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		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
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		<field type="header" subtype="h2" label="Roommate Preference"/>&#13;
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			<option label="I understand" value="i-understand">I understand</option>&#13;
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<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
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		<field type="header" subtype="h2" label="Roommate Preference"/>&#13;
		<field type="text" label="Full name" name="emergency-contact-full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="emergency-contact-phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="I understand my roommate for this booking must pay their deposit in order to secure accommodations for both.&amp;nbsp;&amp;nbsp;" name="i-understand-my-roommate-for-this-booking-must-pay-their-deposit-in-order-to-secure-accommodations-for-both-">&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
			<option label="I have some questions." value="i-have-some-questions">I have some questions.</option>&#13;
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	</fields>&#13;
</form-template>
  </body>
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