TravelJoy

Racquel Nicholson

Laugh Travel & Live LLC

Senegal

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Trip Interest Form"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Trips Interested In 2026" name="trips-interested-in-2026">&#13;
			<option label="Argentina &amp; Uruguay" value="argentina-uruguay">Argentina &amp; Uruguay</option>&#13;
			<option label="Greece" value="greece">Greece</option>&#13;
			<option label="Peru" value="peru">Peru</option>&#13;
			<option label="Senegal" value="senegal">Senegal</option>&#13;
			<option label="Vietnam &amp; Cambodia" value="vietnam-cambodia">Vietnam &amp; Cambodia</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Room Interested In" name="room-interested-in">&#13;
			<option label="Single Occupancy" value="single-occupancy">Single Occupancy</option>&#13;
			<option label="Double Occupancy" value="double-occupancy">Double Occupancy</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>