<form-template> <fields> <field type="select" required="true" label="Regarding" placeholder="Regarding" class="form-control select" name="select-1691091629889"> <option value="Sewer, Water, Streets" selected="true">Sewer, Water, Streets</option> <option value="Recycling, Garbage">Recycling, Garbage</option> <option value="Weed Control">Weed Control</option> <option value="Animal Control">Animal Control</option> <option value="Administration">Administration</option> <option value="Technical">Technical</option> <option value="Other">Other</option> </field> <field type="date" required="true" label="Date Field" class="form-control calendar" name="date-1691091688834"></field> <field type="text" subtype="text" required="true" label="Please enter your name, address and contact information" class="form-control text-input" name="text-1691091693794"></field> <field type="text" subtype="text" required="true" label="Complaint" class="form-control text-input" name="text-1691091705281"></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-1691091735538"></field> </fields> </form-template> Submit Submitting...