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LaSonja Brooks

LaLa's Global Escapes

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Destination Wedding"/>&#13;
		<field type="textarea" label="Couples Names" name="textarea-1765561251523" className="form-control"/>&#13;
		<field type="text" label="Preferred Destination" name="text-1765561287058" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Hotel/Resort type" name="radio-group-1765561612850">&#13;
			<option label="Adult Only" value="adult-only">Adult Only</option>&#13;
			<option label="Family Friendly" value="family-friendly">Family Friendly</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Style of Wedding" name="radio-group-1765561692682">&#13;
			<option label="Beach" value="beach">Beach</option>&#13;
			<option label="Mountain" value="mountain">Mountain</option>&#13;
			<option label="Garden" value="garden">Garden</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Total Wedding Budget" name="radio-group-1765562227084">&#13;
			<option label="$5, 000 to $10, 000" value="5-000-to-10-000">$5, 000 to $10, 000</option>&#13;
			<option label="$10, 000 to $15000" value="10-000-to-15000">$10, 000 to $15000</option>&#13;
			<option label="$15,000 to $20, 000" value="15000-to-20-000">$15,000 to $20, 000</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Will you require group travel?&amp;nbsp;&amp;nbsp;" name="radio-group-1765562647771">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Uncertain" value="uncertain">Uncertain</option>&#13;
		</field>&#13;
		<field type="text" label="If so, for how many guests" name="text-1765562728186" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How did you hear about LaLa&#39;s Global Escapes?" name="text-1765562778352" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Would you like to schedule a consultation call this week, or so?" name="radio-group-1765562857208">&#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="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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred method of contact&amp;nbsp;" name="radio-group-1765563423812" other="true">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Best time to contact" name="radio-group-1765563505366" other="true">&#13;
			<option label="Morning" value="morning">Morning</option>&#13;
			<option label="Afternoon" value="afternoon">Afternoon</option>&#13;
			<option label="Evening" value="evening">Evening</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Must be at least 21" name="checkbox-group-1765563720136">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>