Share your information with Mark Carpenter

Mark Carpenter

Seas, Summits, & Skies Travel, LLC

<html>
  <body>
    <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>&#13;
		<field type="header" subtype="h2" label="Booking Information Form"/>&#13;
		<field type="paragraph" subtype="p" label="After this form is submitted Mark will contact you."/>&#13;
		<field type="header" subtype="h1" label="Enter names just as they appear on your passport or government ID"/>&#13;
		<field type="text" required="true" label="Purchaser&#39;s First name" name="purchasers-first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Purchaser&#39;s Middle name" name="purchasers-middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Purchaser&#39;s Last name" name="purchasers-last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Purchaser&#39;s Suffix" name="purchasers-suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Purchaser&#39;s Preferred name" name="purchasers-preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Purchaser&#39;s Birthdate" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" 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="Telephone Number" name="text-1774568637476" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Secondary Phone Number&amp;nbsp;" name="text-1774568665714" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Passenger Information"/>&#13;
		<field type="text" label="Passenger 2 - Full Name and Birthday" name="text-1774568933667" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passenger 3 - Full Name and Birthday" name="text-1774568977210" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passenger 4 - Full Name and Birthday" name="text-1774569013650" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Additional Passengers- Full Names and Birthdays" name="text-1774569046454" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Cruise Ship Preferences"/>&#13;
		<field type="radio-group" required="true" label="Stateroom Preferences" inline="true" name="radio-group-1774569237700">&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Ocean View (Window or Port Holes)" value="ocean-view-window-or-port-holes">Ocean View (Window or Port Holes)</option>&#13;
			<option label="Interior (No windows)" value="interior-no-windows">Interior (No windows)</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Stateroom Position" inline="true" name="radio-group-1774569386508">&#13;
			<option label="Front" value="front">Front</option>&#13;
			<option label="Middle" value="middle">Middle</option>&#13;
			<option label="Rear" value="rear">Rear</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like for the trip quote to include prepaid gratuities?" inline="true" name="would-you-like-for-the-trip-quote-to-include-prepaid-gratuities">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I need more information" value="i-need-more-information">I need more information</option>&#13;
		</field>&#13;
		<field type="textarea" label="Do you have a Carnival previous cruiser number? Please list the passengers names and numbers." name="textarea-1774572474263" className="form-control"/>&#13;
		<field type="textarea" label="Does anyone have accommodation needs? Please list the names at accomodations needed." name="textarea-1774572718796" className="form-control"/>&#13;
		<field type="text" label="Are there any questions or other things that you need to tell us?" name="text-1774572920470" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>