document.writeln('<OPTION VALUE=BELGIQUE>BELGIQUE');
document.writeln('<OPTION VALUE=CANADA>CANADA');
document.writeln('<OPTION VALUE=FRANCE>FRANCE');
document.writeln('<OPTION VALUE=LUXEMBOURG>LUXEMBOURG');
document.writeln('<OPTION VALUE=MONACO>MONACO');
document.writeln('<OPTION VALUE=SUISSE>SUISSE');
document.writeln('<OPTION VALUE=AUTRE>AUTRES PAYS');
document.writeln('<OPTION VALUE=01>FRANCE: Ain (01)');
document.writeln('<OPTION VALUE=02>FRANCE: Aisne (02)');
document.writeln('<OPTION VALUE=03>FRANCE: Allier (03)');
document.writeln('<OPTION VALUE=04>FRANCE: Alpes de hautes provence (04)');
document.writeln('<OPTION VALUE=06>FRANCE: Alpes maritimes (06)');
document.writeln('<OPTION VALUE=07>FRANCE: Ardeche (07)');
document.writeln('<OPTION VALUE=08>FRANCE: Ardennes (08)');
document.writeln('<OPTION VALUE=09>FRANCE: Ariege (09)');
document.writeln('<OPTION VALUE=10>FRANCE: Aube (10)');
document.writeln('<OPTION VALUE=11>FRANCE: Aude (11)');
document.writeln('<OPTION VALUE=12>FRANCE: Aveyron (12)');
document.writeln('<OPTION VALUE=67>FRANCE: Bas rhin (67)');
document.writeln('<OPTION VALUE=13>FRANCE: Bouches du rhone (13)');
document.writeln('<OPTION VALUE=14>FRANCE: Calvados (14)');
document.writeln('<OPTION VALUE=15>FRANCE: Cantal (15)');
document.writeln('<OPTION VALUE=16>FRANCE: Charente (16)');
document.writeln('<OPTION VALUE=17>FRANCE: Charente maritime (17)');
document.writeln('<OPTION VALUE=18>FRANCE: Cher (18)');
document.writeln('<OPTION VALUE=19>FRANCE: Correze (19)');
document.writeln('<OPTION VALUE=20>FRANCE: Corse (20)');
document.writeln('<OPTION VALUE=22>FRANCE: Cotes d\'armor (22)');
document.writeln('<OPTION VALUE=21>FRANCE: Cotes d\'or (21)');
document.writeln('<OPTION VALUE=23>FRANCE: Creuse (23)');
document.writeln('<OPTION VALUE=79>FRANCE: Deux Sevres (79)');
document.writeln('<OPTION VALUE=24>FRANCE: Dordogne (24)');
document.writeln('<OPTION VALUE=25>FRANCE: Doubs (25)');
document.writeln('<OPTION VALUE=26>FRANCE: Drome (26)');
document.writeln('<OPTION VALUE=91>FRANCE: Essone (91)');
document.writeln('<OPTION VALUE=27>FRANCE: Eure (27)');
document.writeln('<OPTION VALUE=28>FRANCE: Eure-et-Loir (28)');
document.writeln('<OPTION VALUE=29>FRANCE: Finistere (29)');
document.writeln('<OPTION VALUE=30>FRANCE: Gard (30)');
document.writeln('<OPTION VALUE=32>FRANCE: Gers (32)');
document.writeln('<OPTION VALUE=33>FRANCE: Gironde (33)');
document.writeln('<OPTION VALUE=971>FRANCE: Guadeloupe (971)');
document.writeln('<OPTION VALUE=973>FRANCE: Guyane (973)');
document.writeln('<OPTION VALUE=68>FRANCE: Haut rhin (68)');
document.writeln('<OPTION VALUE=31>FRANCE: Haute garonne (31)');
document.writeln('<OPTION VALUE=43>FRANCE: Haute loire (43)');
document.writeln('<OPTION VALUE=52>FRANCE: Haute marne (52)');
document.writeln('<OPTION VALUE=70>FRANCE: Haute saone (70)');
document.writeln('<OPTION VALUE=74>FRANCE: Haute savoie (74)');
document.writeln('<OPTION VALUE=87>FRANCE: Haute vienne (87)');
document.writeln('<OPTION VALUE=05>FRANCE: Hautes alpes (05)');
document.writeln('<OPTION VALUE=65>FRANCE: Hautes pyrenees (65)');
document.writeln('<OPTION VALUE=92>FRANCE: Hauts de seine (92)');
document.writeln('<OPTION VALUE=34>FRANCE: Herault (34)');
document.writeln('<OPTION VALUE=35>FRANCE: Ile et vilaine (35)');
document.writeln('<OPTION VALUE=36>FRANCE: Indre (36)');
document.writeln('<OPTION VALUE=37>FRANCE: Indre et loire (37)');
document.writeln('<OPTION VALUE=38>FRANCE: Isere (38)');
document.writeln('<OPTION VALUE=39>FRANCE: Jura (39)');
document.writeln('<OPTION VALUE=40>FRANCE: Landes (40)');
document.writeln('<OPTION VALUE=41>FRANCE: Loir et cher (41)');
document.writeln('<OPTION VALUE=42>FRANCE: Loire (42)');
document.writeln('<OPTION VALUE=44>FRANCE: Loire atlantique (44)');
document.writeln('<OPTION VALUE=45>FRANCE: Loiret (45)');
document.writeln('<OPTION VALUE=46>FRANCE: Lot (46)');
document.writeln('<OPTION VALUE=47>FRANCE: Lot et garonne (47)');
document.writeln('<OPTION VALUE=48>FRANCE: Lozere (48)');
document.writeln('<OPTION VALUE=49>FRANCE: Maine et loire (49)');
document.writeln('<OPTION VALUE=50>FRANCE: Manche (50)');
document.writeln('<OPTION VALUE=51>FRANCE: Marne (51)');
document.writeln('<OPTION VALUE=972>FRANCE: Martinique (972)');
document.writeln('<OPTION VALUE=53>FRANCE: Mayenne (53)');
document.writeln('<OPTION VALUE=976>FRANCE: Mayotte (976)');
document.writeln('<OPTION VALUE=54>FRANCE: Meurte et moselle (54)');
document.writeln('<OPTION VALUE=55>FRANCE: Meuse (55)');
document.writeln('<OPTION VALUE=56>FRANCE: Morbihan (56)');
document.writeln('<OPTION VALUE=57>FRANCE: Moselle (57)');
document.writeln('<OPTION VALUE=58>FRANCE: Nievre (58)');
document.writeln('<OPTION VALUE=59>FRANCE: Nord (59)');
document.writeln('<OPTION VALUE=992>FRANCE: Nouvelle caledonie (992)');
document.writeln('<OPTION VALUE=60>FRANCE: Oise (60)');
document.writeln('<OPTION VALUE=61>FRANCE: Orne (61)');
document.writeln('<OPTION VALUE=75>FRANCE: Paris (75)');
document.writeln('<OPTION VALUE=62>FRANCE: Pas de calais (62)');
document.writeln('<OPTION VALUE=991>FRANCE: Polynesie francaise (991)');
document.writeln('<OPTION VALUE=63>FRANCE: Puy de dome (63)');
document.writeln('<OPTION VALUE=64>FRANCE: Pyrenees atlantiques (64)');
document.writeln('<OPTION VALUE=66>FRANCE: Pyrenees orientales (66)');
document.writeln('<OPTION VALUE=974>FRANCE: Reunion (974)');
document.writeln('<OPTION VALUE=69>FRANCE: Rhone (69)');
document.writeln('<OPTION VALUE=975>FRANCE: Saint pierre et miquelon (975)');
document.writeln('<OPTION VALUE=71>FRANCE: Saone et loire (71)');
document.writeln('<OPTION VALUE=72>FRANCE: Sarthe (72)');
document.writeln('<OPTION VALUE=73>FRANCE: Savoie (73)');
document.writeln('<OPTION VALUE=77>FRANCE: Seine et marne (77)');
document.writeln('<OPTION VALUE=76>FRANCE: Seine maritime (76)');
document.writeln('<OPTION VALUE=93>FRANCE: Seine saint denis (93)');
document.writeln('<OPTION VALUE=80>FRANCE: Somme (80)');
document.writeln('<OPTION VALUE=81>FRANCE: Tarn (81)');
document.writeln('<OPTION VALUE=82>FRANCE: Tarn et garonne (82)');
document.writeln('<OPTION VALUE=994>FRANCE: Terres australes et antartiques (994)');
document.writeln('<OPTION VALUE=90>FRANCE: Territoire de belfort (90)');
document.writeln('<OPTION VALUE=95>FRANCE: Val d\'oise (95)');
document.writeln('<OPTION VALUE=94>FRANCE: Val de marne (94)');
document.writeln('<OPTION VALUE=83>FRANCE: Var (83)');
document.writeln('<OPTION VALUE=84>FRANCE: Vaucluse (84)');
document.writeln('<OPTION VALUE=85>FRANCE: Vendee (85)');
document.writeln('<OPTION VALUE=86>FRANCE: Vienne (86)');
document.writeln('<OPTION VALUE=88>FRANCE: Vosges (88)');
document.writeln('<OPTION VALUE=993>FRANCE: Wallis et futuna (993)');
document.writeln('<OPTION VALUE=89>FRANCE: Yonne (89)');
document.writeln('<OPTION VALUE=78>FRANCE: Yvelines (78)');