FAIL (the browser should render some flash content, not this).
 
 
Name :
 
  Address :  
  E-Mail :  
  Phone no :  
Country :  
  Check In :   MM/DD/YYYY
  Check Out :   MM/DD/YYYY
  Room Type:  
  Total No. of Guests :  
  Total No. of Rooms :  
  Any other
Requirement: