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leidy ramos

Limitless Realm Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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 required="true"  type="text" 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="Destination(s) you have in mind?" name="text-1777659797028" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Travel dates or preferred window?" name="text-1777659816735" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Number of travelers and ages?" name="text-1777659836996" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Type of trip" name="select-1777659857598" className="form-control">&#13;
			<option label="Cruise" value="cruise" selected="selected">Cruise</option>&#13;
			<option label="All-inclusive" value="allinclusive">All-inclusive</option>&#13;
			<option label="Luxury hotel" value="luxury-hotel">Luxury hotel</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="Group trip" value="group-trip">Group trip</option>&#13;
			<option label="Corporate/business," value="corporatebusiness">Corporate/business,</option>&#13;
			<option label="Honeymoon/romance" value="honeymoonromance">Honeymoon/romance</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="select" label="Approximate total budget" name="select-1777660123716" className="form-control">&#13;
			<option label="Under $3,000 " value="under-3000-" selected="selected">Under $3,000 </option>&#13;
			<option label="$3,000–$7,000 " value="30007000-">$3,000–$7,000 </option>&#13;
			<option label="$7,000–$15,000 " value="700015000-">$7,000–$15,000 </option>&#13;
			<option label="$15,000+" value="15000">$15,000+</option>&#13;
		</field>&#13;
		<field type="textarea" label="Any special requests, celebrations, or must-haves?" name="textarea-1777660184866" className="form-control"/>&#13;
		<field type="select" label="Have you traveled with a travel advisor before?" name="select-1777660224896" className="form-control">&#13;
			<option label="Yes" value="yes" selected="selected">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Not Sure" value="not-sure">Not Sure</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>