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iamjohnrex03

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iamjohnrex03
May 2nd, 2025
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  105.   <div role="main" class="form-all">
  106.     <ul class="form-section page-section" role="presentation">
  107.       <li id="cid_1" class="form-input-wide" data-type="control_head">
  108.         <div class="form-header-group  header-large">
  109.           <div class="header-text httal htvam">
  110.             <h1 id="header_1" class="form-header" data-component="header">All JotForm Fields and Widgets</h1>
  111.           </div>
  112.         </div>
  113.       </li>
  114.       <li class="form-line" data-type="control_textbox" id="id_2"><label class="form-label form-label-top form-label-auto" id="label_2" for="input_2" aria-hidden="false"> Short Text Question </label>
  115.         <div id="cid_2" class="form-input-wide" data-layout="half"> <input type="text" id="input_2" name="q2_shortText" data-type="input-textbox" class="form-textbox" data-defaultvalue="" style="width:310px" size="310" data-component="textbox" aria-labelledby="label_2" value="" /> </div>
  116.       </li>
  117.       <li class="form-line" data-type="control_textarea" id="id_3"><label class="form-label form-label-top form-label-auto" id="label_3" for="input_3" aria-hidden="false"> Long Text Question </label>
  118.         <div id="cid_3" class="form-input-wide" data-layout="full"> <textarea id="input_3" class="form-textarea" name="q3_longText" style="width:648px;height:163px" data-component="textarea" aria-labelledby="label_3"></textarea> </div>
  119.       </li>
  120.       <li class="form-line" data-type="control_signature" id="id_4"><label class="form-label form-label-top form-label-auto" id="label_4" for="input_4" aria-hidden="false"> Signature Question </label>
  121.         <div id="cid_4" class="form-input-wide" data-layout="half">
  122.           <div data-wrapper-react="true">
  123.             <div id="signature_pad_4" class="signature-pad-wrapper">
  124.               <div data-wrapper-react="true">
  125.                 <!--[if IE 7]><script type="text/javascript" src="/js/vendor/json2.js"></script><![endif]-->
  126.               </div>
  127.               <div class="signature-line signature-wrapper signature-placeholder" data-component="signature">
  128.                 <div id="sig_pad_4" data-width="310" data-height="114" data-id="4" data-required="false" class="pad " aria-description="Use your pointer or touch input to draw your signature." aria-labelledby="label_4" tabindex="0"></div><input type="hidden" name="q4_signatureQuestion" class="output4" id="input_4" />
  129.               </div>
  130.               <aside class="signature-pad-aside"><span class="clear-pad-btn clear-pad" role="button" tabindex="0">Clear</span></aside>
  131.             </div>
  132.             <div data-wrapper-react="true">
  133.               <script type="text/javascript">
  134.                 window.signatureForm = true
  135.               </script>
  136.             </div>
  137.           </div>
  138.         </div>
  139.       </li>
  140.       <li class="form-line" data-type="control_fileupload" id="id_5"><label class="form-label form-label-top form-label-auto" id="label_5" for="input_5" aria-hidden="false"> File Upload Question </label>
  141.         <div id="cid_5" class="form-input-wide" data-layout="full">
  142.           <div class="jfQuestion-fields" data-wrapper-react="true">
  143.             <div class="jfField isFilled">
  144.               <div class="jfUpload-wrapper">
  145.                 <div class="jfUpload-container">
  146.                   <div class="jfUpload-button-container">
  147.                     <div class="jfUpload-button" aria-hidden="true" tabindex="0" style="display:none" data-version="v2">Upload a File<div class="jfUpload-heading forDesktop">Drag and drop files here</div>
  148.                       <div class="jfUpload-heading forMobile">Choose a file</div>
  149.                     </div>
  150.                   </div>
  151.                 </div>
  152.                 <div class="jfUpload-files-container">
  153.                   <div class="validate[multipleUpload]"><input type="file" id="input_5" name="q5_fileUpload[]" multiple="" class="form-upload-multiple" data-imagevalidate="yes" data-file-accept="pdf, doc, docx, xls, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif" data-limit-file-size="Yes" data-file-maxsize="10240" data-file-minsize="0" data-file-limit="0" data-component="fileupload" aria-label="Upload a File" /></div>
  154.                 </div>
  155.               </div>
  156.               <div data-wrapper-react="true"></div>
  157.             </div><span style="display:none" class="cancelText">Cancel</span><span style="display:none" class="ofText">of</span>
  158.           </div>
  159.         </div>
  160.       </li>
  161.       <li class="form-line" data-type="control_rating" id="id_6"><label class="form-label form-label-top form-label-auto" id="label_6" for="input_6" aria-hidden="false"> Rating Question </label>
  162.         <div id="cid_6" class="form-input-wide" data-layout="full">
  163.           <div id="input_6" name="q6_ratingQuestion" data-component="rating" data-version="v2"><select name="q6_ratingQuestion" aria-label="Rating Question">
  164.               <option value="1">1</option>
  165.               <option value="2">2</option>
  166.               <option value="3">3</option>
  167.               <option value="4">4</option>
  168.               <option value="5">5</option>
  169.             </select></div>
  170.         </div>
  171.       </li>
  172.       <li class="form-line" data-type="control_dropdown" id="id_7"><label class="form-label form-label-top form-label-auto" id="label_7" for="input_7" aria-hidden="false"> Dropdown Question </label>
  173.         <div id="cid_7" class="form-input-wide" data-layout="half"> <select class="form-dropdown" id="input_7" name="q7_dropdownQuestion" style="width:310px" data-component="dropdown" aria-label="Dropdown Question">
  174.             <option value="">Please Select</option>
  175.             <option value="Option 1">Option 1</option>
  176.             <option value="Option 2">Option 2</option>
  177.             <option value="Option 3">Option 3</option>
  178.           </select> </div>
  179.       </li>
  180.       <li class="form-line" data-type="control_matrix" id="id_8"><label class="form-label form-label-top" id="label_8" for="input_8" aria-hidden="false"> Input Table Question </label>
  181.         <div id="cid_8" class="form-input-wide" data-layout="full">
  182.           <table summary="" role="table" aria-labelledby="label_8" cellPadding="4" cellSpacing="0" class="form-matrix-table" data-component="matrix">
  183.             <tr class="form-matrix-tr form-matrix-header-tr">
  184.               <th class="form-matrix-th" style="border:none"> </th>
  185.               <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_0"><label id="label_8_col_0">Very Satisfied</label></th>
  186.               <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_1"><label id="label_8_col_1">Satisfied</label></th>
  187.               <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_2"><label id="label_8_col_2">Somewhat Satisfied</label></th>
  188.               <th scope="col" class="form-matrix-headers form-matrix-column-headers form-matrix-column_3"><label id="label_8_col_3">Not Satisfied</label></th>
  189.             </tr>
  190.             <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_8 label_8_row_0">
  191.               <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_8_row_0">Service Quality</label></th>
  192.               <td class="form-matrix-values"><input id="input_8_0_0" class="form-radio" type="radio" name="q8_inputTable[0]" aria-labelledby="label_8_col_0 label_8_row_0" aria-label="Cells Radio Button" value="Very Satisfied" /><label for="input_8_0_0" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  193.               <td class="form-matrix-values"><input id="input_8_0_1" class="form-radio" type="radio" name="q8_inputTable[0]" aria-labelledby="label_8_col_1 label_8_row_0" aria-label="Cells Radio Button" value="Satisfied" /><label for="input_8_0_1" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  194.               <td class="form-matrix-values"><input id="input_8_0_2" class="form-radio" type="radio" name="q8_inputTable[0]" aria-labelledby="label_8_col_2 label_8_row_0" aria-label="Cells Radio Button" value="Somewhat Satisfied" /><label for="input_8_0_2" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  195.               <td class="form-matrix-values"><input id="input_8_0_3" class="form-radio" type="radio" name="q8_inputTable[0]" aria-labelledby="label_8_col_3 label_8_row_0" aria-label="Cells Radio Button" value="Not Satisfied" /><label for="input_8_0_3" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  196.             </tr>
  197.             <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_8 label_8_row_1">
  198.               <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_8_row_1">Overall Hygiene</label></th>
  199.               <td class="form-matrix-values"><input id="input_8_1_0" class="form-radio" type="radio" name="q8_inputTable[1]" aria-labelledby="label_8_col_0 label_8_row_1" aria-label="Cells Radio Button" value="Very Satisfied" /><label for="input_8_1_0" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  200.               <td class="form-matrix-values"><input id="input_8_1_1" class="form-radio" type="radio" name="q8_inputTable[1]" aria-labelledby="label_8_col_1 label_8_row_1" aria-label="Cells Radio Button" value="Satisfied" /><label for="input_8_1_1" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  201.               <td class="form-matrix-values"><input id="input_8_1_2" class="form-radio" type="radio" name="q8_inputTable[1]" aria-labelledby="label_8_col_2 label_8_row_1" aria-label="Cells Radio Button" value="Somewhat Satisfied" /><label for="input_8_1_2" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  202.               <td class="form-matrix-values"><input id="input_8_1_3" class="form-radio" type="radio" name="q8_inputTable[1]" aria-labelledby="label_8_col_3 label_8_row_1" aria-label="Cells Radio Button" value="Not Satisfied" /><label for="input_8_1_3" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  203.             </tr>
  204.             <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_8 label_8_row_2">
  205.               <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_8_row_2">Responsiveness</label></th>
  206.               <td class="form-matrix-values"><input id="input_8_2_0" class="form-radio" type="radio" name="q8_inputTable[2]" aria-labelledby="label_8_col_0 label_8_row_2" aria-label="Cells Radio Button" value="Very Satisfied" /><label for="input_8_2_0" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  207.               <td class="form-matrix-values"><input id="input_8_2_1" class="form-radio" type="radio" name="q8_inputTable[2]" aria-labelledby="label_8_col_1 label_8_row_2" aria-label="Cells Radio Button" value="Satisfied" /><label for="input_8_2_1" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  208.               <td class="form-matrix-values"><input id="input_8_2_2" class="form-radio" type="radio" name="q8_inputTable[2]" aria-labelledby="label_8_col_2 label_8_row_2" aria-label="Cells Radio Button" value="Somewhat Satisfied" /><label for="input_8_2_2" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  209.               <td class="form-matrix-values"><input id="input_8_2_3" class="form-radio" type="radio" name="q8_inputTable[2]" aria-labelledby="label_8_col_3 label_8_row_2" aria-label="Cells Radio Button" value="Not Satisfied" /><label for="input_8_2_3" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  210.             </tr>
  211.             <tr class="form-matrix-tr form-matrix-value-tr" aria-labelledby="label_8 label_8_row_3">
  212.               <th scope="row" class="form-matrix-headers form-matrix-row-headers"><label id="label_8_row_3">Kindness and Helpfulness</label></th>
  213.               <td class="form-matrix-values"><input id="input_8_3_0" class="form-radio" type="radio" name="q8_inputTable[3]" aria-labelledby="label_8_col_0 label_8_row_3" aria-label="Cells Radio Button" value="Very Satisfied" /><label for="input_8_3_0" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  214.               <td class="form-matrix-values"><input id="input_8_3_1" class="form-radio" type="radio" name="q8_inputTable[3]" aria-labelledby="label_8_col_1 label_8_row_3" aria-label="Cells Radio Button" value="Satisfied" /><label for="input_8_3_1" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  215.               <td class="form-matrix-values"><input id="input_8_3_2" class="form-radio" type="radio" name="q8_inputTable[3]" aria-labelledby="label_8_col_2 label_8_row_3" aria-label="Cells Radio Button" value="Somewhat Satisfied" /><label for="input_8_3_2" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  216.               <td class="form-matrix-values"><input id="input_8_3_3" class="form-radio" type="radio" name="q8_inputTable[3]" aria-labelledby="label_8_col_3 label_8_row_3" aria-label="Cells Radio Button" value="Not Satisfied" /><label for="input_8_3_3" class="matrix-choice-label matrix-radio-label" aria-hidden="true"></label></td>
  217.             </tr>
  218.           </table>
  219.         </div>
  220.       </li>
  221.       <li class="form-line" data-type="control_phone" id="id_9"><label class="form-label form-label-top form-label-auto" id="label_9" for="input_9_full"> Phone Number Question </label>
  222.         <div id="cid_9" class="form-input-wide" data-layout="half"> <span class="form-sub-label-container" style="vertical-align:top"><input type="tel" id="input_9_full" name="q9_phoneNumber[full]" data-type="mask-number" class="mask-phone-number form-textbox validate[Fill Mask]" data-defaultvalue="" autoComplete="section-input_9 tel-national" style="width:310px" data-masked="true" placeholder="(000) 000-0000" data-component="phone" aria-labelledby="label_9 sublabel_9_masked" value="" /><label class="form-sub-label" for="input_9_full" id="sublabel_9_masked" style="min-height:13px">Please enter a valid phone number.</label></span> </div>
  223.       </li>
  224.       <li class="form-line" data-type="control_number" id="id_10"><label class="form-label form-label-top form-label-auto" id="label_10" for="input_10" aria-hidden="false"> Number Question </label>
  225.         <div id="cid_10" class="form-input-wide" data-layout="half"> <input type="number" id="input_10" name="q10_numberQuestion" data-type="input-number" class=" form-number-input form-textbox validate[]" data-defaultvalue="" style="width:310px" size="310" placeholder="e.g., 23" data-component="number" aria-labelledby="label_10" step="any" value="" /> </div>
  226.       </li>
  227.       <li class="form-line" data-type="control_fullname" id="id_11"><label class="form-label form-label-top form-label-auto" id="label_11" for="first_11" aria-hidden="false"> Full Name Question </label>
  228.         <div id="cid_11" class="form-input-wide" data-layout="full">
  229.           <div data-wrapper-react="true"><span class="form-sub-label-container" style="vertical-align:top" data-input-type="first"><input type="text" id="first_11" name="q11_fullName[first]" class="form-textbox" data-defaultvalue="" autoComplete="section-input_11 given-name" size="10" data-component="first" aria-labelledby="label_11 sublabel_11_first" value="" /><label class="form-sub-label" for="first_11" id="sublabel_11_first" style="min-height:13px">First Name</label></span><span class="form-sub-label-container" style="vertical-align:top" data-input-type="last"><input type="text" id="last_11" name="q11_fullName[last]" class="form-textbox" data-defaultvalue="" autoComplete="section-input_11 family-name" size="15" data-component="last" aria-labelledby="label_11 sublabel_11_last" value="" /><label class="form-sub-label" for="last_11" id="sublabel_11_last" style="min-height:13px">Last Name</label></span></div>
  230.         </div>
  231.       </li>
  232.       <li class="form-line" data-type="control_email" id="id_12"><label class="form-label form-label-top form-label-auto" id="label_12" for="input_12" aria-hidden="false"> Email Question </label>
  233.         <div id="cid_12" class="form-input-wide" data-layout="half"> <span class="form-sub-label-container" style="vertical-align:top"><input type="email" id="input_12" name="q12_emailQuestion" class="form-textbox validate[Email]" data-defaultvalue="" autoComplete="section-input_12 email" style="width:310px" size="310" data-component="email" aria-labelledby="label_12 sublabel_input_12" value="" /><label class="form-sub-label" for="input_12" id="sublabel_input_12" style="min-height:13px">[email protected]</label></span> </div>
  234.       </li>
  235.       <li class="form-line" data-type="control_address" id="id_13" data-compound-hint=",,,,Please Select,,Please Select,"><label class="form-label form-label-top form-label-auto" id="label_13" for="input_13_addr_line1" aria-hidden="false"> Address Question </label>
  236.         <div id="cid_13" class="form-input-wide" data-layout="full">
  237.           <div summary="" class="form-address-table jsTest-addressField">
  238.             <div class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_13_addr_line1" name="q13_addressQuestion[addr_line1]" class="form-textbox form-address-line" data-defaultvalue="" autoComplete="section-input_13 address-line1" data-component="address_line_1" aria-labelledby="label_13 sublabel_13_addr_line1" value="" /><label class="form-sub-label" for="input_13_addr_line1" id="sublabel_13_addr_line1" style="min-height:13px">Street Address</label></span></div>
  239.             <div class="form-address-line form-address-street-line jsTest-address-lineField"><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_13_addr_line2" name="q13_addressQuestion[addr_line2]" class="form-textbox form-address-line" data-defaultvalue="" autoComplete="section-input_13 address-line2" data-component="address_line_2" aria-labelledby="label_13 sublabel_13_addr_line2" value="" /><label class="form-sub-label" for="input_13_addr_line2" id="sublabel_13_addr_line2" style="min-height:13px">Street Address Line 2</label></span></div><span class="form-address-line form-address-city-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_13_city" name="q13_addressQuestion[city]" class="form-textbox form-address-city" data-defaultvalue="" autoComplete="section-input_13 address-level2" data-component="city" aria-labelledby="label_13 sublabel_13_city" value="" /><label class="form-sub-label" for="input_13_city" id="sublabel_13_city" style="min-height:13px">City</label></span></span><span class="form-address-line form-address-state-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_13_state" name="q13_addressQuestion[state]" class="form-textbox form-address-state" data-defaultvalue="" autoComplete="section-input_13 address-level1" data-component="state" aria-labelledby="label_13 sublabel_13_state" value="" /><label class="form-sub-label" for="input_13_state" id="sublabel_13_state" style="min-height:13px">State / Province</label></span></span><span class="form-address-line form-address-zip-line jsTest-address-lineField "><span class="form-sub-label-container" style="vertical-align:top"><input type="text" id="input_13_postal" name="q13_addressQuestion[postal]" class="form-textbox form-address-postal" data-defaultvalue="" autoComplete="section-input_13 postal-code" data-component="zip" aria-labelledby="label_13 sublabel_13_postal" value="" /><label class="form-sub-label" for="input_13_postal" id="sublabel_13_postal" style="min-height:13px">Postal / Zip Code</label></span></span><span class="form-address-line form-address-country-line jsTest-address-lineField form-address-hiddenLine" style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><select class="form-dropdown form-address-country" name="q13_addressQuestion[country]" id="input_13_country" data-component="country" required="" aria-labelledby="label_13 sublabel_13_country" autoComplete="section-input_13 off">
  240.                   <option value="">Please Select</option>
  241.                   <option value="Afghanistan">Afghanistan</option>
  242.                   <option value="Albania">Albania</option>
  243.                   <option value="Algeria">Algeria</option>
  244.                   <option value="American Samoa">American Samoa</option>
  245.                   <option value="Andorra">Andorra</option>
  246.                   <option value="Angola">Angola</option>
  247.                   <option value="Anguilla">Anguilla</option>
  248.                   <option value="Antigua and Barbuda">Antigua and Barbuda</option>
  249.                   <option value="Argentina">Argentina</option>
  250.                   <option value="Armenia">Armenia</option>
  251.                   <option value="Aruba">Aruba</option>
  252.                   <option value="Australia">Australia</option>
  253.                   <option value="Austria">Austria</option>
  254.                   <option value="Azerbaijan">Azerbaijan</option>
  255.                   <option value="The Bahamas">The Bahamas</option>
  256.                   <option value="Bahrain">Bahrain</option>
  257.                   <option value="Bangladesh">Bangladesh</option>
  258.                   <option value="Barbados">Barbados</option>
  259.                   <option value="Belarus">Belarus</option>
  260.                   <option value="Belgium">Belgium</option>
  261.                   <option value="Belize">Belize</option>
  262.                   <option value="Benin">Benin</option>
  263.                   <option value="Bermuda">Bermuda</option>
  264.                   <option value="Bhutan">Bhutan</option>
  265.                   <option value="Bolivia">Bolivia</option>
  266.                   <option value="Bosnia and Herzegovina">Bosnia and Herzegovina</option>
  267.                   <option value="Botswana">Botswana</option>
  268.                   <option value="Brazil">Brazil</option>
  269.                   <option value="Brunei">Brunei</option>
  270.                   <option value="Bulgaria">Bulgaria</option>
  271.                   <option value="Burkina Faso">Burkina Faso</option>
  272.                   <option value="Burundi">Burundi</option>
  273.                   <option value="Cambodia">Cambodia</option>
  274.                   <option value="Cameroon">Cameroon</option>
  275.                   <option value="Canada">Canada</option>
  276.                   <option value="Cape Verde">Cape Verde</option>
  277.                   <option value="Cayman Islands">Cayman Islands</option>
  278.                   <option value="Central African Republic">Central African Republic</option>
  279.                   <option value="Chad">Chad</option>
  280.                   <option value="Chile">Chile</option>
  281.                   <option value="China">China</option>
  282.                   <option value="Christmas Island">Christmas Island</option>
  283.                   <option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
  284.                   <option value="Colombia">Colombia</option>
  285.                   <option value="Comoros">Comoros</option>
  286.                   <option value="Congo">Congo</option>
  287.                   <option value="Cook Islands">Cook Islands</option>
  288.                   <option value="Costa Rica">Costa Rica</option>
  289.                   <option value="Cote d&#x27;Ivoire">Cote d&#x27;Ivoire</option>
  290.                   <option value="Croatia">Croatia</option>
  291.                   <option value="Cuba">Cuba</option>
  292.                   <option value="Curaçao">Curaçao</option>
  293.                   <option value="Cyprus">Cyprus</option>
  294.                   <option value="Czech Republic">Czech Republic</option>
  295.                   <option value="Democratic Republic of the Congo">Democratic Republic of the Congo</option>
  296.                   <option value="Denmark">Denmark</option>
  297.                   <option value="Djibouti">Djibouti</option>
  298.                   <option value="Dominica">Dominica</option>
  299.                   <option value="Dominican Republic">Dominican Republic</option>
  300.                   <option value="Ecuador">Ecuador</option>
  301.                   <option value="Egypt">Egypt</option>
  302.                   <option value="El Salvador">El Salvador</option>
  303.                   <option value="Equatorial Guinea">Equatorial Guinea</option>
  304.                   <option value="Eritrea">Eritrea</option>
  305.                   <option value="Estonia">Estonia</option>
  306.                   <option value="Ethiopia">Ethiopia</option>
  307.                   <option value="Falkland Islands">Falkland Islands</option>
  308.                   <option value="Faroe Islands">Faroe Islands</option>
  309.                   <option value="Fiji">Fiji</option>
  310.                   <option value="Finland">Finland</option>
  311.                   <option value="France">France</option>
  312.                   <option value="French Polynesia">French Polynesia</option>
  313.                   <option value="Gabon">Gabon</option>
  314.                   <option value="The Gambia">The Gambia</option>
  315.                   <option value="Georgia">Georgia</option>
  316.                   <option value="Germany">Germany</option>
  317.                   <option value="Ghana">Ghana</option>
  318.                   <option value="Gibraltar">Gibraltar</option>
  319.                   <option value="Greece">Greece</option>
  320.                   <option value="Greenland">Greenland</option>
  321.                   <option value="Grenada">Grenada</option>
  322.                   <option value="Guadeloupe">Guadeloupe</option>
  323.                   <option value="Guam">Guam</option>
  324.                   <option value="Guatemala">Guatemala</option>
  325.                   <option value="Guernsey">Guernsey</option>
  326.                   <option value="Guinea">Guinea</option>
  327.                   <option value="Guinea-Bissau">Guinea-Bissau</option>
  328.                   <option value="Guyana">Guyana</option>
  329.                   <option value="Haiti">Haiti</option>
  330.                   <option value="Honduras">Honduras</option>
  331.                   <option value="Hong Kong">Hong Kong</option>
  332.                   <option value="Hungary">Hungary</option>
  333.                   <option value="Iceland">Iceland</option>
  334.                   <option value="India">India</option>
  335.                   <option value="Indonesia">Indonesia</option>
  336.                   <option value="Iran">Iran</option>
  337.                   <option value="Iraq">Iraq</option>
  338.                   <option value="Ireland">Ireland</option>
  339.                   <option value="Israel">Israel</option>
  340.                   <option value="Italy">Italy</option>
  341.                   <option value="Jamaica">Jamaica</option>
  342.                   <option value="Japan">Japan</option>
  343.                   <option value="Jersey">Jersey</option>
  344.                   <option value="Jordan">Jordan</option>
  345.                   <option value="Kazakhstan">Kazakhstan</option>
  346.                   <option value="Kenya">Kenya</option>
  347.                   <option value="Kiribati">Kiribati</option>
  348.                   <option value="North Korea">North Korea</option>
  349.                   <option value="South Korea">South Korea</option>
  350.                   <option value="Kosovo">Kosovo</option>
  351.                   <option value="Kuwait">Kuwait</option>
  352.                   <option value="Kyrgyzstan">Kyrgyzstan</option>
  353.                   <option value="Laos">Laos</option>
  354.                   <option value="Latvia">Latvia</option>
  355.                   <option value="Lebanon">Lebanon</option>
  356.                   <option value="Lesotho">Lesotho</option>
  357.                   <option value="Liberia">Liberia</option>
  358.                   <option value="Libya">Libya</option>
  359.                   <option value="Liechtenstein">Liechtenstein</option>
  360.                   <option value="Lithuania">Lithuania</option>
  361.                   <option value="Luxembourg">Luxembourg</option>
  362.                   <option value="Macau">Macau</option>
  363.                   <option value="Macedonia">Macedonia</option>
  364.                   <option value="Madagascar">Madagascar</option>
  365.                   <option value="Malawi">Malawi</option>
  366.                   <option value="Malaysia">Malaysia</option>
  367.                   <option value="Maldives">Maldives</option>
  368.                   <option value="Mali">Mali</option>
  369.                   <option value="Malta">Malta</option>
  370.                   <option value="Marshall Islands">Marshall Islands</option>
  371.                   <option value="Martinique">Martinique</option>
  372.                   <option value="Mauritania">Mauritania</option>
  373.                   <option value="Mauritius">Mauritius</option>
  374.                   <option value="Mayotte">Mayotte</option>
  375.                   <option value="Mexico">Mexico</option>
  376.                   <option value="Micronesia">Micronesia</option>
  377.                   <option value="Moldova">Moldova</option>
  378.                   <option value="Monaco">Monaco</option>
  379.                   <option value="Mongolia">Mongolia</option>
  380.                   <option value="Montenegro">Montenegro</option>
  381.                   <option value="Montserrat">Montserrat</option>
  382.                   <option value="Morocco">Morocco</option>
  383.                   <option value="Mozambique">Mozambique</option>
  384.                   <option value="Myanmar">Myanmar</option>
  385.                   <option value="Nagorno-Karabakh">Nagorno-Karabakh</option>
  386.                   <option value="Namibia">Namibia</option>
  387.                   <option value="Nauru">Nauru</option>
  388.                   <option value="Nepal">Nepal</option>
  389.                   <option value="Netherlands">Netherlands</option>
  390.                   <option value="Netherlands Antilles">Netherlands Antilles</option>
  391.                   <option value="New Caledonia">New Caledonia</option>
  392.                   <option value="New Zealand">New Zealand</option>
  393.                   <option value="Nicaragua">Nicaragua</option>
  394.                   <option value="Niger">Niger</option>
  395.                   <option value="Nigeria">Nigeria</option>
  396.                   <option value="Niue">Niue</option>
  397.                   <option value="Norfolk Island">Norfolk Island</option>
  398.                   <option value="Turkish Republic of Northern Cyprus">Turkish Republic of Northern Cyprus</option>
  399.                   <option value="Northern Mariana">Northern Mariana</option>
  400.                   <option value="Norway">Norway</option>
  401.                   <option value="Oman">Oman</option>
  402.                   <option value="Pakistan">Pakistan</option>
  403.                   <option value="Palau">Palau</option>
  404.                   <option value="Palestine">Palestine</option>
  405.                   <option value="Panama">Panama</option>
  406.                   <option value="Papua New Guinea">Papua New Guinea</option>
  407.                   <option value="Paraguay">Paraguay</option>
  408.                   <option value="Peru">Peru</option>
  409.                   <option value="Philippines">Philippines</option>
  410.                   <option value="Pitcairn Islands">Pitcairn Islands</option>
  411.                   <option value="Poland">Poland</option>
  412.                   <option value="Portugal">Portugal</option>
  413.                   <option value="Puerto Rico">Puerto Rico</option>
  414.                   <option value="Qatar">Qatar</option>
  415.                   <option value="Republic of the Congo">Republic of the Congo</option>
  416.                   <option value="Romania">Romania</option>
  417.                   <option value="Russia">Russia</option>
  418.                   <option value="Rwanda">Rwanda</option>
  419.                   <option value="Saint Barthelemy">Saint Barthelemy</option>
  420.                   <option value="Saint Helena">Saint Helena</option>
  421.                   <option value="Saint Kitts and Nevis">Saint Kitts and Nevis</option>
  422.                   <option value="Saint Lucia">Saint Lucia</option>
  423.                   <option value="Saint Martin">Saint Martin</option>
  424.                   <option value="Saint Pierre and Miquelon">Saint Pierre and Miquelon</option>
  425.                   <option value="Saint Vincent and the Grenadines">Saint Vincent and the Grenadines</option>
  426.                   <option value="Samoa">Samoa</option>
  427.                   <option value="San Marino">San Marino</option>
  428.                   <option value="Sao Tome and Principe">Sao Tome and Principe</option>
  429.                   <option value="Saudi Arabia">Saudi Arabia</option>
  430.                   <option value="Senegal">Senegal</option>
  431.                   <option value="Serbia">Serbia</option>
  432.                   <option value="Seychelles">Seychelles</option>
  433.                   <option value="Sierra Leone">Sierra Leone</option>
  434.                   <option value="Singapore">Singapore</option>
  435.                   <option value="Slovakia">Slovakia</option>
  436.                   <option value="Slovenia">Slovenia</option>
  437.                   <option value="Solomon Islands">Solomon Islands</option>
  438.                   <option value="Somalia">Somalia</option>
  439.                   <option value="Somaliland">Somaliland</option>
  440.                   <option value="South Africa">South Africa</option>
  441.                   <option value="South Ossetia">South Ossetia</option>
  442.                   <option value="South Sudan">South Sudan</option>
  443.                   <option value="Spain">Spain</option>
  444.                   <option value="Sri Lanka">Sri Lanka</option>
  445.                   <option value="Sudan">Sudan</option>
  446.                   <option value="Suriname">Suriname</option>
  447.                   <option value="Svalbard">Svalbard</option>
  448.                   <option value="eSwatini">eSwatini</option>
  449.                   <option value="Sweden">Sweden</option>
  450.                   <option value="Switzerland">Switzerland</option>
  451.                   <option value="Syria">Syria</option>
  452.                   <option value="Taiwan">Taiwan</option>
  453.                   <option value="Tajikistan">Tajikistan</option>
  454.                   <option value="Tanzania">Tanzania</option>
  455.                   <option value="Thailand">Thailand</option>
  456.                   <option value="Timor-Leste">Timor-Leste</option>
  457.                   <option value="Togo">Togo</option>
  458.                   <option value="Tokelau">Tokelau</option>
  459.                   <option value="Tonga">Tonga</option>
  460.                   <option value="Transnistria Pridnestrovie">Transnistria Pridnestrovie</option>
  461.                   <option value="Trinidad and Tobago">Trinidad and Tobago</option>
  462.                   <option value="Tristan da Cunha">Tristan da Cunha</option>
  463.                   <option value="Tunisia">Tunisia</option>
  464.                   <option value="Turkey">Turkey</option>
  465.                   <option value="Turkmenistan">Turkmenistan</option>
  466.                   <option value="Turks and Caicos Islands">Turks and Caicos Islands</option>
  467.                   <option value="Tuvalu">Tuvalu</option>
  468.                   <option value="Uganda">Uganda</option>
  469.                   <option value="Ukraine">Ukraine</option>
  470.                   <option value="United Arab Emirates">United Arab Emirates</option>
  471.                   <option value="United Kingdom">United Kingdom</option>
  472.                   <option value="United States">United States</option>
  473.                   <option value="Uruguay">Uruguay</option>
  474.                   <option value="Uzbekistan">Uzbekistan</option>
  475.                   <option value="Vanuatu">Vanuatu</option>
  476.                   <option value="Vatican City">Vatican City</option>
  477.                   <option value="Venezuela">Venezuela</option>
  478.                   <option value="Vietnam">Vietnam</option>
  479.                   <option value="British Virgin Islands">British Virgin Islands</option>
  480.                   <option value="Isle of Man">Isle of Man</option>
  481.                   <option value="US Virgin Islands">US Virgin Islands</option>
  482.                   <option value="Wallis and Futuna">Wallis and Futuna</option>
  483.                   <option value="Western Sahara">Western Sahara</option>
  484.                   <option value="Yemen">Yemen</option>
  485.                   <option value="Zambia">Zambia</option>
  486.                   <option value="Zimbabwe">Zimbabwe</option>
  487.                   <option value="other">Other</option>
  488.                 </select><label class="form-sub-label" for="input_13_country" id="sublabel_13_country" style="min-height:13px">Country</label></span></span>
  489.           </div>
  490.         </div>
  491.       </li>
  492.       <li class="form-line" data-type="control_datetime" id="id_14"><label class="form-label form-label-top form-label-auto" id="label_14" for="lite_mode_14" aria-hidden="false"> Date Picker Question </label>
  493.         <div id="cid_14" class="form-input-wide" data-layout="half">
  494.           <div data-wrapper-react="true">
  495.             <div style="display:none"><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[limitDate]" id="month_14" name="q14_datePicker[month]" type="tel" size="2" data-maxlength="2" data-age="" maxLength="2" autoComplete="off" aria-labelledby="label_14 sublabel_14_month" value="" /><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="month_14" id="sublabel_14_month" style="min-height:13px">Month</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[limitDate]" id="day_14" name="q14_datePicker[day]" type="tel" size="2" data-maxlength="2" data-age="" maxLength="2" autoComplete="off" aria-labelledby="label_14 sublabel_14_day" value="" /><span class="date-separate" aria-hidden="true"> -</span><label class="form-sub-label" for="day_14" id="sublabel_14_day" style="min-height:13px">Day</label></span><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[limitDate]" id="year_14" name="q14_datePicker[year]" type="tel" size="4" data-maxlength="4" data-age="" maxLength="4" autoComplete="off" aria-labelledby="label_14 sublabel_14_year" value="" /><label class="form-sub-label" for="year_14" id="sublabel_14_year" style="min-height:13px">Year</label></span></div><span class="form-sub-label-container" style="vertical-align:top"><input class="form-textbox validate[limitDate, validateLiteDate]" id="lite_mode_14" type="text" size="12" data-maxlength="12" maxLength="12" data-age="" data-format="mmddyyyy" data-seperator="-" placeholder="MM-DD-YYYY" data-placeholder="MM-DD-YYYY" autoComplete="off" aria-labelledby="label_14 sublabel_14_litemode" value="" /><button type="button" class=" newDefaultTheme-dateIcon focusable icon-liteMode" id="input_14_pick" data-component="datetime" aria-hidden="true" data-allow-time="No" data-version="v2"></button><label class="form-sub-label" for="lite_mode_14" id="sublabel_14_litemode" style="min-height:13px">Date</label></span>
  496.           </div>
  497.         </div>
  498.       </li>
  499.       <li class="form-line" data-type="control_checkbox" id="id_15"><label class="form-label form-label-top form-label-auto" id="label_15" aria-hidden="false"> Multiple Choice Question </label>
  500.         <div id="cid_15" class="form-input-wide" data-layout="full">
  501.           <div class="form-single-column" role="group" aria-labelledby="label_15" data-component="checkbox"><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_15" type="checkbox" class="form-checkbox" id="input_15_0" name="q15_multipleChoice[]" value="Option 1" /><label id="label_input_15_0" for="input_15_0">Option 1</label></span><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_15" type="checkbox" class="form-checkbox" id="input_15_1" name="q15_multipleChoice[]" value="Option 2" /><label id="label_input_15_1" for="input_15_1">Option 2</label></span><span class="form-checkbox-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_15" type="checkbox" class="form-checkbox" id="input_15_2" name="q15_multipleChoice[]" value="Option 3" /><label id="label_input_15_2" for="input_15_2">Option 3</label></span></div>
  502.         </div>
  503.       </li>
  504.       <li class="form-line" data-type="control_radio" id="id_16"><label class="form-label form-label-top form-label-auto" id="label_16" aria-hidden="false"> Single Choice Question </label>
  505.         <div id="cid_16" class="form-input-wide" data-layout="full">
  506.           <div class="form-single-column" role="group" aria-labelledby="label_16" data-component="radio"><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_16" type="radio" class="form-radio" id="input_16_0" name="q16_singleChoice" value="Option 1" /><label id="label_input_16_0" for="input_16_0">Option 1</label></span><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_16" type="radio" class="form-radio" id="input_16_1" name="q16_singleChoice" value="Option 2" /><label id="label_input_16_1" for="input_16_1">Option 2</label></span><span class="form-radio-item" style="clear:left"><span class="dragger-item"></span><input aria-describedby="label_16" type="radio" class="form-radio" id="input_16_2" name="q16_singleChoice" value="Option 3" /><label id="label_input_16_2" for="input_16_2">Option 3</label></span></div>
  507.         </div>
  508.       </li>
  509.       <li class="form-line" data-type="control_appointment" id="id_17"><label class="form-label form-label-top" id="label_17" for="input_17" aria-hidden="false"> Appointment Question </label>
  510.         <div id="cid_17" class="form-input-wide" data-layout="full">
  511.           <div id="input_17" class="appointmentFieldWrapper jfQuestion-fields"><input class="appointmentFieldInput" name="q17_appointmentQuestion[implementation]" id="input_17implementation" aria-hidden="true" type="hidden" value="new" /><input class="appointmentFieldInput " name="q17_appointmentQuestion[date]" id="input_17_date" data-timeformat="AM/PM" aria-hidden="true" type="hidden" /><input class="appointmentFieldInput" name="q17_appointmentQuestion[duration]" id="input_17_duration" aria-hidden="true" type="hidden" value="60" /><input class="appointmentFieldInput" name="q17_appointmentQuestion[timezone]" id="input_17_timezone" aria-hidden="true" type="hidden" value="America/New_York (GMT-04:00)" />
  512.             <div class="appointmentField"></div>
  513.           </div>
  514.         </div>
  515.       </li>
  516.       <li class="form-line" data-type="control_captcha" id="id_18"><label class="form-label form-label-top form-label-auto" id="label_18" for="input_18" aria-hidden="false"> Captcha Question </label>
  517.         <div id="cid_18" class="form-input-wide" data-layout="full">
  518.           <div class="form-captcha" data-component="captcha"><label for="input_18"><img alt="Captcha - Reload if not displayed" id="input_18_captcha" class="form-captcha-image" style="background:url(https://cdn.jotfor.ms/images/loader-big.gif) no-repeat center" src="https://cdn.jotfor.ms/images/blank.gif" width="150" height="41" /></label>
  519.             <div style="white-space:nowrap"><input type="text" id="input_18" class="form-textbox validate[required]" name="captcha" style="width:130px" /><img src="https://cdn.jotfor.ms/images/reload.png" alt="Reload" style="cursor:pointer;vertical-align:middle" id="input_18_reload" /><input type="hidden" name="captcha_id" id="input_18_captcha_id" value="0" /></div>
  520.           </div>
  521.         </div>
  522.       </li>
  523.       <li class="form-line" data-type="control_scale" id="id_19"><label class="form-label form-label-top form-label-auto" id="label_19" for="input_19" aria-hidden="false"> Scale Question </label>
  524.         <div id="cid_19" class="form-input-wide" data-layout="full"> <span class="form-sub-label-container" style="vertical-align:top">
  525.             <div role="radiogroup" aria-labelledby="label_19 sublabel_input_19_description" cellPadding="4" cellSpacing="0" class="form-scale-table" data-component="scale">
  526.               <div class="rating-item-group">
  527.                 <div class="rating-item"><span class="rating-item-title for-from"><label for="input_19_worst" aria-hidden="true"></label></span><input aria-labelledby="label_input_19" class="form-radio" type="radio" name="q19_scaleQuestion" title="1" id="input_19_1" value="1" /><label for="input_19_1">1</label></div>
  528.                 <div class="rating-item"><input aria-labelledby="label_input_19" class="form-radio" type="radio" name="q19_scaleQuestion" title="2" id="input_19_2" value="2" /><label for="input_19_2">2</label></div>
  529.                 <div class="rating-item"><input aria-labelledby="label_input_19" class="form-radio" type="radio" name="q19_scaleQuestion" title="3" id="input_19_3" value="3" /><label for="input_19_3">3</label></div>
  530.                 <div class="rating-item"><input aria-labelledby="label_input_19" class="form-radio" type="radio" name="q19_scaleQuestion" title="4" id="input_19_4" value="4" /><label for="input_19_4">4</label></div>
  531.                 <div class="rating-item"><span class="rating-item-title for-to"><label for="input_19_best" aria-hidden="true">Best</label></span><input aria-labelledby="label_input_19" class="form-radio" type="radio" name="q19_scaleQuestion" title="5" id="input_19_5" value="5" /><label for="input_19_5">5</label></div>
  532.               </div>
  533.             </div><label class="form-sub-label" id="sublabel_input_19_description" style="border:0;clip:rect(0 0 0 0);height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px;white-space:nowrap">1 is , 5 is Best</label>
  534.           </span> </div>
  535.       </li>
  536.       <li class="form-line" data-type="control_spinner" id="id_20"><label class="form-label form-label-top form-label-auto" id="label_20" for="input_20" aria-hidden="false"> Spinner Question </label>
  537.         <div id="cid_20" class="form-input-wide" data-layout="half">
  538.           <div data-wrapper-react="true"><input type="number" id="input_20" name="q20_spinnerQuestion" data-type="input-spinner" class="form-spinner-input  form-textbox" data-spinnermin="1" data-spinnermax="10" data-defaultvalue="0" data-component="spinner" aria-labelledby="label_20" value="0" /></div>
  539.         </div>
  540.       </li>
  541.       <li class="form-line" data-type="control_time" id="id_21"><label class="form-label form-label-top form-label-auto" id="label_21" for="input_21_hourSelect" aria-hidden="false"> Time Question </label>
  542.         <div id="cid_21" class="form-input-wide" data-layout="half">
  543.           <div data-wrapper-react="true">
  544.             <div class="time-wrapper"><span class="form-sub-label-container hasAMPM" style="vertical-align:top"><input class="time-dropdown form-textbox validate[time]" id="input_21_timeInput" name="q21_timeQuestion[timeInput]" type="text" placeholder="HH : MM" aria-labelledby="label_21 sublabel_21_hour" data-mask="hh:MM" autoComplete="off" data-version="v2" value="" /><input type="hidden" class="form-hidden-time" id="input_21_hourSelect" name="q21_timeQuestion[hourSelect]" /><input type="hidden" class="form-hidden-time" id="input_21_minuteSelect" name="q21_timeQuestion[minuteSelect]" /><label data-seperate-translate="true" class="form-sub-label" for="input_21_timeInput" id="sublabel_21_hour" style="min-height:13px">Hour Minutes</label></span></div>
  545.             <div class="time-wrapper"><span class="form-sub-label-container" style="vertical-align:top"><select class="time-dropdown form-dropdown" id="input_21_ampm" name="q21_timeQuestion[ampm]" data-component="time-ampm" aria-labelledby="label_21 sublabel_21_ampm" autoComplete="off">
  546.                   <option value="AM" selected="">AM</option>
  547.                   <option value="PM">PM</option>
  548.                 </select><label class="form-sub-label" for="input_21_ampm" id="sublabel_21_ampm" style="border:0;clip:rect(0 0 0 0);height:1px;margin:-1px;overflow:hidden;padding:0;position:absolute;width:1px;white-space:nowrap">AM/PM Option</label></span></div>
  549.           </div>
  550.         </div>
  551.       </li>
  552.       <li class="form-line" data-type="control_payment" id="id_22" data-payment="true"><label class="form-label form-label-top" id="label_22" for="input_22" aria-hidden="false"> Product List </label>
  553.         <div id="cid_22" class="form-input-wide" data-layout="full">
  554.           <div data-wrapper-react="true">
  555.             <div data-wrapper-react="true" class="product-container-wrapper">
  556.               <div class="filter-container"></div><input type="hidden" name="simple_fpc" data-payment_type="payment" data-component="payment1" value="22" /><input type="hidden" name="payment_transaction_uuid" id="paymentTransactionId" /><input type="hidden" name="payment_version" id="payment_version" value="4" /><input type="hidden" name="payment_total_checksum" id="payment_total_checksum" data-component="payment2" /><input type="hidden" name="payment_discount_value" id="payment_discount_value" data-component="payment3" />
  557.               <div id="image-overlay" class="overlay-content" style="display:none"><img id="current-image" /><span class="lb-prev-button">prev</span><span class="lb-next-button">next</span><span class="lb-close-button">( X )</span><span class="image-overlay-product-container">
  558.                   <ul class="form-overlay-item" pid="1001" hasicon="false" hasimages="false" iconvalue=""></ul>
  559.                 </span></div>
  560.               <div data-wrapper-react="true"><span class="form-product-item hover-product-item  show_desc new_ui" categories="non-categorized" pid="1001" aria-labelledby="label_22">
  561.                   <div data-wrapper-react="true" class="form-product-item-detail new_ui">
  562.                     <div class="p_col">
  563.                       <div class="p_checkbox"><input class="form-checkbox  form-product-input" type="checkbox" id="input_22_1001" name="q22_productList[][id]" data-inputname="q22_productList[][id]" readonly="" aria-label="Select Product: Product 1" data-is-default-required="false" data-is-default-selected="false" value="1001" />
  564.                         <div class="checked"></div>
  565.                         <div class="select_border"></div>
  566.                       </div>
  567.                     </div>
  568.                     <div class="p_image">
  569.                       <div class="image_area "></div>
  570.                     </div>
  571.                     <div for="input_22_1001" class="form-product-container"><span data-wrapper-react="true">
  572.                         <div class="title_description"><span class="form-product-name" id="product-name-input_22_1001">Product 1</span><span class="form-product-description" id="product-name-description-input_22_1001">Description 1</span></div><span class="form-product-details"><b><span data-wrapper-react="true">$<span id="input_22_1001_price">10.00</span></span></b></span>
  573.                       </span></div>
  574.                     <div class="focus_action_button_container"><a class="btn-inline-product-delete" tabindex="0" role="button" aria-label="Delete Product"> </a><a class="btn-inline-product-settings" tabindex="0" role="button" aria-label="Product Settings"> </a></div>
  575.                   </div>
  576.                 </span>
  577.                 <div class="payment_footer new_ui ">
  578.                   <div class="total_area">
  579.                     <div class="form-payment-total">
  580.                       <div id="total-text">Total</div>
  581.                       <div class="form-payment-price"><span data-wrapper-react="true">$<span id="payment_total">0.00</span></span></div>
  582.                     </div>
  583.                   </div>
  584.                 </div>
  585.               </div>
  586.             </div>
  587.           </div>
  588.         </div>
  589.       </li>
  590.       <li class="form-line" data-type="control_widget" id="id_23">
  591.         <div id="cid_23" class="form-input-wide" data-layout="full">
  592.           <div data-widget-name="" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="52948fb29322cd302b00000c" title="Terms &amp; Condition" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_23" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  593.             <div class="widget-inputs-wrapper"><input id="input_23" class="form-hidden form-widget  " type="hidden" name="q23_termsAnd" value="" /><input id="widget_settings_23" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22termsText%22%2C%22value%22%3A%22I%20agree%20to%20%7Bterms%20%26%20conditions%7D.%22%7D%2C%7B%22name%22%3A%22termsLink%22%2C%22value%22%3A%22www.example.com%22%7D%2C%7B%22name%22%3A%22theme%22%2C%22value%22%3A%22default%22%7D%2C%7B%22name%22%3A%22acceptedText%22%2C%22value%22%3A%22Accepted%22%7D%5D" /></div>
  594.             <script type="text/javascript">
  595.               setTimeout(function()
  596.               {
  597.                 function renderWidget()
  598.                 {
  599.                   var _cFieldFrame = document.getElementById("customFieldFrame_23");
  600.                   if (_cFieldFrame)
  601.                   {
  602.                     _cFieldFrame.onload = function()
  603.                     {
  604.                       if (typeof widgetFrameLoaded !== 'undefined')
  605.                       {
  606.                         widgetFrameLoaded(23,
  607.                         {
  608.                           "formID": 251215002560036
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  610.                       }
  611.                     };
  612.                     _cFieldFrame.src = "//app-widgets.jotform.io/termsConditions/?qid=23&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  613.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '&ndt=1' + '' + '' +
  614.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  615.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  616.                   }
  617.                 }
  618.                 if (false)
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  620.                   var _interval = setInterval(function()
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  622.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  623.                     if (dataMode === 'fillMode')
  624.                     {
  625.                       renderWidget()
  626.                       clearInterval(_interval);
  627.                     }
  628.                   }, 1000);
  629.                 }
  630.                 else
  631.                 {
  632.                   renderWidget();
  633.                 }
  634.               }, 0);
  635.             </script>
  636.           </div>
  637.         </div>
  638.       </li>
  639.       <li class="form-line" data-type="control_widget" id="id_24">
  640.         <div id="cid_24" class="form-input-wide" data-layout="full">
  641.           <div data-widget-name="QR Code" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="52900b6557a7644251000004" title="QR Code" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_24" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  642.             <div class="widget-inputs-wrapper"><input id="input_24" class="form-hidden form-widget  " type="hidden" name="q24_qrCode" value="" /><input id="widget_settings_24" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22qrSize%22%2C%22value%22%3A%22128%22%7D%5D" /></div>
  643.             <script type="text/javascript">
  644.               setTimeout(function()
  645.               {
  646.                 function renderWidget()
  647.                 {
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  650.                   {
  651.                     _cFieldFrame.onload = function()
  652.                     {
  653.                       if (typeof widgetFrameLoaded !== 'undefined')
  654.                       {
  655.                         widgetFrameLoaded(24,
  656.                         {
  657.                           "formID": 251215002560036
  658.                         }, undefined)
  659.                       }
  660.                     };
  661.                     _cFieldFrame.src = "//widgets.jotform.io/qrcode/?qid=24&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  662.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  663.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  664.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  665.                   }
  666.                 }
  667.                 if (false)
  668.                 {
  669.                   var _interval = setInterval(function()
  670.                   {
  671.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  672.                     if (dataMode === 'fillMode')
  673.                     {
  674.                       renderWidget()
  675.                       clearInterval(_interval);
  676.                     }
  677.                   }, 1000);
  678.                 }
  679.                 else
  680.                 {
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  682.                 }
  683.               }, 0);
  684.             </script>
  685.           </div>
  686.         </div>
  687.       </li>
  688.       <li class="form-line" data-type="control_widget" id="id_25"><label class="form-label form-label-top form-label-auto" id="label_25" for="input_25" aria-hidden="false"> Take Photo Field </label>
  689.         <div id="cid_25" class="form-input-wide" data-layout="full">
  690.           <div data-widget-name="Take Photo" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="529c8286a75dae5e7f000005" title="Take Photo" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_25" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  691.             <div class="widget-inputs-wrapper"><input id="input_25" class="form-hidden form-widget  " type="hidden" name="q25_takePhoto" value="" /><input id="widget_settings_25" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22cameraFacing%22%2C%22value%22%3A%22Front%22%7D%2C%7B%22name%22%3A%22takePhotoBtnText%22%2C%22value%22%3A%22Take%20Photo%22%7D%2C%7B%22name%22%3A%22retakePhotoBtnText%22%2C%22value%22%3A%22Retake%20Photo%22%7D%2C%7B%22name%22%3A%22updatePhotoBtnText%22%2C%22value%22%3A%22Update%20Photo%22%7D%2C%7B%22name%22%3A%22notification%22%2C%22value%22%3A%22Your%20photo%20was%20successfully%20uploaded.%22%7D%5D" /></div>
  692.             <script type="text/javascript">
  693.               setTimeout(function()
  694.               {
  695.                 function renderWidget()
  696.                 {
  697.                   var _cFieldFrame = document.getElementById("customFieldFrame_25");
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  699.                   {
  700.                     _cFieldFrame.onload = function()
  701.                     {
  702.                       if (typeof widgetFrameLoaded !== 'undefined')
  703.                       {
  704.                         widgetFrameLoaded(25,
  705.                         {
  706.                           "formID": 251215002560036
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  708.                       }
  709.                     };
  710.                     _cFieldFrame.src = "//widgets.jotform.io/takephoto/?qid=25&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  711.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  712.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  713.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  714.                   }
  715.                 }
  716.                 if (false)
  717.                 {
  718.                   var _interval = setInterval(function()
  719.                   {
  720.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  721.                     if (dataMode === 'fillMode')
  722.                     {
  723.                       renderWidget()
  724.                       clearInterval(_interval);
  725.                     }
  726.                   }, 1000);
  727.                 }
  728.                 else
  729.                 {
  730.                   renderWidget();
  731.                 }
  732.               }, 0);
  733.             </script>
  734.           </div>
  735.         </div>
  736.       </li>
  737.       <li class="form-line" data-type="control_widget" id="id_26"><label class="form-label form-label-top form-label-auto" id="label_26" for="input_26" aria-hidden="false"> Check List Question </label>
  738.         <div id="cid_26" class="form-input-wide" data-layout="full">
  739.           <div data-widget-name="" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="52961c97e3e5266570000004" title="Checklist Widget" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_26" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  740.             <div class="widget-inputs-wrapper"><input id="input_26" class="form-hidden form-widget  " type="hidden" name="q26_checkList" value="" /><input id="widget_settings_26" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22items%22%2C%22value%22%3A%22Option%201%5CnOption%202%5CnOption%203%22%7D%2C%7B%22name%22%3A%22hideunchecked%22%2C%22value%22%3A%22No%22%7D%2C%7B%22name%22%3A%22other%22%2C%22value%22%3A%22No%22%7D%2C%7B%22name%22%3A%22othertext%22%2C%22value%22%3A%22Other%22%7D%5D" /></div>
  741.             <script type="text/javascript">
  742.               setTimeout(function()
  743.               {
  744.                 function renderWidget()
  745.                 {
  746.                   var _cFieldFrame = document.getElementById("customFieldFrame_26");
  747.                   if (_cFieldFrame)
  748.                   {
  749.                     _cFieldFrame.onload = function()
  750.                     {
  751.                       if (typeof widgetFrameLoaded !== 'undefined')
  752.                       {
  753.                         widgetFrameLoaded(26,
  754.                         {
  755.                           "formID": 251215002560036
  756.                         }, undefined)
  757.                       }
  758.                     };
  759.                     _cFieldFrame.src = "//widgets.jotform.io/checklist/?qid=26&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  760.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  761.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  762.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  763.                   }
  764.                 }
  765.                 if (false)
  766.                 {
  767.                   var _interval = setInterval(function()
  768.                   {
  769.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  770.                     if (dataMode === 'fillMode')
  771.                     {
  772.                       renderWidget()
  773.                       clearInterval(_interval);
  774.                     }
  775.                   }, 1000);
  776.                 }
  777.                 else
  778.                 {
  779.                   renderWidget();
  780.                 }
  781.               }, 0);
  782.             </script>
  783.           </div>
  784.         </div>
  785.       </li>
  786.       <li class="form-line" data-type="control_widget" id="id_27"><label class="form-label form-label-top form-label-auto" id="label_27" for="input_27" aria-hidden="false"> Configurable List Field </label>
  787.         <div id="cid_27" class="form-input-wide" data-layout="full">
  788.           <div data-widget-name="" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="533946093c1ad0c45d000070" title="ConfigurableList" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_27" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  789.             <div class="widget-inputs-wrapper"><input id="input_27" class="form-hidden form-widget  " type="hidden" name="q27_configurableList" value="" /><input id="widget_settings_27" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22fields%22%2C%22value%22%3A%22Short%20Text%20%3A%20text%5CnDropdown%20%3A%20dropdown%20%3A%20one%2C%20two%2C%20three%20%3A%20Please%20Select%5CnCalendar%20%3A%20dateInput%20%3A%20m%2Fd%2Fy%5CnTime%3A%20timeInput%20%3A%2012%22%7D%2C%7B%22name%22%3A%22minRowsNumber%22%2C%22value%22%3A%221%22%7D%2C%7B%22name%22%3A%22limit%22%2C%22value%22%3A%220%22%7D%2C%7B%22name%22%3A%22labelAdd%22%2C%22value%22%3A%22%2B%20Add%20Row%22%7D%2C%7B%22name%22%3A%22labelRemove%22%2C%22value%22%3A%22x%22%7D%2C%7B%22name%22%3A%22isTableView%22%2C%22value%22%3A%22undefined%22%7D%5D" /></div>
  790.             <script type="text/javascript">
  791.               setTimeout(function()
  792.               {
  793.                 function renderWidget()
  794.                 {
  795.                   var _cFieldFrame = document.getElementById("customFieldFrame_27");
  796.                   if (_cFieldFrame)
  797.                   {
  798.                     _cFieldFrame.onload = function()
  799.                     {
  800.                       if (typeof widgetFrameLoaded !== 'undefined')
  801.                       {
  802.                         widgetFrameLoaded(27,
  803.                         {
  804.                           "formID": 251215002560036
  805.                         }, undefined)
  806.                       }
  807.                     };
  808.                     _cFieldFrame.src = "//widgets.jotform.io/configurableList/index.html?qid=27&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  809.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  810.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  811.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  812.                   }
  813.                 }
  814.                 if (false)
  815.                 {
  816.                   var _interval = setInterval(function()
  817.                   {
  818.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  819.                     if (dataMode === 'fillMode')
  820.                     {
  821.                       renderWidget()
  822.                       clearInterval(_interval);
  823.                     }
  824.                   }, 1000);
  825.                 }
  826.                 else
  827.                 {
  828.                   renderWidget();
  829.                 }
  830.               }, 0);
  831.             </script>
  832.           </div>
  833.         </div>
  834.       </li>
  835.       <li class="form-line" data-type="control_widget" id="id_28"><label class="form-label form-label-top form-label-auto" id="label_28" for="input_28" aria-hidden="false"> Multiple Text Field </label>
  836.         <div id="cid_28" class="form-input-wide" data-layout="full">
  837.           <div data-widget-name="" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="538dddaa976bf61129000004" title="Multiple Text Fields" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_28" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  838.             <div class="widget-inputs-wrapper"><input id="input_28" class="form-hidden form-widget  " type="hidden" name="q28_multipleText" value="" /><input id="widget_settings_28" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22fields%22%2C%22value%22%3A%22Country%5CnState%5CnCity%5CnStreet%5CnPostal%20code%22%7D%5D" /></div>
  839.             <script type="text/javascript">
  840.               setTimeout(function()
  841.               {
  842.                 function renderWidget()
  843.                 {
  844.                   var _cFieldFrame = document.getElementById("customFieldFrame_28");
  845.                   if (_cFieldFrame)
  846.                   {
  847.                     _cFieldFrame.onload = function()
  848.                     {
  849.                       if (typeof widgetFrameLoaded !== 'undefined')
  850.                       {
  851.                         widgetFrameLoaded(28,
  852.                         {
  853.                           "formID": 251215002560036
  854.                         }, undefined)
  855.                       }
  856.                     };
  857.                     _cFieldFrame.src = "//widgets.jotform.io/multipleTextFields/?qid=28&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  858.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  859.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  860.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  861.                   }
  862.                 }
  863.                 if (false)
  864.                 {
  865.                   var _interval = setInterval(function()
  866.                   {
  867.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  868.                     if (dataMode === 'fillMode')
  869.                     {
  870.                       renderWidget()
  871.                       clearInterval(_interval);
  872.                     }
  873.                   }, 1000);
  874.                 }
  875.                 else
  876.                 {
  877.                   renderWidget();
  878.                 }
  879.               }, 0);
  880.             </script>
  881.           </div>
  882.         </div>
  883.       </li>
  884.       <li class="form-line" data-type="control_widget" id="id_29"><label class="form-label form-label-top form-label-auto" id="label_29" for="input_29" aria-hidden="false"> Smooth Signature Field </label>
  885.         <div id="cid_29" class="form-input-wide" data-layout="full">
  886.           <div data-widget-name="Smooth Signature" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="529467003477f3512000001f" title="Smooth Signature" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_29" src="" style="max-width:310px;border:none;width:100%;height:114px" data-width="310" data-height="114"></iframe>
  887.             <div class="widget-inputs-wrapper"><input id="input_29" class="form-hidden form-widget  " type="hidden" name="q29_smoothSignature" value="" /><input id="widget_settings_29" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%5D" /></div>
  888.             <script type="text/javascript">
  889.               setTimeout(function()
  890.               {
  891.                 function renderWidget()
  892.                 {
  893.                   var _cFieldFrame = document.getElementById("customFieldFrame_29");
  894.                   if (_cFieldFrame)
  895.                   {
  896.                     _cFieldFrame.onload = function()
  897.                     {
  898.                       if (typeof widgetFrameLoaded !== 'undefined')
  899.                       {
  900.                         widgetFrameLoaded(29,
  901.                         {
  902.                           "formID": 251215002560036
  903.                         }, undefined)
  904.                       }
  905.                     };
  906.                     _cFieldFrame.src = "//data-widgets.jotform.io/signature-pad/?qid=29&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  907.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '&ndt=1' + '' + '' +
  908.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  909.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  910.                   }
  911.                 }
  912.                 if (false)
  913.                 {
  914.                   var _interval = setInterval(function()
  915.                   {
  916.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  917.                     if (dataMode === 'fillMode')
  918.                     {
  919.                       renderWidget()
  920.                       clearInterval(_interval);
  921.                     }
  922.                   }, 1000);
  923.                 }
  924.                 else
  925.                 {
  926.                   renderWidget();
  927.                 }
  928.               }, 0);
  929.             </script>
  930.           </div>
  931.         </div>
  932.       </li>
  933.       <li class="form-line" data-type="control_widget" id="id_30"><label class="form-label form-label-top form-label-auto" id="label_30" for="input_30" aria-hidden="false"> Orderable List Field </label>
  934.         <div id="cid_30" class="form-input-wide" data-layout="full">
  935.           <div data-widget-name="Orderable List" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="52943d56dacb3d5320000010" title="Orderable List" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_30" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  936.             <div class="widget-inputs-wrapper"><input id="input_30" class="form-hidden form-widget  " type="hidden" name="q30_orderableList" value="" /><input id="widget_settings_30" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22items%22%2C%22value%22%3A%22alpha%5Cnbeta%5Cngamma%22%7D%5D" /></div>
  937.             <script type="text/javascript">
  938.               setTimeout(function()
  939.               {
  940.                 function renderWidget()
  941.                 {
  942.                   var _cFieldFrame = document.getElementById("customFieldFrame_30");
  943.                   if (_cFieldFrame)
  944.                   {
  945.                     _cFieldFrame.onload = function()
  946.                     {
  947.                       if (typeof widgetFrameLoaded !== 'undefined')
  948.                       {
  949.                         widgetFrameLoaded(30,
  950.                         {
  951.                           "formID": 251215002560036
  952.                         }, undefined)
  953.                       }
  954.                     };
  955.                     _cFieldFrame.src = "//app-widgets.jotform.io/orderPicker/?qid=30&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  956.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  957.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  958.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  959.                   }
  960.                 }
  961.                 if (false)
  962.                 {
  963.                   var _interval = setInterval(function()
  964.                   {
  965.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  966.                     if (dataMode === 'fillMode')
  967.                     {
  968.                       renderWidget()
  969.                       clearInterval(_interval);
  970.                     }
  971.                   }, 1000);
  972.                 }
  973.                 else
  974.                 {
  975.                   renderWidget();
  976.                 }
  977.               }, 0);
  978.             </script>
  979.           </div>
  980.         </div>
  981.       </li>
  982.       <li class="form-line" data-type="control_widget" id="id_31"><label class="form-label form-label-top form-label-auto" id="label_31" for="input_31" aria-hidden="false"> Inventory Field </label>
  983.         <div id="cid_31" class="form-input-wide" data-layout="full">
  984.           <div data-widget-name="Inventory" style="width:100%;text-align:Left;overflow-x:auto" data-component="widget-field"><iframe data-client-id="53bbb6f656bbf16119000011" title="Inventory" frameBorder="0" scrolling="no" allowtransparency="true" allow="geolocation; microphone; camera; autoplay; encrypted-media; fullscreen" data-type="iframe" class="custom-field-frame" id="customFieldFrame_31" src="" style="max-width:580px;border:none;width:100%;height:50px" data-width="580" data-height="50"></iframe>
  985.             <div class="widget-inputs-wrapper"><input id="input_31" class="form-hidden form-widget  " type="hidden" name="q31_inventoryField" value="" /><input id="widget_settings_31" class="form-hidden form-widget-settings" type="hidden" data-version="2" value="%5B%7B%22name%22%3A%22itemName%22%2C%22value%22%3A%223lbs%20at%20%2420%20each%22%7D%2C%7B%22name%22%3A%22inputType%22%2C%22value%22%3A%22Dropdown%22%7D%2C%7B%22name%22%3A%22range%22%2C%22value%22%3A%221-50%22%7D%2C%7B%22name%22%3A%22includeLabel%22%2C%22value%22%3A%22No%22%7D%2C%7B%22name%22%3A%22counterLabel%22%2C%22value%22%3A%22remaining%22%7D%2C%7B%22name%22%3A%22hideQuantityLeft%22%2C%22value%22%3A%22No%22%7D%2C%7B%22name%22%3A%22errorMessage%22%2C%22value%22%3A%22You%20can%20only%20select%20%7Bcount%7D%20item(s)%20or%20less.%22%7D%2C%7B%22name%22%3A%22apiKey%22%2C%22value%22%3A%22encrypted%3AyoMmnk4AYUtIaqA0CaZYwqdZhea0jTqOc3Cv6ks%2B0sZJ0e8uG0hvf%2FfkNgl2QF%2FenW%2F9ewLbwyG6StSlZGquJ0rwFtdE%2BwLq%2F9eqLW7MwIuGn%2FanhAg9XxF4fYpQqrSi%22%7D%5D" /></div>
  986.             <script type="text/javascript">
  987.               setTimeout(function()
  988.               {
  989.                 function renderWidget()
  990.                 {
  991.                   var _cFieldFrame = document.getElementById("customFieldFrame_31");
  992.                   if (_cFieldFrame)
  993.                   {
  994.                     _cFieldFrame.onload = function()
  995.                     {
  996.                       if (typeof widgetFrameLoaded !== 'undefined')
  997.                       {
  998.                         widgetFrameLoaded(31,
  999.                         {
  1000.                           "formID": 251215002560036
  1001.                         }, undefined)
  1002.                       }
  1003.                     };
  1004.                     _cFieldFrame.src = "//app-widgets.jotform.io/inventoryV2/?qid=31&isOpenedInPortal=undefined&isOpenedInAgent=undefined&align=Left&ref=" +
  1005.                      encodeURIComponent(window.location.protocol + "//" + window.location.host) + '' + '' + '' +
  1006.                      '&injectCSS=' + encodeURIComponent(window.location.search.indexOf("ndt=1") > -1);
  1007.                     _cFieldFrame.addClassName("custom-field-frame-rendered");
  1008.                   }
  1009.                 }
  1010.                 if (false)
  1011.                 {
  1012.                   var _interval = setInterval(function()
  1013.                   {
  1014.                     var dataMode = document.querySelector('html').getAttribute('data-mode');
  1015.                     if (dataMode === 'fillMode')
  1016.                     {
  1017.                       renderWidget()
  1018.                       clearInterval(_interval);
  1019.                     }
  1020.                   }, 1000);
  1021.                 }
  1022.                 else
  1023.                 {
  1024.                   renderWidget();
  1025.                 }
  1026.               }, 0);
  1027.             </script>
  1028.           </div>
  1029.         </div>
  1030.       </li>
  1031.       <li class="form-line" data-type="control_button" id="id_32">
  1032.         <div id="cid_32" class="form-input-wide" data-layout="full">
  1033.           <div data-align="auto" class="form-buttons-wrapper form-buttons-auto   jsTest-button-wrapperField"><button id="input_32" type="submit" class="form-submit-button form-submit-button-reports-400 submit-button jf-form-buttons jsTest-submitField legacy-submit" data-component="button" data-content="">Submit</button></div>
  1034.         </div>
  1035.       </li>
  1036.       <li style="display:none">Should be Empty: <input type="text" name="website" value="" type="hidden" /></li>
  1037.     </ul>
  1038.   </div>
  1039.   <script>
  1040.     JotForm.showJotFormPowered = "0";
  1041.   </script>
  1042.   <script>
  1043.     JotForm.poweredByText = "Powered by Jotform";
  1044.   </script><input type="hidden" class="simple_spc" id="simple_spc" name="simple_spc" value="251215002560036" />
  1045.   <script type="text/javascript">
  1046.     var all_spc = document.querySelectorAll("form[id='251215002560036'] .si" + "mple" + "_spc");
  1047.     for (var i = 0; i < all_spc.length; i++)
  1048.    {
  1049.      all_spc[i].value = "251215002560036-251215002560036";
  1050.    }
  1051.  </script>
  1052. </form><script type="text/javascript">JotForm.ownerView=true;</script><script type="text/javascript">JotForm.isAdmin=true;</script><script type="text/javascript">JotForm.isNewSACL=true;</script><div id="form-toolbar" style="display: none"><div class="admin-column left"><div class="embed-dropdown">
  1053.                 <div class="embed-dropdown-header">
  1054.                     <a id="fill-form" class="fill-form">Fill Form</a>
  1055.                     <label class="is-actually-link dropdown-down-icon" for="embed-dropdown-2"></label>
  1056.                 </div>
  1057.                 <input class="embed-dropdown-open" type="checkbox" id="embed-dropdown-2" aria-hidden="true" hidden />
  1058.  
  1059.                 <label for="embed-dropdown-2" class="embed-dropdown-overlay"></label>
  1060.                 <ul class="embed-dropdown-inner fill-form-dropdown">
  1061.                   <li><a id="fill-form-with-fake-data">Fill Form with Fake Data</a></li>
  1062.                 </ul>
  1063.             </div></div><div class="admin-column right"><div class="embed-dropdown">
  1064.                 <label class="is-actually-link" for="embed-dropdown-1">Test Form</label>
  1065.                 <input class="embed-dropdown-open" type="checkbox" id="embed-dropdown-1" aria-hidden="true" hidden />
  1066.  
  1067.                 <label for="embed-dropdown-1" class="embed-dropdown-overlay"></label>
  1068.                 <ul class="embed-dropdown-inner">
  1069.                   <li><a class="embedLink" target="_blank" href="https://www.jotform.com/viewer/?formID=251215002560036&theme=wordpress2">Wordpress Theme</a></li>
  1070.                   <li><a class="embedLink" target="_blank" href="https://www.jotform.com/viewer/?formID=251215002560036&theme=wordpress3">Wordpress Theme 2</a></li>
  1071.                   <li><a class="embedLink" target="_blank" href="https://www.jotform.com/viewer/?formID=251215002560036&theme=wordpress4">Wordpress Theme 3</a></li>
  1072.                   <li><a class="embedLink" target="_blank" href="https://www.jotform.com/viewer/?formID=251215002560036&theme=wordpress5">Wordpress Theme 4</a></li>
  1073.                   <li><a id="openAllEmbed">Open All</a></li>
  1074.                 </ul>
  1075.             </div><a id="open-v4" target="_blank" href="https://www.jotform.com/build/251215002560036">Open in Builder</a><a id="clone-form" target="_blank" href="https://support.jotform.com/admn/cloneform.php?formID=251215002560036&preserveFormType=1">Clone Form</a><a id="open-admin" target="_blank" href="https://support.jotform.com/jfadmin/search.php?keyword=251215002560036">Admin</a><a id="close-bar">✕</a></div></div><link type='text/css' rel='stylesheet' href='/css/styles/adminToolbar.css'><link rel='stylesheet' href='https://cdn.jotfor.ms/fonts/?family=Circular'><script type="text/javascript">function initializeAdminToolBar(){$("fill-form").observe("click", function(e){var s = document.createElement("script");s.src = "/js/form-tester.js?3.3.62583";document.body.appendChild(s);});$("close-bar").observe("click", function(e){$("form-toolbar").remove();});document.querySelector("#fill-form-with-fake-data").addEventListener("click", function(e){var fillFormWithFakeDataScript = document.createElement("script");fillFormWithFakeDataScript.type = "module";fillFormWithFakeDataScript.src = "/js/fillFormWithFakeData.js";document.body.appendChild(fillFormWithFakeDataScript);});$("openAllEmbed").observe("click", function(e){$$("a.embedLink").each(function(item) {window.open(item.getAttribute("href"), "_blank");});});}if (document.readyState == "complete"){initializeAdminToolBar();} else {document.addEventListener("DOMContentLoaded", initializeAdminToolBar);}</script>
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