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asiahighlights.com/aspbackup/forms/inquiry-form.asp

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<!doctype html>
<html>
<head>
<meta charset="utf-8">
<title>Inquiry Form - Asia Highlights</title>
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta content="width=device-width, initial-scale=1.0" name="viewport">
<meta content="yes" name="apple-mobile-web-app-capable">
<link href="/css/global.min.css" rel="stylesheet">
<link href="/css/basic.css" rel="stylesheet">
<link href="/css/inquiry-form.css" rel="stylesheet">
<link href="/css/tailor-make.css" rel="stylesheet">
<script src="/js/jquery-1.8.2.min.js"></script>
<script src="/js/bootstrap.min.js"></script>
</head>
<body>
<!--#include virtual="/aspbackup/inc/header.asp" -->
<div id="inquiryForm">
<div class="container">
<div class="row">
<div class="col-md-2 col-sm-2 hidden-xs"></div>
<div class="col-md-3 col-sm-3 col-xs-6 pgHead"><img src="/image/peggie.png" class="img-responsive"></div>
<div class="col-md-19 col-sm-19 col-xs-18"> <span class="advisorInfo"> <span class="arrow"></span> I'm Peggie, my team and I are Vietnam travel experts! Just let us know your requirements
and my team will reply to you in a few hours, maximum 24 hours!</span>
</div>
<div class="clearfix"></div>
<div class="col-md-5 col-sm-5 hidden-xs"></div>
<div class="col-md-19 col-sm-19 col-xs-24">
<div class="FormDetail">
<div class="row TourInfo">
<div class="col-md-7 col-sm-7 InquiryOn">You are inquiry on:</div>
<div class="col-md-17 col-sm-17 tourDetail">
<ul>
<li><span class="detailName">Tour Code:</span>线路代码</li>
<li><span class="detailName">Length:</span>线路天数</li>
<li><span class="detailName">Destinations:</span>经过城市</li>
</ul>
</div>
</div>
<div class="formItem">
<div class="Question">1. Travelers</div>
<div class="row">
<div class="col-md-8 col-sm-8 who">Adults (18+)
<select type="text" name="adultsNumber" id="adultsNumber" value="" class="partner">
<option value="1">1</option>
<option value="2" selected>2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="20+">20+</option>
</select>
</div>
<div class="col-md-8 col-sm-8 who">Youth (12-17)
<select type="text" name="ChildrenNumber" id="ChildrenNumber" value="" class="partner">
<option value="0" selected>0</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="20+">20+</option>
</select>
</div>
<div class="col-md-8 col-sm-8 who">Kids (&lt;12)
<select type="text" name="BabiesNumber" id="BabiesNumber" value="" class="partner">
<option value="0" selected>0</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="20+">20+</option>
</select>
</div>
</div>
</div>
<div class="hotelBlock">
<h2 class="Question">2. Hotel Style <sup>*</sup></h2>
<div class="row">
<div class="col-md-8 col-sm-12">
<label for="fiveStar">
<div class="hotelStyle luxury">
<input name="hotel" type="radio" value="5 star Hotel Chains" id="fiveStar">
Luxury Style(5 stars &amp; up) <span class="priceRange">USD250+/room</span> </div>
</label>
</div>
<div class="col-md-8 col-sm-12">
<label for="fourStarv">
<div class="hotelStyle boutique">
<input name="hotel" type="radio" value="4 star Best Value" id="fourStarv">
Handpicked Comfort(4-5 stars) <span class="priceRange">USD200+/room</span> </div>
</label>
</div>
<div class="col-md-8 col-sm-12">
<label for="fourStarl">
<div class="hotelStyle standard">
<input name="hotel" type="radio" value="Self Booking" id="fourStarl">
Standard Style(3-4 stars) <span class="priceRange">USD50-100/room</span> </div>
</label>
</div>
</div>
</div>
<div class="formItem">
<div class="Question">3. Date of Arrival</div>
<div class="row">
<div class="col-md-10 col-sm-10">
<input type="date" autocomplete="off" placeholder="mm/dd/yyyy" value="" name="ArrivalDate" class="arrivalDate">
</div>
<div class="col-md-14 col-sm-14"><span class="dateFlexible">Are your dates flexible?</span> <br>
<input type="radio" name="dates" value="" class="hotel">
Yes
<input type="radio" name="dates" value="" class="hotel">
No </div>
</div>
<div class="Flexible">Flexible to arrive or depart? Choose the date!</div>
<div class="row ChooseDate">
<div class="col-md-3 col-sm-3">Arrive:</div>
<div class="col-md-21 col-sm-21">
<input type="date" name="Date_Start" id="Date_Start" value="" class="flexibleDate">
</div>
</div>
<div class="row ChooseDate">
<div class="col-md-3 col-sm-3">Depart:</div>
<div class="col-md-21 col-sm-21">
<input type="date" name="date" value="" class="flexibleDate">
</div>
</div>
</div>
<div class="formItem">
<div class="Question">4. What do you expect for this trip?</div>
<textarea placeholder="Tell us more to help us understand you better. How can we make it extra special?" onblur="hideTips('sCustominfoTipsid')" name="additionalrequirements" id="additionalrequirements" class="ExpectTrip col-md-22 col-sm-22"></textarea>
<div class="clear"></div>
</div>
<div class="Question">5. Contact Details</div>
<div class="row">
<div class="personalInfo col-md-10 col-sm-10">
<div class="input-group margin-bottom-sm"> <span class="input-group-addon">
<select id="gender" name="gender">
<option value="Mr."> Mr.</option>
<option value="Ms."> Ms.</option>
</select>
</span>
<input type="text" id="realname" name="realname" placeholder="Full Name*" class="form-control fullname">
</div>
</div>
<div class="personalInfo col-md-10 col-sm-10">
<div class="input-group margin-bottom-sm"> <span class="input-group-addon"><i class="fa fa-globe"></i></span> <span role="status" aria-live="polite" class="ui-helper-hidden-accessible"></span>
<input type="text" id="Nationality" name="Nationality" placeholder="Nationality*" class="form-control nationality ui-autocomplete-input" autocomplete="off">
</div>
<input type="hidden" id="destinationCode2" name="destinationCode2">
</div>
<div class="clear"></div>
<div class="personalInfo col-md-10 col-sm-10">
<div class="input-group"> <span class="input-group-addon"><i class="fa fa-envelope-o fa-fw"></i></span>
<input type="email" id="email" name="email" placeholder="Email*" class="form-control email">
</div>
<span class="noSpam hidden-xs hidden-sm">We never spam you or sell your address.</span> </div>
<div class="personalInfo col-md-10 col-sm-10 col-xs-23">
<div class="input-group margin-bottom-sm"> <span class="input-group-addon"><i class="fa fa-phone"></i></span>
<input type="tel" id="PhoneNo" name="PhoneNo" placeholder="+country code and number." class="form-control telephone">
</div>
<span class="noSpam hidden-xs hidden-sm">Only call you if you ask, or for email issues.</span> </div>
</div>
<div class="sendInquiry row">
<div class="col-md-7 col-md-7 hidden-xs"></div>
<div class="col-md-10 col-sm-10 col-xs-24">
<input type="submit" id="js_nextsteps" value="Send my inquiry">
</div>
<div class="col-md-7 col-md-7 hidden-xs"></div>
</div>
</div>
</div>
</div>
</div>
<!--#include virtual="/aspbackup/inc/footer.asp" -->
</body>
</html>
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