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rtyley/Checkout

Created March 24, 2016 15:27
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Jellyfish tracking
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Checkout
<!DOCTYPE html>
<html lang="en-GB">
<head>
<meta charset="utf-8">
<title>Details - name and address | Subscriptions | The Guardian</title>
<meta name="google-site-verification" content="qf7V0ceP_mY_0jTl7R7C1wZSKn2gK7TlharWVLr8Ea0" />
<meta http-equiv="X-UA-Compatible" content="IE=Edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<meta name="format-detection" content="telephone=no">
<meta name="HandheldFriendly" content="True">
<!--[if lte IE 9]>
<script src="/assets/dist/javascripts/vendor/740675b8/polyfills.js"></script>
<![endif]-->
<!--[if lt IE 9]>
<script src="/assets/dist/javascripts/vendor/96da12df/html5shiv.js"></script>
<![endif]-->
<script id="gu">
var guardian = JSON.parse('{"user":{"isSignedIn":false,"ignorePageLoadTracking":true},"currency":"GBP","country":"GB"}');
guardian.analyticsEnabled = true;
guardian.buildNumber = '9040';
guardian.isDev = false;
guardian.isModernBrowser = (
'querySelector' in document
&& 'addEventListener' in window
&& 'localStorage' in window
&& 'sessionStorage' in window
&& 'bind' in Function
&& (('XMLHttpRequest' in window && 'withCredentials' in new XMLHttpRequest()) || 'XDomainRequest' in window)
);
guardian.pageInfo = {
channel: 'Subscriber',
slug: null,
name: document.title,
product: 'Subscriber',
productData: null
};
guardian.stripePublicKey = 'pk_test_Qm3CGRdrV4WfGYCpm0sftR0f';
guardian.trackerUrl = 'soulmates-collector.event-analytics.guardianapis.com';
(function(isModern) {
// We want to add/remove classes to HTML ASAP to avoid FOUC
var htmlClassNames = ['js-on'];
document.documentElement.className = document.documentElement.className.replace(/\bjs-off\b/g, '') + ' ' + htmlClassNames.join(' ');
if (!isModern) {
document.documentElement.className += ' js-ancient-browser';
}
/**
* Simple XHR abstraction
*/
function loadData( url, cb ) {
var xhr = new XMLHttpRequest();
xhr.open('GET', url, true);
xhr.onreadystatechange = function() {
if (xhr.readyState === 4 && xhr.status === 200) {
if (cb) { cb.call(this, xhr); }
}
}
xhr.timeout = 5000;
xhr.send();
}
/**
* Add data to local storage, with buildNumber key
* Break cache if buildNumber has changed.
*/
function updateLocalStorage(prefix, data) {
var expr = new RegExp('^' + prefix + '.', 'g');
Object.keys(localStorage).forEach(function(key) {
if (key.match(expr)) {
try {
localStorage.removeItem(key);
} catch(e) { }
}
});
try {
localStorage.setItem(prefix + '.' + guardian.buildNumber, data);
} catch(e) {}
}
/**
* Insert SVG sprite into document
*/
function inlineSvg(data) {
var el = document.createElement('div');
el.innerHTML = data;
var ref = document.getElementsByTagName('script')[0];
ref.parentNode.insertBefore(el, ref);
}
function loadSvgIcons() {
var data = !guardian.isDev && localStorage.getItem('icons.' + guardian.buildNumber);
if (data) {
inlineSvg(data);
} else {
loadData("/assets/dist/images/c6efb617/svg-sprite.svg", function(xhr) {
inlineSvg(xhr.responseText);
updateLocalStorage('icons', xhr.responseText);
});
}
}
if (isModern) {
loadSvgIcons();
}
})(guardian.isModernBrowser);
</script>
<link rel="stylesheet" href="/assets/dist/stylesheets/2f0ce971/main.min.css"/>
<!--[if (IE 9)]>
<link rel="stylesheet" href="/assets/dist/stylesheets/75a2b1d1/ie9.min.css"/>
<![endif]-->
<!--[if (lt IE 9)]>
<link rel="stylesheet" href="/assets/dist/stylesheets/2c9dc972/ie-old.min.css"/>
<![endif]-->
<link rel="shortcut icon" type="image/png" href="/assets/dist/images/favicons/7283d7ef/32x32.ico"/>
<script id="script-curl">
var curl = {
apiName: "require",
paths: {
zxcvbn: '/assets/dist/javascripts/vendor/7c40eeae/zxcvbn.js',
omniture: '/assets/dist/javascripts/vendor/ea2f2136/omniture-2014-11-19.js',
snowplow: '/assets/dist/javascripts/vendor/fe623cfd/snowplow.js',
stripe: 'https://js.stripe.com/v2/stripe-dss3'
}
};
</script>
<script src="/assets/dist/javascripts/vendor/58ce8394/curl.js"></script>
</head>
<body class="js-off is-wide">
<div class="warning-message">
Using test backend: <strong><code>UAT</code></strong>
because you have a valid <code>pre-signin-test-user</code> cookie - note you still need to create the user with the Test Username
</div>
<noscript>
<div class="warning-message warning-message--javascript">
<strong>Please enable JavaScript</strong>&ndash;we use it to enhance behaviour for Guardian Subscriptions.
<a href="http://www.enable-javascript.com/">See instructions to do so in your browser</a>.
</div>
</noscript>
<div class="warning-message warning-message--browser">
You are using an <strong>outdated</strong> browser.
If possible <a href="http://browsehappy.com/">upgrade your browser</a> to improve your experience.
</div>
<header class="global-header">
<div class="global-header__inner gs-container">
<div class="global-header__controls">
<ul class="o-inline-list">
<li class="o-inline-list__item">
<a href="https://profile.theguardian.com/signin?returnUrl=https://subscribe.theguardian.com"
class="control js-identity-menu-toggle"
id="qa-identity-control"
title="Your account"
role="menuitem"
>
<span class="control__item">
<span class="control__icon icon-holder icon-holder--large icon-holder--neutral">
<svg class="icon ">
<use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-user"></use>
</svg>
</span>
</span>
<span class="control__item u-hide-until-tablet">
<span class="control__info">
<span class="u-lowercase js-user-displayname">Sign in</span>
</span>
</span>
</a>
<ul class="popup js-identity-menu" role="navigation" aria-label="Profile menu">
<li class="popup__item">
<a href="https://profile.theguardian.com/user/id/"
class="popup__link"
data-identity-link="comment-activity"
id="qa-identity-nav-comment-activity"
>Comment activity</a>
</li>
<li class="popup__item">
<a href="https://profile.theguardian.com/public/edit"
class="popup__link"
data-identity-link="edit-profile"
id="qa-identity-nav-edit-profile"
>Edit profile</a>
</li>
<li class="popup__item">
<a href="https://profile.theguardian.com/email-prefs"
class="popup__link"
data-identity-link="email-preferences"
id="qa-identity-nav-email-preferences"
>Email preferences</a>
</li>
<li class="popup__item">
<a href="https://profile.theguardian.com/password/change"
class="popup__link"
data-identity-link="change-password"
id="qa-identity-nav-change-password"
>Change password</a>
</li>
<li class="popup__item">
<a href="https://profile.theguardian.com/signout"
class="popup__link"
data-identity-link="sign-out"
id="qa-identity-nav-sign-out"
>Sign out</a>
</li>
</ul>
</li>
<li class="o-inline-list__item">
<a class="control" href="http://theguardian.com/" role="menuitem">
<span class="control__item">
<svg class="icon icon--large">
<use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#icon-g-mark"></use>
</svg>
</span>
<span class="control__item u-hide-until-tablet">
<span class="control__info">the guardian</span>
</span>
</a>
</li>
</ul>
</div>
<div class="global-header__branding">
<a href="http://www.theguardian.com" class="u-block-link">
<i class="global-header__logo" aria-label="The Guardian Subscriptions"></i>
</a>
</div>
</div>
</header>
<nav class="global-nav">
<div class="global-nav__inner gs-container">
<a href="/" class="global-nav__link">Subscriptions</a>
</div>
</nav>
<div class="global-container">
<main class="page-container gs-container">
<section class="checkout-container">
<form class="form js-checkout-form" action="/checkout" method="POST" novalidate>
<input type="hidden" name="csrfToken" value="66200a1f6af99ad3682bc1611bafee5de99600a8-1458833242899-f5ab66ec537c22a142372019"/>
<div class="checkout-header">
<h1 class="checkout-header__title">Checkout</h1>
</div>
<div class="checkout-container__sidebar js-basket">
<div class="basket-preview basket-preview--products">
<h3 class="basket-preview__title">You've chosen:</h3>
<div class="basket-preview__image">
<img src="/assets/dist/images/eae8e1ab/digital-pack.png" alt="Digital Pack">
</div>
<div class="basket-preview__product">
<span class="basket-preview__product__title">
Digital Pack
</span>
<span class="basket-preview__product__caption">
(Daily Edition / Guardian App Premium Tier)
</span>
<span class="basket-preview__product__payment js-option-mirror-value"></span>
</div>
</div>
<div class="basket-options-toggle u-note prose">
<a class="js-toggle checkout-container__frequency" data-toggle="change-payment-frequency">
Change payment frequency
</a>
</div>
<fieldset class="basket-billing-options is-hidden js-payment-frequency js-option-mirror-group" id="change-payment-frequency">
<label class="option" data-currency="EUR">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="€12.50 every month"
data-option-mirror-label="€12.50 every month"
data-amount="11.99"
data-amount-in-currency="12.5"
data-currency-identifier="€"
data-frequency="every month"
data-number-of-months="1"
data-currency="EUR"
value="2c92c0f94f2acf73014f2c908f671591"
checked
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf73014f2c908f671591-EUR">€12.50 every month</span>
</label>
<label class="option" data-currency="CAD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="CA$13.50 every month"
data-option-mirror-label="CA$13.50 every month"
data-amount="11.99"
data-amount-in-currency="13.5"
data-currency-identifier="CA$"
data-frequency="every month"
data-number-of-months="1"
data-currency="CAD"
value="2c92c0f94f2acf73014f2c908f671591"
checked
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf73014f2c908f671591-CAD">CA$13.50 every month</span>
</label>
<label class="option" data-currency="USD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="US$13 every month"
data-option-mirror-label="US$13 every month"
data-amount="11.99"
data-amount-in-currency="13.0"
data-currency-identifier="US$"
data-frequency="every month"
data-number-of-months="1"
data-currency="USD"
value="2c92c0f94f2acf73014f2c908f671591"
checked
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf73014f2c908f671591-USD">US$13 every month</span>
</label>
<label class="option" data-currency="AUD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="AU$14 every month"
data-option-mirror-label="AU$14 every month"
data-amount="11.99"
data-amount-in-currency="14.0"
data-currency-identifier="AU$"
data-frequency="every month"
data-number-of-months="1"
data-currency="AUD"
value="2c92c0f94f2acf73014f2c908f671591"
checked
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf73014f2c908f671591-AUD">AU$14 every month</span>
</label>
<label class="option" data-currency="NZD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="NZ$14.50 every month"
data-option-mirror-label="NZ$14.50 every month"
data-amount="11.99"
data-amount-in-currency="14.5"
data-currency-identifier="NZ$"
data-frequency="every month"
data-number-of-months="1"
data-currency="NZD"
value="2c92c0f94f2acf73014f2c908f671591"
checked
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf73014f2c908f671591-NZD">NZ$14.50 every month</span>
</label>
<label class="option" data-currency="GBP">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="£11.99 every month"
data-option-mirror-label="£11.99 every month"
data-amount="11.99"
data-amount-in-currency="11.99"
data-currency-identifier="£"
data-frequency="every month"
data-number-of-months="1"
data-currency="GBP"
value="2c92c0f94f2acf73014f2c908f671591"
checked
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf73014f2c908f671591-GBP">£11.99 every month</span>
</label>
<label class="option" data-currency="NZD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="NZ$46 every 3 months"
data-option-mirror-label="NZ$46 every 3 months"
data-amount="35.0"
data-amount-in-currency="46.0"
data-currency-identifier="NZ$"
data-frequency="every 3 months"
data-number-of-months="3"
data-currency="NZD"
value="2c92c0f94f2acf76014f2c92b5791f0f"
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf76014f2c92b5791f0f-NZD">NZ$46 every 3 months</span>
</label>
<label class="option" data-currency="AUD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="AU$45 every 3 months"
data-option-mirror-label="AU$45 every 3 months"
data-amount="35.0"
data-amount-in-currency="45.0"
data-currency-identifier="AU$"
data-frequency="every 3 months"
data-number-of-months="3"
data-currency="AUD"
value="2c92c0f94f2acf76014f2c92b5791f0f"
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf76014f2c92b5791f0f-AUD">AU$45 every 3 months</span>
</label>
<label class="option" data-currency="CAD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="CA$42 every 3 months"
data-option-mirror-label="CA$42 every 3 months"
data-amount="35.0"
data-amount-in-currency="42.0"
data-currency-identifier="CA$"
data-frequency="every 3 months"
data-number-of-months="3"
data-currency="CAD"
value="2c92c0f94f2acf76014f2c92b5791f0f"
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf76014f2c92b5791f0f-CAD">CA$42 every 3 months</span>
</label>
<label class="option" data-currency="GBP">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="£35 every 3 months"
data-option-mirror-label="£35 every 3 months"
data-amount="35.0"
data-amount-in-currency="35.0"
data-currency-identifier="£"
data-frequency="every 3 months"
data-number-of-months="3"
data-currency="GBP"
value="2c92c0f94f2acf76014f2c92b5791f0f"
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf76014f2c92b5791f0f-GBP">£35 every 3 months</span>
</label>
<label class="option" data-currency="EUR">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="€37 every 3 months"
data-option-mirror-label="€37 every 3 months"
data-amount="35.0"
data-amount-in-currency="37.0"
data-currency-identifier="€"
data-frequency="every 3 months"
data-number-of-months="3"
data-currency="EUR"
value="2c92c0f94f2acf76014f2c92b5791f0f"
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf76014f2c92b5791f0f-EUR">€37 every 3 months</span>
</label>
<label class="option" data-currency="USD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="US$40 every 3 months"
data-option-mirror-label="US$40 every 3 months"
data-amount="35.0"
data-amount-in-currency="40.0"
data-currency-identifier="US$"
data-frequency="every 3 months"
data-number-of-months="3"
data-currency="USD"
value="2c92c0f94f2acf76014f2c92b5791f0f"
>
</span>
<span class="option__label" id="label-for-2c92c0f94f2acf76014f2c92b5791f0f-USD">US$40 every 3 months</span>
</label>
<label class="option" data-currency="NZD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="NZ$165 every 12 months"
data-option-mirror-label="NZ$165 every 12 months"
data-amount="140.0"
data-amount-in-currency="165.0"
data-currency-identifier="NZ$"
data-frequency="every 12 months"
data-number-of-months="12"
data-currency="NZD"
value="2c92c0f84f2ac59d014f2c94aea9199e"
>
</span>
<span class="option__label" id="label-for-2c92c0f84f2ac59d014f2c94aea9199e-NZD">NZ$165 every 12 months</span>
</label>
<label class="option" data-currency="AUD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="AU$160 every 12 months"
data-option-mirror-label="AU$160 every 12 months"
data-amount="140.0"
data-amount-in-currency="160.0"
data-currency-identifier="AU$"
data-frequency="every 12 months"
data-number-of-months="12"
data-currency="AUD"
value="2c92c0f84f2ac59d014f2c94aea9199e"
>
</span>
<span class="option__label" id="label-for-2c92c0f84f2ac59d014f2c94aea9199e-AUD">AU$160 every 12 months</span>
</label>
<label class="option" data-currency="GBP">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="£140 every 12 months"
data-option-mirror-label="£140 every 12 months"
data-amount="140.0"
data-amount-in-currency="140.0"
data-currency-identifier="£"
data-frequency="every 12 months"
data-number-of-months="12"
data-currency="GBP"
value="2c92c0f84f2ac59d014f2c94aea9199e"
>
</span>
<span class="option__label" id="label-for-2c92c0f84f2ac59d014f2c94aea9199e-GBP">£140 every 12 months</span>
</label>
<label class="option" data-currency="CAD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="CA$155 every 12 months"
data-option-mirror-label="CA$155 every 12 months"
data-amount="140.0"
data-amount-in-currency="155.0"
data-currency-identifier="CA$"
data-frequency="every 12 months"
data-number-of-months="12"
data-currency="CAD"
value="2c92c0f84f2ac59d014f2c94aea9199e"
>
</span>
<span class="option__label" id="label-for-2c92c0f84f2ac59d014f2c94aea9199e-CAD">CA$155 every 12 months</span>
</label>
<label class="option" data-currency="USD">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="US$150 every 12 months"
data-option-mirror-label="US$150 every 12 months"
data-amount="140.0"
data-amount-in-currency="150.0"
data-currency-identifier="US$"
data-frequency="every 12 months"
data-number-of-months="12"
data-currency="USD"
value="2c92c0f84f2ac59d014f2c94aea9199e"
>
</span>
<span class="option__label" id="label-for-2c92c0f84f2ac59d014f2c94aea9199e-USD">US$150 every 12 months</span>
</label>
<label class="option" data-currency="EUR">
<span class="option__input">
<input
type="radio" name="ratePlanId"
data-option-mirror-label-default="€145 every 12 months"
data-option-mirror-label="€145 every 12 months"
data-amount="140.0"
data-amount-in-currency="145.0"
data-currency-identifier="€"
data-frequency="every 12 months"
data-number-of-months="12"
data-currency="EUR"
value="2c92c0f84f2ac59d014f2c94aea9199e"
>
</span>
<span class="option__label" id="label-for-2c92c0f84f2ac59d014f2c94aea9199e-EUR">€145 every 12 months</span>
</label>
</fieldset>
<div class="js-checkout-notices notices-container" data-set="checkout-notices" hidden="true">
<div class="js-append">
<div class="js-payment-type-direct-debit u-note">
<div class="notice">
<h3 class="notice__header">Advanced Notice</h3>
<div class="u-note prose">
<p>
The details of your Direct Debit instruction including payment schedule,
due date, frequency and amount will be sent to you within three working days.
All the normal Direct Debit safeguards and guarantees apply.
</p>
</div>
</div>
<div class="notice">
<h3 class="notice__header">Money Back Guarantee</h3>
<div class="u-note prose">
<p>
If you wish to cancel your subscription, we will send
you a refund of the unexpired part of your subscription.
</p>
</div>
</div>
<div class="notice">
<h3 class="notice__header">Direct Debit</h3>
<div class="u-note prose">
<address>
The Guardian, The Quorum,
Bond Street, Bristol, BS1 3AE,
United Kingdom
</address>
<ul class="o-unstyled-list">
<li>Tel: +44 (0) 330 333 6767</li>
<li><a href="mailto:digitalpack@theguardian.com">digitalpack@theguardian.com</a></li>
</ul>
<aside class="direct-debit">
<div class="direct-debit__logo">
<img src="/assets/dist/images/6be44e25/direct-debit.png" alt="Direct Debit">
</div>
<div class="direct-debit__disclaimer prose">
Your payments are protected by the
<a href="#direct-debit-guarantee" class="js-toggle" data-toggle="direct-debit-guarantee">
Direct Debit guarantee.
</a>
</div>
<div id="direct-debit-guarantee" class="prose" data-toggle-hidden>
<ul>
<li>
The Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits
</li>
<li>
If there are any changes to the amount, date or frequency of your Direct Debit Guardian Subscriptions
will notify you (normally 3 working days) in advance of your account being debited or as otherwise agreed.
If you request Guardian Subscriptions to collect a payment, confirmation of the amount and date will be
given to you at the time of the request
</li>
<li>
If an error is made in the payment of your Direct Debit, by Guardian Subscriptions or your bank or building society,
you are entitled to a full and immediate refund of the amount paid from your bank or building society
</li>
<li>
If you receive a refund you are not entitled to, you must pay it back when Guardian Subscriptions asks you to.
You can cancel a Direct Debit at any time by simply contacting your bank or building society.
Written confirmation may be required. Please also notify Guardian Subscriptions.
</li>
</ul>
</div>
</aside>
</div>
</div>
</div>
<div class="js-payment-type-card" hidden="true">
<div class="notice">
<h3 class="notice__header">Advanced Notice</h3>
<div class="u-note prose">
<p>
The details of your continuous credit card instruction including payment schedule,
due date, frequency and amount will be sent to you within three working days.
</p>
</div>
</div>
<div class="notice">
<h3 class="notice__header">Money Back Guarantee</h3>
<div class="u-note prose">
<p>
If you wish to cancel your subscription, we will send
you a refund of the unexpired part of your subscription.
</p>
</div>
</div>
</div>
</div>
</div>
<div class="checkout-promo-code js-promo-code">
<label class="label" for="promo-code">Promo code</label>
<div class="form-field field-group__item">
<div class="col-2">
<input id="promo-code" name="promoCode" value="" class="input-text js-input" data-lookup-url="/checkout/lookupPromotion"/>
<a class="button button--primary button--large button--arrow-right js-promo-code-validate">
Apply</a>
</div>
<div class="form-field__error-message js-error-message">Please enter a valid promo code.</div>
</div>
<div class="js-promo-code-applied promo-code-applied" style="display:none"><strong>✓&nbsp;</strong>Promotion applied</div>
<div class="promo-code-snippet js-promo-code-snippet"></div>
</div>
</div>
<div class="checkout-container__form">
<div id="yourDetails" class="field-panel js-fieldset-your-details">
<fieldset>
<legend class="field-panel__legend">
<span class="field-panel__legend__num">1</span> Your details
</legend>
<div class="field-panel__intro">
<div class="field-note field-note--offset prose">
<span class="field-note__label">Already have a Guardian account?</span>
<a href="https://profile.theguardian.com/signin?returnUrl=https://subscribe.theguardian.com/checkout&amp;skipConfirmation=true">Sign in</a>
</div>
</div>
<div class="field-panel__edit">
<a href="#yourDetails" class="text-button u-button-reset js-edit-your-details" title="Edit your personal details">Edit</a>
</div>
<div class="field-panel__fields">
<div class="form-field js-checkout-first">
<label class="label" for="first">First name</label>
<input type="text" class="input-text js-input" name="personal.first" id="first"
value="" maxlength="30" required>
<div class="form-field__error-message js-error-message">This field is required</div>
</div>
<div class="form-field js-checkout-last">
<label class="label" for="last">Last name</label>
<input type="text" class="input-text js-input" name="personal.last" id="last"
value="" maxlength="50" required>
<div class="form-field__error-message js-error-message">This field is required</div>
</div>
<div class="form-field js-checkout-email">
<label class="label" for="email">Email address</label>
<input type="email" class="input-text js-input" name="personal.emailValidation.email" id="email"
value="" maxlength="80" >
<div class="form-field__error-message js-error-message"></div>
</div>
<div class="form-field js-checkout-confirm-email">
<label class="label" for="confirm">Confirm email address</label>
<input type="email" class="input-text js-input" name="personal.emailValidation.confirm" id="confirm" value="" required>
<div class="form-field__error-message js-error-message">The confirmation email must match your email address</div>
</div>
<div class="form-field js-checkout-phone-number">
<label class="label optional-marker" for="phone-number">Phone Number</label>
<input type="tel" class="input-text js-input input-text"
id="phone-number" name="personal.telephoneNumber"
value="" maxlength="20">
</div>
<div class="js-checkout-full-address">
<div class="form-field">
<label class="label" for="country">Country</label>
<select name="personal.address.country" class=" select select--wide js-country">
<option></option>
<option value="AF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Afghanistan</option>
<option value="AL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Albania</option>
<option value="DZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Algeria</option>
<option value="AS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">American Samoa</option>
<option value="AD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Andorra</option>
<option value="AO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Angola</option>
<option value="AI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Anguilla</option>
<option value="AQ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Antarctica</option>
<option value="AG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Antigua &amp; Barbuda</option>
<option value="AR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Argentina</option>
<option value="AM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Armenia</option>
<option value="AW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Aruba</option>
<option value="AU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/Territory" data-currency-choice="AUD">Australia</option>
<option value="AT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Austria</option>
<option value="AZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Azerbaijan</option>
<option value="BS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bahamas</option>
<option value="BH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bahrain</option>
<option value="BD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bangladesh</option>
<option value="BB" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Barbados</option>
<option value="BY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Belarus</option>
<option value="BE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Belgium</option>
<option value="BZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Belize</option>
<option value="BJ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Benin</option>
<option value="BM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bermuda</option>
<option value="BT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bhutan</option>
<option value="BO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bolivia</option>
<option value="BQ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bonaire, Sint Eustatius and Saba</option>
<option value="BA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Bosnia-Herzegovina</option>
<option value="BW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Botswana</option>
<option value="BV" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Bouvet Island</option>
<option value="BR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Brazil</option>
<option value="IO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">British Indian Ocean Territory</option>
<option value="VG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">British Virgin Islands</option>
<option value="BN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Brunei Darussalam</option>
<option value="BG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Bulgaria</option>
<option value="BF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Burkina Faso</option>
<option value="BI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Burundi</option>
<option value="KH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Cambodia</option>
<option value="CM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Cameroon</option>
<option value="CA" data-postcode-required="true" data-subdivision-required="true" data-subdivision-list="Alberta,British Columbia,Manitoba,New Brunswick,Newfoundland and Labrador,Nova Scotia,Northwest Territories,Nunavut,Ontario,Prince Edward Island,Quebec,Saskatchewan,Yukon" data-postcode-label="Postal code" data-subdivision-label="Province/Territory" data-currency-choice="CAD">Canada</option>
<option value="CV" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Cape Verde Islands</option>
<option value="KY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Cayman Islands</option>
<option value="CF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Central African Republic</option>
<option value="TD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Chad</option>
<option value="CL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Chile</option>
<option value="CN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">China</option>
<option value="CX" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Christmas Island</option>
<option value="CC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Cocos (Keeling) Islands</option>
<option value="CO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Colombia</option>
<option value="KM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Comoros</option>
<option value="CG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Congo (Brazzaville)</option>
<option value="CD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Congo (Kinshasa)</option>
<option value="CK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="NZD">Cook Islands</option>
<option value="CR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Costa Rica</option>
<option value="HR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Croatia</option>
<option value="CU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Cuba</option>
<option value="CW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Curaçao</option>
<option value="CY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Cyprus</option>
<option value="CZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Czech Republic</option>
<option value="DK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Denmark</option>
<option value="DJ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Djibouti</option>
<option value="DM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Dominica</option>
<option value="DO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Dominican Republic</option>
<option value="TL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">East Timor</option>
<option value="EC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Ecuador</option>
<option value="EG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Egypt</option>
<option value="SV" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">El Salvador</option>
<option value="GQ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Equatorial Guinea</option>
<option value="ER" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Eritrea</option>
<option value="EE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Estonia</option>
<option value="ET" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Ethiopia</option>
<option value="FO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Faeroe Islands</option>
<option value="FK" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">Falkland Islands</option>
<option value="FJ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Fiji</option>
<option value="FI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Finland</option>
<option value="FR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">France</option>
<option value="GF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">French Guiana</option>
<option value="PF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">French Polynesia</option>
<option value="TF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">French Southern Territories</option>
<option value="GA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Gabon</option>
<option value="GM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Gambia</option>
<option value="GE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Georgia</option>
<option value="DE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Germany</option>
<option value="GH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Ghana</option>
<option value="GI" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">Gibraltar</option>
<option value="GR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Greece</option>
<option value="GL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Greenland</option>
<option value="GD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Grenada</option>
<option value="GP" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Guadeloupe</option>
<option value="GU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Guam</option>
<option value="GT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Guatemala</option>
<option value="GG" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">Guernsey</option>
<option value="GN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Guinea</option>
<option value="GW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Guinea-Bissau</option>
<option value="GY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Guyana</option>
<option value="HT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Haiti</option>
<option value="HM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Heard Island and McDonald Islands</option>
<option value="VA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Holy See</option>
<option value="HN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Honduras</option>
<option value="HK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Hong Kong</option>
<option value="HU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Hungary</option>
<option value="IS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Iceland</option>
<option value="IN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">India</option>
<option value="ID" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Indonesia</option>
<option value="IR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Iran</option>
<option value="IQ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Iraq</option>
<option value="IE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Ireland</option>
<option value="IM" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">Isle of Man</option>
<option value="IL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Israel</option>
<option value="IT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Italy</option>
<option value="CI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Ivory Coast</option>
<option value="JM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Jamaica</option>
<option value="JP" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Japan</option>
<option value="JE" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">Jersey</option>
<option value="JO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Jordan</option>
<option value="KZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Kazakhstan</option>
<option value="KE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Kenya</option>
<option value="KI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/Territory" data-currency-choice="AUD">Kiribati</option>
<option value="KW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Kuwait</option>
<option value="KG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Kyrgyzstan</option>
<option value="LA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Laos</option>
<option value="LV" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Latvia</option>
<option value="LB" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Lebanon</option>
<option value="LS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Lesotho</option>
<option value="LR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Liberia</option>
<option value="LY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Libya</option>
<option value="LI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Liechtenstein</option>
<option value="LT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Lithuania</option>
<option value="LU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Luxembourg</option>
<option value="MO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Macau</option>
<option value="MK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Macedonia</option>
<option value="MG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Madagascar</option>
<option value="MW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Malawi</option>
<option value="MY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Malaysia</option>
<option value="MV" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Maldives</option>
<option value="ML" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Mali</option>
<option value="MT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Malta</option>
<option value="MH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Marshall Islands</option>
<option value="MQ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Martinique</option>
<option value="MR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Mauritania</option>
<option value="MU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Mauritius</option>
<option value="YT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Mayotte</option>
<option value="MX" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Mexico</option>
<option value="FM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Micronesia</option>
<option value="MD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Moldova</option>
<option value="MC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Monaco</option>
<option value="MN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Mongolia</option>
<option value="ME" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Montenegro</option>
<option value="MS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Montserrat</option>
<option value="MA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Morocco</option>
<option value="MZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Mozambique</option>
<option value="MM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Myanmar</option>
<option value="NA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Namibia</option>
<option value="NR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/Territory" data-currency-choice="AUD">Nauru</option>
<option value="NP" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Nepal</option>
<option value="NL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Netherlands</option>
<option value="NC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">New Caledonia</option>
<option value="NZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="NZD">New Zealand</option>
<option value="NI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Nicaragua</option>
<option value="NE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Niger</option>
<option value="NG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Nigeria</option>
<option value="NU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Niue</option>
<option value="NF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/Territory" data-currency-choice="AUD">Norfolk Island</option>
<option value="KP" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">North Korea</option>
<option value="MP" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Northern Mariana Islands</option>
<option value="NO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Norway</option>
<option value="OM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Oman</option>
<option value="PK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Pakistan</option>
<option value="PW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Palau</option>
<option value="PS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Palestinian Territories</option>
<option value="PA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Panama</option>
<option value="PG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Papua New Guinea</option>
<option value="PY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Paraguay</option>
<option value="PE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Peru</option>
<option value="PH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Philippines</option>
<option value="PN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Pitcairn Islands</option>
<option value="PL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Poland</option>
<option value="PT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Portugal</option>
<option value="PR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Puerto Rico</option>
<option value="QA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Qatar</option>
<option value="RO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Romania</option>
<option value="RU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Russia</option>
<option value="RW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Rwanda</option>
<option value="RE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Réunion</option>
<option value="BL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Saint Barthélemy</option>
<option value="KN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Saint Christopher &amp; Nevis</option>
<option value="SH" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">Saint Helena</option>
<option value="LC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Saint Lucia</option>
<option value="MF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Saint Martin</option>
<option value="PM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Saint Pierre &amp; Miquelon</option>
<option value="VC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Saint Vincent &amp; The Grenadines</option>
<option value="WS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Samoa</option>
<option value="SM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">San Marino</option>
<option value="ST" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Sao Tome &amp; Principe</option>
<option value="SA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Saudi Arabia</option>
<option value="SN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Senegal</option>
<option value="RS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Serbia</option>
<option value="SC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Seychelles</option>
<option value="SL" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Sierra Leone</option>
<option value="SG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Singapore</option>
<option value="SX" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Sint Maarten</option>
<option value="SK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Slovakia</option>
<option value="SI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Slovenia</option>
<option value="SB" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Solomon Islands</option>
<option value="SO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Somalia</option>
<option value="ZA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">South Africa</option>
<option value="GS" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">South Georgia &amp; The South Sandwish Islands</option>
<option value="KR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">South Korea</option>
<option value="ES" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Spain</option>
<option value="LK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Sri Lanka</option>
<option value="SD" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Sudan</option>
<option value="SR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Suriname</option>
<option value="SJ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Svalbard and Jan Mayen</option>
<option value="SZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Swaziland</option>
<option value="SE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Sweden</option>
<option value="CH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Switzerland</option>
<option value="SY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Syria</option>
<option value="TW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Taiwan</option>
<option value="TJ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Tajikistan</option>
<option value="TZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Tanzania</option>
<option value="TH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Thailand</option>
<option value="TG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Togo</option>
<option value="TK" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Tokelau</option>
<option value="TO" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Tonga</option>
<option value="TT" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Trinidad &amp; Tobago</option>
<option value="TN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Tunisia</option>
<option value="TR" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Turkey</option>
<option value="TM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Turkmenistan</option>
<option value="TC" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Turks &amp; Caicos Islands</option>
<option value="TV" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/Territory" data-currency-choice="AUD">Tuvalu</option>
<option value="UG" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Uganda</option>
<option value="UA" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Ukraine</option>
<option value="AE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">United Arab Emirates</option>
<option value="GB" data-postcode-required="true" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="County" data-currency-choice="GBP">United Kingdom</option>
<option value="US" data-postcode-required="true" data-subdivision-required="true" data-subdivision-list="Alaska,Alabama,Arkansas,Arizona,California,Colorado,Connecticut,Delaware,Florida,Georgia,Guam,Hawaii,Iowa,Idaho,Illinois,Indiana,Kansas,Kentucky,Louisiana,Massachusetts,Maryland,Maine,Michigan,Minnesota,Missouri,Mississippi,Montana,North Carolina,North Dakota,Nebraska,New Hampshire,New Jersey,New Mexico,Nevada,New York,Ohio,Oklahoma,Oregon,Pennsylvania,Puerto Rico,Rhode Island,South Carolina,South Dakota,Tennessee,Texas,Utah,Virginia,Virgin Islands,Vermont,Washington,Washington DC,Wisconsin,West Virginia,Wyoming" data-postcode-label="ZIP code" data-subdivision-label="State" data-currency-choice="USD">United States</option>
<option value="UM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">United States Minor Outlying Islands</option>
<option value="VI" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">United States Virgin Islands</option>
<option value="UY" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Uruguay</option>
<option value="UZ" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Uzbekistan</option>
<option value="VU" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Vanuatu</option>
<option value="VE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Venezuela</option>
<option value="VN" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Vietnam</option>
<option value="WF" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Wallis &amp; Futuna</option>
<option value="EH" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Western Sahara</option>
<option value="YE" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Yemen</option>
<option value="ZM" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Zambia</option>
<option value="ZW" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="USD">Zimbabwe</option>
<option value="AX" data-postcode-required="false" data-subdivision-required="false" data-postcode-label="Postcode" data-subdivision-label="State/County" data-currency-choice="EUR">Åland Islands</option>
</select>
<div class="form-field__error-message js-error-message">This field is required</div>
</div>
<div class="js-postcode"><!--populated in js--></div>
<div class="form-field js-checkout-house">
<label class="label" for="address-line-1">Address line 1</label>
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value="" maxlength="126" required>
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<div class="form-field js-checkout-street">
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value="" maxlength="40" required>
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</div>
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</div>
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This site is secure
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</label>
</div>
<div class="field-group__item">
<label class="option">
<span class="option__input">
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</label>
</div>
</div>
</div>
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<div class="form-field__error-message js-error-message">Please enter between 6 and 10 digits for the account number, and make sure the account is valid</div>
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placeholder="00-00-00" maxlength="8" required
data-masker-delim="-" data-masker-length="2">
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I confirm that I am the account holder and I am solely able to authorise debit from the account
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<i class="sprite-card sprite-card--small sprite-card--visa"></i>
</li>
<li class="u-align-middle o-inline-list__item">
<i class="sprite-card sprite-card--small sprite-card--mastercard"></i>
</li>
<li class="u-align-middle o-inline-list__item">
<i class="sprite-card sprite-card--small sprite-card--american-express"></i>
</li>
</ul>
</div>
<div class="card-number">
<i class="card-number__icon sprite-card sprite-card--unknown js-credit-card-image"></i>
<input type="text" pattern="[0-9]*" size="20"
class="input-text js-input"
id="payment-card-number"
placeholder="0000 0000 0000 0000"
maxlength="19"
data-masker-delim=" " data-masker-length="4"/>
<div class="form-field__error-message js-error-message">Please check your card number</div>
</div>
</div>
<div class="field-group">
<div class="form-field js-checkout-card-expiry field-group__item">
<span class="label">Expiry</span>
<div class="card-expiry">
<div class="card-expiry__field js-checkout-card-expiry-month">
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id="payment-card-expiry-month"
placeholder="MM"
type="text" pattern="[0-9]*" maxlength="2" size="3">
</div>/
<div class="card-expiry__field js-checkout-card-expiry-year">
<label class="label label--inline u-sr-only" for="payment-card-expiry-year">Expiry Year</label>
<input class="input-text js-input"
id="payment-card-expiry-year"
placeholder="YY"
type="text" pattern="[0-9]*" maxlength="2" size="3">
</div>
</div>
<div class="form-field__error-message js-error-message"></div>
</div>
<div class="form-field js-checkout-card-cvc field-group__item">
<label class="label" for="payment-card-cvc">Security code</label>
<input type="text" pattern="[0-9]*"
size="4" class="input-text js-input"
id="payment-card-cvc"
placeholder="CVC"
maxlength="4" />
<div class="form-field__error-message js-error-message"></div>
</div>
</div>
<div class="form-field__error-message js-error-message">There was a problem processing your payment. Please check your card details.</div>
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<div class="loader js-payment-details-validating">Validating...</div>
</div>
</div>
</fieldset>
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<span class="field-panel__legend__num">3</span> Review and confirm
</legend>
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<div class="review-details__item">
<span class="review-details__heading">Your details</span>
<div class="review-details__list">
<ul class="o-unstyled-list">
<li class="js-checkout-review-name sessioncamhidetext"></li>
<li class="js-checkout-review-address sessioncamhidetext"></li>
<li class="js-checkout-review-email sessioncamhidetext"></li>
</ul>
</div>
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<div class="review-details__item">
<span class="review-details__heading">Payment details</span>
<div class="review-details__list js-payment-type-direct-debit">
<ul class="o-unstyled-list">
<li><span class="review-details__detail">Payment method:</span> Direct Debit</li>
<li><span class="review-details__detail">Bank account:</span> <span class="js-checkout-review-account sessioncamhidetext"></span></li>
<li><span class="review-details__detail">Sort code:</span> <span class=" js-checkout-review-sortcode sessioncamhidetext"></span></li>
<li><span class="review-details__detail">Account holder:</span> <span class=" js-checkout-review-holder sessioncamhidetext"></span></li>
</ul>
</div>
<div class="review-details__list js-payment-type-card" hidden="true">
<ul class="o-unstyled-list">
<li><span class="review-details__detail">Payment method:</span> Credit/Debit card</li>
<li><span class="review-details__detail">Card number:</span> <span class="js-checkout-review-card-number sessioncamhidetext"></span></li>
<li><span class="review-details__detail">Expiry:</span> <span class="js-checkout-review-card-expiry sessioncamhidetext"></span></li>
</ul>
</div>
</div>
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Your subscription includes a range of exclusive benefits which will be sent to you from Guardian Subscriptions. These may include special offers from other companies, but your data will not be shared with these companies.
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<button type="submit" class="js-checkout-submit button button--primary button--large u-margin-bottom">
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