TravelJoy

Lisa's Luxury Travel LLC

Lisa's Luxury Travel

Disney Cruise Request

Oct 26, 2024 to Oct 26, 2099

<html>
  <body>
    <form-template>&#13;
	<fields>&#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" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" 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="Country of Citizenship" name="country-of-citizenship" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Names and DOB of other travelers&amp;nbsp;" name="names-and-dob-of-other-travelers-" className="form-control"/>&#13;
		<field type="text" required="true" label="Desired Sail Date" name="desired-sail-date" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Flexible on Dates?" name="flexible-on-dates">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Number of Nights" name="number-of-nights" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Desired Destination" name="desired-destination">&#13;
			<option label="Alaska " value="alaska-">Alaska </option>&#13;
			<option label="Bahamas" value="bahamas">Bahamas</option>&#13;
			<option label="Bermuda " value="bermuda-">Bermuda </option>&#13;
			<option label="Canada " value="canada-">Canada </option>&#13;
			<option label="Caribbean " value="caribbean-">Caribbean </option>&#13;
			<option label="Europe " value="europe-">Europe </option>&#13;
			<option label="Hawaii " value="hawaii-">Hawaii </option>&#13;
			<option label="Mexico " value="mexico-">Mexico </option>&#13;
			<option label="Pacific Coast " value="pacific-coast-">Pacific Coast </option>&#13;
			<option label="Panama Canal " value="panama-canal-">Panama Canal </option>&#13;
			<option label="Transatlantic " value="transatlantic-">Transatlantic </option>&#13;
			<option label="Any " value="any-">Any </option>&#13;
			<option label="Other " value="other-">Other </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Departing From" name="departing-from" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Desired Disney Cruise Ship" name="desired-disney-cruise-ship" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Desired Room Type" name="desired-room-type">&#13;
			<option label="Inside" value="inside">Inside</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label=" Verandah" value="-verandah"> Verandah</option>&#13;
			<option label="Concierge" value="concierge">Concierge</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Add Vacation Protection&amp;nbsp;" name="add-vacation-protection-">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you military? (Active Duty, Reservist, National Guard, Retired, or Military Spouse)" name="are-you-military-active-duty-reservist-national-guard-retired-or-military-spouse">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="radio-group" label="Professional Planning Fee Per Cabin-There is a $30 Planning Fee- Are you ready to pay?" name="professional-planning-fee-per-cabinthere-is-a-30-planning-fee-are-you-ready-to-pay">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>