<form-template> <fields> <field type="checkbox-group" label="Are you registering a Cat or a Dog ?" class="checkbox-group" name="checkbox-group-1679334070758"> <option value="Cat" selected="true">Cat</option> <option value="Dog">Dog</option> </field> <field type="text" subtype="text" label="Name of Animal Owner" class="form-control text-input" name="text-1675976901909"></field> <field type="text" subtype="text" label="Street Address" class="form-control text-input" name="text-1675976916457"></field> <field type="text" subtype="text" label="Box Number" class="form-control text-input" name="text-1675976942904"></field> <field type="text" subtype="text" label="Telephone Number" class="form-control text-input" name="text-1675976955738"></field> <field type="paragraph" subtype="output" label="Description of animal being licensed: " class="paragraph"></field> <field type="text" subtype="text" label="Name" class="form-control text-input" name="text-1675977026204"></field> <field type="text" subtype="text" label="Breed" class="form-control text-input" name="text-1675977034447"></field> <field type="text" subtype="text" label="Age" class="form-control text-input" name="text-1675977044446"></field> <field type="text" subtype="text" label="Sex" class="form-control text-input" name="text-1675977068343"></field> <field type="checkbox-group" label="Sterilized/Neutered" class="checkbox-group" name="checkbox-group-1675977125401"> <option value="Yes" selected="true">Yes</option> <option value="No">No</option> </field> <field type="text" subtype="text" label="Colour" class="form-control text-input" name="text-1675977105969"></field> <field type="date" label="Rabies Shot Date" class="form-control calendar" name="date-1675977200717"></field> <field type="paragraph" subtype="p" label="I certify the above information to be correct." class="paragraph"></field> <field type="date" label="Today's Date" class="form-control calendar" name="date-1675977288399"></field> <field type="text" subtype="text" label="Name of Owner" class="form-control text-input" name="text-1675977314871"></field> <field type="paragraph" subtype="p" label="Payment can be made by E-transfer to kiptown@sasktel.net. Please note in the memo what the payment is for, or by Credit Card over the telephone 306-736-2515. " class="paragraph"></field> <field type="paragraph" subtype="p" label="For Office Use Only:" class="paragraph"></field> <field type="text" subtype="text" label="Licence Number:" class="form-control text-input" name="text-1679333855290"></field> <field type="text" subtype="text" label="Fee Paid:" class="form-control text-input" name="text-1675977377764"></field> <field type="text" subtype="text" label="Issuer:" class="form-control text-input" name="text-1679333921654"></field> </fields> </form-template> Submit Submitting...