUND" >
                            GROUND</option>
					  <option value="GROVE" >
                            GROVE</option>
					  <option value="GULLY" >
                            GULLY</option>
					  <option value="HEIGHTS" >
                            HEIGHTS</option>
					  <option value="HIGHROAD" >
                            HIGHROAD</option>
					  <option value="HIGHWAY" >
                            HIGHWAY</option>
					  <option value="HILL" >
                            HILL</option>
					  <option value="INTERCHANGE" >
                            INTERCHANGE</option>
					  <option value="INTERSECTION" >
                            INTERSECTION</option>
					  <option value="JUNCTION" >
                            JUNCTION</option>
					  <option value="KEY" >
                            KEY</option>
					  <option value="LANDING" >
                            LANDING</option>
					  <option value="LANE" >
                            LANE</option>
					  <option value="LANEWAY" >
                            LANEWAY</option>
					  <option value="LEES" >
                            LEES</option>
					  <option value="LINE" >
                            LINE</option>
					  <option value="LINK" >
                            LINK</option>
					  <option value="LITTLE" >
                            LITTLE</option>
					  <option value="LOOKOUT" >
                            LOOKOUT</option>
					  <option value="LOOP" >
                            LOOP</option>
					  <option value="LOWER" >
                            LOWER</option>
					  <option value="LOWER" >
                            LOWER</option>
					  <option value="MALL" >
                            MALL</option>
					  <option value="MEANDER" >
                            MEANDER</option>
					  <option value="MEW" >
                            MEW</option>
					  <option value="MEWS" >
                            MEWS</option>
					  <option value="MOTORWAY" >
                            MOTORWAY</option>
					  <option value="MOUNT" >
                            MOUNT</option>
					  <option value="NOOK" >
                            NOOK</option>
					  <option value="NORTH" >
                            NORTH</option>
					  <option value="NORTH EAST" >
                            NORTH EAST</option>
					  <option value="NORTH WEST" >
                            NORTH WEST</option>
					  <option value="OUTLOOK" >
                            OUTLOOK</option>
					  <option value="PARK" >
                            PARK</option>
					  <option value="PARKLANDS" >
                            PARKLANDS</option>
					  <option value="PARKWAY" >
                            PARKWAY</option>
					  <option value="PART" >
                            PART</option>
					  <option value="PASS" >
                            PASS</option>
					  <option value="PATH" >
                            PATH</option>
					  <option value="PATHWAY" >
                            PATHWAY</option>
					  <option value="PIAZZA" >
                            PIAZZA</option>
					  <option value="PLATEAU" >
                            PLATEAU</option>
					  <option value="PLAZA" >
                            PLAZA</option>
					  <option value="POCKET" >
                            POCKET</option>
					  <option value="POINT" >
                            POINT</option>
					  <option value="PORT" >
                            PORT</option>
					  <option value="PROMENADE" >
                            PROMENADE</option>
					  <option value="QUAD" >
                            QUAD</option>
					  <option value="QUADRANGLE" >
                            QUADRANGLE</option>
					  <option value="QUADRANT" >
                            QUADRANT</option>
					  <option value="QUAY" >
                            QUAY</option>
					  <option value="QUAYS" >
                            QUAYS</option>
					  <option value="RAMBLE" >
                            RAMBLE</option>
					  <option value="RAMP" >
                            RAMP</option>
					  <option value="RANGE" >
                            RANGE</option>
					  <option value="REACH" >
                            REACH</option>
					  <option value="RESERVE" >
                            RESERVE</option>
					  <option value="REST" >
                            REST</option>
					  <option value="RETREAT" >
                            RETREAT</option>
					  <option value="RIDE" >
                            RIDE</option>
					  <option value="RIDGE" >
                            RIDGE</option>
					  <option value="RIDGEWAY" >
                            RIDGEWAY</option>
					  <option value="RIGHT OF WAY" >
                            RIGHT OF WAY</option>
					  <option value="RING" >
                            RING</option>
					  <option value="RISE" >
                            RISE</option>
					  <option value="RIVER" >
                            RIVER</option>
					  <option value="RIVERWAY" >
                            RIVERWAY</option>
					  <option value="RIVIERA" >
                            RIVIERA</option>
					  <option value="ROADS" >
                            ROADS</option>
					  <option value="ROADSIDE" >
                            ROADSIDE</option>
					  <option value="ROADWAY" >
                            ROADWAY</option>
					  <option value="RONDE" >
                            RONDE</option>
					  <option value="ROSEBOWL" >
                            ROSEBOWL</option>
					  <option value="ROTARY" >
                            ROTARY</option>
					  <option value="ROUND" >
                            ROUND</option>
					  <option value="ROUTE" >
                            ROUTE</option>
					  <option value="ROW" >
                            ROW</option>
					  <option value="RUE" >
                            RUE</option>
					  <option value="RUN" >
                            RUN</option>
					  <option value="SERVICE WAY" >
                            SERVICE WAY</option>
					  <option value="SIDING" >
                            SIDING</option>
					  <option value="SLOPE" >
                            SLOPE</option>
					  <option value="SOUND" >
                            SOUND</option>
					  <option value="SOUTH" >
                            SOUTH</option>
					  <option value="SOUTH EAST" >
                            SOUTH EAST</option>
					  <option value="SOUTH WEST" >
                            SOUTH WEST</option>
					  <option value="SPUR" >
                            SPUR</option>
					  <option value="SQUARE" >
                            SQUARE</option>
					  <option value="STAIRS" >
                            STAIRS</option>
					  <option value="STATE HIGHWAY" >
                            STATE HIGHWA</option>
					  <option value="STEPS" >
                            STEPS</option>
					  <option value="STEYNE" >
                            STEYNE</option>
					  <option value="STRAND" >
                            STRAND</option>
					  <option value="STRIP" >
                            STRIP</option>
					  <option value="SUBWAY" >
                            SUBWAY</option>
					  <option value="TARN" >
                            TARN</option>
					  <option value="TERRACE" >
                            TERRACE</option>
					  <option value="THOROUGHFARE" >
                            THOROUGHFARE</option>
					  <option value="TOLLWAY" >
                            TOLLWAY</option>
					  <option value="TOP" >
                            TOP</option>
					  <option value="TOR" >
                            TOR</option>
					  <option value="TOWERS" >
                            TOWERS</option>
					  <option value="TRACK" >
                            TRACK</option>
					  <option value="TRAIL" >
                            TRAIL</option>
					  <option value="TRAILER" >
                            TRAILER</option>
					  <option value="TRIANGLE" >
                            TRIANGLE</option>
					  <option value="TRUNKWAY" >
                            TRUNKWAY</option>
					  <option value="TURN" >
                            TURN</option>
					  <option value="UNDERPASS" >
                            UNDERPASS</option>
					  <option value="UPPER" >
                            UPPER</option>
					  <option value="UPPER" >
                            UPPER</option>
					  <option value="VALE" >
                            VALE</option>
					  <option value="VIADUCT" >
                            VIADUCT</option>
					  <option value="VIEW" >
                            VIEW</option>
					  <option value="VILLAS" >
                            VILLAS</option>
					  <option value="VISTA" >
                            VISTA</option>
					  <option value="WADE" >
                            WADE</option>
					  <option value="WALK" >
                            WALK</option>
					  <option value="WALKWAY" >
                            WALKWAY</option>
					  <option value="WAY" >
                            WAY</option>
					  <option value="WEST" >
                            WEST</option>
					  <option value="WHARF" >
                            WHARF</option>
					  <option value="WYND" >
                            WYND</option>
					  <option value="YARD" >
                            YARD</option>
              </select></td>
      </tr>

      <tr> 
        <td align="left"><div id="objContactAus1">Suburb</div></td>
        <td align="left"><div id="objContactAus2"><input name="Contact_Suburb"  value="" type="Text" size="16"> 
        State&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<select name="chContactState" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactPostcode.focus()};">

					<option value=""></option>
            <option value="ACT" >ACT</option>
            <option value="NSW" >NSW</option>
            <option value="NT" >NT</option>
            <option value="QLD" >QLD</option>
            <option value="SA" >SA</option>
            <option value="TAS" >TAS</option>
            <option value="VIC" >VIC</option>
            <option value="WA " >WA </option>

          </select> Postcode<img src="images/spacer.gif" width="10" height="1" border="0"><input name="Contact_Postcode" value="" type="Text" size="4" maxlength="4">  </div></td>
      </tr> 

       <tr> 
         <td align="left">Daytime Phone</td>
        <td ><select name="chContactPhone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactPhone2.focus()};" id="chContactPhone1">

		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>			

		  </select>
			  <input type="text" name="chContactPhone2"   value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactPhone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">
			  <input type="text" name="chContactPhone3" value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactMobile1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">
			 <img src="images/spacer.gif" width="1" height="1" border="0">Mobile<img src="images/spacer.gif" width="44" height="1" border="0"><input type="text" name="chContactMobile1" size="4" value="" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactMobile2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	
		  <input type="text" name="chContactMobile2" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactMobile3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		  <input type="text" name="chContactMobile3" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chContactEmail.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		  &nbsp;         
		</td>
      </tr>    

      <tr> 
         <td align="left">Email</td>
        <td><input name="Contact_Email"  value="" type="Text" style="width:199px;" onBlur="checkEmail(this);" maxlength="50"> Relationship <input name="Contact_Relationship"  value="" type="Text" size="26" maxlength="50">
		</td>
      </tr> 

      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

      <tr>
	  	<td align="left" width="171"><strong class="navytext">REFEREES: <span class="redstar">*</span> </strong> (not relatives)</td>
        <td  width="568">&nbsp;</td>
	  </tr>

      <tr>
	  	<td align="left" width="171">1) Name</td>
        <td  width="568"><input name="Reference1_FirstName"  value="" type="Text"   size="16" maxlength="50"> <input name="Reference_One_Surname" value="" type="Text" size="16" maxlength="50"><img src="images/spacer.gif" height="1" border="0" width="33">Occupation<img src="images/spacer.gif" height="1" border="0" width="7"><input name="Reference1_Occupation" value="" type="Text" size="16" maxlength="50"> </td>
	  </tr>

      <tr> 
         <td align="left">Daytime Phone</td>
        <td ><select name="chReference1Phone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference1Phone2.focus()};" id="chReference1Phone1">

		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                       09</option>			
		  </select>
			  <input type="text" name="chReference1Phone2" value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference1Phone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">
			  <input type="text" name="chReference1Phone3" value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference1Mobile1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">
			 <img src="images/spacer.gif" height="1" border="0" width="42">Mobile <input type="text" name="chReference1Mobile1" value="" size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference1Mobile2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	
		  <input type="text" name="chReference1Mobile2" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference1Mobile3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		  <input type="text" name="chReference1Mobile3" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference2FirstName.focus()};" onBlur="checkNumeric(this,1,'','','','','');">
		  &nbsp;         
		</td>
      </tr>

            <tr>

	  	<td align="left" width="171">2) Name</td>
        <td  width="568"><input name="Reference_Two_FirstName" value="" type="Text" size="16" maxlength="50"> <input name="Reference_Two_Surname" value="" type="Text" size="16" maxlength="50"><img src="images/spacer.gif" height="1" border="0" width="33">Occupation<img src="images/spacer.gif" height="1" border="0" width="7"><input name="Reference_Two_Occupation"  value="" type="Text" size="16" maxlength="50"> </td>

	  </tr>

      <tr> 
         <td align="left">Daytime Phone</td>
        <td ><select name="chReference2Phone1" onchange="if((event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference2Phone2.focus()};" id="chReference2Phone1">

		  		<option value="">(Area Code)</option>	
                    <option value="01" >
                        01</option>
                    <option value="02" >
                        02</option>
                    <option value="03" >
                        03</option>
                    <option value="05" >
                        05</option>
                    <option value="06" >
                        06</option>
                    <option value="07" >
                        07</option>
                    <option value="08" >
                        08</option>
                    <option value="09" >
                        09</option>				

		  </select>

			  <input type="text" name="chReference2Phone2"  value=""  onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference2Phone3.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			  <input type="text" name="chReference2Phone3" value="" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference2Mobile1.focus()};" size="4" maxlength="4" onBlur="checkNumeric(this,1,'','','','','');">

			<img src="images/spacer.gif" height="1" border="0" width="42">Mobile <input type="text" name="chReference2Mobile1" value="" size="4" maxlength="4" onkeyup="if((this.value.length==4)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference2Mobile2.focus()};" onBlur="checkNumeric(this,1,'','','','','');">	

		  <input type="text" name="chReference2Mobile2"  value=""size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chReference2Mobile3.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  <input type="text" name="chReference2Mobile3" value="" size="3" maxlength="3" onkeyup="if((this.value.length==3)&&(event.KeyCode!=8)&&(event.keyCode!=16)&&(event.keyCode!= 9)){chkAdvertisedLocalPress.focus()};" onBlur="checkNumeric(this,1,'','','','','');">

		  &nbsp;         
		</td>
      </tr>

      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

       <tr> 
         <td align="left" colspan="2"><strong class="navytext">Where did you see the property advertised?</strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Local Press 

           <input type="checkbox" class="formcheckbox" name="chkAdvertisedLocalPress">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Signboard <input type="checkbox" class="formcheckbox" name="chkAdvertisedSignBoard">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Referral <input type="checkbox" class="formcheckbox" name="chkAdvertisedReferral">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Internet <input type="checkbox" class="formcheckbox" name="chkAdvertisedInternet"></td>
      </tr> 

        <tr> 
         <td align="left">Other</td>
        <td><input name="Advertised_Other" type="Text" style="width:436px;" maxlength="50"></td>
      </tr>

      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 		

	 <tr valign="top" align="left"> 
        <td height="3" colspan="2" width="100%" class="bigbox2"><table cellpadding="0" cellspacing="0" width="90%" style="border-style:double; border-width:3px; border-color:#647882"><tr><td><br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<span class="redbackgroundwhitetext"><strong>IMPORTANT NOTICE REGARDING SCANNED DOCUMENTS:</strong></span><br>

        <br>

        <span class="bigbox">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Add scanned documents to speed up the process of application.<br><br>
       &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Please do not attach all documents to a single button as a combined scan. Each individual document i.e. passport,<br>
       &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;driver&#8217;s license etc. should be attached to the correctly labelled button. This is important for privacy compliance.<br><br>    
       &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<input type="checkbox"  class="formcheckbox" name="isDocIdentifiersTicked">&nbsp;&nbsp;I, the applicant, have read and understood the above statement and take full responsibility for attaching my<br>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;documents to the correct buttons.</span><br><br>
</td></tr></table></td>

      </tr>   

      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

      

      <tr valign="top" align="left">
        <td colspan="2">
        To add a scan, click the 'Browse' button of the description of the object scanned, for   example TRA Disclosure or Drivers Licence<br>
        to 
        locate the file on your computer, then click on that file which will attach to your application.<br>
Allowable file formats are: .gif, .jpg, .png, .pdf. Maximum size 200KB. </td>
      </tr>

        <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

        <tr>
	  	<td align="left" width="171" class="navytext"><strong>IDENTIFIER DOCUMENTS:</strong></td>
        <td  width="568">&nbsp;</td>
	  </tr>  

      <tr align="left"> 
        <td height="3">TRA Disclosure</td>
        <td height="3" ><input type="file" name="chFilename1"> Working Visa<img src="images/spacer.gif" width="25" height="1" border="0"><input type="file" name="chFilename9"></td>
      </tr>

      <tr align="left"> 
        <td height="3">Drivers Licence</td>
        <td height="3" ><input type="file" name="chFilename2"> 
        Birth Certificate<img src="images/spacer.gif" width="14" height="1" border="0"><input type="file" name="chFilename10"></td>
      </tr>    

      <tr align="left"> 
        <td height="3" nowrap>Passport</td>
        <td height="3" ><input type="file" name="chFilename3"> 
        Photo Id<img src="images/spacer.gif" width="52" height="1" border="0"><input type="file" name="chFilename6"></td>
      </tr>

       <tr align="left"> 
        <td height="3" nowrap>Student ID</td>
        <td height="3" ><input type="file" name="chFilename11"></td>
      </tr>

  

        <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

        <tr>
	  	<td align="left" width="171" class="navytext"><strong>CONFIDENTAL DOCUMENTS:</strong></td>
        <td  width="568">&nbsp;</td>
	  </tr>  



      <tr align="left"> 
        <td height="3">Ledger</td>
        <td height="3"><input type="file" name="chFilename12"> Business Reg<img src="images/spacer.gif" width="30" height="1" border="0"><input type="file" name="chFilename13"></td>
      </tr>

      <tr align="left"> 
        <td height="3">Bank Statement</td>
        <td height="3" ><input type="file" name="chFilename14"> 
        Water Rates<img src="images/spacer.gif" width="41" height="1" border="0"><input type="file" name="chFilename15"></td>

      </tr>

      <tr align="left"> 
        <td height="3" nowrap>Utility Bills</td>
        <td height="3" ><input type="file" name="chFilename16"> 

        Comp. Statement<img src="images/spacer.gif" width="13" height="1" border="0"><input type="file" name="chFilename17"></td>

      </tr>
       <tr align="left"> 
        <td height="3" nowrap>Current Pay Slip</td>

        <td height="3" ><input type="file" name="chFilename18"> 
        Council Rates<img src="images/spacer.gif" width="31" height="1" border="0"><input type="file" name="chFilename19"></td>
      </tr>

      

       <tr align="left"> 
        <td height="3" nowrap>Written Reference</td>
        <td height="3" ><input type="file" name="chFilename20"></td>
      </tr>  

        <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

      <tr valign="top" align="left"> 

        <td height="3" colspan="2" width="100%" class="bigbox2"><br><table cellpadding="0" cellspacing="0" width="90%" style="border-style:double; border-width:3px; border-color:#647882"><tr><td>
			<span class="redbackgroundwhitetext"><strong>IMPORTANT NOTICE:</strong></span><span class="bigbox"><p>To process your application we need a signed TRA disclosure. Click here to view and print: <a href="https://tradingreference.com/forms/tendec.pdf" target="_blank">TRA Tenancy Disclosure</a>.</p>

        <p>If you don't have a printer we will provide you   with this document. Scan and attach it to this application, or print and take into our office at your convenience.</p></span>
      
</td></tr></table><br></td>

      </tr>

     <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

       <tr>
	  	<td align="left" colspan="2" class="navytext"><strong>NSW FAIR TRADING TENANT CHECKLIST:</strong></td>
	  </tr>  

      <tr><td height="3" colspan="2"> 
          <table cellpadding=0 cellspacing=0 border=0>		  
		  	<tr  valign="top">

			  <td><input type="checkbox"  class="formcheckbox" name="isFairTradeTicked">&nbsp;&nbsp;<span class="navytext"><strong>I, </strong></span> the <span class="navytext"><strong>APPLICANT</strong></span>, have read and understood the following document: <a href="http://www.fairtrading.nsw.gov.au/Factsheet_print/Tenants_and_home_owners/Renting_a_home/FTR72_New_tenant_checklist.pdf" target="_blank">Tenant Checklist</a></td>

	  		</tr>
		  </table>
        </td>
      </tr> 

      <tr>
	  	<td align="left" colspan="2" style="height:10px;"></td>
	  </tr> 

      <tr>
	  	<td align="left" width="171" class="navytext"><strong>TRA PRIVACY CONSENT:</strong></td>
        <td  width="568">&nbsp;</td>
	  </tr>  

      <tr><td height="3" colspan="2"> 
          <table cellpadding=0 cellspacing=0 border=0>		  
		  	<tr  valign="top">
			  <td><input type="checkbox" onclick="disclosurepopup()"  class="formcheckbox" name="isPrivacyConsent">

			  &nbsp;&nbsp;<span class="navytext"><strong>I, </strong></span> the <span class="navytext"><strong>APPLICANT</strong></span>, understand and agree that the information entered onto the TRA database will be delivered through the TRA website to any agency I am applying to or may apply to   for rental of property for examination and evaluation of such application for   identification of me.

			  <br>

			    <br>

			    <span class="redtext"><strong>I also state that the TRA Disclosure, Drivers Licence, Passport and Photo ID   attached to this document belong to me as do the signatures. I   understand that all search results and logins are monitored within an internal   auditing system and are date-time stamped together with my IP address and   account details. Any misuse of the TRA facilities can be traced to my point of   access origin and may lead to civil action or criminal prosecution for serious   offences.</strong>

			    </span><br>

			    <p>I acknowledge and agree that information provided to TRA and/or the agent by   these authorities given by me be disclosed to: a) Real Estate Agents, Landlords,   Trades persons, Emergency Contacts, Employers past, present or prospective,   Referees, Housing New South Wales, Compass Housing, Dentists, Video stores to   assist them in evaluating applications which may be made by me to any of these   parties, for the purpose of managing any property and my requirements as   tenant/s during my tenancy of any property owned or managed by any of those   parties and b) Real Estate Agents, Landlords, Dentists, Video stores, Banks,   Utility companies, Commercial Agents, organisations or any other members for the   reason of locating me for any lawful purpose and I hereby consent to such use and disclosure of that information for those purposes. Should any such party   transfer its business to another person, I consent to the new person (and any further person to whom that business may be transferred) taking any step which   the former party could have taken. </p>

<p>To the   extent permitted by law I agree that TRA will not be liable to me for any misuse of my information by any party to whom my information is disclosed in accordance   with the these authorities and release TRA from any such liability. I acknowledge that the information entered by me onto the TRA database and   disclosed by TRA in accordance with these authorities given by me for such time as TRA shall be entitled by law to hold such information on its   database.</p></td>
	  		</tr>
		  </table>
        </td>
      </tr>	  

      <tr> 
      	<td>&nbsp;</td>
        <td><div style="width:425px;" align="center"><input type="submit" name="Submit" class="btnSmall"  value="SUBMIT">
          </div>        	
        </td>
      </tr>
    </table>
</form>
	<!--Welcome text-->
		<!--end Welcome text-->			
			<!--*Menu*-->
		   <!--*End Menu*-->			
		   
		   <div id="footer1">
		      <!--#include FILE="footer.inc" -->
		   		<!--<div id="bottom1"></div>-->
			
			<!-- THis is the devider from the links to the contents -->
		  </div> <!-- THis is the footer div -->			
		</div>
	</div>	
	</body>
</html>

Open in new window

<%@ Page Language="VB" %>
<%@ Import Namespace="System.Net.Mail" %>
<script runat="server">
    Private Sub Page_Load(ByVal sender As System.Object, ByVal e As System.EventArgs)

		'***************************************************************************************************************************
		'* TERMS OF USE
		'* The purpose of this script is to allow Santa Barbara City College Students to create form email.
		'* This script is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
		'* This script was designed for use on Tango Students Hosting.
		'* This script was designed for use on Microsoft IIS Servers that utilize Net.Mail using VB.NET 2
		'* This script must not be used for illegal purposes.
		'* Version Date: 4/27/2011
		'***************************************************************************************************************************
		
		'Dimension variables (DO NOT CHANGE THIS SECTION UNLESS YOU KNOW WHAT YOU ARE DOING)
		Dim objSendMail, strUsername, strPassword
		Dim strTo, strFrom, strHTMLSubject, strSubject, strHTMLHeader, strHTMLBody, strHTMLFooter
		Dim strDateTime, strEmailAddress, strFromURL, strContactName, strReturnURL, objItem, strSMTPServer, strExcludedFields
		Dim strHTTP_REFERER, strHTTP_USER_AGENT, strHTTP_HOST
		
		'***************************************************************************************************************************
		'* Begin User Specified Variables (YOU MAY CHANGE THESE VALUES)
		'***************************************************************************************************************************
		strContactName = "Oria"	'This is the name of the person who is receiving the form email
		strTo = "itsupport@adbydesigns.com.au"	'This is the recipient of this Web Form email and will usually be your email address. 
		strSubject = "Tenancy Application"	'This is the subject of the email that the recipient receive (unless there is a form field named Subject)
		strFromURL = "http://www.adbydesigns.com.au/clients/b/tenancyapplication.asp"	'This is the fully-qualified URL of your Web Form
		strReturnURL = "http://www.adbydesigns.com.au/clients/b/home.asp"	'This is the fully-qualified URL of the Thank You or result page
		strSMTPServer = "192.168.0.105"	'This is the Tango Students SMTP server. Your host will provide this information
		strUsername = ""	'Enter username to authenticate to the email server 
		strPassword = ""	'Enter password to authenticate to the email server 
		'***************************************************************************************************************************
		'* End User Specified Variables
		'***************************************************************************************************************************
		
		'***************************************************************************************************************************
		'* PLEASE DO NOT CHANGE ANYTHING BELOW UNLESS YOU KNOW WHAT YOU ARE DOING 
		'***************************************************************************************************************************
		
		'Automatically acquire the referring page and the browser information
		strHTTP_REFERER = Request.ServerVariables("HTTP_REFERER")
		strHTTP_USER_AGENT = Request.ServerVariables("HTTP_USER_AGENT")
		strHTTP_HOST = Request.ServerVariables("HTTP_HOST")
		
		'Check to see if the form is on this domain, if so process the mail, if not, sent them back to the form
		If (InStr(LCase(strHTTP_REFERER), LCase(strHTTP_HOST)) = 0) Then
		  Response.Redirect(strFromURL & "?Referer=NotLocal")
		  Response.End()
		End If

		'If the form specifies a Subject, use it
		If Trim(Request.Form("Subject")) <> "" Then
			strSubject = Trim(Request.Form("Subject"))
		End If
		
		'Encode form information for display in the HTML email and the time of submission
		strHTMLSubject = Server.HTMLEncode(strSubject)
		strDateTime = Now
		strFromURL = Server.HTMLEncode(strFromURL)
		strContactName = Server.HTMLEncode(strContactName)
		
		'Check for the existence of a FromURL Form Field - Use it if it there
		If Trim(Request.Form("FromURL")) <> "" Then
			strFromURL = Trim(Request.Form("FromURL"))
		End If
		
		'Check for the existence of a ReturnURL Form Field - Use it if it there
		If Trim(Request.Form("ReturnURL")) <> "" Then
			strReturnURL = Trim(Request.Form("ReturnURL"))
		End If
		
		strExcludedFields = "subject, fromurl, returnurl, submit" 'Exclude these fields from the email
		
		'Check for a valid email address. If the address appears valid, use it as the sender, if not use the recipient
		If Trim(Request.Form("EmailAddress")) <> "" Then
		  If InStr(Trim(Request.Form("EmailAddress")),"@") <> 0  Then
			If InStr(Trim(Request.Form("EmailAddress")),".") <> 0 Then
			  strFrom = Trim(Request.Form("EmailAddress"))
			  strEmailAddress = strFrom
			Else
			  strFrom = strTo
			  strEmailAddress = "Invalid Email Address"
			End If
		  Else
			strFrom = strTo
			strEmailAddress = "Invalid Email Address"
		  End If
		Else
		  strFrom = strTo
		  strEmailAddress = "No Email Address Submitted"
		End If  
		
		'Compose the HTML Header for the email
		strHTMLHeader = vbCr & _
		"<" & "!" & "DOCTYPE HTML PUBLIC ""-//W3C//DTD HTML 4.01 Transitional//EN"" ""http://www.w3.org/TR/html4/loose.dtd"">" & vbCr & _
		"<html lang=""en-us"">" & vbCr & _
		"<head>" & vbCr & _
		"<meta http-equiv=""Content-Type"" content=""text/html; charset=iso-8859-1"">" & vbCr & _
		"<title>" & strHTMLSubject & "</title>" & vbCr & _
		"<style type=""text/css"">" & vbCr & _
		"<!--" & vbCr & _
		"body {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #000000;" & vbCr & _
		"	background-color: #FFFFFF;" & vbCr & _
		"}" & vbCr & _
		"td {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #000000;" & vbCr & _
		"	padding: 3px;" & vbCr & _
		"	background-color: #FFFFFF;" & vbCr & _
		"}" & vbCr & _
		"th {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #FFFFFF;" & vbCr & _
		"	background-color: #003399;" & vbCr & _
		"	font-weight: bold;" & vbCr & _
		"	padding: 3px;" & vbCr & _
		"	text-align: left;" & vbCr & _
		"}" & vbCr & _
		"h1 {" & vbCr & _
		"	font-size: 18px;" & vbCr & _
		"}" & vbCr & _
		"h2 {" & vbCr & _
		"	font-size: 16px;" & vbCr & _
		"}" & vbCr & _
		"h3 {" & vbCr & _
		"	font-size: 14px;" & vbCr & _
		"}" & vbCr & _
		".Footer {" & vbCr & _
		"	font-size: 10px;" & vbCr & _
		"	color: #999999;" & vbCr & _
		"}" & vbCr & _
		".GrayText {" & vbCr & _
		"	color: #999999;" & vbCr & _
		"}" & vbCr & _
		".BlueText {" & vbCr & _
		"	color: #003399;" & vbCr & _
		"}" & vbCr & _
		".SectionHeading {" & vbCr & _
		"	background-color: #DDDDFF;" & vbCr & _
		"}" & vbCr & _
		"-->" & vbCr & _
		"</style>" & vbCr & _
		"</head>" & vbCr & _
		"<body>" & vbCr & _
		"<h1>"& strHTMLSubject & "</h1>" & vbCr & _
		"<p>This information was submitted on: " &  strDateTime & "</p>"
		
		'Start the table to display the form fields and values
		strHTMLBody =  vbCr & _
		"<table width=""100%"" cellpadding=""0"" cellspacing=""1"" bgcolor=""#DDDDFF"">" & vbCr & _
		"  <tr>" & vbCr & _
		"    <th scope=""col"">Field</th>" & vbCr & _
		"    <th scope=""col"">Value</th>" & vbCr & _
		"  </tr>" & vbCr
		
		'Get each of the form fields and compile them into table rows
		For Each objItem in Request.Form
			If InStr(strExcludedFields,LCase(objItem)) = 0 Then
				If Trim(Request.Form(objItem)) <> "" Then
					strHTMLBody = strHTMLBody & _
					"  <tr>" & vbCr & _
					"    <td valign=""top"">" & objItem & "</td>" & vbCr & _
					"    <td class=""BlueText"">" & Replace(Server.HTMLEncode(Trim(Request.Form(objItem))),vbCr,"<br>") & "</td>" & vbCr & _
					"  </tr>" & vbCr
				Else
					strHTMLBody = strHTMLBody & _
					"  <tr>" & vbCr & _
					"    <td>" & objItem & "</td>" & vbCr & _
					"    <td class=""GrayText"">No Response</td>" & vbCr & _
					"  </tr>" & vbCr
				End If
			End If
		Next
		
		'Get the Referer and the User Agent Information and put it at the bottom of the table
		'strHTMLBody = strHTMLBody & vbCr & _
		'"  <tr>" & vbCr & _
		'"    <td valign=""top"" colspan=""2"" class=""SectionHeading"">Browser Information</td>" & vbCr & _
		'"  </tr>" & vbCr & _
		'"  <tr>" & vbCr & _
		'"    <td valign=""top"">HTTP User Agent</td>" & vbCr & _
		'"    <td class=""BlueText"">" & strHTTP_USER_AGENT & "</td>" & vbCr & _
		'"  </tr>" & vbCr & _
		'"</table>" & vbCr
		
		'Get the Referer and the User Agent Information and put it at the bottom of the table
		strHTMLBody = strHTMLBody & vbCr & _
		"</table>" & vbCr		
		
		'Compose the footer of the email
		'strHTMLFooter = vbCr & _
		'"<p><hr align=""left"" width=""100%"" size=""1"" noshade>" & vbCr & _
		'"<div class=""Footer"">This automated email was sent from <a href=""" & strFromURL & """>" & strFromURL & "</a>.<br>" & vbCr & _
		'"Please contact " & strContactName & ", <a href=""mailto:" & strTo & """>" & strTo & "</a>, if you have questions or problems with this email.</div></p>" & vbCr & _
		'"</body>" & vbCr & _
		'"</html>"

		'Compose the footer of the email
		strHTMLFooter = vbCr & _
		"<p><hr align=""left"" width=""100%"" size=""1"" noshade>" & vbCr & _
		"<div class=""Footer"">This automated email was sent from <a href=""" & strFromURL & """>" & strFromURL & "</a>.<br>" & vbCr & _
		"</body>" & vbCr & _
		"</html>"
		
		' Create the Mail object and send the email as HTML
        Dim MailMsg As New MailMessage(New MailAddress(strFrom.Trim()), New MailAddress(strTo))
        MailMsg.BodyEncoding = Encoding.Default
        'MailMsg.Bcc.Add("barneybeale@gmail.com")
        'MailMsg.Bcc.Add("selfservemediaarchive@dbasplus.com")
        MailMsg.Subject = strSubject
        MailMsg.Body = strHTMLHeader & strHTMLBody & strHTMLFooter
        MailMsg.Priority = MailPriority.Normal
        MailMsg.IsBodyHtml = True
		
        'Dimension and instantiate object to send the mail message (new in 2011 to allow for basic authentication)
        Dim SmtpMail As New SmtpClient
        Dim basicAuthenticationInfo As New System.Net.NetworkCredential(strUsername, strPassword) 
        SmtpMail.Host = strSMTPServer
        SmtpMail.UseDefaultCredentials = False
	    SmtpMail.Credentials = basicAuthenticationInfo
        SmtpMail.Send(MailMsg)
		
		'Send your visitor to the Thank You page and quit
		MailMsg = Nothing
		SmtpMail = Nothing
		Response.Redirect(strReturnURL)
		Response.End()
		
		'***************************************************************************************************************************
		'* End Script
		'***************************************************************************************************************************

    End Sub
</script>

Open in new window

awolarczukAsked:
Who is Participating?
I wear a lot of hats...

"The solutions and answers provided on Experts Exchange have been extremely helpful to me over the last few years. I wear a lot of hats - Developer, Database Administrator, Help Desk, etc., so I know a lot of things but not a lot about one thing. Experts Exchange gives me answers from people who do know a lot about one thing, in a easy to use platform." -Todd S.

sammySeltzerCommented:
first, are you talking about attaching file to an email via asp or are you talking about form upload.

Two different things.

I also noticed that you have both classic and .net files.

What are you trying to do?
0
awolarczukAuthor Commented:
at the bottom of the from you would be avble to see that there are area where the client can attach file i need to att this to the script to allow the file to be attached  to the emall
0
sammySeltzerCommented:
so, so what you want is to be able to attach file via email.

Is this .net or classic asp?

Again, as stated, you have a version of .net and a version of classic asp.

Please clarify
0
Ultimate Tool Kit for Technology Solution Provider

Broken down into practical pointers and step-by-step instructions, the IT Service Excellence Tool Kit delivers expert advice for technology solution providers. Get your free copy now.

awolarczukAuthor Commented:
yes this is what i want
as u can see there is a script (the aspx file) thet goes through my form (the asp file) and collect the data at the end of the asp file there is a option for attachments i wound like this to be added to the script as this need to be attached to the emil
0
sammySeltzerCommented:
It doesn't work like that.

You cannot mix and match asp with aspx.

Decide which of the two you want and we can go from there.
0
awolarczukAuthor Commented:
well it seems to be working with no issue atm with the script reading from the asp fiel so i dont really understand why it wont work like that, it is reading with no issues i just have got the files been attached
0
awolarczukAuthor Commented:
i know this is the code but just need help adding it my script
// Beginning of attachments processing

// Check the first open file dialog for a value

 if (ofdAttachment1.PostedFile != null)
 {
  // Get a reference to PostedFile object

  HttpPostedFile ulFile = ofdAttachment1.PostedFile;
  // Get size of the file

  int nFileLen = ulFile.ContentLength; 
  // Make sure the size of the file is > 0

  if( nFileLen > 0 )
  {
   // Get the file name

   strFileName = Path.GetFileName(ofdAttachment1.PostedFile.FileName);
   // Preced the file name with "attachments/" so 

   // the file is saved to our attachments directory

   strFileName = "attachments/" + strFileName;
   // Save the file on the server

   ofdAttachment1.PostedFile.SaveAs(Server.MapPath(strFileName));
   // Create the email attachment with the uploaded file

   MailAttachment attach = new MailAttachment(Server.MapPath(strFileName));
   // Attach the newly created email attachment

   email.Attachments.Add(attach);
   // Store filename so we can delete it later

   attach1 = strFileName;
  }
 }

Open in new window

0
sammySeltzerCommented:
pls see attachments. tested and works.

Ok the attachment doesn't work because of dll. You can generate one and put in a bin directory.

send.aspx

<%@ Page language="c#" Codebehind="Send.aspx.cs" AutoEventWireup="false" Inherits="MailWebService.WebForm1" %>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN" >
<HTML>
	<HEAD>
		<title></title>
		<meta content="http://schemas.microsoft.com/intellisense/ie5" name="vs_targetSchema">
		<style type="text/css">
		TD { FONT-SIZE: 10pt; COLOR: #000000; FONT-STYLE: normal; FONT-FAMILY: Arial, Helvetica, sans-serif }
		.width386 { WIDTH: 386px }
		.basic { FONT-SIZE: 10pt; COLOR: #000000; FONT-STYLE: normal; FONT-FAMILY: Arial, Helvetica, sans-serif }
		.titl { FONT-WEIGHT: bold; FONT-SIZE: 13pt; COLOR: #ffffff; FONT-STYLE: normal; FONT-FAMILY: Arial, Helvetica, sans-serif }
		BODY { BORDER-RIGHT: 0px; BORDER-TOP: 0px; BACKGROUND: white; MARGIN: 0px; BORDER-LEFT: 0px; BORDER-BOTTOM: 0px; FONT-FAMILY: Arial, Helvetica, sans-serif }
		</style>
	</HEAD>
	<body>
		<table cellSpacing="0" cellPadding="3" width="100%" bgColor="navy" border="0">
			<tr>
				<td align="center"><span class="titl">ASP.NET&nbsp;Email</span></td>
			</tr>
		</table>
		<br>
		<div align="center"><asp:Label id="lblMessage" runat="server" Font-Names="Arial" Font-Size="X-Small" Width="540"
				Visible="False"></asp:Label></div>
		<br>
		<div align="center">
			<form id="Form1" name="form2" method="post" encType="multipart/form-data" runat="server">
				<table cellSpacing="0" cellPadding="4" bgColor="navy" border="0">
					<tr>
						<td>
							<table cellSpacing="3" cellPadding="4" width="540" bgColor="white">
								<tr>
									<td vAlign="middle" align="right" width="80">From:</td>
									<td><asp:textbox id="txtSender" tabIndex="1" runat="server" MaxLength="100" Width="386px" CssClass="width386"
											Font-Size="X-Small" Font-Names="Arial"></asp:textbox></td>
								</tr>
								<tr>
									<td vAlign="middle" align="right" width="80">To:</td>
									<td><asp:textbox id="txtReceiver" tabIndex="1" runat="server" MaxLength="100" Width="386px" CssClass="width386"
											Font-Size="X-Small" Font-Names="Arial"></asp:textbox></td>
								</tr>
								<tr>
									<td vAlign="middle" align="right">Subject:</td>
									<td><asp:textbox id="txtSubject" tabIndex="2" runat="server" MaxLength="200" Width="386px" CssClass="width386"
											Font-Size="X-Small" Font-Names="Arial"></asp:textbox></td>
								</tr>
								<tr>
									<td vAlign="middle" align="right">Format:</td>
									<td><asp:radiobuttonlist id="rblMailFormat" tabIndex="3" runat="server" repeatcolumns="2" repeatdirection="Horizontal">
											<asp:ListItem Value="text" Selected="True">text</asp:ListItem>
											<asp:ListItem Value="html">html</asp:ListItem>
										</asp:radiobuttonlist></td>
								</tr>
								<tr>
									<td vAlign="top" align="right">Message:</td>
									<td height="84">
										<p><asp:textbox id="txtBody" tabIndex="4" runat="server" columns="40" rows="5" textmode="MultiLine"
												width="451px" CssClass="width386" Font-Size="X-Small" Font-Names="Arial"></asp:textbox></p>
									</td>
								</tr>
								<tr>
									<td vAlign="middle" align="right">Attachment:</td>
									<td><input id="ofdAttachment1" tabIndex="5" type="file" size="56" name="filMyFile" runat="server"></td>
								</tr>
								<tr>
									<td vAlign="middle" align="right">Attachment:</td>
									<td><input id="ofdAttachment2" tabIndex="6" type="file" size="56" name="filMyFile" runat="server"></td>
								</tr>
								<tr>
									<td vAlign="middle" align="right">Attachment:</td>
									<td><input id="ofdAttachment3" tabIndex="7" type="file" size="56" name="filMyFile" runat="server"></td>
								</tr>
								<tr>
									<td align="center" colSpan="2"><asp:button id="btnSend" tabIndex="9" runat="server" width="100px" text="Send"></asp:button></td>
								</tr>
							</table>
						</td>
					</tr>
				</table>
			</form>
			<h1></h1>
			<br>
			<br>
			<br>
			<br>
			<br>
		</div>
	</body>
</HTML>

Open in new window


send.aspx.cs

using System;
using System.Collections;
using System.ComponentModel;
using System.Configuration;
using System.Drawing;
using System.Data;
using System.IO;
using System.Web;
using System.Web.Mail;
using System.Web.SessionState;
using System.Web.UI;
using System.Web.UI.WebControls;
using System.Web.UI.HtmlControls;


namespace MailWebService
{
	/// <summary>
	/// Summary description for WebForm1.
	/// </summary>
	public class WebForm1 : System.Web.UI.Page
	{
		protected System.Web.UI.WebControls.RadioButtonList rblMailFormat;
		protected System.Web.UI.WebControls.Button btnSend;
		protected System.Web.UI.HtmlControls.HtmlInputFile ofdAttachment1;
		protected System.Web.UI.HtmlControls.HtmlInputFile ofdAttachment2;
		protected System.Web.UI.HtmlControls.HtmlInputFile ofdAttachment3;
		protected System.Web.UI.WebControls.TextBox txtSender;
		protected System.Web.UI.WebControls.TextBox txtReceiver;
		protected System.Web.UI.WebControls.TextBox txtSubject;
		protected System.Web.UI.WebControls.TextBox txtBody;
		protected System.Web.UI.WebControls.Label lblMessage;
		protected string strFileName;
	
		private void Page_Load(object sender, System.EventArgs e)
		{
			// Put user code to initialize the page here
			
		}


		#region Web Form Designer generated code
		override protected void OnInit(EventArgs e)
		{
			//
			// CODEGEN: This call is required by the ASP.NET Web Form Designer.
			//
			InitializeComponent();
			base.OnInit(e);
		}
		
		/// <summary>
		/// Required method for Designer support - do not modify
		/// the contents of this method with the code editor.
		/// </summary>
		private void InitializeComponent()
		{    
			this.btnSend.Click += new System.EventHandler(this.btnSend_Click);
			this.Load += new System.EventHandler(this.Page_Load);

		}
		#endregion

		private void btnSend_Click(object sender, System.EventArgs e)
		{
			try
			{
				// Create a new blank MailMessage
				MailMessage email = new MailMessage ();


				// Set the properties of the MailMessage to the
				// values on the form
				if (rblMailFormat.SelectedItem.Text == "text")
					email.BodyFormat = MailFormat.Text;
				else
					email.BodyFormat = MailFormat.Html;
				email.From = txtSender.Text;
				email.To = txtReceiver.Text;
				email.Subject = txtSubject.Text;
				email.Body = txtBody.Text;
            

				// We use the 3 following variables to keep track of
				// attachments so we can delete them and strFileName is
				// used to for the name of the file attachment being 
				// processed.
				string attach1 = null;
				string attach2 = null;
				string attach3 = null;
				string strFileName = null;

				// Beginning of attachments processing
				// Check the first open file dialog for a value
				if (ofdAttachment1.PostedFile != null)
				{
					// Get a reference to PostedFile object
					HttpPostedFile ulFile = ofdAttachment1.PostedFile;
					// Get size of the file
					int nFileLen = ulFile.ContentLength; 
					// Make sure the size of the file is > 0
					if( nFileLen > 0 )
					{
						// Get the file name
						strFileName = Path.GetFileName(ofdAttachment1.PostedFile.FileName);
						// Preced the file name with "attachments/" so 
						// the file is saved to our attachments directory
						strFileName = "attachments/" + strFileName;
						// Save the file on the server
						ofdAttachment1.PostedFile.SaveAs(Server.MapPath(strFileName));
						// Create the email attachment with the uploaded file
						MailAttachment attach = new MailAttachment(Server.MapPath(strFileName));
						// Attach the newly created email attachment
						email.Attachments.Add(attach);
						// Store filename so we can delete it later
						attach1 = strFileName;
					}
				}
				// Repeat previous step if there is an attachment #2
				if (ofdAttachment2.PostedFile != null)
				{
					HttpPostedFile ulFile = ofdAttachment2.PostedFile;
					int nFileLen = ulFile.ContentLength; 
					if( nFileLen > 0 )
					{
						strFileName = Path.GetFileName(ofdAttachment2.PostedFile.FileName);
						strFileName = "attachments/" + strFileName;
						ofdAttachment2.PostedFile.SaveAs(Server.MapPath(strFileName));
						MailAttachment attach = new MailAttachment(Server.MapPath(strFileName));
						email.Attachments.Add(attach);
						attach2 = strFileName;
					}
				}
				// Repeat previous step if there is an attachment #3
				if (ofdAttachment3.PostedFile != null)
				{
					HttpPostedFile ulFile = ofdAttachment3.PostedFile;
					int nFileLen = ulFile.ContentLength; 
					if( nFileLen > 0 )
					{
						strFileName = Path.GetFileName(ofdAttachment3.PostedFile.FileName);
						strFileName = "attachments/" + strFileName;
						ofdAttachment3.PostedFile.SaveAs(Server.MapPath(strFileName));
						MailAttachment attach = new MailAttachment(Server.MapPath(strFileName));
						email.Attachments.Add(attach);
						attach3 = strFileName;
					}
				}
				// End of attachments processing
            
				// Set the SMTP server and send the email
				SmtpMail.SmtpServer = "localhost";
				SmtpMail.Send (email);

				// Delete the attachements if any
				if (attach1 != null)
					File.Delete(Server.MapPath(attach1));
				if (attach2 != null)
					File.Delete(Server.MapPath(attach2));
				if (attach3 != null)
					File.Delete(Server.MapPath(attach3));	

				// Reset the form
				txtSender.Text = "";
				txtReceiver.Text = "";
				txtSubject.Text = "";
				txtBody.Text = "";

                // Dispaly a friendly message telling the user
				// his email has been sent
				lblMessage.Visible = true;
				lblMessage.ForeColor = Color.Black;
				lblMessage.Text = "Your email has been sent";
			}
			catch(Exception ex)
			{
				// Print a much less friendly message informing the 
				// user about the exception that was risen
				lblMessage.Visible = true;
				lblMessage.ForeColor = Color.Red;
				lblMessage.Text = ex.ToString();
			}
			
		}

	}
}

Open in new window

0
awolarczukAuthor Commented:
Thank you for ur help thus far but can u please show me how to include that script in my script and code

Below is my script
<%@ Page Language="VB" %>
<%@ Import Namespace="System.Net.Mail" %>
<script runat="server">
    Private Sub Page_Load(ByVal sender As System.Object, ByVal e As System.EventArgs)

		'***************************************************************************************************************************
		'* TERMS OF USE
		'* The purpose of this script is to allow Santa Barbara City College Students to create form email.
		'* This script is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
		'* This script was designed for use on Tango Students Hosting.
		'* This script was designed for use on Microsoft IIS Servers that utilize Net.Mail using VB.NET 2
		'* This script must not be used for illegal purposes.
		'* Version Date: 4/27/2011
		'***************************************************************************************************************************
		
		'Dimension variables (DO NOT CHANGE THIS SECTION UNLESS YOU KNOW WHAT YOU ARE DOING)
		Dim objSendMail, strUsername, strPassword
		Dim strTo, strFrom, strHTMLSubject, strSubject, strHTMLHeader, strHTMLBody, strHTMLFooter
		Dim strDateTime, strEmailAddress, strFromURL, strContactName, strReturnURL, objItem, strSMTPServer, strExcludedFields
		Dim strHTTP_REFERER, strHTTP_USER_AGENT, strHTTP_HOST
		
		'***************************************************************************************************************************
		'* Begin User Specified Variables (YOU MAY CHANGE THESE VALUES)
		'***************************************************************************************************************************
		strContactName = "Oria"	'This is the name of the person who is receiving the form email
		strTo = "itsupport@adbydesigns.com.au"	'This is the recipient of this Web Form email and will usually be your email address. 
		strSubject = "Tenancy Application"	'This is the subject of the email that the recipient receive (unless there is a form field named Subject)
		strFromURL = "http://www.adbydesigns.com.au/clients/b/tenancyapplication.asp"	'This is the fully-qualified URL of your Web Form
		strReturnURL = "http://www.adbydesigns.com.au/clients/b/home.asp"	'This is the fully-qualified URL of the Thank You or result page
		strSMTPServer = "192.168.0.105"	'This is the Tango Students SMTP server. Your host will provide this information
		strUsername = ""	'Enter username to authenticate to the email server 
		strPassword = ""	'Enter password to authenticate to the email server 
		'***************************************************************************************************************************
		'* End User Specified Variables
		'***************************************************************************************************************************
		
		'***************************************************************************************************************************
		'* PLEASE DO NOT CHANGE ANYTHING BELOW UNLESS YOU KNOW WHAT YOU ARE DOING 
		'***************************************************************************************************************************
		
		'Automatically acquire the referring page and the browser information
		strHTTP_REFERER = Request.ServerVariables("HTTP_REFERER")
		strHTTP_USER_AGENT = Request.ServerVariables("HTTP_USER_AGENT")
		strHTTP_HOST = Request.ServerVariables("HTTP_HOST")
		
		'Check to see if the form is on this domain, if so process the mail, if not, sent them back to the form
		If (InStr(LCase(strHTTP_REFERER), LCase(strHTTP_HOST)) = 0) Then
		  Response.Redirect(strFromURL & "?Referer=NotLocal")
		  Response.End()
		End If

		'If the form specifies a Subject, use it
		If Trim(Request.Form("Subject")) <> "" Then
			strSubject = Trim(Request.Form("Subject"))
		End If
		
		'Encode form information for display in the HTML email and the time of submission
		strHTMLSubject = Server.HTMLEncode(strSubject)
		strDateTime = Now
		strFromURL = Server.HTMLEncode(strFromURL)
		strContactName = Server.HTMLEncode(strContactName)
		
		'Check for the existence of a FromURL Form Field - Use it if it there
		If Trim(Request.Form("FromURL")) <> "" Then
			strFromURL = Trim(Request.Form("FromURL"))
		End If
		
		'Check for the existence of a ReturnURL Form Field - Use it if it there
		If Trim(Request.Form("ReturnURL")) <> "" Then
			strReturnURL = Trim(Request.Form("ReturnURL"))
		End If
		
		strExcludedFields = "subject, fromurl, returnurl, submit" 'Exclude these fields from the email
		
		'Check for a valid email address. If the address appears valid, use it as the sender, if not use the recipient
		If Trim(Request.Form("EmailAddress")) <> "" Then
		  If InStr(Trim(Request.Form("EmailAddress")),"@") <> 0  Then
			If InStr(Trim(Request.Form("EmailAddress")),".") <> 0 Then
			  strFrom = Trim(Request.Form("EmailAddress"))
			  strEmailAddress = strFrom
			Else
			  strFrom = strTo
			  strEmailAddress = "Invalid Email Address"
			End If
		  Else
			strFrom = strTo
			strEmailAddress = "Invalid Email Address"
		  End If
		Else
		  strFrom = strTo
		  strEmailAddress = "No Email Address Submitted"
		End If  
		
		'Compose the HTML Header for the email
		strHTMLHeader = vbCr & _
		"<" & "!" & "DOCTYPE HTML PUBLIC ""-//W3C//DTD HTML 4.01 Transitional//EN"" ""http://www.w3.org/TR/html4/loose.dtd"">" & vbCr & _
		"<html lang=""en-us"">" & vbCr & _
		"<head>" & vbCr & _
		"<meta http-equiv=""Content-Type"" content=""text/html; charset=iso-8859-1"">" & vbCr & _
		"<title>" & strHTMLSubject & "</title>" & vbCr & _
		"<style type=""text/css"">" & vbCr & _
		"<!--" & vbCr & _
		"body {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #000000;" & vbCr & _
		"	background-color: #FFFFFF;" & vbCr & _
		"}" & vbCr & _
		"td {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #000000;" & vbCr & _
		"	padding: 3px;" & vbCr & _
		"	background-color: #FFFFFF;" & vbCr & _
		"}" & vbCr & _
		"th {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #FFFFFF;" & vbCr & _
		"	background-color: #003399;" & vbCr & _
		"	font-weight: bold;" & vbCr & _
		"	padding: 3px;" & vbCr & _
		"	text-align: left;" & vbCr & _
		"}" & vbCr & _
		"h1 {" & vbCr & _
		"	font-size: 18px;" & vbCr & _
		"}" & vbCr & _
		"h2 {" & vbCr & _
		"	font-size: 16px;" & vbCr & _
		"}" & vbCr & _
		"h3 {" & vbCr & _
		"	font-size: 14px;" & vbCr & _
		"}" & vbCr & _
		".Footer {" & vbCr & _
		"	font-size: 10px;" & vbCr & _
		"	color: #999999;" & vbCr & _
		"}" & vbCr & _
		".GrayText {" & vbCr & _
		"	color: #999999;" & vbCr & _
		"}" & vbCr & _
		".BlueText {" & vbCr & _
		"	color: #003399;" & vbCr & _
		"}" & vbCr & _
		".SectionHeading {" & vbCr & _
		"	background-color: #DDDDFF;" & vbCr & _
		"}" & vbCr & _
		"-->" & vbCr & _
		"</style>" & vbCr & _
		"</head>" & vbCr & _
		"<body>" & vbCr & _
		"<h1>"& strHTMLSubject & "</h1>" & vbCr & _
		"<p>This information was submitted on: " &  strDateTime & "</p>"
		
		'Start the table to display the form fields and values
		strHTMLBody =  vbCr & _
		"<table width=""100%"" cellpadding=""0"" cellspacing=""1"" bgcolor=""#DDDDFF"">" & vbCr & _
		"  <tr>" & vbCr & _
		"    <th scope=""col"">Field</th>" & vbCr & _
		"    <th scope=""col"">Value</th>" & vbCr & _
		"  </tr>" & vbCr
		
		'Get each of the form fields and compile them into table rows
		For Each objItem in Request.Form
			If InStr(strExcludedFields,LCase(objItem)) = 0 Then
				If Trim(Request.Form(objItem)) <> "" Then
					strHTMLBody = strHTMLBody & _
					"  <tr>" & vbCr & _
					"    <td valign=""top"">" & objItem & "</td>" & vbCr & _
					"    <td class=""BlueText"">" & Replace(Server.HTMLEncode(Trim(Request.Form(objItem))),vbCr,"<br>") & "</td>" & vbCr & _
					"  </tr>" & vbCr
				Else
					strHTMLBody = strHTMLBody & _
					"  <tr>" & vbCr & _
					"    <td>" & objItem & "</td>" & vbCr & _
					"    <td class=""GrayText"">No Response</td>" & vbCr & _
					"  </tr>" & vbCr
				End If
			End If
		Next
		
		'Get the Referer and the User Agent Information and put it at the bottom of the table
		'strHTMLBody = strHTMLBody & vbCr & _
		'"  <tr>" & vbCr & _
		'"    <td valign=""top"" colspan=""2"" class=""SectionHeading"">Browser Information</td>" & vbCr & _
		'"  </tr>" & vbCr & _
		'"  <tr>" & vbCr & _
		'"    <td valign=""top"">HTTP User Agent</td>" & vbCr & _
		'"    <td class=""BlueText"">" & strHTTP_USER_AGENT & "</td>" & vbCr & _
		'"  </tr>" & vbCr & _
		'"</table>" & vbCr
		
		'Get the Referer and the User Agent Information and put it at the bottom of the table
		strHTMLBody = strHTMLBody & vbCr & _
		"</table>" & vbCr		
		
		'Compose the footer of the email
		'strHTMLFooter = vbCr & _
		'"<p><hr align=""left"" width=""100%"" size=""1"" noshade>" & vbCr & _
		'"<div class=""Footer"">This automated email was sent from <a href=""" & strFromURL & """>" & strFromURL & "</a>.<br>" & vbCr & _
		'"Please contact " & strContactName & ", <a href=""mailto:" & strTo & """>" & strTo & "</a>, if you have questions or problems with this email.</div></p>" & vbCr & _
		'"</body>" & vbCr & _
		'"</html>"

		'Compose the footer of the email
		strHTMLFooter = vbCr & _
		"<p><hr align=""left"" width=""100%"" size=""1"" noshade>" & vbCr & _
		"<div class=""Footer"">This automated email was sent from <a href=""" & strFromURL & """>" & strFromURL & "</a>.<br>" & vbCr & _
		"</body>" & vbCr & _
		"</html>"
		
		' Create the Mail object and send the email as HTML
        Dim MailMsg As New MailMessage(New MailAddress(strFrom.Trim()), New MailAddress(strTo))
        MailMsg.BodyEncoding = Encoding.Default
        'MailMsg.Bcc.Add("barneybeale@gmail.com")
        'MailMsg.Bcc.Add("selfservemediaarchive@dbasplus.com")
        MailMsg.Subject = strSubject
        MailMsg.Body = strHTMLHeader & strHTMLBody & strHTMLFooter
        MailMsg.Priority = MailPriority.Normal
        MailMsg.IsBodyHtml = True
		
        'Dimension and instantiate object to send the mail message (new in 2011 to allow for basic authentication)
        Dim SmtpMail As New SmtpClient
        Dim basicAuthenticationInfo As New System.Net.NetworkCredential(strUsername, strPassword) 
        SmtpMail.Host = strSMTPServer
        SmtpMail.UseDefaultCredentials = False
	    SmtpMail.Credentials = basicAuthenticationInfo
        SmtpMail.Send(MailMsg)
		
		'Send your visitor to the Thank You page and quit
		MailMsg = Nothing
		SmtpMail = Nothing
		Response.Redirect(strReturnURL)
		Response.End()
		
		'***************************************************************************************************************************
		'* End Script
		'***************************************************************************************************************************

    End Sub
</script>

Open in new window

0
sammySeltzerCommented:
I sent 2 different scripts. Which one do you wan to include in this one?
0
awolarczukAuthor Commented:

<%@ Page Language="VB" %>
<%@ Import Namespace="System.Net.Mail" %>
<script runat="server">
    Private Sub Page_Load(ByVal sender As System.Object, ByVal e As System.EventArgs)

		'***************************************************************************************************************************
		'* TERMS OF USE
		'* The purpose of this script is to allow Santa Barbara City College Students to create form email.
		'* This script is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.
		'* This script was designed for use on Tango Students Hosting.
		'* This script was designed for use on Microsoft IIS Servers that utilize Net.Mail using VB.NET 2
		'* This script must not be used for illegal purposes.
		'* Version Date: 4/27/2011
		'***************************************************************************************************************************
		
		'Dimension variables (DO NOT CHANGE THIS SECTION UNLESS YOU KNOW WHAT YOU ARE DOING)
		Dim objSendMail, strUsername, strPassword
		Dim strTo, strFrom, strHTMLSubject, strSubject, strHTMLHeader, strHTMLBody, strHTMLFooter
		Dim strDateTime, strEmailAddress, strFromURL, strContactName, strReturnURL, objItem, strSMTPServer, strExcludedFields
		Dim strHTTP_REFERER, strHTTP_USER_AGENT, strHTTP_HOST
		
		'***************************************************************************************************************************
		'* Begin User Specified Variables (YOU MAY CHANGE THESE VALUES)
		'***************************************************************************************************************************
		strContactName = "Oria"	'This is the name of the person who is receiving the form email
		strTo = "itsupport@adbydesigns.com.au"	'This is the recipient of this Web Form email and will usually be your email address. 
		strSubject = "Tenancy Application"	'This is the subject of the email that the recipient receive (unless there is a form field named Subject)
		strFromURL = "http://www.adbydesigns.com.au/clients/b/tenancyapplication.asp"	'This is the fully-qualified URL of your Web Form
		strReturnURL = "http://www.adbydesigns.com.au/clients/b/home.asp"	'This is the fully-qualified URL of the Thank You or result page
		strSMTPServer = "192.168.0.105"	'This is the Tango Students SMTP server. Your host will provide this information
		strUsername = ""	'Enter username to authenticate to the email server 
		strPassword = ""	'Enter password to authenticate to the email server 
		'***************************************************************************************************************************
		'* End User Specified Variables
		'***************************************************************************************************************************
		
		'***************************************************************************************************************************
		'* PLEASE DO NOT CHANGE ANYTHING BELOW UNLESS YOU KNOW WHAT YOU ARE DOING 
		'***************************************************************************************************************************
		
		'Automatically acquire the referring page and the browser information
		strHTTP_REFERER = Request.ServerVariables("HTTP_REFERER")
		strHTTP_USER_AGENT = Request.ServerVariables("HTTP_USER_AGENT")
		strHTTP_HOST = Request.ServerVariables("HTTP_HOST")
		
		'Check to see if the form is on this domain, if so process the mail, if not, sent them back to the form
		If (InStr(LCase(strHTTP_REFERER), LCase(strHTTP_HOST)) = 0) Then
		  Response.Redirect(strFromURL & "?Referer=NotLocal")
		  Response.End()
		End If

		'If the form specifies a Subject, use it
		If Trim(Request.Form("Subject")) <> "" Then
			strSubject = Trim(Request.Form("Subject"))
		End If
		
		'Encode form information for display in the HTML email and the time of submission
		strHTMLSubject = Server.HTMLEncode(strSubject)
		strDateTime = Now
		strFromURL = Server.HTMLEncode(strFromURL)
		strContactName = Server.HTMLEncode(strContactName)
		
		'Check for the existence of a FromURL Form Field - Use it if it there
		If Trim(Request.Form("FromURL")) <> "" Then
			strFromURL = Trim(Request.Form("FromURL"))
		End If
		
		'Check for the existence of a ReturnURL Form Field - Use it if it there
		If Trim(Request.Form("ReturnURL")) <> "" Then
			strReturnURL = Trim(Request.Form("ReturnURL"))
		End If
		
		strExcludedFields = "subject, fromurl, returnurl, submit" 'Exclude these fields from the email
		
		'Check for a valid email address. If the address appears valid, use it as the sender, if not use the recipient
		If Trim(Request.Form("EmailAddress")) <> "" Then
		  If InStr(Trim(Request.Form("EmailAddress")),"@") <> 0  Then
			If InStr(Trim(Request.Form("EmailAddress")),".") <> 0 Then
			  strFrom = Trim(Request.Form("EmailAddress"))
			  strEmailAddress = strFrom
			Else
			  strFrom = strTo
			  strEmailAddress = "Invalid Email Address"
			End If
		  Else
			strFrom = strTo
			strEmailAddress = "Invalid Email Address"
		  End If
		Else
		  strFrom = strTo
		  strEmailAddress = "No Email Address Submitted"
		End If  
		
		'Compose the HTML Header for the email
		strHTMLHeader = vbCr & _
		"<" & "!" & "DOCTYPE HTML PUBLIC ""-//W3C//DTD HTML 4.01 Transitional//EN"" ""http://www.w3.org/TR/html4/loose.dtd"">" & vbCr & _
		"<html lang=""en-us"">" & vbCr & _
		"<head>" & vbCr & _
		"<meta http-equiv=""Content-Type"" content=""text/html; charset=iso-8859-1"">" & vbCr & _
		"<title>" & strHTMLSubject & "</title>" & vbCr & _
		"<style type=""text/css"">" & vbCr & _
		"<!--" & vbCr & _
		"body {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #000000;" & vbCr & _
		"	background-color: #FFFFFF;" & vbCr & _
		"}" & vbCr & _
		"td {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #000000;" & vbCr & _
		"	padding: 3px;" & vbCr & _
		"	background-color: #FFFFFF;" & vbCr & _
		"}" & vbCr & _
		"th {" & vbCr & _
		"	font-family: Verdana, Arial, Helvetica, sans-serif;" & vbCr & _
		"	font-size: 12px;" & vbCr & _
		"	color: #FFFFFF;" & vbCr & _
		"	background-color: #003399;" & vbCr & _
		"	font-weight: bold;" & vbCr & _
		"	padding: 3px;" & vbCr & _
		"	text-align: left;" & vbCr & _
		"}" & vbCr & _
		"h1 {" & vbCr & _
		"	font-size: 18px;" & vbCr & _
		"}" & vbCr & _
		"h2 {" & vbCr & _
		"	font-size: 16px;" & vbCr & _
		"}" & vbCr & _
		"h3 {" & vbCr & _
		"	font-size: 14px;" & vbCr & _
		"}" & vbCr & _
		".Footer {" & vbCr & _
		"	font-size: 10px;" & vbCr & _
		"	color: #999999;" & vbCr & _
		"}" & vbCr & _
		".GrayText {" & vbCr & _
		"	color: #999999;" & vbCr & _
		"}" & vbCr & _
		".BlueText {" & vbCr & _
		"	color: #003399;" & vbCr & _
		"}" & vbCr & _
		".SectionHeading {" & vbCr & _
		"	background-color: #DDDDFF;" & vbCr & _
		"}" & vbCr & _
		"-->" & vbCr & _
		"</style>" & vbCr & _
		"</head>" & vbCr & _
		"<body>" & vbCr & _
		"<h1>"& strHTMLSubject & "</h1>" & vbCr & _
		"<p>This information was submitted on: " &  strDateTime & "</p>"
		
		'Start the table to display the form fields and values
		strHTMLBody =  vbCr & _
		"<table width=""100%"" cellpadding=""0"" cellspacing=""1"" bgcolor=""#DDDDFF"">" & vbCr & _
		"  <tr>" & vbCr & _
		"    <th scope=""col"">Field</th>" & vbCr & _
		"    <th scope=""col"">Value</th>" & vbCr & _
		"  </tr>" & vbCr
		
		'Get each of the form fields and compile them into table rows
		For Each objItem in Request.Form
			If InStr(strExcludedFields,LCase(objItem)) = 0 Then
				If Trim(Request.Form(objItem)) <> "" Then
					strHTMLBody = strHTMLBody & _
					"  <tr>" & vbCr & _
					"    <td valign=""top"">" & objItem & "</td>" & vbCr & _
					"    <td class=""BlueText"">" & Replace(Server.HTMLEncode(Trim(Request.Form(objItem))),vbCr,"<br>") & "</td>" & vbCr & _
					"  </tr>" & vbCr
				Else
					strHTMLBody = strHTMLBody & _
					"  <tr>" & vbCr & _
					"    <td>" & objItem & "</td>" & vbCr & _
					"    <td class=""GrayText"">No Response</td>" & vbCr & _
					"  </tr>" & vbCr
				End If
			End If
		Next
		
		'Get the Referer and the User Agent Information and put it at the bottom of the table
		'strHTMLBody = strHTMLBody & vbCr & _
		'"  <tr>" & vbCr & _
		'"    <td valign=""top"" colspan=""2"" class=""SectionHeading"">Browser Information</td>" & vbCr & _
		'"  </tr>" & vbCr & _
		'"  <tr>" & vbCr & _
		'"    <td valign=""top"">HTTP User Agent</td>" & vbCr & _
		'"    <td class=""BlueText"">" & strHTTP_USER_AGENT & "</td>" & vbCr & _
		'"  </tr>" & vbCr & _
		'"</table>" & vbCr
		
		'Get the Referer and the User Agent Information and put it at the bottom of the table
		strHTMLBody = strHTMLBody & vbCr & _
		"</table>" & vbCr		
		
		'Compose the footer of the email
		'strHTMLFooter = vbCr & _
		'"<p><hr align=""left"" width=""100%"" size=""1"" noshade>" & vbCr & _
		'"<div class=""Footer"">This automated email was sent from <a href=""" & strFromURL & """>" & strFromURL & "</a>.<br>" & vbCr & _
		'"Please contact " & strContactName & ", <a href=""mailto:" & strTo & """>" & strTo & "</a>, if you have questions or problems with this email.</div></p>" & vbCr & _
		'"</body>" & vbCr & _
		'"</html>"

		'Compose the footer of the email
		strHTMLFooter = vbCr & _
		"<p><hr align=""left"" width=""100%"" size=""1"" noshade>" & vbCr & _
		"<div class=""Footer"">This automated email was sent from <a href=""" & strFromURL & """>" & strFromURL & "</a>.<br>" & vbCr & _
		"</body>" & vbCr & _
		"</html>"
		
		' Create the Mail object and send the email as HTML
        Dim MailMsg As New MailMessage(New MailAddress(strFrom.Trim()), New MailAddress(strTo))
        MailMsg.BodyEncoding = Encoding.Default
        'MailMsg.Bcc.Add("barneybeale@gmail.com")
        'MailMsg.Bcc.Add("selfservemediaarchive@dbasplus.com")
        MailMsg.Subject = strSubject
        MailMsg.Body = strHTMLHeader & strHTMLBody & strHTMLFooter
        MailMsg.Priority = MailPriority.Normal
        MailMsg.IsBodyHtml = True
		
        'Dimension and instantiate object to send the mail message (new in 2011 to allow for basic authentication)
        Dim SmtpMail As New SmtpClient
        Dim basicAuthenticationInfo As New System.Net.NetworkCredential(strUsername, strPassword) 
        SmtpMail.Host = strSMTPServer
        SmtpMail.UseDefaultCredentials = False
	    SmtpMail.Credentials = basicAuthenticationInfo
        SmtpMail.Send(MailMsg)
		
		'Send your visitor to the Thank You page and quit
		MailMsg = Nothing
		SmtpMail = Nothing
		Response.Redirect(strReturnURL)
		Response.End()
		
		'***************************************************************************************************************************
		'* End Script
		'***************************************************************************************************************************

    End Sub
</script>

Open in new window

0
awolarczukAuthor Commented:
Which ever one will work to attach file :)
0
sammySeltzerCommented:
Ok, please explain to me a little bit what is wrong with this code.

I have it now on my vs2010 and I can see all the many browse(for attachemtns) 16 of them.
0
awolarczukAuthor Commented:
which code are you talking about the one i sent or the one you sent?? sorry confused
0
awolarczukAuthor Commented:
if it is the code i sent you i know they are listed at hte bottom but  they are not attached
0
Mark BradyPrincipal Data EngineerCommented:
Has anyone thought of showing the asker how to attach a file to a form? Perhaps that is all he/she is asking? If that is what you want then add this to your form header:

<form action="your_script" method="POST" enctype="multipart/form-data">
then the rest of your form elements go here.
When you want to add the file upload section - put this code in your form...

<label for="file">Filename:</label>
<input type="file" name="file" id="file" />
<br />
<input type="submit" name="submit" value="Submit" />
</form>

The "input type="file" will place a file selection button on your form for the user to select the file for upload.
When the form is submitted, you then need to 1: process the form data as usual and 2: process the file. There are many methods for processing the file using php or asp. If you would like a php version I can help you but I don't know asp at all I'm sorry.

Is this any help to you?
0
awolarczukAuthor Commented:
it is a good help thank you, wouldf there be any chance you could helop me add it to the script i have attached above
0
Mark BradyPrincipal Data EngineerCommented:
Like I said, I don't know asp or aspx or VB. I have never coded in those languages on PHP which in my opinion is much better and easier to code in. Before all you asp and VB developers jump down my throat, I'm only saying in my opinion Php is a better choice for web development.

If you could find someone to convert php to VB then I could write a php script for you.

Just a quick thought, does your Web Hosting company have php installed on their server? If so, then why not use a php script to process your form data including uploading the files/attachments to your server?

That I can help you with but I can't do anything with your current scripts.
0
sammySeltzerCommented:
The problem, though, from my understanding is trying do an email attachment.

If that's the case, the code you posted is for uploading a file to a server or to some folder.

Is that what he wants?

Another option for him is to use my code that I posted worked and modified it to suit his needs.
0
Mark BradyPrincipal Data EngineerCommented:
Hi sammySeltzer. I'm not exactly sure to be honest. I got an one of those new alerts so waqs just having a quick look over the question. If you have given him modified code that works for emailing the he should be trying to use it and asking you if he has trouble.  My mistake :)
0
awolarczukAuthor Commented:
sammySeltzer:; You code does nto work i have tried it nd i did replay but you didnt not get back to me.

elvin66: i would be more then happy to use php if it works like the one i am using, the one i am using looks through the form that is created and pulls the data out meaning i dont have to tell it each time i add a new fuild to the form
0
sammySeltzerCommented:
sorry, I missed your response.

To simplify this, here is another sample:

Markup:


<%@ Page Language="VB" AutoEventWireup="true"  CodeFile="sendEmail.aspx.vb" Inherits="sendEmail" %>

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">

<html xmlns="http://www.w3.org/1999/xhtml" >
<head id="Head1" runat="server">
    <title>Email with Attachment</title>
</head>
<body>
<form id="form1" runat="server">
<div>
    <asp:Panel runat="server" ID="EmailForm">  
        <table border="0">
            <tr>
                <td><b>Your Email:</b></td>
                <td><asp:TextBox runat="server" ID="UsersEmail" Columns="30"></asp:TextBox></td>
            </tr>
            <tr>
                <td><b>File to Send:</b></td>
                <td>
                    <asp:FileUpload ID="AttachmentFile" runat="server" />
                </td>
            </tr>
            <tr>
                <td colspan="2">
                    <b>Body:</b><br />
                    <asp:TextBox runat="server" ID="Comments" TextMode="MultiLine" Columns="55" Rows="10"></asp:TextBox>
                </td>
            </tr>
            <tr>
                <td colspan="2" align="center">
                    <asp:Button runat="server" ID="SendEmail" Text="Send Feedback" />
                </td>
            </tr>
        </table>
    </asp:Panel>
    
    <asp:Panel runat="server" ID="EmailSentSender">
        Your email has been sent successfully... thanks!
    </asp:Panel>
</asp:Content>
</div>
</fotm>

Open in new window


CodeBehind:

Imports System.Net.Mail

Partial Class SendEmail
    Inherits System.Web.UI.Page

    Protected Sub SendEmail_Click(ByVal sender As Object, ByVal e As System.EventArgs) Handles SendEmail.Click
        'Make sure a file has been uploaded
        If String.IsNullOrEmpty(AttachmentFile.FileName) OrElse AttachmentFile.PostedFile Is Nothing Then
            Throw New ApplicationException("Egad, a file wasn't uploaded... you should probably use more graceful error handling than this, though...")
        End If

        Const ToAddress As String = "Put your email Address!!"

        '(1) Create the MailMessage instance
        Dim mm As New MailMessage(UsersEmail.Text, ToAddress)

        '(2) Assign the MailMessage's properties
        mm.Subject = "Emailing an Uploaded File as an Attachment"
        mm.Body = Body.Text
        mm.IsBodyHtml = False

        'Attach the file
        mm.Attachments.Add(New Attachment(AttachmentFile.PostedFile.InputStream, AttachmentFile.FileName))

        '(3) Create the SmtpClient object
        Dim smtp As New SmtpClient

        '(4) Send the MailMessage (will use the Web.config settings)
        smtp.Send(mm)


        'Show the EmailSentForm Panel and hide the EmailForm Panel
        EmailSentForm.Visible = True
        EmailForm.Visible = False
    End Sub

    Protected Sub Page_Load(ByVal sender As Object, ByVal e As System.EventArgs) Handles Me.Load
        If Not Page.IsPostBack Then
            'On the first page load, hide the EmailSentForm Panel
            EmailSentForm.Visible = False
        End If
    End Sub
End Class

Open in new window


Test it first as is and if it works like it did for me, then integrate with your code.


0
awolarczukAuthor Commented:
Hi again than you for tyhe code but i need ti to be included in aspx screipy i sent at the top of this, i need it to be part of the scan of the form.  if you view the script you wtill see it scan the form and send the information in a email, i just need it to see if there is a attachement in the form, as you can see in my form there is a place for them at the bottom.

If you could show me how to do this it would be good
0
sammySeltzerCommented:
Did you test it first?

Test it to convince yourself that it works.

Then indicate specifically which part of it needs to be integrated the code you are talking about.
0

Experts Exchange Solution brought to you by

Your issues matter to us.

Facing a tech roadblock? Get the help and guidance you need from experienced professionals who care. Ask your question anytime, anywhere, with no hassle.

Start your 7-day free trial
awolarczukAuthor Commented:
sammySeltzer:
Thank you gain fo getting back t o me but i have said many many many times where i need it and how i need it to work, could you please help me with this
0
awolarczukAuthor Commented:
I've requested that this question be closed as follows:

Accepted answer: 0 points for awolarczuk's comment http:/Q_27386546.html#36976827

for the following reason:

after asking amny times for help no one helped
0
awolarczukAuthor Commented:
thank you everyone for you help pn this isue
0
It's more than this solution.Get answers and train to solve all your tech problems - anytime, anywhere.Try it for free Edge Out The Competitionfor your dream job with proven skills and certifications.Get started today Stand Outas the employee with proven skills.Start learning today for free Move Your Career Forwardwith certification training in the latest technologies.Start your trial today
ASP

From novice to tech pro — start learning today.

Question has a verified solution.

Are you are experiencing a similar issue? Get a personalized answer when you ask a related question.

Have a better answer? Share it in a comment.