Merry Jennifer Markham

MMarkham Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Request Hotel Rates"/>&#13;
		<field type="paragraph" subtype="p" label="Submit your information and the specifics of your hotel booking request below. If you have any questions, reach out to us at hello@mmarkhamtravel.com!"/>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Your Contact Information"/>&#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="header" subtype="h1" label="Your Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" 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="header" subtype="h1" label="Hotel Stay Specifics"/>&#13;
		<field type="text" required="true" label="Which hotel/resort are you interested in? Be sure to list the location of the hotel!" placeholder="E.g., Cap Juluca, Belmond - Anguilla" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Arrival Date" name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Date" name="ending-at" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Which room category/type at are you interested in?&amp;nbsp;" placeholder="E.g.  Deluxe View with 2 Queens" name="who-will-be-traveling-please-list-all-full-names-including-middle-and-birthdays-" rows="2" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="With our hotel bookings, you can still earn your loyalty points."/>&#13;
		<field type="clientLoyaltyPrograms" label="&amp;nbsp;Loyalty Program Name and Account Number" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Who is traveling?"/>&#13;
		<field type="text" required="true" label="What is the number of adults in each room?" placeholder="E.g.  2 adults" name="what-are-your-amenity-musthaves" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is the number (and ages) of children in each room?&amp;nbsp;" placeholder="E.g.  2 children (ages 5 and 7)" name="is-there-anything-else-that-you-must-do-or-see" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Anything else we - or the hotel - should know? Any special requests? Do you need more than 1 room?"/>&#13;
		<field type="textarea" required="true" label="List requests here." name="what-else-would-you-like-me-to-know-about-your-ideal-vacation" className="form-control"/>&#13;
		<field type="select" required="true" label="Would you like to receive our newsletter?" name="would-you-like-to-receive-our-twicemonthly-newsletter" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>