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contact-congress/members/R000605.yaml
amy-chinlai f4e75dae06 Update R000605.yaml - topic options
2025-09-19 10:07:55 -04:00

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bioguide: R000605
contact_form:
method: post
action: "https://www.rounds.senate.gov/contact/email-mike"
steps:
- visit: "https://www.rounds.senate.gov/contact/email-mike"
- javascript:
- value: document.querySelector('.SiteLayout__main').innerHTML = '<div class=\"TypeDropdowns js-dropdown\"><div class=\"TypeDropdowns__container\"><label for=\"issue-dropdowns\" class=\"sr-only\">Select a Dropdown</label><select class=\"InputSelect js-dropdown-item\" name=\"issue-dropdowns\" id=\"issue-dropdowns\"><option value=\"\" selected=\"\" disabled=\"\">How Can I Help You</option>\<option data-uid=\"002DA741-4040-F985-52CD-7028167EDB88\" value=\"opinion\">Share your opinions or comment on legislation or issues</option>\<option data-uid=\"A48E78F0-4040-F985-52CD-539B0D52B52A\" value=\"meeting\">Scheduling Request</option>\<option data-uid=\"001D1157-4040-F985-52CD-64B94B832659\" value=\"federal_agency\">Help with a federal agency</option>\<option data-uid=\"A493CEC9-4040-F985-52CD-01C2C7AE2899\" value=\"tour\">Tour Request</option>\<option data-uid=\"0020A15D-4040-F985-52CD-18B56701EED8\" value=\"flag\">Request a flag to be flown over the Capitol</option>\</select>\<div class=\"row no-gutters mt-3\">\<div id=\"002DA741-4040-F985-52CD-7028167EDB88\" style=\"\" class=\"RawHTML col-12 js-topicDesc\">\<div class=\"RawHTML\"><div id=\"form-4873565B-4040-F985-52CD-58F5E3BCC94D\" class=\"amend-form-container loaded\"><form id=\"4873565B-4040-F985-52CD-58F5E3BCC94D\" action=\"https&#58;//www.rounds.senate.gov/contact/email-mike\" method=\"post\"><fieldset><legend>Your Name</legend><div class=\"control-group\"><div class=\"controls\"><input id=\"prefixend\" name=\"input_4F6942A9-5056-A066-60F7-EF49A7A049D0\" type=\"hidden\"></div></div><div class=\"row\"><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"prefixselect\">Prefix</label><div class=\"controls\"><select id=\"prefixselect\" name=\"input_4F6942DF-5056-A066-6035-28DF3CDC6FEC\"><option value=\"\">--- Please Select an Option ---</option><option value=\"None\">None</option><option value=\"Mr.\">Mr.</option><option value=\"Ms.\">Ms.</option><option value=\"Mrs.\">Mrs.</option><option value=\"Professor\">Professor</option><option value=\"Dr.\">Dr.</option><option value=\"Father\">Father</option><option value=\"Sister\">Sister</option><option value=\"Rabbi\">Rabbi</option><option value=\"Reverend\">Reverend</option><option value=\"General\">Air Force - General</option><option value=\"Lieutenant General\">Air Force - Lieutenant General</option><option value=\"Major General\">Air Force - Major General</option><option value=\"Brigadier General\">Air Force - Brigadier General</option><option value=\"Colonel\">Air Force - Colonel</option><option value=\"Lieutenant Colonel\">Air Force - Lieutenant Colonel</option><option value=\"Major\">Air Force - Major</option><option value=\"Captain\">Air Force - Captain</option><option value=\"First Lieutenant\">Air Force - First Lieutenant</option><option value=\"Second Lieutenant\">Air Force - Second Lieutenant</option><option value=\"Chief Master Sergeant of the Air Force\">Air Force - Chief Master Sergeant of the Air Force</option><option value=\"Command Chief Master Sergeant\">Air Force - Command Chief Master Sergeant</option><option value=\"First Sergeant (E-9)\">Air Force - First Sergeant (E-9)</option><option value=\"Chief Master Sergeant\">Air Force - Chief Master Sergeant</option><option value=\"First Sergeant (E-8)\">Air Force - First Sergeant (E-8)</option><option value=\"Senior Master Sergeant\">Air Force - Senior Master Sergeant</option><option value=\"First Sergeant (E-7)\">Air Force - First Sergeant (E-7)</option><option value=\"Master Sergeant\">Air Force - Master Sergeant</option><option value=\"Technical Sergeant\">Air Force - Technical Sergeant</option><option value=\"Staff Sergeant\">Air Force - Staff Sergeant</option><option value=\"Senior Airman\">Air Force - Senior Airman</option><option value=\"Airman First Class\">Air Force - Airman First Class</option><option value=\"Airman\">Air Force - Airman</option><option value=\"Airman Basic\">Air Force - Airman Basic</option><option value=\"General\">Army - General</option><option value=\"Lieutenant General\">Army - Lieutenant General</option><option value=\"Major General\">Army - Major General</option><option value=\"Brigadier General\">Army - Brigadier General</option><option value=\"Colonel\">Army - Colonel</option><option value=\"Lieutenant Colonel\">Army - Lieutenant Colonel</option><option value=\"Major\">Army - Major</option><option value=\"Captain\">Army - Captain</option><option value=\"First Lieutenant\">Army - First Lieutenant</option><option value=\"Second Lieutenant\">Army - Second Lieutenant</option><option value=\"Chief Warrant Officer - 5\">Army - Chief Warrant Officer - 5</option><option value=\"Chief Warrant Officer - 4\">Army - Chief Warrant Officer - 4</option><option value=\"Chief Warrant Officer - 3\">Army - Chief Warrant Officer - 3</option><option value=\"Chief Warrant Officer - 2\">Army - Chief Warrant Officer - 2</option><option value=\"Warrant Officer\">Army - Warrant Officer</option><option value=\"Sergeant Major of the Army\">Army - Sergeant Major of the Army</option><option value=\"Command Sergeant Major\">Army - Command Sergeant Major</option><option value=\"Sergeant Major\">Army - Sergeant Major</option><option value=\"First Sergeant\">Army - First Sergeant</option><option value=\"Master Sergeant\">Army - Master Sergeant</option><option value=\"Sergeant First Class\">Army - Sergeant First Class</option><option value=\"Staff Sergeant\">Army - Staff Sergeant</option><option value=\"Sergeant\">Army - Sergeant</option><option value=\"Corporal\">Army - Corporal</option><option value=\"Specialist\">Army - Specialist</option><option value=\"Private First Class\">Army - Private First Class</option><option value=\"Private (E-2)\">Army - Private (E-2)</option><option value=\"Private\">Army - Private</option><option value=\"Admiral\">Coast Guard - Admiral</option><option value=\"Vice Admiral\">Coast Guard - Vice Admiral</option><option value=\"Rear Admiral, Upper Half\">Coast Guard - Rear Admiral, Upper Half</option><option value=\"Rear Admiral, Lower Half\">Coast Guard - Rear Admiral, Lower Half</option><option value=\"Captain\">Coast Guard - Captain</option><option value=\"Commander\">Coast Guard - Commander</option><option value=\"Lieutenant Commander\">Coast Guard - Lieutenant Commander</option><option value=\"Lieutenant\">Coast Guard - Lieutenant</option><option value=\"Lieutenant Junior Grade\">Coast Guard - Lieutenant Junior Grade</option><option value=\"Ensign\">Coast Guard - Ensign</option><option value=\"Chief Warrant Officer - 4\">Coast Guard - Chief Warrant Officer - 4</option><option value=\"Chief Warrant Officer - 3\">Coast Guard - Chief Warrant Officer - 3</option><option value=\"Chief Warrant Officer - 2\">Coast Guard - Chief Warrant Officer - 2</option><option value=\"Master Chief Petty Officer of the Coast Guard\">Coast Guard - Master Chief Petty Officer of the Coast Guard</option><option value=\"Master Chief Petty Officer\">Coast Guard - Master Chief Petty Officer</option><option value=\"Senior Chief Petty Officer\">Coast Guard - Senior Chief Petty Officer</option><option value=\"Chief Petty Officer\">Coast Guard - Chief Petty Officer</option><option value=\"Petty Officer First Class\">Coast Guard - Petty Officer First Class</option><option value=\"Petty Officer Second Class\">Coast Guard - Petty Officer Second Class</option><option value=\"Petty Officer Third Class\">Coast Guard - Petty Officer Third Class</option><option value=\"Seaman\">Coast Guard - Seaman</option><option value=\"Seaman Apprentice\">Coast Guard - Seaman Apprentice</option><option value=\"Seaman Recruit\">Coast Guard - Seaman Recruit</option><option value=\"General\">Marine Corps - General</option><option value=\"Lieutenant General\">Marine Corps - Lieutenant General</option><option value=\"Major General\">Marine Corps - Major General</option><option value=\"Brigadier General\">Marine Corps - Brigadier General</option><option value=\"Colonel\">Marine Corps - Colonel</option><option value=\"Lieutenant Colonel\">Marine Corps - Lieutenant Colonel</option><option value=\"Major\">Marine Corps - Major</option><option value=\"Captain\">Marine Corps - Captain</option><option value=\"First Lieutenant\">Marine Corps - First Lieutenant</option><option value=\"Second Lieutenant\">Marine Corps - Second Lieutenant</option><option value=\"Chief Warrant Officer - 5\">Marine Corps - Chief Warrant Officer - 5</option><option value=\"Chief Warrant Officer - 4\">Marine Corps - Chief Warrant Officer - 4</option><option value=\"Chief Warrant Officer - 3\">Marine Corps - Chief Warrant Officer - 3</option><option value=\"Chief Warrant Officer - 2\">Marine Corps - Chief Warrant Officer - 2</option><option value=\"Warrant Officer\">Marine Corps - Warrant Officer</option><option value=\"Sergeant Major of the Marine Corps\">Marine Corps - Sergeant Major of the Marine Corps</option><option value=\"Sergeant Major\">Marine Corps - Sergeant Major</option><option value=\"Master Gunnery Sergeant\">Marine Corps - Master Gunnery Sergeant</option><option value=\"First Sergeant\">Marine Corps - First Sergeant</option><option value=\"Master Sergeant\">Marine Corps - Master Sergeant</option><option value=\"Gunnery Sergeant\">Marine Corps - Gunnery Sergeant</option><option value=\"Staff Sergeant\">Marine Corps - Staff Sergeant</option><option value=\"Sergeant\">Marine Corps - Sergeant</option><option value=\"Corporal\">Marine Corps - Corporal</option><option value=\"Lance Corporal\">Marine Corps - Lance Corporal</option><option value=\"Private First Class\">Marine Corps - Private First Class</option><option value=\"Private\">Marine Corps - Private</option><option value=\"Admiral\">Navy - Admiral</option><option value=\"Vice Admiral\">Navy - Vice Admiral</option><option value=\"Rear Admiral, Upper Half\">Navy - Rear Admiral, Upper Half</option><option value=\"Rear Admiral, Lower Half\">Navy - Rear Admiral, Lower Half</option><option value=\"Captain\">Navy - Captain</option><option value=\"Commander\">Navy - Commander</option><option value=\"Lieutenant Commander\">Navy - Lieutenant Commander</option><option value=\"Lieutenant\">Navy - Lieutenant</option><option value=\"Lieutenant Junior Grade\">Navy - Lieutenant Junior Grade</option><option value=\"Ensign\">Navy - Ensign</option><option value=\"Chief Warrant Officer - 4\">Navy - Chief Warrant Officer - 4</option><option value=\"Chief Warrant Officer - 3\">Navy - Chief Warrant Officer - 3</option><option value=\"Chief Warrant Officer - 2\">Navy - Chief Warrant Officer - 2</option><option value=\"Master Chief Petty Officer of the Navy\">Navy - Master Chief Petty Officer of the Navy</option><option value=\"Master Chief Petty Officer\">Navy - Master Chief Petty Officer</option><option value=\"Senior Chief Petty Officer\">Navy - Senior Chief Petty Officer</option><option value=\"Chief Petty Officer\">Navy - Chief Petty Officer</option><option value=\"Petty Officer First Class\">Navy - Petty Officer First Class</option><option value=\"Petty Officer Second Class\">Navy - Petty Officer Second Class</option><option value=\"Petty Officer Third Class\">Navy - Petty Officer Third Class</option><option value=\"Seaman Apprentice\">Navy - Seaman Apprentice</option><option value=\"Seaman\">Navy - Seaman</option><option value=\"Seaman Recruit\">Navy - Seaman Recruit</option><option value=\"Other\">Other</option></select></div></div></div><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-CA8821FE-5056-A066-60B7-DC774D223D86\">Location/Hometown</label><div class=\"controls\"><input id=\"input-CA8821FE-5056-A066-60B7-DC774D223D86\" name=\"input_CA8821FE-5056-A066-60B7-DC774D223D86\" type=\"text\"><div data-lastpass-icon-root=\"\"</div></div></div></div></div><br><div id=\"prefixotherfield\" class=\"hide\"><div class=\"control-group\"><label class=\"control-label\" for=\"prefixother\">Other&#58;<span>*</span></label><div class=\"controls\"><input id=\"prefixother\" name=\"input_4F69436E-5056-A066-604F-5CAA3206D300\" type=\"text\"></div></div><br></div><div class=\"row\"><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB59F0AE-4040-F985-52CD-AA63153C7925\">First Name<span>*</span></label><div class=\"controls\"><input id=\"input-AB59F0AE-4040-F985-52CD-AA63153C7925\" name=\"input_AB59F0AE-4040-F985-52CD-AA63153C7925\" type=\"text\"></div></div></div><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB59F0ED-4040-F985-52CD-265D9CF13F5E\">Last Name<span">*</span></label><div class=\"controls\"><input id=\"input-AB59F0ED-4040-F985-52CD-265D9CF13F5E\" name=\"input_AB59F0ED-4040-F985-52CD-265D9CF13F5E\" type=\"text\" placeholder=\"Required\"></div></div></div></div></fieldset><fieldset><legend>Your Contact Information</legend><div class=\"row\"><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB5B6829-4040-F985-52CD-BF81DCC1F57D\">Street Address<span>*</span></label><div class=\"controls\"><input id=\"input-AB5B6829-4040-F985-52CD-BF81DCC1F57D\" name=\"input_AB5B6829-4040-F985-52CD-BF81DCC1F57D\" type=\"text\" placeholder=\"Required\"></div></div></div><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB5B6853-4040-F985-52CD-7517D971BE75\">Street Address (2)</label><div class=\"controls\"><input id=\"input-AB5B6853-4040-F985-52CD-7517D971BE75\" name=\"input_AB5B6853-4040-F985-52CD-7517D971BE75\" type=\"text\"></div></div></div></div><div class=\"row\"><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB5B6875-4040-F985-52CD-909541CB4B6C\">City<span>*</span></label><div class=\"controls\"><input id=\"input-AB5B6875-4040-F985-52CD-909541CB4B6C\" name=\"input_AB5B6875-4040-F985-52CD-909541CB4B6C\" type=\"text\" placeholder=\"Required\"><div data-lastpass-icon-root=\"\"></div></div></div></div><div class=\"col-md-2\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB5B6894-4040-F985-52CD-DFC6D3C729DF\">State<span>*</span></label><div class=\"controls\"><select id=\"input-AB5B6894-4040-F985-52CD-DFC6D3C729DF\" name=\"input_AB5B6894-4040-F985-52CD-DFC6D3C729DF\"><option value=\"\">--</option><option value=\"AL\">AL</option><option value=\"AK\">AK</option><option value=\"AR\">AR</option><option value=\"AZ\">AZ</option><option value=\"CA\">CA</option><option value=\"CO\">CO</option><option value=\"CT\">CT</option><option value=\"DC\">DC</option><option value=\"DE\">DE</option><option value=\"FL\">FL</option><option value=\"GA\">GA</option><option value=\"HI\">HI</option><option value=\"ID\">ID</option><option value=\"IL\">IL</option><option value=\"IN\">IN</option><option value=\"IA\">IA</option><option value=\"KS\">KS</option><option value=\"KY\">KY</option><option value=\"LA\">LA</option><option value=\"ME\">ME</option><option value=\"MD\">MD</option><option value=\"MA\">MA</option><option value=\"MI\">MI</option><option value=\"MN\">MN</option><option value=\"MS\">MS</option><option value=\"MO\">MO</option><option value=\"MT\">MT</option><option value=\"NE\">NE</option><option value=\"NV\">NV</option><option value=\"NH\">NH</option><option value=\"NJ\">NJ</option><option value=\"NM\">NM</option><option value=\"NY\">NY</option><option value=\"NC\">NC</option><option value=\"ND\">ND</option><option value=\"OH\">OH</option><option value=\"OK\">OK</option><option value=\"OR\">OR</option><option value=\"PA\">PA</option><option value=\"RI\">RI</option><option value=\"SC\">SC</option><option value=\"SD\">SD</option><option value=\"TN\">TN</option><option value=\"TX\">TX</option><option value=\"UT\">UT</option><option value=\"VT\">VT</option><option value=\"VA\">VA</option><option value=\"WA\">WA</option><option value=\"WV\">WV</option><option value=\"WI\">WI</option><option value=\"WY\">WY</option></select></div></div></div><div class=\"col-md-4\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB5B68B4-4040-F985-52CD-269A4338D057\">Zip<span>*</span></label><div class=\"controls\"><input id=\"input-AB5B68B4-4040-F985-52CD-269A4338D057\" name=\"input_AB5B68B4-4040-F985-52CD-269A4338D057\" type=\"text\" placeholder=\"Required\"></div></div></div></div><div class=\"row\"><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB67BC2F-4040-F985-52CD-007A86DA4D47\">Phone Number<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-AB67BC2F-4040-F985-52CD-007A86DA4D47\" name=\"input_AB67BC2F-4040-F985-52CD-007A86DA4D47\" type=\"text\" placeholder=\"Required\"></div></div></div><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB67BC4E-4040-F985-52CD-CA9C3E214B73\">Alternate Phone Number</label><div class=\"controls\"><input id=\"input-AB67BC4E-4040-F985-52CD-CA9C3E214B73\" name=\"input_AB67BC4E-4040-F985-52CD-CA9C3E214B73\" type=\"text\"></div></div></div></div><div class=\"row\"><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"email\">Email<span>*</span></label><div class=\"controls\"><input id=\"email\" name=\"input_AB721CC4-4040-F985-52CD-76D1474A55F4\" type=\"text\" placeholder=\"Required\"></div></div></div><div class=\"col-md-6\"><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB721CE8-4040-F985-52CD-9E550E8A76AA\">Verify Email<span>*</span></label><div class=\"controls\"><input id=\"input-AB721CE8-4040-F985-52CD-9E550E8A76AA\" name=\"input_AB721CE8-4040-F985-52CD-9E550E8A76AA\" type=\"text\" placeholder=\"Required\"></div></div></div></div></fieldset><fieldset><legend>Your Message</legend><div class=\"control-group\"><label class=\"control-label\" for=\"input-FB39F9E5-5056-A066-6090-70989F519869\">Subject<span class=\"required\">*</span></label><div class=\"controls\"><input id=\"input-FB39F9E5-5056-A066-6090-70989F519869\" name=\"input_FB39F9E5-5056-A066-6090-70989F519869\" type=\"text\" placeholder=\"Example&#58; RESTORE resolution\"></div></div><div class=\"control-group\"><label class=\"control-label\" for=\"input-AB8156A0-4040-F985-52CD-49CE65770EFC\">Message Topic<span>*</span></label><div class=\"controls\"><select id=\"input-AB8156A0-4040-F985-52CD-49CE65770EFC\" name=\"input_AB8156A0-4040-F985-52CD-49CE65770EFC\"><option value=\"\">--</option><option value=\"AGR\">Agriculture</option><option value=\"BNK\">Banking</option><option value=\"BUD\">Budget &amp; Deficit</option><option value=\"DEF\">Defense and Military</option><option value=\"ECON\">Economy</option><option value=\"EDU\">Education</option><option value=\"ELECT\">Election Issues</option><option value=\"ENE\">Energy</option><option value=\"ENV\">Environmental &amp; Water Management</option><option value=\"FOR\">Foreign Relations</option><option value=\"HEA\">Health Care</option><option value=\"HOM\">Homeland Security &amp; FEMA</option><option value=\"HOU\">Housing</option><option value=\"IMM\">Immigration &amp; Border Security</option><option value=\"INDN\">Indian Affairs</option><option value=\"INT\">Interior and National Parks</option><option value=\"JUD\">Judicial, Law Enforcement and Drugs</option><option value=\"LAB\">Labor</option><option value=\"LIFE\">Life Issues</option><option value=\"MED\">Medicare and Medicaid</option><option value=\"OTH\">Other</option><option value=\"Presidential Issues\">POTUS</option><option value=\"SBUS\">Small Business</option><option value=\"SEC\">Second Amendment</option><option value=\"SSEC\">Social Security</option><option value=\"TAX\">Taxes</option><option value=\"TEL\">Telecom and Technology</option><option value=\"TRA\">Transportation &amp; Infrastructure</option><option value=\"TRD\">Trade</option><option value=\"VET\">Veterans Affairs</option></select></div></div><div class=\"control-group\"><label class=\"control-label\" for=\"input-ADE64E73-4040-F985-52CD-A3AB6BCD2C51\">Message<span>*</span></label><div class=\"controls\"><textarea id=\"input-ADE64E73-4040-F985-52CD-A3AB6BCD2C51\" name=\"input_ADE64E73-4040-F985-52CD-A3AB6BCD2C51\"></textarea></div></div><div class=\"control-group\"><input id=\"email-optin\" name=\"input_A4E18009-4040-F985-52CD-6366A651E958\" type=\"checkbox\" value=\"EMAIL.OPTIN\"><label for=\"email-optin\">Subscribe to my email newsletter</label></div></fieldset><div><input type=\"hidden\" id=\"creativengine-form-identifier\" name=\"creativengine_form_identifier\" value=\"4873565B-4040-F985-52CD-58F5E3BCC94D\"><input type=\"hidden\" id=\"email-address-validation-field\" name=\"email_address_validation_field\" value=\"\"></div><div class=\"control-group\"><div class=\"controls\"><button type=\"submit\" class=\"btn\">Submit</button></div></div></form></div>'
- find:
- selector: "#issue-dropdowns"
- select:
- name: input_AE7457DD-4040-F985-52CD-B99385041C51
selector: "#issue-dropdowns"
value: opinion
required: true
options:
Share your opinions or comment on legislation or issues: opinion
Scheduling Request: meeting
Help with a federal agency: federal_agency
Tour Request: tour
Request a flag to be flown over the Capitol: flag
- wait:
- value: 3
- find:
- selector: "#form-4873565B-4040-F985-52CD-58F5E3BCC94D"
- fill_in:
- name: input_AB59F0AE-4040-F985-52CD-AA63153C7925
selector: "#input-AB59F0AE-4040-F985-52CD-AA63153C7925"
value: $NAME_FIRST
required: true
- name: input_AB59F0ED-4040-F985-52CD-265D9CF13F5E
selector: "#input-AB59F0ED-4040-F985-52CD-265D9CF13F5E"
value: $NAME_LAST
required: true
- name: input_AB5B6829-4040-F985-52CD-BF81DCC1F57D
selector: "#input-AB5B6829-4040-F985-52CD-BF81DCC1F57D"
value: $ADDRESS_STREET
required: true
- name: input_AB5B6875-4040-F985-52CD-909541CB4B6C
selector: "#input-AB5B6875-4040-F985-52CD-909541CB4B6C"
value: $ADDRESS_CITY
required: true
- name: input_AB5B68B4-4040-F985-52CD-269A4338D057
selector: "#input-AB5B68B4-4040-F985-52CD-269A4338D057"
value: $ADDRESS_ZIP5
required: true
- name: input_AB67BC2F-4040-F985-52CD-007A86DA4D47
selector: "#input-AB67BC2F-4040-F985-52CD-007A86DA4D47"
value: $PHONE
required: true
- name: input_AB721CC4-4040-F985-52CD-76D1474A55F4
selector: "#email"
value: $EMAIL
required: true
- name: input_AB721CE8-4040-F985-52CD-9E550E8A76AA
selector: "#input-AB721CE8-4040-F985-52CD-9E550E8A76AA"
value: $EMAIL
required: true
- name: input_FB39F9E5-5056-A066-6090-70989F519869
selector: "#input-FB39F9E5-5056-A066-6090-70989F519869"
value: $SUBJECT
required: true
- name: input_ADE64E73-4040-F985-52CD-A3AB6BCD2C51
selector: "#input-ADE64E73-4040-F985-52CD-A3AB6BCD2C51"
value: $MESSAGE
required: true
- select:
- name: input_4F6942DF-5056-A066-6035-28DF3CDC6FEC
selector: "#prefixselect"
value: $NAME_PREFIX
required: true
options:
- Mr.
- Ms.
- Mrs.
- Professor
- Dr.
- Father
- Sister
- Rabbi
- Reverend
- Air Force - General
- Air Force - Lieutenant General
- Air Force - Major General
- Air Force - Brigadier General
- Air Force - Colonel
- Air Force - Lieutenant Colonel
- Air Force - Major
- Air Force - Captain
- Air Force - First Lieutenant
- Air Force - Second Lieutenant
- Air Force - Chief Master Sergeant of the Air Force
- Air Force - Command Chief Master Sergeant
- Air Force - First Sergeant (E-9)
- Air Force - Chief Master Sergeant
- Air Force - First Sergeant (E-8)
- Air Force - Senior Master Sergeant
- Air Force - First Sergeant (E-7)
- Air Force - Master Sergeant
- Air Force - Technical Sergeant
- Air Force - Staff Sergeant
- Air Force - Senior Airman
- Air Force - Airman First Class
- Air Force - Airman
- Air Force - Airman Basic
- Army - General
- Army - Lieutenant General
- Army - Major General
- Army - Brigadier General
- Army - Colonel
- Army - Lieutenant Colonel
- Army - Major
- Army - Captain
- Army - First Lieutenant
- Army - Second Lieutenant
- Army - Chief Warrant Officer - 5
- Army - Chief Warrant Officer - 4
- Army - Chief Warrant Officer - 3
- Army - Chief Warrant Officer - 2
- Army - Warrant Officer
- Army - Sergeant Major of the Army
- Army - Command Sergeant Major
- Army - Sergeant Major
- Army - First Sergeant
- Army - Master Sergeant
- Army - Sergeant First Class
- Army - Staff Sergeant
- Army - Sergeant
- Army - Corporal
- Army - Specialist
- Army - Private First Class
- Army - Private (E-2)
- Army - Private
- Coast Guard - Admiral
- Coast Guard - Vice Admiral
- "Coast Guard - Rear Admiral, Upper Half"
- "Coast Guard - Rear Admiral, Lower Half"
- Coast Guard - Captain
- Coast Guard - Commander
- Coast Guard - Lieutenant Commander
- Coast Guard - Lieutenant
- Coast Guard - Lieutenant Junior Grade
- Coast Guard - Ensign
- Coast Guard - Chief Warrant Officer - 4
- Coast Guard - Chief Warrant Officer - 3
- Coast Guard - Chief Warrant Officer - 2
- Coast Guard - Master Chief Petty Officer of the Coast Guard
- Coast Guard - Master Chief Petty Officer
- Coast Guard - Senior Chief Petty Officer
- Coast Guard - Chief Petty Officer
- Coast Guard - Petty Officer First Class
- Coast Guard - Petty Officer Second Class
- Coast Guard - Petty Officer Third Class
- Coast Guard - Seaman
- Coast Guard - Seaman Apprentice
- Coast Guard - Seaman Recruit
- Marine Corps - General
- Marine Corps - Lieutenant General
- Marine Corps - Major General
- Marine Corps - Brigadier General
- Marine Corps - Colonel
- Marine Corps - Lieutenant Colonel
- Marine Corps - Major
- Marine Corps - Captain
- Marine Corps - First Lieutenant
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- Marine Corps - Chief Warrant Officer - 5
- Marine Corps - Chief Warrant Officer - 4
- Marine Corps - Chief Warrant Officer - 3
- Marine Corps - Chief Warrant Officer - 2
- Marine Corps - Warrant Officer
- Marine Corps - Sergeant Major of the Marine Corps
- Marine Corps - Sergeant Major
- Marine Corps - Master Gunnery Sergeant
- Marine Corps - First Sergeant
- Marine Corps - Master Sergeant
- Marine Corps - Gunnery Sergeant
- Marine Corps - Staff Sergeant
- Marine Corps - Sergeant
- Marine Corps - Corporal
- Marine Corps - Lance Corporal
- Marine Corps - Private First Class
- Marine Corps - Private
- Navy - Admiral
- Navy - Vice Admiral
- "Navy - Rear Admiral, Upper Half"
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- Navy - Captain
- Navy - Commander
- Navy - Lieutenant Commander
- Navy - Lieutenant
- Navy - Lieutenant Junior Grade
- Navy - Ensign
- Navy - Chief Warrant Officer - 4
- Navy - Chief Warrant Officer - 3
- Navy - Chief Warrant Officer - 2
- Navy - Master Chief Petty Officer of the Navy
- Navy - Master Chief Petty Officer
- Navy - Senior Chief Petty Officer
- Navy - Chief Petty Officer
- Navy - Petty Officer First Class
- Navy - Petty Officer Second Class
- Navy - Petty Officer Third Class
- Navy - Seaman Apprentice
- Navy - Seaman
- Navy - Seaman Recruit
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