<form-template> <fields> <field type="select" required="true" label="Regarding" class="form-control select" name="select-1770930967985"> <option value="Sewer, Water, Streets">Sewer, Water, Streets</option> <option value="Recycling, Garbage">Recycling, Garbage</option> <option value="Weed Control" selected="true">Weed Control</option> <option value="Animal Control">Animal Control</option> <option value="Administration">Administration</option> <option value="Other">Other</option> </field> <field type="date" required="true" label="Date Field" class="form-control calendar" name="date-1770931150855" value="date filled"></field> <field type="text" subtype="text" required="true" label="Please enter your name, address and contact information" description="name, address, phone" class="form-control text-input" name="text-1770931164935" value="name, address, phone"></field> <field type="text" subtype="text" required="true" label="Complaint" class="form-control text-input" name="text-1770931178871" value="issue"></field> <field type="checkbox" required="true" label="By clicking here I confirm my name to this document and have completed this complaint form in a truthful manner *" class="checkbox" name="checkbox-1770931194958" value="completed truthfully"></field> </fields> </form-template> Submit Submitting...
