{% extends 'base.html' %} {% block content %}

Issues Submission Form

Submit your issues in the form below. The responder team will reach out to you as soon as possible to resolve your issue.

{{ form.non_field_errors }} {% csrf_token %}
{% if form.errors %}
{{ form.errors }}
{% endif %}

Personal Particulars

{{ form.first_name }}
{{ form.last_name }}
{{ form.email }}
{{ form.phone }}

Issue Encountered

{{ form.summary }}
{{ form.description }}
{{ form.location }}

Only image files are allowed

{{ form.evidence }}

Type of issue

{{ form.type }}
{% endblock %}