Share your information with Delores Montez

Delores Montez

Magic Travel Deals

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#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="Preferred name (nickname)" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers total?" name="how-many-travelers-total" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many cabins will you need?" name="how-many-cabins-will-you-need" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Which travel deal would you like to book? Check post for the special code." name="which-travel-deal-would-you-like-to-book-check-post-for-the-special-code" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Any Questions?" name="any-questions" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are you ready to pay the deposit?" name="are-you-ready-to-pay-the-deposit">&#13;
			<option label="YES" value="yes">YES</option>&#13;
			<option label="NO" value="no">NO</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Which cabin would you like?" name="which-cabin-would-you-like">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>