<html> <body> <form-template> <fields> <field label="Questions for your trip" subtype="h2" type="header"/> <field label="Which Trip Best Describes Your Needs" name="which-trip-best-describes-your-needs" other="true" required="true" type="checkbox-group"> <option label="Discover Egypt" selected="selected" value="discover-egypt">Discover Egypt</option> <option label="Egypt Highlights & Nile" value="egypt-highlights-nile">Egypt Highlights & Nile</option> <option label="Israel & Jordan" value="israel-jordan">Israel & Jordan</option> <option label="Israel, Jordan & Egypt" value="israel-jordan-egypt">Israel, Jordan & Egypt</option> <option label="Dubai & Egypt Highlights" value="dubai-egypt-highlights">Dubai & Egypt Highlights</option> <option label="Dubai, Abu Dhabi & Oman" value="dubai-abu-dhabi-oman">Dubai, Abu Dhabi & Oman</option> </field> <field description="If you're not sure just give me a few destinations you're considering." label="If you picked other, please list the countries and cities you would like to visit in Egypt/Middle East.&nbsp; We Customize.&nbsp;" name="destination" placeholder="ex: Tahiti" required="true" subtype="text" type="text" className="form-control"/> <field label="Full name" subtype="h2" type="header"/> <field label="Prefix" name="prefix" subtype="text" type="text" className="form-control"/> <field label="First name" name="first-name" required="true" subtype="text" type="text" className="form-control"/> <field label="Middle name" name="middle-name" subtype="text" type="text" className="form-control"/> <field label="Last name" name="last-name" required="true" subtype="text" type="text" className="form-control"/> <field label="Suffix" name="suffix" subtype="text" type="text" className="form-control"/> <field label="Preferred name" name="preferred-name" required="true" subtype="text" type="text" className="form-control"/> <field description="This just gives me a general idea of when you like to go; it can be changed later." label="When would you like to depart?" name="starting-at" required="true" type="date" className="form-control"/> <field description="This just gives me a general idea of when you like to return; it can be changed later." label="When would you like to return?" name="ending-at" required="true" type="date" className="form-control"/> <field description="Where will you be flying from?" label="What is your departure city?" name="departure-city" subtype="text" type="text" className="form-control"/> <field label="How many travelers?" name="number-of-travelers" type="text" className="form-control"/> <field description="What else would you like me to know about your travelers budget and/or travel preferences?" label="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" required="true" type="textarea" className="form-control"/> <field label="When May we Contact you?" name="when-may-we-contact-you" required="true" type="date" className="form-control"/> <field label="What Time Zone are you in and What Time is best for us to call you?" name="what-time-zone-are-you-in-and-what-time-is-best-for-us-to-call-you" required="true" subtype="text" type="text" className="form-control"/> <field label="Email" name="email" required="true" subtype="text" type="text" className="form-control"/> <field label="Phone number" name="phone-number" required="true" subtype="text" type="text" className="form-control"/> </fields> </form-template> </body> </html>
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