New Online Form Request
1.
Request Date
2.
Your Contact Information
First Name
Phone Number
Last Name
Department / Organization
Email
Website
3.
Information Regarding the requested form
Form Name
Form needed before:
4.
Will this form collect
confidential
or
Personally Identifiable Information
?
Yes
No
5.
Will this form be open for a specific time period?
Yes - Do not allow users to fill this form out after a certain date and time
No - This form will stay active until the department decides to remove it from the website
Other : (Please specify)
6.
Welcome Message (If any)
7.
List the items that will be required/mandatory in this form.
List of required fields
8.
List the items that will be optional in this form.
List of optional fields
9.
If you have the form as a document, please upload here:
(File types allowed: PDF, Doc and Docx only)
10.
What
"Thank you"
message should be displayed once someone submits the form?
Thank you message:
11.
Do you want us to notify you via email whenever someone submits this form online?
If yes, please provide an email address
Email Address
What would you like to see in that notification?
List of fields for notification
12.
Besides you, who will need access to this form?
Access To:
User Info
View Reports
Download Data
First Name
Last Name
Email Address
User 1
User 2
User 3
User 4
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