TravelJoy

Price Family Travel

Priceless Memories in Ghana

<form-template>
	<fields>
		<field type="header" subtype="h1" label="I would like more information."/>
		<field type="header" subtype="h2" label="Full name"/>
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>
		<field type="checkbox-group" required="true" label="Do you have a passport ?&amp;nbsp;" description="A passport is required to travel to South Africa with an expiration date of six months after the return date." name="do-you-have-a-passport-">
			<option label="Yes " value="yes-">Yes </option>
			<option label="No " value="no-">No </option>
		</field>
		<field type="text" required="true" label="Country of Citizenship ?&amp;nbsp;" name="country-of-citizenship-" subtype="text" className="form-control"/>
		<field type="checkbox-group" required="true" label="How are you traveling /&amp;nbsp;" name="room-type-">
			<option label="Single ( 1 Guest) " value="single-1-guest-">Single ( 1 Guest) </option>
			<option label="Double (2 guest) " value="double-2-guest-">Double (2 guest) </option>
		</field>
		<field type="checkbox-group" required="true" label="Bed Type&amp;nbsp;" name="bed-type-">
			<option label="1 Bed" value="1-bed">1 Bed</option>
			<option label="2 Beds" value="2-beds">2 Beds</option>
		</field>
		<field type="text" label="What is your closest departure airport ?&amp;nbsp;" name="what-is-your-closest-departure-airport-" subtype="text" className="form-control"/>
		<field type="checkbox-group" required="true" label="ADA Special Needs ?&amp;nbsp;" name="ada-special-needs-">
			<option label="No " value="no-">No </option>
			<option label="Yes " value="yes-">Yes </option>
		</field>
		<field type="text" label="How did you hear about this trip ?&amp;nbsp;" name="how-did-you-hear-about-this-trip-" subtype="text" className="form-control"/>
	</fields>
</form-template>