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<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="Travel Planning Questionnaire"/> <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" required="true" 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" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Travel Preferences"/> <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="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="select" required="true" label="Who Will Be Traveling?" name="who-will-be-traveling" className="form-control"> <option label="Solo" value="solo">Solo</option> <option label="Couple" value="couple">Couple</option> <option label="Family/Friends" value="familyfriends">Family/Friends</option> </field> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Are all travelers fully vaccinated?" name="are-all-travelers-fully-vaccinated"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="If no, will they be fully vaccinated before the departure date?" name="if-no-will-they-be-fully-vaccinated-before-the-departure-date"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="N/A" value="na">N/A</option> </field> <field type="textarea" required="true" label="Full Names and Date of Birth of Travelers" name="full-names-of-travelers" className="form-control"/> <field type="text" required="true" label="How Many Rooms" name="how-many-rooms" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Bed Configurations" name="bed-configurations"> <option label="1 King Bed" value="1-king-bed">1 King Bed</option> <option label="2 Queen Beds" value="2-queen-beds">2 Queen Beds</option> <option label="2 Double/Twin Beds (depending on destination)" value="2-doubletwin-beds-depending-on-destination">2 Double/Twin Beds (depending on destination)</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" required="true" label="If Other please explain" name="if-other-please-explain" value="i.e. Room 1 -w/1 King Bed Room 2 - w/2 Queen Beds Rooms 3 - w/3 single beds" className="form-control"/> <field type="select" required="true" label="Is Air required?" name="is-air-required" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="select" required="true" label="If Yes, Please Choose An Option" name="if-yes-please-choose-an-option" className="form-control"> <option label="Direct Flights Preferred" value="direct-flights-preferred">Direct Flights Preferred</option> <option label="Connections OK" value="connections-ok">Connections OK</option> <option label="Least Expensive Option" value="least-expensive-option">Least Expensive Option</option> </field> <field type="radio-group" required="true" label="What Class?" name="what-class"> <option label="First" value="first">First</option> <option label="Business" value="business">Business</option> <option label="Premium Economy" value="premium-economy">Premium Economy</option> <option label="Economy" value="economy">Economy</option> </field> <field type="radio-group" required="true" label="Seat Preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Opposite Aisle" value="opposite-aisle">Opposite Aisle</option> <option label="Doesn't Matter" value="doesnt-matter">Doesn't Matter</option> </field> <field type="radio-group" required="true" label="Flight Departure Time Preferences" name="flight-departure-time-preferences"> <option label="6:00 AM - 12:00 PM" value="600-am-1200-pm">6:00 AM - 12:00 PM</option> <option label="12:00 PM - 5:00 PM" value="1200-pm-500-pm">12:00 PM - 5:00 PM</option> <option label="5:00 PM - 10:00 PM" value="500-pm-1000-pm">5:00 PM - 10:00 PM</option> <option label="10:00 PM or later" value="1000-pm-or-later">10:00 PM or later</option> <option label="No Preference" value="no-preference">No Preference</option> </field> <field type="radio-group" required="true" label="Flight Return Time Preferences" name="flight-return-time-preferences"> <option label="6:00 AM - 12:00 PM" value="600-am-1200-pm">6:00 AM - 12:00 PM</option> <option label="12:00 PM - 5:00 PM" value="1200-pm-500-pm">12:00 PM - 5:00 PM</option> <option label="5:00 PM - 10:00 PM" value="500-pm-1000-pm">5:00 PM - 10:00 PM</option> <option label="10:00 PM or later" value="1000-pm-or-later">10:00 PM or later</option> <option label="No Preference" value="no-preference">No Preference</option> </field> <field type="radio-group" required="true" label="What is your maximum budget per traveler?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$2,500 to $4,500" value="2500-to-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-to-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-to-10000">$8,500 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="radio-group" required="true" label="Does this budget include your domestic or international flights?" name="does-this-budget-include-your-domestic-or-international-flights"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="What's most important to you?" name="whats-most-important-to-you"> <option label="Keeping to your budget" value="keeping-to-your-budget">Keeping to your budget</option> <option label="For the right trip, I'll increase my budget" value="for-the-right-trip-ill-increase-my-budget">For the right trip, I'll increase my budget</option> <option label="Taking the perfect trip" value="taking-the-perfect-trip">Taking the perfect trip</option> </field> <field type="select" required="true" label="Airport Transfers" name="airport-trnasfers" className="form-control"> <option label="Private" value="private">Private</option> <option label="None" value="none">None</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference"> <option label="Luxury" value="luxury">Luxury</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Boutique" value="boutique">Boutique</option> <option label="Villa" value="villa">Villa</option> </field> <field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." 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> </field> <field type="checkbox-group" required="true" 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" required="true" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="textarea" required="true" label="What else would you like me to know? Share any other information to make your trip more comfortable." description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="header" subtype="h2" label="Dietary Restrictions"/> <field type="radio-group" required="true" label="Do you have any dietary restrictions?" name="would-you-like-information-about-travel-insurance"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="If yes, select which one" name="how-did-you-hear-about-maisante-travel-design"> <option label="None" value="none">None</option> <option label="Vegetarian" value="vegetarian">Vegetarian</option> <option label="Vegan" value="vegan">Vegan</option> <option label="Pescatarian" value="pescatarian">Pescatarian</option> <option label="Other" value="other">Other</option> </field> <field type="text" label="If other please explain" name="text-1764712132724" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Would you like Information about Travel Insurance?" name="radio-group-1764711976249"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="How did you hear about Maisante' Travel Design" name="checkbox-group-1764712055025"> <option label="Website" value="website">Website</option> <option label="Instagram" value="instagram">Instagram</option> <option label="Facebook" value="facebook">Facebook</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" required="true" label="If other, please list" name="if-other-please-list" className="form-control"/> <field type="header" subtype="h1" label="Don't Forget To Book Your Complimentary&nbsp;&nbsp;30 Minute&nbsp;Consultation!&nbsp;"/> </fields> </form-template> </body> </html>
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