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<h2>Online Quote</h2>
<p>We are currently experiencing a very busy period and may not be able to reply to your online quote within 48 hours. If therefore your quote is urgent and pertains to a late booking within 14 days of departure, we would ask you to call our offices where we will respond to you immediately (Tel: UK (44) 0870 727 3755).</p>
<p>We apologise for any inconvenience caused.</p>
<p>All Fields must be completed.
Read our <a href="http://www.designholidays.co.uk/pages/policy.htm">privacy statement</a> </p>
<table width="560" border="0" cellpadding="8" cellspacing="0" class="brochure">
<tr>
<td colspan="2"><p class="form">Personal Details</p></td>
</tr>
<tr>
<td width="123">Title</td>
<td>
<SELECT name="title">
<OPTION></OPTION>
<OPTION>Mr</OPTION>
<OPTION>Mrs</OPTION>
<OPTION>Miss</OPTION>
<OPTION>Ms</OPTION>
<OPTION>Dr</OPTION>
<OPTION>Other</OPTION>
</SELECT>
</td>
</tr>
<tr>
<td>Initial</td>
<td><INPUT type="text" name="initial" size="3" maxlength="4" /></td>
</tr>
<tr>
<td>Surname</td>
<td><INPUT type="text" name="surname" size="15" maxlength="30" /></td>
</tr>
<tr>
<td>E Mail</td>
<td><INPUT type="text" name="email" size="15" maxlength="40" /></td>
</tr>
<tr>
<td>Telephone</td>
<td>
<INPUT type="text" name="phone" size="15" maxlength="20" /></td>
</tr>
</table>
<table width="560" border="0" cellpadding="8" cellspacing="0" class="brochure">
<tr>
<td colspan="3"><p class="form">Holiday Details</p></td>
</tr>
<tr>
<td width="194">Estimated budget:</td>
<td width="151">
<select size="1" name="select">
<option>£200-400 (Short Breaks)</option>
<option>£400-500</option>
<option>£500-750</option>
<option>£750+</option>
</select>
</td>
<td width="165"><p class="small3">per person per week</p></td>
</tr>
<tr>
<td> </td>
<td colspan="2"><p class="small3">We can provide a range of quotes based on your budget. The difference will be in the type of accommodation offered.</p></td>
</tr>
<tr>
<td>Holiday Start Date:</td>
<td colspan="2"><select name="day">
<option></option>
<option>1st</option>
<option>2nd</option>
<option>3rd</option>
<option>4th</option>
<option>5th</option>
<option>6th</option>
<option>7th</option>
<option>8th</option>
<option>9th</option>
<option>10th</option>
<option>11th</option>
<option>12th</option>
<option>13th</option>
<option>14th</option>
<option>15th</option>
<option>16th</option>
<option>17th</option>
<option>18th</option>
<option>19th</option>
<option>20th</option>
<option>21st</option>
<option>22nd</option>
<option>23rd</option>
<option>24th</option>
<option>25th</option>
<option>26th</option>
<option>27th</option>
<option>28th</option>
<option>29th</option>
<option>30th</option>
<option>31st</option>
</select>
<select name="month">
<option></option>
<option>January</option>
<option>February</option>
<option>March</option>
<option>April</option>
<option>May</option>
<option>June</option>
<option>July</option>
<option>August</option>
<option>September</option>
<option>October</option>
<option>November</option>
<option>December</option>
</select>
<select name="year">
<option></option>
<option>2003</option>
<option>2004</option>
</select></td>
</tr>
<tr>
<td>Duration/ Days:</td>
<td colspan="2">
<select name="select2" size="1">
<option></option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
<option>16</option>
<option>17</option>
<option>18</option>
<option>19</option>
<option>20</option>
<option>21</option>
</select>
</td>
</tr>
<tr>
<td>Adults: (over 12 years)</td>
<td colspan="2"><select name="select3">
<option></option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
</select></td>
</tr>
<tr>
<td>Children: (under 12)</td>
<td colspan="2"><select name="select4">
<option></option>
<option>zero</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
</select></td>
</tr>
<tr>
<td>Infants (under 2 years of age)</td>
<td colspan="2"><select name="select5" size="1">
<option></option>
<option>zero</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
</select></td>
</tr>
<tr>
<td>Departure Airport:</td>
<td colspan="2"><select name="airport">
<option></option>
<option>Aberdeen</option>
<option>Birmingham</option>
<option>Belfast</option>
<option>Bristol</option>
<option>Cardiff</option>
<option>Exeter</option>
<option>Edinburgh</option>
<option>East Midlands</option>
<option>Gatwick</option>
<option>Glasgow</option>
<option>Heathrow</option>
<option>Luton</option>
<option>Leeds/ Bradford</option>
<option>Manchester</option>
<option>Newcastle</option>
<option>Stansted</option>
</select></td>
</tr>
<tr>
<td>Resort:</td>
<td colspan="2">
<select name="resort" size="1">
<option></option>
<option>La Manga Club</option>
<option>Algarve</option>
<option>Mallorca</option>
<option>Marbella</option>
<option>Sardinia (Hotel Only)</option>
</select>
</td>
</tr>
<tr>
<td>Accommodation Type:</td>
<td>
<select name="accommodation_type">
<option></option>
<option>Apartment</option>
<option>Townhouse</option>
<option>Villa</option>
<option>Villa with plunge pool</option>
<option>Villa with pool</option>
<option>Hotel</option>
</select>
</td>
<td>
<select name="quality" size="1">
<option>---------</option>
<option>3*</option>
<option>4*</option>
<option>5*</option>
</select>
</td>
</tr>
<tr>
<td>Bedrooms:</td>
<td colspan="2">
<select name="bedrooms">
<option></option>
<option>Studio</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>Single</option>
<option>Twin</option>
<option>Double</option>
<option>Triple</option>
</select>
</td>
</tr>
<tr>
<td>Car Group:</td>
<td colspan="2">
<select name="car">
<option></option>
<option>A</option>
<option>B</option>
<option>C</option>
<option>D</option>
<option>E</option>
<option>F</option>
<option>G</option>
<option>H</option>
<option>I</option>
<option>J</option>
</select>
</td>
</tr>
<tr>
<td>Travel Insurance:</td>
<td colspan="2">
<input type="radio" name="insurance" value="Yes" class="empty" />Yes
<input type="radio" name="insurance" value="No" class="empty" />No
</td>
</tr>
<tr>
<td>Special Requests
<p class="small3">(optional):</p></td>
<td colspan="2">
<textarea name="special_requests" cols="30" rows="4" wrap="VIRTUAL"></textarea>
</td>
</tr>
</table>
<table width="560" border="0" cellpadding="8" cellspacing="0" class="brochure">
<tr>
<td colspan="3"><p class="form">How would you like to receive your quote?</p></td>
</tr>
<tr>
<td width="188">By telephone</td>
<td width="338" colspan="2">
<input type="radio" name="response" value="Telephone" class="empty" />
</td>
</tr>
<tr>
<td>By e-mail<br /></td>
<td colspan="2">
<input type="radio" name="response" value="E-mail" class="empty" />
</td>
</tr>
</table>
<table width="560" border="0" cellpadding="8" cellspacing="0" class="brochure">
<tr>
<td colspan="4"><p class="form">Your Feedback</p></td>
</tr>
<tr>
<td colspan="4">What do you think of our site?
</td>
</tr>
<tr>
<td colspan="2"><p class="form">Design</p></td>
<td colspan="2"><p class="form">Information</p></td>
</tr>
<tr>
<td width="72">
Excellent
</td>
<td width="20"><input type="radio" name="Design" value="Excellent" class="empty" /></td>
<td width="78">Excellent</td>
<td width="324">
<input type="radio" name="Information" value="Excellent" class="empty" />
</td>
</tr>
<tr>
<td>Good</td>
<td>
<input type="radio" name="Design" value="Good" class="empty" />
</td>
<td>Good</td>
<td>
<input type="radio" name="Information" value="Good" class="empty" />
</td>
</tr>
<tr>
<td>Fair</td>
<td>
<input type="radio" name="Design" value="Fair" class="empty" />
</td>
<td>Fair</td>
<td>
<input type="radio" name="Information" value="Fair" class="empty" />
</td>
</tr>
<tr>
<td>Poor</td>
<td>
<input type="radio" name="Design" value="Poor" class="empty" />
</td>
<td>Poor</td>
<td>
<input type="radio" name="Information" value="Poor" class="empty" />
</td>
</tr>
<tr>
<td> </td>
<td> </td>
<td> </td>
<td> </td>
</tr>
<tr>
<td colspan="4">What do you think of our site?</td>
</tr>
<tr>
<td colspan="2">
<input type="text" name="Hear_From" size="20" />
</td>
<td colspan="2"><p class="small3">e.g.. personal referral, Sunday Times,
Yahoo, etc.</p></td>
</tr>
</table>
<table width="560" border="0" cellpadding="8" cellspacing="0" class="brochure3">
<tr>
<td colspan="4">Please keep me informed with
your quarterly e-mail bulletin</td>
</tr>
<tr>
<td width="28">Yes</td>
<td width="52">
<input type="radio" name="subscribe" value="Yes" checked="checked" class="empty" />
</td>
<td width="30">No</td>
<td width="384">
<input type="radio" name="subscribe" value="No" class="empty" />
</td>
</tr>
<tr>
<td colspan="4"> </td>
</tr>
<tr align="right">
<td colspan="4">
<input type="submit" name="Submit" value="Submit For Quote" class="submit" />
</td>
</tr>
</table>
</form>
</td>
</tr>
</table>
</div>
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