TravelJoy

Vesta Florence

Bugsy Travel

Caribbean Trip

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let's Coordinate Your CancunTrip"/>&#13;
		<field type="text" required="true" label="First name" name="first-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" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What best describes your room preference?" name="radio-group-1739384689469">&#13;
			<option label="Privilege Junior Suite $1105" value="privilege-junior-suite-1105">Privilege Junior Suite $1105</option>&#13;
			<option label="Privilege Honeymoon Deluxe Suite  $1131" value="privilege-honeymoon-deluxe-suite-1131">Privilege Honeymoon Deluxe Suite  $1131</option>&#13;
			<option label="Privilege Romance Suite $1344" value="privilege-romance-suite-1344">Privilege Romance Suite $1344</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Insurance (Cost will be added to the deposit)" name="insurance">&#13;
			<option label="Travel Credit  $69" value="travel-credit-69">Travel Credit  $69</option>&#13;
			<option label="Cash Refund $129" value="cash-refund-129">Cash Refund $129</option>&#13;
			<option label="Insurance w/Medical $123" value="insurance-wmedical-123">Insurance w/Medical $123</option>&#13;
			<option label="No Insurance" value="no-insurance">No Insurance</option>&#13;
			<option label="I will add later book now for $50" value="i-will-add-later-book-now-for-50">I will add later book now for $50</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Bed Request (based on hotel availability at the time of check-in)" name="bed-request-based-on-hotel-availability">&#13;
			<option label="1 King" value="1-king">1 King</option>&#13;
			<option label="2 Doubles" value="2-doubles">2 Doubles</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="How many people? (Occupancy)" name="how-many-people-occupancy">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Add on Excursions - Luxury Sunset Sailing + Free Shopping Tour" name="add-on-excursions-cool-running-boat-ride-dunns-river">&#13;
			<option label="Yes, please" value="yes-please">Yes, please</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are You Ready To Book CANCUN?" name="are-you-deposit-ready">&#13;
			<option label="Yes please" value="yes-please">Yes please</option>&#13;
			<option label="Ready in a week" value="ready-in-a-week">Ready in a week</option>&#13;
			<option label="I'll be ready in 2 weeks or more (will risk paying more)" value="ill-be-ready-in-2-weeks-or-more-will-risk-paying-more">I'll be ready in 2 weeks or more (will risk paying more)</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know?" description="Ex: How many would participate in excursions  ect." name="what-else-would-you-like-me-to-know" className="form-control"/>&#13;
		<field type="textarea" label="Additional Requests" name="additional-requests" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Click to sign