{"id":1549,"date":"2021-07-03T16:34:10","date_gmt":"2021-07-03T16:34:10","guid":{"rendered":"https:\/\/beable.com.my\/?page_id=1549"},"modified":"2021-07-03T16:34:12","modified_gmt":"2021-07-03T16:34:12","slug":"submit-resume-page","status":"publish","type":"page","link":"https:\/\/beable.com.my\/ja\/submit-resume-page\/","title":{"rendered":"submit resume page"},"content":{"rendered":"<form action=\"\/ja\/wp-json\/wp\/v2\/pages\/1549\" method=\"post\" id=\"submit-resume-form\" class=\"job-manager-form\" enctype=\"multipart\/form-data\" data-trp-original-action=\"\/ja\/wp-json\/wp\/v2\/pages\/1549\">\n\n\t\n\t\n\t\t    <fieldset class=\"fieldset-login_required\">\n        <label>Have an account?<\/label>\n        <div class=\"field account-sign-in\">\n            <a class=\"button\" href=\"https:\/\/beable.com.my\/ja\/register-login\/#jh-login-tab-content\">Sign in<\/a>\n\n            \n                If you don&rsquo;t have an account you can create one below by entering your email address. Your account details will be confirmed via email.\n                    <\/div>\n    <\/fieldset>\n\n    \n\n\t\n\t\n\t\t<!-- Resume Fields -->\n\t\t\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_name\">\n\t\t\t\t<label for=\"candidate_name\">Your name<\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_name\" id=\"candidate_name\" placeholder=\"Your full name\" value=\"\" maxlength=\"\" required \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_email\">\n\t\t\t\t<label for=\"candidate_email\">Your email<\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_email\" id=\"candidate_email\" placeholder=\"you@yourdomain.com\" value=\"\" maxlength=\"\" required \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_title\">\n\t\t\t\t<label for=\"candidate_title\">Professional title<\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_title\" id=\"candidate_title\" placeholder=\"e.g. &quot;Web Developer&quot;\" value=\"\" maxlength=\"\" required \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_location\">\n\t\t\t\t<label for=\"candidate_location\">Location<\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_location\" id=\"candidate_location\" placeholder=\"e.g. &quot;London, UK&quot;, &quot;New York&quot;, &quot;Houston, TX&quot;\" value=\"\" maxlength=\"\" required \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_photo\">\n\t\t\t\t<label for=\"candidate_photo\">Photo <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<div class=\"job-manager-uploaded-files\">\n\t<\/div>\n\n<input\n\ttype=\"file\"\n\tclass=\"input-text\"\n\tdata-file_types=\"jpg|jpeg|gif|png\"\n\t accept=\".jpg,.jpeg,.gif,.png\"\t\t\t\t\tname=\"candidate_photo\"\n\tid=\"candidate_photo\"\n\tplaceholder=\"\"\n\/>\n<small class=\"description\">\n\t\t\u6700\u5927\u30d5\u30a1\u30a4\u30eb\u30b5\u30a4\u30ba: 100 MB\u3002<\/small>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_video\">\n\t\t\t\t<label for=\"candidate_video\">Video <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_video\" id=\"candidate_video\" placeholder=\"A link to a video about yourself\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_twitter\">\n\t\t\t\t<label for=\"candidate_twitter\">Twitter <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_twitter\" id=\"candidate_twitter\" placeholder=\"your twitter page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_facebook\">\n\t\t\t\t<label for=\"candidate_facebook\">Facebook <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_facebook\" id=\"candidate_facebook\" placeholder=\"your facebook page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_googleplus\">\n\t\t\t\t<label for=\"candidate_googleplus\">Google+ <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_googleplus\" id=\"candidate_googleplus\" placeholder=\"your google plus page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_linkedin\">\n\t\t\t\t<label for=\"candidate_linkedin\">Linked in <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_linkedin\" id=\"candidate_linkedin\" placeholder=\"your linked in page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_instagram\">\n\t\t\t\t<label for=\"candidate_instagram\">Instagram <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_instagram\" id=\"candidate_instagram\" placeholder=\"your instagram page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_youtube\">\n\t\t\t\t<label for=\"candidate_youtube\">Youtube <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_youtube\" id=\"candidate_youtube\" placeholder=\"your youtube page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_behance\">\n\t\t\t\t<label for=\"candidate_behance\">Behance <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_behance\" id=\"candidate_behance\" placeholder=\"your behance page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_pinterest\">\n\t\t\t\t<label for=\"candidate_pinterest\">Pinterest <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_pinterest\" id=\"candidate_pinterest\" placeholder=\"your pinterest page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_github\">\n\t\t\t\t<label for=\"candidate_github\">Github <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<input type=\"text\" class=\"input-text\" name=\"candidate_github\" id=\"candidate_github\" placeholder=\"your github in page link\" value=\"\" maxlength=\"\"  \/>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_experience\">\n\t\t\t\t<label for=\"resume_experience\">Candidate Experience <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select name='resume_experience[]' id='resume_experience' class='job-manager-category-dropdown' multiple='multiple' data-placeholder='Choose a experience\u2026' data-no_results_text='\u4e00\u81f4\u3059\u308b\u7d50\u679c\u304c\u3042\u308a\u307e\u305b\u3093' data-multiple_text='\u30aa\u30d7\u30b7\u30e7\u30f3\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044'>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_current_salary\">\n\t\t\t\t<label for=\"resume_current_salary\">Candidate Current Salary <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select name='resume_current_salary[]' id='resume_current_salary' class='job-manager-category-dropdown' multiple='multiple' data-placeholder='Choose a current salary\u2026' data-no_results_text='\u4e00\u81f4\u3059\u308b\u7d50\u679c\u304c\u3042\u308a\u307e\u305b\u3093' data-multiple_text='\u30aa\u30d7\u30b7\u30e7\u30f3\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044'>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_expected_salary\">\n\t\t\t\t<label for=\"resume_expected_salary\">Candidate Expected Salary <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select name='resume_expected_salary[]' id='resume_expected_salary' class='job-manager-category-dropdown' multiple='multiple' data-placeholder='Choose a expected salary\u2026' data-no_results_text='\u4e00\u81f4\u3059\u308b\u7d50\u679c\u304c\u3042\u308a\u307e\u305b\u3093' data-multiple_text='\u30aa\u30d7\u30b7\u30e7\u30f3\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044'>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_education_level\">\n\t\t\t\t<label for=\"resume_education_level\">Candidate Education Level <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select name='resume_education_level[]' id='resume_education_level' class='job-manager-category-dropdown' multiple='multiple' data-placeholder='Choose a education level\u2026' data-no_results_text='\u4e00\u81f4\u3059\u308b\u7d50\u679c\u304c\u3042\u308a\u307e\u305b\u3093' data-multiple_text='\u30aa\u30d7\u30b7\u30e7\u30f3\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044'>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_language\">\n\t\t\t\t<label for=\"resume_language\">Candidate Language <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select name='resume_language[]' id='resume_language' class='job-manager-category-dropdown' multiple='multiple' data-placeholder='Choose a language\u2026' data-no_results_text='\u4e00\u81f4\u3059\u308b\u7d50\u679c\u304c\u3042\u308a\u307e\u305b\u3093' data-multiple_text='\u30aa\u30d7\u30b7\u30e7\u30f3\u3092\u9078\u629e\u3057\u3066\u304f\u3060\u3055\u3044'>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_content\">\n\t\t\t\t<label for=\"resume_content\">Resume Content<\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<div id=\"wp-resume_content-wrap\" class=\"wp-core-ui wp-editor-wrap tmce-active\"><link rel='stylesheet' id='dashicons-css' href='https:\/\/beable.com.my\/wp-includes\/css\/dashicons.min.css?ver=b5532cd02a25ec0b860d9a6100a1f76f' media='all' \/>\n<link rel='stylesheet' id='editor-buttons-css' href='https:\/\/beable.com.my\/wp-includes\/css\/editor.min.css?ver=b5532cd02a25ec0b860d9a6100a1f76f' media='all' \/>\n<style> .mce-top-part button { background-color: rgba(0,0,0,0.0) !important; } <\/style>\n<div id=\"wp-resume_content-editor-container\" class=\"wp-editor-container\"><textarea class=\"wp-editor-area\" rows=\"8\" autocomplete=\"off\" cols=\"40\" name=\"resume_content\" id=\"resume_content\"><\/textarea><\/div>\n<\/div>\n\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-links\">\n\t\t\t\t<label for=\"links\">URL(s) <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t\n<a href=\"#\" class=\"resume-manager-add-row\" data-row=\"\t\t&lt;div class=&quot;resume-manager-data-row&quot;&gt;\t\t\t&lt;input type=&quot;hidden&quot; class=&quot;repeated-row-index&quot; name=&quot;repeated-row-links[]&quot; value=&quot;%%repeated-row-index%%&quot; \/&gt;\t\t\t&lt;a href=&quot;#&quot; class=&quot;resume-manager-remove-row&quot;&gt;Remove&lt;\/a&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-name&quot;&gt;\t\t\t\t\t&lt;label for=&quot;name&quot;&gt;Name&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;links_name_%%repeated-row-index%%&quot; id=&quot;name&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-url&quot;&gt;\t\t\t\t\t&lt;label for=&quot;url&quot;&gt;URL&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;links_url_%%repeated-row-index%%&quot; id=&quot;url&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t&lt;\/div&gt;\t\">+ Add URL<\/a>\n<small class=\"description\">Optionally provide links to any of your websites or social network profiles.<\/small>\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_gender\">\n\t\t\t\t<label for=\"resume_gender\">Candidate Gender <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select  name='resume_gender' id='resume_gender' class='postform'>\n\t<option value='' selected='selected'>Choose a gender\u2026<\/option>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-resume_age\">\n\t\t\t\t<label for=\"resume_age\">Candidate Age <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t<select  name='resume_age' id='resume_age' class='postform'>\n\t<option value='' selected='selected'>Choose a age\u2026<\/option>\n<\/select>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_education\">\n\t\t\t\t<label for=\"candidate_education\">Education <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t\n<a href=\"#\" class=\"resume-manager-add-row\" data-row=\"\t\t&lt;div class=&quot;resume-manager-data-row&quot;&gt;\t\t\t&lt;input type=&quot;hidden&quot; class=&quot;repeated-row-index&quot; name=&quot;repeated-row-candidate_education[]&quot; value=&quot;%%repeated-row-index%%&quot; \/&gt;\t\t\t&lt;a href=&quot;#&quot; class=&quot;resume-manager-remove-row&quot;&gt;Remove&lt;\/a&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-location&quot;&gt;\t\t\t\t\t&lt;label for=&quot;location&quot;&gt;School name&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;candidate_education_location_%%repeated-row-index%%&quot; id=&quot;location&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-qualification&quot;&gt;\t\t\t\t\t&lt;label for=&quot;qualification&quot;&gt;Qualification(s)&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;candidate_education_qualification_%%repeated-row-index%%&quot; id=&quot;qualification&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-date&quot;&gt;\t\t\t\t\t&lt;label for=&quot;date&quot;&gt;Start\/end date&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;candidate_education_date_%%repeated-row-index%%&quot; id=&quot;date&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-notes&quot;&gt;\t\t\t\t\t&lt;label for=&quot;notes&quot;&gt;Notes &lt;small&gt;(optional)&lt;\/small&gt;&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;textarea cols=&quot;20&quot; rows=&quot;3&quot; class=&quot;input-text&quot; name=&quot;candidate_education_notes_%%repeated-row-index%%&quot; id=&quot;notes&quot; placeholder=&quot;&quot; maxlength=&quot;&quot; &gt;&lt;\/textarea&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t&lt;\/div&gt;\t\">+ Add Education<\/a>\n\t\t\t\t<\/div>\n\t\t\t<\/fieldset>\n\t\t\t\t\t<fieldset class=\"fieldset-candidate_experience\">\n\t\t\t\t<label for=\"candidate_experience\">Experience <small>(optional)<\/small><\/label>\n\t\t\t\t<div class=\"field\">\n\t\t\t\t\t\n<a href=\"#\" class=\"resume-manager-add-row\" data-row=\"\t\t&lt;div class=&quot;resume-manager-data-row&quot;&gt;\t\t\t&lt;input type=&quot;hidden&quot; class=&quot;repeated-row-index&quot; name=&quot;repeated-row-candidate_experience[]&quot; value=&quot;%%repeated-row-index%%&quot; \/&gt;\t\t\t&lt;a href=&quot;#&quot; class=&quot;resume-manager-remove-row&quot;&gt;Remove&lt;\/a&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-employer&quot;&gt;\t\t\t\t\t&lt;label for=&quot;employer&quot;&gt;Employer&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;candidate_experience_employer_%%repeated-row-index%%&quot; id=&quot;employer&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-job_title&quot;&gt;\t\t\t\t\t&lt;label for=&quot;job_title&quot;&gt;Job Title&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;candidate_experience_job_title_%%repeated-row-index%%&quot; id=&quot;job_title&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-date&quot;&gt;\t\t\t\t\t&lt;label for=&quot;date&quot;&gt;Start\/end date&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;input type=&quot;text&quot; class=&quot;input-text&quot; name=&quot;candidate_experience_date_%%repeated-row-index%%&quot; id=&quot;date&quot; placeholder=&quot;&quot; value=&quot;&quot; maxlength=&quot;&quot; required \/&gt;\t\t\t\t\t&lt;\/div&gt;\t\t\t\t&lt;\/fieldset&gt;\t\t\t\t\t\t\t&lt;fieldset class=&quot;fieldset-notes&quot;&gt;\t\t\t\t\t&lt;label for=&quot;notes&quot;&gt;Notes &lt;small&gt;(optional)&lt;\/small&gt;&lt;\/label&gt;\t\t\t\t\t&lt;div class=&quot;field&quot;&gt;\t\t\t\t\t\t&lt;textarea cols=&quot;20&quot; rows=&quot;3&quot; 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