Share your information with Brenda Arnold-Richard

Brenda Arnold-Richard

Travel with the Magic

<html>
  <body>
    <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" 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?" 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;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="How many adults/children will be traveling?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you have a budget range in mind for your trip?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Under $2,000" value="under-2000">Under $2,000</option>&#13;
			<option label="$2,000 to $5,000" value="2000-to-5000">$2,000 to $5,000</option>&#13;
			<option label="$5,000 to $9,000" value="5000-to-9000">$5,000 to $9,000</option>&#13;
			<option label="$9,000+" value="9000">$9,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel/cruise preference?" inline="true" 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 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, Snorkel" value="scuba-snorkel">Scuba, Snorkel</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Art, Museums, and Theater" value="art-museums-and-theater">Art, Museums, and Theater</option>&#13;
			<option label="Theme Parks" value="theme-parks">Theme Parks</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="text" label="Would you like to chat about your vacation to get started?" description="If not  we can do everything via email! No worries!" name="text-1758662549223" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>