<!DOCTYPE html>
<html lang="en" class="cog-public-form">
<head>
<meta charset="utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<title>Untitled | Cognito Forms</title>
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0">
<style>
@media (max-width: 860px) {
:root:root:root:root:root:root:root .cog-form__container {
width: 100%;
max-width: 100%;
min-height: 100vh;
min-height: 100dvh;
margin: 0;
}
:root:root:root:root:root:root:root:root .cog-form--opaque-background {
background-image: none;
background-color: var(--form__background-color);
}
:root:root:root:root:root:root:root .cog-form--opaque-background .cog-form__container {
min-height: initial;
box-shadow: none;
}
}
</style>
<link rel="stylesheet" type="text/css" href="https://www.cognitoforms.com/Content/public-form.css?cachehash=-277612914" class="cog-style" />
<link rel="apple-touch-icon" sizes="180x180" href="https://www.cognitoforms.com/Content/Images/favicons/apple-touch-icon.png">
<link rel="icon" type="image/png" href="https://www.cognitoforms.com/Content/Images/favicons/favicon-32x32.png">
<link rel="manifest" href="https://www.cognitoforms.com//Content/site.webmanifest">
<link rel="mask-icon" href="https://www.cognitoforms.com/Content/Images/favicons/safari-pinned-tab.svg" color="#D85427">
<link rel="alternate" type="application/json+oembed" href="https://www.cognitoforms.com/f/oembed?url=https%3a%2f%2fwww.cognitoforms.com%2fUsmanJanu%2fForm12" title="Untitled" />
<meta name="msapplication-TileColor" content="#234652">
<meta name="msapplication-config" content="https://www.cognitoforms.com/Content/Images/favicons/browserconfig.xml">
<meta name="theme-color" content="#ffffff">
<meta name="robots" content="noindex, nofollow">
</head>
<body>
<script src="/Scripts/testing/AutotestDetect.js"></script>
<script src="/Scripts/vertical-form-edge-snapping.js?cachehash=-277612914"></script>
<script data-form="18"
data-key="s5z_UY6e6U6YrKX7oO7rRQ"
data-context="public"
src="/f/seamless.js?cachehash=5a90644c64280b1da83a167cc9674116">
</script>
<div class="cog-loader">
<div class="cog-loader__cog"></div>
</div>
</body>
</html>