PHP Test Form 7-30-2025

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[{"type":"text","subtype":"email","required":true,"label":"Email","name":"email","className":"col-md-6"},{"type":"text","subtype":"email","required":true,"label":"Email Confirmation","name":"email-confirmed","className":"col-md-6"},{"type":"checkbox-group","required":true,"label":"Check all that apply","name":"Check-all-that-apply","className":"d-block","values":[{"label":"Dog","value":"dog"},{"label":"Cat","value":"cat"},{"label":"Fish","value":"fish"}]},{"type":"file","label":"Please select one or more files for upload. You may upload up to 20 files (35 Mb max). Files can be PDF, JPG, JPEG format. To upload multiple files, please hold control while clicking on multiple files before clicking \"Open\".","name":"file-upload","subtype":"file","multiple":true,"className":"d-block"},{"type":"date","required":true,"label":"Today's Date","name":"Todays-date","className":"d-block"},{"type":"paragraph","subtype":"p","label":"Testing Testing Testing","className":"d-block"},{"type":"header","subtype":"h2","label":"PHP Test","className":"d-block"},{"type":"radio-group","label":"Is this a test?","name":"Is-this-a-test","other":true,"className":"d-block","values":[{"label":"Yes","value":"yes"},{"label":"No","value":"no"}]},{"type":"select","required":true,"label":"Choose one:","name":"Choose-one","className":"d-block","values":[{"label":"Purple","value":"purple","selected":true},{"label":"Pink","value":"pink"},{"label":"Green","value":"green"}]},{"type":"text","label":"Middle Name:","name":"Middle-Name","className":"col-md-6","subtype":"text"},{"type":"textarea","label":"Explain:","name":"Explain","subtype":"textarea","className":"d-block"},{"type":"select","label":"State","name":"State","className":"d-block","values":[{"label":"Alabama","value":"AL"},{"label":"Alaska","value":"AK"},{"label":"Arizona","value":"AZ"},{"label":"Arkansas","value":"AR"},{"label":"California","value":"CA"},{"label":"Colorado","value":"CO"},{"label":"Connecticut","value":"CT"},{"label":"Delaware","value":"DE"},{"label":"District of Columbia","value":"DC","selected":true},{"label":"Florida","value":"FL"},{"label":"Georgia","value":"GA"},{"label":"Hawaii","value":"HI"},{"label":"Idaho","value":"ID"},{"label":"Illinois","value":"IL"},{"label":"Indiana","value":"IN"},{"label":"Iowa","value":"IA"},{"label":"Kansas","value":"KS"},{"label":"Kentucky","value":"KY"},{"label":"Louisiana","value":"LA"},{"label":"Maine","value":"ME"},{"label":"Maryland","value":"MD"},{"label":"Massachusetts","value":"MA"},{"label":"Michigan","value":"MI"},{"label":"Minnesota","value":"MN"},{"label":"Mississippi","value":"MS"},{"label":"Missouri","value":"MO"},{"label":"Montana","value":"MT"},{"label":"Nebraska","value":"NE"},{"label":"Nevada","value":"NV"},{"label":"New Hampshire","value":"NH"},{"label":"New Jersey","value":"NJ"},{"label":"New Mexico","value":"NM"},{"label":"New York","value":"NY"},{"label":"North Carolina","value":"NC"},{"label":"North Dakota","value":"ND"},{"label":"Ohio","value":"OH"},{"label":"Oklahoma","value":"OK"},{"label":"Oregon","value":"OR"},{"label":"Pennsylvania","value":"PA"},{"label":"Rhode Island","value":"RI"},{"label":"South Carolina","value":"SC"},{"label":"South Dakota","value":"SD"},{"label":"Tennessee","value":"TN"},{"label":"Texas","value":"TX"},{"label":"Utah","value":"UT"},{"label":"Vermont","value":"VT"},{"label":"Virginia","value":"VA"},{"label":"Washington","value":"WA"},{"label":"West Virginia","value":"WV"},{"label":"Wisconsin","value":"WI"},{"label":"Wyoming","value":"WY"}]},{"type":"number","label":"Number of tests:","name":"Number-of-tests","min":0,"max":200,"step":20,"className":"d-block"},{"type":"paragraph","subtype":"p","label":"<hr>","className":"d-block"},{"type":"paragraph","subtype":"p","label":"<div class=\"clear\"></div>","className":"d-block"},{"type":"autocomplete","label":"Type of housing:","name":"Type-of-housing","className":"d-block","values":[{"label":"HCV","value":"hcv"},{"label":"Public Housing","value":"Public Housing"},{"label":"PBV","value":"pbv"}]}]

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PHP Test Form 7-30-2025

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