Share your information with Ericka LeAnn

Ericka LeAnn

Lipsticks & Laughs | Travel & Events

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h3" label="LOVE &amp;amp; FOOTBALL CRUISE_ INQUIRY FORM"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-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="Cell Phone Number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="How Many Additional Travelers Will Be In Your Cabin?" description="Cabin rates are average per person rates based on double occupancy" name="how-many-additional-travelers-will-be-in-your-cabin" className="form-control">&#13;
			<option label="Solo " value="All by myself">Solo </option>&#13;
			<option label="Two" value="two">Two</option>&#13;
			<option label="Three or more " value="three-or-more-">Three or more </option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" required="true" label="CABIN PREFERENCE" name="seat-preference">&#13;
			<option label="INTERIOR" value="interior">INTERIOR</option>&#13;
			<option label="BALCONY" value="balcony">BALCONY</option>&#13;
			<option label="SUITE" value="suite">SUITE</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="CABIN LOCATION PREFERENCE" name="hotel-preference">&#13;
			<option label="Forward" value="Front of the ship">Forward</option>&#13;
			<option label="Midship" value="Middle of the ship">Midship</option>&#13;
			<option label="Aft" value="Back of the ship">Aft</option>&#13;
			<option label="No Preference" value="Just get me on the ship ">No Preference</option>&#13;
			<option label="Undecided" value="I have no idea">Undecided</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Additional Information"/>&#13;
		<field type="text" label="Notes" description="Any notes or questions?" name="additional-traveler-contact-information-name-email-cell-phone-number" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>