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First Name:	Surname:
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Country: Australia New Zealand ------------------- Afghanistan Albania Australia Algeria American Samoa Andorra Angola Antarctica Antigua Argentina Armenia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burma Burundi Byelorussian Ssr (Bielorussia) Canada Canton and Enderbury Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Columbia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech. Czechoslovakia Democratic Kampuchea Democratic Yemen Denmark Djibouti Dominica Dominican Republic Dronning Maud Land East Timor Ecuador Egypt El Salvador Equatorial Guinea Ethiopia Faeroe Islands Falkland Islands (Malvinas) Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bisseu Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Johnston Island Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan (Kirgistan) Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Madagascar Malasia Malawi Maldives Mali Malta Martinique Mauritania Mauritius Mexico Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Napal Nauru Netherlands Netherlands Antilles Neutral Zone New Calidonia Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Other Pacific Islands Pakistan Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Kitts Nevis Anguilla St. Pierre and Miquelon Sth Korea Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syran Arab Republic Taiwan Tajikistan Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukrainian SSR United Arab Emirates United Kingdom United Republic of Cameroon United Republic of Tanzania Upper Volta Uruguay USA US Minor Outlying Islands USSR Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietname Virgin Islands (U.S.) Wake Island Wallis and Futuma Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe
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First Name:	Surname:
Address:
Suburb/Town:	State:	Postcode:
Country: Australia New Zealand ------------------- Afghanistan Albania Australia Algeria American Samoa Andorra Angola Antarctica Antigua Argentina Armenia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burma Burundi Byelorussian Ssr (Bielorussia) Canada Canton and Enderbury Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Columbia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech. Czechoslovakia Democratic Kampuchea Democratic Yemen Denmark Djibouti Dominica Dominican Republic Dronning Maud Land East Timor Ecuador Egypt El Salvador Equatorial Guinea Ethiopia Faeroe Islands Falkland Islands (Malvinas) Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bisseu Guyana Haiti Heard and Mc Donald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Johnston Island Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan (Kirgistan) Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Madagascar Malasia Malawi Maldives Mali Malta Martinique Mauritania Mauritius Mexico Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Napal Nauru Netherlands Netherlands Antilles Neutral Zone New Calidonia Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Other Pacific Islands Pakistan Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Kitts Nevis Anguilla St. Pierre and Miquelon Sth Korea Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syran Arab Republic Taiwan Tajikistan Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukrainian SSR United Arab Emirates United Kingdom United Republic of Cameroon United Republic of Tanzania Upper Volta Uruguay USA US Minor Outlying Islands USSR Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietname Virgin Islands (U.S.) Wake Island Wallis and Futuma Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe