TravelJoy

Maria LaDuca

The Agency Chic - Pocono

Couples Weekend Escapes Inquiries

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  <body>
    <form-template xmlns="http://www.w3.org/1999/xhtml">
      <fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>
        <field type="header" subtype="h2" label="Questions for your trip"/>
        <field type="radio-group" required="true" label="Where are you escaping to?" inline="true" name="where-are-you-escaping-to" other="true"><option label="Punta Cana" value="punta-cana">Punta Cana</option>
<option label="Napa Valley, California" value="napa-valley-california">Napa Valley, California</option>
<option label="NOLA, New Orleans" value="nola-new-orleans">NOLA, New Orleans</option></field>
        <field type="date" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>
        <field type="date" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>
        <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">
          <option label="Yes" value="yes">Yes</option>
        </field>
        <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>
        <field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>
        <field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget"><option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>
<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>
<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>
<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>
<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>
<option label="$10,000+" value="10000">$10,000+</option></field>
        <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"><option label="Economy" value="value">Economy</option>
<option label="Moderate" value="moderate">Moderate</option>
<option label="Luxury" value="luxury">Luxury</option>
<option label="Boutique" value="boutique">Boutique</option></field>
        <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"><option label="Romantic" value="romantic">Romantic</option>
<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>
<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>
<option label="Party" value="party">Party</option>
<option label="Local culture" value="local-culture">Local culture</option>
<option label="Family friendly" value="family-friendly">Family friendly</option>
<option label="Food and wine" value="food-wine">Food and wine</option></field>
        <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"><option label="Beach and water" value="beach-water">Beach and water</option>
<option label="Gambling" value="gambling">Gambling</option>
<option label="Scuba" value="scuba">Scuba</option>
<option label="Adventure activities" value="adventure">Adventure activities</option>
<option label="Golf" value="golf">Golf</option>
<option label="Nightlife" value="nightlife">Nightlife</option>
<option label="Arts and theater" value="art-theater">Arts and theater</option></field>
        <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>
        <field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers, budget and/or travel preferences?" name="notes" className="form-control"/>
      </fields>
    </form-template>
  </body>
</html>