TravelJoy

Tara T Talbert

Geaux Trippin

Geaux Trippin Travel Request

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Trip details"/>&#13;
		<field type="select" required="true" label="What type of vacation are you interested in?" name="what-type-of-vacation-are-you-interested-in" className="form-control">&#13;
			<option label="Hotel only" value="hotel-only">Hotel only</option>&#13;
			<option label="All Inclusive Resort" value="all-inclusive-resort">All Inclusive Resort</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Family Friendly" value="family-friendly">Family Friendly</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you like to geaux?" 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" required="true" label="Preferred departure date" 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" required="true" label="Preferred return date" 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?" inline="true" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you deposit or full payment ready" inline="true" name="are-you-deposit-or-full-payment-ready">&#13;
			<option label="Deposit Ready" value="deposit-ready">Deposit Ready</option>&#13;
			<option label="Full Payment Ready" value="full-payment-ready">Full Payment Ready</option>&#13;
			<option label="Neither" value="neither">Neither</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you have a valid passport?" inline="true" 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" required="true" label="What is your departure city &amp;amp; state?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adult travelers (18 and older)?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many kids? List age at time of travel" name="kids-ages" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="What is your budget per person?" name="what-is-your-per-person-budget" className="form-control">&#13;
			<option label="$ 800 - $1200" value="-800-1200">$ 800 - $1200</option>&#13;
			<option label="$1200 - $1500" value="1200-1500">$1200 - $1500</option>&#13;
			<option label="$1500 - $2000" value="1500-2000">$1500 - $2000</option>&#13;
			<option label="$2000 - $3000" value="2000-3000">$2000 - $3000</option>&#13;
			<option label="$3000 and up" value="3000-and-up">$3000 and up</option>&#13;
			<option label="" value=""/>&#13;
		</field>&#13;
		<field type="select" label="Would you like your vacation to include any of the following?" name="would-you-like-your-vacation-to-include-any-of-the-following" multiple="multiple" className="form-control">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Excursions" value="excursions">Excursions</option>&#13;
			<option label="Ride Transfers" value="ride-transfers">Ride Transfers</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="No add ons" value="no-add-ons">No add ons</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#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="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="checkbox-group" label="Which airline do you prefer?" name="which-airline-do-you-prefer">&#13;
			<option label="American" value="american">American</option>&#13;
			<option label="Delta" value="delta">Delta</option>&#13;
			<option label="Frontier" value="frontier">Frontier</option>&#13;
			<option label="Southwest" value="southwest">Southwest</option>&#13;
			<option label="Spirit" value="spirit">Spirit</option>&#13;
			<option label="United" value="united">United</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" inline="true" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" 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="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name (as it appears on passport/state issued ID)" 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 (as it appears on passport/state issued ID)" 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;
	</fields>&#13;
</form-template>
  </body>
</html>