Joomla Feedback Form

Joomla Feedback Form
The attached PDF document shows one form that has to be included into our existing joomla project.

The little quares show the elements that have to be clickable (round) option fields.
In the first PDF page there are two columns.

1. The left column “Antragsteller” is for the person that applies.
2. The right column “Ehegatte/…” contains the same input fields as the left column. This only will be filled if another member of the same family wants to apply, too.
3. Before the last text paragraph there will be a checkbox field that the user has to click before submitting the form.

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