<form-template> <fields> <field type="text" subtype="text" required="true" label="First Name" description="f" class="form-control text-input" name="text-1599163454209" value="First Name"></field> <field type="text" subtype="text" required="true" label="Last Name" description="l" class="form-control text-input" name="text-1599163479500" value="Last Name"></field> <field type="text" subtype="text" required="true" label="Address" description="a" class="form-control text-input" name="text-1599163506356" value="Address"></field> <field type="text" subtype="text" label="Home Phone #" description="p" class="form-control text-input" name="text-1599163582285" value="Phone #"></field> <field type="text" subtype="email" label="Email" class="form-control text-input" name="text-1599163691688" value="Email"></field> <field type="date" label="Date Field" class="form-control calendar" name="date-1600286908026"></field> <field type="checkbox" label="If you would like to receive the quarterly MD Newsletter by email, please check the box" class="checkbox" name="checkbox-1599163720784" value="If you would like to receive the quarterly MD Newsletter by email, please check the box"></field> <field type="paragraph" subtype="p" label="This personal information is being collected under the authority of the Freedom of Information and Protection of Privacy Act and will only be used for the purpose for which it was collected. It is protected by the privacy provision of the FOIP Act." class="paragraph"></field> </fields> </form-template> Submit Submitting...
