Share your information with Christine Hernandez

Christine Hernandez

Sight Sea Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget per traveler?" description="This just gives me a general starting point and can always be changed later." name="radio-group-1779505652993">&#13;
			<option label="$500 to $1,000" value="500-to-1000">$500 to $1,000</option>&#13;
			<option label="$1,500 to $2,500" value="1500-to-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-to-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option>&#13;
			<option label="I'm flexible for the right experience" value="im-flexible-for-the-right-experience">I'm flexible for the right experience</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Acommodation Type" name="radio-group-1774193037999">&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Rental Properties" value="rental-properties">Rental Properties</option>&#13;
			<option label="Resort" value="resort">Resort</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Departure City" name="text-1774193300692" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival City" name="text-1774193301713" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of guests" name="text-1774193358941" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Hotel Chain/Airline Preferences?" name="text-1774193373356" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Number of Rooms?" name="text-1774193404550" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Check-in Date" name="date-1774193431160" className="form-control"/>&#13;
		<field type="date" required="true" label="Check-out Date" name="date-1774193438601" className="form-control"/>&#13;
		<field type="radio-group" label="Car Rental or Airport Transfers Needed?" name="radio-group-1774193662679">&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Airport Transfer" value="airport-transfer">Airport Transfer</option>&#13;
			<option label="No Thanks - I'll make my own way there" value="no-thanks-ill-make-my-own-way-there">No Thanks - I'll make my own way there</option>&#13;
		</field>&#13;
		<field type="text" label="Special Requests?" description="i.e room references  beachfront, near the airport, flight time preferences." name="text-1774193718237" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>