<html> <head> <script src="http://www.jotform.com/js/form.js?v2.0.644" type="text/javascript"></script> <style type="text/css"> html,body{height:100%; margin:0;} .tbmain{ /* Changes on the form */ background: url(http://www.jotform.com/images/styles/style1_bg.gif) #ffffff top repeat-x !important; } .left{ /* Changes on the form */ color: #000000 !important; font-family: Trebuchet MS !important; font-size: 12px !important; } td.left { font-family: "Trebuchet MS"; font-size: 11px; font-weight:bold; color:#ff5200; vertical-align: top; text-align: left; } .pagebreak{ font-family: "Trebuchet MS"; font-size: 11px; font-weight:bold; color:black; } td.right { font-family: "Trebuchet MS"; font-size: 11px; font-weight:normal; color:#333333; vertical-align: top; text-align: left; } .tbmain{ height:100%; color:#333333; background:url(http://www.jotform.com/images/styles/style1_bg.gif) #ffffff top repeat-x; } .head{ font-family: "Trebuchet MS"; font-size: large; font-weight: bold; color:#ff5200; vertical-align: top; text-align: left; } .notvalid{ border:2px red solid; font-family:"Trebuchet MS"; } .text{ font-family: "Trebuchet MS"; font-size: 11px; font-weight:normal; color:#333333; border:1px #cccccc solid; background:url(http://www.jotform.com/images/styles/style1_txt_bg.gif) #f6f6f6 top repeat-x; } select.other{ font-family: "Trebuchet MS"; font-size: 11px; font-weight:normal; color:#333333; border:1px #cccccc solid; background:url(http://www.jotform.com/images/styles/style1_txt_bg.gif) #f6f6f6 top repeat-x; } .btn{ font-family: "Trebuchet MS"; font-size: 11px; font-weight:normal; color:#333333; border:1px #c6c7ca solid; background: url(http://www.jotform.com/images/styles/style1_btn_bg.gif) #e4e4e4 top repeat-x; } span.required{ font-size: 13px !important; color: red !important; } </style> <script language="javascript" src="includes/cal.js"></script> <script language="javascript" src="includes/cal_conf.js"></script> </head> <body topmargin="0" leftmargin="0"> <table width="100%" cellpadding="2" cellspacing="0" class="tbmain"> <tr><td class="topleft" width="10" height="10">&nbsp;</td> <td class="topmid">&nbsp;</td> <td class="topright" width="10" height="10">&nbsp;</td> </tr> <tr> <td class="midleft" width="10">&nbsp;&nbsp;&nbsp;</td> <td class="midmid" valign="top"> <form action="http://www.jotform.com/submit.php" method="post" name="q_form_80491613583"> <input type="hidden" name="formID" value="80491613583" /> <div id="main"> <table width="702" cellpadding="5" cellspacing="0"> <tr > <td width="700" align ="left" colspan="4" ><font face="Tahoma" size="2"> <strong >Welcome to  Plan your trip with ThaiTourismGuide.com.</strong> </font></td> </tr> <tr > <td width="700" align ="left" colspan="4" ><font face="Tahoma" size="2"> Tell us about your dream vacation by completing our  Plan your trip form! Please provide us with your destination, occasion, your time frame, the experiences you re looking for and more. Whether you are traveling for business, pleasure, or honeymoon, we will help you to create the whole trip in cheaper price and travel on your own style. Find local attractions, things to do, must eat, must see, get the best deal and book together to make your limited travel time to be your memorable moment. </font> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label ><font size="2">My First Name: </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q2_FirstName" class="text" value="" id="q2" onblur="validate(this,'Required')" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma" size="2"> <label >Middle Name:</label> </font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q9_MiddleName" class="text" value="" id="q9" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label ><font size="2">Last Name: </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q10_LastName" class="text" value="" id="q10" onblur="validate(this,'Required')" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" valign="top" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma" size="2"> <label>Your Country:</label> </font></span> </td> <td class="right" colspan="3"> <select class="other" name="q8_YourCountry" id="q8" > <option></option> <option>Abkhazia</option> <option>Afghanistan</option> <option>United Kingdom Akrotiri and Dhekelia</option> <option>Aland</option> <option>Albania</option> <option>Algeria</option> <option>American Samoa</option> <option>Andorra</option> <option>Angola</option> <option>Anguilla</option> <option>Antigua and Barbuda</option> <option>Argentina Argentina</option> <option>Armenia</option> <option>Aruba</option> <option>United Kingdom Ascension Island</option> <option>Australia</option> <option>Austria</option> <option>Azerbaijan</option> <option>The Bahamas</option> <option>Bahrain</option> <option>Bangladesh</option> <option>Barbados</option> <option>Belarus</option> <option>Belgium</option> <option>Belize</option> <option>Benin</option> <option>Bermuda</option> <option>Bhutan</option> <option>Bolivia</option> <option>Bosnia and Herzegovina</option> <option>Botswana</option> <option>Brazil</option> <option>Brunei</option> <option>Bulgaria</option> <option>Burkina Faso</option> <option>Burundi</option> <option>Cambodia</option> <option>Cameroon</option> <option>Canada</option> <option>Cape Verde</option> <option>Cayman Islands</option> <option>Central African Republic</option> <option>Chad</option> <option>Chile</option> <option>People's Republic of China</option> <option>Republic of China</option> <option>Christmas Island</option> <option>Cocos (Keeling) Islands</option> <option>Colombia</option> <option>Comoros</option> <option>Congo</option> <option>Cook Islands</option> <option>Costa Rica</option> <option>Cýÿte d'Ivoire</option> <option>Croatia</option> <option>Cuba</option> <option>Cyprus</option> <option>Czech Republic</option> <option>Denmark</option> <option>Djibouti</option> <option>Dominica</option> <option>Dominican Republic</option> <option>Ecuador</option> <option>Egypt</option> <option>El Salvador</option> <option>Equatorial Guinea</option> <option>Eritrea</option> <option>Estonia</option> <option>Ethiopia</option> <option>Falkland Islands</option> <option>Faroe Islands</option> <option>Fiji</option> <option>Finland</option> <option>France</option> <option>French Polynesia</option> <option>Gabon</option> <option>The Gambia</option> <option>Georgia</option> <option>Germany</option> <option>Ghana</option> <option>Gibraltar</option> <option>Greece</option> <option>Greenland</option> <option>Grenada</option> <option>Guam</option> <option>Guatemala</option> <option>Guernsey</option> <option>Guinea</option> <option>Guinea-Bissau</option> <option>Guyana Guyana</option> <option>Haiti Haiti</option> <option>Honduras</option> <option>Hong Kong</option> <option>Hungary</option> <option>Iceland</option> <option>India</option> <option>Indonesia</option> <option>Iran</option> <option>Iraq</option> <option>Ireland</option> <option>Israel</option> <option>Italy</option> <option>Jamaica</option> <option>Japan</option> <option>Jersey</option> <option>Jordan</option> <option>Kazakhstan</option> <option>Kenya</option> <option>Kiribati</option> <option>North Korea</option> <option>South Korea</option> <option>Kosovo</option> <option>Kuwait</option> <option>Kyrgyzstan</option> <option>Laos</option> <option>Latvia</option> <option>Lebanon</option> <option>Lesotho</option> <option>Liberia</option> <option>Libya</option> <option>Liechtenstein</option> <option>Lithuania</option> <option>Luxembourg</option> <option>Macau</option> <option>Macedonia</option> <option>Madagascar</option> <option>Malawi</option> <option>Malaysia</option> <option>Maldives</option> <option>Mali</option> <option>Malta</option> <option>Marshall Islands</option> <option>Mauritania</option> <option>Mauritius</option> <option>Mayotte</option> <option>Mexico</option> <option>Micronesia</option> <option>Moldova</option> <option>Monaco</option> <option>Mongolia</option> <option>Montenegro</option> <option>Montserrat</option> <option>Morocco</option> <option>Mozambique</option> <option>Myanmar</option> <option>Nagorno-Karabakh</option> <option>Namibia</option> <option>Nauru</option> <option>Nepal</option> <option>Netherlands</option> <option>Netherlands Antilles</option> <option>New Caledonia</option> <option>New Zealand</option> <option>Nicaragua</option> <option>Niger</option> <option>Nigeria</option> <option>Niue</option> <option>Norfolk Island</option> <option>Turkish Republic of Northern Cyprus</option> <option>Northern Mariana</option> <option>Norway</option> <option>Pakistan</option> <option>Palau</option> <option>Palestine</option> <option>Panama</option> <option>Papua New Guinea</option> <option>Paraguay</option> <option>Peru</option> <option>Philippines</option> <option>Pitcairn Islands</option> <option>Poland</option> <option>Portugal</option> <option>Transnistria Pridnestrovie</option> <option>Puerto Rico</option> <option>Qatar</option> <option>Romania</option> <option>Russia</option> <option>Rwanda</option> <option>Saint Barthelemy</option> <option>Saint Helena</option> <option>Saint Kitts and Nevis</option> <option>Saint Lucia</option> <option>Saint Martin</option> <option>Saint Pierre and Miquelon</option> <option>Saint Vincent and the Grenadines</option> <option>Samoa</option> <option>San Marino</option> <option>Sýÿo Tomýÿ and Prýÿncipe</option> <option>Saudi Arabia</option> <option>Senegal</option> <option>Serbia</option> <option>Seychelles</option> <option>Sierra Leone</option> <option>Singapore</option> <option>Slovakia</option> <option>Slovenia</option> <option>Solomon Islands</option> <option>Somalia</option> <option>Somaliland</option> <option>South Africa</option> <option>South Ossetia</option> <option>Spain</option> <option>Sri Lanka</option> <option>Sudan</option> <option>Suriname</option> <option>Svalbard</option> <option>Swaziland</option> <option>Sweden</option> <option>Switzerland</option> <option>Syria</option> <option>Tajikistan</option> <option>Tanzania</option> <option>Thailand</option> <option>Timor-Leste</option> <option>Togo</option> <option>Tokelau</option> <option>Tonga</option> <option>Trinidad and Tobago</option> <option>Tristan da Cunha</option> <option>Tunisia</option> <option>Turkey</option> <option>Turkmenistan</option> <option>Turks and Caicos Islands</option> <option>Tuvalu</option> <option>Uganda</option> <option>Ukraine</option> <option>United Arab Emirates</option> <option>United Kingdom</option> <option>United States</option> <option>Uruguay</option> <option>Uzbekistan</option> <option>Vanuatu</option> <option>Vatican City</option> <option>Venezuela</option> <option>Vietnam</option> <option>British Virgin Islands</option> <option>US Virgin Islands</option> <option>Wallis and Futuna</option> <option>Western Sahara</option> <option>Yemen</option> <option>Zambia</option> <option>Zimbabwe</option> </select> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label ><font size="2">E-mail: </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q3_E-mail" class="text" value="" id="q3" onblur="validate(this,'Required')" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label ><font size="2">Departing From: </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q12_DepartingFrom" class="text" value="" id="q12" onblur="validate(this,'Required')" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma" size="2"> <label>Departing Date:</label> </font></span> </td> <td class="right" colspan="3"> <script type="text/javascript" src="http://www.jotform.com/js/datetimepicker.js?v2.0.644"></script> <input type="text" class="text" size="10" name="q5_DepartingDate" id="q5" /> <a href="javascript:showCal('Calendar1')"> <img src="http://www.jotform.com/images/cal.gif" border="0" alt="Select date" /></a>&nbsp; ( mm-dd-yyyy : 12-24-2009 )</td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label ><font size="2">Destination: </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q13_Destination" class="text" value="" id="q13" onblur="validate(this,'Required')" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma" size="2"> <label >Travelling Period:</label> </font></span> </td> <td class="right" colspan="3" > <input type="text" size="50" name="q14_TravellingPeriod" class="text" value="" id="q14" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma" size="2"> <label >No. of traveller:</label> </font></span> </td> <td class="right" colspan="3" > <input type="text" size="20" name="q19_Nooftraveller" class="text" value="" id="q19" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="20%" class="left" valign="top" bgcolor="#F0F0F0" > <p style="margin-top: 0; margin-bottom: 0; "> <span style="font-weight: 400"> <font face="Tahoma" size="2"> <label>Traveling Styles:</label> </font> </span> </td> <td valign="top" class="right" width="18%"> <p style="margin-top: 10pt; margin-bottom: 10pt"> <font face="Arial"> <input type="checkbox" name="q18_TravellingStyle[]" class="other" id="q18_0" value="Beach Travel" /><font size="2"> </font></font><font face="Arial" size="2">Beach Travel</font><font face="Arial"><font size="2"><br /> </font> <input type="checkbox" name="q18_TravellingStyle[]" class="other" id="q18_1" value="Mountain Travel" /><font size="2"> </font></font><font face="Arial" size="2">Mountain Travel</font><font face="Arial"><font size="2"><br /> </font> <input type="checkbox" name="q18_TravellingStyle[]" class="other" id="q18_2" value="Buddhism & Meditation" /><font size="2"> </font></font><font face="Arial" size="2">Buddhism &amp; Meditation</font></td> <td valign="top" class="right" width="18%"> <p style="margin-top: 10px; margin-bottom: 10px"> <font face="Arial"> <input type="checkbox" name="q18_TravellingStyle[]1" class="other" id="q18_3" value="Cruises & Diving Travel" /><font size="2"> </font></font><font face="Arial" size="2">Cruises &amp; Diving Travel</font><font face="Arial"><font size="2"><br /> </font> <input type="checkbox" name="q18_TravellingStyle[]2" class="other" id="q18_4" value="Golf & Spa" /><font size="2"> </font></font><font face="Arial" size="2">Golf &amp; Spa</font><font face="Arial"><font size="2"><br /> </font> <input type="checkbox" name="q18_TravellingStyle[]3" class="other" id="q18_5" value="Romantic Travel" /><font size="2"> </font></font><font face="Arial" size="2">Romantic Travel</font></td> <td valign="top" class="right" width="17%"> <p style="margin-top: 10px; margin-bottom: 10px"> <font face="Arial"> <input type="checkbox" name="q18_TravellingStyle[]4" class="other" id="q18_6" value="Ago-Tourism" /><font size="2"> </font></font><font face="Arial" size="2">Agro-Tourism</font><font face="Arial"><font size="2"><br /> </font> <input type="checkbox" name="q18_TravellingStyle[]5" class="other" id="q18_7" value="Luxury Travel" /><font size="2"> </font></font><font face="Arial" size="2">Luxury Travel</font></td> </tr> <tr > <td width="20%" class="left" valign="top" bgcolor="#F0F0F0" > <p style="margin-bottom: 0; margin-top:0"> <span style="font-weight: 400"> <font face="Tahoma" size="2"> <label>Interested Services:</label> </font> </span> </td> <td valign="top" class="right" width="18%"> <p style="margin-bottom: 10px"> <font face="Arial"> <input type="checkbox" name="q15_InterestedServices[]" class="other" id="q15_0" value="Flight" /><font size="2"> Flight<br /> </font> <input type="checkbox" name="q15_InterestedServices[]" class="other" id="q15_1" value="Car Transfer" /><font size="2"> Car Transfer <br /> </font> <input type="checkbox" name="q15_InterestedServices[]" class="other" id="q15_2" value="Car Hire" /><font size="2"> Car Hire</font></font></td> <td valign="top" class="right" width="18%"> <p style="margin-bottom: 10px"><font face="Arial"> <input type="checkbox" name="q15_InterestedServices[]3" class="other" id="q15_3" value="Hotel" /><font size="2"> Hotel<br /> </font> <input type="checkbox" name="q15_InterestedServices[]1" class="other" id="q15_4" value="Package Tour" /><font size="2"> Package Tour<br /> </font> <input type="checkbox" name="q15_InterestedServices[]2" class="other" id="q15_5" value="Group Tour" /><font size="2"> </font></font><font face="Arial" size="2">Group Tour</font></td> <td valign="top" class="right" width="17%"> <p style="margin-bottom: 10px"> <font face="Arial"> <input type="checkbox" name="q15_InterestedServices[]4" class="other" id="q15_6" value="Sightseeing Package" /><font size="2"> Sightseeing Package<br /> </font> <input type="checkbox" name="q15_InterestedServices[]5" class="other" id="q15_7" value="Long Stay" /><font size="2"> Long Stay</font></font></td> </tr> <tr > <td width="20%" class="left" valign="top" bgcolor="#F0F0F0" > <p style="margin-top:0; margin-bottom:0"> <span style="font-weight: 400"> <font face="Tahoma" size="2"> <label>Additional Interest:</label> </span> </td> <td class="right" colspan="3" > <textarea cols="50" rows="5" name="q16_AdditionalInterest" class="text" id="q16" ></textarea> </td> </tr> <tr > <td width="150" class="left" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label ><font size="2">Estimated budget: </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3" > <input type="text" size="30" name="q17_Estimatedbudget" class="text" value="" id="q17" onblur="validate(this,'Required')" maxlength="100" maxsize="100" /> </td> </tr> <tr > <td width="150" class="left" valign="top" bgcolor="#F0F0F0" > <span style="font-weight: 400"><font face="Tahoma"> <label><font size="2">Budget Currency </font> <span class="required">*</span></label><font size="2"> </font></font></span> </td> <td class="right" colspan="3"> <select class="other" name="q21_BudgetCurrency" id="q21" onblur="validate(this,'Required')" > <option></option> <option>USD - United States Dollars</option> <option>EUR - Euro</option> <option>CAD - Canada Dollars</option> <option>GBP - United Kingdom Pounds</option> <option>DEM - Germany Deutsche Marks</option> <option>FRF - France Francs</option> <option>JPY - Japan Yen</option> <option>NLG - Netherlands Guilders</option> <option>ITL - Italy Lira</option> <option>CHF - Switzerland Francs</option> <option>DZD - Algeria Dinars</option> <option>ARP - Argentina Pesos</option> <option>AUD - Australia Dollars</option> <option>ATS - Austria Schillings</option> <option>BSD - Bahamas Dollars</option> <option>BBD - Barbados Dollars</option> <option>BEF - Belgium Francs</option> <option>BMD - Bermuda Dollars</option> <option>BRR - Brazil Real</option> <option>BGL - Bulgaria Lev</option> <option>CAD - Canada Dollars</option> <option>CLP - Chile Pesos</option> <option>CNY - China Yuan Renmimbi</option> <option>CYP - Cyprus Pounds</option> <option>CSK - Czech Republic Koruna</option> <option>DKK - Denmark Kroner</option> <option>XLG - Dutch Guilders</option> <option>XCD - Eastern Caribbean Dollars</option> <option>EGP - Egypt Pounds</option> <option>EUR - Euro</option> <option>FJD - Fiji Dollars</option> <option>FIM - Finland Markka</option> <option>FRF - France Francs</option> <option>DEM - Germany Deutsche Marks</option> <option>XAU - Gold Ounces</option> <option>GRD - Greece Drachmas</option> <option>HKD - Hong Kong Dollars</option> <option>HUF - Hungary Forint</option> <option>ISK - Iceland Krona</option> <option>INR - India Rupees</option> <option>IDR - Indonesia Rupiah</option> <option>IEP - Ireland Punt</option> <option>ILS - Israel New Shekels</option> <option>ITL - Italy Lira</option> <option>JMD - Jamaica Dollars</option> <option>JPY - Japan Yen</option> <option>JOD - Jordan Dinar</option> <option>KRW - Korea (South) Won</option> <option>LBP - Lebanon Pounds</option> <option>LUF - Luxembourg Francs</option> <option>MYR - Malaysia Ringgit</option> <option>MXP - Mexico Pesos</option> <option>NLG - Netherlands Guilders</option> <option>NZD - New Zealand Dollars</option> <option>NOK - Norway Kroner</option> <option>PKR - Pakistan Rupees</option> <option>XPD - Palladium Ounces</option> <option>PHP - Philippines Pesos</option> <option>XPT - Platinum Ounces</option> <option>PLZ - Poland Zloty</option> <option>PTE - Portugal Escudo</option> <option>ROL - Romania Leu</option> <option>RUR - Russia Rubles</option> <option>SAR - Saudi Arabia Riyal</option> <option>XAG - Silver Ounces</option> <option>SGD - Singapore Dollars</option> <option>SKK - Slovakia Koruna</option> <option>ZAR - South Africa Rand</option> <option>KRW - South Korea Won</option> <option>ESP - Spain Pesetas</option> <option>XDR - Special Drawing Right (IMF)</option> <option>SDD - Sudan Dinar</option> <option>SEK - Sweden Krona</option> <option>CHF - Switzerland Francs</option> <option>TWD - Taiwan Dollars</option> <option>THB - Thailand Baht</option> <option>TTD - Trinidad and Tobago Dollars</option> <option>TRL - Turkey Lira</option> <option>GBP - United Kingdom Pounds</option> <option>USD - United States Dollars</option> <option>VEB - Venezuela Bolivar</option> <option>ZMK - Zambia Kwacha</option> </select> </td> </tr> <tr > <td width="150" class="left" >&nbsp;</td> <td class="right" colspan="3"><input type="submit" class="btn" value="Submit" /></td> </tr> <tr > <td width="700" align ="left" colspan="4" ><hr /><font face="Tahoma" size="2"> Please feel free to <a href ="contact.html" target ="_blank" >Contact us</a>. We have more information for each destination in Thailand to provide for free.</font><br /></td> </tr> <tr > <td width="700" align ="left" colspan="4" ><font face="Tahoma" size="2"> <strong >Thank you and ENJOY your Trip!</strong> </font></td> </tr> <tr > <td width="700" align ="left" colspan="4" ><font face="Tahoma" size="1"><em >Your privacy on the Internet is of the utmost importance to us. At ThaiTourismGuide.com, we want to make your experience online satisfying and safe. We don't sell or rent your personal information to third parties for their marketing purposes without your explicit consent.</em></font></td> </tr> </table> </div> </form> </td> <td class="midright" width="10">&nbsp;&nbsp;&nbsp;</td> </tr> <tr> <td class="bottomleft" width="10" height="10">&nbsp;</td> <td class="bottommid">&nbsp;</td> <td class="bottomright" width="10" height="10">&nbsp;</td> </tr> </table> <script type="text/javascript"> validate("q_form_80491613583"); </script>