Share your information with Darby Venosa

Darby Venosa

Destinations with Darbs - Pixie Travel Co

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		<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="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" 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="checkbox-group" required="true" label="Where Would You Like your Wedding to be?" name="where-would-you-like-to-travel" other="true">&#13;
			<option label="Caribbean | Central America" value="caribbean-central-america">Caribbean | Central America</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="North America" value="north-america">North America</option>&#13;
			<option label="Walt Disney World" value="walt-disney-world">Walt Disney World</option>&#13;
			<option label="Disneyland" value="disneyland">Disneyland</option>&#13;
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		<field type="text" required="true" label="Do you have a Date in Mind for your Wedding?" name="when-would-you-like-to-travel" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Do You Have Passports?" name="do-you-have-passports">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="Yes but Expired" value="yes-but-expired">Yes but Expired</option>&#13;
			<option label="No" value="no">No</option>&#13;
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		<field type="radio-group" required="true" label="Do You have a Budget in Mind?" name="do-you-have-a-budget-in-mind">&#13;
			<option label="Budget Friendly" value="budget-friendly">Budget Friendly</option>&#13;
			<option label="Moderately Prices" value="moderately-prices">Moderately Prices</option>&#13;
			<option label="Luxury Prices" value="luxury-prices">Luxury Prices</option>&#13;
			<option label="Not Sure - Help!" value="not-sure-help">Not Sure - Help!</option>&#13;
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		<field type="radio-group" label="Do You Need Vendor Recommendations in the Location?" name="do-you-need-vendor-recommendations-in-the-location">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
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		<field type="radio-group" label="Do You Need Help with Guest Reservations?" name="do-you-need-help-with-guest-reservations">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
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		<field type="checkbox-group" required="true" label="What is Most Important when it comes to your Wedding?" name="what-is-most-important-when-it-comes-to-your-vacation" other="true">&#13;
			<option label="Budget" value="budget">Budget</option>&#13;
			<option label="Luxury | Butler" value="luxury-butler">Luxury | Butler</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Quiet Relaxation" value="quiet-relaxation">Quiet Relaxation</option>&#13;
			<option label="Beach Ceremony" value="beach-ceremony">Beach Ceremony</option>&#13;
			<option label="Multiple Venues" value="multiple-venues">Multiple Venues</option>&#13;
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		<field type="textarea" required="true" label="Any other Details you&#39;d like me to know?" name="any-other-details-youd-like-me-to-know-are-you-celebrating-anything-special-" className="form-control"/>&#13;
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