TravelJoy

TOYAH EPPERSON

Travel Request

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="The Basics"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="The Adventure"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you're not sure  just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<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"/>&#13;
		<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"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city? (Please List if Multiple)" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you have a passport?" name="do-you-have-a-passport">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="How many Adult travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many Children? (Please list their ages at the time of travel)" name="how-many-children-please-list-their-ages-at-the-time-of-travel" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget per traveler?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$0 to $500" value="0-to-500">$0 to $500</option>&#13;
			<option label="$501 to $1,000" value="501-to-1000">$501 to $1,000</option>&#13;
			<option label="$1,001 to $2,000" value="1001-to-2000">$1,001 to $2,000</option>&#13;
			<option label="$2,001 to $3,500" value="2001-to-3500">$2,001 to $3,500</option>&#13;
			<option label="$3,500 to $5,000" value="3500-to-5000">$3,500 to $5,000</option>&#13;
			<option label="$5,001+" value="5001">$5,001+</option>&#13;
		</field>&#13;
		<field type="text" label="How soon are you looking to pay your deposit?" name="how-soon-are-you-looking-to-pay-your-deposit" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Would you be interested in financing via Uplift?" name="would-you-be-interested-in-financing-via-uplift">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What would you like to include in your booking?" name="what-would-you-like-to-include-in-your-booking">&#13;
			<option label="Activities/Excursions/Tours" value="activitiesexcursionstours">Activities/Excursions/Tours</option>&#13;
			<option label="Air" value="air">Air</option>&#13;
			<option label="Airport Transfers" value="airport-transfers">Airport Transfers</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Hotel/Resort" value="hotelresort">Hotel/Resort</option>&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you traveling for a Special Occasion?" name="are-you-traveling-for-a-special-occasion">&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Destination Bachelor/Bachelorette Party" value="destination-bachelorbachelorette-party">Destination Bachelor/Bachelorette Party</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Family Reunion" value="family-reunion">Family Reunion</option>&#13;
			<option label="Family Vacation" value="family-vacation">Family Vacation</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
		</field>&#13;
		<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"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs (Including TSA Pre Check, include numbers if available)" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="text" label="How did you hear about us?" name="how-did-you-hear-about-travels-with-toni-j" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>