<p>單位名稱：[text reservation-company] </p>

<p>*聯絡人：[text* reservation-name] </p>

<p>性別：[radio reservation-sex "男" "女"]</p>

<p>*電子郵件：[text* reservation-email]</p>

<p>*聯絡電話：[text* reservation-tel]</p>

<p>*預約日期：[text* reservation-date]</p>

<p>*貴賓人數：[text* reservation-number]</p>

<p>貴賓族群：[radio reservation-type "機關團體" "學術單位" "社區協會" "自由行" "家庭旅遊"]</p>

<p>貴賓年齡：[radio reservation-year "20歲以下" "20~30歲" "30~40歲" "40~50歲" "50~60歲" "60~70歲" "以上皆有"]</p>

<p>其他留言：[textarea reservation-message]</p>

<p class="tdbun">[submit "確定送出"]</p>