Share your information with Tonesha Turner

Tonesha Turner

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    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h1" label="The Getaway Cure Cruise Inquiry Form"/>&#13;
		<field type="paragraph" subtype="p" label="Please complete this form in full for your cruise Booking request. A non-refundable research fee is required before quotes are provided. This allows me to secure the best pricing and options for your tip."/>&#13;
		<field type="paragraph" subtype="p" label="IMPORTANT:&amp;nbsp; If you are inquiring about a cruise deal or group cruise that has already been posted by The Getaway Cure, a research fee is NOT REQUIRED! If you are unsure, please text 404-641-3205 before submitting payment to confirm.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Traveler Information"/>&#13;
		<field type="text" required="true" label="Full Name" name="full-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email Address&amp;nbsp;" name="email-address-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Header"/>&#13;
		<field type="text" required="true" label="Phone Number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="DOB" name="dob" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Cruise Details&amp;nbsp;"/>&#13;
		<field type="checkbox-group" required="true" label="Cruise Line Preference&amp;nbsp;" name="cruise-line-preference-">&#13;
			<option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option>&#13;
			<option label="Royal Caribbean Internaltional" value="royal-caribbean-internaltional">Royal Caribbean Internaltional</option>&#13;
			<option label="Norwegian Cruise Line" value="norwegian-cruise-line">Norwegian Cruise Line</option>&#13;
			<option label="No Preference " value="no-preference-">No Preference </option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Destination&amp;nbsp;" name="checkbox-group-1775502802659">&#13;
			<option label="Bahamas" value="bahamas">Bahamas</option>&#13;
			<option label="Carribbean" value="carribbean">Carribbean</option>&#13;
			<option label="Mexico " value="mexico-">Mexico </option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Departure Port" name="checkbox-group-1775502924794">&#13;
			<option label="Miami" value="miami">Miami</option>&#13;
			<option label="Fort Lauderdale" value="fort-lauderdale">Fort Lauderdale</option>&#13;
			<option label="Port Canaveral" value="port-canaveral">Port Canaveral</option>&#13;
			<option label="other" value="other">other</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Preferred Travel Dates or month&amp;nbsp;" name="textarea-1775503113552" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Length of Cruise&amp;nbsp;" name="radio-group-1775503253169">&#13;
			<option label="3--- 4 days  " value="3-4-days-">3--- 4 days  </option>&#13;
			<option label="5 - 7 days" value="5-7-days">5 - 7 days</option>&#13;
			<option label="7+ days " value="7-days-">7+ days </option>&#13;
		</field>&#13;
		<field type="radio-group" label="Radio Group" name="radio-group-1775503886371">&#13;
			<option label="Option 1" value="option-1">Option 1</option>&#13;
			<option label="Option 2" value="option-2">Option 2</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Cabin Type" name="radio-group-1775503525719">&#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="text" required="true" label="Number of Travelers&amp;nbsp;" name="text-1775503711142" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Ages of Travelers&amp;nbsp;" name="text-1775503780009" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Passport and Readiness"/>&#13;
		<field type="radio-group" label="PassPort Status&amp;nbsp;" name="passport-status-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="In Progress " value="in-progress-">In Progress </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Ready to Book"/>&#13;
		<field type="radio-group" required="true" label="Are you ready to Book within the 1-2 weeks if pricing fits&amp;gt;" name="radio-group-1775504014806">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Just exploring " value="just-exploring-">Just exploring </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Budget&amp;nbsp;"/>&#13;
		<field type="radio-group" required="true" label="Budget Per Peson" name="radio-group-1775504032940">&#13;
			<option label="$300 - $600" value="300-600">$300 - $600</option>&#13;
			<option label="$600- $1000" value="600-1000">$600- $1000</option>&#13;
			<option label="$1,0000 - $2,000" value="10000-2000">$1,0000 - $2,000</option>&#13;
			<option label="$2,000" value="2000">$2,000</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Add Ons"/>&#13;
		<field type="radio-group" label="Interested in Add-Ons" name="radio-group-1775504475118">&#13;
			<option label="Drink Package" value="drink-package">Drink Package</option>&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
			<option label="Airport Transfers" value="airport-transfers">Airport Transfers</option>&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Research&amp;nbsp; Fee Agreement&amp;nbsp;" name="checkbox-group-1775504684628">&#13;
			<option label="I understand that a non refundable $25 research  is required before any cruise quotes are provided " value="i-understand-that-a-non-refundable-25-research-is-required-before-any-cruise-quotes-are-provided-">I understand that a non refundable $25 research  is required before any cruise quotes are provided </option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Price Acknowledgement&amp;nbsp;" name="checkbox-group-1775504857014">&#13;
			<option label="I understand that cruise pricing is subject to change until deposit is made" value="i-understand-that-cruise-pricing-is-subject-to-change-until-deposit-is-made">I understand that cruise pricing is subject to change until deposit is made</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Group Cruise Interest&amp;nbsp;" name="checkbox-group-1775504886525">&#13;
			<option label="I am interested in joining a group cruise hosted by THE GETAWAY CURE deporting from Miami   , FL on 9/17 to 9/21" value="i-am-interested-in-joining-a-group-cruise-hosted-by-the-getaway-cure-deporting-from-miami-fl-on-917-to-921">I am interested in joining a group cruise hosted by THE GETAWAY CURE deporting from Miami   , FL on 9/17 to 9/21</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>