Phyllis Nsiah-Kumi

Global Celebrations

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Contact Information&amp;nbsp;"/>&#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 type="date" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" required="true" label="Primary Email Address" 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="checkbox-group" required="true" label="Are you ready to book or just exploring options?" name="are-you-ready-to-book-or-just-exploring-options">&#13;
			<option label="Ready to Book" value="ready-to-book">Ready to Book</option>&#13;
			<option label="Just Gathering Info" value="just-gathering-info">Just Gathering Info</option>&#13;
			<option label="Planning Ahead" value="planning-ahead">Planning Ahead</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you like help booking flights?" name="would-you-like-help-booking-flights">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Maybe" value="maybe">Maybe</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Are you interested in travel insurance?&amp;nbsp;" name="are-you-interested-in-travel-insurance-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Please send me info" value="please-send-me-info">Please send me info</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="How many travelers are in your group?" name="textarea-1742857605620" className="form-control"/>&#13;
		<field type="textarea" required="true" label="List of all passengers ( name, date of birth, emails)" name="is-there-anything-else-you-would-like-for-me-to-know" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Do you have any special requests or accessibility needs?" name="textarea-1742857664280" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>