Share your information with Angie Blaze

Angie Blaze

Well Traveled Moments

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	<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="How did you hear about us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/>&#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;
		</field>&#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="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers under the age of 18?" name="how-many-travelers-under-the-age-of-18" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many rooms?" name="how-many-rooms" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your budget for this trip to include all travelers as well as flight and transportation?" description="To give you the best value and save both of us time  I absolutely need a sense of your total budget for this trip. Options for travel range wildly. I could research a five-star luxury resort package, a boutique hotel with local tours, or a self-drive itinerary with budget accommodations. Without a price range, I&#39;m essentially guessing, and I could present you with ideas that are either far higher than your budget or far below your expectations. Knowing your number allows me to immediately filter and focus my expertise on the options that will truly work for you." name="what-is-your-budget-for-this-trip-to-include-all-travelers-as-well-as-flight-and-transportation" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What travel style and level of activity are you looking for in this trip?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Adults Only" value="adults-only">Adults Only</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="All-Inclusive" value="allinclusive">All-Inclusive</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Action/Nightlife" value="actionnightlife">Action/Nightlife</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;
			<option label="Nature" value="nature">Nature</option>&#13;
			<option label="Active or Daily Excursions" value="active-or-daily-excursions">Active or Daily Excursions</option>&#13;
			<option label="Slow Paced or Just a Few Excursions" value="slow-paced-or-just-a-few-excursions">Slow Paced or Just a Few Excursions</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?&amp;nbsp; Are you celebrating anything special?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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