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<label class=" required control-label cf_customer_city_au_767774-label " for="helpdesk_ticket_cf_customer_city_au_767774">Your City</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_customer_city_au_767774]" id="helpdesk_ticket_custom_field_cf_customer_city_au_767774" /> </div>
<label class=" required control-label cf_customer_country_au_767774-label " for="helpdesk_ticket_cf_customer_country_au_767774">Your Country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_customer_country_au_767774]" id="helpdesk_ticket_custom_field_cf_customer_country_au_767774" /> </div>
<label class=" control-label cf_access_account_ai_767774-label " for="helpdesk_ticket_cf_access_account_ai_767774">Account Number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_access_account_ai_767774]" id="helpdesk_ticket_custom_field_cf_access_account_ai_767774" /> </div>
<label class=" required control-label cf_does_the_label_on_your_journal_include_a_number_that_begins_with_100_767774-label " for="helpdesk_ticket_cf_does_the_label_on_your_journal_include_a_number_that_begins_with_100_767774">Does the label on your journal include a number that begins with 100?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_does_the_label_on_your_journal_include_a_number_that_begins_with_100_767774]" id="helpdesk_ticket_custom_field_cf_does_the_label_on_your_journal_include_a_number_that_begins_with_100_767774"><option value="">...</option> <option data-id="7000162407" value="Yes">Yes</option> <option data-id="7000162408" value="No">No</option></select> </div>
<label class=" control-label cf_if_yes_please_provide_this_number_767774-label " for="helpdesk_ticket_cf_if_yes_please_provide_this_number_767774">If yes, please provide this number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_if_yes_please_provide_this_number_767774]" id="helpdesk_ticket_custom_field_cf_if_yes_please_provide_this_number_767774" /> </div>
<label class=" required control-label cf_full_name_add_767774-label " for="helpdesk_ticket_cf_full_name_add_767774">Full Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_full_name_add_767774]" id="helpdesk_ticket_custom_field_cf_full_name_add_767774" /> </div>
<label class=" required control-label cf_previous_address_line_1_767774-label " for="helpdesk_ticket_cf_previous_address_line_1_767774">Previous Street Address</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_previous_address_line_1_767774]" id="helpdesk_ticket_custom_field_cf_previous_address_line_1_767774" /> </div>
<label class=" control-label cf_previous_address_line_2_767774-label " for="helpdesk_ticket_cf_previous_address_line_2_767774">Previous Address: Apt, flat, unit, floor, etc.</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_previous_address_line_2_767774]" id="helpdesk_ticket_custom_field_cf_previous_address_line_2_767774" /> </div>
<label class=" required control-label cf_previous_citytown_767774-label " for="helpdesk_ticket_cf_previous_citytown_767774">Previous Town/City</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_previous_citytown_767774]" id="helpdesk_ticket_custom_field_cf_previous_citytown_767774" /> </div>
<label class=" control-label cf_previous_state_if_applicable_767774-label " for="helpdesk_ticket_cf_previous_state_if_applicable_767774">Previous State (if applicable)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_previous_state_if_applicable_767774]" id="helpdesk_ticket_custom_field_cf_previous_state_if_applicable_767774" /> </div>
<label class=" required control-label cf_previous_zippostal_code_767774-label " for="helpdesk_ticket_cf_previous_zippostal_code_767774">Previous Zip/Postal Code</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_previous_zippostal_code_767774]" id="helpdesk_ticket_custom_field_cf_previous_zippostal_code_767774" /> </div>
<label class=" required control-label cf_previous_country_767774-label " for="helpdesk_ticket_cf_previous_country_767774">Previous Country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_previous_country_767774]" id="helpdesk_ticket_custom_field_cf_previous_country_767774" /> </div>
<label class=" required control-label cf_new_street_address_767774-label " for="helpdesk_ticket_cf_new_street_address_767774">New Street Address</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_new_street_address_767774]" id="helpdesk_ticket_custom_field_cf_new_street_address_767774" /> </div>
<label class=" control-label cf_new_address_apt_flat_unit_floor_etc_767774-label " for="helpdesk_ticket_cf_new_address_apt_flat_unit_floor_etc_767774">New Address: Apt, flat, unit, floor, etc.</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_new_address_apt_flat_unit_floor_etc_767774]" id="helpdesk_ticket_custom_field_cf_new_address_apt_flat_unit_floor_etc_767774" /> </div>
<label class=" required control-label cf_new_towncity_767774-label " for="helpdesk_ticket_cf_new_towncity_767774">New Town/City</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_new_towncity_767774]" id="helpdesk_ticket_custom_field_cf_new_towncity_767774" /> </div>
<label class=" control-label cf_new_state_if_applicable_767774-label " for="helpdesk_ticket_cf_new_state_if_applicable_767774">New State (if applicable)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_new_state_if_applicable_767774]" id="helpdesk_ticket_custom_field_cf_new_state_if_applicable_767774" /> </div>
<label class=" required control-label cf_new_zippostal_code_767774-label " for="helpdesk_ticket_cf_new_zippostal_code_767774">New Zip/Postal Code</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_new_zippostal_code_767774]" id="helpdesk_ticket_custom_field_cf_new_zippostal_code_767774" /> </div>
<label class=" required control-label cf_new_country_767774-label " for="helpdesk_ticket_cf_new_country_767774">New Country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_new_country_767774]" id="helpdesk_ticket_custom_field_cf_new_country_767774" /> </div>
<label class=" control-label cf_reason_of_contact_campus_767774-label " for="helpdesk_ticket_cf_reason_of_contact_campus_767774">Query type</label> <div class="controls nested_field "> <select class=" nested_field section_field" id="helpdesk_ticket_custom_field_cf_reason_of_contact_campus_767774_7000162550" name="helpdesk_ticket[custom_field][cf_reason_of_contact_campus_767774]"><option value="">...</option> <option value="Bugs">Bugs</option> <option value="Course content">Course content</option> <option value="Technical issues">Technical issues</option> <option value="Other">Other</option> <option value="Trial request">Trial request</option> <option value="Access issues">Access issues</option> <option value="Institutional enquiry">Institutional enquiry</option> <option value="General contact us">General contact us</option> <option value="Course progress">Course progress</option> <option value="Delete/manage account">Delete/manage account</option></select><div class="level_2"><label class="">Detail</label><select class=" nested_field section_field" id="helpdesk_ticket_custom_field_cf_detail_campus_767774_7000162550" name="helpdesk_ticket[custom_field][cf_detail_campus_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_reason_of_contact_campus_767774_7000162550').nested_select_tag({"data_tree":[["Bugs","Bugs",[]],["Course content","Course content",[]],["Technical issues","Technical issues",[]],["Other","Other",[["Other","Other",[]]]],["Trial request","Trial request",[]],["Access issues","Access issues",[]],["Institutional enquiry","Institutional enquiry",[]],["General contact us","General contact us",[]],["Course progress","Course progress",[]],["Delete/manage account","Delete/manage account",[]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000162550","subcategory_id":"helpdesk_ticket_custom_field_cf_detail_campus_767774_7000162550"}); //]]> </script> </div>
<label class=" control-label cf_ship_to_name_eb_767774-label " for="helpdesk_ticket_cf_ship_to_name_eb_767774">Ship to first and last name</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_name_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_name_eb_767774" /> </div>
<label class=" required control-label cf_ship_to_address_line_1_if_767774-label " for="helpdesk_ticket_cf_ship_to_address_line_1_if_767774">Home/residential address line 1</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_address_line_1_if_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_address_line_1_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_address_line_2_if_767774-label " for="helpdesk_ticket_cf_homeresidential_address_line_2_if_767774">Home/residential address line 2</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_address_line_2_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_address_line_2_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_city_if_767774-label " for="helpdesk_ticket_cf_homeresidential_city_if_767774">Home/residential city</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_city_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_city_if_767774" /> </div>
<label class=" control-label cf_shipping_state_if_767774-label " for="helpdesk_ticket_cf_shipping_state_if_767774">Home/residential state</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_state_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_state_if_767774" /> </div>
<label class=" required control-label cf_postal_code_if_767774-label " for="helpdesk_ticket_cf_postal_code_if_767774">Postal code</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_postal_code_if_767774]" id="helpdesk_ticket_custom_field_cf_postal_code_if_767774" /> </div>
<label class=" required control-label cf_shipping_country_if_767774-label " for="helpdesk_ticket_cf_shipping_country_if_767774">Home/residential country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_country_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_country_if_767774" /> </div>
<label class=" control-label cf_ship_to_phone_eb_767774-label " for="helpdesk_ticket_cf_ship_to_phone_eb_767774">Ship to phone (include country code)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_phone_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_phone_eb_767774" /> </div>
<label class=" required control-label cf_produc_767774-label " for="helpdesk_ticket_cf_produc_767774">Product 1 ISBN</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_produc_767774]" id="helpdesk_ticket_custom_field_cf_produc_767774" /> </div>
<label class=" required control-label cf_product_1_title_author_if_767774-label " for="helpdesk_ticket_cf_product_1_title_author_if_767774">Product 1 Title & Author</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_1_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_1_title_author_if_767774" /> </div>
<label class=" control-label cf_product_2_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_2_isbn_eb_767774">Product 2 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_2_title_author_if_767774-label " for="helpdesk_ticket_cf_product_2_title_author_if_767774">Product 2 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_2_title_author_if_767774" /> </div>
<label class=" control-label cf_product_isbn_3_eb_767774-label " for="helpdesk_ticket_cf_product_isbn_3_eb_767774">Product 3 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_isbn_3_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_isbn_3_eb_767774" /> </div>
<label class=" control-label cf_product_3_title_author_767774-label " for="helpdesk_ticket_cf_product_3_title_author_767774">Product 3 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_title_author_767774]" id="helpdesk_ticket_custom_field_cf_product_3_title_author_767774" /> </div>
<label class=" control-label cf_ship_to_name_eb_767774-label " for="helpdesk_ticket_cf_ship_to_name_eb_767774">Ship to first and last name</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_name_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_name_eb_767774" /> </div>
<label class=" required control-label cf_ship_to_address_line_1_if_767774-label " for="helpdesk_ticket_cf_ship_to_address_line_1_if_767774">Home/residential address line 1</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_address_line_1_if_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_address_line_1_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_address_line_2_if_767774-label " for="helpdesk_ticket_cf_homeresidential_address_line_2_if_767774">Home/residential address line 2</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_address_line_2_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_address_line_2_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_city_if_767774-label " for="helpdesk_ticket_cf_homeresidential_city_if_767774">Home/residential city</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_city_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_city_if_767774" /> </div>
<label class=" control-label cf_shipping_state_if_767774-label " for="helpdesk_ticket_cf_shipping_state_if_767774">Home/residential state</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_state_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_state_if_767774" /> </div>
<label class=" required control-label cf_postal_code_if_767774-label " for="helpdesk_ticket_cf_postal_code_if_767774">Postal code</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_postal_code_if_767774]" id="helpdesk_ticket_custom_field_cf_postal_code_if_767774" /> </div>
<label class=" required control-label cf_shipping_country_if_767774-label " for="helpdesk_ticket_cf_shipping_country_if_767774">Home/residential country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_country_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_country_if_767774" /> </div>
<label class=" control-label cf_ship_to_phone_eb_767774-label " for="helpdesk_ticket_cf_ship_to_phone_eb_767774">Ship to phone (include country code)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_phone_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_phone_eb_767774" /> </div>
<label class=" required control-label cf_produc_767774-label " for="helpdesk_ticket_cf_produc_767774">Product 1 ISBN</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_produc_767774]" id="helpdesk_ticket_custom_field_cf_produc_767774" /> </div>
<label class=" required control-label cf_product_1_title_author_if_767774-label " for="helpdesk_ticket_cf_product_1_title_author_if_767774">Product 1 Title & Author</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_1_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_1_title_author_if_767774" /> </div>
<label class=" control-label cf_product_2_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_2_isbn_eb_767774">Product 2 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_2_title_author_if_767774-label " for="helpdesk_ticket_cf_product_2_title_author_if_767774">Product 2 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_2_title_author_if_767774" /> </div>
<label class=" control-label cf_product_isbn_3_eb_767774-label " for="helpdesk_ticket_cf_product_isbn_3_eb_767774">Product 3 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_isbn_3_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_isbn_3_eb_767774" /> </div>
<label class=" control-label cf_product_3_title_author_767774-label " for="helpdesk_ticket_cf_product_3_title_author_767774">Product 3 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_title_author_767774]" id="helpdesk_ticket_custom_field_cf_product_3_title_author_767774" /> </div>
<label class=" control-label cf_product_4_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_4_isbn_eb_767774">Product 4 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_4_title_author_if_767774-label " for="helpdesk_ticket_cf_product_4_title_author_if_767774">Product 4 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_4_title_author_if_767774" /> </div>
<label class=" control-label cf_product_5_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_5_isbn_eb_767774">Product 5 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_5_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_5_title_author_if_767774-label " for="helpdesk_ticket_cf_product_5_title_author_if_767774">Product 5 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_5_title_author_if_767774" /> </div>
<label class=" control-label cf_ship_to_name_eb_767774-label " for="helpdesk_ticket_cf_ship_to_name_eb_767774">Ship to first and last name</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_name_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_name_eb_767774" /> </div>
<label class=" required control-label cf_ship_to_address_line_1_if_767774-label " for="helpdesk_ticket_cf_ship_to_address_line_1_if_767774">Home/residential address line 1</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_address_line_1_if_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_address_line_1_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_address_line_2_if_767774-label " for="helpdesk_ticket_cf_homeresidential_address_line_2_if_767774">Home/residential address line 2</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_address_line_2_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_address_line_2_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_city_if_767774-label " for="helpdesk_ticket_cf_homeresidential_city_if_767774">Home/residential city</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_city_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_city_if_767774" /> </div>
<label class=" control-label cf_shipping_state_if_767774-label " for="helpdesk_ticket_cf_shipping_state_if_767774">Home/residential state</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_state_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_state_if_767774" /> </div>
<label class=" required control-label cf_postal_code_if_767774-label " for="helpdesk_ticket_cf_postal_code_if_767774">Postal code</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_postal_code_if_767774]" id="helpdesk_ticket_custom_field_cf_postal_code_if_767774" /> </div>
<label class=" required control-label cf_shipping_country_if_767774-label " for="helpdesk_ticket_cf_shipping_country_if_767774">Home/residential country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_country_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_country_if_767774" /> </div>
<label class=" control-label cf_ship_to_phone_eb_767774-label " for="helpdesk_ticket_cf_ship_to_phone_eb_767774">Ship to phone (include country code)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_phone_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_phone_eb_767774" /> </div>
<label class=" required control-label cf_produc_767774-label " for="helpdesk_ticket_cf_produc_767774">Product 1 ISBN</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_produc_767774]" id="helpdesk_ticket_custom_field_cf_produc_767774" /> </div>
<label class=" required control-label cf_product_1_title_author_if_767774-label " for="helpdesk_ticket_cf_product_1_title_author_if_767774">Product 1 Title & Author</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_1_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_1_title_author_if_767774" /> </div>
<label class=" control-label cf_product_2_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_2_isbn_eb_767774">Product 2 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_2_title_author_if_767774-label " for="helpdesk_ticket_cf_product_2_title_author_if_767774">Product 2 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_2_title_author_if_767774" /> </div>
<label class=" control-label cf_product_isbn_3_eb_767774-label " for="helpdesk_ticket_cf_product_isbn_3_eb_767774">Product 3 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_isbn_3_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_isbn_3_eb_767774" /> </div>
<label class=" control-label cf_product_3_title_author_767774-label " for="helpdesk_ticket_cf_product_3_title_author_767774">Product 3 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_title_author_767774]" id="helpdesk_ticket_custom_field_cf_product_3_title_author_767774" /> </div>
<label class=" control-label cf_product_4_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_4_isbn_eb_767774">Product 4 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_4_title_author_if_767774-label " for="helpdesk_ticket_cf_product_4_title_author_if_767774">Product 4 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_4_title_author_if_767774" /> </div>
<label class=" control-label cf_product_5_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_5_isbn_eb_767774">Product 5 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_5_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_5_title_author_if_767774-label " for="helpdesk_ticket_cf_product_5_title_author_if_767774">Product 5 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_5_title_author_if_767774" /> </div>
<label class=" control-label cf_product_6_isbn_if_767774-label " for="helpdesk_ticket_cf_product_6_isbn_if_767774">Product 6 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_6_isbn_if_767774]" id="helpdesk_ticket_custom_field_cf_product_6_isbn_if_767774" /> </div>
<label class=" control-label cf_product_6_title_author_if_767774-label " for="helpdesk_ticket_cf_product_6_title_author_if_767774">Product 6 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_6_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_6_title_author_if_767774" /> </div>
<label class=" control-label cf_product_7_isbn_if_767774-label " for="helpdesk_ticket_cf_product_7_isbn_if_767774">Product 7 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_7_isbn_if_767774]" id="helpdesk_ticket_custom_field_cf_product_7_isbn_if_767774" /> </div>
<label class=" control-label cf_product_7_title_author_if_767774-label " for="helpdesk_ticket_cf_product_7_title_author_if_767774">Product 7 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_7_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_7_title_author_if_767774" /> </div>
<label class=" control-label cf_ship_to_name_eb_767774-label " for="helpdesk_ticket_cf_ship_to_name_eb_767774">Ship to first and last name</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_name_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_name_eb_767774" /> </div>
<label class=" required control-label cf_ship_to_address_line_1_if_767774-label " for="helpdesk_ticket_cf_ship_to_address_line_1_if_767774">Home/residential address line 1</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_address_line_1_if_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_address_line_1_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_address_line_2_if_767774-label " for="helpdesk_ticket_cf_homeresidential_address_line_2_if_767774">Home/residential address line 2</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_address_line_2_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_address_line_2_if_767774" /> </div>
<label class=" required control-label cf_homeresidential_city_if_767774-label " for="helpdesk_ticket_cf_homeresidential_city_if_767774">Home/residential city</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_homeresidential_city_if_767774]" id="helpdesk_ticket_custom_field_cf_homeresidential_city_if_767774" /> </div>
<label class=" control-label cf_shipping_state_if_767774-label " for="helpdesk_ticket_cf_shipping_state_if_767774">Home/residential state</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_state_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_state_if_767774" /> </div>
<label class=" required control-label cf_postal_code_if_767774-label " for="helpdesk_ticket_cf_postal_code_if_767774">Postal code</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_postal_code_if_767774]" id="helpdesk_ticket_custom_field_cf_postal_code_if_767774" /> </div>
<label class=" required control-label cf_shipping_country_if_767774-label " for="helpdesk_ticket_cf_shipping_country_if_767774">Home/residential country</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_shipping_country_if_767774]" id="helpdesk_ticket_custom_field_cf_shipping_country_if_767774" /> </div>
<label class=" control-label cf_ship_to_phone_eb_767774-label " for="helpdesk_ticket_cf_ship_to_phone_eb_767774">Ship to phone (include country code)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_phone_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_phone_eb_767774" /> </div>
<label class=" required control-label cf_produc_767774-label " for="helpdesk_ticket_cf_produc_767774">Product 1 ISBN</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_produc_767774]" id="helpdesk_ticket_custom_field_cf_produc_767774" /> </div>
<label class=" required control-label cf_product_1_title_author_if_767774-label " for="helpdesk_ticket_cf_product_1_title_author_if_767774">Product 1 Title & Author</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_1_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_1_title_author_if_767774" /> </div>
<label class=" control-label cf_product_2_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_2_isbn_eb_767774">Product 2 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_2_title_author_if_767774-label " for="helpdesk_ticket_cf_product_2_title_author_if_767774">Product 2 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_2_title_author_if_767774" /> </div>
<label class=" control-label cf_product_isbn_3_eb_767774-label " for="helpdesk_ticket_cf_product_isbn_3_eb_767774">Product 3 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_isbn_3_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_isbn_3_eb_767774" /> </div>
<label class=" control-label cf_product_3_title_author_767774-label " for="helpdesk_ticket_cf_product_3_title_author_767774">Product 3 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_title_author_767774]" id="helpdesk_ticket_custom_field_cf_product_3_title_author_767774" /> </div>
<label class=" control-label cf_product_4_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_4_isbn_eb_767774">Product 4 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_4_title_author_if_767774-label " for="helpdesk_ticket_cf_product_4_title_author_if_767774">Product 4 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_4_title_author_if_767774" /> </div>
<label class=" control-label cf_product_5_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_5_isbn_eb_767774">Product 5 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_5_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_5_title_author_if_767774-label " for="helpdesk_ticket_cf_product_5_title_author_if_767774">Product 5 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_5_title_author_if_767774" /> </div>
<label class=" control-label cf_product_6_isbn_if_767774-label " for="helpdesk_ticket_cf_product_6_isbn_if_767774">Product 6 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_6_isbn_if_767774]" id="helpdesk_ticket_custom_field_cf_product_6_isbn_if_767774" /> </div>
<label class=" control-label cf_product_6_title_author_if_767774-label " for="helpdesk_ticket_cf_product_6_title_author_if_767774">Product 6 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_6_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_6_title_author_if_767774" /> </div>
<label class=" control-label cf_product_7_isbn_if_767774-label " for="helpdesk_ticket_cf_product_7_isbn_if_767774">Product 7 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_7_isbn_if_767774]" id="helpdesk_ticket_custom_field_cf_product_7_isbn_if_767774" /> </div>
<label class=" control-label cf_product_7_title_author_if_767774-label " for="helpdesk_ticket_cf_product_7_title_author_if_767774">Product 7 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_7_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_7_title_author_if_767774" /> </div>
<label class=" control-label cf_product_8_isbn_if_767774-label " for="helpdesk_ticket_cf_product_8_isbn_if_767774">Product 8 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_8_isbn_if_767774]" id="helpdesk_ticket_custom_field_cf_product_8_isbn_if_767774" /> </div>
<label class=" control-label cf_product_8_title_author_if_767774-label " for="helpdesk_ticket_cf_product_8_title_author_if_767774">Product 8 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_8_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_8_title_author_if_767774" /> </div>
<label class=" control-label cf_product_9_isbn_if_767774-label " for="helpdesk_ticket_cf_product_9_isbn_if_767774">Product 9 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_9_isbn_if_767774]" id="helpdesk_ticket_custom_field_cf_product_9_isbn_if_767774" /> </div>
<label class=" control-label cf_product_9_title_author_if_767774-label " for="helpdesk_ticket_cf_product_9_title_author_if_767774">Product 9 Title & Author</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_9_title_author_if_767774]" id="helpdesk_ticket_custom_field_cf_product_9_title_author_if_767774" /> </div>
<label class=" required control-label cf_where_are_you_sales_team_located_eb_767774-label " for="helpdesk_ticket_cf_where_are_you_sales_team_located_eb_767774">Where are you (sales team) located?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_where_are_you_sales_team_located_eb_767774]" id="helpdesk_ticket_custom_field_cf_where_are_you_sales_team_located_eb_767774"><option value="">...</option> <option data-id="7000170986" value="North, Central and South America">North, Central and South America</option> <option data-id="7000170987" value="In Europe, Africa, Asia and Oceania">In Europe, Africa, Asia and Oceania</option></select> </div>
<label class=" required control-label cf_original_invoice_number_eb_767774-label " for="helpdesk_ticket_cf_original_invoice_number_eb_767774">Original Invoice Number</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_original_invoice_number_eb_767774]" id="helpdesk_ticket_custom_field_cf_original_invoice_number_eb_767774" /> </div>
<label class=" required control-label cf_partial_or_full_eb_767774-label " for="helpdesk_ticket_cf_partial_or_full_eb_767774">Partial or Full Credit Memo</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_partial_or_full_eb_767774]" id="helpdesk_ticket_custom_field_cf_partial_or_full_eb_767774"><option value="">...</option> <option data-id="7000170984" value="Partial">Partial</option> <option data-id="7000170985" value="Full">Full</option></select> </div>
<label class=" required control-label cf_credit_memo_reason_eb_767774-label " for="helpdesk_ticket_cf_credit_memo_reason_eb_767774">Credit memo reason</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_credit_memo_reason_eb_767774]" id="helpdesk_ticket_custom_field_cf_credit_memo_reason_eb_767774"><option value="">...</option> <option data-id="7000169768" value="Invoice amendment">Invoice amendment</option> <option data-id="7000169769" value="Order/request cancelled">Order/request cancelled</option> <option data-id="7000169805" value="Other - please explain in 'Comments'">Other - please explain in 'Comments'</option></select> </div>
<label class=" required control-label cf_produc_767774-label " for="helpdesk_ticket_cf_produc_767774">Product 1 ISBN</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_produc_767774]" id="helpdesk_ticket_custom_field_cf_produc_767774" /> </div>
<label class=" required control-label cf_amount_to_credit_eb_767774-label " for="helpdesk_ticket_cf_amount_to_credit_eb_767774">Product 1 amount to credit</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_amount_to_credit_eb_767774]" id="helpdesk_ticket_custom_field_cf_amount_to_credit_eb_767774" /> </div>
<label class=" control-label cf_product_2_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_2_isbn_eb_767774">Product 2 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_2_amount_to_credit_eb_767774-label " for="helpdesk_ticket_cf_product_2_amount_to_credit_eb_767774">Product 2 amount to credit</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_amount_to_credit_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_amount_to_credit_eb_767774" /> </div>
<label class=" control-label cf_product_isbn_3_eb_767774-label " for="helpdesk_ticket_cf_product_isbn_3_eb_767774">Product 3 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_isbn_3_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_isbn_3_eb_767774" /> </div>
<label class=" control-label cf_product_3_amount_to_credit_eb_767774-label " for="helpdesk_ticket_cf_product_3_amount_to_credit_eb_767774">Product 3 amount to credit</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_amount_to_credit_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_3_amount_to_credit_eb_767774" /> </div>
<label class=" control-label cf_product_4_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_4_isbn_eb_767774">Product 4 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_4_amount_to_credit_eb_767774-label " for="helpdesk_ticket_cf_product_4_amount_to_credit_eb_767774">Product 4 amount to credit</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_amount_to_credit_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_amount_to_credit_eb_767774" /> </div>
<label class=" control-label cf_product_5_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_5_isbn_eb_767774">Product 5 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_5_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_5_amount_to_credit_eb_767774-label " for="helpdesk_ticket_cf_product_5_amount_to_credit_eb_767774">Product 5 amount to credit</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_amount_to_credit_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_5_amount_to_credit_eb_767774" /> </div>
<label class=" required control-label cf_sales_require_copy_if_767774-label " for="helpdesk_ticket_cf_sales_require_copy_if_767774">Send Invoice/Credit Copy to:</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_sales_require_copy_if_767774]" id="helpdesk_ticket_custom_field_cf_sales_require_copy_if_767774"><option value="">...</option> <option data-id="7000172387" value="Sales">Sales</option> <option data-id="7000172388" value="Customer">Customer</option> <option data-id="7000179682" value="Both Sales & Customer">Both Sales & Customer</option></select> </div>
<label class=" required control-label cf_where_are_you_sales_team_located_eb_767774-label " for="helpdesk_ticket_cf_where_are_you_sales_team_located_eb_767774">Where are you (sales team) located?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_where_are_you_sales_team_located_eb_767774]" id="helpdesk_ticket_custom_field_cf_where_are_you_sales_team_located_eb_767774"><option value="">...</option> <option data-id="7000170986" value="North, Central and South America">North, Central and South America</option> <option data-id="7000170987" value="In Europe, Africa, Asia and Oceania">In Europe, Africa, Asia and Oceania</option></select> </div>
<label class=" required control-label cf_platform_eb103278_767774-label " for="helpdesk_ticket_cf_platform_eb103278_767774">Platform</label> <div class="controls nested_field "> <select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_platform_eb103278_767774_7000162519" name="helpdesk_ticket[custom_field][cf_platform_eb103278_767774]"><option value="">...</option> <option value="VitalSource">VitalSource</option> <option value="Redshelf">Redshelf</option> <option value="Other">Other</option></select><div class="level_2"><label class="required">Product Type</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_product_type_eb_767774_7000162519" name="helpdesk_ticket[custom_field][cf_product_type_eb_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_platform_eb103278_767774_7000162519').nested_select_tag({"data_tree":[["VitalSource","VitalSource",[["VitalSource codes","VitalSource codes",[]],["VitalSource VLE integration","VitalSource VLE integration",[]],["VitalSource Explore","VitalSource Explore",[]],["Other","Other",[]]]],["Redshelf","Redshelf",[]],["Other","Other",[]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000162519","subcategory_id":"helpdesk_ticket_custom_field_cf_product_type_eb_767774_7000162519"}); //]]> </script> </div>
<label class=" control-label cf_existing_customer_account_number_eb_767774-label " for="helpdesk_ticket_cf_existing_customer_account_number_eb_767774">If existing customer, provide account number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_existing_customer_account_number_eb_767774]" id="helpdesk_ticket_custom_field_cf_existing_customer_account_number_eb_767774" /> </div>
<label class=" required control-label cf_bill_to_name_767774-label " for="helpdesk_ticket_cf_bill_to_name_767774">Bill to name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_name_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_name_767774" /> </div>
<label class=" required control-label cf_bill_to_address_line_1_767774-label " for="helpdesk_ticket_cf_bill_to_address_line_1_767774">Bill to address line 1</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_address_line_1_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_address_line_1_767774" /> </div>
<label class=" required control-label cf_bill_to_address_line_2_eb_767774-label " for="helpdesk_ticket_cf_bill_to_address_line_2_eb_767774">Bill to address line 2</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_address_line_2_eb_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_address_line_2_eb_767774" /> </div>
<label class=" required control-label cf_bill_to_city_eb_767774-label " for="helpdesk_ticket_cf_bill_to_city_eb_767774">Bill to city</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_city_eb_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_city_eb_767774" /> </div>
<label class=" control-label cf_bill_to_state_eb_767774-label " for="helpdesk_ticket_cf_bill_to_state_eb_767774">Bill to state</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_state_eb_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_state_eb_767774" /> </div>
<label class=" control-label cf_bill_to_territory_eb_767774-label " for="helpdesk_ticket_cf_bill_to_territory_eb_767774">Bill to territory</label> <div class="controls nested_field "> <select class=" nested_field section_field" id="helpdesk_ticket_custom_field_cf_bill_to_territory_eb_767774_7000162519" name="helpdesk_ticket[custom_field][cf_bill_to_territory_eb_767774]"><option value="">...</option> <option value="AP">AP</option> <option value="GB">GB</option> <option value="IN">IN</option> <option value="US">US</option></select><div class="level_2"><label class="">Bill to country</label><select class=" nested_field section_field" id="helpdesk_ticket_custom_field_cf_bill_to_country_eb_767774_7000162519" name="helpdesk_ticket[custom_field][cf_bill_to_country_eb_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_bill_to_territory_eb_767774_7000162519').nested_select_tag({"data_tree":[["AP","AP",[["American Samoa","American Samoa",[]],["Australia","Australia",[]],["British Indian Ocean Territory","British Indian Ocean Territory",[]],["Brunei Darussalam","Brunei Darussalam",[]],["Cambodia","Cambodia",[]],["Caroline Islands","Caroline Islands",[]],["China","China",[]],["Christmas Island","Christmas Island",[]],["Cook Islands","Cook Islands",[]],["East Timor","East Timor",[]],["Fiji","Fiji",[]],["French Polynesia","French Polynesia",[]],["Guam","Guam",[]],["Heard and McDonald Islands","Heard and McDonald Islands",[]],["Hong Kong","Hong Kong",[]],["Indonesia","Indonesia",[]],["Japan","Japan",[]],["Kiribati","Kiribati",[]],["Korea, Democratic People's Republic","Korea, Democratic People's Republic",[]],["Lao People's Democratic Republic","Lao People's Democratic Republic",[]],["Macau","Macau",[]],["Malaysia","Malaysia",[]],["Marshall Islands","Marshall Islands",[]],["Micronesia, Federated States of","Micronesia, Federated States of",[]],["Mongolia","Mongolia",[]],["Myanmar","Myanmar",[]],["Nauru","Nauru",[]],["New Caledonia","New Caledonia",[]],["New Zealand","New Zealand",[]],["Niue","Niue",[]],["Norfolk Island","Norfolk Island",[]],["Northern Mariana Islands","Northern Mariana Islands",[]],["Palau","Palau",[]],["Papua New Guinea","Papua New Guinea",[]],["Philippines","Philippines",[]],["Pitcairn","Pitcairn",[]],["Republic Of Korea","Republic Of Korea",[]],["Samoa","Samoa",[]],["Singapore","Singapore",[]],["Solomon Islands","Solomon Islands",[]],["Taiwan. Republic of China","Taiwan. Republic of China",[]],["Thailand","Thailand",[]],["Tokelau","Tokelau",[]],["Tonga","Tonga",[]],["Tuvalu","Tuvalu",[]],["Vanuatu","Vanuatu",[]],["Vietnam","Vietnam",[]],["Wallis and Futuna Islands","Wallis and Futuna Islands",[]]]],["GB","GB",[["Afghanistan","Afghanistan",[]],["Albania","Albania",[]],["Algeria","Algeria",[]],["Andorra","Andorra",[]],["Angola","Angola",[]],["Armenia","Armenia",[]],["Austria","Austria",[]],["Azerbaijan","Azerbaijan",[]],["Bahrain","Bahrain",[]],["Belarus","Belarus",[]],["Belgium","Belgium",[]],["Benin","Benin",[]],["Bosnia and Herzegowina","Bosnia and Herzegowina",[]],["Botswana","Botswana",[]],["Bouvet Island","Bouvet Island",[]],["Bulgaria","Bulgaria",[]],["Burkina Faso","Burkina Faso",[]],["Burundi","Burundi",[]],["Cameroon","Cameroon",[]],["Cape Verde","Cape Verde",[]],["Central African Republic","Central African Republic",[]],["Chad","Chad",[]],["Comoros","Comoros",[]],["Congo","Congo",[]],["Congo, The Democratic Republic of the","Congo, The Democratic Republic of the",[]],["Cote D'Ivoire","Cote D'Ivoire",[]],["Croatia (Local name : Hrvatska)","Croatia (Local name : Hrvatska)",[]],["Cyprus","Cyprus",[]],["Czech Republic","Czech Republic",[]],["Denmark","Denmark",[]],["Djibouti","Djibouti",[]],["Egypt","Egypt",[]],["Equatorial Guinea","Equatorial Guinea",[]],["Eritrea","Eritrea",[]],["Estonia","Estonia",[]],["Ethiopia","Ethiopia",[]],["Faroe Islands","Faroe Islands",[]],["Finland","Finland",[]],["France","France",[]],["France, Metropolitan","France, Metropolitan",[]],["French Southern Territories","French Southern Territories",[]],["Gabon","Gabon",[]],["Gambia","Gambia",[]],["Georgia","Georgia",[]],["Germany","Germany",[]],["Ghana","Ghana",[]],["Gibraltar","Gibraltar",[]],["Great Britain","Great Britain",[]],["Greece","Greece",[]],["Guernsey","Guernsey",[]],["Guinea","Guinea",[]],["Guinea-Bissau","Guinea-Bissau",[]],["Holy See (Vatican City State)","Holy See (Vatican City State)",[]],["Hungary","Hungary",[]],["Iceland","Iceland",[]],["Iran (Islamic Republic of)","Iran (Islamic Republic of)",[]],["Iraq","Iraq",[]],["Ireland","Ireland",[]],["Isle of Man","Isle of Man",[]],["Israel","Israel",[]],["Italy","Italy",[]],["Jersey","Jersey",[]],["Jordan","Jordan",[]],["Kazakhstan","Kazakhstan",[]],["Kenya","Kenya",[]],["Kuwait","Kuwait",[]],["Kyrgyzstan","Kyrgyzstan",[]],["Latvia","Latvia",[]],["Lebanon","Lebanon",[]],["Lesotho","Lesotho",[]],["Liberia","Liberia",[]],["Libyan Arab Jamahiriya","Libyan Arab Jamahiriya",[]],["Liechtenstein","Liechtenstein",[]],["Lithuania","Lithuania",[]],["Luxembourg","Luxembourg",[]],["Macedonia, The Former Yugoslav Republic","Macedonia, The Former Yugoslav Republic",[]],["Madagascar","Madagascar",[]],["Malawi","Malawi",[]],["Mali","Mali",[]],["Malta","Malta",[]],["Mauritania","Mauritania",[]],["Mauritius","Mauritius",[]],["Mayotte","Mayotte",[]],["Moldova, Republic of","Moldova, Republic of",[]],["Monaco","Monaco",[]],["Montenegro","Montenegro",[]],["Morocco","Morocco",[]],["Mozambique","Mozambique",[]],["Namibia","Namibia",[]],["Netherlands","Netherlands",[]],["Niger","Niger",[]],["Nigeria","Nigeria",[]],["Northern Ireland","Northern Ireland",[]],["Norway","Norway",[]],["Oman","Oman",[]],["Palestine","Palestine",[]],["Poland","Poland",[]],["Portugal","Portugal",[]],["Qatar","Qatar",[]],["Rep of Kosovo","Rep of Kosovo",[]],["Reunion","Reunion",[]],["Romania","Romania",[]],["Russian Federation","Russian Federation",[]],["Rwanda","Rwanda",[]],["San Marino","San Marino",[]],["Sao Tome and Principe","Sao Tome and Principe",[]],["Saudi Arabia","Saudi Arabia",[]],["Senegal","Senegal",[]],["Serbia","Serbia",[]],["Seychelles","Seychelles",[]],["Sierra Leone","Sierra Leone",[]],["Slovakia(Slovak Republic)","Slovakia(Slovak Republic)",[]],["Slovenia","Slovenia",[]],["Somalia","Somalia",[]],["South Africa","South Africa",[]],["South Sudan","South Sudan",[]],["Spain","Spain",[]],["St Helena","St Helena",[]],["Sudan","Sudan",[]],["Svalbard and Jan Mayen Islands","Svalbard and Jan Mayen Islands",[]],["Swaziland","Swaziland",[]],["Sweden","Sweden",[]],["Switzerland","Switzerland",[]],["Syrian Arab Republic","Syrian Arab Republic",[]],["Tajikistan","Tajikistan",[]],["Tanzania","Tanzania",[]],["Togo","Togo",[]],["Tunisia","Tunisia",[]],["Turkey","Turkey",[]],["Turkmenistan","Turkmenistan",[]],["Uganda","Uganda",[]],["Ukraine","Ukraine",[]],["United Arab Emirates","United Arab Emirates",[]],["Uzbekistan","Uzbekistan",[]],["Western Sahara","Western Sahara",[]],["Yemen","Yemen",[]],["Yugoslavia","Yugoslavia",[]],["Zambia","Zambia",[]],["Zimbabwe","Zimbabwe",[]],["Sri Lanka","Sri Lanka",[]],["Pakistan","Pakistan",[]]]],["IN","IN",[["Bangladesh","Bangladesh",[]],["Bhutan","Bhutan",[]],["Cocos (Keeling) Islands","Cocos (Keeling) Islands",[]],["India","India",[]],["Maldives","Maldives",[]],["Nepal","Nepal",[]]]],["US","US",[["Anguilla","Anguilla",[]],["Antarctica","Antarctica",[]],["Antigua and Barbuda","Antigua and Barbuda",[]],["Argentina","Argentina",[]],["Aruba","Aruba",[]],["Bahamas","Bahamas",[]],["Barbados","Barbados",[]],["Belize","Belize",[]],["Bermuda","Bermuda",[]],["Bolivia","Bolivia",[]],["Brazil","Brazil",[]],["Canada","Canada",[]],["Cayman Islands","Cayman Islands",[]],["Chile","Chile",[]],["Colombia","Colombia",[]],["Costa Rica","Costa Rica",[]],["Cuba","Cuba",[]],["Dominica","Dominica",[]],["Dominican Republic","Dominican Republic",[]],["Ecuador","Ecuador",[]],["El Salvador","El Salvador",[]],["Falkland Islands (Malvinas)","Falkland Islands (Malvinas)",[]],["French Antilles","French Antilles",[]],["French Guiana","French Guiana",[]],["Greenland","Greenland",[]],["Grenada","Grenada",[]],["Guadeloupe","Guadeloupe",[]],["Guatemala","Guatemala",[]],["Guyana","Guyana",[]],["Haiti","Haiti",[]],["Honduras","Honduras",[]],["Jamaica","Jamaica",[]],["Martinique","Martinique",[]],["Mexico","Mexico",[]],["Montserrat","Montserrat",[]],["Netherlands Antilles","Netherlands Antilles",[]],["Nicaragua","Nicaragua",[]],["Panama","Panama",[]],["Paraguay","Paraguay",[]],["Peru","Peru",[]],["Puerto Rico","Puerto Rico",[]],["Saint Kitts and Nevis","Saint Kitts and Nevis",[]],["Saint Lucia","Saint Lucia",[]],["Saint Vincent and the Grenadines","Saint Vincent and the Grenadines",[]],["South Georgia and the South Sanwich Islands","South Georgia and the South Sanwich Islands",[]],["St Piere and Miquelon","St Piere and Miquelon",[]],["Surinam","Surinam",[]],["Trinidad and Tobago","Trinidad and Tobago",[]],["Turks and Caicos Islands","Turks and Caicos Islands",[]],["United States of America","United States of America",[]],["Uruguay","Uruguay",[]],["Venezuela","Venezuela",[]],["Virgin Islands (British)","Virgin Islands (British)",[]],["Virgin Islands (U.S.)","Virgin Islands (U.S.)",[]],["West Indies","West Indies",[]]]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000162519","subcategory_id":"helpdesk_ticket_custom_field_cf_bill_to_country_eb_767774_7000162519"}); //]]> </script> </div>
<label class=" control-label cf_bill_to_tax_id_eb_767774-label " for="helpdesk_ticket_cf_bill_to_tax_id_eb_767774">Bill to Tax ID. If in US, please attach Tax Certificate below</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_tax_id_eb_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_tax_id_eb_767774" /> </div>
<label class=" required control-label cf_bill_to_email_address_eb_767774-label " for="helpdesk_ticket_cf_bill_to_email_address_eb_767774">Bill to email address</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_email_address_eb_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_email_address_eb_767774" /> </div>
<label class=" required control-label cf_bill_to_phone_number_eb_767774-label " for="helpdesk_ticket_cf_bill_to_phone_number_eb_767774">Bill to phone number</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_bill_to_phone_number_eb_767774]" id="helpdesk_ticket_custom_field_cf_bill_to_phone_number_eb_767774" /> </div>
<label class=" required control-label cf_is_bill_to_the_same_as_ship_to_eb_767774-label " for="helpdesk_ticket_cf_is_bill_to_the_same_as_ship_to_eb_767774">Is bill to the same as ship to?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_is_bill_to_the_same_as_ship_to_eb_767774]" id="helpdesk_ticket_custom_field_cf_is_bill_to_the_same_as_ship_to_eb_767774"><option value="">...</option> <option data-id="7000170170" value="Yes">Yes</option> <option data-id="7000170171" value="No">No</option></select> </div>
<label class=" control-label cf_ship_to_name_eb_767774-label " for="helpdesk_ticket_cf_ship_to_name_eb_767774">Ship to first and last name</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_name_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_name_eb_767774" /> </div>
<label class=" control-label cf_ship_to_address_line_1_eb_767774-label " for="helpdesk_ticket_cf_ship_to_address_line_1_eb_767774">Ship to address line 1</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_address_line_1_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_address_line_1_eb_767774" /> </div>
<label class=" control-label cf_ship_to_address_line_2_eb_767774-label " for="helpdesk_ticket_cf_ship_to_address_line_2_eb_767774">Ship to address line 2</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_address_line_2_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_address_line_2_eb_767774" /> </div>
<label class=" control-label cf_ship_to_city_eb_767774-label " for="helpdesk_ticket_cf_ship_to_city_eb_767774">Ship to city</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_city_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_city_eb_767774" /> </div>
<label class=" control-label cf_ship_to_state_eb_767774-label " for="helpdesk_ticket_cf_ship_to_state_eb_767774">Ship to state</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_state_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_state_eb_767774" /> </div>
<label class=" control-label cf_ship_to_country_eb_767774-label " for="helpdesk_ticket_cf_ship_to_country_eb_767774">Ship to country</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_country_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_country_eb_767774" /> </div>
<label class=" control-label cf_ship_to_phone_eb_767774-label " for="helpdesk_ticket_cf_ship_to_phone_eb_767774">Ship to phone (include country code)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_ship_to_phone_eb_767774]" id="helpdesk_ticket_custom_field_cf_ship_to_phone_eb_767774" /> </div>
<label class=" required control-label cf_list_or_net_price_if_767774-label " for="helpdesk_ticket_cf_list_or_net_price_if_767774">Are you providing price as List or Net?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_list_or_net_price_if_767774]" id="helpdesk_ticket_custom_field_cf_list_or_net_price_if_767774"><option value="">...</option> <option data-id="7000172792" value="List">List</option> <option data-id="7000172793" value="Net">Net</option></select> </div>
<label class=" required control-label cf_produc_767774-label " for="helpdesk_ticket_cf_produc_767774">Product 1 ISBN</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_produc_767774]" id="helpdesk_ticket_custom_field_cf_produc_767774" /> </div>
<label class=" required control-label cf_product_quantity_eb_767774-label " for="helpdesk_ticket_cf_product_quantity_eb_767774">Product 1 quantity</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_quantity_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_quantity_eb_767774" /> </div>
<label class=" required control-label cf_product_1_price_if_767774-label " for="helpdesk_ticket_cf_product_1_price_if_767774">Product 1 price</label> <div class="controls "> <input class=" required decimal section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_1_price_if_767774]" id="helpdesk_ticket_custom_field_cf_product_1_price_if_767774" /> </div>
<label class=" control-label cf_product_2_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_2_isbn_eb_767774">Product 2 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_2_quantity_eb_767774-label " for="helpdesk_ticket_cf_product_2_quantity_eb_767774">Product 2 quantity</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_quantity_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_2_quantity_eb_767774" /> </div>
<label class=" control-label cf_product_2_price_if_767774-label " for="helpdesk_ticket_cf_product_2_price_if_767774">Product 2 price</label> <div class="controls "> <input class=" decimal section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_2_price_if_767774]" id="helpdesk_ticket_custom_field_cf_product_2_price_if_767774" /> </div>
<label class=" control-label cf_product_isbn_3_eb_767774-label " for="helpdesk_ticket_cf_product_isbn_3_eb_767774">Product 3 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_isbn_3_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_isbn_3_eb_767774" /> </div>
<label class=" control-label cf_product_3_quantity_eb_767774-label " for="helpdesk_ticket_cf_product_3_quantity_eb_767774">Product 3 quantity</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_quantity_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_3_quantity_eb_767774" /> </div>
<label class=" control-label cf_product_3_price_if_767774-label " for="helpdesk_ticket_cf_product_3_price_if_767774">Product 3 price</label> <div class="controls "> <input class=" decimal section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_3_price_if_767774]" id="helpdesk_ticket_custom_field_cf_product_3_price_if_767774" /> </div>
<label class=" control-label cf_product_4_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_4_isbn_eb_767774">Product 4 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_4_quantity_eb_767774-label " for="helpdesk_ticket_cf_product_4_quantity_eb_767774">Product 4 quantity</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_quantity_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_4_quantity_eb_767774" /> </div>
<label class=" control-label cf_product_4_price_if_767774-label " for="helpdesk_ticket_cf_product_4_price_if_767774">Product 4 price</label> <div class="controls "> <input class=" decimal section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_price_if_767774]" id="helpdesk_ticket_custom_field_cf_product_4_price_if_767774" /> </div>
<label class=" control-label cf_product_5_isbn_eb_767774-label " for="helpdesk_ticket_cf_product_5_isbn_eb_767774">Product 5 ISBN</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_isbn_eb_767774]" id="helpdesk_ticket_custom_field_cf_product_5_isbn_eb_767774" /> </div>
<label class=" control-label cf_product_4_quantity_eb743296_767774-label " for="helpdesk_ticket_cf_product_4_quantity_eb743296_767774">Product 5 quantity</label> <div class="controls "> <input class=" number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_4_quantity_eb743296_767774]" id="helpdesk_ticket_custom_field_cf_product_4_quantity_eb743296_767774" /> </div>
<label class=" control-label cf_product_5_price_if_767774-label " for="helpdesk_ticket_cf_product_5_price_if_767774">Product 5 price</label> <div class="controls "> <input class=" decimal section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_product_5_price_if_767774]" id="helpdesk_ticket_custom_field_cf_product_5_price_if_767774" /> </div>
<label class=" control-label cf_discretionary_discount_eb_767774-label " for="helpdesk_ticket_cf_discretionary_discount_eb_767774">Discretionary discount, if applicable (%)</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_discretionary_discount_eb_767774]" id="helpdesk_ticket_custom_field_cf_discretionary_discount_eb_767774" /> </div>
<label class=" control-label cf_comments_to_be_included_on_invoice_eb_767774-label " for="helpdesk_ticket_cf_comments_to_be_included_on_invoice_eb_767774">Comments to be included on invoice (maximum 400 characters)</label> <div class="controls "> <textarea class=" paragraph section_field span12" rows="6" placeholder="" name="helpdesk_ticket[custom_field][cf_comments_to_be_included_on_invoice_eb_767774]" id="helpdesk_ticket_custom_field_cf_comments_to_be_included_on_invoice_eb_767774"> </textarea> </div>
<label class=" required control-label cf_customer_type_author_yn_eb_767774-label " for="helpdesk_ticket_cf_customer_type_author_yn_eb_767774">Customer Type: Author? (Y/N)</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_customer_type_author_yn_eb_767774]" id="helpdesk_ticket_custom_field_cf_customer_type_author_yn_eb_767774"><option value="">...</option> <option data-id="7000168975" value="Yes - Author">Yes - Author</option> <option data-id="7000168976" value="No - Author">No - Author</option></select> </div>
<label class=" required control-label cf_currency_for_billing_eb_767774-label " for="helpdesk_ticket_cf_currency_for_billing_eb_767774">Currency for billing</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_currency_for_billing_eb_767774]" id="helpdesk_ticket_custom_field_cf_currency_for_billing_eb_767774"><option value="">...</option> <option data-id="7000168977" value="USD">USD</option> <option data-id="7000168978" value="GBP">GBP</option> <option data-id="7000171240" value="AUD">AUD</option> <option data-id="7000171241" value="EUR">EUR</option> <option data-id="7000171242" value="CAD">CAD</option></select> </div>
<label class=" control-label cf_po_number_eb_767774-label " for="helpdesk_ticket_cf_po_number_eb_767774">PO Number (attach below) || LEPT sales hosted on Talis precede PO # or date with L- || VitalSource Explore sales precede PO # or date with E- || VitalSource Code sales precede PO # or date with C-</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_po_number_eb_767774]" id="helpdesk_ticket_custom_field_cf_po_number_eb_767774" /> </div>
<label class=" required control-label cf_sales_require_copy_if_767774-label " for="helpdesk_ticket_cf_sales_require_copy_if_767774">Send Invoice/Credit Copy to:</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_sales_require_copy_if_767774]" id="helpdesk_ticket_custom_field_cf_sales_require_copy_if_767774"><option value="">...</option> <option data-id="7000172387" value="Sales">Sales</option> <option data-id="7000172388" value="Customer">Customer</option> <option data-id="7000179682" value="Both Sales & Customer">Both Sales & Customer</option></select> </div>
<label class=" required control-label cf_customer_name_it_767774-label " for="helpdesk_ticket_cf_customer_name_it_767774">Customer name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_customer_name_it_767774]" id="helpdesk_ticket_custom_field_cf_customer_name_it_767774" /> </div>
<label class=" required control-label cf_customer_email_it_767774-label " for="helpdesk_ticket_cf_customer_email_it_767774">Customer email address</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_customer_email_it_767774]" id="helpdesk_ticket_custom_field_cf_customer_email_it_767774" /> </div>
<label class=" control-label cf_customer_telephone_number_it_767774-label " for="helpdesk_ticket_cf_customer_telephone_number_it_767774">Customer telephone number</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_customer_telephone_number_it_767774]" id="helpdesk_ticket_custom_field_cf_customer_telephone_number_it_767774" /> </div>
<label class=" required control-label cf_institution_name_it_767774-label " for="helpdesk_ticket_cf_institution_name_it_767774">Institution name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_institution_name_it_767774]" id="helpdesk_ticket_custom_field_cf_institution_name_it_767774" /> </div>
<label class=" required control-label cf_product_it_767774-label " for="helpdesk_ticket_cf_product_it_767774">Which would you like help with?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_product_it_767774]" id="helpdesk_ticket_custom_field_cf_product_it_767774"><option value="">...</option> <option data-id="7000172875" value="Vantage Integration">Vantage Integration</option> <option data-id="7000172282" value="Vantage Content">Vantage Content</option> <option data-id="7000172876" value="Vantage Platform">Vantage Platform</option> <option data-id="7000172877" value="Sage Website">Sage Website</option> <option data-id="7000170490" value="VitalSource/Redshelf">VitalSource/Redshelf</option> <option data-id="7000172878" value="Public Speaking Plus">Public Speaking Plus</option> <option data-id="7000172080" value="Sage UK/Corwin">Sage UK/Corwin</option> <option data-id="7000170491" value="Other">Other</option></select> </div>
<label class=" required control-label cf_request_type_it_767774-label " for="helpdesk_ticket_cf_request_type_it_767774">Request type</label> <div class="controls nested_field "> <select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_request_type_it_767774_7000169771" name="helpdesk_ticket[custom_field][cf_request_type_it_767774]"><option value="">...</option> <option value="Cases (Integration)">Cases (Integration)</option> <option value="Instructor Issue">Instructor Issue</option> <option value="Training">Training</option> <option value="Student Issue">Student Issue</option> <option value="Other">Other</option></select><div class="level_2"><label class="required">Request detail</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_request_detail_it_767774_7000169771" name="helpdesk_ticket[custom_field][cf_request_detail_it_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_request_type_it_767774_7000169771').nested_select_tag({"data_tree":[["Cases (Integration)","Cases (Integration)",[]],["Instructor Issue","Instructor Issue",[]],["Training","Training",[]],["Student Issue","Student Issue",[]],["Other","Other",[["Other","Other",[]]]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000169771","subcategory_id":"helpdesk_ticket_custom_field_cf_request_detail_it_767774_7000169771"}); //]]> </script> </div>
<label class=" required control-label cf_customer_type_sagpeubcom_767774-label " for="helpdesk_ticket_cf_customer_type_sagpeubcom_767774">Which customer type best describes you?</label> <div class="controls nested_field "> <select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_customer_type_sagpeubcom_767774_7000170519" name="helpdesk_ticket[custom_field][cf_customer_type_sagpeubcom_767774]"><option value="">...</option> <option value="Librarian">Librarian</option> <option value="Student">Student</option> <option value="Instructor">Instructor</option> <option value="Researcher">Researcher</option> <option value="Author or Editor">Author or Editor</option> <option value="Society Member">Society Member</option> <option value="Other">Other</option></select><div class="level_2"><label class="required">Which product is this regarding?</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_product_sagepubcom_767774_7000170519" name="helpdesk_ticket[custom_field][cf_product_sagepubcom_767774]"><option value="">...</option> </select></div><div class="level_3"><label class="required">What can we help you with?</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_reason_of_contact_sagepubcom_767774_7000170519" name="helpdesk_ticket[custom_field][cf_reason_of_contact_sagepubcom_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_customer_type_sagpeubcom_767774_7000170519').nested_select_tag({"data_tree":[["Librarian","Librarian",[["SAGE Journals","SAGE Journals",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Author queries","Author queries"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Pay per view","Pay per view"],["Submissions","Submissions"],["Other","Other"]]],["SAGE Books: Print","SAGE Books: Print",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Electronic","SAGE Books: Electronic",[["Inspection Copies","Inspection Copies"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Both Print and Electronic","SAGE Books: Both Print and Electronic",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Business Cases","SAGE Business Cases",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["SAGE Knowledge","SAGE Knowledge",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["SAGE Research Methods","SAGE Research Methods",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["SAGE Stats","SAGE Stats",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["SAGE Video","SAGE Video",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["CQ Press Library","CQ Press Library",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["CQ Press Researcher","CQ Press Researcher",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["Data Planet","Data Planet",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Other","Other"]]],["Vantage","Vantage",[["Technical Support","Technical Support"],["Student Orders/Purchase Inquiries","Student Orders/Purchase Inquiries"],["Instructor Access","Instructor Access"]]],["Other or more than one","Other or more than one",[]]]],["Student","Student",[["SAGE Journals","SAGE Journals",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Author queries","Author queries"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Pay per view","Pay per view"],["Submissions","Submissions"],["Other","Other"]]],["SAGE Books: Print","SAGE Books: Print",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Electronic","SAGE Books: Electronic",[["Inspection Copies","Inspection Copies"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Both Print and Electronic","SAGE Books: Both Print and Electronic",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Business Cases","SAGE Business Cases",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Knowledge","SAGE Knowledge",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Research Methods","SAGE Research Methods",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Stats","SAGE Stats",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Video","SAGE Video",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Press Library","CQ Press Library",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Researcher","CQ Researcher",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Data Planet","Data Planet",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Vantage","Vantage",[["Technical Support","Technical Support"],["Student Orders/Purchase Inquiries","Student Orders/Purchase Inquiries"],["Instructor Access","Instructor Access"]]],["Other or more than one","Other or more than one",[]]]],["Instructor","Instructor",[["SAGE Journals","SAGE Journals",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Author queries","Author queries"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Pay per view","Pay per view"],["Submissions","Submissions"],["Other","Other"]]],["SAGE Books: Print","SAGE Books: Print",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Electronic","SAGE Books: Electronic",[["Inspection Copies","Inspection Copies"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Both Print and Electronic","SAGE Books: Both Print and Electronic",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Business Cases","SAGE Business Cases",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Knowledge","SAGE Knowledge",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Research Methods","SAGE Research Methods",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Stats","SAGE Stats",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Video","SAGE Video",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Press Library","CQ Press Library",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Researcher","CQ Researcher",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Data Planet","Data Planet",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Vantage","Vantage",[["Technical Support","Technical Support"],["Student Orders/Purchase Inquiries","Student Orders/Purchase Inquiries"],["Instructor Access","Instructor Access"]]],["Other or more than one","Other or more than one",[]]]],["Researcher","Researcher",[["SAGE Journals","SAGE Journals",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Author queries","Author queries"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Pay per view","Pay per view"],["Submissions","Submissions"],["Other","Other"]]],["SAGE Books: Print","SAGE Books: Print",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Electronic","SAGE Books: Electronic",[["Inspection Copies","Inspection Copies"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Both Print and Electronic","SAGE Books: Both Print and Electronic",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Business Cases","SAGE Business Cases",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Knowledge","SAGE Knowledge",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Research Methods","SAGE Research Methods",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Stats","SAGE Stats",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Video","SAGE Video",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Press Library","CQ Press Library",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Researcher","CQ Researcher",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Data Planet","Data Planet",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Vantage","Vantage",[["Technical Support","Technical Support"],["Student Orders/Purchase Inquiries","Student Orders/Purchase Inquiries"],["Instructor Access","Instructor Access"]]],["Other or more than one","Other or more than one",[]]]],["Author or Editor","Author or Editor",[["SAGE Journals","SAGE Journals",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Author queries","Author queries"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Pay per view","Pay per view"],["Submissions","Submissions"],["Other","Other"]]],["SAGE Books: Print","SAGE Books: Print",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Electronic","SAGE Books: Electronic",[["Inspection Copies","Inspection Copies"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Both Print and Electronic","SAGE Books: Both Print and Electronic",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Business Cases","SAGE Business Cases",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Knowledge","SAGE Knowledge",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Research Methods","SAGE Research Methods",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Stats","SAGE Stats",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Video","SAGE Video",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Press Library","CQ Press Library",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Researcher","CQ Researcher",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Data Planet","Data Planet",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Vantage","Vantage",[["Technical Support","Technical Support"],["Student Orders/Purchase Inquiries","Student Orders/Purchase Inquiries"],["Instructor Access","Instructor Access"]]],["Other or more than one","Other or more than one",[]]]],["Society Member","Society Member",[]],["Other","Other",[["SAGE Journals","SAGE Journals",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Author queries","Author queries"],["Cancellations, Claims & Refunds","Cancellations, Claims & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Renewals","Renewals"],["Pay per view","Pay per view"],["Submissions","Submissions"],["Other","Other"]]],["SAGE Books: Print","SAGE Books: Print",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Electronic","SAGE Books: Electronic",[["Inspection Copies","Inspection Copies"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Books: Both Print and Electronic","SAGE Books: Both Print and Electronic",[["Update Your Profile","Update Your Profile"],["Inspection Copies","Inspection Copies"],["Claims, Returns & Refunds","Claims, Returns & Refunds"],["Orders, Quotes & Price Enquiries","Orders, Quotes & Price Enquiries"],["Other","Other"]]],["SAGE Business Cases","SAGE Business Cases",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Knowledge","SAGE Knowledge",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Research Methods","SAGE Research Methods",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Stats","SAGE Stats",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["SAGE Video","SAGE Video",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Press Library","CQ Press Library",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["CQ Researcher","CQ Researcher",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Data Planet","Data Planet",[["Online Access","Online Access"],["Update Your Profile","Update Your Profile"],["Other","Other"]]],["Vantage","Vantage",[["Technical Support","Technical Support"],["Student Orders/Purchase Inquiries","Student Orders/Purchase Inquiries"],["Instructor Access","Instructor Access"]]],["Other or more than one","Other or more than one",[]]]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000170519","subcategory_id":"helpdesk_ticket_custom_field_cf_product_sagepubcom_767774_7000170519","item_id":"helpdesk_ticket_custom_field_cf_reason_of_contact_sagepubcom_767774_7000170519"}); //]]> </script> </div>
<label class=" required control-label cf_manuscript_id_sage_open_j_767774-label " for="helpdesk_ticket_cf_manuscript_id_sage_open_j_767774">Manuscript ID</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_manuscript_id_sage_open_j_767774]" id="helpdesk_ticket_custom_field_cf_manuscript_id_sage_open_j_767774" /> </div>
<label class=" required control-label cf_reason_of_contact_sage_open_j_767774-label " for="helpdesk_ticket_cf_reason_of_contact_sage_open_j_767774">Request type</label> <div class="controls nested_field "> <select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_reason_of_contact_sage_open_j_767774_7000169770" name="helpdesk_ticket[custom_field][cf_reason_of_contact_sage_open_j_767774]"><option value="">...</option> <option value="Status update">Status update</option> <option value="Revision extension">Revision extension</option> <option value="Reviewer certificate">Reviewer certificate</option> <option value="Waiver/discount">Waiver/discount</option> <option value="Transfer">Transfer</option> <option value="Monographs">Monographs</option> <option value="Special collections">Special collections</option> <option value="Editorial Board">Editorial Board</option> <option value="Production checklist">Production checklist</option> <option value="Initial checklist">Initial checklist</option> <option value="Post publication changes">Post publication changes</option> <option value="General">General</option> <option value="AE Response">AE Response</option> <option value="Author Response">Author Response</option> <option value="Author List">Author List</option> <option value="Other">Other</option> <option value="Reviewer Response">Reviewer Response</option></select><div class="level_2"><label class="required">Request detail</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_reason_detail_sage_open_j_767774_7000169770" name="helpdesk_ticket[custom_field][cf_reason_detail_sage_open_j_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_reason_of_contact_sage_open_j_767774_7000169770').nested_select_tag({"data_tree":[["Status update","Status update",[]],["Revision extension","Revision extension",[]],["Reviewer certificate","Reviewer certificate",[]],["Waiver/discount","Waiver/discount",[]],["Transfer","Transfer",[]],["Monographs","Monographs",[]],["Special collections","Special collections",[]],["Editorial Board","Editorial Board",[]],["Production checklist","Production checklist",[]],["Initial checklist","Initial checklist",[]],["Post publication changes","Post publication changes",[]],["General","General",[]],["AE Response","AE Response",[]],["Author Response","Author Response",[]],["Author List","Author List",[]],["Other","Other",[["Other","Other",[]],["Auto close","Auto close",[]]]],["Reviewer Response","Reviewer Response",[]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000169770","subcategory_id":"helpdesk_ticket_custom_field_cf_reason_detail_sage_open_j_767774_7000169770"}); //]]> </script> </div>
<label class=" required control-label cf_author_reviewer_article_editorsection_editor_other_767774-label " for="helpdesk_ticket_cf_author_reviewer_article_editorsection_editor_other_767774">Are you an Author, Reviewer, Article Editor/Section Editor or Other?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_author_reviewer_article_editorsection_editor_other_767774]" id="helpdesk_ticket_custom_field_cf_author_reviewer_article_editorsection_editor_other_767774"><option value="">...</option> <option data-id="7000182926" value="Author">Author</option> <option data-id="7000182927" value="Reviewer">Reviewer</option> <option data-id="7000182928" value="Article Editor/Section Editor">Article Editor/Section Editor</option> <option data-id="7000182929" value="Other">Other</option></select> </div>
<label class=" required control-label cf_salutation_path_767774-label " for="helpdesk_ticket_cf_salutation_path_767774">Salutation</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_salutation_path_767774]" id="helpdesk_ticket_custom_field_cf_salutation_path_767774"><option value="">...</option> <option data-id="7000179565" value="Miss">Miss</option> <option data-id="7000179566" value="Mr">Mr</option> <option data-id="7000179567" value="Mrs">Mrs</option> <option data-id="7000179568" value="Ms">Ms</option> <option data-id="7000179569" value="Dr">Dr</option> <option data-id="7000183975" value="Mx">Mx</option></select> </div>
<label class=" required control-label cf_first_name_767774-label " for="helpdesk_ticket_cf_first_name_767774">First Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_first_name_767774]" id="helpdesk_ticket_custom_field_cf_first_name_767774" /> </div>
<label class=" required control-label cf_last_name_767774-label " for="helpdesk_ticket_cf_last_name_767774">Last Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_last_name_767774]" id="helpdesk_ticket_custom_field_cf_last_name_767774" /> </div>
<label class=" required control-label cf_author_editor_sage_other_767774-label " for="helpdesk_ticket_cf_author_editor_sage_other_767774">Are you an Author, Editor, Sage Employee, or Other?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_author_editor_sage_other_767774]" id="helpdesk_ticket_custom_field_cf_author_editor_sage_other_767774"><option value="">...</option> <option data-id="7000166777" value="Author">Author</option> <option data-id="7000166778" value="Editor">Editor</option> <option data-id="7000195814" value="Employee">Employee</option> <option data-id="7000166780" value="Other">Other</option></select> </div>
<label class=" required control-label cf_how_can_we_help_path_767774-label " for="helpdesk_ticket_cf_how_can_we_help_path_767774">How can we help?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_how_can_we_help_path_767774]" id="helpdesk_ticket_custom_field_cf_how_can_we_help_path_767774"><option value="">...</option> <option data-id="7000166854" value="Withdraw Manuscript">Withdraw Manuscript</option> <option data-id="7000166855" value="Status update on manuscript">Status update on manuscript</option> <option data-id="7000166857" value="Accept Manuscript to journal (for Editors only)">Accept Manuscript to journal (for Editors only)</option> <option data-id="7000166858" value="Reject Manuscript to journal (for Editors only)">Reject Manuscript to journal (for Editors only)</option> <option data-id="7000179648" value="I can't afford the Open Access Fee/APC">I can't afford the Open Access Fee/APC</option> <option data-id="7000179649" value="Help selecting journals during submission process">Help selecting journals during submission process</option> <option data-id="7000179650" value="Journals from Recommender are not available in Submission process">Journals from Recommender are not available in Submission process</option> <option data-id="7000186368" value="Add Journal to SAGE Path">Add Journal to SAGE Path</option> <option data-id="7000186316" value="Account Help/Technical Difficulties">Account Help/Technical Difficulties</option> <option data-id="7000186369" value="How does SAGE Path Work?">How does SAGE Path Work?</option> <option data-id="7000194632" value="Post-Transfer Submissions">Post-Transfer Submissions</option> <option data-id="7000166859" value="Other Editor question">Other Editor question</option> <option data-id="7000166860" value="Other Author question">Other Author question</option> <option data-id="7000166861" value="Other SAGE Path related question">Other SAGE Path related question</option></select> </div>
<label class=" control-label cf_manuscript_id_path_767774-label " for="helpdesk_ticket_cf_manuscript_id_path_767774">Manuscript ID, if applicable</label> <div class="controls "> <input class=" text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_manuscript_id_path_767774]" id="helpdesk_ticket_custom_field_cf_manuscript_id_path_767774" /> </div>
<label class=" required control-label cf_customer_name_767774-label " for="helpdesk_ticket_cf_customer_name_767774">Customer or Organization Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_customer_name_767774]" id="helpdesk_ticket_custom_field_cf_customer_name_767774" /> </div>
<label class=" required control-label cf_a2r_account_number_tele_767774-label " for="helpdesk_ticket_cf_a2r_account_number_tele_767774">Access Account Number</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_a2r_account_number_tele_767774]" id="helpdesk_ticket_custom_field_cf_a2r_account_number_tele_767774" /> </div>
<label class=" required control-label cf_status_applies_to_all_or_some_tele_767774-label " for="helpdesk_ticket_cf_status_applies_to_all_or_some_tele_767774">Status applies to</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_status_applies_to_all_or_some_tele_767774]" id="helpdesk_ticket_custom_field_cf_status_applies_to_all_or_some_tele_767774"><option value="">...</option> <option data-id="7000166162" value="100% of their titles">100% of their titles</option> <option data-id="7000166163" value="Roughly 75% of their titles">Roughly 75% of their titles</option> <option data-id="7000166446" value="Roughly 50% of their titles">Roughly 50% of their titles</option> <option data-id="7000166447" value="Roughly 25% of their titles">Roughly 25% of their titles</option></select> </div>
<label class=" required control-label cf_subscription_status_tele371356_767774-label " for="helpdesk_ticket_cf_subscription_status_tele371356_767774">Subscription Status </label> <div class="controls nested_field "> <select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_subscription_status_tele371356_767774_7000149487" name="helpdesk_ticket[custom_field][cf_subscription_status_tele371356_767774]"><option value="">...</option> <option value="Cancelled">Cancelled</option> <option value="Pending">Pending</option> <option value="Already renewed before contacted">Already renewed before contacted</option> <option value="Unknown/Not Specified">Unknown/Not Specified</option></select><div class="level_2"><label class="required">Subscription Status Detail</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_subscription_status_detail_tele_767774_7000149487" name="helpdesk_ticket[custom_field][cf_subscription_status_detail_tele_767774]"><option value="">...</option> </select></div><div class="level_3"><label class="required">Subscription Status Further Detail</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_subscription_status_further_detail_as_determined_by_accucomms_tele_767774_7000149487" name="helpdesk_ticket[custom_field][cf_subscription_status_further_detail_as_determined_by_accucomms_tele_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_subscription_status_tele371356_767774_7000149487').nested_select_tag({"data_tree":[["Cancelled","Cancelled",[["Part of a deal","Part of a deal",[]],["Upgraded to Special Collection","Upgraded to Special Collection",[]],["Upgraded to package","Upgraded to package",[]],["Budget","Budget",[["Standard budget cut","Standard budget cut"],["Ongoing budget cuts","Ongoing budget cuts"],["Temporary budget cut","Temporary budget cut"],["Budget being used elsewhere","Budget being used elsewhere"]]],["Price","Price",[]],["Low usage title(s)","Low usage title(s)",[]],["Accessing content outside of subscribing","Accessing content outside of subscribing",[["Inter library loan","Inter library loan"],["OA content","OA content"]]],["Relevance","Relevance",[]]]],["Pending","Pending",[["Not sure","Not sure",[]],["Will be renewing","Will be renewing",[["Requested invoice to be sent","Requested invoice to be sent"],["Will renew now after reminder sent","Will renew now after reminder sent"],["via EBSCO","via EBSCO"],["via Harrassowitz","via Harrassowitz"],["via China National","via China National"],["via Lily Journal","via Lily Journal"],["via Maruzen","via Maruzen"],["via Kinokuniya","via Kinokuniya"],["via Exlibris","via Exlibris"],["via LM Info","via LM Info"],["via Lehmans Media","via Lehmans Media"],["via China Education","via China Education"],["via Karger Libri","via Karger Libri"],["via TYM","via TYM"],["via Celdes","via Celdes"],["via Journalpia","via Journalpia"],["via ABE","via ABE"],["via Suweco","via Suweco"],["via Prenax","via Prenax"]]],["Would like to renew","Would like to renew",[["Further data required from SAGE to decide","Further data required from SAGE to decide"]]],["Delayed decision making","Delayed decision making",[]]]],["Already renewed before contacted","Already renewed before contacted",[]],["Unknown/Not Specified","Unknown/Not Specified",[]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000149487","subcategory_id":"helpdesk_ticket_custom_field_cf_subscription_status_detail_tele_767774_7000149487","item_id":"helpdesk_ticket_custom_field_cf_subscription_status_further_detail_as_determined_by_accucomms_tele_767774_7000149487"}); //]]> </script> </div>
<label class=" required control-label cf_reference_number_renewal_or_other_pp_767774-label " for="helpdesk_ticket_cf_reference_number_renewal_or_other_pp_767774">Reference Number (Renewal or Other)</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_reference_number_renewal_or_other_pp_767774]" id="helpdesk_ticket_custom_field_cf_reference_number_renewal_or_other_pp_767774" /> </div>
<label class=" required control-label cf_what_is_your_query_regarding_pp_767774-label " for="helpdesk_ticket_cf_what_is_your_query_regarding_pp_767774">What is your query regarding?</label> <div class="controls "> <select class=" required dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_what_is_your_query_regarding_pp_767774]" id="helpdesk_ticket_custom_field_cf_what_is_your_query_regarding_pp_767774"><option value="">...</option> <option data-id="7000210959" value="Change address">Change address</option> <option data-id="7000178198" value="Change Journal Format Type">Change Journal Format Type</option> <option data-id="7000210957" value="Issue with credit card payment">Issue with credit card payment</option> <option data-id="7000210958" value="Issue with paying by invoice">Issue with paying by invoice</option> <option data-id="7000210961" value="My subscription is not appearing for renewal">My subscription is not appearing for renewal</option> <option data-id="7000178199" value="Other">Other</option></select> </div>
<label class=" required control-label cf_reference_number_renewal_or_other_pp_767774-label " for="helpdesk_ticket_cf_reference_number_renewal_or_other_pp_767774">Reference Number (Renewal or Other)</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_reference_number_renewal_or_other_pp_767774]" id="helpdesk_ticket_custom_field_cf_reference_number_renewal_or_other_pp_767774" /> </div>
<label class=" required control-label cf_customer_selection_query_type_pc_767774-label " for="helpdesk_ticket_cf_customer_selection_query_type_pc_767774">What is your query regarding</label> <div class="controls nested_field "> <select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_customer_selection_query_type_pc_767774_7000195641" name="helpdesk_ticket[custom_field][cf_customer_selection_query_type_pc_767774]"><option value="">...</option> <option value="Update billpayer">Update billpayer</option> <option value="VAT number to be added, removed or edited">VAT number to be added, removed or edited</option> <option value="PO number to be added, removed or edited">PO number to be added, removed or edited</option> <option value="Can't pay invoice">Can't pay invoice</option> <option value="Can't register on the Portal">Can't register on the Portal</option> <option value="Sage Choice request">Sage Choice request</option> <option value="OA Sales Deal">OA Sales Deal</option> <option value="Other">Other</option></select><div class="level_2"><label class="required">Category</label><select class=" required nested_field section_field" id="helpdesk_ticket_custom_field_cf_category_pc_767774_7000195641" name="helpdesk_ticket[custom_field][cf_category_pc_767774]"><option value="">...</option> </select></div><script> //<![CDATA[ jQuery('#helpdesk_ticket_custom_field_cf_customer_selection_query_type_pc_767774_7000195641').nested_select_tag({"data_tree":[["Update billpayer","Update billpayer",[]],["VAT number to be added, removed or edited","VAT number to be added, removed or edited",[]],["PO number to be added, removed or edited","PO number to be added, removed or edited",[]],["Can't pay invoice","Can't pay invoice",[]],["Can't register on the Portal","Can't register on the Portal",[]],["Sage Choice request","Sage Choice request",[]],["OA Sales Deal","OA Sales Deal",[]],["Other","Other",[["Other","Other",[]]]]],"initValues":null,"disable_children":false,"include_blank":"...","selected":null,"pl_value_id":"7000195641","subcategory_id":"helpdesk_ticket_custom_field_cf_category_pc_767774_7000195641"}); //]]> </script> </div>
<label class=" control-label cf_invoice_charge_pc_767774-label " for="helpdesk_ticket_cf_invoice_charge_pc_767774">Invoice Charge</label> <div class="controls "> <select class=" dropdown_blank section_field" data-placeholder="..." name="helpdesk_ticket[custom_field][cf_invoice_charge_pc_767774]" id="helpdesk_ticket_custom_field_cf_invoice_charge_pc_767774"><option value="">...</option> <option data-id="7000178316" value="Page charges">Page charges</option> <option data-id="7000178317" value="Page charges and colour figures">Page charges and colour figures</option> <option data-id="7000178318" value="Colour figures">Colour figures</option> <option data-id="7000191909" value="Publishing charges">Publishing charges</option> <option data-id="7000191910" value="Over 4,000 words">Over 4,000 words</option> <option data-id="7000178319" value="Other">Other</option></select> </div>
<label class=" required control-label cf_journal_name_767774-label " for="helpdesk_ticket_cf_journal_name_767774">Journal Name</label> <div class="controls "> <input class=" required text section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_journal_name_767774]" id="helpdesk_ticket_custom_field_cf_journal_name_767774" /> </div>
<label class=" required control-label cf_doi_pc_767774-label " for="helpdesk_ticket_cf_doi_pc_767774">DOI</label> <div class="controls "> <input class=" required number section_field span12" placeholder="" type="text" name="helpdesk_ticket[custom_field][cf_doi_pc_767774]" id="helpdesk_ticket_custom_field_cf_doi_pc_767774" /> </div>
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