Login/Register
Survey.StylesManager.applyTheme("modern");
var json = {
"completeText": "Finish",
"pageNextText": "Continue",
"pagePrevText": "Previous",
"pages": [
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "html",
"name": "income_intro",
"html": "<article class='intro'> <h1 class='intro__heading intro__heading--income title'> Income </h1> <div class='intro__body wysiwyg'> <p>In this section, you will be asked about your current employment and any other way you and your partner currently receive income.</p> <p>It will be handy to have the following in front of you:</p> <ul> \t<li> \t\tPayslip (for employment details) \t</li> \t<li> \t\t<p>A current Centrelink Schedule for any account based pension from super, annuities, or other income stream products that you own</p> \t\t<p> \t\t\tIf you don't have a current one you can get these schedules by contacting your income stream provider \t\t</p> \t</li> \t<li> \t\tLatest statement from any payments (from Centrelink or other authority) \t</li> </ul> </div> </article>"
}
],
"name": "panel1"
}
],
"name": "page0"
},
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
"Married",
"In a registered relationship",
"Living with my partner",
"Widowed",
"Single"
],
"name": "maritalstatus_c",
"title": " "
}
],
"name": "panel13",
"title": "What is your marital status?"
}
],
"name": "page1"
},
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
{
"value": "1",
"text": "Yes"
},
{
"value": "0",
"text": "No"
}
],
"colCount": 2,
"isRequired": true,
"name": "member_receives_income_from_employment",
"title": " "
},
{
"type": "checkbox",
"name": "member_type_of_employment",
"visible": false,
"visibleIf": "{member_receives_income_from_employment} =1",
"title": " ",
"isRequired": true,
"choices": [
"Self employment",
"All other types of employment"
]
}
],
"name": "panel2",
"title": "You"
},
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
{
"value": "1",
"text": "Yes"
},
{
"value": "0",
"text": "No"
}
],
"colCount": 2,
"isRequired": true,
"name": "partner_receives_income_from_employment",
"title": " "
},
{
"type": "checkbox",
"name": "partner_type_of_employment",
"visible": false,
"visibleIf": "{partner_receives_income_from_employment} =1",
"title": " ",
"isRequired": true,
"choices": [
"Self employment",
"All other types of employment"
]
}
],
"name": "panel1",
"startWithNewLine": false,
"title": "Your Partner",
"visible": false,
"visibleIf": "{maritalstatus_c} = 'Married' or {maritalstatus_c} = 'In a registered relationship' or {maritalstatus_c} = 'Living with my partner'"
}
],
"name": "panel5",
"title": "Do you and/or your partner currently receive income from employment?"
}
],
"name": "page2"
},
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "panel",
"elements": [
{
"type": "paneldynamic",
"minPanelCount": 1,
"name": "member_arrray_employer_names",
"valueName": "member_arrray_employer",
"title": "Please enter all your employers",
"panelAddText": "Add another employer",
"panelCount": 1,
"templateElements": [
{
"type": "text",
"name": "member_employer_name",
"valueName": "name",
"title": "Name of employer"
}
]
}
],
"name": "panel2",
"title": "You",
"visible": false,
"visibleIf": "{member_type_of_employment} contains 'All other types of employment'"
},
{
"type": "panel",
"elements": [
{
"type": "paneldynamic",
"minPanelCount": 1,
"name": "partner_arrray_employer_names",
"valueName": "partner_arrray_employer",
"title": "Please enter all your partner employers",
"panelAddText": "Add another employer",
"panelCount": 1,
"templateElements": [
{
"type": "text",
"name": "partner_employer_name",
"valueName": "name",
"title": "Name of employer"
}
]
}
],
"name": "panel8",
"startWithNewLine": false,
"title": "Your Partner",
"visible": false,
"visibleIf": "{partner_type_of_employment} contains 'All other types of employment'"
}
],
"name": "panel6",
"title": "Who are you employed by?"
}
],
"name": "page3.1",
"visible": false,
"visibleIf": "{member_type_of_employment} contains 'All other types of employment' or {partner_type_of_employment} contains 'All other types of employment'"
},
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "panel",
"elements": [
{
"type": "paneldynamic",
"renderMode": "progressTop",
"allowAddPanel": false,
"allowRemovePanel": false,
"name": "member_arrray_employer_info",
"title": "Your employers",
"valueName": "member_arrray_employer",
"panelCount": 1,
"templateElements": [
{
"type": "panel",
"name": "panel_member_employer_address",
"title": "Address",
"elements": [{
"type": "text",
"name": "member_employer_address",
"valueName": "address",
"title": "Address"
},
{
"type": "text",
"name": "member_employer_phone",
"valueName": "phone",
"title": "Phone number:"
},
{
"type": "text",
"name": "member_employer_abn",
"valueName": "abn",
"title": "ABN"
}
]
},
{
"type": "panel",
"name": "panel_member_employer_role",
"title": "What is your role?",
"elements": [
{
"type": "radiogroup",
"choices": [
"Full time",
"Part time",
"Casual",
"Seasonal"
],
"name": "member_employer_role",
"title": "Your role",
"valueName": "role"
}
]
},
{
"type": "panel",
"name": "panel_member_employer_hours_work",
"title": "What hours do you work?",
"elements": [
{
"type": "text",
"inputType": "number",
"name": "member_employer_hours_worked",
"valueName": "hours_worked",
"title": "Hours:"
},
{
"type": "dropdown",
"name": "member_employer_hours_worked_frequency",
"title": "Worked Frequency:",
"valueName": "hours_worked_frequency",
"startWithNewLine": false,
"defaultValue": "Year",
"choices": [
"Day",
"Week",
"Fortnight",
"Month",
"Year"
]
}
]
},
{
"type": "panel",
"name": "panel_member_employer_income",
"title": "What income do you receive?",
"elements": [
{
"type": "text",
"inputType": "number",
"name": "member_employer_income",
"valueName": "income",
"title": "Income:"
},
{
"type": "dropdown",
"name": "member_employer_income_frequency",
"title": "Income Frequency",
"valueName": "income_frequency",
"startWithNewLine": false,
"defaultValue": "Year",
"choices": [
"Day",
"Week",
"Fortnight",
"Month",
"Year"
]
}
]
}
],
"templateTitle": "Employer name: {panel.name}"
}
],
"name": "panel17",
"title": "You",
"visibleIf": "{member_type_of_employment} contains 'All other types of employment'"
},
{
"type": "panel",
"elements": [
{
"type": "paneldynamic",
"renderMode": "progressTop",
"allowAddPanel": false,
"allowRemovePanel": false,
"name": "partner_arrray_employer_info",
"title": "Your partner employers",
"valueName": "partner_arrray_employer",
"panelCount": 1,
"templateElements": [
{
"type": "panel",
"name": "panel_partner_employer_address",
"title": "Address",
"elements": [{
"type": "text",
"name": "partner_employer_address",
"valueName": "address",
"title": "Address:"
},
{
"type": "text",
"name": "partner_employer_phone",
"valueName": "phone",
"title": "Phone number"
},
{
"type": "text",
"name": "partner_employer_abn",
"valueName": "abn",
"title": "ABN"
}
]
},
{
"type": "panel",
"name": "panel_partner_employer_role",
"title": "What is your role?",
"elements": [
{
"type": "radiogroup",
"choices": [
"Full time",
"Part time",
"Casual",
"Seasonal"
],
"name": "partner_employer_role",
"title": "Your role",
"valueName": "role"
}
]
},
{
"type": "panel",
"name": "panel_partner_employer_hours_work",
"title": "What hours do you work?",
"elements": [
{
"type": "text",
"inputType": "number",
"name": "partner_employer_hours_worked",
"valueName": "hours_worked",
"title": "Hours"
},
{
"type": "dropdown",
"name": "partner_employer_hours_worked_frequency",
"valueName": "hours_worked_frequency",
"title": "Worked Frequency:",
"startWithNewLine": false,
"defaultValue": "Year",
"choices": [
"Day",
"Week",
"Fortnight",
"Month",
"Year"
]
}
]
},
{
"type": "panel",
"name": "panel_partner_employer_income",
"title": "What income do you receive?",
"elements": [
{
"type": "text",
"inputType": "number",
"name": "partner_employer_income",
"valueName": "income",
"title": "Income:"
},
{
"type": "dropdown",
"name": "partner_employer_income_frequency",
"valueName": "income_frequency",
"title": "Income frequency:",
"startWithNewLine": false,
"defaultValue": "Year",
"choices": [
"Day",
"Week",
"Fortnight",
"Month",
"Year"
]
}
]
}
],
"templateTitle": "Employer name: {panel.name}"
}
],
"name": "panel18",
"startWithNewLine": false,
"title": "You partner",
"visibleIf": "{partner_type_of_employment} contains 'All other types of employment'"
}
],
"name": "panel16",
"title": "Tells us about your employer(s)"
}
],
"name": "page3.2",
"visibleIf": "{member_type_of_employment} contains 'All other types of employment' or {partner_type_of_employment} contains 'All other types of employment'"
},
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
{
"value": "1",
"text": "Yes"
},
{
"value": "0",
"text": "No"
}
],
"colCount": 2,
"isRequired": true,
"name": "member_receive_fringe_benefits",
"title": " "
},
{
"type": "panel",
"elements": [
{
"type": "text",
"name": "member_fringe_benefits_type"
},
{
"type": "text",
"name": "member_fringe_benefits_value"
},
{
"type": "radiogroup",
"choices": [
"Grossed up",
"Not grossed up"
],
"name": "member_fringe_benefits_grossing"
}
],
"name": "panel11",
"visible": false,
"visibleIf": "{member_receive_fringe_benefits} = 1"
}
],
"name": "panel2",
"title": "You",
"visible": false,
"visibleIf": "{member_type_of_employment} contains 'All other types of employment'"
},
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
{
"value": "1",
"text": "Yes"
},
{
"value": "0",
"text": "No"
}
],
"colCount": 2,
"isRequired": true,
"name": "partner_receive_fringe_benefits",
"title": " "
},
{
"type": "panel",
"elements": [
{
"type": "text",
"name": "partner_fringe_benefits_type"
},
{
"type": "text",
"name": "partner_fringe_benefits_value"
},
{
"type": "radiogroup",
"choices": [
"Grossed up",
"Not grossed up"
],
"name": "partner_fringe_benefits_grossing"
}
],
"name": "panel12",
"visible": false,
"visibleIf": "{partner_receive_fringe_benefits} = 1"
}
],
"name": "panel1",
"startWithNewLine": false,
"title": "Your Partner",
"visible": false,
"visibleIf": "{partner_type_of_employment} contains 'All other types of employment'"
}
],
"name": "panel9",
"title": "Do any of your employers provide you with fringe benefits?"
}
],
"name": "page4",
"visible": false,
"visibleIf": "{member_type_of_employment} contains 'All other types of employment' or {partner_type_of_employment} contains 'All other types of employment'"
},
{
"elements": [
{
"type": "panel",
"elements": [
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
{
"value": "1",
"text": "Yes"
},
{
"value": "0",
"text": "No"
}
],
"colCount": 2,
"isRequired": true,
"name": "member_seasonal_intermittent_or_contract_work",
"title": " "
}
],
"name": "panel2",
"title": "You",
"visible": false,
"visibleIf": "{member_receives_income_from_employment} = 1"
},
{
"type": "panel",
"elements": [
{
"type": "radiogroup",
"choices": [
{
"value": "1",
"text": "Yes"
},
{
"value": "0",
"text": "No"
}
],
"colCount": 2,
"isRequired": true,
"name": "partner_seasonal_intermittent_or_contract_work",
"title": " "
}
],
"name": "panel1",
"startWithNewLine": false,
"title": "Your Partner",
"visible": false,
"visibleIf": "{partner_receives_income_from_employment} =1 "
}
],
"name": "panel10",
"title": "In the last 6 months, have you done any seasonal, intermittent or contract work?"
}
],
"name": "page5",
"visible": false,
"visibleIf": "{member_receives_income_from_employment} = 1 or {partner_receives_income_from_employment} =1 "
}
],
"requiredText": "",
"showQuestionNumbers": "off",
"storeOthersAsComment": false
};
window.survey = new Survey.Model(json);
survey.onComplete.add(function(result) {
document.querySelector('#surveyResult').textContent =
"Result JSON:\n" + JSON.stringify(result.data, null, 3);
});
$("#surveyElement").Survey({
model: survey
});
<!DOCTYPE html>
<html lang="en">
<head>
<title>Customer and his/her partner income survey (credit card application example), jQuery Survey Library Example</title>
<meta name="viewport" content="width=device-width" />
<script src="https://unpkg.com/jquery"></script>
<script src="https://surveyjs.azureedge.net/1.8.11/survey.jquery.min.js"></script>
<link href="https://surveyjs.azureedge.net/1.8.11/modern.css" type="text/css" rel="stylesheet" />
<link rel="stylesheet" href="./index.css">
</head>
<body>
<div id="surveyElement" style="display:inline-block;width:100%;">
</div>
<div id="surveyResult"></div>
<script type="text/javascript" src="./index.js"></script>
</body>
</html>