Pre filled pdf with 2 editable fields

Hi all,
I need a reference for a auto filled form in PDF format with two editable fields(fields may text, checkbox etc.,) Anyone have an user experience with a requirement like this?

How is this related to Django?

Are you looking:

  • for Django to create such a form?
  • to present that form on a page?
  • to accept the fields from the form as input?
  • to fill out that form from user-entered data?