{{#with data}}

<div class="lead-qualifier-container">
    <div class="lead-qualifier-text-section">
        <p><span class="bs4--d-block">Buying or selling?</span><span class="bs4--d-block">Let's talk!</span></p>
    </div>
    <div class="lead-qualifier-questions">
        <div class="question-container">
            <fieldset class="question-section is-active">
                <h3>Do you currently rent or own?</h3>
                <div class="question-body">
                    <input type="radio" id="rent" name="propertyType" value="rent" />
                    <label class="next" data-name="next" for="rent">Rent</label>
                    <input type="radio" id="own" name="propertyType" value="own" />
                    <label class="next" data-name="next" for="own">Own</label>
                </div>
                <div class="question-footer">
                    1 of 5
                </div>
            </fieldset>
            <fieldset class="question-section">
                <h3>When do you plan to buy a home?</h3>
                <div class="question-body">
                    <input type="radio" id="3months" name="buyTime" value="within 3 months" />
                    <label class="next" data-name="next" for="3months">Within 3 Months</label>
                    <input type="radio" id="1year" name="buyTime" value="within a year" />
                    <label class="next" data-name="next" for="1year">Within a Year</label>
                    <input type="radio" id="notsure" name="buyTime" value="not sure" />
                    <label class="next" data-name="next" for="notsure">Not Sure</label>
                </div>
                <div class="question-footer">
                    <button class="back-btn bs4--d-inline" data-name="back" aria-hidden="true"><i
                            class="material-icons bs4--align-middle" aria-hidden="true">arrow_back</i></button>
                    <span>2 of 5</span>
                </div>
            </fieldset>
            <fieldset class="question-section">
                <h3>Are you already working with an agent?</h3>
                <div class="question-body">
                    <input type="radio" id="agentYes" name="haveAgent" value="yes" />
                    <label class="next" data-name="next" for="agentYes">Yes</label>
                    <input type="radio" id="agentNo" name="haveAgent" value="no" />
                    <label class="next" data-name="next" for="agentNo">No</label>
                </div>
                <div class="question-footer">
                    <button class="back-btn bs4--d-inline" data-name="back" aria-hidden="true"><i
                            class="material-icons bs4--align-middle" aria-hidden="true">arrow_back</i></button>
                    <span>3 of 5</span>
                </div>
            </fieldset>
            <fieldset class="question-section">
                <h3>Are you pre-approved for a mortgage?</h3>
                <div class="question-body">
                    <input type="radio" id="preApprovedYes" name="preApproved" value="yes" />
                    <label class="next" data-name="next" for="preApprovedYes">Yes</label>
                    <input type="radio" id="preApprovedNo" name="preApproved" value="no" />
                    <label class="next" data-name="skip" for="preApprovedNo">No</label>
                </div>
                <div class="question-footer">
                    <button class="back-btn bs4--d-inline" data-name="back" aria-hidden="true"><i
                            class="material-icons bs4--align-middle" aria-hidden="true">arrow_back</i></button>
                    <span>4 of 5</span>
                </div>
            </fieldset>
            <fieldset class="question-section">
                <h3>Enter the bank that you are pre-approved with</h3>
                <form id="{{@root/dom/formBank}}" class="rew-qualifier-bank-form bs4--mx-auto bs4--mt-7">
                    <label class="sr-only" for="preApprovedWith">Bank Name</label>
                    <input type="text" class="bs4--form-control" name="preApprovedWith" required
                        placeholder="Bank Name" />
                    <button type="button" data-name="bankValidateButton"
                        class="bs4--btn bs4--btn-sm next-btn touch-hover-event bs4--text-white bs4--mt-3">Next</button>
                </form>
                <div class="question-footer-skip">
                    <button class="back-btn bs4--d-inline" data-name="back" aria-hidden="true"><i
                            class="material-icons bs4--align-middle" aria-hidden="true">arrow_back</i></button>
                    <button class="skip-btn pointer btn-no-border" data-name="skipBank">Skip this Step</button>
                </div>
            </fieldset>
            <fieldset class="question-section">
                <h3>Where can I reach you?</h3>
                <form id="{{@root/dom/formLead}}"
                    class="bs4--form-group rew-qualifier-contact-form bs4--mt-5 bs4--mx-auto">
                    <label class="sr-only" for="{{@root/dom/inputName}}">Your Name</label>
                    <input id="{{@root/dom/inputName}}" type="text" name="name"
                        class="bs4--form-control name-input bs4--mt-2" required placeholder="Your Name" />
                    <label class="sr-only" for="{{@root/dom/inputEmail}}">Your Email</label>
                    <input id="{{@root/dom/inputEmail}}" type="email" name="email"
                        class="bs4--form-control email-input bs4--mt-3" required placeholder="Your Email" />
                    <label class="sr-only" for="{{@root/dom/inputPhoneNumber}}">Number to Reach You (optional)</label>
                    <input id="{{@root/dom/inputPhoneNumber}}" name="phone" type="tel"
                        class="bs4--form-control phone-input bs4--mt-3" placeholder="Number to Reach You (optional)" />
                    <button id="{{@root/dom/btnSubmit}}" type="submit" data-name="send-btn"
                        class="bs4--btn bs4--btn-sm bs4--mx-auto send-btn touch-hover-event bs4--mt-3">Send</button>
                    <div id="{{@root/dom/divLoader}}" class="send-status-div hidden">
                        <img src="/images/loader.gif" />
                    </div>
                </form>
                <div class="question-footer">
                    <button class="back-btn bs4--d-inline" data-name="back" aria-hidden="true"><i
                            class="material-icons bs4--align-middle" aria-hidden="true">arrow_back</i></button>
                    <span>5 of 5</span>
                </div>
            </fieldset>
            <fieldset class="question-section">
                <h3 class="success-msg"> Looking forward to speaking with you</h3>
            </fieldset>
        </div>
    </div>


    {{/with}}