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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Roommate Matching: Find Your Fit"/>&#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="Name of Preferred Roommate&amp;nbsp;" name="text-1766490924289" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Which trip are you scheduled for?" name="checkbox-group-1766490955859">&#13;
			<option label="Eat. Pray. Slay. Bali" value="eat-pray-slay-bali">Eat. Pray. Slay. Bali</option>&#13;
			<option label="Deck The Seas: Holiday Cruise" value="deck-the-seas-holiday-cruise">Deck The Seas: Holiday Cruise</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Personality/Attitude" name="radio-group-1766491013470">&#13;
			<option label="I am very mild-mannered" value="i-am-very-mildmannered">I am very mild-mannered</option>&#13;
			<option label="I have a bad attitude, but know how to keep it in control" value="i-have-a-bad-attitude-but-know-how-to-keep-it-in-control">I have a bad attitude, but know how to keep it in control</option>&#13;
			<option label="I like things done my way, and not willing to compromise" value="i-like-things-done-my-way-and-not-willing-to-compromise">I like things done my way, and not willing to compromise</option>&#13;
			<option label="I am a team player" value="i-am-a-team-player">I am a team player</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Sleep Habits" name="radio-group-1766491087777">&#13;
			<option label="Early riser (6am - 8am)" value="early-riser-6am-8am">Early riser (6am - 8am)</option>&#13;
			<option label="Sleep i)n later (after 10am)" value="sleep-in-later-after-10am">Sleep i)n later (after 10am)</option>&#13;
			<option label="Night Owl (come in after midnight" value="night-owl-come-in-after-midnight">Night Owl (come in after midnight</option>&#13;
			<option label="Go to be early (before 9pm)" value="go-to-be-early-before-9pm">Go to be early (before 9pm)</option>&#13;
			<option label="I have been told that I snore" value="i-have-been-told-that-i-snore">I have been told that I snore</option>&#13;
			<option label="I am a quiet sleeper" value="i-am-a-quiet-sleeper">I am a quiet sleeper</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Hotel Room Temperature Preference" name="radio-group-1766491174949">&#13;
			<option label="I like it cold (under 70 degrees)" value="i-like-it-cold-under-70-degrees">I like it cold (under 70 degrees)</option>&#13;
			<option label="I like to be comfortable (between 70-75 degrees)" value="i-like-to-be-comfortable-between-7075-degrees">I like to be comfortable (between 70-75 degrees)</option>&#13;
			<option label="I like to stay warm (75 degrees+)" value="i-like-to-stay-warm-75-degrees">I like to stay warm (75 degrees+)</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Cleanliness" name="radio-group-1766491236185">&#13;
			<option label="I consider myself a neat freak, and prefer a roommate with the same habits" value="i-consider-myself-a-neat-freak-and-prefer-a-roommate-with-the-same-habits">I consider myself a neat freak, and prefer a roommate with the same habits</option>&#13;
			<option label="I tend to be a little messy on vacations, so prefer a roommate that can cope with this" value="i-tend-to-be-a-little-messy-on-vacations-so-prefer-a-roommate-that-can-cope-with-this">I tend to be a little messy on vacations, so prefer a roommate that can cope with this</option>&#13;
			<option label="I am neither overly neat, nor messy" value="i-am-neither-overly-neat-nor-messy">I am neither overly neat, nor messy</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Timeliness and Planning" name="radio-group-1766491358241">&#13;
			<option label="I am very timely when it comes to scheduled activities" value="i-am-very-timely-when-it-comes-to-scheduled-activities">I am very timely when it comes to scheduled activities</option>&#13;
			<option label="I am not very punctual, and tend to run late very often" value="i-am-not-very-punctual-and-tend-to-run-late-very-often">I am not very punctual, and tend to run late very often</option>&#13;
			<option label="I try my best to be timely for scheduled activities, but sometimes run late" value="i-try-my-best-to-be-timely-for-scheduled-activities-but-sometimes-run-late">I try my best to be timely for scheduled activities, but sometimes run late</option>&#13;
			<option label="I am very organized, and tend to have my travel agenda planned out" value="i-am-very-organized-and-tend-to-have-my-travel-agenda-planned-out">I am very organized, and tend to have my travel agenda planned out</option>&#13;
			<option label="I prefer to just “go with the flow”, and do my own thing without sticking to the group's planned activities" value="i-prefer-to-just-go-with-the-flow-and-do-my-own-thing-without-sticking-to-the-groups-planned-activities">I prefer to just “go with the flow”, and do my own thing without sticking to the group's planned activities</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Bedtime Preferences" name="radio-group-1766491289856">&#13;
			<option label="I prefer to sleep in complete darkness" value="i-prefer-to-sleep-in-complete-darkness">I prefer to sleep in complete darkness</option>&#13;
			<option label="I enjoy sleeping with the TV on with sound" value="i-enjoy-sleeping-with-the-tv-on-with-sound">I enjoy sleeping with the TV on with sound</option>&#13;
			<option label="I enjoy background light, and sleep better with the TV on mute" value="i-enjoy-background-light-and-sleep-better-with-the-tv-on-mute">I enjoy background light, and sleep better with the TV on mute</option>&#13;
			<option label="I need a night light on" value="i-need-a-night-light-on">I need a night light on</option>&#13;
			<option label="I can sleep through anything, so I am willing to accept a roommate with any of these habits" value="i-can-sleep-through-anything-so-i-am-willing-to-accept-a-roommate-with-any-of-these-habits">I can sleep through anything, so I am willing to accept a roommate with any of these habits</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="My Ideal Roommate" name="radio-group-1766491440517">&#13;
			<option label="Quiet" value="quiet">Quiet</option>&#13;
			<option label="Mildly conversational" value="mildly-conversational">Mildly conversational</option>&#13;
			<option label="Talkative/Outgoing" value="talkativeoutgoing">Talkative/Outgoing</option>&#13;
			<option label="Party Animal" value="party-animal">Party Animal</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Roommate Age Preference" name="radio-group-1766491492831">&#13;
			<option label="30 - 40 years" value="30-40-years">30 - 40 years</option>&#13;
			<option label="40 - 50 years" value="40-50-years">40 - 50 years</option>&#13;
			<option label="50 - 60 years" value="50-60-years">50 - 60 years</option>&#13;
			<option label="60 - 70 years" value="60-70-years">60 - 70 years</option>&#13;
			<option label="70 years +" value="70-years-">70 years +</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Describe your ideal roommate" name="textarea-1766491545287" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Why would you make the best roommate?" name="textarea-1766491594597" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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