Share your information with Erik Herbster

Erik Herbster

Travelmation, LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Let&#39;s Plan Your Vacation!"/>&#13;
		<field type="paragraph" subtype="p" label="Please describe the vacation you have in mind below!"/>&#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="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="How would you like to be contacted?" name="how-would-you-like-to-be-contacted">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Either" value="either">Either</option>&#13;
		</field>&#13;
		<field type="radio-group" label="How soon are you looking to book?" name="how-soon-are-you-looking-to-book">&#13;
			<option label="ASAP!" value="asap">ASAP!</option>&#13;
			<option label="Within next 7-10 days" value="within-next-710-days">Within next 7-10 days</option>&#13;
			<option label="In a few months" value="in-a-few-months">In a few months</option>&#13;
			<option label="Just considering options" value="just-considering-options">Just considering options</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What kind of vacation are you looking for?" name="what-kind-of-vacation-are-you-looking-for" other="true">&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All-Inclusive Resort/Caribbean" value="allinclusive-resortcaribbean">All-Inclusive Resort/Caribbean</option>&#13;
			<option label="Disney Parks" value="disney-parks">Disney Parks</option>&#13;
			<option label="Universal Parks" value="universal-parks">Universal Parks</option>&#13;
			<option label="Europe/Asia" value="europeasia">Europe/Asia</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="What else would you like me to know?" placeholder="Are you celebrating anything special?" name="what-else-would-you-like-me-to-know" className="form-control"/>&#13;
		<field type="text" label="Did anyone refer you whom I may thank?" placeholder="Friend/Family  Social Media... or skip if we&#39;ve worked together before!" name="who-referred-you" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>