Share your information with Claudette Hatcher

Claudette Hatcher

Claudette Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="REQUEST FOR&amp;nbsp; CRUISE RATE IN CAD"/>&#13;
		<field type="paragraph" subtype="p" label="Please fill out this form to receive a custom quote for your cruise in CAD.&amp;nbsp; We will get back to you within 24 hours with the rate, along with any applicable booking deposits.&amp;nbsp; A Credit Card Authorization form will be sent to you upon your reply to secure your cabin. If the quoted rate increases, we will contact you before processing your credit card.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Guest Info"/>&#13;
		<field type="text" required="true" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Birthdate" name="birthdate" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#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/Province" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip/Postal Code" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Full name and birthdate of each guest" description="Note &quot;NONE&quot; if no additional guests" name="full-name-of-each-guest" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" required="true" label="Itinerary name" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Name of cruise line" name="text-1788809222883" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure date" name="starting-at" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city and local airport?" name="text-1788809067797" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Cruise Line Loyalty Number" description="Note Cruise Line with Loyalty Number  or just Cruise Line if you don&#39;t know the number." name="text-1768250046323" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Type of cabin" name="budget">&#13;
			<option label="Inside" value="inside">Inside</option>&#13;
			<option label="Oceanview " value="oceanview-">Oceanview </option>&#13;
			<option label="Balcony " value="balcony-">Balcony </option>&#13;
			<option label="Suite " value="suite-">Suite </option>&#13;
		</field>&#13;
		<field type="textarea" label="NOTES: What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Click to sign