document.write("<form name='myform' action='http://www.goabeachresortholidays.com/cgi-bin/forms/FormMail.cgi' method='POST'>");
document.write("<input type='hidden' name='recipient' value=bookings@goabeachresortholidays.com>");
document.write("<input type=hidden name='subject' value='Dona Sylvia Beach Resort'>");

document.write("<input type='hidden' name='redirect' value='http://www.goabeachresortholidays.com/forms/thanks.htm'>");

document.write("<pre><p>              Please select name of the Resort <select name='country'><option>Dona Sylvia Beach Resort</option><option>Victor Exotica Beach Resort</option> <option>Devaaya Ayurveda Spa Resort</option></select></p>   ");

document.write("<p>              Name                   <input type='TEXT' name='name' size=35 maxlength=50> </p>      ");
document.write("<p>              Address                <input type='text' name='address' ");
document.write("size='35' maxlength='50'></p>     ");
document.write("<p>              City and Country<font size='1'>     </font>   ");
document.write("<input type='text' name='city' size='35' maxlength='50'> </p>     ");

document.write("<p>              Phone Number           <input type='text' name='phone' ");
document.write("size='35' maxlength='30'> </font></p>   ");

document.write("<p>              E-Mail Address         <input type='TEXT' name='email' ");
document.write("size=35 maxlength=50></p>   ");

document.write("<p>              Total Adults           <input type='text' name='adults' size='3'");

document.write("maxlength='3'>  Children <input type='text' name='children' size='3' ");
document.write("maxlength='3'>");

document.write("Age of children <input type='text' name='childrenage' size='8' ");
document.write("maxlength='8'></p>             ");

document.write("<p>              No of Rooms require    <input type='text' name='no_of_rooms_to_book' size='3' maxlength='3'><br> ");

document.write("<p>              Departure Dates       Date <select name='checkin_dd'> <option>1</option> <option>2</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> <option>22</option> <option>23</option> <option>24</option> <option>25</option> <option>26</option> <option>27</option> <option>28</option> <option>29</option> <option>30</option> <option>31</option> </select>");


document.write(" Month <select name='checkin_mm'> <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>");
document.write(" Year <select name='checkin_yy'><option>2012</option><option>2013</option> <option>2014</option><option>2015</option></select></p>   ");

document.write("<p>              Return dates          Date <select name='checkout_dd'> <option>1</option> <option>2</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> <option>22</option> <option>23</option> <option>24</option> <option>25</option> <option>26</option> <option>27</option> <option>28</option> <option>29</option> <option>30</option> <option>31</option> </select>");


document.write(" Month <select name='checkout_mm'> <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>");
document.write(" Year <select name='checkout_yy'><option>2012</option><option>2013</option> <option>2014</option><option>2015</option> </select></p>   ");

document.write("<p>              Total No of nights to stay   <input type='TEXT' name='nights2stay' ");
document.write("size=3 maxlength=3></p>   ");

document.write("<p>              Other Information which will help us serve you better <font size='1'> </font><br>                         ");

document.write("            <textarea name='other' rows='5' cols='30'></textarea></p>   ");      
document.write(" </pre>");
document.write("  <div align='center'>");
document.write("    <pre>");
document.write("<p><input type='submit' value='Submit' name='submit'>   <input type='reset' ");
document.write("value='Reset' name='reset'></p> ");
 
document.write("</pre>");
document.write("</div>");

document.write("<input type='HIDDEN' name='required' ");
document.write("value='no_of_rooms_to_book,adults,name,address,");
document.write("city,country,phone,email,checkin_dd,checkin_mm,checkin_yy,checkout_dd,checkout_mm,checkout_yy,nights2stay'>");

