Please complete the form below: @media screen and (max-width: 480px) { .wdform-field-section-break { max-width: 220px !important; } .wdform_page { padding: 0 !important; } .wdform-element-section { max-width: 285px; min-width: 150px !important; } div[type="type_editor"]{ max-width: 280px; } .wdform-field{ max-width: 285px; } } @media screen and (min-width: 481px) and (max-width: 768px) { div[type="type_editor"]{ max-width:480px; } } .g-recaptcha >div { height: inherit !important; } #form13 .recaptcha_input_area input{height:initial !important;}#form13 a.ui-spinner-button{border-radius:0px !important;background: none!important;}#form13 a.ui-slider-handle {width: 8px;height: 8px;top: -4px;border: 0px;border-radius: 13px;background: #FAFAFA;border: 3px solid #B1B1B1;outline: none;}#form13 .ui-slider { height: 6px; background: #F5F5F5 !important; margin: 7px 0px;}#form13 .wdform_grading input { width: 100px;}#form13 .wdform-matrix-cell input[type="text"] { width: 100px;}#form13 .wdform-matrix-cell select { width: 60px;}#form13 .wdform_section .wdform_column:last-child { padding-right: 0px !important;}#form13 .wdform_preload { display: none;}#form13 .wdform_grading { padding: 3px 0px;}#form13 .wdform-matrix-table { display: table; border-spacing: 0px;}#form13 .wdform-matrix-column { text-align: left; display: table-cell;}#form13 .wdform-matrix-cell { text-align: center; display: table-cell; padding: 6px 10px;}#form13 .wdform-matrix-head>div { display: table-cell; text-align: center;}#form13 .wdform-matrix-head { display: table-row;}#form13 .wdform-matrix-row0 { background: #DFDFDF; display: table-row;}#form13 .wdform-matrix-row1 { background: #E9E9E9; display: table-row;}#form13 .selected-text { text-align: left; color: #000;}#form13 .wdform-quantity { width: 30px; margin: 2px 0px;}#form13 .wdform_scale_rating label { vertical-align: middle;}#form13 .ui-corner-all { border-radius: 0px;}#form13 .ui-widget-content { border: 0px; background: transparent;}#form13 .ui-slider-range { background: #8A8A8A !important;}#form13 .wdform_map { border: 6px solid #fff;}#form13 .wdform-page-and-images { width: 100%;border-top: 1px solid #7F7F7F !important;}#form13 .paypal-property { display: inline-block; margin-right: 15px; vertical-align: middle;}#form13 .sel-wrap { display: inline-block; vertical-align: middle; width:100%;}#form13 .sel-wrap select { position: absolute; z-index:-1; width: 0px !important;}#form13 .sel-imul { display: inline-block;}#form13 .sel-imul .sel-selected { cursor: pointer; position: relative; display: inline-block; border-radius: 0px; padding: 0px 0px 0px 2px; font-size: 13px; height: 22px; line-height: 22px; overflow: hidden; background: #F8F8F8;border: 1px solid #B7B7B7; background-position: right 2px center; width: 100%;}#form13 .sel-imul.act .sel-selected { background: #fff;}#form13 .sel-selected .sel-arraw { height: 23px; width: 30px; background: url(/components/com_formmaker/images/09/01.png) 50% 50% no-repeat; position: absolute; top: 0px; right: 0px; padding: 0px;}#form13 .sel-imul:hover .sel-selected .sel-arraw {// background-color:#e0e0e0;// border-left:1px solid #bbb;}#form13 .sel-imul.act .sel-selected .sel-arraw {// background-color:#e0e0e0;// border-left:1px solid #bbb;}#form13 .sel-imul .sel-options { background: #fff; border: 1px solid #dbdbdb; border-top: none; position: absolute; width: inherit; display: none; z-index: 10; max-height: 200px; overflow-y: auto; overflow-x: hidden;}#form13 .sel-options .sel-option { padding: 3px 4px; font-size: 13px; border: 1px solid #fff; border-right: none; border-left: none; text-align: left;}#form13 .sel-options .sel-option:hover { border-color: #dbdbdb; cursor: pointer;}#form13 .sel-options .sel-option.sel-ed { background: #dbdbdb; border-color: #dbdbdb;}#form13 input[type=text]{ margin: 0px;}#form13 input[type=password]{ margin: 0px;}#form13 input[type=url]{ margin: 0px;}#form13 input[type=email]{ margin: 0px;}#form13 input.text{ margin: 0px;}#form13 input.title{ margin: 0px;}#form13 textarea{ margin: 0px;}#form13 select { margin: 0px;}#form13 .form-error { border-color: red !important;}#form13 .form-error:focus { border-color: red !important;}#form13 .wdform-field { display: table-cell; padding: 5px 0px;}#form13 .wdform-label-section{ text-align: left; display: table-cell;}#form13 .wdform-element-section { text-align: left; display: table-cell; min-width: 150px;}#form13 .file-upload input { position: absolute; visibility: hidden;}#form13 .file-upload-status { margin-left: 10px; max-width: 200px; font-weight: bold; font-size: 16px; color: #888; position: absolute; border-radius: 0px; height: 23px; padding-left: 5px; padding-right: 5px; white-space: nowrap; overflow: hidden; }#form13 .file-picker { width: 41px; height: 32px; background: url(/components/com_formmaker/images/09/01/upload.png) no-repeat; display: inline-block;}#form13 .next-page div.wdform-page-button { color: #A2A2A2; cursor: pointer; display: inline-block; height: 35px; line-height: 32px; background: url(/components/com_formmaker/images/09/next.png) no-repeat right; padding: 0px 36px 0 20px; vertical-align: middle; font-size: 18px; border: 1px solid #CECECE;}#form13 .previous-page div.wdform-page-button { color: #A2A2A2; cursor: pointer; display: inline-block; height: 35px; line-height: 35px; background: url(/components/com_formmaker/images/09/previous.png) no-repeat left; padding: 0 20px 0 36px; vertical-align: middle; font-size: 18px; border: 1px solid #CECECE;}#form13 .button-submit { color: #ffffff; cursor: pointer; display: inline-block; line-height: 35px; background: #013D7C; padding: 0px 20px; vertical-align: middle; font-size: 18px; min-width: 80px; min-height: 35px; font-family: Segoe UI; border: 1px solid transparent; margin: 5px;}#form13 .button-reset { color: #787878; cursor: pointer; display: inline-block; line-height: 35px; background: #F0EFEF; padding: 0px 20px; vertical-align: middle; font-size: 18px; min-width: 80px; min-height: 35px; font-family: Segoe UI; float: right; border: 1px solid transparent; margin: 5px;}#form13 .wdform_page { background: #EEEEEE; padding: 15px; border-radius: 0px; font-family: Segoe UI;}#form13 .wdform_column { border-right: none !important; padding-right: 20px !important; float: left; border-spacing: 2px; border-collapse: separate !important;}#form13 .wdform_section_break2 { color: #013D7C; display: inline-block; text-align: left; font-size: 23px;margin: 16px 10px 40px 0px;}#form13 .wdform_section_break { color: #013D7C; font-size: 23px;margin: 16px 0px;}#form13 .wdform_section { display: inline-block;}#form13 select { border-radius: 0px; height: 24px; overflow: hidden; box-shadow: none;background: #F8F8F8;border: 1px solid #B7B7B7; outline: none;}#form13 input[type="text"]{ border-radius: 0px; height: 22px;padding:0 3px !important;box-shadow:none; background: #F8F8F8;border:1px solid #B7B7B7;}#form13 input[type="password"]{ border-radius: 0px; height: 22px;padding:0 3px !important;box-shadow:none; background: #F8F8F8;border:1px solid #B7B7B7;}#form13 textarea { border-radius: 0px; height: 22px;padding:0 3px !important;box-shadow:none; background: #F8F8F8;border:1px solid #B7B7B7;}#form13 input[type="text"]:focus{ outline: none;box-shadow:none;}#form13 input[type="password"]:focus{ outline: none;box-shadow:none;}#form13 textarea:focus{ outline: none;box-shadow:none;}#form13 .input_deactive { color: #999999; font-style: italic;}#form13 .input_active { color: #000000; font-style: normal;}#form13 .am_pm_select { width: 30px; vertical-align: middle;}#form13 .checkbox-div input[type=checkbox] { position : absolute; z-index: -1;}#form13 .checkbox-div { width: 13px; height: 12px; background: transparent; border: 1px solid #8B8B8B; border-radius: 0px; position: relative; display: inline-block;}#form13 .checkbox-div label {cursor: pointer;-ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=0)";filter: alpha(opacity=0);opacity: 0;content: '';position: absolute;width: 13px;height: 9px;background: url(/components/com_formmaker/images/09/checkbox.png) no-repeat;border-radius: 0px;top: 1px;left: 2px;}#form13 .checkbox-div label:hover { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=30)"; filter: alpha(opacity=30); opacity: 0.3;}#form13 .checkbox-div .wdform-ch-rad-label:hover { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=30)"; filter: alpha(opacity=30); opacity: 0.3;}#form13 .wdform-ch-rad-label:hover + .checkbox-div label { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=30)"; filter: alpha(opacity=30); opacity: 0.3;}#form13 .checkbox-div input[type=checkbox]:checked + label { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=100)"; filter: alpha(opacity=100); opacity: 1;}#form13 .wdform-calendar-button { display:inline-block; background: transparent url(/components/com_formmaker/images/03/date.png) no-repeat; border: 0px; color: transparent; width: 22px; height: 22px; position: relative; left: -22px; vertical-align: top; outline: none;}#form13 .radio-div input[type=radio] { position : absolute; z-index: -1;}#form13 .forlabs { float: right; margin-right: 20px;}#form13 .radio-div { width: 13px; height: 12px; background: transparent; border: 1px solid #8B8B8B; border-radius: 0px; position: relative; display: inline-block; top: 2px;}#form13 .radio-div label { cursor: pointer; -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=0)"; filter: alpha(opacity=0); opacity: 0; content: ''; position: absolute; width: 9px; height: 8px; background: #8B8B8B; border-radius: 0px; top: 2px; left: 2px;}#form13 .radio-div label:hover { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=30)"; filter: alpha(opacity=30); opacity: 0.3;}#form13 .radio-div .wdform-ch-rad-label:hover { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=30)"; filter: alpha(opacity=30); opacity: 0.3;}#form13 .wdform-ch-rad-label:hover + .radio-div label { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=30)"; filter: alpha(opacity=30); opacity: 0.3;}#form13 .radio-div input[type=radio]:checked + label { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=100)"; filter: alpha(opacity=100); opacity: 1;}#form13 .if-ie-div-label { -ms-filter: "progid:DXImageTransform.Microsoft.Alpha(Opacity=100)" !important; filter: alpha(opacity=100) !important; opacity: 1 !important;}#form13 .wdform-ch-rad-label { display: inline; margin-right:5px; float: left; color: #000; cursor: pointer}#form13 textarea { padding-top: 5px;}#form13 .wdform-date { display:inline-block; width: 105px}#form13 .wdform_footer { margin-top: 15px;}#form13 .page-numbers { vertical-align: middle;}#form13 .time_box { text-align: right; width: 30px; vertical-align: middle}#form13 .mini_label { font-size: 10px; font-family: 'Lucida Grande', Tahoma, Arial, Verdana, sans-serif; color: #8A8A8A;}#form13 .wdform-label { border: none; color: #000; vertical-align: top; line-height: 17px;}#form13 .wdform_colon { color: #000}#form13 .wdform_separator { font-style: bold; vertical-align: middle; color: #000;}#form13 .wdform_line { color: #000}#form13 .wdform-required { border: none; color: red; vertical-align: top;}#form13 .captcha_img { border-width: 0px; margin: 0px; padding: 0px; cursor: pointer; border-radius: 0px;}#form13 .captcha_refresh { width: 30px; height: 30px; border-width: 0px; margin: 0px; padding: 0px; vertical-align: middle; cursor: pointer; background-image: url(/components/com_formmaker/images/refresh_black.png);}#form13 .captcha_input { height: 20px; border-width: 1px; margin: 0px; padding: 0px; vertical-align: middle;}#form13 .file_upload { border: 0px solid white; border-radius: 0px; margin: 0px; padding: 0px; color: black; background-color: white;}#form13 .page_deactive {color: #808080;background-color: #E5E5E5;cursor: pointer;display: inline-block;height: 27px;text-align: center;vertical-align: bottom;padding: 5px 25px 0px 25px;font-size: 22px;margin-left:3px;margin-bottom:2px;}#form13 .page_active { color: #C2C2C2;cursor: pointer;background-color: #FFFFFF;display: inline-block;vertical-align: bottom;height: 29px;text-align: center;font-size: 22px;padding: 5px 25px 0px 25px;border: 1px solid #7F7F7F;margin-left:3px;margin-bottom: -1px;border-bottom: none;line-height: 26px;}#form13 .page_percentage_active {padding: 0px;border-spacing: 0px;height: 10px;background: #727272;float: left;}#form13 .page_percentage_deactive {height: 10px;line-height: 20px;background-color: #E5E5E5;text-align: left !important;margin-bottom: 2px;}#form13 .page_numbers { font-size: 14px; color: #000;}#form13 .phone_area_code { width: 50px;}#form13 .phone_number { width: 100px;}#form13 button { cursor: pointer;}#form13 .other_input { border-radius: 0px; border-width: 1px; height: 16px; font-size: 12px; padding: 1px; margin: 1px; margin-left: 25px; z-index: 100; position: absolute;}#form13 .wdform_page_navigation { text-align: right !important;}#form13 .wdform_percentage_text {color: #fff;font-size: 12px;position: relative;background: url(/pordznakan/components/com_formmaker/images/09/01/02.png) no-repeat;width: 36px;display: inline-block;height: 36px;top: -37px;left: 17px;text-align: center;line-height: 27px;float: right;}#form13 .wdform_percentage_title { color: #000000; font-style: italic; margin: 0px 0px 0px 40px; display: inline-block; line-height: 20px; height: 20px; vertical-align: middle;}#form13 .wdform_button button { background: #4D792C; cursor: pointer; font-size: 17px; border-radius: 0px; min-width: 80px; min-height: 31px; color: #fff; border: 2px solid #68943B; margin: 5px; box-shadow: 0px 0px 2px #c9c9c9; font-family: Segoe UI;}#form13 Name:* First Last Institute:*Department:E-mail:*Phone:Subject:*Message:* Recaptcha Word Verification:SubmitReset <script type="text/javascript"> JURI_ROOT =''; WDF_GRADING_TEXT ='Your score should be less than'; WDF_INVALID_GRADING = '`grading_label` Total should be less than `grading_total`'; FormCurrency ='$'; FormPaypalTax ='0'; function formOnload13() { if (wdformjQuery.browser.msie && parseInt(wdformjQuery.browser.version, 10) === 8) { wdformjQuery("#form13").find(wdformjQuery("input[type='radio']")).click(function() {wdformjQuery("input[type='radio']+label").removeClass('if-ie-div-label'); wdformjQuery("input[type='radio']:checked+label").addClass('if-ie-div-label')}); wdformjQuery("#form13").find(wdformjQuery("input[type='radio']:checked+label")).addClass('if-ie-div-label'); wdformjQuery("#form13").find(wdformjQuery("input[type='checkbox']")).click(function() {wdformjQuery("input[type='checkbox']+label").removeClass('if-ie-div-label'); wdformjQuery("input[type='checkbox']:checked+label").addClass('if-ie-div-label')}); wdformjQuery("#form13").find(wdformjQuery("input[type='checkbox']:checked+label")).addClass('if-ie-div-label'); } if(wdformjQuery.browser.msie) { wdformjQuery(".wdform-calendar-button").click(function() { var pos = wdformjQuery(this).offset().top; setTimeout(function(){ wdformjQuery(".calendar").each(function (){ if(wdformjQuery(this).css("display") == "block"){ wdformjQuery(this).css("top", parseInt(pos)-wdformjQuery(this).height()+"px"); } }); },300); }); } wdformjQuery("div[type='type_text'] input, div[type='type_number'] input, div[type='type_phone'] input, div[type='type_name'] input, div[type='type_submitter_mail'] input, div[type='type_paypal_price'] input, div[type='type_textarea'] textarea").focus(function() {delete_value(this)}).blur(function() {return_value(this)}); wdformjQuery("div[type='type_number'] input, div[type='type_phone'] input, div[type='type_spinner'] input, div[type='type_range'] input, .wdform-quantity").keypress(function(evt) {return check_isnum(evt)}); wdformjQuery("div[type='type_grading'] input").keypress(function() {return check_isnum_or_minus(event)}); wdformjQuery("div[type='type_paypal_checkbox'] input[type='checkbox'], div[type='type_paypal_radio'] input[type='radio'], div[type='type_paypal_shipping'] input[type='radio']").click(function() {set_total_value(13)}); wdformjQuery("div[type='type_paypal_select'] select, div[type='type_paypal_price'] input").change(function() {set_total_value(13)}); wdformjQuery(".wdform-quantity").change(function() {set_total_value(13)}); wdformjQuery("div[type='type_time'] input").blur(function() {add_0(this)}); wdformjQuery('.wdform-element-section').each(function() { if(!wdformjQuery(this).parent()[0].style.width && parseInt(wdformjQuery(this).width())!=0) { if(wdformjQuery(this).css('display')=="table-cell") { if(wdformjQuery(this).parent().attr('type')!="type_captcha") wdformjQuery(this).parent().css('width', parseInt(wdformjQuery(this).width()) + parseInt(wdformjQuery(this).parent().find(wdformjQuery(".wdform-label-section"))[0].style.width)+15); else wdformjQuery(this).parent().css('width', (parseInt(wdformjQuery(this).parent().find(wdformjQuery(".captcha_input"))[0].style.width)*2+50) + parseInt(wdformjQuery(this).parent().find(wdformjQuery(".wdform-label-section"))[0].style.width)+15); } } if(parseInt(wdformjQuery(this)[0].style.width.replace('px', '')) < parseInt(wdformjQuery(this).css('min-width').replace('px', ''))) wdformjQuery(this).css('min-width', parseInt(wdformjQuery(this)[0].style.width.replace('px', ''))-10); }); wdformjQuery('.wdform-label').each(function() { if(parseInt(wdformjQuery(this).height()) >= 2*parseInt(wdformjQuery(this).css('line-height').replace('px', ''))) { wdformjQuery(this).parent().css('max-width',wdformjQuery(this).parent().width()); wdformjQuery(this).parent().css('width',''); } }); (function(wdformjQuery){ wdformjQuery.fn.shuffle = function() { var allElems = this.get(), getRandom = function(max) { return Math.floor(Math.random() * max); }, shuffled = wdformjQuery.map(allElems, function(){ var random = getRandom(allElems.length), randEl = wdformjQuery(allElems[random]).clone(true)[0]; allElems.splice(random, 1); return randEl; }); this.each(function(i){ wdformjQuery(this).replaceWith(wdformjQuery(shuffled[i])); }); return wdformjQuery(shuffled); }; })(wdformjQuery); wdformjQuery("").appendTo("#form13"); if(window.before_load) { before_load(); } } function formAddToOnload13() { if(formOldFunctionOnLoad13){ formOldFunctionOnLoad13(); } formOnload13(); } function formLoadBody13() { formOldFunctionOnLoad13 = window.onload; window.onload = formAddToOnload13; } var formOldFunctionOnLoad13 = null; formLoadBody13(); form_view_count13=0; for(i=1; i1) { for(i=1; i