Shippable-ls.github.io/referenceform.html at master · Shippable-ls/Shippable-ls.github.io · GitHub

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<html>

<meta name="viewport" content="width=device-width, initial-scale=1.0 user-scalable=no"/>

<head>
  <link rel="stylesheet" type="text/css" href="css/referenceform.css">

<p> &nbsp; R_Block Reference</p>

</head>

<body>

  <div class="outer">
  <div class="middle">
    <div class="inner">

      <div id="Candidate">Candidate</div>
      <div id="Referee">Referee</div>


<form id="test-form">

  <div>
    <label class="label"></label>
    <input type="hidden" id ="form_field_1" name="form_field_1" placeholder="Candidate ID"/>
  </div>

  <div>
    <div class="label" id="Q1">...</div>
               <textarea id ="form_field_2" name="form_field_2" type="text" placeholder=""></textarea>
    <input type="hidden" id ="form_field_3" name="form_field_3" placeholder="Question ID"/>
  </div>

  <div>
    <div class="label" id="Q2">...</div>
               <textarea id ="form_field_4" name="form_field_4" type="text" placeholder=""></textarea>
    <input type="hidden" id ="form_field_5" name="form_field_5" placeholder="Question ID"/>
  </div>

 <div>
    <div class="label" id="Q3">...</div>
               <textarea id ="form_field_6" name="form_field_6" type="text" placeholder=""></textarea>
    <input type="hidden" id ="form_field_7" name="form_field_7" placeholder="Question ID"/>
  </div>

  <div>
    <div class="label" id="Q4">...</div>
               <textarea id ="form_field_8" name="form_field_8" type="text" placeholder=""></textarea>
    <input type="hidden" id ="form_field_9" name="form_field_9" placeholder="Question ID"/>
    <input type="hidden" id ="form_field_10" name="form_field_10" placeholder="Candidate"/>
    <input type="hidden" id ="form_field_11" name="form_field_11" placeholder="Referee"/>
  </div>

  <div>
    <input type="submit" id="submit-form" onclick="" value="Submit">
  </div>

</form>

<div id="Note"> <br></br>  Sent securely to luke@rblock.co</div>

 </div>
</div>
</div>

<script src="js/md5.js"></script>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.1.1/jquery.min.js"></script>
<script src="js/jquery.serialize-object.min.js"></script>
<script src="js/referenceform.js"></script>


</body>
</html>