<?xml version="1.0" encoding="UTF-8"?>

<form url="reservation.php"
 window="_self"
 method="POST"
 fontname="MS Sans Serif"
 width="488"
 height="516"
 bkcolor="0xFFFFFF"
 transparent="f"
 fontcolor="0x000000"
 outlinecolor="0x000000"
 themecolor="0xCCFFCC"
 fontcolor2="#000000"
 bkcolor2="#FFFFFF"
 includeresults="false"
 emailuser="true"
 bcc=""
 cc=""
 reqmessage="One or More Fields are Required"
 transition="0"
 autoresponseincluderesults="t"
 autoresponseaddtotop="f"
 usephp="true"
 disableclicktoactiveprompt="true"
 extensions="*.txt;*.gif;*.jpg;*.jpeg;*.zip;*.doc;*.png;*.pdf;*.rtf"
>

<hidden
 name="thankyoupage"
 value="http://www.deltavipvacationrental.com"
></hidden>

<hidden
 name="subject"
 value="Delta VIP Reservation"
></hidden>

<image
 image="thankyou.jpg"
 x="339"
 y="467"
></image>

<image
 image="deltavip1.jpg"
 x="8"
 y="5"
></image>

<textinput
 name="Name"
 x="60"
 y="116"
 w="232"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<textinput
 name="Phone"
 x="356"
 y="116"
 w="123"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<textinput
 name="Street Address"
 x="128"
 y="152"
 w="351"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<textinput
 name="City"
 x="48"
 y="188"
 w="160"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<combobox
 name="State"
 x="264"
 y="188"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select One:"></item>
  <item name="Alabama"></item>
  <item name="Alaska"></item>
  <item name="Arizona"></item>
  <item name="Arkansas"></item>
  <item name="California"></item>
  <item name="Colorado"></item>
  <item name="Connecticut"></item>
  <item name="Delaware"></item>
  <item name="Florida"></item>
  <item name="Georgia"></item>
  <item name="Hawaii"></item>
  <item name="Idaho"></item>
  <item name="Illinois"></item>
  <item name="Indiana"></item>
  <item name="Iowa"></item>
  <item name="Kansas"></item>
  <item name="Kentucky"></item>
  <item name="Louisiana"></item>
  <item name="Maine"></item>
  <item name="Maryland"></item>
  <item name="Massachusetts"></item>
  <item name="Michigan"></item>
  <item name="Minnesota"></item>
  <item name="Mississippi"></item>
  <item name="Missouri"></item>
  <item name="Montana"></item>
  <item name="Nebraska"></item>
  <item name="Nevada"></item>
  <item name="New Hampshire"></item>
  <item name="New Jersey"></item>
  <item name="New Mexico"></item>
  <item name="New York"></item>
  <item name="North Carolina"></item>
  <item name="North Dakota"></item>
  <item name="Ohio"></item>
  <item name="Oklahoma"></item>
  <item name="Oregon"></item>
  <item name="Pennsylvania"></item>
  <item name="Rhode Island"></item>
  <item name="South Carolina"></item>
  <item name="South Dakota"></item>
  <item name="Tennessee"></item>
  <item name="Texas"></item>
  <item name="Utah"></item>
  <item name="Vermont"></item>
  <item name="Virginia"></item>
  <item name="Washington"></item>
  <item name="West Virginia"></item>
  <item name="Wisconsin"></item>
  <item name="Wyoming"></item>
</combobox>

<textinput
 name="Zip"
 x="404"
 y="188"
 w="75"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
>
</textinput>

<textinput
 name="Email Address"
 x="128"
 y="224"
 w="352"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
 required="true"
 emailbox="true"
  restrict="email"
>
</textinput>

<combobox
 name="Arrival Month"
 x="12"
 y="292"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select Month:"></item>
  <item name="January"></item>
  <item name="February"></item>
  <item name="March"></item>
  <item name="April"></item>
  <item name="May"></item>
  <item name="June"></item>
  <item name="July"></item>
  <item name="August"></item>
  <item name="September"></item>
  <item name="October"></item>
  <item name="November"></item>
  <item name="December"></item>
</combobox>

<combobox
 name="Arrival Day"
 x="120"
 y="292"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select  Day:"></item>
  <item name="1"></item>
  <item name="2"></item>
  <item name="3"></item>
  <item name="4"></item>
  <item name="5"></item>
  <item name="6"></item>
  <item name="7"></item>
  <item name="8"></item>
  <item name="9"></item>
  <item name="10"></item>
  <item name="11"></item>
  <item name="12"></item>
  <item name="13"></item>
  <item name="14"></item>
  <item name="15"></item>
  <item name="16"></item>
  <item name="17"></item>
  <item name="18"></item>
  <item name="19"></item>
  <item name="20"></item>
  <item name="21"></item>
  <item name="22"></item>
  <item name="23"></item>
  <item name="24"></item>
  <item name="25"></item>
  <item name="26"></item>
  <item name="27"></item>
  <item name="28"></item>
  <item name="29"></item>
  <item name="30"></item>
  <item name="31"></item>
</combobox>

<combobox
 name="Departure Month"
 x="260"
 y="292"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select Month"></item>
  <item name="January"></item>
  <item name="February"></item>
  <item name="March"></item>
  <item name="April"></item>
  <item name="May"></item>
  <item name="June"></item>
  <item name="July"></item>
  <item name="August"></item>
  <item name="September"></item>
  <item name="October"></item>
  <item name="November"></item>
  <item name="December"></item>
</combobox>

<combobox
 name="Departure Day"
 x="376"
 y="292"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select Day:"></item>
  <item name="1"></item>
  <item name="2"></item>
  <item name="3"></item>
  <item name="4"></item>
  <item name="5"></item>
  <item name="6"></item>
  <item name="7"></item>
  <item name="8"></item>
  <item name="9"></item>
  <item name="10"></item>
  <item name="11"></item>
  <item name="12"></item>
  <item name="13"></item>
  <item name="14"></item>
  <item name="15"></item>
  <item name="16"></item>
  <item name="17"></item>
  <item name="18"></item>
  <item name="19"></item>
  <item name="20"></item>
  <item name="21"></item>
  <item name="22"></item>
  <item name="23"></item>
  <item name="24"></item>
  <item name="25"></item>
  <item name="26"></item>
  <item name="27"></item>
  <item name="28"></item>
  <item name="29"></item>
  <item name="30"></item>
  <item name="31"></item>
</combobox>

<combobox
 name="Year"
 x="192"
 y="324"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select Year:"></item>
  <item name="2007"></item>
  <item name="2008"></item>
  <item name="2009"></item>
  <item name="2010"></item>
  <item name="2011"></item>
  <item name="2012"></item>
  <item name="2013"></item>
  <item name="2014"></item>
  <item name="2015"></item>
</combobox>

<combobox
 name="Number of Guests"
 x="324"
 y="352"
 bkcolor="0xFFFFFF"
 fontcolor="0x000000"
 required="true"
 isemail="false"
 w="100"
 h="20">
  <item name="Select One:"></item>
  <item name="1"></item>
  <item name="2"></item>
  <item name="3"></item>
  <item name="4"></item>
  <item name="5"></item>
  <item name="6"></item>
  <item name="7"></item>
  <item name="8"></item>
  <item name="9"></item>
  <item name="10"></item>
</combobox>

<checkbox
 name="Boat Yes"
 x="176"
 y="396"
 w="38"
 h="19"
 label="YES"
 labelPos="right"
 value="checked"
 fontbold="bold"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<checkbox
 name="Boat No"
 x="228"
 y="396"
 w="33"
 h="19"
 label="NO"
 labelPos="right"
 value="checked"
 fontbold="bold"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></checkbox>

<textinput
 name="Boat Size"
 x="412"
 y="392"
 w="63"
 h="22"
 initvalue=""
 bkcolor="0xFFFFFF"
  fontname="Arial"
  fontcolor="0x000000"
>
</textinput>

<textarea
 name="Comments"
 x="16"
 y="431"
 w="264"
 h="70"
 initvalue="Comments/Questions:"
 wordwrap="true"
 bkcolor="0xFFFFFF"
  fontsize="12"
  fontname="Arial"
  fontcolor="0x000000"
></textarea>

<submitbutton
 name="Submit Button"
 x="296"
 y="448"
 w="185"
 h="20"
 label="Submit Reservation"
 fontname="Georgia"
 fontcolor="0xFF0000"
 fontbold="bold"
  fontsize="12"
></submitbutton>

<label
 name="My Text 2"
 x="300"
 y="120"
 w="42"
 h="18"
 text="Phone"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 3"
 x="8"
 y="228"
 w="94"
 h="18"
 text="E-Mail Address"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 4"
 x="8"
 y="120"
 w="38"
 h="18"
 text="Name"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 5"
 x="164"
 y="12"
 w="302"
 h="29"
 text="Delta VIP Vacation Rental"
 fontbold="bold"
  fontname="Harrington"
  fontcolor="0x000080"
  fontsize="23"
></label>

<label
 name="My Text 6"
 x="172"
 y="48"
 w="287"
 h="18"
 text="Please submit this form to place a reservation"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x003366"
  fontsize="13"
></label>

<label
 name="My Text 7"
 x="8"
 y="156"
 w="94"
 h="18"
 text="Street Address"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 8"
 x="8"
 y="192"
 w="28"
 h="18"
 text="City"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 9"
 x="220"
 y="188"
 w="35"
 h="18"
 text="State"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 10"
 x="372"
 y="188"
 w="23"
 h="18"
 text="Zip"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 11"
 x="176"
 y="260"
 w="127"
 h="22"
 text="Dates Requested"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x0000FF"
  fontsize="16"
></label>

<label
 name="My Text 12"
 x="228"
 y="292"
 w="21"
 h="18"
 text="to"
 fontbold="bold"
  fontname="Georgia"
  fontcolor="0x800000"
  fontsize="16"
></label>

<label
 name="My Text 1"
 x="184"
 y="72"
 w="256"
 h="18"
 text="You will receive a confirmation via email"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0xFF0000"
  fontsize="13"
></label>

<label
 name="My Text 13"
 x="12"
 y="392"
 w="155"
 h="18"
 text="Are you bringing a boat?"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 14"
 x="292"
 y="392"
 w="112"
 h="18"
 text="If Yes, what size?"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x800000"
  fontsize="13"
></label>

<label
 name="My Text 15"
 x="32"
 y="352"
 w="280"
 h="22"
 text="Total number of guests in your party"
 fontbold="bold"
  fontname="Trebuchet MS"
  fontcolor="0x0000FF"
  fontsize="16"
></label>

</form>