Address
{
"type": "AdaptiveCard",
"$schema": "http://adaptivecards.io/schemas/adaptive-card.json",
"version": "1.3",
"body": [
{
"type": "Input.Text",
"placeholder": "",
"id": "street_1",
"isRequired": true,
"errorMessage": "Enter a street address",
"label": "Address line 1"
},
{
"type": "Input.Text",
"placeholder": "",
"label": "Address line 2 (optional)",
"id": "street_2"
},
{
"type": "Input.Text",
"placeholder": "",
"label": "City/Town",
"id": "city",
"isRequired": true,
"errorMessage": "Enter city or town"
},
{
"type": "Input.ChoiceSet",
"choices": [
{
"value": "AL",
"title": "Alabama "
},
{
"value": "AK",
"title": "Alaska "
},
{
"value": "AS",
"title": "American Samoa "
},
{
"value": "AZ",
"title": "Arizona "
},
{
"value": "AR",
"title": "Arkansas "
},
{
"value": "CA",
"title": "California "
},
{
"value": "CO",
"title": "Colorado "
},
{
"value": "CT",
"title": "Connecticut "
},
{
"value": "DE",
"title": "Delaware "
},
{
"value": "DC",
"title": "District of Columbia "
},
{
"value": "FM",
"title": "Federated States of Micronesia "
},
{
"value": "FL",
"title": "Florida "
},
{
"value": "GA",
"title": "Georgia "
},
{
"value": "GU",
"title": "Guam "
},
{
"value": "HI",
"title": "Hawaii "
},
{
"value": "ID",
"title": "Idaho "
},
{
"value": "IL",
"title": "Illinois "
},
{
"value": "IN",
"title": "Indiana "
},
{
"value": "IA",
"title": "Iowa "
},
{
"value": "KS",
"title": "Kansas "
},
{
"value": "KY",
"title": "Kentucky "
},
{
"value": "LA",
"title": "Louisiana "
},
{
"value": "ME",
"title": "Maine "
},
{
"value": "MH",
"title": "Marshall Islands "
},
{
"value": "MD",
"title": "Maryland "
},
{
"value": "MA",
"title": "Massachusetts "
},
{
"value": "MI",
"title": "Michigan "
},
{
"value": "MN",
"title": "Minnesota "
},
{
"value": "MS",
"title": "Mississippi "
},
{
"value": "MO",
"title": "Missouri "
},
{
"value": "MT",
"title": "Montana "
},
{
"value": "NE",
"title": "Nebraska "
},
{
"value": "NV",
"title": "Nevada "
},
{
"value": "NH",
"title": "New Hampshire "
},
{
"value": "NJ",
"title": "New Jersey "
},
{
"value": "NM",
"title": "New Mexico "
},
{
"value": "NY",
"title": "New York "
},
{
"value": "NC",
"title": "North Carolina "
},
{
"value": "ND",
"title": "North Dakota "
},
{
"value": "MP",
"title": "Northern Mariana Islands "
},
{
"value": "OH",
"title": "Ohio "
},
{
"value": "OK",
"title": "Oklahoma "
},
{
"value": "OR",
"title": "Oregon "
},
{
"value": "PW",
"title": "Palau "
},
{
"value": "PA",
"title": "Pennsylvania "
},
{
"value": "PR",
"title": "Puerto Rico "
},
{
"value": "RI",
"title": "Rhode Island "
},
{
"value": "SC",
"title": "South Carolina "
},
{
"value": "SD",
"title": "South Dakota "
},
{
"value": "TN",
"title": "Tennessee "
},
{
"value": "TX",
"title": "Texas "
},
{
"value": "UT",
"title": "Utah "
},
{
"value": "VT",
"title": "Vermont "
},
{
"value": "VI",
"title": "Virgin Islands (US) "
},
{
"value": "VA",
"title": "Virginia "
},
{
"value": "WA",
"title": "Washington "
},
{
"value": "WV",
"title": "West Virginia "
},
{
"value": "WI",
"title": "Wisconsin "
},
{
"value": "WY",
"title": "Wyoming "
},
{
"value": "AE",
"title": "Armed Forces Europe "
},
{
"value": "AP",
"title": "Armed Forces Pacific "
},
{
"value": "AA",
"title": "Armed Forces Americas "
}
],
"placeholder": "Choose a state or U.S. territory ",
"id": "stateCode",
"label": "State/U.S. Territory",
"isRequired": true,
"errorMessage": "Select a state"
},
{
"type": "Input.Text",
"placeholder": "5-digit zip",
"id": "zipCodeValue",
"maxLength": 5,
"label": "ZIP Code",
"isRequired": true,
"errorMessage": "Enter 5 digit zip"
},
{
"type": "ActionSet",
"id": "submitButton",
"actions": [
{
"type": "Action.Submit",
"title": "Submit",
"style": "positive",
"id": "submit"
}
]
}
]
}
About You
{
"type": "AdaptiveCard",
"$schema": "http://adaptivecards.io/schemas/adaptive-card.json",
"version": "1.3",
"body": [
{
"type": "ColumnSet",
"columns": [
{
"type": "Column",
"width": "stretch",
"items": [
{
"type": "TextBlock",
"text": "Enter your name as it appears on your legal ID.",
"wrap": true
},
{
"type": "ColumnSet",
"columns": [
{
"type": "Column",
"width": "stretch",
"items": [
{
"type": "Input.Text",
"placeholder": "First Name",
"id": "firstName",
"value": "",
"isRequired": true,
"label": "First Name",
"errorMessage": "Enter first name"
}
]
},
{
"type": "Column",
"width": "stretch",
"items": [
{
"type": "Input.Text",
"placeholder": "Last Name",
"id": "lastName",
"label": "Last Name",
"isRequired": true,
"errorMessage": "Enter Last Name"
}
]
}
]
}
]
}
]
},
{
"type": "ColumnSet",
"columns": [
{
"type": "Column",
"width": "stretch",
"items": [
{
"type": "Input.Text",
"placeholder": "123 345-7689",
"id": "cellPhone",
"value": "",
"isRequired": true,
"label": "Cell Phone Number",
"errorMessage": "Enter a phone number",
"regex": "^(\\+\\d{1,2}\\s?)?1?\\-?\\.?\\s?\\(?\\d{3}\\)?[\\s.-]?\\d{3}[\\s.-]?\\d{4}$"
}
]
},
{
"type": "Column",
"width": "stretch",
"items": [
{
"type": "Input.Text",
"placeholder": "MM/DD/YYYY",
"id": "dateOfBirth",
"label": "Date Of Birth",
"isRequired": true,
"regex": "^(?:(1[0-2]|0?[1-9])/(3[01]|[12][0-9]|0?[1-9])|↵ (3[01]|[12][0-9]|0?[1-9])/(1[0-2]|0?[1-9]))/(?:[0-9]{2})?[0-9]{2}$",
"errorMessage": "Not a valid a valid date"
}
]
}
]
},
{
"type": "Input.Text",
"placeholder": "me@example.com",
"value": "",
"isRequired": true,
"id": "email",
"label": "Email Address",
"regex": "^[\\w-\\.]+@([\\w-]+\\.)+[\\w-]{2,4}$",
"errorMessage": "Enter valid email"
},
{
"type": "ActionSet",
"id": "Submit",
"actions": [
{
"type": "Action.Submit",
"title": "Submit",
"id": "submit",
"style": "positive"
}
]
}
]
}