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Dewitt Steward

Steward Manor Estate

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	<fields>&#13;
		<field type="header" subtype="h2" label="Travel Details"/>&#13;
		<field type="select" required="true" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="Select" name="sail-to" className="form-control">&#13;
			<option label="A Coruña" value="a-coru-a">A Coruña</option>&#13;
			<option label="Aarhus" value="aarhus">Aarhus</option>&#13;
			<option label="Acapulco" value="acapulco">Acapulco</option>&#13;
			<option label="Adelaide" value="adelaide">Adelaide</option>&#13;
			<option label="Airlie Beach" value="airlie-beach">Airlie Beach</option>&#13;
			<option label="Akureyri" value="akureyri">Akureyri</option>&#13;
			<option label="Alaska" value="alaska">Alaska</option>&#13;
			<option label="Albany" value="albany">Albany</option>&#13;
			<option label="Alicante" value="alicante">Alicante</option>&#13;
			<option label="Amalfi Coast" value="amalfi-coast">Amalfi Coast</option>&#13;
			<option label="Amber Cove" value="amber-cove">Amber Cove</option>&#13;
			<option label="Amsterdam" value="amsterdam">Amsterdam</option>&#13;
			<option label="Anchorage" value="anchorage">Anchorage</option>&#13;
			<option label="Antigua" value="antigua">Antigua</option>&#13;
			<option label="Antwerp" value="antwerp">Antwerp</option>&#13;
			<option label="Aomori" value="aomori">Aomori</option>&#13;
			<option label="Aruba" value="aruba">Aruba</option>&#13;
			<option label="Asia" value="asia">Asia</option>&#13;
			<option label="Auckland" value="auckland">Auckland</option>&#13;
			<option label="Australia" value="australia">Australia</option>&#13;
			<option label="Baltimore" value="baltimore">Baltimore</option>&#13;
			<option label="Bangkok" value="bangkok">Bangkok</option>&#13;
			<option label="Bar" value="bar">Bar</option>&#13;
			<option label="Barbados" value="barbados">Barbados</option>&#13;
			<option label="Barcelona" value="barcelona">Barcelona</option>&#13;
			<option label="Bari" value="bari">Bari</option>&#13;
			<option label="Basseterre" value="basseterre">Basseterre</option>&#13;
			<option label="Bay of Islands" value="bay-of-islands">Bay of Islands</option>&#13;
			<option label="Beijing" value="beijing">Beijing</option>&#13;
			<option label="Belfast" value="belfast">Belfast</option>&#13;
			<option label="Belize City" value="belize-city">Belize City</option>&#13;
			<option label="Bergen" value="bergen">Bergen</option>&#13;
			<option label="Berlin" value="berlin">Berlin</option>&#13;
			<option label="Bermuda" value="bermuda">Bermuda</option>&#13;
			<option label="Bilbao" value="bilbao">Bilbao</option>&#13;
			<option label="Bimini" value="bimini">Bimini</option>&#13;
			<option label="Blowing Point Harbour" value="blowing-point-harbour">Blowing Point Harbour</option>&#13;
			<option label="Bonaire" value="bonaire">Bonaire</option>&#13;
			<option label="Boston" value="boston">Boston</option>&#13;
			<option label="Brasília" value="bras-lia">Brasília</option>&#13;
			<option label="Bridgetown" value="bridgetown">Bridgetown</option>&#13;
			<option label="Brisbane" value="brisbane">Brisbane</option>&#13;
			<option label="Broome" value="broome">Broome</option>&#13;
			<option label="Bruges" value="bruges">Bruges</option>&#13;
			<option label="Brussels" value="brussels">Brussels</option>&#13;
			<option label="Budapest" value="budapest">Budapest</option>&#13;
			<option label="Buenos Aires" value="buenos-aires">Buenos Aires</option>&#13;
			<option label="Burrard Inlet" value="burrard-inlet">Burrard Inlet</option>&#13;
			<option label="Busan (Pusan), South Korea" value="busan-pusan-south-korea">Busan (Pusan), South Korea</option>&#13;
			<option label="Cabo San Lucas" value="cabo-san-lucas">Cabo San Lucas</option>&#13;
			<option label="Cairns" value="cairns">Cairns</option>&#13;
			<option label="Cairo" value="cairo">Cairo</option>&#13;
			<option label="Callao (Lima)" value="callao-lima">Callao (Lima)</option>&#13;
			<option label="Canada &amp; New England" value="canada-and-new-england">Canada &amp; New England</option>&#13;
			<option label="Cancún" value="canc-n">Cancún</option>&#13;
			<option label="Cape Breton Island" value="cape-breton-island">Cape Breton Island</option>&#13;
			<option label="Cape Canaveral" value="cape-canaveral">Cape Canaveral</option>&#13;
			<option label="Cape Town" value="cape-town">Cape Town</option>&#13;
			<option label="Caribbean" value="caribbean">Caribbean</option>&#13;
			<option label="Cartagena" value="cartagena">Cartagena</option>&#13;
			<option label="Casablanca" value="casablanca">Casablanca</option>&#13;
			<option label="Castries" value="castries">Castries</option>&#13;
			<option label="Celebration Key™" value="celebration-key">Celebration Key™</option>&#13;
			<option label="Charlottetown" value="charlottetown">Charlottetown</option>&#13;
			<option label="Civitavecchia (Rome)" value="civitavecchia-rome">Civitavecchia (Rome)</option>&#13;
			<option label="Cockburn Town" value="cockburn-town">Cockburn Town</option>&#13;
			<option label="Colón" value="col-n">Colón</option>&#13;
			<option label="Copenhagen" value="copenhagen">Copenhagen</option>&#13;
			<option label="Coquimbo (La Serena)" value="coquimbo-la-serena">Coquimbo (La Serena)</option>&#13;
			<option label="Corfu" value="corfu">Corfu</option>&#13;
			<option label="Cork" value="cork">Cork</option>&#13;
			<option label="Corner Brook, NL" value="corner-brook-nl">Corner Brook, NL</option>&#13;
			<option label="Corsica" value="corsica">Corsica</option>&#13;
			<option label="Costa Maya | Cruise Port" value="costa-maya-cruise-port">Costa Maya | Cruise Port</option>&#13;
			<option label="Coxen Hole" value="coxen-hole">Coxen Hole</option>&#13;
			<option label="Crete" value="crete">Crete</option>&#13;
			<option label="Cristóbal" value="crist-bal">Cristóbal</option>&#13;
			<option label="Cruise Amalia Glacier" value="cruise-amalia-glacier">Cruise Amalia Glacier</option>&#13;
			<option label="Cruise Cape Horn" value="cruise-cape-horn">Cruise Cape Horn</option>&#13;
			<option label="Cruise Chilean Fjords" value="cruise-chilean-fjords">Cruise Chilean Fjords</option>&#13;
			<option label="Cruise Darwin Channel" value="cruise-darwin-channel">Cruise Darwin Channel</option>&#13;
			<option label="Cruise Fiordland National Park" value="cruise-fiordland-national-park">Cruise Fiordland National Park</option>&#13;
			<option label="Cruise Great Oyster Bay" value="cruise-great-oyster-bay">Cruise Great Oyster Bay</option>&#13;
			<option label="Cruise Hubbard Glacier" value="cruise-hubbard-glacier">Cruise Hubbard Glacier</option>&#13;
			<option label="Cruise Mutiny on the Bounty" value="cruise-mutiny-on-the-bounty">Cruise Mutiny on the Bounty</option>&#13;
			<option label="Cruise Strait of Magellan" value="cruise-strait-of-magellan">Cruise Strait of Magellan</option>&#13;
			<option label="Cruise Tracy Arm Fjord" value="cruise-tracy-arm-fjord">Cruise Tracy Arm Fjord</option>&#13;
			<option label="Curaçao" value="cura-ao">Curaçao</option>&#13;
			<option label="Cusco" value="cusco">Cusco</option>&#13;
			<option label="Darwin" value="darwin">Darwin</option>&#13;
			<option label="Denpasar" value="denpasar">Denpasar</option>&#13;
			<option label="District of Columbia" value="district-of-columbia">District of Columbia</option>&#13;
			<option label="Djupivogur" value="djupivogur">Djupivogur</option>&#13;
			<option label="Doha" value="doha">Doha</option>&#13;
			<option label="Dominica" value="dominica">Dominica</option>&#13;
			<option label="Donostia-San Sebastian" value="donostia-san-sebastian">Donostia-San Sebastian</option>&#13;
			<option label="Dravuni Island" value="dravuni-island">Dravuni Island</option>&#13;
			<option label="Dubai" value="dubai">Dubai</option>&#13;
			<option label="Dublin" value="dublin">Dublin</option>&#13;
			<option label="Dubrovnik" value="dubrovnik">Dubrovnik</option>&#13;
			<option label="Eden, Australia" value="eden-australia">Eden, Australia</option>&#13;
			<option label="El Guamache" value="el-guamache">El Guamache</option>&#13;
			<option label="Ensenada" value="ensenada">Ensenada</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Fairbanks" value="fairbanks">Fairbanks</option>&#13;
			<option label="Falmouth" value="falmouth">Falmouth</option>&#13;
			<option label="Federal Territory of Kuala Lumpur" value="federal-territory-of-kuala-lumpur">Federal Territory of Kuala Lumpur</option>&#13;
			<option label="Fira" value="fira">Fira</option>&#13;
			<option label="Florence" value="florence">Florence</option>&#13;
			<option label="Fort Lauderdale" value="fort-lauderdale">Fort Lauderdale</option>&#13;
			<option label="Fort-de-France" value="fort-de-france">Fort-de-France</option>&#13;
			<option label="Frederick Sound" value="frederick-sound">Frederick Sound</option>&#13;
			<option label="Frederiksted" value="frederiksted">Frederiksted</option>&#13;
			<option label="Freeport" value="freeport">Freeport</option>&#13;
			<option label="Fremantle (Perth)" value="fremantle-perth">Fremantle (Perth)</option>&#13;
			<option label="French Riviera" value="french-riviera">French Riviera</option>&#13;
			<option label="Fukuoka (Hakata)" value="fukuoka-hakata">Fukuoka (Hakata)</option>&#13;
			<option label="Funchal, Madeira" value="funchal-madeira">Funchal, Madeira</option>&#13;
			<option label="Galveston" value="galveston">Galveston</option>&#13;
			<option label="George Town" value="george-town">George Town</option>&#13;
			<option label="Ghent" value="ghent">Ghent</option>&#13;
			<option label="Gibraltar" value="gibraltar">Gibraltar</option>&#13;
			<option label="Grand Cayman" value="grand-cayman">Grand Cayman</option>&#13;
			<option label="Grand Turk" value="grand-turk">Grand Turk</option>&#13;
			<option label="Greenland &amp; Canada" value="greenland-and-canada">Greenland &amp; Canada</option>&#13;
			<option label="Greenock (Glasgow)" value="greenock-glasgow">Greenock (Glasgow)</option>&#13;
			<option label="Grenada" value="grenada">Grenada</option>&#13;
			<option label="Grundarfjordur" value="grundarfjordur">Grundarfjordur</option>&#13;
			<option label="Gruž" value="gru">Gruž</option>&#13;
			<option label="Guadeloupe" value="guadeloupe">Guadeloupe</option>&#13;
			<option label="Haifa" value="haifa">Haifa</option>&#13;
			<option label="Haines" value="haines">Haines</option>&#13;
			<option label="Hakodate" value="hakodate">Hakodate</option>&#13;
			<option label="Half Moon Cay" value="half-moon-cay">Half Moon Cay</option>&#13;
			<option label="Halifax" value="halifax">Halifax</option>&#13;
			<option label="Hamburg" value="hamburg">Hamburg</option>&#13;
			<option label="Hamilton Island" value="hamilton-island">Hamilton Island</option>&#13;
			<option label="Hanoi" value="hanoi">Hanoi</option>&#13;
			<option label="Havana" value="havana">Havana</option>&#13;
			<option label="Hawaii" value="hawaii">Hawaii</option>&#13;
			<option label="Heimaey, Westman Islands" value="heimaey-westman-islands">Heimaey, Westman Islands</option>&#13;
			<option label="Helsinki" value="helsinki">Helsinki</option>&#13;
			<option label="Hilo" value="hilo">Hilo</option>&#13;
			<option label="Hiroshima" value="hiroshima">Hiroshima</option>&#13;
			<option label="Ho Chi Minh City" value="ho-chi-minh-city">Ho Chi Minh City</option>&#13;
			<option label="Holyhead, Wales" value="holyhead-wales">Holyhead, Wales</option>&#13;
			<option label="Hong Kong" value="hong-kong">Hong Kong</option>&#13;
			<option label="Honolulu" value="honolulu">Honolulu</option>&#13;
			<option label="Houston" value="houston">Houston</option>&#13;
			<option label="Ibiza" value="ibiza">Ibiza</option>&#13;
			<option label="Icy Strait Point" value="icy-strait-point">Icy Strait Point</option>&#13;
			<option label="Invergordon, Scotland" value="invergordon-scotland">Invergordon, Scotland</option>&#13;
			<option label="Jacksonville" value="jacksonville">Jacksonville</option>&#13;
			<option label="Jerusalem" value="jerusalem">Jerusalem</option>&#13;
			<option label="Jost Van Dyke" value="jost-van-dyke">Jost Van Dyke</option>&#13;
			<option label="Juneau" value="juneau">Juneau</option>&#13;
			<option label="Kahului" value="kahului">Kahului</option>&#13;
			<option label="Kailua-Kona" value="kailua-kona">Kailua-Kona</option>&#13;
			<option label="Kalamata" value="kalamata">Kalamata</option>&#13;
			<option label="Kangaroo Island" value="kangaroo-island">Kangaroo Island</option>&#13;
			<option label="Katakolo" value="katakolo">Katakolo</option>&#13;
			<option label="Katakolon (Olympia)" value="katakolon-olympia">Katakolon (Olympia)</option>&#13;
			<option label="Kathmandu" value="kathmandu">Kathmandu</option>&#13;
			<option label="Kavala (Neapolis)" value="kavala-neapolis">Kavala (Neapolis)</option>&#13;
			<option label="Keelung (Taipei)" value="keelung-taipei">Keelung (Taipei)</option>&#13;
			<option label="Ketchikan" value="ketchikan">Ketchikan</option>&#13;
			<option label="Key West" value="key-west">Key West</option>&#13;
			<option label="Kingstown" value="kingstown">Kingstown</option>&#13;
			<option label="Kirkwall, Orkney Islands" value="kirkwall-orkney-islands">Kirkwall, Orkney Islands</option>&#13;
			<option label="Kodiak" value="kodiak">Kodiak</option>&#13;
			<option label="Koh Samui" value="koh-samui">Koh Samui</option>&#13;
			<option label="Komodo Island" value="komodo-island">Komodo Island</option>&#13;
			<option label="Kotor" value="kotor">Kotor</option>&#13;
			<option label="Kralendijk" value="kralendijk">Kralendijk</option>&#13;
			<option label="Krong Siem Reap" value="krong-siem-reap">Krong Siem Reap</option>&#13;
			<option label="Kusadasi (Ephesus), Turkey" value="kusadasi-ephesus-turkey">Kusadasi (Ephesus), Turkey</option>&#13;
			<option label="Kuşadası" value="ku-adas">Kuşadası</option>&#13;
			<option label="Kyoto" value="kyoto">Kyoto</option>&#13;
			<option label="La Coruña" value="la-coru-a">La Coruña</option>&#13;
			<option label="La Goulette (Tunis)" value="la-goulette-tunis">La Goulette (Tunis)</option>&#13;
			<option label="La Paz" value="la-paz">La Paz</option>&#13;
			<option label="La Romana" value="la-romana">La Romana</option>&#13;
			<option label="Langkawi" value="langkawi">Langkawi</option>&#13;
			<option label="Las Vegas" value="las-vegas">Las Vegas</option>&#13;
			<option label="Lautoka" value="lautoka">Lautoka</option>&#13;
			<option label="Le Verdon (Bordeaux)" value="le-verdon-bordeaux">Le Verdon (Bordeaux)</option>&#13;
			<option label="Lembar (Lombok)" value="lembar-lombok">Lembar (Lombok)</option>&#13;
			<option label="Lifou" value="lifou">Lifou</option>&#13;
			<option label="Limassol" value="limassol">Limassol</option>&#13;
			<option label="Limón Province" value="lim-n-province">Limón Province</option>&#13;
			<option label="Lisbon" value="lisbon">Lisbon</option>&#13;
			<option label="Liverpool" value="liverpool">Liverpool</option>&#13;
			<option label="London" value="london">London</option>&#13;
			<option label="Long Beach (Los Angeles)" value="long-beach-los-angeles">Long Beach (Los Angeles)</option>&#13;
			<option label="Los Angeles" value="los-angeles">Los Angeles</option>&#13;
			<option label="Lucayan Knoll" value="lucayan-knoll">Lucayan Knoll</option>&#13;
			<option label="Lyon" value="lyon">Lyon</option>&#13;
			<option label="Lyttelton (Christchurch)" value="lyttelton-christchurch">Lyttelton (Christchurch)</option>&#13;
			<option label="Maceio" value="maceio">Maceio</option>&#13;
			<option label="Madrid" value="madrid">Madrid</option>&#13;
			<option label="Mahogany Bay, Roatan" value="mahogany-bay-roatan">Mahogany Bay, Roatan</option>&#13;
			<option label="Maldive Islands" value="maldive-islands">Maldive Islands</option>&#13;
			<option label="Malta" value="malta">Malta</option>&#13;
			<option label="Managua" value="managua">Managua</option>&#13;
			<option label="Manta" value="manta">Manta</option>&#13;
			<option label="Marrakesh" value="marrakesh">Marrakesh</option>&#13;
			<option label="Marseille" value="marseille">Marseille</option>&#13;
			<option label="Martinique" value="martinique">Martinique</option>&#13;
			<option label="Mazatlan" value="mazatlan">Mazatlan</option>&#13;
			<option label="Melbourne" value="melbourne">Melbourne</option>&#13;
			<option label="Messina, Sicily" value="messina-sicily">Messina, Sicily</option>&#13;
			<option label="Metro Manila" value="metro-manila">Metro Manila</option>&#13;
			<option label="Metropolitan City of Genoa" value="metropolitan-city-of-genoa">Metropolitan City of Genoa</option>&#13;
			<option label="Metropolitan City of Rome Capital" value="metropolitan-city-of-rome-capital">Metropolitan City of Rome Capital</option>&#13;
			<option label="Metropolitan City of Venice" value="metropolitan-city-of-venice">Metropolitan City of Venice</option>&#13;
			<option label="Mexico" value="mexico">Mexico</option>&#13;
			<option label="Miami" value="miami">Miami</option>&#13;
			<option label="Milan" value="milan">Milan</option>&#13;
			<option label="Mobile" value="mobile">Mobile</option>&#13;
			<option label="Monte Carlo" value="monte-carlo">Monte Carlo</option>&#13;
			<option label="Montego Bay" value="montego-bay">Montego Bay</option>&#13;
			<option label="Montevideo" value="montevideo">Montevideo</option>&#13;
			<option label="Montreal" value="montreal">Montreal</option>&#13;
			<option label="Moorea" value="moorea">Moorea</option>&#13;
			<option label="Moscow" value="moscow">Moscow</option>&#13;
			<option label="Mumbai" value="mumbai">Mumbai</option>&#13;
			<option label="Munich" value="munich">Munich</option>&#13;
			<option label="Muscat" value="muscat">Muscat</option>&#13;
			<option label="Mykonos Town Hall" value="mykonos-town-hall">Mykonos Town Hall</option>&#13;
			<option label="Mystery Island" value="mystery-island">Mystery Island</option>&#13;
			<option label="Málaga" value="m-laga">Málaga</option>&#13;
			<option label="Nagasaki" value="nagasaki">Nagasaki</option>&#13;
			<option label="Naha, Okinawa" value="naha-okinawa">Naha, Okinawa</option>&#13;
			<option label="Nairobi" value="nairobi">Nairobi</option>&#13;
			<option label="Nanortalik" value="nanortalik">Nanortalik</option>&#13;
			<option label="Napier" value="napier">Napier</option>&#13;
			<option label="Naples" value="naples">Naples</option>&#13;
			<option label="Nassau" value="nassau">Nassau</option>&#13;
			<option label="Nawiliwili, Kauai" value="nawiliwili-kauai">Nawiliwili, Kauai</option>&#13;
			<option label="New Orleans" value="new-orleans">New Orleans</option>&#13;
			<option label="New York" value="new-york">New York</option>&#13;
			<option label="New Zealand" value="new-zealand">New Zealand</option>&#13;
			<option label="Nice" value="nice">Nice</option>&#13;
			<option label="Nord de Palma District" value="nord-de-palma-district">Nord de Palma District</option>&#13;
			<option label="Norfolk" value="norfolk">Norfolk</option>&#13;
			<option label="Norfolk Island" value="norfolk-island">Norfolk Island</option>&#13;
			<option label="Noumea" value="noumea">Noumea</option>&#13;
			<option label="Nuku’alofa" value="nuku-alofa">Nuku’alofa</option>&#13;
			<option label="Ocho Rios" value="ocho-rios">Ocho Rios</option>&#13;
			<option label="Oranjestad" value="oranjestad">Oranjestad</option>&#13;
			<option label="Osaka" value="osaka">Osaka</option>&#13;
			<option label="Oslo" value="oslo">Oslo</option>&#13;
			<option label="Otaru (Sapporo)" value="otaru-sapporo">Otaru (Sapporo)</option>&#13;
			<option label="Panama Canal" value="panama-canal">Panama Canal</option>&#13;
			<option label="Panama City" value="panama-city">Panama City</option>&#13;
			<option label="Papeete, Tahiti" value="papeete-tahiti">Papeete, Tahiti</option>&#13;
			<option label="Paris" value="paris">Paris</option>&#13;
			<option label="Patmos" value="patmos">Patmos</option>&#13;
			<option label="Pensacola" value="pensacola">Pensacola</option>&#13;
			<option label="Philipsburg" value="philipsburg">Philipsburg</option>&#13;
			<option label="Phillip Island" value="phillip-island">Phillip Island</option>&#13;
			<option label="Phu My (Ho Chi Minh)" value="phu-my-ho-chi-minh">Phu My (Ho Chi Minh)</option>&#13;
			<option label="Picton" value="picton">Picton</option>&#13;
			<option label="Piraeus" value="piraeus">Piraeus</option>&#13;
			<option label="Playa del Carmen" value="playa-del-carmen">Playa del Carmen</option>&#13;
			<option label="Ponta Delgada" value="ponta-delgada">Ponta Delgada</option>&#13;
			<option label="Port Chalmers (Dunedin)" value="port-chalmers-dunedin">Port Chalmers (Dunedin)</option>&#13;
			<option label="Port Denarau" value="port-denarau">Port Denarau</option>&#13;
			<option label="Port Douglas" value="port-douglas">Port Douglas</option>&#13;
			<option label="Port Elizabeth" value="port-elizabeth">Port Elizabeth</option>&#13;
			<option label="Port Klang (Kuala Lumpur)" value="port-klang-kuala-lumpur">Port Klang (Kuala Lumpur)</option>&#13;
			<option label="Port Lincoln" value="port-lincoln">Port Lincoln</option>&#13;
			<option label="Port Vila" value="port-vila">Port Vila</option>&#13;
			<option label="Port of Lisbon" value="port-of-lisbon">Port of Lisbon</option>&#13;
			<option label="Port of Spain" value="port-of-spain">Port of Spain</option>&#13;
			<option label="Portland Oregon" value="portland-oregon">Portland Oregon</option>&#13;
			<option label="Porto" value="porto">Porto</option>&#13;
			<option label="Prague" value="prague">Prague</option>&#13;
			<option label="Prince Rupert, BC" value="prince-rupert-bc">Prince Rupert, BC</option>&#13;
			<option label="Princess Cays" value="princess-cays">Princess Cays</option>&#13;
			<option label="Progreso, Yucatán" value="progreso-yucat-n">Progreso, Yucatán</option>&#13;
			<option label="Puerto Madryn" value="puerto-madryn">Puerto Madryn</option>&#13;
			<option label="Puerto Vallarta" value="puerto-vallarta">Puerto Vallarta</option>&#13;
			<option label="Puntarenas Province" value="puntarenas-province">Puntarenas Province</option>&#13;
			<option label="Qaqortoq" value="qaqortoq">Qaqortoq</option>&#13;
			<option label="Queenstown" value="queenstown">Queenstown</option>&#13;
			<option label="Québec City" value="qu-bec-city">Québec City</option>&#13;
			<option label="Reykjavík" value="reykjav-k">Reykjavík</option>&#13;
			<option label="Rhodes" value="rhodes">Rhodes</option>&#13;
			<option label="Riga" value="riga">Riga</option>&#13;
			<option label="Rio de Janeiro" value="rio-de-janeiro">Rio de Janeiro</option>&#13;
			<option label="Road Harbour" value="road-harbour">Road Harbour</option>&#13;
			<option label="Roseau" value="roseau">Roseau</option>&#13;
			<option label="Rotterdam" value="rotterdam">Rotterdam</option>&#13;
			<option label="Saint George" value="saint-george">Saint George</option>&#13;
			<option label="Saint Petersburg" value="saint-petersburg">Saint Petersburg</option>&#13;
			<option label="Saint Thomas" value="saint-thomas">Saint Thomas</option>&#13;
			<option label="Saint john" value="saint-john">Saint john</option>&#13;
			<option label="Salerno (Amalfi/Pompeii)" value="salerno-amalfi-pompeii">Salerno (Amalfi/Pompeii)</option>&#13;
			<option label="San Antonio (Santiago)" value="san-antonio-santiago">San Antonio (Santiago)</option>&#13;
			<option label="San Diego" value="san-diego">San Diego</option>&#13;
			<option label="San Francisco" value="san-francisco">San Francisco</option>&#13;
			<option label="San José Province" value="san-jos-province">San José Province</option>&#13;
			<option label="San Juan" value="san-juan">San Juan</option>&#13;
			<option label="San Miguel de Cozumel" value="san-miguel-de-cozumel">San Miguel de Cozumel</option>&#13;
			<option label="Santa Catalina Island" value="santa-catalina-island">Santa Catalina Island</option>&#13;
			<option label="Santo Domingo" value="santo-domingo">Santo Domingo</option>&#13;
			<option label="Santorini" value="santorini">Santorini</option>&#13;
			<option label="Scarborough" value="scarborough">Scarborough</option>&#13;
			<option label="Seattle" value="seattle">Seattle</option>&#13;
			<option label="Seogwipo (Jeju)" value="seogwipo-jeju">Seogwipo (Jeju)</option>&#13;
			<option label="Seville" value="seville">Seville</option>&#13;
			<option label="Seward" value="seward">Seward</option>&#13;
			<option label="Seydisfjordur" value="seydisfjordur">Seydisfjordur</option>&#13;
			<option label="Shanghai" value="shanghai">Shanghai</option>&#13;
			<option label="Sharm El-Sheikh" value="sharm-el-sheikh">Sharm El-Sheikh</option>&#13;
			<option label="Shimizu (Mt. Fuji)" value="shimizu-mt-fuji">Shimizu (Mt. Fuji)</option>&#13;
			<option label="Sihanoukville" value="sihanoukville">Sihanoukville</option>&#13;
			<option label="Sinai Peninsula" value="sinai-peninsula">Sinai Peninsula</option>&#13;
			<option label="Singapore" value="singapore">Singapore</option>&#13;
			<option label="Sitka" value="sitka">Sitka</option>&#13;
			<option label="Skagway" value="skagway">Skagway</option>&#13;
			<option label="South America" value="south-america">South America</option>&#13;
			<option label="South Pacific" value="south-pacific">South Pacific</option>&#13;
			<option label="Split" value="split">Split</option>&#13;
			<option label="St Barths" value="st-barths">St Barths</option>&#13;
			<option label="St. Anthony, NL" value="st-anthony-nl">St. Anthony, NL</option>&#13;
			<option label="St. Croix" value="st-croix">St. Croix</option>&#13;
			<option label="St. Kitts" value="st-kitts">St. Kitts</option>&#13;
			<option label="St. Lucia" value="st-lucia">St. Lucia</option>&#13;
			<option label="St. Maarten" value="st-maarten">St. Maarten</option>&#13;
			<option label="St. Peter Port" value="st-peter-port">St. Peter Port</option>&#13;
			<option label="St. Petersburg" value="st-petersburg">St. Petersburg</option>&#13;
			<option label="Stockholm" value="stockholm">Stockholm</option>&#13;
			<option label="Stornoway" value="stornoway">Stornoway</option>&#13;
			<option label="Suva" value="suva">Suva</option>&#13;
			<option label="Sydney" value="sydney">Sydney</option>&#13;
			<option label="Tallinn" value="tallinn">Tallinn</option>&#13;
			<option label="Tampa Bay" value="tampa-bay">Tampa Bay</option>&#13;
			<option label="Tangalooma – Moreton Island" value="tangalooma-moreton-island">Tangalooma – Moreton Island</option>&#13;
			<option label="Tangier" value="tangier">Tangier</option>&#13;
			<option label="Tanjung Priok, Jakarta, Indonesia" value="tanjung-priok-jakarta-indonesia">Tanjung Priok, Jakarta, Indonesia</option>&#13;
			<option label="Tauranga" value="tauranga">Tauranga</option>&#13;
			<option label="Tel Aviv-Yafo" value="tel-aviv-yafo">Tel Aviv-Yafo</option>&#13;
			<option label="Tenerife" value="tenerife">Tenerife</option>&#13;
			<option label="The Bahamas" value="the-bahamas">The Bahamas</option>&#13;
			<option label="Thessaloniki" value="thessaloniki">Thessaloniki</option>&#13;
			<option label="Tokyo" value="tokyo">Tokyo</option>&#13;
			<option label="Tortola" value="tortola">Tortola</option>&#13;
			<option label="Toulon (Provence)" value="toulon-provence">Toulon (Provence)</option>&#13;
			<option label="Transatlantic" value="transatlantic">Transatlantic</option>&#13;
			<option label="Transpacific" value="transpacific">Transpacific</option>&#13;
			<option label="Tripoli" value="tripoli">Tripoli</option>&#13;
			<option label="Ushuaia, Argentina" value="ushuaia-argentina">Ushuaia, Argentina</option>&#13;
			<option label="Valletta" value="valletta">Valletta</option>&#13;
			<option label="Victoria" value="victoria">Victoria</option>&#13;
			<option label="Victoria Harbour" value="victoria-harbour">Victoria Harbour</option>&#13;
			<option label="Viejo San Juan" value="viejo-san-juan">Viejo San Juan</option>&#13;
			<option label="Vigo" value="vigo">Vigo</option>&#13;
			<option label="Virgin Gorda" value="virgin-gorda">Virgin Gorda</option>&#13;
			<option label="Wadi Musa" value="wadi-musa">Wadi Musa</option>&#13;
			<option label="Wellington" value="wellington">Wellington</option>&#13;
			<option label="Whittier" value="whittier">Whittier</option>&#13;
			<option label="Willemstad" value="willemstad">Willemstad</option>&#13;
			<option label="Willis Island (Onboard Experience)" value="willis-island-onboard-experience">Willis Island (Onboard Experience)</option>&#13;
			<option label="Xi’An" value="xi-an">Xi’An</option>&#13;
			<option label="Zanzibar" value="zanzibar">Zanzibar</option>&#13;
			<option label="İstanbul" value="i-stanbul">İstanbul</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are there any specific places you would like to visit?" name="are-there-any-specific-places-you-would-like-to-visit" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When are you looking to travel?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return home?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="select" required="true" label="How flexible are you travel dates?" placeholder="Select" name="how-flexible-are-you-travel-dates" className="form-control">&#13;
			<option label="Partially Flexible" value="partially-flexible">Partially Flexible</option>&#13;
			<option label="Flexible" value="flexible">Flexible</option>&#13;
			<option label="Not Flexible" value="not-flexible">Not Flexible</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How flexible are you on trip length?" placeholder="Select" name="how-flexible-are-you-on-trip-length" className="form-control">&#13;
			<option label="Partially Flexible" value="partially-flexible">Partially Flexible</option>&#13;
			<option label="Flexible" value="flexible">Flexible</option>&#13;
			<option label="Not Flexible" value="not-flexible">Not Flexible</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Will you be traveling with anyone who is +55 years old?" placeholder="Select" name="will-you-be-traveling-with-anyone-who-is-55-years-old" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Will you be traveling with anyone who is 17 years of age or younger?" placeholder="Select" name="will-you-be-traveling-with-anyone-who-is-17-years-of-age-or-younger" className="form-control">&#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="Where would you like to leave from?" name="where-would-you-like-to-leave-from" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Are you flexible on your departure location?" placeholder="Select" name="select-1778162377480" className="form-control">&#13;
			<option label="Partially Flexible" value="partially-flexible">Partially Flexible</option>&#13;
			<option label="Flexible" value="flexible">Flexible</option>&#13;
			<option label="Not Flexible" value="not-flexible">Not Flexible</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Style"/>&#13;
		<field type="select" required="true" label="Have you taken a trip like this before?" placeholder="Select" name="have-you-taken-a-trip-like-this-before" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="What did you like or dislike about the last trip?" name="what-did-you-like-or-dislike-about-the-last-trip" className="form-control"/>&#13;
		<field type="text" required="true" label="What type of room or accommodations are you looking for?" name="what-type-of-room-or-accommodations-are-you-looking-for" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Will you be driving, flying, or making your own travel arrangements?" placeholder="Select" name="select-1778164516782" className="form-control">&#13;
			<option label="Driving" value="driving">Driving</option>&#13;
			<option label="Flying" value="flying">Flying</option>&#13;
			<option label="Making my own travel arrangements" value="making-my-own-travel-arrangements">Making my own travel arrangements</option>&#13;
			<option label="Combination of options" value="combination-of-options">Combination of options</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Would you like help with transportation or lodging?" placeholder="Select" name="select-1778164616577" className="form-control">&#13;
			<option label="Transportation only" value="transportation-only">Transportation only</option>&#13;
			<option label="Lodging only" value="lodging-only">Lodging only</option>&#13;
			<option label="Transportation and lodging" value="transportation-and-lodging">Transportation and lodging</option>&#13;
			<option label="No assistance needed" value="no-assistance-needed">No assistance needed</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="What travel documents will you be using for this trip?" name="what-travel-documents-will-you-be-using-for-this-trip" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Budget?"/>&#13;
		<field type="radio-group" required="true" label="What is the maximum total amount you are willing to spend for this trip per person?&amp;nbsp;" description="This just gives me a general starting point and can always be changed later." name="budget" className="radio-group">&#13;
			<option label="$500 to $1000" value="500-to-1000">$500 to $1000</option>&#13;
			<option label="$1000 to $1500" value="1000-to-1500">$1000 to $1500</option>&#13;
			<option label="$1500 - $2000" value="1500-2000">$1500 - $2000</option>&#13;
			<option label="$2000 to $2500" value="2000-to-2500">$2000 to $2500</option>&#13;
			<option label="$2500 to $3000" value="2500-to-3000">$2500 to $3000</option>&#13;
			<option label="$3000 to $3500" value="3000-to-3500">$3000 to $3500</option>&#13;
			<option label="$3500 to $4000" value="3500-to-4000">$3500 to $4000</option>&#13;
			<option label="$4000 to $4500" value="4000-to-4500">$4000 to $4500</option>&#13;
			<option label="$4500 to $5000" value="4500-to-5000">$4500 to $5000</option>&#13;
			<option label="$5000 to $5500" value="5000-to-5500">$5000 to $5500</option>&#13;
			<option label="$5500 to $6000" value="5500-to-6000">$5500 to $6000</option>&#13;
			<option label="$6000 to $6500" value="6000-to-6500">$6000 to $6500</option>&#13;
			<option label="$6500 to $7000" value="6500-to-7000">$6500 to $7000</option>&#13;
			<option label="$7000 to $7500" value="7000-to-7500">$7000 to $7500</option>&#13;
			<option label="$7500 to $8000" value="7500-to-8000">$7500 to $8000</option>&#13;
			<option label="$8000 to $8500" value="8000-to-8500">$8000 to $8500</option>&#13;
			<option label="$8500 to $9000" value="8500-to-9000">$8500 to $9000</option>&#13;
			<option label="$9000 to $9500" value="9000-to-9500">$9000 to $9500</option>&#13;
			<option label="$9500 to $10000" value="9500-to-10000">$9500 to $10000</option>&#13;
			<option label="$10000 or More" value="10000-or-more">$10000 or More</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Loyalty Programs"/>&#13;
		<field type="clientLoyaltyPrograms" label="Are you apart of any Loyalty Programs?" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#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;
	</fields>&#13;
</form-template>
  </body>
</html>