<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="header" subtype="h2" label="Full name"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" required="true" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do you currently have a valid passport?" description="Please check that your passport doesn't expire within six months of return from travel" name="do-you-currently-have-a-valid-passport" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h2" label="Passport Info"/> <field type="file" label="Passport photo" description="Please include a photo of the picture page inside of your passport; you do NOT have to fill out the passport information if you provide the photo." name="passport_photo" subtype="file" className="form-control"/> <field type="text" label="Full name as it appears on passport" description="Fill out this section ONLY if you are not including a photo of the inside of your passport." name="passport-name" subtype="text" className="form-control"/> <field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/> <field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/> <field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/> <field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/> <field type="radio-group" required="true" label="Gender" name="gender"> <option label="F" value="female">F</option> <option label="M" value="male">M</option> <option label="X" value="other">X</option> </field> <field type="text" required="true" label="Citizenship" name="citizenship" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Important Dates"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="Please list the names and birthdates of additional travelers including children." description="If traveling solo please type NA if traveling in a group just the approximate number of guests and age ranges is sufficient at this time" placeholder="Mr. John Michael Smith - 02/15/1975 Miss Jennifer Nicole Smith - 07/07/2020" name="please-list-the-names-of-additional-travelers-including-children-please-provide-the-ages-of-children" subtype="text" className="form-control"/> <field type="text" required="true" 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"/> <field type="date" required="true" 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" required="true" 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="text" required="true" label="What is your departure city?" description="Which city/airport/airport identifier will you be departing from?" name="departure-city" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for this vacation?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <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" required="true" 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="radio-group" required="true" label="What type of resort are you interested in?" name="what-type-of-resort-are-you-interested-in" other="true"> <option label="All Inclusive (Mainly Jamaica, Mexico, or the Dominican Republic)" value="all-inclusive-mainly-jamaica-mexico-or-the-dominican-republic">All Inclusive (Mainly Jamaica, Mexico, or the Dominican Republic)</option> <option label="European Plan (pay as you go)" value="european-plan-pay-as-you-go">European Plan (pay as you go)</option> </field> <field type="radio-group" required="true" label="What type of room layout would you prefer?" name="what-type-of-room-layout-would-you-prefer"> <option label="Double/Queen" value="doublequeen">Double/Queen</option> <option label="King" value="king">King</option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" label="Which cruiseline are you interested in sailing?" description="Select all that apply; you may skip this section if you are not interested in a cruise vacation" name="which-cruiseline-are-you-interested-in-sailing" other="true"> <option label="Carnival" value="carnival">Carnival</option> <option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option> <option label="Norwegian" value="norwegian">Norwegian</option> <option label="Princess" value="princess">Princess</option> <option label="Disney" value="disney">Disney</option> <option label="Virgin Voyages (adults only)" value="virgin-voyages-adults-only">Virgin Voyages (adults only)</option> </field> <field type="checkbox-group" label="What type of cruise cabin do you prefer?" name="what-type-of-cruise-cabin-do-you-prefer" other="true"> <option label="Inside" value="inside">Inside</option> <option label="Oceanview" value="oceanview">Oceanview</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Suite" value="suite">Suite</option> </field> <field type="header" subtype="h2" label="Travel Preferences"/> <field type="radio-group" required="true" label="Seat preference (for flights)" name="seat-preference" other="true"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> </field> <field type="radio-group" required="true" label="Bed preference" name="bed-preference"> <option label="King" value="king">King</option> <option label="2 Twin/Double/Queen" value="2-twindoublequeen">2 Twin/Double/Queen</option> </field> <field type="checkbox-group" label="Vibe preferences" 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> <option label="Multi-generational" value="multi-generational">Multi-generational</option> <option label="Adventure" value="adventure">Adventure</option> <option label="LGBTQ" value="lgbtq">LGBTQ</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"/> <field type="radio-group" required="true" label="How did you find me?" name="how-did-you-find-me" other="true"> <option label="Facebook" value="facebook">Facebook</option> <option label="Instagram" value="instagram">Instagram</option> <option label="Web Search" value="web-search">Web Search</option> <option label="Twitter" value="twitter">Twitter</option> <option label="Linkedin" value="linkedin">Linkedin</option> <option label="Word of Mouth" value="word-of-mouth">Word of Mouth</option> </field> </fields> </form-template> </body> </html>
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