Kasie Provencal

PRO TOUR & CRUISES

<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" required="true" label="Last name" name="last-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="textarea" required="true" label="How many people in your traveling party (# of adults)&amp;nbsp; and (# of children and AGES)" name="how-many-people-in-your-traveling-party-of-adults-and-of-children-and-ages" className="form-control"/>&#13;
		<field type="textarea" required="true" label="When do you want to travel?&amp;nbsp; Please list month or Dates" name="when-do-you-want-to-travel-please-list-month-or-dates" className="form-control"/>&#13;
		<field type="select" required="true" label="How Many Days would you like to be there?" name="how-many-days-would-you-like-to-be-there" multiple="multiple" className="form-control">&#13;
			<option label="4 Nights" value="4-nights" selected="selected">4 Nights</option>&#13;
			<option label="5 Nights" value="5-nights">5 Nights</option>&#13;
			<option label="6 Nights" value="6-nights">6 Nights</option>&#13;
			<option label="7 Nights" value="7-nights">7 Nights</option>&#13;
			<option label="8 Nights" value="8-nights">8 Nights</option>&#13;
			<option label="9 Nights" value="9-nights">9 Nights</option>&#13;
			<option label="3 night (long weekend)" value="3-night-long-weekend">3 night (long weekend)</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Country you would like to go to?" name="country-you-would-like-to-go-to" multiple="multiple" className="form-control">&#13;
			<option label="PUNTA CANA" value="punta-cana" selected="selected">PUNTA CANA</option>&#13;
			<option label="MEXICO" value="mexico">MEXICO</option>&#13;
			<option label="JAMAICA" value="jamaica">JAMAICA</option>&#13;
			<option label="BAHAMAS" value="bahamas">BAHAMAS</option>&#13;
			<option label="ST VINCENTS" value="st-vincents">ST VINCENTS</option>&#13;
			<option label="ST LUCIA" value="st-lucia">ST LUCIA</option>&#13;
			<option label="OTHER PLEASE LIST IN COMMENTS BELOW" value="other-please-list-in-comments-below">OTHER PLEASE LIST IN COMMENTS BELOW</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Do you know what property&amp;nbsp; you would like to stay at?&amp;nbsp; &amp;nbsp;Or any info to help us narrow down the best resort for you." name="do-you-know-what-property-you-would-like-to-stay-at-or-any-info-to-help-us-narrow-down-the-best-resort-for-you" className="form-control"/>&#13;
		<field type="select" required="true" label="What type of Resort?" name="what-type-of-resort" className="form-control">&#13;
			<option label="Adult Only - Calm Upscale" value="adult-only-calm-upscale" selected="selected">Adult Only - Calm Upscale</option>&#13;
			<option label="Adult Only - Spicy, Entertainment" value="adult-only-spicy-entertainment">Adult Only - Spicy, Entertainment</option>&#13;
			<option label="Family Style" value="family-style">Family Style</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Resort Preferences" name="resort-preferences" className="form-control">&#13;
			<option label="Great Pool, we like the pool more then the beach" value="great-pool-we-like-the-pool-more-then-the-beach" selected="selected">Great Pool, we like the pool more then the beach</option>&#13;
			<option label="Great Beach, we like the beach more then the pool" value="great-beach-we-like-the-beach-more-then-the-pool">Great Beach, we like the beach more then the pool</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Type of Room" name="type-of-room" multiple="multiple" className="form-control">&#13;
			<option label="Garden View" value="garden-view" selected="selected">Garden View</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Ocean Front" value="ocean-front">Ocean Front</option>&#13;
			<option label="Butler" value="butler">Butler</option>&#13;
			<option label="Swim Out" value="swim-out">Swim Out</option>&#13;
		</field>&#13;
		<field type="select" label="Dining Preference" name="dining-preference" className="form-control">&#13;
			<option label="We love sitdown restaurants" value="we-love-sitdown-restaurants" selected="selected">We love sitdown restaurants</option>&#13;
			<option label="We love Buffets" value="we-love-buffets">We love Buffets</option>&#13;
			<option label="We like both" value="we-like-both">We like both</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you be flying from?&amp;nbsp; &amp;nbsp;Do you prefer non-stop vs connections if the price is less expensive for connections?" name="where-would-you-be-flying-from-do-you-prefer-nonstop-vs-connections-if-the-price-is-less-expensive-for-connections" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Does everyone in your party have valid passports?" name="does-everyone-in-your-party-have-valid-passports" className="form-control">&#13;
			<option label="Yes, we all have passports that do not expire before the trip" value="yes-we-all-have-passports-that-do-not-expire-before-the-trip" selected="selected">Yes, we all have passports that do not expire before the trip</option>&#13;
			<option label="No, we will be applying" value="no-we-will-be-applying">No, we will be applying</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Budget Range for your whole party" name="budget-range-for-your-whole-party" className="form-control">&#13;
			<option label="$2000-$3000" value="20003000" selected="selected">$2000-$3000</option>&#13;
			<option label="$3000-$4000" value="30004000">$3000-$4000</option>&#13;
			<option label="$4000-$5000" value="40005000">$4000-$5000</option>&#13;
			<option label="$5000-$7000" value="50007000">$5000-$7000</option>&#13;
			<option label="$7000-$10,000" value="700010000">$7000-$10,000</option>&#13;
			<option label="$10,000 +" value="10000-">$10,000 +</option>&#13;
		</field>&#13;
		<field type="text" label="Any Dietary or Medical Needs?" name="any-dietary-or-medical-needs" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Anything else we should know about?" name="anything-else-we-should-know-about" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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