{% extends '../requests_new.html.to' %} {% block subtitle %}

Information About You

{% end %} {% block form %} {% autoescape None %} {% if f.errors %} {% module Alert('There were some errors', message="

Please see below.

", level='error' ) %} {% end %}

Please tell us more about you.

{% module TextInput(f.fname_request,placeholder='First Name') %} {% module TextInput(f.lname_request,placeholder='Last Name') %} {% module TextInput(f.email_request,placeholder='jane@mail.mil') %} {% module TextInput(f.phone_number,placeholder='(123) 456-7890') %}

We want to collect the following information from you for security auditing and determining priviledged user access

{% module TextInput(f.service_branch,placeholder='e.g. US Air Force, US Army, US Navy, Marine Corps, Defense Media Agency') %} {% module OptionsInput(f.citizenship) %} {% module OptionsInput(f.designation) %} {% module TextInput(f.date_latest_training) %} {% end %}