Share your information with Becky Sykes

Becky Sykes

Moms at Sea Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="header" subtype="h1" 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;
		<field type="header" subtype="h1" label="Trip Details"/>&#13;
		<field type="text" 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="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" label="When would you like to travel?" name="when-would-you-like-to-travel" subtype="text" 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="text" label="Is there a budget you&#39;d like to stick to?" name="is-there-a-budget-youd-like-to-stick-to" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Tell Me About Your Family!"/>&#13;
		<field type="text" label="How many travelers?" 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="radio-group" label="Eligible Discounts" name="radio-group-1764865368277">&#13;
			<option label="Military" value="military">Military</option>&#13;
			<option label="Senior 55+" value="senior-55">Senior 55+</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;
		</field>&#13;
		<field type="text" label="State of Residency and Any Cruise Loyalty Numbers" name="text-1764865346778" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Trip Preferences"/>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Perfect Day at Cococay or other private island" value="perfect-day-at-cococay-or-other-private-island">Perfect Day at Cococay or other private island</option>&#13;
			<option label="Waterslides" value="waterslides">Waterslides</option>&#13;
			<option label="Nightly Shows/Entertainment" value="nightly-showsentertainment">Nightly Shows/Entertainment</option>&#13;
			<option label="Diapered Splash Pad" value="diapered-splash-pad">Diapered Splash Pad</option>&#13;
			<option label="Nursery for 6-36 month old" value="nursery-for-636-month-old">Nursery for 6-36 month old</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;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What type of cabin/suite are you interested in?" name="what-type-of-cabinsuite-are-you-interested-in">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Oceanview/Window" value="oceanviewwindow">Oceanview/Window</option>&#13;
			<option label="Oceanview/Balcony" value="oceanviewbalcony">Oceanview/Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Cabin that can accommodate 5+" value="cabin-that-can-accommodate-5">Cabin that can accommodate 5+</option>&#13;
			<option label="Accessible Cabin" value="accessible-cabin">Accessible Cabin</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Tell me about your perfect cruise vacation!" name="textarea-1764865413240" className="form-control"/>&#13;
		<field type="date" label="Date Field" name="date-1770125897874" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>