Share your information with Tiffany Dunagan

Tiffany Dunagan

Michael & Tiffany Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="Legal first name (Must match passport documents)" 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 (Must match passport documents)" 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="date" required="true" label="Date of birth" name="birthday" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary email address" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Sex" name="gender">&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="F" value="female">F</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="I have a valid U.S. Passport that does not expire in the next 6 months." name="i-would-like-booking-information-for">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="select" label="What type of travels are you dreaming of planning today? (Select all that apply)" name="what-type-of-travels-are-you-dreaming-of-planning-today-select-all-that-apply" multiple="multiple" className="form-control">&#13;
			<option label="Cruise" value="cruise" selected="selected">Cruise</option>&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Land Tour" value="land-tour">Land Tour</option>&#13;
			<option label="Disney" value="disney">Disney</option>&#13;
			<option label="Universal" value="universal">Universal</option>&#13;
			<option label="Personalized Itinerary" value="personalized-itinerary">Personalized Itinerary</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="Thank you for your interest in planning your travel with us! Please look for an email from us soon!"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>