<form-template> <fields> <field type="checkbox-group" required="true" label="License Fees (maximum 3 dogs and 2 cats)" description="check the appropriate item" class="checkbox-group" name="checkbox-group-1769788044221" enable-other="true" other="true"> <option value="option-1" selected="true">Dog - over 16 weeks, spayed/ neutered and rabies vaccinated $5 each</option> <option value="option-2">Dog - over 16 weeks, other, and rabies vaccinated $20 each</option> <option>Cat - $0 each</option> <option>Replacement tag - $5 each</option> </field> <field type="text" subtype="text" required="true" label="Pet Owner's Name " class="form-control text-input" name="text-1658954273076"></field> <field type="text" subtype="text" required="true" label="Civic Address " class="form-control text-input" name="text-1658954296339"></field> <field type="text" subtype="text" required="true" label="Mail Address " class="form-control text-input" name="text-1658954310961"></field> <field type="text" subtype="text" label="Email Address " class="form-control text-input" name="text-1658954328193"></field> <field type="text" subtype="text" required="true" label="Phone Number(s)" class="form-control text-input" name="text-1658954349451"></field> <field type="text" subtype="text" required="true" label="Pet's Name " class="form-control text-input" name="text-1658954381658"></field> <field type="text" subtype="text" required="true" label="Pet's Birthdate " class="form-control text-input" name="text-1731599193326"></field> <field type="text" subtype="text" required="true" label="Species " description="dog, cat, etc" class="form-control text-input" name="text-1658954401132"></field> <field type="text" subtype="text" label="Dog Breed (if applicable) " class="form-control text-input" name="text-1658954440995"></field> <field type="text" subtype="text" label="Tattoo Number " class="form-control text-input" name="text-1658954642986"></field> <field type="text" subtype="text" required="true" label="Colour and distinguishing markings" class="form-control text-input" name="text-1658954469069"></field> <field type="text" subtype="text" required="true" label="Pet's gender" class="form-control text-input" name="text-1658954664780"></field> <field type="text" subtype="text" required="true" label="Please specify, has your pet been spayed or neutered?" description="yes or no" class="form-control text-input" name="text-1658954689070"></field> <field type="file" required="true" label="Pet photo" class="form-control file-input" name="file-1658954743487" multiple="true"></field> </fields> </form-template> Submit Submitting...