<link href="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/4.1.1/js/bootstrap.min.js"></script> <script src="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> <!------ Include the above in your HEAD tag ----------> <form class="form-horizontal"> <fieldset> <!-- Form Name --> <legend>GET ACCESS TO INDIOR TOUR BOX</legend> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="First name*">First name*</label> <div class="col-md-4"> <input id="First name*" name="First name*" type="text" placeholder="First name" class="form-control input-md" required=""> <span class="help-block"> Please complete this required field.</span> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Midle name">Midle name</label> <div class="col-md-4"> <input id="Midle name" name="Midle name" type="text" placeholder="Midle Name" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Last name">Last name*</label> <div class="col-md-4"> <input id="Last name" name="Last name" type="text" placeholder="Last Name" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Job Title">Job Title</label> <div class="col-md-4"> <input id="Job Title" name="Job Title" type="text" placeholder="" class="form-control input-md"> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Company name">Company name*</label> <div class="col-md-4"> <input id="Company name" name="Company name" type="text" placeholder="Company Name" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Business Email">Business Email*</label> <div class="col-md-4"> <input id="Business Email" name="Business Email" type="text" placeholder="name@company.com" class="form-control input-md" required=""> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Contact Number">Contact Number*</label> <div class="col-md-4"> <input id="Contact Number" name="Contact Number" type="text" placeholder="Contact Number" class="form-control input-md" required=""> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Country">Country*</label> <div class="col-md-4"> <select id="Country" name="Country" class="form-control"> <option value="1">Country</option> <option value="2">Afghanistan</option> <option value="">Albania</option> <option value="">Algeria</option> <option value="">American Samoa</option> <option value="">Andorra</option> <option value="">Angola</option> <option value="">Anguilla</option> <option value="">Antarctica</option> <option value="">Antigua and Barbuda</option> <option value="">Argentina</option> <option value="">Armenia</option> <option value="">Aruba</option> <option value="">Australia</option> <option value="">Austria</option> <option value="">Azerbaijan</option> <option value="">Bahamas</option> <option value="">Bahrain</option> <option value="">Bangladesh</option> <option value="">Barbados</option> <option value="">Belarus</option> <option value="">Belgium</option> <option value="">Belize</option> <option value="">Benin</option> <option value="">Bermuda</option> <option value="">Bhutan</option> <option value="">Bolivia</option> <option value="">Bosnia and Herzegovina</option> <option value="">Botswana</option> <option value="">Brazil</option> <option value="">British Indian Ocean Territory</option> <option value="">British Virgin Islands</option> <option value="">Brunei</option> <option value="">Bulgaria</option> <option value="">Burkina Faso</option> <option value="">Burundi</option> <option value="">Cambodia</option> <option value="">Cameroon</option> <option value="">Canada</option> <option value="">Cape Verde</option> <option value="">Cayman Islands</option> <option value="">Central African Republic</option> <option value="">Chad</option> <option value="">Chile</option> <option value="">China</option> <option value="">Christmas Island</option> <option value="">Cocos (Keeling) Islands</option> <option value="">Colombia</option> <option value="">Comoros</option> <option value="">Cook Islands</option> <option value="">Costa Rica</option> <option value="">Croatia</option> <option value="">Cuba</option> <option value="">Curacao</option> <option value="">Cyprus</option> <option value="">Czech Republic</option> <option value="">Democratic Republic of the Congo</option> <option value="">Denmark</option> <option value="">Djibouti</option> <option value="">Dominica</option> <option value="">Dominican Republic</option> <option value="">East Timor</option> <option value="">Ecuador</option> <option value="">Egypt</option> <option value="">El Salvador</option> <option value="">Equatorial Guinea</option> <option value="">Eritrea</option> <option value="">Estonia</option> <option value="">Ethiopia</option> <option value="">Falkland Islands</option> <option value="">Faroe Islands</option> <option value="">Fiji</option> <option value="">Finland</option> <option value="">France</option> <option value="">French Polynesia</option> <option value="">Gabon</option> <option value="">Gambia</option> <option value="">Georgia</option> <option value="">Germany</option> <option value="">Ghana</option> <option value="">Gibraltar</option> <option value="">Greece</option> <option value="">Greenland</option> <option value="">Grenada</option> <option value="">Guam</option> <option value="">Guatemala</option> <option value="">Guernsey</option> <option value="">Guinea</option> <option value="">Guinea-Bissau</option> <option value="">Guyana</option> <option value="">Haiti</option> <option value="">Honduras</option> <option value="">Hong Kong</option> <option value="">Hungary</option> <option value="">Iceland</option> <option value="">India</option> <option value="">Indonesia</option> <option value="">Iran</option> <option value="">Iraq</option> <option value="">Ireland</option> <option value="">Isle of Man</option> <option value="">Israel</option> <option value="">Italy</option> <option value="">Ivory Coast</option> <option value="">Jamaica</option> <option value="">Japan</option> <option value="">Jersey</option> <option value="">Jordan</option> <option value="">Kazakhstan</option> <option value="">Kenya</option> <option value="">Kiribati</option> <option value="">Kosovo</option> <option value="">Kuwait</option> <option value="">Kyrgyzstan</option> <option value="">Laos</option> <option value="">Latvia</option> <option value="">Lebanon</option> <option value="">Lesotho</option> <option value="">Liberia</option> <option value="">Libya</option> <option value="">Liechtenstein</option> <option value="">Lithuania</option> <option value="">Luxembourg</option> <option value="">Macau</option> <option value="">Macedonia</option> <option value="">Madagascar</option> <option value="">Malawi</option> <option value="">Malaysia</option> <option value="">Maldives</option> <option value="">Mali</option> <option value="">Malta</option> <option value="">Marshall Islands</option> <option value="">Mauritania</option> <option value="">Mauritius</option> <option value="">Mayotte</option> <option value="">Mexico</option> <option value="">Micronesia</option> <option value="">Moldova</option> <option value="">Monaco</option> <option value="">Mongolia</option> <option value="">Montenegro</option> <option value="">Montserrat</option> <option value="">Morocco</option> <option value="">Mozambique</option> <option value="">Myanmar</option> <option value="">Namibia</option> <option value="">Nauru</option> <option value="">Nepal</option> <option value="">Netherlands</option> <option value="">Netherlands Antilles</option> <option value="">New Caledonia</option> <option value="">New Zealand</option> <option value="">Nicaragua</option> <option value="">Niger</option> <option value="">Nigeria</option> <option value="">Niue</option> <option value="">North Korea</option> <option value="">Northern Mariana Islands</option> <option value="">Norway</option> <option value="">Oman</option> <option value="">Pakistan</option> <option value="">Palau</option> <option value="">Palestine</option> <option value="">Panama</option> <option value="">Papua New Guinea</option> <option value="">Paraguay</option> <option value="">Peru</option> <option value="">Philippines</option> <option value="">Pitcairn</option> <option value="">Poland</option> <option value="">Portugal</option> <option value="">Puerto Rico</option> <option value="">Qatar</option> <option value="">Republic of the Congo</option> <option value="">Reunion</option> <option value="">Romania</option> <option value="">Russia</option> <option value="">Rwanda</option> <option value="">Saint Barthelemy</option> <option value="">Saint Helena</option> <option value="">Saint Kitts and Nevis</option> <option value="">Saint Lucia</option> <option value="">Saint Martin</option> <option value="">Saint Pierre and Miquelon</option> <option value="">Saint Vincent and the Grenadines</option> <option value="">Samoa</option> <option value="">San Marino</option> <option value="">Sao Tome and Principe</option> <option value="">Saudi Arabia</option> <option value="">Senegal</option> <option value="">Serbia</option> <option value="">Seychelles</option> <option value="">Sierra Leone</option> <option value="">Singapore</option> <option value="">Sint Maarten</option> <option value="">Slovakia</option> <option value="">Slovenia</option> <option value="">Solomon Islands</option> <option value="">Somalia</option> <option value="">South Africa</option> <option value="">South Korea</option> <option value="">South Sudan</option> <option value="">Spain</option> <option value="">Sri Lanka</option> <option value="">Sudan</option> <option value="">Suriname</option> <option value="">Svalbard and Jan Mayen</option> <option value="">Swaziland</option> <option value="">Sweden</option> <option value="">Switzerland</option> <option value="">Syria</option> <option value="">Taiwan</option> <option value="">Tajikistan</option> <option value="">Tanzania</option> <option value="">Thailand</option> <option value="">Togo</option> <option value="">Tokelau</option> <option value="">Tonga</option> <option value="">Trinidad and Tobago</option> <option value="">Tunisia</option> <option value="">Turkey</option> <option value="">Turkmenistan</option> <option value="">Turks and Caicos Islands</option> <option value="">Tuvalu</option> <option value="">U.S. Virgin Islands</option> <option value="">Uganda</option> <option value="">Ukraine</option> <option value="">United Arab Emirates</option> <option value="">United Kingdom</option> <option value="">United States</option> <option value="">Uruguay</option> <option value="">Uzbekistan</option> <option value="">Vanuatu</option> <option value="">Vatican</option> <option value="">Venezuela</option> <option value="">Vietnam</option> <option value="">Wallis and Futuna</option> <option value="">Western Sahara</option> <option value="">Yemen</option> <option value="">Zambia</option> <option value="">Zimbabwe</option> <option value="">Aland Islands</option> <option value="">Bouvet Island</option> <option value="">French Guiana</option> <option value="">Guadeloupe</option> <option value="">Martinique</option> <option value="">Norfolk Island</option> <option value="">French Southern Territories</option> <option value="">US Minor Outlying Islands</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Company Category">Company Category*</label> <div class="col-md-4"> <select id="Company Category" name="Company Category" class="form-control"> <option value="1">Company Category</option> <option value="2">Business Premium Travel</option> <option value="3">Concierges</option> <option value="4">Consolidator</option> <option value="5">Consortium</option> <option value="6">Corporate</option> <option value="7">Cruise</option> <option value="8">Destination Management Company</option> <option value="9">Group Travel</option> <option value="10">Meta Search Engine</option> <option value="11">MICE</option> <option value="12">Online Travel Agency</option> <option value="13">Rewards / Loyalty / Miles program</option> <option value="14">Technology Integration Partners</option> <option value="15">Tour Operator</option> <option value="16">Travel Agency</option> <option value="17">Travel Clubs</option> <option value="18">Travel Management Company</option> <option value="19">Others</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="Product*">Product*</label> <div class="col-md-4"> <select id="Product*" name="Product*" class="form-control"> <option value="1">Product</option> <option value="2">MyFareBox</option> <option value="">OnePoint</option> </select> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="What's the minimum number of tickets you do every month? ">What's the minimum number of tickets you do every month? *</label> <div class="col-md-4"> <select id="What's the minimum number of tickets you do every month? " name="What's the minimum number of tickets you do every month? " class="form-control"> <option value="1">Your monthly number of tickets</option> <option value="2">More than 1,00,000</option> <option value="">30,000 to 1,00,000</option> <option value="">5,000 to 30,000</option> <option value="">Below 5,000</option> </select> </div> </div> <!-- Text input--> <div class="form-group"> <label class="col-md-4 control-label" for="Monthly ticket sale value in USD">Monthly gross ticket sale value (in US dollars)*</label> <div class="col-md-4"> <input id="Monthly ticket sale value in USD" name="Monthly ticket sale value in USD" type="text" placeholder="Monthly ticket sale value in USD" class="form-control input-md" required=""> </div> </div> <!-- Select Basic --> <div class="form-group"> <label class="col-md-4 control-label" for="What percentage of your sales is from international tickets?">What percentage of your sales is from international tickets?*</label> <div class="col-md-4"> <select id="What percentage of your sales is from international tickets?" name="What percentage of your sales is from international tickets?" class="form-control"> <option value="1">Please Select</option> <option value="2">100%</option> <option value="">90%</option> <option value="">80%</option> <option value="">70%</option> <option value="">60%</option> <option value="">50%</option> <option value="">40%</option> <option value="">30%</option> <option value="">20%</option> <option value="">10%</option> <option value="">I don't sell international tickets</option> </select> </div> </div> <!-- Multiple Checkboxes (inline) --> <div class="form-group"> <label class="col-md-4 control-label" for="checkboxes">What are the regions you Specialize in?*</label> <div class="col-md-4"> <label class="checkbox-inline" for="checkboxes-0"> <input type="checkbox" name="checkboxes" id="checkboxes-0" value="1"> APAC </label> <label class="checkbox-inline" for="checkboxes-1"> <input type="checkbox" name="checkboxes" id="checkboxes-1" value="2"> Southeast Asia </label> <label class="checkbox-inline" for="checkboxes-2"> <input type="checkbox" name="checkboxes" id="checkboxes-2" value="3"> EMEA </label> <label class="checkbox-inline" for="checkboxes-3"> <input type="checkbox" name="checkboxes" id="checkboxes-3" value="4"> Americas </label> <label class="checkbox-inline" for="checkboxes-4"> <input type="checkbox" name="checkboxes" id="checkboxes-4" value=""> We're committed to your privacy. Indior Tours uses the information you provide to us to contact you about our relevant content, products, and services. You may unsubscribe from these communications at any time. For more information, check out our Privacy Policy. </label> <label class="checkbox-inline" for="checkboxes-5"> <input type="checkbox" name="checkboxes" id="checkboxes-5" value=""> I'd like to stay in touch through digital communication from Mystifly. </label> </div> </div> <!-- Button --> <div class="form-group"> <label class="col-md-4 control-label" for="singlebutton"></label> <div class="col-md-4"> <button id="singlebutton" name="singlebutton" class="btn btn-danger">Submit </button> </div> </div> </fieldset> </form>