Share your information with Jeff Bartlett

Jeff Bartlett

Travel Marks Intl

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Travel Inquiry Form- Let&#39;s Start Planning Your Next Journey"/>&#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 required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Desired Destination" name="desired-destination" className="form-control"/>&#13;
		<field type="radio-group" label="Where are you in the planning process?" name="where-are-you-in-the-planning-process">&#13;
			<option label="Just exploring ideas" value="just-exploring-ideas">Just exploring ideas</option>&#13;
			<option label="Ready to  plan within 3 months" value="ready-to-plan-within-3-months">Ready to  plan within 3 months</option>&#13;
			<option label="Ready to book now" value="ready-to-book-now">Ready to book now</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like to schedule a complimentary travel consultation ?" name="would-you-like-to-schedule-a-complimentary-travel-consultation-">&#13;
			<option label="Yes- please contact me" value="yes-please-contact-me">Yes- please contact me</option>&#13;
			<option label="Not yet" value="not-yet">Not yet</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>