Share your information with Michele Karnes

Michele Karnes

Shell’s Sweet Escape Travel Services

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  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Purpose of this Form: The details provided will help me to find travel options that best meet your requests and needs."/>&#13;
		<field type="header" subtype="h2" label="Primary Traveler Information"/>&#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" 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" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Preferred method of contact (email, text, phone call, ALL are ok)" name="preferred-method-of-contact" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;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" name="when-would-you-like-to-return" 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="textarea" label="Please provide details re: flexibility" name="please-provide-details-re-flexibility" className="form-control"/>&#13;
		<field type="text" label="Number of those 18 years of age and above" name="number-of-those-18-years-of-age-and-above" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Number of Children and Ages (please denote age at time of travel)" name="number-of-children-and-ages-please-denote-age-at-time-of-travel" subtype="text" className="form-control"/>&#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="Text Field" name="text-1757098956617" value="Preferred airport or Cruise Port" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Please check if you have one or more of these" name="please-check-if-you-have-one-or-more-of-these" multiple="multiple" className="form-control">&#13;
			<option label="Real ID" value="real-id" selected="selected">Real ID</option>&#13;
			<option label="Passport" value="passport">Passport</option>&#13;
			<option label="Passport Card" value="passport-card">Passport Card</option>&#13;
		</field>&#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="checkbox-group" label="Please include (check all that apply)" name="please-include-check-all-that-apply">&#13;
			<option label="Hotel/Resort/Vacation Rental" value="hotelresortvacation-rental">Hotel/Resort/Vacation Rental</option>&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Activities" value="activities">Activities</option>&#13;
			<option label="Structured Tour" value="structured-tour">Structured Tour</option>&#13;
			<option label="Other: Please note in comments" value="other-please-note-in-comments">Other: Please note in comments</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="radio-group" label="What best describes your hotel /Resort or Vacation Rental 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="text" label="Are there any must-see sights or experiences on your list?&amp;nbsp;" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Do you have any dietary, mobility, sensory, or other specific needs you’d like us to consider in your travel plans?" name="do-you-have-any-dietary-mobility-sensory-or-other-specific-needs-youd-like-us-to-consider-in-your-travel-plans" 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="paragraph" subtype="p" label="Thank you! This form will be reviewed upon receipt. I will reach out for additional clarifying information if needed. I will provide 2-3 options, depending on the trip. I do hope you will enjoy being part of the planning process.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Michele Karnes, Travel Planner, Certified Accessible and Special Needs Travel Planner"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>