I created a custom form using PowerApps connected to a SharePoint List. I don't have any errors but even though I have the fields below:

when I go to preview the app I get this:

I thought perhaps it was due to the list not having any information yet but when I published the form and went back to start a new item I get this:

I'm not seeing any errors that would explain this so I'm hoping someone can point me in the right direction.