96 lines
2.8 KiB
Plaintext
96 lines
2.8 KiB
Plaintext
{% extends '../requests_new.html.to' %}
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{% block form %}
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<h2>Organizational Info</h2>
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<p>Lorem ipsum dolor sit amet, consectetur adipisicing elit. Doloremque placeat distinctio accusamus quo temporibus facilis, dicta delectus asperiores. Nihil aut quod quibusdam id fugit, officia dolorum laudantium! Quidem tempora, aliquam.</p>
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<h3 id="information-about-you">Information About You</h3>
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<form>
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<label for="">Name</label>
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<input id="" name="" type="text">
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<label for="">Email</label>
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<input id="" name="" type="email" placeholder="i.e. name@mail.gov">
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<label for="">Phone Number</label>
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<input id="" name="" type="text" placeholder="i.e. (123) 456-7890">
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<label for="">Office Symbol / Department</label>
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<input id="" name="" type="text" placeholder="i.e. Army PEO-EIS">
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<fieldset>
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<label for="">Citizenship</label>
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<ul class="usa-unstyled-list">
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<li>
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<input id="" type="radio" name="" value"">
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<label class="input-label">United States</label>
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</li>
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<li>
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<input id="" type="radio" name="" value"">
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<label class="input-label">Foreign National</label>
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</li>
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<li>
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<input id="" type="radio" name="" value"">
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<label class="input-label">Other</label>
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</li>
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</ul>
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</fieldset>
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<fieldset>
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<label for="">Designation of Person</label>
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<ul class="usa-unstyled-list">
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<li>
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<input id="" type="radio" name="" value"">
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<label class="input-label">Military</label>
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</li>
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<li>
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<input id="" type="radio" name="" value"">
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<label class="input-label">Civilian</label>
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</li>
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<li>
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<input id="" type="radio" name="" value"">
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<label class="input-label">Contractor</label>
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</li>
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</ul>
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</fieldset>
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<fieldset>
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<label for="">Latest IA Training completion date</label>
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<div class="usa-date-input">
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<div class="usa-form-group usa-form-group-month">
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<label for="">Month</label>
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<input class="usa-input-inline" id="" name="" type="number" min="1" max="12" value="">
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</div>
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<div class="usa-form-group usa-form-group-day">
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<label for="">Day</label>
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<input class="usa-input-inline" id="" name="" type="number" min="1" max="31" value="">
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</div>
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<div class="usa-form-group usa-form-group-year">
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<label for="">Year</label>
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<input class="usa-input-inline" id="" name="" type="number" min="1900" max="2000" value="">
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</div>
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</div>
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</fieldset>
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</form>
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<h3 id="information-about-your-collaborators">Information About Your Collaborators</h3>
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<form>
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<p>Please designate a Contracting Officer that will help you complete this process.</p>
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<label for="">Name</label>
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<input id="" name="" type="text">
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<label for="">Email</label>
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<input id="" name="" type="text" placeholder="i.e. name@mail.gov">
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</form>
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{% end %}
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