Simply Mary'ed,LLC: Destination Weddings & Travel Planning

Simply Mary'ed

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Client Vacation Inquiry Form"/>&#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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you're not sure  just give me a few destinations you'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="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many Adults &amp;amp; Children. (please list ages of Children)" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-to-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-to-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Please tell us what we can help you plan?" name="hotel-preference" other="true">&#13;
			<option label="All - inclusive vacation" value="all-inclusive-vacation">All - inclusive vacation</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Disney Vacation" value="disney-vacation">Disney Vacation</option>&#13;
			<option label="Universal Orlando" value="universal-orlando">Universal Orlando</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Group Travel" value="group-travel">Group Travel</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like us 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;
		<field type="checkbox-group" label="How did you hear about us?" name="how-did-you-hear-about-us">&#13;
			<option label="Social Media" value="social-media">Social Media</option>&#13;
			<option label="Google Search" value="google-search">Google Search</option>&#13;
			<option label="Wedding Wire" value="wedding-wire">Wedding Wire</option>&#13;
			<option label="The Knot" value="the-knot">The Knot</option>&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>