Share your information with Julie Harrington

Julie Harrington

The Bonded Compass

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Family Cruise Inquiry Form&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Name"/>&#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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country" name="address-country" 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="text" required="true" label="Number of travelers including yourself" name="number-of-travelers-including-yourself" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="List all travelers Names &amp;amp; Birthdates" name="list-all-travelers-names-birthdates" className="form-control"/>&#13;
		<field type="select" required="true" label="Are all travelers US citizens?" name="are-all-travelers-us-citizens" 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="Do all travelers have valid passports?" name="do-all-travelers-have-valid-passports" 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" label="Will you be celebrating a special occassion?" name="will-you-be-celebrating-a-special-occassion" multiple="multiple" className="form-control">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Graduation" value="graduation">Graduation</option>&#13;
			<option label="Retirement" value="retirement">Retirement</option>&#13;
			<option label="Thanksgiving" value="thanksgiving">Thanksgiving</option>&#13;
			<option label="Christmas" value="christmas">Christmas</option>&#13;
			<option label="Adoption" value="adoption">Adoption</option>&#13;
			<option label="Family Reunion" value="family-reunion">Family Reunion</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What cruise line are you interested in?" description="Choose all that apply" name="what-cruise-line-are-you-interested-in" other="true">&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Royal Caribbean Cruise Line" value="royal-caribbean-cruise-line">Royal Caribbean Cruise Line</option>&#13;
			<option label=" Norwegian Cruise Line" value="-norwegian-cruise-line"> Norwegian Cruise Line</option>&#13;
			<option label="Unsure" value="unsure">Unsure</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="When would you like to depart?" 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?" 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="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What cruise itinerary are you interested in?" name="what-cruise-itinerary-are-you-interested-in" other="true">&#13;
			<option label="Bahamas" value="bahamas">Bahamas</option>&#13;
			<option label="Caribbean - Eastern" value="caribbean-eastern">Caribbean - Eastern</option>&#13;
			<option label="Caribbean - Western" value="caribbean-western">Caribbean - Western</option>&#13;
			<option label="Southern Caribbean" value="southern-caribbean">Southern Caribbean</option>&#13;
			<option label="Alaska" value="alaska">Alaska</option>&#13;
			<option label="European" value="european">European</option>&#13;
			<option label="Bermuda" value="bermuda">Bermuda</option>&#13;
			<option label="Mexico" value="mexico">Mexico</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What best describes your stateroom preference?" name="hotel-preference" other="true">&#13;
			<option label="Inside" value="inside">Inside</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many staterooms do you need?" name="how-many-staterooms-do-you-need" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What kind of cruise vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Big Ship" value="big-ship">Big Ship</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Exploration" value="exploration">Exploration</option>&#13;
			<option label="Spoil me" value="spoil-me">Spoil me</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and drinks" value="food-and-drinks">Food and drinks</option>&#13;
			<option label="Smaller Intimate Ship" value="smaller-intimate-ship">Smaller Intimate Ship</option>&#13;
			<option label="Newer Ships Only" value="newer-ships-only">Newer Ships Only</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Family Activities" value="family-activities">Family Activities</option>&#13;
			<option label="Spa &amp; Wellness" value="spa-wellness">Spa &amp; Wellness</option>&#13;
			<option label="Speciality Dining" value="speciality-dining">Speciality Dining</option>&#13;
			<option label="Youth Programs" value="youth-programs">Youth Programs</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What add ons would you like to explore?" name="what-add-ons-would-you-like-to-explore" other="true">&#13;
			<option label="Beverage Package" value="beverage-package">Beverage Package</option>&#13;
			<option label="Speciality Dining Package" value="speciality-dining-package">Speciality Dining Package</option>&#13;
			<option label="Wifi" value="wifi">Wifi</option>&#13;
			<option label="Shore Excursions" value="shore-excursions">Shore Excursions</option>&#13;
			<option label="Spa &amp; Wellness Appointment" value="spa-wellness-appointment">Spa &amp; Wellness Appointment</option>&#13;
			<option label="VIP Passes" value="vip-passes">VIP Passes</option>&#13;
			<option label="Cruise Transfers" value="cruise-transfers">Cruise Transfers</option>&#13;
			<option label="Show Reservations" value="show-reservations">Show Reservations</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Any Food Allergies or Dietary Restrictions" name="any-food-allergies-or-dietary-restrictions">&#13;
			<option label="Food Allergy" value="food-allergy">Food Allergy</option>&#13;
			<option label="Dietary Restrictions" value="dietary-restrictions">Dietary Restrictions</option>&#13;
			<option label="None" value="none">None</option>&#13;
		</field>&#13;
		<field type="textarea" label="Please explain below:" name="please-explain-below" className="form-control"/>&#13;
		<field type="text" required="true" label="Anything you absolutely must do or see?" description="Excursions  Family Photography Session, Tours, Specific Destination, etc." name="must-dos" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>