Service Request

<form-template>
	<fields>
		<field type="text" subtype="text" required="true" label="Name" class="form-control text-input" name="text-1667579396434"></field>
		<field type="text" subtype="text" required="true" label="Land Location or Civic Address" class="form-control text-input" name="text-1667579409310"></field>
		<field type="text" subtype="email" required="true" label="Email" class="form-control text-input" name="text-1667579402683"></field>
		<field type="text" subtype="text" required="true" label="Phone" class="form-control text-input" name="text-1667579397584"></field>
		<field type="select" required="true" label="What can we help you with?" class="form-control select" name="select-1732889542580">
			<option selected="true">Road Maintenance Request</option>
			<option>General Inquiry</option>
			<option>Development or Building Inquiry</option>
		</field>
		<field type="textarea" required="true" label="Message" class="form-control text-area" name="textarea-1667579412318"></field>
	</fields>
</form-template>

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