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<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-select-title'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-select-title"
placeholder="${ parent.decodeEntities(`Select`) } "
isSearchable=${false}
options=${[{"label":"Ms.","value":"value-1","isDisabled":false},{"label":"Mrs.","value":"value-2","isDisabled":false},{"label":"Mr.","value":"value-3","isDisabled":false}]}
value=${parent.getValue("mf-select-title") ? [{"label":"Ms.","value":"value-1","isDisabled":false},{"label":"Mrs.","value":"value-2","isDisabled":false},{"label":"Mr.","value":"value-3","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select-title"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-select-title")}
ref=${() => {
register({ name: "mf-select-title" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-select-title") === '' && false ) {
parent.setValue( 'mf-select-title', '', true );
parent.handleChange({
target: {
name: 'mf-select-title',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-select-title"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-first-name"
as=${html``}
/>
${ parent.decodeEntities(`Enter your first name here`) }
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-middle-name"
as=${html``}
/>
${ parent.decodeEntities(`Enter your middle name here`) }
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-last-name"
as=${html``}
/>
${ parent.decodeEntities(`Enter your lst name here`) }
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-telephone"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","emailMessage":"Please enter a valid Email address","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-email"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Date`) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":true},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-number"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-address"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-city"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-state"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":true,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-zip"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-EMERGENCY"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-RALAY"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-PHONE"
as=${html``}
/>
<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-select"
placeholder="${ parent.decodeEntities(`Select`) } "
isSearchable=${false}
options=${[{"label":"Trucking dispatcher","value":"Trucking dispatcher","isDisabled":false},{"label":"Sales manager","value":"value-2S","isDisabled":false},{"label":"OTR Owner Operator","value":"value-3O","isDisabled":false}]}
value=${parent.getValue("mf-select") ? [{"label":"Trucking dispatcher","value":"Trucking dispatcher","isDisabled":false},{"label":"Sales manager","value":"value-2S","isDisabled":false},{"label":"OTR Owner Operator","value":"value-3O","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-select")}
ref=${() => {
register({ name: "mf-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-select") === '' && false ) {
parent.setValue( 'mf-select', '', true );
parent.handleChange({
target: {
name: 'mf-select',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-select"
as=${html``}
/>
2. TRUCK DRIVER APPLICATION
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","required":false,"file_types":[".jpg",".jpeg",".gif",".png"],"type_message":"Invalid file extension","size_limit":-1,"limit_message":"This field is required."}, el) }
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-file-uploadcdl"
as=${html``}
/>
${parent.getFileLabel( 'mf-file-uploadcdl', 'No file chosen.' )}
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text-issue"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date-cdl-exp"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(``) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date-cdl-exp')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date-cdl-exp'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date-cdl-exp"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(``) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","required":false,"file_types":[".jpg",".jpeg",".gif",".png"],"type_message":"Invalid file extension","size_limit":-1,"limit_message":"This field is required."}, el) }
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-file-upload"
as=${html``}
/>
${parent.getFileLabel( 'mf-file-upload', 'No file chosen.' )}
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text-current"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date-start"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Date`) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date-start')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date-start'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date-start"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date-end"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Date`) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date-end')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date-end'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date-end"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text-position"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-telephone-pos-phone"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text-pos-state"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text-pos-city"
as=${html``}
/>
{
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-text-pos-address"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-number-ACCIDENTS"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-number-PREV-ACCIDENTS"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false,"expression":"null"}, el)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-number-TICKETS"
as=${html``}
/>
<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-select"
placeholder="${ parent.decodeEntities(`Select`) } "
isSearchable=${false}
options=${[{"label":" Less than 6 months ","value":"value-1-6MONTH","isDisabled":false},{"label":"Less than 1 year ","value":"value-2-1YEARSLESS","isDisabled":false},{"label":" More than 1 year ","value":"value-3-1YEARS","isDisabled":false},{"label":"More than 2 years ","value":"Input Value-2YEARS","isDisabled":false}]}
value=${parent.getValue("mf-select") ? [{"label":" Less than 6 months ","value":"value-1-6MONTH","isDisabled":false},{"label":"Less than 1 year ","value":"value-2-1YEARSLESS","isDisabled":false},{"label":" More than 1 year ","value":"value-3-1YEARS","isDisabled":false},{"label":"More than 2 years ","value":"Input Value-2YEARS","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-select")}
ref=${() => {
register({ name: "mf-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-select") === '' && false ) {
parent.setValue( 'mf-select', '', true );
parent.handleChange({
target: {
name: 'mf-select',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-select"
as=${html``}
/>
parent.activateValidation({"message":"This field is required.","required":false,"file_types":[".jpg",".jpeg",".gif",".png"],"type_message":"Invalid file extension","size_limit":-1,"limit_message":"This field is required."}, el) }
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-file-upload-MVR"
as=${html``}
/>
${parent.getFileLabel( 'mf-file-upload-MVR', 'No file chosen.' )}
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-textarea"
as=${html``}
/>
<${props.Flatpickr}
name="mf-date-DUI"
className="mf-input mf-date-input mf-left-parent "
placeholder="${ parent.decodeEntities(`Date`) } "
options=${{"minDate":"","maxDate":"","dateFormat":"m-d-Y","enableTime":"","disable":[],"mode":"single","static":true,"disableMobile":true,"time_24hr":false}}
value=${parent.getValue('mf-date-DUI')}
onInput=${parent.handleDateTime}
aria-invalid=${validation.errors['mf-date-DUI'] ? 'true' : 'false'}
ref=${el => props.DateWidget(
el,
'',
{"message":"This field is required.","required":false},
register,
parent
)}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-date-DUI"
as=${html``}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-textarea444"
as=${html``}
/>
3. ADDITIONAL INFO
<${props.Select}
className=${"mf-input mf-input-select " + ( validation.errors['mf-select'] ? 'mf-invalid' : '' )}
classNamePrefix="mf_select"
name="mf-select"
placeholder="${ parent.decodeEntities(`Select`) } "
isSearchable=${false}
options=${[{"label":" 2+ years of verifiable tractor-trailer experience ","value":"value-1","isDisabled":false},{"label":" 1-2 years of verifiable tractor-trailer experience ","value":"value-2","isDisabled":false},{"label":" 6 months - 1 year of verifiable tractor-trailer experience ","value":"value-3","isDisabled":false},{"label":" less than 6 months of verifiable tractor-trailer experience ","value":"Input Value","isDisabled":false}]}
value=${parent.getValue("mf-select") ? [{"label":" 2+ years of verifiable tractor-trailer experience ","value":"value-1","isDisabled":false},{"label":" 1-2 years of verifiable tractor-trailer experience ","value":"value-2","isDisabled":false},{"label":" 6 months - 1 year of verifiable tractor-trailer experience ","value":"value-3","isDisabled":false},{"label":" less than 6 months of verifiable tractor-trailer experience ","value":"Input Value","isDisabled":false}].filter(item => item.value === parent.getValue("mf-select"))[0] : []}
onChange=${(e)=> parent.handleSelect(e, "mf-select")}
ref=${() => {
register({ name: "mf-select" }, parent.activateValidation({"message":"This field is required.","minLength":1,"maxLength":"","type":"none","required":false}));
if ( parent.getValue("mf-select") === '' && false ) {
parent.setValue( 'mf-select', '', true );
parent.handleChange({
target: {
name: 'mf-select',
value: ''
}
});
}
}}
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-select"
as=${html``}
/>
<${props.SignaturePad}
clearButton="true"
penColor=""
name="mf-signature"
onEnd=${function () { parent.handleSignature(this) }}
/>
parent.activateValidation({"message":"This field is required.","required":false}, el) }
/>
<${validation.ErrorMessage}
errors=${validation.errors}
name="mf-signature"
as=${html``}
/>
parent.activateValidation({"message":"reCAPTCHA is required.","required":true}, el)}
/>
<${validation.ErrorMessage} errors=${validation.errors} name="g-recaptcha-response" as=${html``} />