Cannot submit Developer Program purchase form

I'm trying to purchase an iOS developer program. I filled all nessesary data in the form but the Continue button is still inactive.
Help.

Hello
I had tried to use apple site but I could not to send my
Information. There were always a problem.
So the solution was to send a fax to Apple.
They sent to me a pdf file where you have to fill your credit card number and security code.
I sent a fax to Apple and They processed my order. In two business days I could access my ios dev account.

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Cannot submit Developer Program purchase form

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