t-form">
				<div class="form-group has-feedback">

					<div class="form-group">
						<label class="col-sm-2 control-label">Date</label>
						<div class="col-sm-10">
							<div>

								<input class="form-control" type="text" placeholder="YYYY-MM-DD" title="Enter a date in this format: YYYY-MM-DD" pattern="(?:19|20)[0-9]{2}-(?:(?:0[1-9]|1[0-2])-(?:0[1-9]|1[0-9]|2[0-9])|(?:(?!02)(?:0[1-9]|1[0-2])-(?:30))|(?:(?:0[13578]|1[02])-31))" id="date" name="date" value="2020-12-14" />
							</div>
							<span c