<form-template> <fields> <field type="header" subtype="h2" label="Please complete the online form below to change your address." class="header"></field> <field type="header" subtype="h3" label="Personal Information" class="header"></field> <field type="text" subtype="text" required="true" label="First Name" description="Enter your first name here" class="form-control text-input" name="text-1634244218930" value="First Name"></field> <field type="text" subtype="text" required="true" label="Last Name" description="Enter your last name here" class="form-control text-input" name="text-1634244220258" value="Last Name"></field> <field type="text" subtype="text" required="true" label="Daytime Phone Number" description="Enter daytime phone number here" class="form-control text-input" name="text-1634244221865" value="Daytime Phone Number"></field> <field type="header" subtype="h3" label="Address Information" class="header"></field> <field type="text" subtype="text" required="true" label="New Address" description="Enter new address here" class="form-control text-input" name="text-1634244249916" value="New Address"></field> <field type="text" subtype="text" required="true" label="Old Address" description="Enter old address here" class="form-control text-input" name="text-1634244252627" value="Old Address"></field> <field type="text" subtype="text" required="true" label="Utility Account Number" description="Enter utility account number here" class="form-control text-input" name="text-1634244254678" value="Utility Account Number"></field> <field type="radio-group" required="true" label="Are You Moving?" class="radio-group" name="radio-group-1634244330772"> <option value="Yes" selected="true">Yes</option> <option value="No">No</option> </field> <field type="date" required="true" label="Date of Change" description="Enter date of change here" class="form-control calendar" name="date-1634244282058" value="Date of Change"></field> <field type="text" subtype="email" required="true" label="Email Address" class="form-control text-input" name="text-1634581087562" value="Email Address"></field> </fields> </form-template> Submit Submitting...
