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<option value="Montenegro"> Montenegro </option> <option
value="Montserrat"> Montserrat </option> <option value="Morocco">
Morocco </option> <option value="Mozambique"> Mozambique </option>
<option value="Myanmar"> Myanmar </option> <option
value="Nagorno-Karabakh"> Nagorno-Karabakh </option> <option
value="Namibia"> Namibia </option> <option value="Nauru"> Nauru
</option> <option value="Nepal"> Nepal </option> <option
value="Netherlands"> Netherlands </option> <option
value="Netherlands Antilles"> Netherlands Antilles </option> <option
value="New Caledonia"> New Caledonia </option> <option value="New
Zealand"> New Zealand </option> <option value="Nicaragua"> Nicaragua
</option> <option value="Niger"> Niger </option> <option
value="Nigeria"> Nigeria </option> <option value="Niue"> Niue
</option> <option value="Norfolk Island"> Norfolk Island </option>
<option value="Turkish Republic of Northern Cyprus"> Turkish
Republic of Northern Cyprus </option> <option value="Northern
Mariana"> Northern Mariana </option> <option value="Norway"> Norway
</option> <option value="Oman"> Oman </option> <option
value="Pakistan"> Pakistan </option> <option value="Palau"> Palau
</option> <option value="Palestine"> Palestine </option> <option
value="Panama"> Panama </option> <option value="Papua New Guinea">
Papua New Guinea </option> <option value="Paraguay"> Paraguay
</option> <option value="Peru"> Peru </option> <option
value="Philippines"> Philippines </option> <option value="Pitcairn
Islands"> Pitcairn Islands </option> <option value="Poland"> Poland
</option> <option value="Portugal"> Portugal </option> <option
value="Puerto Rico"> Puerto Rico </option> <option value="Qatar">
Qatar </option> <option value="Republic of the Congo"> Republic of
the Congo </option> <option value="Romania"> Romania </option>
<option value="Russia"> Russia </option> <option value="Rwanda">
Rwanda </option> <option value="Saint Barthelemy"> Saint Barthelemy
</option> <option value="Saint Helena"> Saint Helena </option>
<option value="Saint Kitts and Nevis"> Saint Kitts and Nevis
</option> <option value="Saint Lucia"> Saint Lucia </option> <option
value="Saint Martin"> Saint Martin </option> <option value="Saint
Pierre and Miquelon"> Saint Pierre and Miquelon </option> <option
value="Saint Vincent and the Grenadines"> Saint Vincent and the
Grenadines </option> <option value="Samoa"> Samoa </option> <option
value="San Marino"> San Marino </option> <option value="Sao Tome and
Principe"> Sao Tome and Principe </option> <option value="Saudi
Arabia"> Saudi Arabia </option> <option value="Senegal"> Senegal
</option> <option value="Serbia"> Serbia </option> <option
value="Seychelles"> Seychelles </option> <option value="Sierra
Leone"> Sierra Leone </option> <option value="Singapore"> Singapore
</option> <option value="Slovakia"> Slovakia </option> <option
value="Slovenia"> Slovenia </option> <option value="Solomon
Islands"> Solomon Islands </option> <option value="Somalia"> Somalia
</option> <option value="Somaliland"> Somaliland </option> <option
value="South Africa"> South Africa </option> <option value="South
Ossetia"> South Ossetia </option> <option value="South Sudan"> South
Sudan </option> <option value="Spain"> Spain </option> <option
value="Sri Lanka"> Sri Lanka </option> <option value="Sudan"> Sudan
</option> <option value="Suriname"> Suriname </option> <option
value="Svalbard"> Svalbard </option> <option value="eSwatini">
eSwatini </option> <option value="Sweden"> Sweden </option> <option
value="Switzerland"> Switzerland </option> <option value="Syria">
Syria </option> <option value="Taiwan"> Taiwan </option> <option
value="Tajikistan"> Tajikistan </option> <option value="Tanzania">
Tanzania </option> <option value="Thailand"> Thailand </option>
<option value="Timor-Leste"> Timor-Leste </option> <option
value="Togo"> Togo </option> <option value="Tokelau"> Tokelau
</option> <option value="Tonga"> Tonga </option> <option
value="Transnistria Pridnestrovie"> Transnistria Pridnestrovie
</option> <option value="Trinidad and Tobago"> Trinidad and Tobago
</option> <option value="Tristan da Cunha"> Tristan da Cunha
</option> <option value="Tunisia"> Tunisia </option> <option
value="Turkey"> Turkey </option> <option value="Turkmenistan">
Turkmenistan </option> <option value="Turks and Caicos Islands">
Turks and Caicos Islands </option> <option value="Tuvalu"> Tuvalu
</option> <option value="Uganda"> Uganda </option> <option
value="Ukraine"> Ukraine </option> <option value="United Arab
Emirates"> United Arab Emirates </option> <option value="United
Kingdom"> United Kingdom </option> <option value="Uruguay"> Uruguay
</option> <option value="Uzbekistan"> Uzbekistan </option> <option
value="Vanuatu"> Vanuatu </option> <option value="Vatican City">
Vatican City </option> <option value="Venezuela"> Venezuela
</option> <option value="Vietnam"> Vietnam </option> <option
value="British Virgin Islands"> British Virgin Islands </option>
<option value="Isle of Man"> Isle of Man </option> <option value="US
Virgin Islands"> US Virgin Islands </option> <option value="Wallis
and Futuna"> Wallis and Futuna </option> <option value="Western
Sahara"> Western Sahara </option> <option value="Yemen"> Yemen
</option> <option value="Zambia"> Zambia </option> <option
value="Zimbabwe"> Zimbabwe </option> <option value="other"> Other
</option> </select> <label class="form-sub-label"
for="input_12_country" id="sublabel_12_country"
style="min-height:13px" aria-hidden="false"> Country </label>
</span> </span> </div> </div> </div> </li> <li class="form-line"
data-type="control_textbox" id="id_27"> <label class="form-label
form-label-left form-label-auto" id="label_27" for="input_27">
Church Name </label> <div id="cid_27" class="form-input"> <span
class="form-sub-label-container " style="vertical-align:top"> <input
type="text" id="input_27" name="q27_churchName"
data-type="input-textbox" class="form-textbox" size="60" value=""
data-component="textbox" aria-labelledby="label_27
sublabel_input_27" /> <label class="form-sub-label" for="input_27"
id="sublabel_input_27" style="min-height:13px" aria-hidden="false">
The name of the church or other kind of religious place you
regularly physically attend </label> </span> </div> </li> <li
class="form-line" data-type="control_textbox" id="id_29"> <label
class="form-label form-label-left form-label-auto" id="label_29"
for="input_29"> Church Suburb </label> <div id="cid_29"
class="form-input"> <span class="form-sub-label-container "
style="vertical-align:top"> <input type="text" id="input_29"
name="q29_churchSuburb" data-type="input-textbox"
class="form-textbox" size="30" value="" data-component="textbox"
aria-labelledby="label_29 sublabel_input_29" /> <label
class="form-sub-label" for="input_29" id="sublabel_input_29"
style="min-height:13px" aria-hidden="false"> The name of the suburb
for the main church or religious place you attend. </label> </span>
</div> </li> <li class="form-line" data-type="control_dropdown"
id="id_28"> <label class="form-label form-label-left
form-label-auto" id="label_28" for="input_28"> Religion (Census
Category) </label> <div id="cid_28" class="form-input"> <select
class="form-dropdown" id="input_28" name="q28_religioncensus"
style="width:150px" data-component="dropdown"
aria-labelledby="label_28"> <option value=""> </option> <option
value="No Religion"> No Religion </option> <option value="Anglican">
Anglican </option> <option value="Baptist"> Baptist </option>
<option value="Buddhism"> Buddhism </option> <option
value="Catholic"> Catholic </option> <option value="Christian
(Other)"> Christian (Other) </option> <option value="Eastern
Orthodox"> Eastern Orthodox </option> <option value="Hinduism">
Hinduism </option> <option value="Islam"> Islam </option> <option
value="Jehovah's Witnesses"> Jehovah's Witnesses </option>
<option value="Judaism"> Judaism </option> <option value="Latter-day
Saints"> Latter-day Saints </option> <option value="Lutheran">
Lutheran </option> <option value="Oriental Orthodox"> Oriental
Orthodox </option> <option value="Pentecostal"> Pentecostal
</option> <option value="Presbyterian/Reform"> Presbyterian/Reform
</option> <option value="Protestant-Other"> Protestant-Other
</option> <option value="Seventhday Adventist"> Seventhday Adventist
</option> <option value="Sikhism"> Sikhism </option> <option
value="Uniting Church"> Uniting Church </option> </select> </div>
</li> <li class="form-line" data-type="control_checkbox" id="id_31">
<label class="form-label form-label-left form-label-auto"
id="label_31" for="input_31"> What "last days" prayer
&/or outreach role might you be interested in? </label> <div
id="cid_31" class="form-input"> <div class="form-single-column"
role="group" aria-labelledby="label_31" data-component="checkbox">
<span class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_0" name="q31_whatlast31[]"
value="In-Church" /> <label id="label_input_31_0" for="input_31_0">
In-Church </label> </span> <span class="form-checkbox-item"
style="clear:left"> <span class="dragger-item"> </span> <input
type="checkbox" class="form-checkbox" id="input_31_1"
name="q31_whatlast31[]" value="Inter-Church" /> <label
id="label_input_31_1" for="input_31_1"> Inter-Church </label>
</span> <span class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_2" name="q31_whatlast31[]"
value="Leadership & Strategy Training" /> <label
id="label_input_31_2" for="input_31_2"> Leadership & Strategy
Training </label> </span> <span class="form-checkbox-item"
style="clear:left"> <span class="dragger-item"> </span> <input
type="checkbox" class="form-checkbox" id="input_31_3"
name="q31_whatlast31[]" value="On-Street (Local Neighborhood Street
Block)" /> <label id="label_input_31_3" for="input_31_3"> On-Street
(Local Neighborhood Street Block) </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_4" name="q31_whatlast31[]"
value="Outside Local School" /> <label id="label_input_31_4"
for="input_31_4"> Outside Local School </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_5" name="q31_whatlast31[]"
value="Inside Shopping Centres" /> <label id="label_input_31_5"
for="input_31_5"> Inside Shopping Centres </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_6" name="q31_whatlast31[]"
value="Local Government Representative Effectiveness" /> <label
id="label_input_31_6" for="input_31_6"> Local Government
Representative Effectiveness </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_7" name="q31_whatlast31[]"
value="State Government Representative Effectiveness" /> <label
id="label_input_31_7" for="input_31_7"> State Government
Representative Effectiveness </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_8" name="q31_whatlast31[]"
value="Federal Government Representative Effectiveness" /> <label
id="label_input_31_8" for="input_31_8"> Federal Government
Representative Effectiveness </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_31_9" name="q31_whatlast31[]"
value="Regions Arise (a new strategic initiative)" /> <label
id="label_input_31_9" for="input_31_9"> Regions Arise (a new
strategic initiative) </label> </span> </div> </div> </li> <li
class="form-line" data-type="control_radio" id="id_35"> <label
class="form-label form-label-left form-label-auto" id="label_35"
for="input_35"> If you ticked "Regions Arise", what region
interests you most to see more progress in? (Tick one only) </label>
<div id="cid_35" class="form-input"> <div class="form-single-column"
role="group" aria-labelledby="label_35" data-component="radio">
<span class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_0" name="q35_ifYou35" value="Adelaide - Northern
Metropolitan Region" /> <label id="label_input_35_0"
for="input_35_0"> Adelaide - Northern Metropolitan Region </label>
</span> <span class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_1" name="q35_ifYou35" value="Adelaide - Eastern
Metropolitan Region" /> <label id="label_input_35_1"
for="input_35_1"> Adelaide - Eastern Metropolitan Region </label>
</span> <span class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_2" name="q35_ifYou35" value="Adelaide - Western
Metropolitan Region" /> <label id="label_input_35_2"
for="input_35_2"> Adelaide - Western Metropolitan Region </label>
</span> <span class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_3" name="q35_ifYou35" value="Adelaide - Southern
Metropolitan Region" /> <label id="label_input_35_3"
for="input_35_3"> Adelaide - Southern Metropolitan Region </label>
</span> <span class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_4" name="q35_ifYou35" value="Adelaide Hills Region" />
<label id="label_input_35_4" for="input_35_4"> Adelaide Hills Region
</label> </span> <span class="form-radio-item" style="clear:left">
<span class="dragger-item"> </span> <input type="radio"
class="form-radio" id="input_35_5" name="q35_ifYou35" value="Barossa
Region" /> <label id="label_input_35_5" for="input_35_5"> Barossa
Region </label> </span> <span class="form-radio-item"
style="clear:left"> <span class="dragger-item"> </span> <input
type="radio" class="form-radio" id="input_35_6" name="q35_ifYou35"
value="Eyre & Western Region" /> <label id="label_input_35_6"
for="input_35_6"> Eyre & Western Region </label> </span> <span
class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_7" name="q35_ifYou35" value="Far North Region" />
<label id="label_input_35_7" for="input_35_7"> Far North Region
</label> </span> <span class="form-radio-item" style="clear:left">
<span class="dragger-item"> </span> <input type="radio"
class="form-radio" id="input_35_8" name="q35_ifYou35"
value="Fleurieu & Kangaroo Island Region" /> <label
id="label_input_35_8" for="input_35_8"> Fleurieu & Kangaroo Island
Region </label> </span> <span class="form-radio-item"
style="clear:left"> <span class="dragger-item"> </span> <input
type="radio" class="form-radio" id="input_35_9" name="q35_ifYou35"
value="Limestone Coast Region" /> <label id="label_input_35_9"
for="input_35_9"> Limestone Coast Region </label> </span> <span
class="form-radio-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="radio" class="form-radio"
id="input_35_10" name="q35_ifYou35" value="Murray & Mallee
Region" /> <label id="label_input_35_10" for="input_35_10"> Murray &
Mallee Region </label> </span> <span class="form-radio-item"
style="clear:left"> <span class="dragger-item"> </span> <input
type="radio" class="form-radio" id="input_35_11" name="q35_ifYou35"
value="Yorke & Mid-North Region" /> <label
id="label_input_35_11" for="input_35_11"> Yorke & Mid-North Region
</label> </span> <span class="form-radio-item" style="clear:left">
<span class="dragger-item"> </span> <input type="radio"
class="form-radio" id="input_35_12" name="q35_ifYou35"
value="Don't Know" /> <label id="label_input_35_12"
for="input_35_12"> Don't Know </label> </span> </div> </div> </li>
<li class="form-line" data-type="control_checkbox" id="id_36">
<label class="form-label form-label-left form-label-auto"
id="label_36" for="input_36"> Why that Region? (Multiple Choice)
</label> <div id="cid_36" class="form-input"> <div
class="form-single-column" role="group" aria-labelledby="label_36"
data-component="checkbox"> <span class="form-checkbox-item"
style="clear:left"> <span class="dragger-item"> </span> <input
type="checkbox" class="form-checkbox" id="input_36_0"
name="q36_whyThat36[]" value="I live there" /> <label
id="label_input_36_0" for="input_36_0"> I live there </label>
</span> <span class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_36_1" name="q36_whyThat36[]"
value="I work there" /> <label id="label_input_36_1"
for="input_36_1"> I work there </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_36_2" name="q36_whyThat36[]"
value="I attend Church there" /> <label id="label_input_36_2"
for="input_36_2"> I attend Church there </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_36_3" name="q36_whyThat36[]"
value="I like going there" /> <label id="label_input_36_3"
for="input_36_3"> I like going there </label> </span> <span
class="form-checkbox-item" style="clear:left"> <span
class="dragger-item"> </span> <input type="checkbox"
class="form-checkbox" id="input_36_4" name="q36_whyThat36[]"
value="It has bigger potential" /> <label id="label_input_36_4"
for="input_36_4"> It has bigger potential </label> </span> <span
class="form-checkbox-item" style="clear:left"> <input
type="checkbox" class="form-checkbox-other form-checkbox"
name="q36_whyThat36[other]" id="other_36" value="other"
aria-label="Other" /> <label id="label_other_36"
style="text-indent:0" for="other_36"> </label> <input type="text"
class="form-checkbox-other-input form-textbox"
name="q36_whyThat36[other]" data-otherhint="Other" size="15"
id="input_36" placeholder="Other" /> <br/> </span> </div> </div>
</li> <li class="form-line" data-type="control_textarea" id="id_24">
<label class="form-label form-label-left form-label-auto"
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id="input_24" class="form-textarea" name="q24_commentsQuestions"
cols="40" rows="6" data-component="textarea"
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