TravelJoy

Maria LaDuca

The Agency Chic - Pocono

Bali Solo Trip

Jun 26, 2023 to Jul 4, 2023

<html>
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    <form-template>&#13;
	<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>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" required="true" label="Cell number" name="phone-number" subtype="text" className="form-control"/>&#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;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="If traveling with kids please indicate the ages for kids on dates of travel" description="Example Mary will be 6 on June 11  2024 etc." name="if-traveling-with-kids-please-indicate-the-ages-for-kids-on-dates-of-travel" className="form-control"/>&#13;
		<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">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="text" label="Does this budget include airfare?" name="does-this-budget-include-airfare" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you looking to use your VALID passport?" name="are-you-looking-to-use-your-valid-passport">&#13;
			<option label="YES, my passport is ready to go!" value="yes-my-passport-is-ready-to-go">YES, my passport is ready to go!</option>&#13;
			<option label="NO,  my passport is not ready but it will be in time for this trip!" value="no-my-passport-is-not-ready-but-it-will-be-in-time-for-this-trip">NO,  my passport is not ready but it will be in time for this trip!</option>&#13;
			<option label="NO, not interested in using a passport!" value="no-not-interested-in-using-a-passport">NO, not interested in using a passport!</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="select" required="true" label="Select Your Agent" name="select-your-agent" className="form-control">&#13;
			<option label="Adrienne" value="adrienne">Adrienne</option>&#13;
			<option label="Anthony" value="anthony">Anthony</option>&#13;
			<option label="Bianca" value="bianca">Bianca</option>&#13;
			<option label="Brenda" value="brenda">Brenda</option>&#13;
			<option label="GraceAnn" value="graceann">GraceAnn</option>&#13;
			<option label="Irma" value="irma">Irma</option>&#13;
			<option label="Jessmarie" value="jessmarie">Jessmarie</option>&#13;
			<option label="Kait" value="kait">Kait</option>&#13;
			<option label="Kelly" value="kelly">Kelly</option>&#13;
			<option label="Maria" value="maria">Maria</option>&#13;
			<option label="Nicole" value="nicole">Nicole</option>&#13;
			<option label="Rayvn" value="rayvn">Rayvn</option>&#13;
		</field>&#13;
		<field type="text" label="How did you hear about our Agency?" name="how-did-you-hear-about-our-agency" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>