{"status":"ok","result":"\r\n\r\n<form data-provide=\"validator\" id=\"formSubmission\" action=\"\/apps\/form_zone\/modules\/formzonemodule\/formzone_submit.php?request=submit-form\" method=\"post\" enctype=\"multipart\/form-data\" class=\"payment-display\"> \r\n       \r\n    <div class=\"panel panel-primary form-horizontal\">\r\n        <div class=\"panel-heading\">Form<\/div>\r\n        <div class=\"panel-body\">\r\n            <div class=\"form-wrapper\">\r\n                <div role=\"alert\" class=\"alert alert-info\">\r\n                    Populate the fields in the form and when complete, submit the form for processing.\r\n                <\/div>\r\n                <h1>Headmistress' Breakfast Feedback Form<\/h1>\r\n                <div style=\"background-color: transparent !important; color: black !important; border-color: black !important\" class=\"form-horizontal\">\r\n                    \r\n                            <div class=\"form-field parent-field\">\r\n                                <div class=\"form-group\">\r\n                                    <label class=\"col-sm-3 control-label\"><span class=\"text-danger\">* <\/span>Submitted by<\/label>\r\n                                    <div class=\"col-sm-7\">\r\n                                        <div class=\"row\">\r\n                                            <div class=\"col-sm-5 col-xs-6\">\r\n                                                <input type=\"text\" data-validate=\"text-required\" placeholder=\"Your first name\" class=\"form-control\" name=\"first-name\">\r\n                                            <\/div>\r\n                                            <div class=\"col-sm-7 col-xs-6\">\r\n                                                <input type=\"text\" data-validate=\"text-required\" placeholder=\"Your last name\" class=\"form-control\" name=\"last-name\">\r\n                                            <\/div>\r\n                                        <\/div>\r\n                                    <\/div>\r\n                                <\/div>\r\n                            <\/div>\r\n                            <div class=\"form-field parent-field\">\r\n                                <div class=\"form-group\">\r\n                                    <div class=\"col-sm-offset-3 col-sm-7\">\r\n                                        <input type=\"text\" data-validate=\"email-required\" placeholder=\"Your email address\" class=\"form-control\" name=\"replay-email\">\r\n                                    <\/div>\r\n                                <\/div>\r\n                            <\/div>\r\n                            \r\n                    \r\n\r\n                    \r\n\r\n                     \r\n                    \r\n                    \r\n                    <div class=\"form-field form-hr-preview parent-field\">\r\n                        <hr style=\"border-top: 1px solid black\"\/>\r\n                    <\/div>\r\n                    \r\n                    \r\n                    <div id=\"form-details\" class=\"\">\r\n                        <div data-conditions=\"\" class=\"form-field parent-field formbuild_30513\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Student Name<\/label><div class=\"col-sm-7\"><div class=\"row\"><div class=\"col-xs-6\"><input type=\"text\" name=\"form_30513[]\" value=\"\" class=\"form-control\" placeholder=\"First name\" data-validate=\"text\" ><\/div><div class=\"col-xs-6\"><input type=\"text\" name=\"form_30513[]\" value=\"\" class=\"form-control\" placeholder=\"Surname\" data-validate=\"text\" ><\/div><\/div><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30500\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Date<\/label><div class=\"col-sm-7\"><div class=\"row\"><div class=\"col-xs-12\"><div class=\"input-group form-date\">\r\n                                                    <input type=\"text\" class=\"form-control\" placeholder=\"Select the date\" readonly=\"readonly\"   data-format=\"dd\/MM\/yyyy\" name=\"form_30500\" value=\"\">\r\n                                                    <span class=\"input-group-btn add-on\">\r\n                                                        <button type=\"button\" class=\"btn btn-primary\">\r\n                                                            <span class=\"glyphicon glyphicon-calendar\"><\/span>\r\n                                                        <\/button>\r\n                                                    <\/span>\r\n                                                <\/div><\/div><\/div><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30501\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Overall opinion of the Breakfast<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30501\"  ><option value=\"Excellent\" >Excellent<\/option><option value=\"Good\" >Good<\/option><option value=\"Average\" >Average<\/option><option value=\"Poor\" >Poor<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30503\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Headmistress' Address<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30503\"  ><option value=\"Excellent\" >Excellent<\/option><option value=\"Good\" >Good<\/option><option value=\"Average\" >Average<\/option><option value=\"Poor\" >Poor<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30502\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Student tour guide<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30502\"  ><option value=\"Excellent\" >Excellent<\/option><option value=\"Good\" >Good<\/option><option value=\"Average\" >Average<\/option><option value=\"Poor\" >Poor<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30504\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Length of the event<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30504\"  ><option value=\"Too short\" >Too short<\/option><option value=\"just right\" >just right<\/option><option value=\"too long\" >too long<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30505\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Ease with which you booked the event<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30505\"  ><option value=\"very easy\" >very easy<\/option><option value=\"easy\" >easy<\/option><option value=\"difficult\" >difficult<\/option><option value=\"very difficult\" >very difficult<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30506\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Quality of information you received before the event (SHSK website, communications from the Admissions team)<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30506\"  ><option value=\"Excellent\" >Excellent<\/option><option value=\"Good\" >Good<\/option><option value=\"Average\" >Average<\/option><option value=\"Poor\" >Poor<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30507\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">The helpfulness of staff and students you met at the event<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30507\"  ><option value=\"Very helpful\" >Very helpful<\/option><option value=\"Helpful\" >Helpful<\/option><option value=\"Unhelpful\" >Unhelpful<\/option><option value=\"Very Unhelpful\" >Very Unhelpful<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30508\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">What was your daughter's opinion of the event?<\/label><div class=\"col-sm-7\"><textarea rows=\" 5 \" class=\"form-control\" name=\"form_30508\"  placeholder=\"\"><\/textarea><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30509\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">What could we do to improve this event?<\/label><div class=\"col-sm-7\"><textarea rows=\" 5 \" class=\"form-control\" name=\"form_30509\"  placeholder=\"\"><\/textarea><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30510\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Was there anything else you would have liked to see or anyone else you would have liked to meet?<\/label><div class=\"col-sm-7\"><textarea rows=\" 5 \" class=\"form-control\" name=\"form_30510\"  placeholder=\"\"><\/textarea><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30511\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Are you more or less likely to pursue an application to St Helen's as a result of this event?<\/label><div class=\"col-sm-7\"><select class=\"form-control\" name=\"form_30511\"  ><option value=\"More likely\" >More likely<\/option><option value=\"No change\" >No change<\/option><option value=\"Less likely\" >Less likely<\/option><option value=\"We will not pursue an application\" >We will not pursue an application<\/option><option value=\"We have already registered\" >We have already registered<\/option><\/select><\/div>\r\n                        <\/div><\/div><div data-conditions=\"\" class=\"form-field parent-field formbuild_30512\" ><div class=\"form-group\"><label class=\"col-sm-3 control-label\">Any other comments?<\/label><div class=\"col-sm-7\"><textarea rows=\" 5 \" class=\"form-control\" name=\"form_30512\"  placeholder=\"\"><\/textarea><\/div>\r\n                        <\/div><\/div>\r\n                    <\/div>\r\n                    \r\n                <\/div>\r\n                <div class=\"form-field padding-top no-payment\">\r\n                    <div class=\"form-group\">\r\n                        <label class=\"col-sm-3 control-label\">Summary<\/label>\r\n                        <div class=\"col-sm-7\">\r\n                            <div class=\"btn-group summary-button\">\r\n                                <button class=\"btn btn-default\" data-repeat=\"yes\" type=\"button\">Yes<\/button>\r\n                                <button class=\"btn btn-default\" data-repeat=\"no\" type=\"button\">No<\/button>\r\n                            <\/div>\r\n                            <input type=\"hidden\" id=\"summary\" name=\"summary\" value=\"yes\">\r\n                            <p class=\"help-block\" style=\"color:black\">Choose to download a summary of the data entered into the form upon submitting.<\/p>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n                \r\n                <div class=\"form-field no-payment\">\r\n                    <div class=\"form-group\">\r\n                        <label class=\"col-sm-3 control-label\">Confirmation E-mail<\/label>\r\n                        <div class=\"col-sm-7\">\r\n                            <div class=\"btn-group\" data-toggle=\"buttons\">\r\n                                <label class=\"btn btn-default active\">\r\n                                    <input type=\"radio\" checked name=\"emailConfirmation\" value=\"yes\"> Yes\r\n                                <\/label>\r\n                                <label class=\"btn btn-default\">\r\n                                    <input type=\"radio\" name=\"emailConfirmation\" value=\"no\"> No\r\n                                <\/label>\r\n                            <\/div>\r\n                            <p class=\"help-block\" style=\"color:black\">Choose to receive a confirmation e-mail upon submitting.<\/p>\r\n                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n                \r\n                \r\n                \r\n                    <div class=\"g-recaptcha\" data-sitekey=\"6LeQY1wUAAAAAL60dZUsSEJmYh5UYT0UjV3SmP9H\" data-badge=\"inline\" data-size=\"invisible\" data-callback=\"onSubmit\"><\/div>\r\n                            \r\n            <\/div>\r\n            <div class=\"submitted-wrapper hide\">\r\n                <p class=\"form-control-static\">Thank you for your submission.<\/p>\r\n            <\/div>\r\n        <\/div>\r\n        \r\n    <\/div>    \r\n    \r\n    <div class=\"well well-sm no-payment\">\r\n        <div class=\"btn-toolbar dropup\">\r\n            <input type=\"hidden\" name=\"fieldIds\" value=\"[&quot;30513&quot;,&quot;30500&quot;,&quot;30501&quot;,&quot;30503&quot;,&quot;30502&quot;,&quot;30504&quot;,&quot;30505&quot;,&quot;30506&quot;,&quot;30507&quot;,&quot;30508&quot;,&quot;30509&quot;,&quot;30510&quot;,&quot;30511&quot;,&quot;30512&quot;]\"\/>\r\n            <input type=\"hidden\" name=\"formId\" value=\"2489\"\/>\r\n            <input type=\"hidden\" name=\"sharedId\" value=\"\"\/>\r\n            <input type=\"hidden\" name=\"submissionType\" value=\"single\" id=\"submissionType\"\/>\r\n            <input type=\"hidden\" name=\"submissionId\" value=\"\" id=\"submissionId\"\/>\r\n            <input type=\"hidden\" name=\"flag\" value=\"submit\" id=\"flag\"\/>\r\n            <input type=\"hidden\" name=\"roleId\" value=\"319\" id=\"roleId\"\/>\r\n            <input type=\"hidden\" name=\"formPreview\" value=\"0\" id=\"formPreview\"\/>\r\n            <a class=\"btn pull-right btn-success submit\" id=\"submit-form\"><span class=\"glyphicon glyphicon-check\"><\/span> Submit<\/a>\r\n            \r\n        <\/div>\r\n    <\/div>\r\n        \r\n<\/form>\r\n\r\n<script src=\"https:\/\/www.google.com\/recaptcha\/api.js\" async defer><\/script>\r\r\n"}