Share your information with Billy Miller

Billy Miller

Miller Travel Group

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="I&#39;m Ready to Plan For Alaska!"/>&#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 required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="How many people are traveling?&amp;nbsp;" name="how-many-people-are-traveling-" other="true">&#13;
			<option label="I'm on my own" value="im-on-my-own">I'm on my own</option>&#13;
			<option label="2 people" value="2-people">2 people</option>&#13;
			<option label="3 people" value="3-people">3 people</option>&#13;
			<option label="4 people" value="4-people">4 people</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you thinking cruise, land tour, or both?&amp;nbsp;" name="are-you-thinking-cruise-land-tour-or-both-" other="true">&#13;
			<option label="Cruise (Inside Passage)" value="cruise-inside-passage">Cruise (Inside Passage)</option>&#13;
			<option label="Land / National Parks" value="land-national-parks">Land / National Parks</option>&#13;
			<option label="Both" value="both">Both</option>&#13;
		</field>&#13;
		<field type="radio-group" label="When are you hoping to go?" name="radio-group-1777672354076" other="true">&#13;
			<option label="Summer 2026" value="summer-2026">Summer 2026</option>&#13;
			<option label="Summer 2027 " value="summer-2027-">Summer 2027 </option>&#13;
			<option label="Still figuring it out" value="still-figuring-it-out">Still figuring it out</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="I have to see / experience...." description="Choose all the ones that a must-haves!" name="checkbox-group-1777673253834">&#13;
			<option label="White Pass Railway" value="white-pass-railway">White Pass Railway</option>&#13;
			<option label="Mendenhall Glacier" value="mendenhall-glacier">Mendenhall Glacier</option>&#13;
			<option label="Whale Watching" value="whale-watching">Whale Watching</option>&#13;
			<option label="Denali / Interior Alaska" value="denali-interior-alaska">Denali / Interior Alaska</option>&#13;
			<option label="Ketchikan / Totem Poles" value="ketchikan-totem-poles">Ketchikan / Totem Poles</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything else I should know?" name="anything-specific-you-dont-want-to-miss" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>