{ "title": "SupaMoto Existing Customer Claim", "pages": [ { "name": "screening", "elements": [ { "type": "text", "name": "ecs:customerId", "title": "Customer ID", "isRequired": true, "readOnly": true }, { "type": "dropdown", "name": "ecs:clientType", "title": "Client Group Type", "isRequired": true, "choices": [ "Utility", "Utility-Staff", "Non-Utility", "Non-Utility Staff", "Organisation", "Retired", "Unregistered", "Reseller" ], "showOtherItem": true }, { "type": "text", "name": "schema:givenName", "title": "First Name", "isRequired": true, "validators": [ { "type": "regex", "regex": "^[A-Za-z ]+$" } ] }, { "type": "text", "name": "schema:familyName", "title": "Last Name", "isRequired": true, "validators": [ { "type": "regex", "regex": "^[A-Za-z ]+$" } ] }, { "type": "radiogroup", "name": "person:gender", "title": "Gender", "isRequired": true, "choices": [ { "value": "male", "text": "Male" }, { "value": "female", "text": "Female" } ] }, { "type": "text", "name": "schema:birthDate", "title": "Date of Birth", "inputType": "date" }, { "type": "text", "name": "person:nationalId", "title": "National Registration Number", "isRequired": true, "validators": [ { "type": "regex", "text": "Use the format xxxxxx/xx/x", "regex": "^\\d{6}/\\d{2}/\\d{1}$" } ], "placeholder": "xxxxxx/xx/x" }, { "type": "file", "name": "person:nationalIdCard", "title": "NRC photos (front and back)", "isRequired": true, "allowMultiple": true, "acceptedTypes": "image/*,.pdf", "waitForUpload": true, "maxSize": 10000000, "sourceType": "file-camera" }, { "type": "text", "name": "schema:telephone", "title": "Contact number", "isRequired": true, "validators": [ { "type": "regex", "text": "Please enter the phone number in international format, including the country code (e.g. +260977123456).", "regex": "^\\+[1-9]\\d{6,14}$" } ], "inputType": "tel" }, { "type": "text", "name": "schema:telephone_2", "title": "Alternative Contact number", "validators": [ { "type": "regex", "text": "Please enter the phone number in international format, including the country code (e.g. +260977123456).", "regex": "^\\+[1-9]\\d{6,14}$" } ], "inputType": "tel" }, { "type": "radiogroup", "name": "schema:DeliveryMethod", "title": "How would you prefer to get your pellet bag?", "isRequired": true, "choices": [ { "value": "Collect from neighbor", "text": "Lead Generator (Neighbor) pickup" }, { "value": "Shop Pickup", "text": "SupaMoto Shop pickup" }, "Home Delivery" ] }, { "type": "file", "name": "schema:profileImage", "title": "Profile Image ", "description": "Provide the reference the customer can use for real‑time payment assignment.", "isRequired": true, "acceptedTypes": "image/*,.pdf", "waitForUpload": true, "maxSize": 10000000, "sourceType": "file-camera", "allowMultiple": true }, { "type": "text", "name": "schema:addressCountry", "title": "Country", "isRequired": true }, { "type": "text", "name": "geo:coordinates:latitude", "title": "Coordinates: Latitude ", "isRequired": true }, { "type": "text", "name": "geo:coordinates:longitude", "title": "Coordinates: Longitude", "isRequired": true }, { "type": "file", "name": "schema:dataWaiver", "title": "Signed Carbon/Data Waiver (all pages)", "description": "Provide the reference the customer can use for real‑time payment assignment.", "isRequired": true, "acceptedTypes": "image/*,.pdf", "waitForUpload": true, "maxSize": 10000000, "sourceType": "file-camera", "allowMultiple": true }, { "type": "text", "name": "schema:dataWaiverDate", "title": "Date of signature (Carbon Waiver)", "isRequired": true }, { "type": "file", "name": "schema:signedContract", "title": "Upload photo of the signed contract (all pages)", "description": "Provide the reference the customer can use for real‑time payment assignment.", "isRequired": true, "acceptedTypes": "image/*,.pdf", "waitForUpload": true, "maxSize": 10000000, "sourceType": "file-camera", "allowMultiple": true }, { "type": "text", "name": "schema:signedContractDate", "title": "Date of signature (Contract)", "isRequired": true } ], "title": "Questions" }, { "name": "household", "title": "Household Survey", "elements": [ { "type": "radiogroup", "name": "ecs:marital_status", "title": "Marital status", "choices": [ { "value": "single", "text": "Single" }, { "value": "married", "text": "Married" }, { "value": "divorced", "text": "Divorced" }, { "value": "widowed", "text": "Widowed" } ] }, { "type": "dropdown", "name": "schema:occupancy", "title": "Household size (number of people)", "choices": [ "1", "2", "3", "4", "5", "6", "7", "8", "9", "10", "11-15", "15+" ] }, { "type": "text", "name": "ecs:occupation", "title": "Occupation" }, { "type": "text", "name": "ecs:quantityBreakfast", "title": "How many people do you cook breakfast for?", "inputType": "number" }, { "type": "text", "name": "ecs:quantityLunch", "title": "How many people do you cook lunch for?", "inputType": "number" }, { "type": "text", "name": "ecs:quantityDinner", "title": "How many people do you cook dinner for?", "inputType": "number" }, { "type": "radiogroup", "name": "ecs:charcoalBusiness", "title": "Do you run a charcoal business?", "choices": [ "Yes", "No" ] }, { "type": "dropdown", "name": "ecs:charcoalExpenditure", "title": "Monthly charcoal expenditure (ZMW)", "choices": [ "0", "1-50", "50-100", "100-200", "200-300", "300-400", "400-500", "500-600", "600+" ] }, { "type": "dropdown", "name": "ecs:charcoalPurchaseFrequency", "title": "How often do you buy charcoal?", "choices": [ "Daily", "Weekly", "Bi-weekly", "Monthly", "Never" ] }, { "type": "dropdown", "name": "ecs:charcoalBagSizeKg", "title": "Usual charcoal bag size (kg)", "choices": [ "1-20", "21-50", "51-90", "91+" ], "showOtherItem": true }, { "type": "dropdown", "name": "ecs:stoveUse", "title": "How will the stove be used?", "choices": [ "Home use", "Commercial use (a defined and registered business with minimum 2 employees)" ] }, { "type": "radiogroup", "name": "ecs:ownsStove", "title": "Do you already own a SupaMoto stove?", "choices": [ "Yes", "No" ] }, { "type": "dropdown", "name": "ecs:ignitionMethod", "title": "How do you light your charcoal stove?", "choices": [ "Sticks", "Plastics", "Paper", "Paraffin", "Methylated Spirit" ], "showOtherItem": true }, { "type": "radiogroup", "name": "schema:electricitySupply", "title": "Do you have access to electricity?", "choices": [ "Yes", "No" ] }, { "type": "dropdown", "name": "ecs:quantityElectricityCooking", "title": "Days per month cooking with electricity", "choices": [ "0", "1-7", "8-14", "15-21", "22-31" ], "visibleIf": "{schema:electricitySupply} = 'Yes'" }, { "type": "dropdown", "name": "ecs:quantityLPGCooking", "title": "Days per month cooking with LPG", "choices": [ "0", "1-7", "8-14", "15-21", "22-31" ] }, { "type": "radiogroup", "name": "ecs:fuelBudgetAbility", "title": "Can you spend K130 per month on pellets?", "choices": [ "Yes", "No" ] }, { "type": "radiogroup", "name": "ecs:membershipFeeWilling", "title": "Willing to pay the once-off membership fee?", "choices": [ "Yes", "No" ] }, { "type": "radiogroup", "name": "ecs:signingContract", "title": "Willing to self-sign the contract?", "choices": [ "Yes", "No" ] } ] }, { "name": "legacyRecord", "title": "Legacy Record", "elements": [ { "type": "text", "name": "ecs:operatorId", "title": "Supa Operator", "isRequired": true, "description": "Supa Operator ID for the sales operation this customer belongs to." }, { "type": "text", "name": "ecs:legacyLgId", "title": "Legacy Collection Partner ID", "readOnly": true, "description": "collection_partners.id from the legacy system (customers.lg_id)" }, { "type": "text", "name": "ecs:timeRegistered", "title": "Registered at (legacy)", "readOnly": true, "isRequired": false }, { "type": "text", "name": "ecs:timeLeadRegistered", "title": "Lead registered at (legacy)", "readOnly": true, "isRequired": false }, { "type": "text", "name": "ecs:freshdeskId", "title": "Freshdesk ID", "readOnly": true, "isRequired": false } ] } ], "checkErrorsMode": "onValueChanged", "validateVisitedEmptyFields": true, "textUpdateMode": "onTyping", "showPreviewBeforeComplete": true }