Nicole Balducci

Moms at Sea Travel, A Dreams Vacation Franchise

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#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="select" label="Would you like a phone call?" name="would-you-like-a-phone-call" className="form-control">&#13;
			<option label="Yes! As soon as possible, I am ready to cruise!" value="yes-as-soon-as-possible-i-am-ready-to-cruise" selected="selected">Yes! As soon as possible, I am ready to cruise!</option>&#13;
			<option label="Yes, but I'd like to schedule it." value="yes-but-id-like-to-schedule-it">Yes, but I'd like to schedule it.</option>&#13;
			<option label="Not at this time." value="not-at-this-time">Not at this time.</option>&#13;
		</field>&#13;
		<field type="select" label="Would you like me to TEXT you when I have sent my initial email? My emails often get lost in spam and i find this helps you when I have responded to your email.&amp;nbsp;" name="would-you-like-me-to-text-you-when-i-have-sent-my-initial-email-my-emails-often-get-lost-in-spam-and-i-find-this-helps-you-when-i-have-responded-to-your-email-" className="form-control">&#13;
			<option label="Yes, please text me" value="yes-please-text-me" selected="selected">Yes, please text me</option>&#13;
			<option label="No, thank you" value="no-thank-you">No, thank you</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What cruise line are you interested in?" name="what-cruise-line-are-you-interested-in">&#13;
			<option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Carnival Cruise Line" value="carnival-cruise-line">Carnival Cruise Line</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have a certain ship in mind? Or any other amenities you desire or ports you prefer to leave from?&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;Amenities could include: waterslides, diapered splash pad, nursery for children under 3, certain ports, etc.&amp;nbsp;" name="do-you-have-a-certain-ship-in-mind-or-any-other-amenities-you-desire-or-ports-you-prefer-to-leave-from-amenities-could-include-waterslides-diapered-splash-pad-nursery-for-children-under-3-certain-ports-etc-" subtype="text" className="form-control"/>&#13;
		<field type="select" label="How many guests in total?" name="how-many-guests-in-total" className="form-control">&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4" selected="selected">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6+" value="6">6+</option>&#13;
		</field>&#13;
		<field type="select" label="How many guests 12 and under?" name="how-many-guests-12-and-under" className="form-control">&#13;
			<option label="1" value="1" selected="selected">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4+" value="4">4+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Cabin type preference" name="cabin-type-preference">&#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;
			<option label="Cabins for 5+ passengers " value="cabins-for-5-passengers-">Cabins for 5+ passengers </option>&#13;
			<option label="Accessible Cabin" value="accessible-cabin">Accessible Cabin</option>&#13;
			<option label="Connecting Cabins" value="connecting-cabins">Connecting Cabins</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Eligible Discounts" name="eligible-discounts">&#13;
			<option label="Military" value="military">Military</option>&#13;
			<option label="Law Enforcement" value="law-enforcement">Law Enforcement</option>&#13;
			<option label="EMT/First Responders" value="emtfirst-responders">EMT/First Responders</option>&#13;
			<option label="Senior 55+" value="senior-55">Senior 55+</option>&#13;
		</field>&#13;
		<field type="textarea" label="Do you have any thoughts on your experience you would like to share with me?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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