title: not to send when a value of the input field is empty if I click the submit button
body: <ol>
  <li><p>How is it possible not to send when a value of the input field is empty if I click the submit button?</p>
  </li>
  <li><p>I have the select-1 and select-2 javascript how can I name its value to the name given for example
  for select-1 if I select AS400 (the value is set to option-1 but I want to name it AS400) then when selecting the options for select-2 AS400 New Account((the value is set to option-1a class is option-1 but I want to name it AS400 New Account)</p>
  </li>
  <li><p>When I send the form I only get the inputs I selected and not selected and i don't get any of the text inputs I entered</p>
  </li>
  </ol>
  <p><div class="snippet" data-lang="js" data-hide="false" data-console="true" data-babel="false">
  <div class="snippet-code">
  <pre class="snippet-code-js lang-js prettyprint-override"><code>$(function() {
    // on page load wrap all select-2 options in span so they cannot be selected without specifying select-1
    $('#select-2 option:not([default])').wrap('&lt;span/&gt;');
  });
  
  // when select-1 is changed, hide all options that do not have the class corresponding to the value of select-1
  $('#select-1').change(function() {
    $('#select-2 span &gt; option').unwrap();
    $('#select-2 option:not(.' + $('#select-1').val() + ', [default])').wrap('&lt;span/&gt;');
    //console.log($('#select-2').val());
  });
  
  $('#select-2').trigger('change');
  $("#otherFieldGroupMod").hide();
  $("#otherFieldGroupRes").hide();
  $("#otherFieldGroupOutacc").hide();
  $("#outlookAccountDistri").hide();
  $("#otherFieldGroupWinacc").hide();
  $("#otherFieldGroupKdrive").hide();
  $("#otherFieldGroupDcnet").hide();
  $("#otherFieldGroupResPass").hide();
  $("#otherFieldGroupValpo").hide();
  
  //AS400 NEW ACCOUNT SCRIPT//
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-1a") {
        $("#otherFieldGroupNewacc").show();
      } else {
        $("#otherFieldGroupNewacc").hide();
      }
    });
  });
  
  //AS400 MODFIY ACCOUNT SCRIPT//
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-1b") {
        $("#otherFieldGroupMod").show();
      } else {
        $("#otherFieldGroupMod").hide();
      }
    });
  });
  
  //AS400 RESET ACCOUNT SCRIPT//
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-1c") {
        $("#otherFieldGroupRes").show();
      } else {
        $("#otherFieldGroupRes").hide();
      }
    });
  });
  
  /////////////////////////////////////////////////////////////////
  //OUTLOOK NEW ACCOUNT /
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-2a") {
        $("#otherFieldGroupOutacc").show();
      } else {
        $("#otherFieldGroupOutacc").hide();
      }
    });
  });
  
  //Add TO DISTRIBUTION LIST
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-2b") {
        $("#outlookAccountDistri").show();
      } else {
        $("#outlookAccountDistri").hide();
      }
    });
  });
  
  ////////////////////////////////////////////////////////////////
  //WINDOWS NEW ACCOUNT SCRIPT//
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-3a") {
        $("#otherFieldGroupWinacc").show();
      } else {
        $("#otherFieldGroupWinacc").hide();
      }
    });
  });
  
  //K DRIVE AND GROUP ACCESS
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-3b") {
        $("#otherFieldGroupKdrive").show();
      } else {
        $("#otherFieldGroupKdrive").hide();
      }
    });
  });
  
  //DC NET ACCESS
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-3c") {
        $("#otherFieldGroupDcnet").show();
      } else {
        $("#otherFieldGroupDcnet").hide();
      }
    });
  });
  
  //RESET PASSWORD ACCESS
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-3d") {
        $("#otherFieldGroupResPass").show();
      } else {
        $("#otherFieldGroupResPass").hide();
      }
    });
  });
  
  ////////////////////////////////////////////////////////////////
  //VAPLO NEW ACCOUNT SCRIPT//
  $(function() {
    $("#select-2").change(function() {
      if ($(this).val() == "option-4a") {
        $("#otherFieldGroupValpo").show();
      } else {
        $("#otherFieldGroupValpo").hide();
      }
    });
  });
  
  ///DC NET JOB FUNCTION SCRIPT///
  $(function() {
    // on page load wrap all select-2 options in span so they cannot be selected without specifying select-1
    $('#select-4 option:not([default])').wrap('&lt;span/&gt;');
  });
  
  // when select-1 is changed, hide all options that do not have the class corresponding to the value of select-1
  $('#select-3').change(function() {
    $('#select-4 span &gt; option').unwrap();
    $('#select-4 option:not(.' + $('#select-3').val() + ', [default])').wrap('&lt;span/&gt;');
    //console.log($('#select-2').val());
  });
  
  $('#select-4').trigger('change');
  ///////////////////// END OF SCRIPTS /////////////////////////////</code></pre>
  <pre class="snippet-code-css lang-css prettyprint-override"><code>html,
  body {
    min-height: 100%;
  }
  
  body,
  div,
  form,
  input,
  label {
    padding: 0;
    margin: 0;
    outline: none;
    font-family: Roboto, Arial, sans-serif;
    font-size: 15px;
    color: #666;
    line-height: 22px;
  }
  
  legend {
    color: #fff;
    background-color: #095484;
    padding: 3px 5px;
    font-size: 20px;
  }
  
  h1 {
    position: absolute;
    margin: 0;
    font-size: 36px;
    color: #fff;
    z-index: 2;
  }
  
  .testbox {
    display: flex;
    justify-content: center;
    align-items: center;
    height: inherit;
    padding: 20px;
  }
  
  form {
    width: 75%;
    padding: 20px;
    border-radius: 8px;
    background: #fff;
    box-shadow: 0 0 20px 0 #095484;
  }
  
  .banner {
    position: relative;
    height: 300px;
    background-image: url("/Krishneel/Walgreens Logo's/Walgreens New Logo/banner.png");
    background-size: cover;
    display: flex;
    justify-content: center;
    align-items: center;
    text-align: center;
  }
  
  .banner::after {
    content: "";
    background-color: rgba(0, 0, 0, 0.6);
    width: 100%;
    height: 100%;
  }
  
  input {
    margin-bottom: 10px;
    border: 1px solid #ccc;
    border-radius: 3px;
    font-size: 15px;
    font-weight: bold;
  }
  
  input {
    width: calc(100% - 10px);
    padding: 5px;
  }
  
  select {
    width: 100%;
    padding: 3px 0;
    background: transparent;
    font-size: 15px;
    font-weight: bold;
  }
  
  input[type="date"] {
    padding: 4px 5px;
  }
  
  .item:hover p,
  .item:hover i,
  .question:hover p,
  .question label:hover,
  input:hover::placeholder {
    color: #095484;
  }
  
  .item input:hover {
    border: 1px solid transparent;
    box-shadow: 0 0 6px 0 #095484;
    color: #095484;
  }
  
  .item {
    margin: 10px 0;
  }
  
  input[type="date"]::-webkit-inner-spin-button {
    display: none;
  }
  
  .item i,
  input[type="date"]::-webkit-calendar-picker-indicator {
    position: absolute;
    font-size: 20px;
    color: #095484;
  }
  
  .item i {
    right: 2%;
    top: 30px;
    z-index: 1;
  }
  
  [type="date"]::-webkit-calendar-picker-indicator {
    right: 1%;
    z-index: 2;
    opacity: 0;
    cursor: pointer;
  }
  
  .question span {
    margin-left: 30px;
  }
  
  .btn-block {
    margin-top: 10px;
    text-align: center;
  }
  
  button {
    width: 150px;
    padding: 10px;
    border: none;
    border-radius: 5px;
    background: #095484;
    font-size: 16px;
    color: #fff;
    cursor: pointer;
  }
  
  button:hover {
    background: #4286f4;
  }
  
  @media (min-width: 568px) {
    .name-item,
    .city-item {
      display: flex;
      flex-wrap: wrap;
      justify-content: space-between;
    }
    .name-item input,
    .city-item input,
    .name-item div {
      width: calc(50% - 20px);
    }
    .name-item div input {
      width: 97%;
    }
    .name-item div label {
      display: block;
      padding-bottom: 5px;
    }
  }
  
  .status label:hover input {
    box-shadow: 0 0 5px 0 #095484;
  }
  
  .status-item input,
  .status-item span {
    width: auto;
    vertical-align: middle;
  }
  
  .status-item input {
    margin: 0;
  }
  
  .status-item span {
    margin: 0 20px 0 5px;
  }
  
  textarea {
    width: calc(100% - 12px);
    padding: 5px;
    font-family: Roboto, Arial, sans-serif;
  }
  
  &lt;/style&gt;</code></pre>
  <pre class="snippet-code-html lang-html prettyprint-override"><code>&lt;script src="https://cdnjs.cloudflare.com/ajax/libs/jquery/3.3.1/jquery.min.js"&gt;&lt;/script&gt;
  &lt;div class="testbox"&gt;
    &lt;form name="frmContact" id="" frmContact "" method="post" action="" enctype="multipart/form-data"&gt;
      &lt;div class="banner"&gt;
        &lt;h1&gt;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;&amp;emsp;ID Request Form&lt;/h1&gt;
      &lt;/div&gt;
      &lt;br&gt;
      &lt;p&gt;Please fill out with the information that is requested below and submit the id request form. Thank you!&lt;/p&gt;
      &lt;div class="form-group"&gt;
        &lt;label&gt;Request Type&lt;/label&gt;
        &lt;select id="select-1" name="select-1"&gt;
          &lt;option default&gt;Choose a Category&lt;/option&gt;
          &lt;option value="option-1"&gt;AS400&lt;/option&gt;
          &lt;option value="option-2"&gt;Outlook&lt;/option&gt;
          &lt;option value="option-3"&gt;Windows&lt;/option&gt;
          &lt;option value="option-4"&gt;Valpo&lt;/option&gt;
        &lt;/select&gt;
        &lt;br/&gt;
        &lt;label&gt;Choose a Sub-Category&lt;/label&gt;
        &lt;select id="select-2" name="select-2"&gt;
          &lt;option default&gt;Choose a Sub-Category&lt;/option&gt;
          &lt;option value="option-1a" class="option-1"&gt;AS400 New Account&lt;/option&gt;
          &lt;option value="option-1b" class="option-1"&gt;Modify Account&lt;/option&gt;
          &lt;option value="option-1c" class="option-1"&gt;Reset Password&lt;/option&gt;
          &lt;option value="option-2a" class="option-2"&gt;Outlook New Account&lt;/option&gt;
          &lt;option value="option-2b" class="option-2"&gt;Add to Distribution List&lt;/option&gt;
          &lt;option value="option-3a" class="option-3"&gt;Windows New Account&lt;/option&gt;
          &lt;option value="option-3b" class="option-3"&gt;K Drive and Group Access&lt;/option&gt;
          &lt;option value="option-3c" class="option-3"&gt;DC Net&lt;/option&gt;
          &lt;option value="option-3d" class="option-3"&gt;Password Reset&lt;/option&gt;
          &lt;option value="option-4a" class="option-4"&gt;Valpo New Account
            &lt;!--  --&gt;
          &lt;/option&gt;
        &lt;/select&gt;
      &lt;/div&gt;
      &lt;hr&gt;
      &lt;!----------------------------------------------------- AS400 Account-------------------------------------------&gt;
      &lt;!--AS400 New Account--&gt;
      &lt;div id="otherFieldGroupNewacc"&gt;
        &lt;h2&gt;AS400 New Account&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Requester (Full Name)&lt;/label&gt;
            &lt;input type="text" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userTM"&gt;Beneficiary (Full Name)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userTM" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="selectJob"&gt;New Job Category&lt;/label&gt;
            &lt;select id="selectJob" name="selectJob" placeholder="*Click in box for Job Category List*"&gt;
              &lt;option value="NO CHANGE"&gt;NO CHANGE&lt;/option&gt;
              &lt;option value="ADMCLK = Admin Clerk"&gt;ADMCLK = Admin Clerk&lt;/option&gt;
              &lt;option value="ADMCLK+ = Admin Clerk w/ Manual Book"&gt;ADMCLK+ = Admin Clerk w/ Manual Book&lt;/option&gt;
              &lt;option value="ADMMGR = Admin MGR w/ Manual Book"&gt;ADMMGR = Admin MGR w/ Manual Book&lt;/option&gt;
              &lt;option value="DCM = DC Manager"&gt;DCM = DC Manager&lt;/option&gt;
              &lt;option value="FM IN = Inbound Funtion Manager"&gt;FM IN = Inbound Funtion Manager&lt;/option&gt;
              &lt;option value="FM OUT = Outbound Funtion Manager"&gt;FM OUT = Outbound Funtion Manager&lt;/option&gt;
            &lt;/select&gt;
          &lt;/div&gt;
          &lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userNewAS400"&gt;New AS400 ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userNewAS400" name="userNewAS400" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
      &lt;!--Modify AS400 Account--&gt;
      &lt;div class="form-group" id="otherFieldGroupMod"&gt;
        &lt;h2&gt;AS400 Modify Account&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Requester (Full Name)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userTM"&gt;Beneficiary (Full Name)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userTM" NAME="userTM" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userAS400"&gt;AS400 ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userAS400" name="userAS400" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="selectJobs"&gt;New Job Category&gt;&lt;/label&gt;
            &lt;select id="selectJobs" name="selectJobs" placeholder="*Click in box for Job Category List*"&gt;
              &lt;option value="NO CHANGE"&gt;NO CHANGE&lt;/option&gt;
              &lt;option value="ADMCLK = Admin Clerk"&gt;ADMCLK = Admin Clerk&lt;/option&gt;
              &lt;option value="ADMCLK+ = Admin Clerk w/ Manual Book"&gt;ADMCLK+ = Admin Clerk w/ Manual Book&lt;/option&gt;
              &lt;option value="ADMMGR = Admin MGR w/ Manual Book"&gt;ADMMGR = Admin MGR w/ Manual Book&lt;/option&gt;
              &lt;option value="DCM = DC Manager"&gt;DCM = DC Manager&lt;/option&gt;
              &lt;option value="FM IN = Inbound Funtion Manager"&gt;FM IN = Inbound Funtion Manager&lt;/option&gt;
  
            &lt;/select&gt;
          &lt;/div&gt;
          &lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userNewAS400"&gt;New AS400 ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userNewAS400" name="userNewAS400" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
      &lt;!--Reinstate AS400 Account--&gt;
      &lt;div class="form-group" id="otherFieldGroupRes"&gt;
        &lt;h2&gt;AS400 Reinstate Password&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Requester (Full Name)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userTM"&gt;Beneficiary (Full Name)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userTM" NAME="userTM" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userAS400"&gt;AS400 ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userAS400" name="userAS400" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!-------------------------------------------------------------------------------------------------------------------------------------&gt;
      &lt;!----------------------------------------------------Outlook Account------------------------------------------------------------------&gt;
      &lt;!--New Account--&gt;
      &lt;div class="form-group" id="otherFieldGroupOutacc"&gt;
        &lt;h2&gt;Outlook New Account&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Full Name&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="useroneID"&gt;ONE ID (Formally Authenticator ID)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="useroneID" name="useroneID" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!--Add to Distribution List--&gt;
      &lt;div class="form-group" id="outlookAccountDistri"&gt;
        &lt;h2&gt;Add to Distribution List&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Full Name&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="useroneID"&gt;ONE ID (Formally Authenticator ID)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="useroneID" name="useroneID" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="selectdistri"&gt;Select a Distribution List&lt;/label&gt;
            &lt;select id="selectdistri" name="selectdistri" placeholder="*Click in box for Distribution List*"&gt;
              &lt;option default&gt;Choose a Distribution List&lt;/option&gt;
              &lt;option value="Woodland Location Control"&gt;Woodland Location Control&lt;/option&gt;
              &lt;option value="Woodland Management"&gt;Woodland Management&lt;/option&gt;
              &lt;option value="Woodland SR Managers"&gt;Woodland SR Managers&lt;/option&gt;
              &lt;option value="Woodland HR"&gt;Woodland HR&lt;/option&gt;
              &lt;option value="Woodland IT Support"&gt;Woodland IT Support&lt;/option&gt;
              &lt;option value="Woodland SAIL Coordinators"&gt;Woodland SAIL Coordinators&lt;/option&gt;
              &lt;option value="Woodland Fleet Managers"&gt;Woodland Fleet Managers&lt;/option&gt;
              &lt;option value="Woodland ComputerRoomOperators"&gt;Woodland ComputerRoomOperators&lt;/option&gt;
              &lt;option value="WoodlandMTVMSN"&gt;WoodlandMTVMSN&lt;/option&gt;
              &lt;option value="Woodland Inventory"&gt;Woodland Inventory&lt;/option&gt;
              &lt;option value="WDL_A"&gt;WDL_A&lt;/option&gt;
              &lt;option value="WDL_B"&gt;WDL_B&lt;/option&gt;
              &lt;option value="Woodland DC Zero Waste"&gt;Woodland DC Zero Waste&lt;/option&gt;
              &lt;option value="Woodland CoE Assessment Team"&gt;Woodland CoE Assessment Team&lt;/option&gt;
              &lt;option value="Woodland DC Inbound"&gt;Woodland DC Inbound&lt;/option&gt;
              &lt;option value="Woodland Inbound Managers"&gt;Woodland Inbound Managers&lt;/option&gt;
              &lt;option value="Woodland Supply Chain and Logistics Member Group"&gt;Woodland Supply Chain and Logistics Member Group&lt;/option&gt;
              &lt;option value="Woodland All Company"&gt;Woodland All Company&lt;/option&gt;
            &lt;/select&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!-------------------------------------------------------------------------------------------------------------------------------------&gt;
      &lt;!----------------------------------------------------Windows Account------------------------------------------------------------------&gt;
  
      &lt;!--Windows New Account--&gt;
      &lt;div class="form-group" id="otherFieldGroupWinacc"&gt;
        &lt;h2&gt;Windows New Account&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Full Name&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="useroneID"&gt;ONE ID (Formally Authenticator ID)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="useroneID" name="useroneID" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userMirror"&gt; Mirror Account ONE ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userMirror" name="userMirror" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userComment"&gt;Comments&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userComment" name="userComment" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!--K Drive and Group Access--&gt;
      &lt;div class="form-group" id="otherFieldGroupKdrive"&gt;
        &lt;h2&gt;K Drive and Group Access&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Full Name&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="useroneID"&gt;ONE ID (Formally Authenticator ID)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="useroneID" name="useroneID" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userMirror"&gt; Mirror Account ONE ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userMirror" name="userMirror" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userComment"&gt;Comments&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userComment" name="userComment" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!--DC Net Access--&gt;
      &lt;div class="form-group" id="otherFieldGroupDcnet"&gt;
        &lt;h2&gt;DC Net Access&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Full Name&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="useroneID"&gt;ONE ID (Formally Authenticator ID)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="useroneID" name="useroneID" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label&gt; Select your Job Title&lt;/label&gt;
            &lt;select id="select-3"&gt;
              &lt;option default&gt;Select an option&lt;/option&gt;
              &lt;option value="option-1"&gt;TM&lt;/option&gt;
              &lt;option value="option-2"&gt;DCS&lt;/option&gt;
              &lt;option value="option-3"&gt;AP Officer&lt;/option&gt;
              &lt;option value="option-4"&gt;IO&lt;/option&gt;
              &lt;option value="option-5"&gt;AGM&lt;/option&gt;
              &lt;option value="option-6"&gt;GM&lt;/option&gt;
              &lt;option value="option-7"&gt;IT Support&lt;/option&gt;
            &lt;/select&gt;
            &lt;br&gt;&lt;br&gt;
            &lt;label&gt;Select your Department &amp; Shift&lt;/label&gt;
            &lt;select id="select-4"&gt;
              &lt;option default&gt;Select your option&lt;/option&gt;
              &lt;option value="option-1a" class="option-1"&gt;Cost Recovery&lt;/option&gt;
              &lt;option value="option-1b" class="option-1"&gt;Lean Captain&lt;/option&gt;
              &lt;option value="option-2a" class="option-2"&gt;SC-AM&lt;/option&gt;
              &lt;option value="option-2b" class="option-2"&gt;SC-PM&lt;/option&gt;
              &lt;option value="option-2c" class="option-2"&gt;FC-AM&lt;/option&gt;
              &lt;option value="option-2d" class="option-2"&gt;FC-PM&lt;/option&gt;
              &lt;option value="option-2e" class="option-2"&gt;INB-AM&lt;/option&gt;
              &lt;option value="option-2f" class="option-2"&gt;INB-PM&lt;/option&gt;
              &lt;option value="option-2g" class="option-2"&gt;Shipping-AM&lt;/option&gt;
              &lt;option value="option-2h" class="option-2"&gt;Shipping-PM&lt;/option&gt;
            &lt;/select&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!--Password Access--&gt;
      &lt;div class="form-group" id="otherFieldGroupResPass"&gt;
        &lt;h2&gt;Reset Windows Password&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="col-6"&gt;
          &lt;label for="otherField11"&gt;Click the link for Reset Password Help&lt;/label&gt;
          &lt;a href="https://www.w3schools.com/"&gt;Visit W3Schools.com!&lt;/a&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;!-------------------------------------------------------------------------------------------------------------------------------------&gt;
      &lt;!----------------------------------------------------VALPO Account------------------------------------------------------------------&gt;
      &lt;!--New Account--&gt;
      &lt;div class="form-group" id="otherFieldGroupValpo"&gt;
        &lt;h2&gt;Valpo New Account&lt;/h2&gt;
        &lt;hr&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userName"&gt;Full Name&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userName" name="userName" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmployee"&gt;Employee ID&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmployee" name="userEmployee" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="useroneID"&gt;ONE ID (Formally Authenticator ID)&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="useroneID" name="useroneID" placeholder="Type Here..."&gt;
          &lt;/div&gt;
          &lt;br&gt;&lt;br&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userBadge"&gt;Badge Number&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userBadge" name="userBadge" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;div class="form-group"&gt;
        &lt;div class="row"&gt;
          &lt;div class="col-6"&gt;
            &lt;label for="userEmail"&gt;Enter your Email&lt;/label&gt;
            &lt;input type="text" class="form-control w-100" id="userEmail" name="userEmail" placeholder="Type Here..."&gt;
          &lt;/div&gt;
        &lt;/div&gt;
      &lt;/div&gt;
  
      &lt;input type="submit" name="send" class="btn-submit" value="Send" /&gt;
      &lt;div id="statusMessage"&gt;
        &lt;?php
                                  if (! empty($message)) {
                                      ?&gt;
          &lt;p class='&lt;?php echo $type; ?&gt;Message'&gt;
            &lt;?php echo $message; ?&gt;
          &lt;/p&gt;
          &lt;?php
                                  }
                                  ?&gt;
      &lt;/div&gt;
    &lt;/form&gt;
  &lt;/div&gt;</code></pre>
  </div>
  </div>
  </p>