<select name="county">
<option value="--England--">--England--</option>
<option value="Avon">Avon</option>
<option value="Bedfordshire">Bedfordshire</option>
<option value="Berkshire">Berkshire</option>
<option value="Bristol">Bristol</option>
<option value="Buckinghamshire">Buckinghamshire</option>
<option value="Cambridgeshire">Cambridgeshire</option>
<option value="Cheshire">Cheshire</option>
<option value="Cleveland">Cleveland</option>
<option value="Cornwall">Cornwall</option>
<option value="Cumbria">Cumbria</option>
<option value="Derbyshire">Derbyshire</option>
<option value="Devon">Devon</option>
<option value="Dorset">Dorset</option>
<option value="Durham">Durham</option>
<option value="East Riding of Yorkshire">East Riding of Yorkshire</option>
<option value="East Sussex">East Sussex</option>
<option value="Essex">Essex</option>
<option value="Gloucestershire">Gloucestershire</option>
<option value="Greater Manchester">Greater Manchester</option>
<option value="Hampshire">Hampshire</option>
<option value="Herefordshire">Herefordshire</option>
<option value="Hertfordshire">Hertfordshire</option>
<option value="Humberside">Humberside</option>
<option value="Isle of Wight">Isle of Wight</option>
<option value="Isles of Scilly">Isles of Scilly</option>
<option value="Kent">Kent</option>
<option value="Lancashire">Lancashire</option>
<option value="Leicestershire">Leicestershire</option>
<option value="Lincolnshire">Lincolnshire</option>
<option value="London">London</option>
<option value="Merseyside">Merseyside</option>
<option value="Middlesex">Middlesex</option>
<option value="Norfolk">Norfolk</option>
<option value="North Yorkshire">North Yorkshire</option>
<option value="Northamptonshire">Northamptonshire</option>
<option value="Northumberland">Northumberland</option>
<option value="Nottinghamshire">Nottinghamshire</option>
<option value="Oxfordshire">Oxfordshire</option>
<option value="Rutland">Rutland</option>
<option value="Shropshire">Shropshire</option>
<option value="Somerset">Somerset</option>
<option value="South Yorkshire">South Yorkshire</option>
<option value="Staffordshire">Staffordshire</option>
<option value="Suffolk">Suffolk</option>
<option value="Surrey">Surrey</option>
<option value="Tyne and Wear">Tyne and Wear</option>
<option value="Warwickshire">Warwickshire</option>
<option value="West Midlands">West Midlands</option>
<option value="West Sussex">West Sussex</option>
<option value="West Yorkshire">West Yorkshire</option>
<option value="Wiltshire">Wiltshire</option>
<option value="Worcestershire">Worcestershire</option>
<option value="">&nbsp</option>
<option value="--UK Offshore--">--UK Offshore--</option>
<option value="Channel Islands">Channel Islands</option>
<option value="Isle of Man">Isle of Man</option>
<option value="">&nbsp</option>
<option value="--Northern Ireland--">--Northern Ireland--</option>
<option value="Antrim">Antrim</option>
<option value="Armagh">Armagh</option>
<option value="Down">Down</option>
<option value="Fermanagh">Fermanagh</option>
<option value="Londonderry">Londonderry</option>
<option value="Tyrone">Tyrone</option>
<option value="">&nbsp</option>
<option value="--Scotland--">--Scotland--</option>
<option value="Aberdeen City">Aberdeen City</option>
<option value="Aberdeenshire">Aberdeenshire</option>
<option value="Angus">Angus</option>
<option value="Argyll and Bute">Argyll and Bute</option>
<option value="Borders">Borders</option>
<option value="Clackmannan">Clackmannan</option>
<option value="Dumfries and Galloway">Dumfries and Galloway</option>
<option value="Dundee (City of)">Dundee (City of)</option>
<option value="East Ayrshire">East Ayrshire</option>
<option value="East Dunbartonshire">East Dunbartonshire</option>
<option value="East Lothian">East Lothian</option>
<option value="East Renfrewshire">East Renfrewshire</option>
<option value="Edinburgh (City of)">Edinburgh (City of)</option>
<option value="Falkirk">Falkirk</option>
<option value="Fife">Fife</option>
<option value="Glasgow (City of)">Glasgow (City of)</option>
<option value="Highland">Highland</option>
<option value="Inverclyde">Inverclyde</option>
<option value="Midlothian">Midlothian</option>
<option value="Moray">Moray</option>
<option value="North Ayrshire">North Ayrshire</option>
<option value="North Lanarkshire">North Lanarkshire</option>
<option value="Orkney">Orkney</option>
<option value="Perthshire and Kinross">Perthshire and Kinross</option>
<option value="Renfrewshire">Renfrewshire</option>
<option value="Shetland">Shetland</option>
<option value="South Ayrshire">South Ayrshire</option>
<option value="South Lanarkshire">South Lanarkshire</option>
<option value="Stirling">Stirling</option>
<option value="West Dunbartonshire">West Dunbartonshire</option>
<option value="West Lothian">West Lothian</option>
<option value="Western Isles">Western Isles</option>
<option value="">&nbsp</option>
<option value="--Wales--">--Wales--</option>
<option value="Blaenau Gwent">Blaenau Gwent</option>
<option value="Bridgend">Bridgend</option>
<option value="Caerphilly">Caerphilly</option>
<option value="Cardiff">Cardiff</option>
<option value="Carmarthenshire">Carmarthenshire</option>
<option value="Ceredigion">Ceredigion</option>
<option value="Conwy">Conwy</option>
<option value="Denbighshire">Denbighshire</option>
<option value="Flintshire">Flintshire</option>
<option value="Gwynedd">Gwynedd</option>
<option value="Isle of Anglesey">Isle of Anglesey</option>
<option value="Merthyr Tydfil">Merthyr Tydfil</option>
<option value="Monmouthshire">Monmouthshire</option>
<option value="Neath Port Talbot">Neath Port Talbot</option>
<option value="Newport">Newport</option>
<option value="Pembrokeshire">Pembrokeshire</option>
<option value="Powys">Powys</option>
<option value="Rhondda Cynon Taff">Rhondda Cynon Taff</option>
<option value="Swansea">Swansea</option>
<option value="Torfaen">Torfaen</option>
<option value="The Vale of Glamorgan">The Vale of Glamorgan</option>
<option value="Wrexham">Wrexham</option>
</select>