Amber Durkin

Moms at Sea Travel, a Dream Vacations Franchise

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Inquiry Details"/>&#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="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="radio-group" label="Would you like a text to let you know I have received and responded to your inquiry?" name="would-you-like-a-text-to-let-you-know-i-have-received-and-responded-to-your-inquiry">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no" selected="selected">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like a phone call?&amp;nbsp;" name="would-you-like-a-phone-call-">&#13;
			<option label="Yes, right away! " value="yes-right-away-" selected="selected">Yes, right away! </option>&#13;
			<option label="Yes, but I'd like to schedule it" value="yes-but-id-like-to-schedule-it">Yes, but I'd like to schedule it</option>&#13;
			<option label="Not at this time" value="not-at-this-time">Not at this time</option>&#13;
		</field>&#13;
		<field type="text" label="What ship would you like to sail on?" name="what-ship-would-you-like-to-sail-on" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you have a month or time you are looking to sail?&amp;nbsp;" name="do-you-have-a-month-or-time-you-are-looking-to-sail-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many guests are you looking to book for?&amp;nbsp;" name="how-many-guests-are-you-looking-to-book-for-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please tell me how many guests will be 12 or under at the time of sailing:" name="please-tell-me-how-many-guests-will-be-12-or-under-at-the-time-of-sailing" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Crown &amp;amp; Anchor Number:" name="crown-anchor-number" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Please tell me anything additional you would like me to know!" name="please-tell-me-anything-additional-you-would-like-me-to-know" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>