Share your information with Nicole Marsh (DeMesa)

Nicole Marsh (DeMesa)

Moms at Sea Travel, a Dream Vacations Franchise

<html>
  <body>
    <form-template>&#13;
	<fields>&#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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Would you like a Phone Call right away?" name="would-you-like-a-phone-call-right-away">&#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="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Would you like me to TEXT you when I have sent my initial response? Sometimes emails often get lost in spam and I find this helps you know I have responded to your inquiry." name="would-you-like-me-to-text-you-when-i-have-sent-my-initial-response-sometimes-emails-often-get-lost-in-spam-and-i-find-this-helps-you-know-i-have-responded-to-your-inquiry">&#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="How many guests total?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Any children? If so, what are their ages?" name="any-children-if-so-what-are-their-ages" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How did you find/hear about me?&amp;nbsp;" name="how-did-you-findhear-about-me-" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What cruise lines are you interested in? (Select all that apply)" name="what-cruise-lines-are-you-interested-in-select-all-that-apply">&#13;
			<option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option>&#13;
			<option label="Celebrity" value="celebrity">Celebrity</option>&#13;
			<option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option>&#13;
		</field>&#13;
		<field type="text" label="Do you know what ship you want to sail on specifically?" name="do-you-know-what-ship-you-want-to-sail-on-specifically" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What date would you like to sail?" name="what-date-would-you-like-to-sail" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your preferred Departure Port?" name="what-is-your-preferred-depature-port" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="I don&#39;t know the details yet, but I would like these features" name="i-dont-know-the-details-yet-but-i-would-like-these-features" other="true">&#13;
			<option label="Perfect Day at Cococay" value="perfect-day-at-cococay">Perfect Day at Cococay</option>&#13;
			<option label="Celebration Key" value="celebration-key">Celebration Key</option>&#13;
			<option label="Castaway Cay / Lighthouse Point" value="castaway-cay-lighthouse-point">Castaway Cay / Lighthouse Point</option>&#13;
			<option label="Waterslides" value="waterslides">Waterslides</option>&#13;
			<option label="Diaper Splash Pad" value="diaper-splash-pad">Diaper Splash Pad</option>&#13;
			<option label="Nursery for 6m-36m" value="nursery-for-6m36m">Nursery for 6m-36m</option>&#13;
			<option label="Splash Pad for potty trained kids" value="splash-pad-for-potty-trained-kids">Splash Pad for potty trained kids</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What type of cabin/suite are you most interested in?" name="what-type-of-cabinsuite-are-you-most-interested-in">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Ocean View Window" value="ocean-view-window">Ocean View Window</option>&#13;
			<option label="Ocean View Balcony" value="ocean-view-balcony">Ocean View Balcony</option>&#13;
			<option label="Boardwalk or Central Park Balcony (on Oasis/Icon Class ships)" value="boardwalk-or-central-park-balcony-on-oasisicon-class-ships">Boardwalk or Central Park Balcony (on Oasis/Icon Class ships)</option>&#13;
			<option label="Suite-Royal Caribbean, Haven (NCL), Concierge (DCL), The Retreat (Celebrity)" value="suiteroyal-caribbean-haven-ncl-concierge-dcl-the-retreat-celebrity">Suite-Royal Caribbean, Haven (NCL), Concierge (DCL), The Retreat (Celebrity)</option>&#13;
			<option label="Star Class (Royal Caribbean)" value="star-class-royal-caribbean">Star Class (Royal Caribbean)</option>&#13;
			<option label="Cabins that accommodate 5+" value="cabins-that-accommodate-5">Cabins that accommodate 5+</option>&#13;
			<option label="Accessible cabin" value="accessible-cabin">Accessible cabin</option>&#13;
		</field>&#13;
		<field type="text" label="State of Residency and any appropriate cruise loyalty numbers" name="state-of-residency-and-any-appropriate-cruise-loyalty-numbers" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Eligible discounts" name="eligible-discounts">&#13;
			<option label="Military" value="military">Military</option>&#13;
			<option label="Law Enforcement" value="law-enforcement">Law Enforcement</option>&#13;
			<option label="EMT/First Responder" value="emtfirst-responder">EMT/First Responder</option>&#13;
			<option label="Senior" value="senior">Senior</option>&#13;
		</field>&#13;
		<field type="textarea" label="What can you tell me about the cruise you are looking for?&amp;nbsp;" name="what-can-you-tell-me-about-the-cruise-you-are-looking-for-" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>