Jermany Dorsey

Destins by Dorsey, LLC

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h1" label="Flight Details&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="In order to secure your included airport transfers, we need your flight information. When completing the form, we only need the information for the portion of the flight that directly connects you to your trip destination. For instance, if your flight is from Atlanta to Miami to Jamaica we would only need the Miami to Jamaica portion. The same would apply to your departure flight home. If your flight is from Jamaica to Miami to Atlanta we would just need the Jamaica to Miami portion."/>&#13;
		<field type="text" required="true" label="What is your email address?&amp;nbsp;" name="what-is-your-email-address-" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Which trip are you attending?" name="which-trip-are-you-attending" multiple="multiple" className="form-control">&#13;
			<option label="" value=""/>&#13;
			<option label="Tropic Like It's Hott: Aruba" value="tropic-like-its-hott-aruba">Tropic Like It's Hott: Aruba</option>&#13;
			<option label="Girlfriends In Greece" value="girlfriends-in-greece">Girlfriends In Greece</option>&#13;
		</field>&#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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival Flight: Name of Airline" name="flight-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival Flight: Airline Flight Number" name="text-1739590607908" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival Flight: Departure City Airport Code" name="text-1739590640340" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival Flight: Departure Time&amp;nbsp;" name="text-1739590674944" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Arrival Flight: Departure Date" name="departure-flight-date-final-leg-into-destination-start-of-trip-" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival Flight: Arrival City Airport Code&amp;nbsp;" name="airline" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Arrival Flight: Arrival Time&amp;nbsp;" name="text-1739590785782" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Arrival Flight: Arrival Date" name="date-of-departure" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure Flight: Name of Airline&amp;nbsp;" name="arrival-time" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure Flight: Airline Flight Number&amp;nbsp;" name="name-of-airline" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure Flight: Departure City Airport Code&amp;nbsp;" name="airline-flight-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure Flight: Departure Time&amp;nbsp;" name="text-1685559808597" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Flight: Departure Date&amp;nbsp;" name="departure-flight-departure-date-" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure Flight: Arrival City Airport Code&amp;nbsp;" name="departure-flight-arrival-city-airport-code-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure Flight: Arrival Time&amp;nbsp;" name="departure-flight-arrival-time-" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Flight: Arrival Date&amp;nbsp;" name="departure-flight-arrival-date-" className="form-control"/>&#13;
		<field type="textarea" label="Notes" name="notes" className="form-control"/>&#13;
		<field type="paragraph" subtype="blockquote" label="All passengers are required to check the confirm box before submitting this document. By clicking the confirm box, you confirm that all information is correct and verified with your flight information. You will accept responsibility and all liabilities for any errors submitted within this online form.&amp;nbsp;"/>&#13;
		<field type="checkbox-group" required="true" label="Confirm" name="confirm">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>