CHP BU > CloudPages > API Configurations > CCP Kids' Hero Award > [Test Form] CCP Kids' Hero Award


      <h2>CCP Kids' Hero Award - Test Form</h2>
      <form action="https://pages.upmc.com/ccp-kids-hero-award-api-internal-testing-form" method="post">
         <label>Email</label>
         <input type="text" name="email_address"><br>
         <label>First Name</label>
         <input type="text" name="first_name"><br>
         <label>Last Name</label>
         <input type="text" name="last_name"><br>
         <label>Phone Number</label>
         <input type="text" name="phone_number"><br>
         
         <label>Name of Nominee</label>
         <input type="text" name="nominee_name"><br>

         <label>Name of CCP Practice</label>
         <input type="text" name="practice_name"><br><br>

         <label>Comments (about "hero" nominee)</label><br>
         <textarea type="text" name="comments"></textarea>

            <br><br>

         <label>Service Line</label>
         <input type="text" name="service_line"><br><br>

         <label>Category</label>
         <input type="text" name="category"><br>
         <label>Subcategory</label>
         <input type="text" name="subcategory"><br><br>
         <input name="submitted" type="hidden" value="true" />
         <input type="submit" value="Submit">
      </form>