Form Builder

Application Nameorbeon Form Namepublic-records Form TitleOrbeon Demo: Public Records Act Request Form Form Description<div>This is an example based on the State of California Public Records Act Request Form. It shows the use of:</div> <div> <ul><li>merged section templates</li><li>the Handwritten Signature form control</li><li>repeated grid with a maximum number of repetitions</li><li>a PDF template, with custom PDF template field names</li></ul> </div> /fr/service/persistence/crud/orbeon/builder/data/f2d5187098bfd0e60de353ed7bb9a2f5021b3ee8/497a7a7b97fcf8c58377b1d922b7bbb2d95c49c2.bin true { "inline" : true, "hidden_input" : false, "language" : "en", "statusbar" : false, "menubar" : false, "plugins" : "lists link", "toolbar" : "bold italic | bullist numlist outdent indent | link", "browser_spellcheck" : true, "encoding" : "xml", "entity_encoding" : "raw", "forced_root_block" : "div", "visual_table_class" : "fr-tinymce-table", "skin" : false, "convert_urls" : false, "sandbox_iframes" : true, "convert_unsafe_embeds": true }

It appears that you are using . Form Builder is likely not working properly with this browser. We recommend you upgrade to or newer, or use Google Chrome, Firefox, or Safari. If we made a mistake and you are not using , please let us know.

NameMissing or incorrect value

Date Missing or incorrect value

Company

Mailing street addressMissing or incorrect value

Street address line 2

Phone number

Preferred method of contact in the event of questionsMissing or incorrect value

CityMissing or incorrect value

State, territory, or military post Missing or incorrect value

Urbanization

Fax number

Zip codeMissing or incorrect value

Requested record

Requested recordMissing or incorrect value

Time period covering documents requestedMissing or incorrect value

Signature of requester

Mark this checkbox if you'd like to type HTML tags Click to enter a label Type your label here Click to add a hint Type your hint here Click to enter text Type your text here

Click to enter a section title Type your section title

Form Builder

Orbeon Demo: Public Records Act Request Form

Requester information

Requested records