Share your information with Omar Smith

Omar Smith

The Omar Experience

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Personal Information"/>&#13;
		<field type="text" required="true" label="First name" description="List what appears on your ID." name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Last name" description="List what appears on your ID." name="last-name" 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="h3" label="Trip Questions"/>&#13;
		<field type="text" required="true" label="What is your desired destination?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Cancun" name="text-1746137014201" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="What timeframe would you like to leave for your trip?" description="It doesn&#39;t have to be an exact date  I need a time range." name="what-date-would-you-like-to-leave-for-your-trip" className="form-control"/>&#13;
		<field type="date" required="true" label="What timeframe would you like to return from your trip?" description="It doesn&#39;t have to be an exact date  I need a time range." name="what-timeframe-would-you-like-to-return-from-your-trip" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are the dates flexible?" name="are-the-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What services do you need booked?" name="what-services-do-you-need-booked">&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Airbnb" value="airbnb">Airbnb</option>&#13;
			<option label="Rental Car" value="rental-car">Rental Car</option>&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Activities" value="activities">Activities</option>&#13;
			<option label="Events/Concert" value="eventsconcert">Events/Concert</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many travelers will be attending?" name="how-many-travelers-will-be-attending" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later. You can select other and let me know how much per person you desire to spend." name="what-is-your-budget-for-all-travelers" other="true">&#13;
			<option label="&gt;1,500$" value="1500">&gt;1,500$</option>&#13;
			<option label="$1,500 to $2,500" value="1500-to-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-to-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-to-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-to-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your departure city if flying?" description="Where will you be leaving from?" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="If you need a hotel booked, how many rooms do you desire to have?" name="if-you-need-a-hotel-booked-how-many-rooms-do-you-desire-to-have" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Any Brand Preferences" placeholder="ex: Hilton  Delta  Enterprise  Carnival Cruise" name="any-brand-preferences" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Seat preference for flight" 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 for Hotel/Airbnb" 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="checkbox-group" label="What best describes your Hotel/Airbnb preference?" name="what-best-describes-your-hotel-preference" other="true">&#13;
			<option label="Economy" value="economy">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 type of vibes are you looking for?" description="Check all that apply." name="what-type-of-vibes-are-you-looking-for" 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-and-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="what-activities-are-you-interested-in" other="true">&#13;
			<option label="Beach and water" value="beach-and-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-activities">Adventure activities</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="arts-and-theater">Arts and theater</option>&#13;
			<option label="Historical Sights" value="historical-sights">Historical Sights</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="anything-you-absolutely-must-do-or-see" 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?" placeholder="ex: Celebrating a birthday" name="what-else-would-you-like-me-to-know" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>