Share your information with Julia Wile

Julia Wile

J & J Travel Adventure

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#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" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you like the cruise to leave from?" description="NYC/NJ, FLL, MIA, Port Canaveral, Galveston, LAX" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Is there a specific cruise line you are looking into?" description="Royal Caribbean, Carnival, NCL, MSC, Princess, Virgin Voyages, other" name="is-there-a-specific-cruise-line-you-are-looking-into" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What type of package are you looking for?" description="Wedding, Honeymoon, Vow Renewal, Group Trip, ect." name="what-type-of-package-are-you-looking-for" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many guests are you expecting?" name="how-many-guests-are-you-expecting" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for your cabin not including the specific package?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="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>