Job Registration Form
SUBMIT JOB
[{"lid":"1702356109946","ls":"10","loff":"","li_type":"sb","li_name":"bc_Source","li_title":"Source","li_req":"y","li_variants":"COD\nFirst American (FAHW)\nNSA\nFront Door (AHS)\nSquare Trade (All State)\nAsurion\nCinch (Sears)\nOther","li_selfirstvar":"Select Source","li_nm":"bc_Source"}]
[{"lid":"1702356254552","ls":"10","loff":"","li_type":"in","li_name":"bc_Work_Order","li_ph":"Work Order (Optional)","li_req":"y","li_nm":"bc_Work_Order"}]
[{"lid":"1702593651625","ls":"10","loff":"","li_type":"sb","li_name":"bc_Appliance_Select","li_title":"Appliance","li_req":"y","li_variants":"REFRIGERATOR\nWASHER\nDRYER\nMICROWAVE\nOVEN\nRANGE\nCOOKTOP\nDISHWASHER\nHOOD\nOTHER","li_selfirstvar":"Select an Appliance","li_nm":"bc_Appliance_Select"}]
[{"lid":"1702593830064","ls":"10","loff":"","li_type":"in","li_name":"bc_Appliance_Model_Number","li_ph":"Model Number (Optional)","li_req":"y","li_nm":"bc_Appliance_Model_Number"}]
[{"lid":"1702593946836","ls":"10","loff":"","li_type":"sb","li_name":"bc_Appliance_Brandname","li_req":"y","li_variants":"AMANA\nASKO\nBOSCH\nDAKOR\nELECTROLUX\nFISHER & PAYKEL\nFRIGIDAIRE\nGE\nGE MONOGRAM\nGE PROFILE\nHAIER\nHOTPOINT\nJENN AIR\nKENMORE\nKITCHENAID\nLG\nMAGIC CHEF\nMAYTAG\nMIELE\nSAMSUNG\nSEARS\nSUB ZERO\nTHERMADOOR\nU-LINE\nVIKING\nWHIRPOOL\nWOLF\nOTHER","li_selfirstvar":"Select Brand","li_nm":"bc_Appliance_Brandname"}]
[{"lid":"1702437668001","ls":"10","loff":"","li_type":"uw","li_name":"bc_Appliance_Pictures","li_title":"Attachments","li_uwkey":"google-8611d7a0ef965a8cbf4e61b","li_multiupl":"y","li_nm":"bc_Appliance_Pictures"},{"lid":"1702594308468","ls":"20","loff":"","li_type":"in","li_name":"bc_r_Appliance_Pictures","li_nm":"bc_r_Appliance_Pictures"}]
[{"lid":"1702593562257","ls":"10","loff":"","li_type":"ta","li_name":"bc_Appliance_Description","li_ph":"Description of the Problem","li_rows":"3","li_nm":"bc_Appliance_Description"}]
[{"lid":"1702355931169","ls":"10","loff":"","li_type":"nm","li_name":"bc_Customer_First_Name","li_title":"Customer","li_ph":"First Name","li_req":"y","li_nm":"bc_Customer_First_Name"}]
[{"lid":"1702355938976","ls":"10","loff":"","li_type":"nm","li_name":"bc_Customer_Last_Name","li_ph":"Last Name","li_req":"y","li_nm":"bc_Customer_Last_Name"}]
[{"lid":"1702356329885","ls":"10","loff":"","li_type":"ph","li_name":"bc_Customer_Phone_Number","li_ph":"Phone Number","li_req":"y","li_masktype":"a","li_maskcountry":"US","li_nm":"bc_Customer_Phone_Number"}]
[{"lid":"1702359287072","ls":"10","loff":"","li_type":"nm","li_name":"bc_Customer_EMail_Address","li_ph":"EMail_Address","li_req":"y","li_nm":"bc_Customer_EMail_Address"}]
[{"lid":"1702355942253","ls":"10","loff":"","li_type":"in","li_name":"bc_Customer_Address","li_ph":"Address","li_req":"y","li_nm":"bc_Customer_Address"}]
[{"lid":"1702594469991","ls":"10","loff":"","li_type":"ta","li_name":"bc_Customer_Extra_Contact_info","li_ph":"Any extra info about location: e.g. Gate code, Unit number, Parking, etc...","li_rows":"3","li_nm":"bc_Customer_Extra_Contact_info"}]
