		<option value="WI">Wisconsin</option>
		<option value="WY">Wyoming</option>

	</select>
                    </li>
                    <li>
                    
                        <label class="txtBoxLabel" for="body_txtZIP" id="body_lbltxtZIP">Zip Code</label><input id="body_txtZIP" maxlength="15" name="ctl00$body$txtZIP" type="text">
                    </li>
                    <li class="text">
                        <label class="txtBoxLabel" for="body_txtComments" id="body_lbltxtComments">Comme