Share your information with Lani Parker

Lani Parker

Travel With Lani

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    <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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" 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="radio-group" required="true" label="How soon do you want to book?" name="how-soon-do-you-want-to-book" other="true">&#13;
			<option label="Immediately" value="immediately" selected="selected">Immediately</option>&#13;
			<option label="Within 2 weeks" value="within-2-weeks">Within 2 weeks</option>&#13;
			<option label="Within 1 month" value="within-1-month">Within 1 month</option>&#13;
			<option label="In more than 1 month from today" value="in-more-than-1-month-from-today">In more than 1 month from today</option>&#13;
			<option label="I'm just in the research phase and am comparing prices." value="im-just-in-the-research-phase-and-am-comparing-prices">I'm just in the research phase and am comparing prices.</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Have you done any research on your own or have you started working with a travel agent already?" name="have-you-done-any-research-on-your-own-or-have-you-started-working-with-a-travel-agent-already">&#13;
			<option label="I've done some research." value="ive-done-some-research">I've done some research.</option>&#13;
			<option label="I'm working with another travel agent." value="im-working-with-another-travel-agent">I'm working with another travel agent.</option>&#13;
		</field>&#13;
		<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"/>&#13;
		<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"/>&#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" required="true" 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" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What would you like us to quote (Please select all that apply)?&amp;nbsp;" name="radio-group-1766946496490" other="true">&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All Inclusive" value="all-inclusive">All Inclusive</option>&#13;
			<option label="Vacation Home/Villa" value="vacation-homevilla">Vacation Home/Villa</option>&#13;
			<option label="Tour" value="tour">Tour</option>&#13;
			<option label="Show/Sporting Event/Concert" value="showsporting-eventconcert">Show/Sporting Event/Concert</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" 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="radio-group" required="true" label="What best describes your hotel 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" required="true" 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="checkbox-group" required="true" 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="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="radio-group" required="true" label="Want to Make the Most of Your Travel?&amp;nbsp; We love helping travelers save and enjoy extra perks as a travel agent! Would you like to learn more about: - Special travel discounts and exclusive perks for travel agents. - Opportunities to earn extra income as a travel agent" name="radio-group-1766947529012">&#13;
			<option label="Yes! Please share info!" value="yes-please-share-info">Yes! Please share info!</option>&#13;
			<option label="No thanks." value="no-thanks">No thanks.</option>&#13;
			<option label="Not for me right now, but I know someone who might be interested!" value="not-for-me-right-now-but-i-know-someone-who-might-be-interested">Not for me right now, but I know someone who might be interested!</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
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