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<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8">
<link rel="stylesheet" href="popup.css">
<script src="src/lib/jquery-3.1.1.min.js"></script>
<script src="popup.js"></script>
</head>
<body class="popup">
<header><h1>EOT Nomination Tool</h1></header>
<main>
<form id="form" action="#">
<div class="form-field">
<label class="-required" for="title">Title</label>
<input id="title" required>
</div>
<div class="form-field">
<label class="-required" for="url">URL</label>
<input id="url" required>
</div>
<div class="form-message" id="url-warning">This URL has already been crawled by Internet Archive in the last 30 days</div>
<div class="form-field">
<label for="agencyName">Agency</label>
<div class="_select-wrapper">
<select id="agencyName">
<option>Adjutant General's Office (Army)</option>
<option>Administration for Children and Families</option>
<option>Administrative Office of U.S. Courts</option>
<option>Administrator for Research and Acquisitions</option>
<option>Advisory Committee on the Records of Congress</option>
<option>Advisory Council on Historic Preservation</option>
<option>Aerospace Medicine Office</option>
<option>African and Middle Eastern Division</option>
<option>Aging Administration</option>
<option>Agricultural Marketing Service</option>
<option>Agricultural Research Service</option>
<option>Agriculture Department</option>
<option>Air and Radiation</option>
<option>Air Force Academy</option>
<option>Air Force Department</option>
<option>Air Force Office of the Surgeon General</option>
<option>Air Traffic Operations Service</option>
<option>Aircraft Certification Service</option>
<option>Airport Planning and Programming Office</option>
<option>Airport Safety and Standards Office</option>
<option>Alcohol and Tobacco Tax and Trade Bureau</option>
<option>American Battle Monuments Commission</option>
<option>American Folklife Center</option>
<option>American Forces Information Service</option>
<option>American Historical Association</option>
<option>Animal and Plant Health Inspection Service</option>
<option>Appalachian Regional Commission</option>
<option>Apprenticeship Training, Employer and Labor Services (OATELS)</option>
<option>Architect of the Capitol</option>
<option>Architectural and Transportation Barriers Compliance Board (Access Board)</option>
<option>Arms Control and International Security</option>
<option>Arms Control Bureau</option>
<option>Army Command and General Staff College</option>
<option>Army Department</option>
<option>Army Electronics Research and Development Command</option>
<option>Army Medical Department</option>
<option>Army Ordnance Corps</option>
<option>Asian Division</option>
<option>Biological Resources Division</option>
<option>Bonneville Power Administration</option>
<option>Border and Transportation Security</option>
<option>Broadcasting Board of Governors</option>
<option>Bureau of Alcohol, Tobacco, Firearms, and Explosives</option>
<option>Bureau of Consular Affairs</option>
<option>Bureau of Health Professions</option>
<option>Bureau of Industry and Security</option>
<option>Bureau of Ocean Energy Management, Regulation and Enforcement</option>
<option>Bureau of Primary Health Care</option>
<option>Bureau of Transportation Statistics</option>
<option>Cataloging Directorate</option>
<option>Cataloging Policy and Support Office</option>
<option>Census Bureau</option>
<option>Center for Biologics Evaluation and Research</option>
<option>Center for Devices and Radiological Health</option>
<option>Center For Drug Evaluation and Research</option>
<option>Center for Food Safety and Applied Nutrition</option>
<option>Center for Medicaid and State Operations</option>
<option>Center for Medicare Management</option>
<option>Center for Veterinary Medicine</option>
<option>Centers for Disease Control and Prevention</option>
<option>Centers for Medicare and Medicaid Services</option>
<option>Central Intelligence Agency</option>
<option>Chemical Corps</option>
<option>Chemical Emergency Preparedness and Prevention Office</option>
<option>Chief of Naval Reserve</option>
<option>Child Care Bureau</option>
<option>Child Support Enforcement Office</option>
<option>Children, Youth and Families Administration</option>
<option>Children's Bureau</option>
<option>Citizenship and Immigration Services</option>
<option>Civil Rights Commission</option>
<option>Clinical Standards and Quality Office</option>
<option>Coast Guard</option>
<option>Commerce Department</option>
<option>Commission on Security and Cooperation in Europe</option>
<option>Commissions, Committees, and Boards</option>
<option>Committee for Purchase from the Blind and Other Severely Handicapped</option>
<option>Committee on Agriculture (House)</option>
<option>Committee on Agriculture, Nutrition, and Forestry (Senate)</option>
<option>Committee on Appropriations (House)</option>
<option>Committee on Appropriations (Senate)</option>
<option>Committee on Armed Services (House)</option>
<option>Committee on Armed Services (Senate)</option>
<option>Committee on Banking, Housing, and Urban Affairs (Senate)</option>
<option>Committee on Commerce, Science and Transportation (Senate)</option>
<option>Committee on Education and Labor (House)</option>
<option>Committee on Energy and Commerce (House)</option>
<option>Committee on Energy and Natural Resources (Senate)</option>
<option>Committee on Environment and Public Works (Senate)</option>
<option>Committee on Finance (Senate)</option>
<option>Committee on Financial Services (House)</option>
<option>Committee on Foreign Affairs (House)</option>
<option>Committee on Foreign Relations (Senate)</option>
<option>Committee on Health, Education, Labor, & Pensions (Senate)</option>
<option>Committee on Homeland Security (House)</option>
<option>Committee on Homeland Security and Governmental Affairs (Senate)</option>
<option>Committee on House Administration (House)</option>
<option>Committee on Indian Affairs (Senate)</option>
<option>Committee on International Relations (House)</option>
<option>Committee on Natural Resources (House)</option>
<option>Committee on Oversight and Government Reform (House)</option>
<option>Committee on Rules (House)</option>
<option>Committee on Rules and Administration (Senate)</option>
<option>Committee on Science and Technology (House)</option>
<option>Committee on Small Business (House)</option>
<option>Committee on Small Business & Entrepreneurship (Senate)</option>
<option>Committee on Standards of Official Conduct (House)</option>
<option>Committee on the Budget (House)</option>
<option>Committee on the Budget (Senate)</option>
<option>Committee on the Judiciary (House)</option>
<option>Committee on the Judiciary (Senate)</option>
<option>Committee on Transportation and Infrastructure (House)</option>
<option>Committee on Veterans' Affairs (House)</option>
<option>Committee on Veterans' Affairs (Senate)</option>
<option>Committee on Ways and Means (House)</option>
<option>Commodity Credit Corporation</option>
<option>Commodity Futures Trading Commission</option>
<option>Community Oriented Policing Services</option>
<option>Community Relations Service</option>
<option>Comptroller of Currency</option>
<option>Congress</option>
<option>Congressional Budget Office</option>
<option>Congressional Research Service</option>
<option>Congressional-Executive Commission on China</option>
<option>Consumer Information Center</option>
<option>Consumer Product Safety Commission</option>
<option>Cooperative State Research, Education and Extension Service</option>
<option>Copyright Office</option>
<option>Council on Environmental Quality</option>
<option>Court Services and Offender Supervision Agency</option>
<option>Customs and Border Protection</option>
<option>Defense Base Closure and Realignment Commission</option>
<option>Defense Department</option>
<option>Defense Information Systems Agency</option>
<option>Defense Intelligence Agency</option>
<option>Defense Logistics Agency</option>
<option>Defense Nuclear Facilities Safety Board</option>
<option>Defense Technical Information Center</option>
<option>Defense Threat Reduction Agency</option>
<option>Developmental Disabilities Administration</option>
<option>Disability Employment Policy Office (ODEP)</option>
<option>Domestic Policy Council</option>
<option>Drug Enforcement Administration</option>
<option>Economic Advisors Council</option>
<option>Economic Analysis Bureau</option>
<option>Economic Development Administration</option>
<option>Economic Research Service</option>
<option>Education Department</option>
<option>Educational and Cultural Affairs Bureau</option>
<option>Election Assistance Commission</option>
<option>Elementary and Secondary Education Office</option>
<option>Emergency Preparedness and Response</option>
<option>Employee Benefits Security Administration</option>
<option>Employees Compensation Appeals Board</option>
<option>Employment and Training Administration</option>
<option>Employment Standards Administration</option>
<option>Energy Department</option>
<option>Energy Efficiency and Renewable Energy</option>
<option>Energy Information Administration</option>
<option>Engineers Corps (Army)</option>
<option>Engraving and Printing Bureau</option>
<option>Environmental Protection Agency</option>
<option>Environmental Research Laboratories</option>
<option>Equal Employment Opportunity Commission</option>
<option>European Division</option>
<option>Executive Office for the United States Attorneys</option>
<option>Executive Office of the President</option>
<option>Export-Import Bank of United States</option>
<option>Family and Youth Services Bureau</option>
<option>Farm Credit Administration</option>
<option>Farm Credit System Insurance Corporation</option>
<option>Farm Service Agency</option>
<option>Federal Aviation Administration</option>
<option>Federal Bureau of Investigation</option>
<option>Federal Communications Commission</option>
<option>Federal Crop Insurance Corporation</option>
<option>Federal Deposit Insurance Corporation</option>
<option>Federal Election Commission</option>
<option>Federal Emergency Management Administration (FEMA)</option>
<option>Federal Energy Regulatory Commission</option>
<option>Federal Executive Board</option>
<option>Federal Financial Institutions Examination Council</option>
<option>Federal Geographic Data Committee</option>
<option>Federal Grain Inspection Service</option>
<option>Federal Highway Administration</option>
<option>Federal Housing Administration</option>
<option>Federal Housing Financing Board</option>
<option>Federal Judicial Center</option>
<option>Federal Labor Relations Authority</option>
<option>Federal Maritime Commission</option>
<option>Federal Mediation and Conciliation Service</option>
<option>Federal Mine Safety and Health Review Commission</option>
<option>Federal Motor Carrier Safety Administration</option>
<option>Federal Railroad Administration</option>
<option>Federal Register Office</option>
<option>Federal Reserve System Board of Governors</option>
<option>Federal Retirement Thrift Investment Board</option>
<option>Federal Supply Service</option>
<option>Federal Technology Service</option>
<option>Federal Trade Commission</option>
<option>Federal Transit Administration</option>
<option>Financial Literacy and Education Commission</option>
<option>Financial Management Service</option>
<option>Fine Arts Commission</option>
<option>Fiscal Service</option>
<option>Fish and Wildlife Service</option>
<option>Flight Standards Service</option>
<option>Food and Drug Administration</option>
<option>Food and Nutrition Service</option>
<option>Food Safety and Inspection Service</option>
<option>Foreign Agricultural Service</option>
<option>Foreign Broadcast Information Service</option>
<option>Foreign-Trade Zones Board</option>
<option>Forest Service</option>
<option>Freer Gallery of Art</option>
<option>General Services Administration</option>
<option>Geographic Names Board</option>
<option>Geography and Map Division</option>
<option>Geological Survey</option>
<option>Government Accountability Office</option>
<option>Government Printing Office</option>
<option>Head Start Bureau</option>
<option>Health and Human Services Department</option>
<option>Health Resources and Services Administration</option>
<option>Healthcare Research and Quality Agency</option>
<option>Hirshhorn Museum and Sculpture Garden</option>
<option>Hispanic Division</option>
<option>HIV/AIDS Bureau</option>
<option>Homeland Security</option>
<option>House of Representatives</option>
<option>Housing and Urban Development Department</option>
<option>Humanities and Social Sciences Division</option>
<option>Immigration and Customs Enforcement</option>
<option>Immigration and Naturalization Service</option>
<option>Indian Affairs Bureau</option>
<option>Indian Health Service</option>
<option>Information Analysis and Infrastructure Protection</option>
<option>Institute of Education Sciences</option>
<option>Institute of Museum and Library Services</option>
<option>Inter-American Foundation</option>
<option>Interagency Council on the Homelessness</option>
<option>Interior Department</option>
<option>Internal Revenue Service</option>
<option>International Broadcasting Bureau</option>
<option>International Development Agency</option>
<option>International Information Programs</option>
<option>International Labor Affairs Bureau</option>
<option>International Trade Administration</option>
<option>International Trade Commission</option>
<option>Interstate Commerce Commission</option>
<option>Japan-United States Friendship Commission</option>
<option>John E. Fogarty International Center for Advanced Study in the Health Sciences</option>
<option>Joint Chiefs of Staff</option>
<option>Joint Committee on Printing</option>
<option>Joint Committee on Taxation</option>
<option>Joint Committee on the Library</option>
<option>Joint Economic Committee</option>
<option>Joint Financial Management Improvement Program</option>
<option>Judge Advocate General (Navy)</option>
<option>Judge Advocate General of Air Force</option>
<option>Judge Advocate General's Office (Army)</option>
<option>Judiciary</option>
<option>Justice Assistance Bureau</option>
<option>Justice Department</option>
<option>Justice Statistics Bureau</option>
<option>Juvenile Justice and Delinquency Prevention Office</option>
<option>Labor Department</option>
<option>Labor Statistics Bureau</option>
<option>Land Management Bureau</option>
<option>Law Library</option>
<option>Legal Services Corporation</option>
<option>Library of Congress</option>
<option>Library Services (Includes Cataloging Distribution Service Division)</option>
<option>Management and Budget Office</option>
<option>Manuscript Division</option>
<option>Marine Corps</option>
<option>Marine Mammal Commission</option>
<option>Maritime Administration</option>
<option>Marshals Service</option>
<option>Maternal and Child Health Bureau</option>
<option>Medicare Payment Advisory Commission (MedPAC)</option>
<option>Medicine and Surgery Bureau (Navy)</option>
<option>Merit Systems Protection Board</option>
<option>Migratory Bird Conservation Commission</option>
<option>Military Academy West Point</option>
<option>Military History Center</option>
<option>Military Sealift Command</option>
<option>Mine Safety and Health Administration</option>
<option>Minerals Management Service</option>
<option>Minority Business Development Agency</option>
<option>Mint Bureau</option>
<option>Motion Picture, Broadcasting and Recorded Sound Division</option>
<option>Multi-Family Housing Office</option>
<option>Music Division</option>
<option>National Advisory Council on Indian Education</option>
<option>National Aeronautics and Space Administration: Science Mission Directorate</option>
<option>National Aeronautics and Space Administration: Sciences and Exploration Directorate</option>
<option>National Agricultural Library</option>
<option>National Agricultural Statistics Service</option>
<option>National Air and Space Museum</option>
<option>National Archives and Records Administration</option>
<option>National Cancer Institute</option>
<option>National Capital Planning Commission</option>
<option>National Center for Chronic Disease Prevention and Health Promotion</option>
<option>National Center for Complementary and Alternative Medicine</option>
<option>National Center for Education Evaluation and Regional Assistance (NCEE)</option>
<option>National Center for Education Research (NCER)</option>
<option>National Center for Education Statistics</option>
<option>National Center for Environmental Health</option>
<option>National Center for Health Statistics</option>
<option>National Center for HIV, STD and TB Prevention</option>
<option>National Center for Infectious Diseases</option>
<option>National Center for Injury Prevention and Control</option>
<option>National Centers for Environmental Prediction</option>
<option>National Climatic Data Center</option>
<option>National Commission on Libraries and Information Science</option>
<option>National Council on Disability</option>
<option>National Credit Union Administration</option>
<option>National Defense University</option>
<option>National Endowment for the Arts</option>
<option>National Endowment for the Humanities</option>
<option>National Energy Technology Laboratory (NETL)</option>
<option>National Environmental Satellite, Data, and Information Service</option>
<option>National Eye Institute</option>
<option>National Foundation on the Arts and the Humanities</option>
<option>National Gallery of Art</option>
<option>National Geospatial-Intelligence Agency</option>
<option>National Guard Bureau</option>
<option>National Heart, Lung, and Blood Institute</option>
<option>National Highway Traffic Safety Administration</option>
<option>National Immunization Program</option>
<option>National Institute for Literacy</option>
<option>National Institute for Occupational Safety and Health</option>
<option>National Institute of Allergy and Infectious Diseases</option>
<option>National Institute of Arthritis and Musculoskeletal and Skin Diseases</option>
<option>National Institute of Child Health and Human Development</option>
<option>National Institute of Corrections</option>
<option>National Institute of Dental and Craniofacial Research</option>
<option>National Institute of Diabetes and Digestive and Kidney Diseases</option>
<option>National Institute of Environmental Health Sciences</option>
<option>National Institute of General Medical Sciences</option>
<option>National Institute of Justice</option>
<option>National Institute of Mental Health</option>
<option>National Institute of Neurological Disorders and Stroke</option>
<option>National Institute of Standards and Technology (NIST)</option>
<option>National Institute on Aging</option>
<option>National Institute on Alcohol Abuse and Alcoholism</option>
<option>National Institute on Deafness and Other Communication Disorders</option>
<option>National Institute on Drug Abuse</option>
<option>National Institutes of Health</option>
<option>National Labor Relations Board</option>
<option>National Library of Medicine</option>
<option>National Library Service for the Blind and Physically Handicapped</option>
<option>National Marine Fisheries Service</option>
<option>National Mediation Board</option>
<option>National Museum of African Art</option>
<option>National Museum of American Art</option>
<option>National Museum of American History/National Museum of Natural History</option>
<option>National Museum of the American Indian</option>
<option>National Nuclear Security Administration</option>
<option>National Ocean Service</option>
<option>National Oceanic and Atmospheric Administration</option>
<option>National Oceanographic Data Center</option>
<option>National Park Service</option>
<option>National Portrait Gallery</option>
<option>National Renewable Energy Laboratory (NREL)</option>
<option>National Science Foundation</option>
<option>National Senior Service Corps</option>
<option>National Technical Information Service</option>
<option>National Telecommunications and Information Administration</option>
<option>National Transportation Safety Board</option>
<option>National Weather Service</option>
<option>National Women's Business Council</option>
<option>Native Americans Administration</option>
<option>Natural Resources Conservation Service</option>
<option>Natural Resources Library</option>
<option>Naval Academy</option>
<option>Naval Air Systems Command</option>
<option>Naval Doctrine Command</option>
<option>Naval Education and Training Command</option>
<option>Naval Facilities Engineering Command</option>
<option>Naval Historical Center</option>
<option>Naval Meteorology and Oceanography Command</option>
<option>Naval Observatory</option>
<option>Naval Operations Office</option>
<option>Naval Ordnance Systems Command</option>
<option>Naval Research Office</option>
<option>Naval Sea Systems Command</option>
<option>Naval Supply Systems Command</option>
<option>Naval War College, Newport</option>
<option>Navy Department</option>
<option>Navy Personnel Command</option>
<option>North American Commission for Environmental Cooperation</option>
<option>Northwest Power Planning Council</option>
<option>Nuclear Regulatory Commission</option>
<option>Nuclear Waste Technical Review Board</option>
<option>Occupational Safety and Health Administration</option>
<option>Occupational Safety and Health Review Commission</option>
<option>Oceanic and Atmospheric Research Office</option>
<option>Office for Domestic Preparedness</option>
<option>Office for Victims of Crime</option>
<option>Office of Air Quality Planning and Standards</option>
<option>Office of Civilian Personnel</option>
<option>Office of Communications</option>
<option>Office of Compliance</option>
<option>Office of Congressional Relations</option>
<option>Office of Enforcement and Compliance Assurance</option>
<option>Office of Government Ethics</option>
<option>Office of Hazardous Materials Transportation</option>
<option>Office of Information Services</option>
<option>Office of Inspector General</option>
<option>Office of National Drug Control Policy</option>
<option>Office of Policy Development and Research</option>
<option>Office of Prevention, Pesticides and Toxic Substances</option>
<option>Office of Public Health and Science</option>
<option>Office of Research and Development</option>
<option>Office of Science and Technology</option>
<option>Office of Solid Waste and Emergency Response</option>
<option>Office of Special Counsel</option>
<option>Office of the Director of National Intelligence</option>
<option>Office of the Inspector General</option>
<option>Office of the National Counterintelligence Executive</option>
<option>Office of Thrift Supervision</option>
<option>Office of Transportation and Air Quality</option>
<option>Overseas Private Investment Corporation</option>
<option>Patent and Trademark Office</option>
<option>Peace Corps</option>
<option>Pension Benefit Guaranty Corporation</option>
<option>Permanent Select Committee on Intelligence (House)</option>
<option>Personnel Appeals Board</option>
<option>Personnel Management Office</option>
<option>Pipeline and Hazardous Materials Safety Administration</option>
<option>Postal Regulatory Commission</option>
<option>President of the United States</option>
<option>President's Committee on Mental Retardation</option>
<option>President's Council on Physical Fitness and Sports</option>
<option>Presidential Scholars Commission</option>
<option>Prints and Photographs Division</option>
<option>Prisons Bureau</option>
<option>Privacy and Civil Liberties Oversight Board</option>
<option>Provost Marshal General (Army)</option>
<option>Public Buildings Service</option>
<option>Public Debt Bureau</option>
<option>Quality Assurance Bureau</option>
<option>Quartermaster General of the Army</option>
<option>Radiation & Indoor Air</option>
<option>Railroad Retirement Board</option>
<option>Rare Book and Special Collections Division</option>
<option>Reclamation Bureau</option>
<option>Research and Special Programs Administration</option>
<option>Risk Management Agency</option>
<option>Rural Business/Cooperative Service</option>
<option>Rural Development</option>
<option>Rural Housing Service</option>
<option>Rural Utilities Service</option>
<option>Safety Office</option>
<option>Savings Bonds Marketing Office</option>
<option>Science and Technology Division</option>
<option>Science and Technology Policy Office</option>
<option>Secret Service</option>
<option>Securities and Exchange Commission</option>
<option>Select and Special Committees (as appointed)</option>
<option>Select Committee on Ethics (Senate)</option>
<option>Select Committee on Intelligence (Senate)</option>
<option>Selective Service System</option>
<option>Senate</option>
<option>Serial and Government Publications Division</option>
<option>Small Business Administration</option>
<option>Smithsonian Institution</option>
<option>Social Security Administration</option>
<option>Solicitor of Labor Department</option>
<option>Southeastern Power Administration</option>
<option>Space and Naval Warfare Systems Command</option>
<option>Special Committee on Aging (Senate)</option>
<option>Special Counsel Office</option>
<option>Special Education and Rehabilitative Services Office</option>
<option>St. Lawrence Seaway Development Corporation</option>
<option>State Department</option>
<option>Strategic Planning Office</option>
<option>Substance Abuse and Mental Health Services Administration</option>
<option>Superintendent of Documents</option>
<option>Supreme Court</option>
<option>Surface Mining Office</option>
<option>Surface Transportation Board</option>
<option>Tax Court</option>
<option>Technology Administration</option>
<option>Technology Innovation Office</option>
<option>Technology Transfer</option>
<option>Tennessee Valley Authority</option>
<option>The African Development Foundation</option>
<option>The Corporation for National and Community Service</option>
<option>The Council of Economic Advisers</option>
<option>The Grain Inspection, Packers and Stockyards Administration</option>
<option>Toxic Substances and Disease Registry Agency</option>
<option>Transportation Department</option>
<option>Transportation Security Administration</option>
<option>Treasury Department</option>
<option>U.S. Arctic Research Commission</option>
<option>U.S. Army Air Mobility Research and Development Command</option>
<option>U.S. Circuit Courts of Appeals</option>
<option>U.S. Climate Change Science Program</option>
<option>U.S. Commission for the Preservation of America's Heritage Abroad</option>
<option>U.S. Commission on International Religious Freedom</option>
<option>U.S. Court of Appeals for the Federal Circuit</option>
<option>U.S. Court of Federal Claims</option>
<option>U.S. Fire Administration (USFA)</option>
<option>U.S. Trade and Development Agency</option>
<option>United States Advisory Commission on Public Diplomacy</option>
<option>United States Bankruptcy Court</option>
<option>United States Chemical Safety and Hazard Investigation Board</option>
<option>United States Court of International Trade</option>
<option>United States Court of Veterans Appeals</option>
<option>United States District Court</option>
<option>United States Employment Service</option>
<option>United States Holocaust Memorial Council</option>
<option>United States Institute of Peace</option>
<option>United States Parole Commission</option>
<option>United States Postal Service</option>
<option>United States Secret Service</option>
<option>United States Sentencing Commission</option>
<option>United States Trade Representative</option>
<option>United States-China Security Review Commission</option>
<option>Upper Midwest Environmental Sciences Center</option>
<option>US Agency for International Development</option>
<option>Veteran's Employment and Training Service</option>
<option>Veterans Affairs Department</option>
<option>Vice President of the United States</option>
<option>Violence Against Women Office</option>
<option>Wage and Hour Division</option>
<option>Water Office</option>
<option>Western Area Power Administration</option>
<option>Wetlands, Oceans & Watersheds Office</option>
<option>White House Historical Association</option>
<option>Women's Bureau</option>
<option>Worker's Compensation Programs Office</option>
<option>Workforce Security Office</option>
</select>
</div>
</div>
<div class="form-field">
<label class="-required" for="nominatorName">Your Name</label>
<input id="nominatorName" required>
</div>
<div class="form-field">
<label class="-required" for="nominatorEmail">Your Email</label>
<input id="nominatorEmail" type="email" required>
</div>
<div class="form-field">
<label class="-required" for="eventName">Event Name</label>
<input id="eventName" required>
</div>
<div class="form-field -multi">
<label class="-required" for="agencyId">Agency</label>
<input id="agencyId" type="number" min="0" max="99" required>
<label class="-required" for="subAgencyId">Subagency</label>
<input id="subAgencyId" type="number" min="0" max="99" required>
</div>
<div class="form-field -multi">
<label class="-required" for="organizationId">Organization</label>
<input id="organizationId" type="number" min="0" max="99" required>
<label for="suborgId">Suborganization</label>
<input id="suborgId" type="number" min="0" max="99">
</div>
<div class="form-field -multi">
<label for="subprimerId">Subprimer</label>
<input id="subprimerId" type="number">
<label></label>
<span class="_filler"></span>
</div>
<div class="form-field">
<label>Nature</label>
<fieldset>
<div class="_checkbox-wrapper">
<input type="checkbox" id="hasFtp"> <label for="hasFtp">FTP</label>
</div>
<div class="_checkbox-wrapper">
<input type="checkbox" id="hasManyFiles"> <label for="hasManyFiles">Many Files</label>
</div>
</fieldset>
<fieldset>
<div class="_checkbox-wrapper">
<input type="checkbox" id="hasDatabase"> <label for="hasDatabase">Database</label>
</div>
<div class="_checkbox-wrapper">
<input type="checkbox" id="hasVisualization"> <label for="hasVisualization">Visualization/Interactive</label>
</div>
</fieldset>
</div>
<div class="form-field">
<label for="comments">Comments</label>
<textarea id="comments" rows="3"></textarea>
</div>
<div class="form-footnote">
Required fields
</div>
</form>
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<footer>
<button type="submit" form="form" id="submit">Submit</button>
<div id="status" class="status"></div>
</footer>
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