<form-template> <fields> <field type="date" required="true" label="Date " class="form-control calendar" name="date-1716839175086" value="Date"></field> <field type="text" subtype="text" required="true" label="Name" description="First and Last Name" placeholder="Name" class="form-control text-input" name="text-1716839182300"></field> <field type="text" subtype="email" required="true" label="Email" placeholder="Email" class="form-control text-input" name="text-1716839179035"></field> <field type="text" subtype="text" required="true" label="Phone Number" placeholder="Phone Number" class="form-control text-input" name="text-1716831351798"></field> <field type="text" subtype="text" required="true" label="Property Address" placeholder="Property Address" class="form-control text-input" name="text-1716839290182"></field> <field type="textarea" required="true" label="Mitigation Actions Completed" description="Which of the recommended actions were completed?" placeholder="Description of Mitigation Actions Completed" class="form-control text-area" name="textarea-1716839355668"></field> <field type="file" required="true" label="Attach a photo of your completed work or a related receipt. If you need to send multiple attachments, please email them directly to David Hick (FireSmart Coordinator/Assistant Chief) at dhick@hope.ca. Use the subject line “FireSmart Home Rebate Request.”" description="Attach photos of your completed work and all related receipts. If you need to send multiple attachments, please email them directly to David Hick (FireSmart Coordinator/Assistant Chief) at dhick@hope.ca . Use the subject line “FireSmart Home Rebate Request.”" class="form-control file-input" name="file-1716839405006" multiple="true"></field> <field type="textarea" required="true" label="Hours" description="Enter hours per mitigation task (eg. 2 hrs-gutter cleaning)" placeholder="Hours" class="form-control text-area" name="textarea-1716840968854"></field> </fields> </form-template> Submit Submitting...