<p>Your Name (required)<br />
    [text* your-name] </p>

<p>Your Email (required)<br />
    [email* your-email] </p>

<p>Check In Date<br />
  [date check-in date-format:mm/dd/yy min-date:today]</p>

<p>Check Out Date<br />
   [date* check-out date-format:mm/dd/yy first-day:0]</p>

<p>Hotel<br />
   [select* hotel include_blank "Platinum Royale, Busega" "Wamala Lake View, Mityana" "Green Valley, Mityana" "Emirates, Mityana"]</p>

<p>Room<br />
   [select* room include_blank "Platinum" "Gold" "Silver"]</p>

<p>[submit "Send"]</p>