.panel_form_box {
color:#575757;
font-family:Arial,Helvetica,sans-serif;
margin:0;
padding:0;
width:650px;
height:390px;
}


.panel_form_box h2 {
background:none repeat scroll 0 0 #212121;
color:#F9F9F9;
font-size:16px;
margin:12px 0;
padding:16px 12px;
width:96%;
}
.panel_form_box h3 {
background:none repeat scroll 0 0 #212121;
color:#F9F9F9;
font-size:16px;
margin:12px 0;
padding:16px 12px;
width:96%;
}

ul.panel_form {
overflow:hidden;
width:300px;
}


ul.panel_form li {
display:inline;
float:none;
margin:3px 0 6px;
}
ul.panel_form li label {
color:#06679a;
font-size: 16px;
line-height: 1.8em;


}
ul.panel_form li input {
border:1px solid #CCCCCC;
color:#000000;
font-size:1.4em;
padding: 5px 8px;
}
ul.panel_form li input.text_field_left {
width:274px;
}
ul.panel_form li input.text_field_right {
width:274px;
}
ul.panel_form li input.text_field_full {
width:540px;
}
ul.panel_form li input.state {
margin-right:10px;
width:164px;
}
ul.panel_form li input.zip {
width:64px;
}
ul.panel_form li input.zip_2 {
margin-right:10px;
width:124px;
}


ul.panel_form li input.phone {
margin-right:10px;
width:198px;
}

ul.panel_form li input.country {
width:164px;
}
ul.panel_form li input.dollar {
background:url("../images/icon_dollar.gif") no-repeat scroll 2% 50% #FFFFFF;
padding-left:21px;
width:91px;
}
ul.panel_form li select {
border:1px solid #CCCCCC;
color:#000000;
padding:5px 4px 5px 8px;
}

ul.panel_form li select.state {
margin-right:10px;
width:140px;
}

ul.panel_form li select.country {
margin-right:10px;
width:130px;
}


ul.panel_form li option {
padding-right:18px;
}
ul.panel_form li textarea {
border:1px solid #CCCCCC;
color:#000000;
padding:6px 8px;
}
ul.panel_form li textarea.comments {
width:540px;
}
ul.panel_form_questions {
overflow:hidden;
width:558px;
}
ul.panel_form_questions li {
display:inline;
float:left;
font-size: 1em;
line-height: 16px;
margin:8px 0 0;
overflow:hidden;
width:100%;
}
ul.panel_form_questions li span.float_right {
float:right;
}
ul.panel_form_questions li label {
}
ul.panel_form_questions li input {
border:1px solid #CCCCCC;
color:#000000;
padding:6px 8px;
}
ul.panel_form_questions li input.dollar {
background:url("../images/icon_dollar.gif") no-repeat scroll 2% 50% #FFFFFF;
padding-left:21px;
width:100px;
}
ul.panel_form_questions li input.ccn {
width:200px;
}
ul.panel_form_questions li input.two_digits {
width:20px;
}
ul.panel_form_questions li input.short {
width:40px;
}
ul.panel_form_questions li select {
border:1px solid #CCCCCC;
color:#000000;
padding:4px 4px 4px 8px;
}
ul.panel_form_questions li select.fixed {
border:1px solid #CCCCCC;
color:#000000;
padding:4px 4px 4px 8px;
width:170px;
}
ul.panel_form_questions li option {
padding-right:18px;
}
ul.panel_form_questions li textarea {
border:1px solid #918B7B;
color:#4A4A4A;
padding:6px 8px;
}
ul.panel_form_questions li textarea.comments {
width:540px;
}
.radio {
border:0 none;
padding:0;
}



li.submit {
float: left;
margin-right:0;
padding: 5px 0 0px 0;
}






ul.verification {
border-top:4px solid #EEEEEE;
margin-top:12px;
overflow:hidden;
padding-top:6px;
width:558px;
}
ul.verification li {
display:inline;
float:left;
margin:3px 0 0;
}
ul.verification li img {
margin-right:6px;
margin-top:6px;
}
ul.verification li label {
font-size:0.825em;
font-weight:bold;
text-transform:uppercase;
}
ul.verification li input {
border:1px solid #CCCCCC;
color:#000000;
padding:4px 8px;
}
ul.verification li input.ver_code {
width:64px;
}
ul.verification li.submit {
float:right;
margin-right:0;
margin-top:16px;
}
ul.verification li input.btn_submit {
border:0 none;
padding:0;
}
.confirmation_note {
background:url("../images/icon_check_confirm_small.gif") no-repeat scroll 2% 50% #E6F7B8;
border:1px solid #AECA61;
color:#5BAF07;
margin-right:0;
margin-top:12px;
overflow:hidden;
padding:0 12px;
text-align:center;
width:532px;
}
.confirmation_note p {
margin:8px 0;
}

.fieldnote {
            color: #888;
            margin-left: 10px;
            font-size: 8pt;
           }