Share your information with Brenda Tulissi

Brenda Tulissi

Serafina Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Group Trip Interest Form"/>&#13;
		<field type="paragraph" subtype="p" label="This form is just to express your interest in being part of our group rate.&amp;nbsp;"/>&#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="text" label="How many people will be travelling with you?" name="how-many-people-will-be-travelling-with-you" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many rooms will you need?" name="how-many-rooms-will-you-need" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Consent" name="consent">&#13;
			<option label="I consent to Serafina Travel collecting my personal information." value="i-consent-to-serafina-travel-collecting-my-personal-information">I consent to Serafina Travel collecting my personal information.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>