Charvon Parker

On The Go Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Cruise Travel Inquiry Form"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for choosing us for your cruise vacation planning! To better assist you, please provide as much detail as possible. Our travel experts will review your information and contact you within 24 business hours."/>&#13;
		<field type="header" subtype="h1" label="Primary Contact Information"/>&#13;
		<field type="text" required="true" label="Email" placeholder="you@ilovetravel.com" 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="select" required="true" label="Preferred Contact Method" name="preferred-contact-method" className="form-control">&#13;
			<option label="Email" value="email" selected="selected">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="radio-group" label="&amp;nbsp;I agree to receive text messages about my cruise inquiry" description=" Message and data rates may apply. You can opt-out at any time." name="-i-agree-to-receive-text-messages-about-my-cruise-inquiry">&#13;
			<option label="I agree" value="i-agree">I agree</option>&#13;
			<option label="I do not agree" value="i-do-not-agree">I do not agree</option>&#13;
		</field>&#13;
		<field type="text" label="Lead Passenger" name="text-1729365782120" value="Passenger Information" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" 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" label="Middle name" name="middle-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="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" required="true" label="Birthday" description="Required for accurate pricing and age-specific promotions" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Passenger 2"/>&#13;
		<field type="header" subtype="h2" label="Full name&amp;nbsp;"/>&#13;
		<field type="textarea" label="&amp;nbsp;Name" placeholder="First, Middle, Last" name="-name" className="form-control"/>&#13;
		<field type="date" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Cruise Preferences"/>&#13;
		<field type="select" required="true" label="Preferred Cruise Line" name="preferred-cruise-line" multiple="multiple" className="form-control">&#13;
			<option label="Royal Caribbean" value="royal-caribbean" selected="selected">Royal Caribbean</option>&#13;
			<option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option>&#13;
			<option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option>&#13;
			<option label="Princess Cruises" value="princess-cruises">Princess Cruises</option>&#13;
			<option label="Celebrity Cruises" value="celebrity-cruises">Celebrity Cruises</option>&#13;
			<option label="MSC Cruise Line" value="msc-cruise-line">MSC Cruise Line</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Preferred Cabin Type"/>&#13;
		<field type="select" label="Cabin" description="Not sure? We'll help you choose the best option for your budget and preferences" name="select-1729371624931" multiple="multiple" className="form-control">&#13;
			<option label="Interior" value="interior">Interior</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="header" subtype="h1" label="Preferred Dining Time"/>&#13;
		<field type="radio-group" required="true" label="Select Dining Time" name="select-dining-time">&#13;
			<option label="Early Seating (5:30PM-6:30PM)" value="early-seating-530pm630pm">Early Seating (5:30PM-6:30PM)</option>&#13;
			<option label="Late Seating (7:30PM - 8:30PM)" value="late-seating-730pm-830pm">Late Seating (7:30PM - 8:30PM)</option>&#13;
			<option label="My Time / Flexible Dining" value="my-time-flexible-dining">My Time / Flexible Dining</option>&#13;
			<option label="Specialty Dining" value="specialty-dining">Specialty Dining</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Preferred Travel Dates"/>&#13;
		<field type="textarea" required="true" label="Travel Dates" placeholder="Flexible dates may help us find better deals for you" name="travel-dates" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Preferred Cruise Duration"/>&#13;
		<field type="radio-group" required="true" label="Cruise Duration" inline="true" name="cruise-duration">&#13;
			<option label="3-5 days" value="35-days">3-5 days</option>&#13;
			<option label="6-8 days" value="68-days">6-8 days</option>&#13;
			<option label="9-12 days" value="912-days">9-12 days</option>&#13;
			<option label="13+ days" value="13-days">13+ days</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Additional Services"/>&#13;
		<field type="checkbox-group" label="Optional&amp;nbsp;" toggle="true" inline="true" name="checkbox-group-1729371607717" other="true">&#13;
			<option label="Interested In Pre Paid Gratuities" value="interested-in-pre-paid-gratuities">Interested In Pre Paid Gratuities</option>&#13;
			<option label="Interested In Travel Insurance" value="interested-in-travel-insurance">Interested In Travel Insurance</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Dietary Restrictions/Food Allergies"/>&#13;
		<field type="textarea" label="Dietary Restrictions" name="dietary-restrictions" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Comments or Special Requests"/>&#13;
		<field type="textarea" label="Comments" placeholder="Please share any additional information, preferences, questions, or special occasions we should know about" name="comments" className="form-control"/>&#13;
		<field type="textarea" label="Disclaimer" name="disclaimer" value="By submitting this form, you agree to be contacted regarding your cruise inquiry. All information provided will be kept confidential and used only for travel planning purposes. Prices and availability are subject to change until confirmed with a deposit." className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>