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Submitted URL: https://www.bookings.mcrail.com.au/
Effective URL: https://form.123formbuilder.com/1257845
Submission: On February 09 via automatic, source certstream-suspicious — Scanned from AU
Effective URL: https://form.123formbuilder.com/1257845
Submission: On February 09 via automatic, source certstream-suspicious — Scanned from AU
Form analysis 1 forms found in the DOM
Name: mainform123 — POST https://form.123formbuilder.com/1257845/MCR-Bookings-Form
<form role="form" aria-label="MCR Bookings Form" class="form js-form" action="https://form.123formbuilder.com/1257845/MCR-Bookings-Form" id="mainform123" method="post" name="mainform123" enctype="multipart/form-data" novalidate="">
<input type="hidden" name="action" value="verify">
<input type="hidden" name="tmp_referer" value="">
<input type="hidden" name="tmp_form_host" value="https://form.123formbuilder.com/1257845">
<input type="hidden" size="30" name="viewformr" id="viewformr" value="cfr_1675923604.6076">
<input type="hidden" name="f_autoresponder" id="f_autoresponder" value="32755">
<input type="hidden" name="special_autoresponder" id="special_autoresponder" value="">
<input type="hidden" name="submXMLDatetimeStart" id="submXMLDatetimeStart" value="2023-02-09 16:20:04">
<input type="hidden" id="language" name="language" value="en"><input type="hidden" id="language-changed" name="languageChanged" value="no">
<div class="class123_maintable maintable_centered form-left-aligned container-normal" style="">
<!-- Form headline begins -->
<div class="optionscontainer headline" tabindex="0" role="alertdialog">
<div id="header-text" role="">
<div class="header-text-container"><span style="font-size:x-large;"><img src="https://s3-us-west-2.amazonaws.com/userdata123/www/htmlblocks-images/621/621307/621307_1257845_56d37a7672190.png" alt="" width="307" height="72"></span>
<hr>
<p></p>
</div>
<div class="clear"></div>
</div>
</div>
<!-- Form headline ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer1" data-idcontainer="10652567" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 focus" style=" ">
<div id="row1" class="fieldtype-0-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10652567" for="id123-control10652567">Client</label><br><label class="class123-labelinfo class123-noprint"
id="id123-titlemic10652567">Name of the client/company</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow1" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input id="id123-control10652567" name="control10652567" onclick=" InputActions(this,'row1');" onkeyup=" InputActions(this,'row1'); " onchange="InputRules(10652567); ; " type="text"
value="" style="width: 200px" aria-required="true" aria-describedby="id123-titlemic10652567" aria-labelledby="id123-title10652567" class="no-validation-error"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer2" data-idcontainer="10841069" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row2" class="fieldtype-6-1 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10841069" for="id123-control10841069-1">Name</label><br><label class="class123-labelinfo" id="id123-titlemic10841069">Your full
name</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow2" value="">
<div class="row control-row">
<div class="subitem col-lg-6 col-md-6 col-sm-6"><input type="text" class="" placeholder="First" id="id123-control10841069-1" value="" name="control10841069-1" onclick=" InputActions(this,'row2');" onkeyup=" InputActions(this,'row2'); "
onchange="InputRules(10841069); ; " aria-required="true" aria-describedby="id123-titlemic10841069" aria-label="Name First">
<div class="clear"></div>
</div>
<div class="subitem col-lg-6 col-md-6 col-sm-6"><input type="text" class="" placeholder="Last" id="id123-control10841069-2" value="" name="control10841069-2" onclick=" InputActions(this,'row2');" onkeyup=" InputActions(this,'row2'); "
onchange="InputRules(10841069); ; " aria-required="true" aria-describedby="id123-titlemic10841069" aria-label="Name Last">
<div class="clear"></div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer3" data-idcontainer="10841066" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row3" class="fieldtype-6-3 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10841066" for="id123-control10841066-1">Phone</label><br><label class="class123-labelinfo" id="id123-titlemic10841066">Your
mobile number</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow3" value="">
<div class="row control-row">
<div class="subitem col-lg-3 col-md-3 col-sm-3"><input type="text" class="autotab123 exclude-validation-layout" placeholder="####" size="4" maxlength="4" id="id123-control10841066-1" value="" name="control10841066-1" data-fieldformat="4"
onclick=" InputActions(this,'row3');" onkeyup=" InputActions(this,'row3'); " onchange="InputRules(10841066); ; " aria-required="true" aria-describedby="id123-titlemic10841066" aria-label="Phone type 4 numbers">
<div class="clear"></div>
</div>
<div class="subitem col-lg-2 col-md-2 col-sm-2"><input type="text" class="autotab123 exclude-validation-layout" placeholder="###" size="3" maxlength="3" id="id123-control10841066-2" value="" name="control10841066-2" data-fieldformat="3"
onclick=" InputActions(this,'row3');" onkeyup=" InputActions(this,'row3'); " onchange="InputRules(10841066); ; " aria-required="true" aria-describedby="id123-titlemic10841066" aria-label="Phone type 3 numbers">
<div class="clear"></div>
</div>
<div class="subitem col-lg-2 col-md-2 col-sm-2"><input type="text" class="autotab123 exclude-validation-layout" placeholder="###" size="3" maxlength="3" id="id123-control10841066-3" value="" name="control10841066-3" data-fieldformat="3"
onclick=" InputActions(this,'row3');" onkeyup=" InputActions(this,'row3'); " onchange="InputRules(10841066); ; " aria-required="true" aria-describedby="id123-titlemic10841066" aria-label="Phone type 3 numbers">
<div class="clear"></div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer4" data-idcontainer="11587800" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row4" class="fieldtype-0-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold " id="id123-title11587800" for="id123-control11587800">Email</label><br><label class="class123-labelinfo" id="id123-titlemic11587800">Your email address</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow4" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input id="id123-control11587800" name="control11587800" onclick=" InputActions(this,'row4');" onkeyup=" InputActions(this,'row4'); " onchange="InputRules(11587800); ; " type="text"
value="" style="width: 200px" aria-describedby="id123-titlemic11587800" aria-labelledby="id123-title11587800"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer5" data-idcontainer="10652694" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row5" class="fieldtype-6-5 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10652694" for="id123-control10652694">Start Date</label><br><label class="class123-labelinfo" id="id123-titlemic10652694">Date
work commences</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow5" value="">
<div class="row control-row">
<div class="subitem col-lg-6 col-md-6 col-sm-6"><input type="text" onclick="InputActions(this,'row5');" onchange="InputRules(10652694); " data-toggle="datepicker" data-week-start="0" class="date-time-input" data-date-format="dd/mm/yyyy"
placeholder="DD/MM/YYYY" value="" name="control10652694" id="id123-control10652694" aria-required="true" aria-describedby="id123-titlemic10652694" aria-label="Start Date DD/MM/YYYY"></div>
</div>
<div class="row control-row"></div>
<div class="row control-row hidden-on-form">
<div class="subitem col-lg-6 col-md-6 col-sm-6"><input type="text" class="no-validation-error date-control" placeholder="DD/MM/YYYY" size="2" maxlength="2" id="id123-control10652694-1" value="" name="control10652694-1"
onclick=" InputActions(this,'row5');" onkeyup=" InputActions(this,'row5'); " onchange="InputRules(10652694); ; " aria-required="true" aria-describedby="id123-titlemic10652694" aria-label="Start Date DD/MM/YYYY">
<div class="clear"></div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer6" data-idcontainer="11592089" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row6" class="fieldtype-0-0 field-validation-5 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title11592089" for="id123-control11592089">Start Time</label><br><label class="class123-labelinfo" id="id123-titlemic11592089">In
24-hr time: e.g. 0700</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow6" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input id="id123-control11592089" name="control11592089" onclick=" InputActions(this,'row6');" onkeyup=" InputActions(this,'row6'); " onchange="InputRules(11592089); ; " type="text"
value="" style="width: 200px" aria-required="true" aria-describedby="id123-titlemic11592089" aria-labelledby="id123-title11592089"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer7" data-idcontainer="11587740" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row7" class="fieldtype-0-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title11587740" for="id123-control11587740">Work Location</label><br><label class="class123-labelinfo"
id="id123-titlemic11587740">Meeting place e.g. S.M. Office</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow7" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input id="id123-control11587740" name="control11587740" onclick=" InputActions(this,'row7');" onkeyup=" InputActions(this,'row7'); " onchange="InputRules(11587740); ; " type="text"
value="" style="width: 200px" aria-required="true" aria-describedby="id123-titlemic11587740" aria-labelledby="id123-title11587740"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer8" data-idcontainer="10951757" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row8" class="fieldtype-0-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10951757" for="id123-control10951757">Site Contact Name</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow8" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input id="id123-control10951757" name="control10951757" onclick=" InputActions(this,'row8');" onkeyup=" InputActions(this,'row8'); " onchange="InputRules(10951757); ; " type="text"
value="" style="width: 200px" aria-required="true" aria-labelledby="id123-title10951757"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer9" data-idcontainer="10951763" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row9" class="fieldtype-6-3 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10951763" for="id123-control10951763-1">Site Contact Mobile</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow9" value="">
<div class="row control-row">
<div class="subitem col-lg-3 col-md-3 col-sm-3"><input type="text" class="autotab123 exclude-validation-layout" placeholder="####" size="4" maxlength="4" id="id123-control10951763-1" value="" name="control10951763-1" data-fieldformat="4"
onclick=" InputActions(this,'row9');" onkeyup=" InputActions(this,'row9'); " onchange="InputRules(10951763); ; " aria-required="true" aria-label="Site Contact Mobile type 4 numbers">
<div class="clear"></div>
</div>
<div class="subitem col-lg-2 col-md-2 col-sm-2"><input type="text" class="autotab123 exclude-validation-layout" placeholder="###" size="3" maxlength="3" id="id123-control10951763-2" value="" name="control10951763-2" data-fieldformat="3"
onclick=" InputActions(this,'row9');" onkeyup=" InputActions(this,'row9'); " onchange="InputRules(10951763); ; " aria-required="true" aria-label="Site Contact Mobile type 3 numbers">
<div class="clear"></div>
</div>
<div class="subitem col-lg-2 col-md-2 col-sm-2"><input type="text" class="autotab123 exclude-validation-layout" placeholder="###" size="3" maxlength="3" id="id123-control10951763-3" value="" name="control10951763-3" data-fieldformat="3"
onclick=" InputActions(this,'row9');" onkeyup=" InputActions(this,'row9'); " onchange="InputRules(10951763); ; " aria-required="true" aria-label="Site Contact Mobile type 3 numbers">
<div class="clear"></div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer10" data-idcontainer="10652747" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row10" class="fieldtype-4-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold requiredfield " id="id123-title10652747" for="id123-control10652747">Staff Type</label><br><label class="class123-labelinfo" id="id123-titlemic10652747">Please
select staff required</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow10" value="">
<div class="row control-row select-imp-width">
<div class="subitem col-lg-6 select-imp-width col-md-6 col-sm-6">
<div class="select2-container select2-extra class123-select select2-updated" id="s2id_id123-control10652747" style="width: 100%;">
<a tabindex="-1" class="select2-choice no-text-decoration" onclick="return false;" href="javascript:void(0)"><span class="select2-chosen no-text-decoration">PO1</span><abbr class="select2-search-choice-close"></abbr><span class="select2-arrow"><b></b></span></a>
</div><select id="id123-control10652747" onclick=" InputActions(this,'row10');" onkeyup=" InputActions(this,'row10'); " onchange="InputRules(10652747); ; " name="control10652747"
style="position: absolute; max-width: 100%; opacity: 0.001; height: 32px; width: 100%; margin-top: -32px; display: block;" class="class123-select select2-updated" aria-required="true" aria-describedby="id123-titlemic10652747">
<option value="PO1" selected="selected">PO1</option>
<option value="PO2">PO2</option>
<option value="PO3">PO3</option>
<option value="PO4">PO4</option>
<option value="Power Out Permit">Power Out Permit</option>
<option value="Handsignaller">Handsignaller</option>
<option value="PICOW">PICOW</option>
<option value="Spotter">Spotter</option>
<option value="Traffic Officer">Traffic Officer</option>
<option value="Carpenter">Carpenter</option>
<option value="Zone Marshall">Zone Marshall</option>
<option value="Other (Comment in notes)">Other (Comment in notes)</option>
</select>
</div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer11" data-idcontainer="11591924" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row11" class="fieldtype-4-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold " id="id123-title11591924" for="id123-control11591924">Additional Staff Type</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow11" value="">
<div class="row control-row select-imp-width">
<div class="subitem col-lg-6 select-imp-width col-md-6 col-sm-6">
<div class="select2-container select2-extra class123-select select2-updated" id="s2id_id123-control11591924" style="width: 100%;">
<a tabindex="-1" class="select2-choice no-text-decoration" onclick="return false;" href="javascript:void(0)"><span class="select2-chosen no-text-decoration">N/A</span><abbr class="select2-search-choice-close"></abbr><span class="select2-arrow"><b></b></span></a>
</div><select id="id123-control11591924" onclick=" InputActions(this,'row11');" onkeyup=" InputActions(this,'row11'); " onchange="InputRules(11591924); ; " name="control11591924"
style="position: absolute; max-width: 100%; opacity: 0.001; height: 32px; width: 100%; margin-top: -32px; display: block;" class="class123-select select2-updated">
<option value="N/A" selected="selected">N/A</option>
<option value="PO1">PO1</option>
<option value="PO2">PO2</option>
<option value="PO3">PO3</option>
<option value="PO4">PO4</option>
<option value="Power Out Permit">Power Out Permit</option>
<option value="Handsignaller">Handsignaller</option>
<option value="PICOW">PICOW</option>
<option value="Spotter">Spotter</option>
<option value="Traffic Officer">Traffic Officer</option>
<option value="KK Tester">KK Tester</option>
<option value="Labourer">Labourer</option>
<option value="Carpenter">Carpenter</option>
<option value="Other (Comment in notes)">Other (Comment in notes)</option>
</select>
</div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer12" data-idcontainer="10652594" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row12" class="fieldtype-3-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname fontbold requiredfield " id="id123-title10652594" for="id123-control10652594_0">Power-Out Permit</label><br><label class="class123-labelinfo" id="id123-titlemic10652594">Please select
one</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow12" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input style="background:transparent;border:0;float:left;" title="Yes" type="radio" id="id123-control10652594_0" onclick=" InputActions(this,'row12');"
onkeyup=" InputActions(this,'row12'); " onchange="InputRules(10652594); ; " name="control10652594" value="Yes" aria-required="true" aria-describedby="id123-titlemic10652594"><label style=" opacity: 1; "
class=" class123-label class123-radio" for="id123-control10652594_0"><span class="outside"><span class="inside"></span></span><span class="label-text"><span class="label-cont">Yes</span></span></label><span
class="checkboxSeparator full-width"></span> <input style="background:transparent;border:0;float:left;" title="No" type="radio" id="id123-control10652594_1" onclick=" InputActions(this,'row12');"
onkeyup=" InputActions(this,'row12'); " onchange="InputRules(10652594); ; " name="control10652594" value="No" aria-required="true" aria-describedby="id123-titlemic10652594"><label style=" opacity: 1; "
class=" class123-label class123-radio" for="id123-control10652594_1"><span class="outside"><span class="inside"></span></span><span class="label-text"><span class="label-cont">No</span></span></label>
<div class="row no-padding-vert"></div>
</div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- fieldcontainer -->
<div id="fieldcontainer13" data-idcontainer="11587755" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row13" class="fieldtype-0-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold " id="id123-title11587755" for="id123-control11587755">Purchase Order No.</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow13" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input id="id123-control11587755" name="control11587755" onclick=" InputActions(this,'row13');" onkeyup=" InputActions(this,'row13'); " onchange="InputRules(11587755); ; " type="text"
value="" style="width: 200px" aria-labelledby="id123-title11587755"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- DO-NOT-DELETE:UPLOADS-NEEDED-FLAG -->
<!-- fieldcontainer -->
<div id="fieldcontainer14" data-idcontainer="10951710" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row14" class="fieldtype-6-9 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname fontbold " id="id123-title10951710" for="id123-control10951710">File Upload</label><br><label class="class123-labelinfo dblock" id="id123-titlemic10951710">Purchase orders, maps, etc. Maximum
Limit 20MB</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow14" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12"><input type="text" style="display:none;" id="id123-control10951710" aria-describedby="id123-titlemic10951710" aria-labelledby="id123-title10951710">
<!-- The global progress bar -->
<div id="progress-1" class="progress">
<div>Uploading, please wait...</div>
<div class="progress-bar progress-bar-success"></div>
</div>
<!-- The fileinput-button span is used to style the file input field as button -->
<span class="btn fileinput-button form1257845" id="fileinput-button-1" data-upload-index="1"> Upload <!-- The file input field used as target for the file upload widget -->
<input class="low_zindex_upload_button" aria-describedby="id123-titlemic10951710" aria-labelledby="id123-title10951710" id="fileupload-1" type="file" name="file1">
</span>
<!-- The container for the uploaded files -->
<div id="newfilesattached-1" class="files" style="margin-bottom:2px;"></div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<!-- DO-NOT-DELETE:UPLOADS-NEEDED-FLAG -->
<!-- fieldcontainer -->
<div id="fieldcontainer15" data-idcontainer="11587741" class="fieldcontainer currentPage1 currentPageActive fieldwidth100 " style=" ">
<div id="row15" class="fieldtype-1-0 row row-fluid currentPage1 currentPageActive">
<div class="subitem col-lg-3 rowleft col-md-3 col-sm-3">
<label class="class123-label class123-fieldname class123-labelAligned fontbold " id="id123-title11587741" for="id123-control11587741">Notes</label><br><label class="class123-labelinfo" id="id123-titlemic11587741">For additional staff,
please specify amount and qualifications required</label>
</div>
<div class="subitem col-lg-9 rowright align-left col-md-9 col-sm-9"><input type="hidden" id="errorflagrow15" value="">
<div class="row control-row">
<div class="subitem col-lg-12 col-md-12 col-sm-12">
<div class="textarea-container force_block"><textarea id="id123-control11587741" name="control11587741" onclick=" InputActions(this,'row15');" onkeyup=" InputActions(this,'row15'); " onchange="InputRules(11587741); ; " rows="8"
style="width: 200px" aria-describedby="id123-titlemic11587741"></textarea></div>
</div>
<div class="clear"></div>
</div>
</div>
</div>
</div>
<!-- fieldcontainer ends -->
<div class="row">
<div class="subitem col-lg-12 col-md-12 col-sm-12">
<div id="checkout_form_con"></div>
</div>
</div>
<!-- Buttons begin here -->
<div id="fieldcontainer16" class="fieldcontainer thebuttons" style="">
<div class="row currentPage1 currentPageActive">
<div class="rowright col-lg-12 col-md-12 col-sm-12 btn-row-right" align="center" style="text-align: center !important;"><input type="hidden" name="go_back_and_edit" id="go_back_and_edit" value="0">
<input type="hidden" name="submissionUniqueId" value="pending_63e4909499a21">
<button
onclick="insertPleaseWaitDiv(this,'Please wait...'); ; (function(self){ UploadManager.setSubmitOriginButton( self ); var hiddenInput = document.createElement('input'); $(hiddenInput).attr('name', this.name || '').attr('value', this.value || '').attr('type', 'hidden'); $(self.form).append(hiddenInput); })(this); "
type="submit" class="no-default-image btn submit-btn formdefaultbut ripple-effect" style="background-color:#FF6700;" id="id123-button-send" value="Submit">Submit</button>
</div>
</div>
<div class="clear"></div>
</div>
<!-- fieldcontainer ends -->
<!-- Buttons end here -->
</div>
<input type="hidden" name="PHPSESSID" value="0gn23nhe9gjhs39pt1ctl09p31">
<div class="spam-trap">
<input type="text" name="email">
</div>
<input type="hidden" name="hiddenfields" id="hiddenfields" value="">
<input type="hidden" name="hiddenfields_pages" id="hiddenfields_pages" value="">
<input type="hidden" name="activepage" id="activepage" value="1">
<input type="hidden" name="totalpages" id="totalpages" value="1">
<input type="hidden" name="nextpagenr" id="nextpagenr" value="2">
<input type="hidden" name="prevpagenr" id="prevpagenr" value="0">
</form>Text Content
-------------------------------------------------------------------------------- Client Name of the client/company Name Your full name Phone Your mobile number Email Your email address Start Date Date work commences Start Time In 24-hr time: e.g. 0700 Work Location Meeting place e.g. S.M. Office Site Contact Name Site Contact Mobile Staff Type Please select staff required PO1 PO1 PO2 PO3 PO4 Power Out Permit Handsignaller PICOW Spotter Traffic Officer Carpenter Zone Marshall Other (Comment in notes) Additional Staff Type N/A N/A PO1 PO2 PO3 PO4 Power Out Permit Handsignaller PICOW Spotter Traffic Officer KK Tester Labourer Carpenter Other (Comment in notes) Power-Out Permit Please select one Yes No Purchase Order No. File Upload Purchase orders, maps, etc. Maximum Limit 20MB Uploading, please wait... Upload Notes For additional staff, please specify amount and qualifications required Submit