28 lines
964 B
Plaintext
28 lines
964 B
Plaintext
{% extends '../requests_new.html.to' %}
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{% block subtitle %}
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<h2>Information About You</h2>
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{% end %}
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{% block form %}
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{% autoescape None %}
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{% if f.errors %}
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<b class="usa-input-error-message">There were some errors, see below.</b>
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{% end %}
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<p class="usa-font-lead">Please tell us more about you.</p>
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{% module TextInput(f.fname_request,placeholder='First Name') %}
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{% module TextInput(f.lname_request,placeholder='Last Name') %}
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{% module TextInput(f.email_request,placeholder='jane@mail.mil') %}
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{% module TextInput(f.phone_number,placeholder='(123) 456-7890') %}
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<p>We want to collect the following information from you for security auditing and determining priviledged user access</p>
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{% module TextInput(f.service_branch,placeholder='e.g. US Air Force, US Army, US Navy, Marine Corps, Defense Media Agency') %}
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{% module OptionsInput(f.citizenship) %}
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{% module OptionsInput(f.designation) %}
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{% module TextInput(f.date_latest_training) %}
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{% end %} |