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Hadassah Lombera

Travel by Das

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#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" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#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="Which one are you interested in?" name="which-one-are-you-interested-in" other="true">&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Resort" value="resort">Resort</option>&#13;
			<option label="Group or Solo Guided Tour" value="group-or-solo-guided-tour">Group or Solo Guided Tour</option>&#13;
			<option label="Personalized Trip (Customized itinerary, medical trip, etc.)" value="personalized-trip-customized-itinerary-medical-trip-etc">Personalized Trip (Customized itinerary, medical trip, etc.)</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" 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" required="true" 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" 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 total?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are you traveling with children?" name="radio-group-1769148896274">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1769148860163" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzY5MTQ4ODk2Mjc0Iiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJ0ZXh0LTE3NjkxNDkwNzU1ODkiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJ0ZXh0LTE3NjkxNDkwNzU1ODkiLCJsYWJlbCI6IlBsZWFzZSBsaXN0IGhvdyBtYW55IGNoaWxkcmVuIGFuZCB0aGVpciBhZ2VzIGF0IHRpbWUgb2YgdHJhdmVsIn1dfQ=="/>&#13;
		<field type="text" label="Please list how many children and their ages at time of travel" name="text-1769149075589" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="text" required="true" label="How many rooms?" name="text-1766276668478" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many people per room (4 people max) Example Room 1: 1 adult, 2 children (ages) Room 2: 4 adults" name="how-will-your-sleeping-arrangements-be-example-room-1-2-queen-beds-1-adult-3-kids-ages-5-8-10-please-include-number-of-rooms-bed-types-number-of-adults-and-children-per-room-ages-of-children-at-time-of-travel" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" required="true" label="Flight preference" name="seat-preference" other="true">&#13;
			<option label="First Class" value="first-class">First Class</option>&#13;
			<option label="Business Class" value="business-class">Business Class</option>&#13;
			<option label="Premium Economy" value="premium-economy">Premium Economy</option>&#13;
			<option label="Basic Economy / Economy" value="basic-economy-economy">Basic Economy / Economy</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat Preference" name="radio-group-1766277922605" other="true">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Luggage" name="checkbox-group-1766278680686" other="true">&#13;
			<option label="1 Check-In per person (+/-50 lbs)" value="1-checkin-per-person-50-lbs">1 Check-In per person (+/-50 lbs)</option>&#13;
			<option label="1 Carry-On per person (22in x 14in x 9in, 15–22 lbs)" value="1-carryon-per-person-22in-x-14in-x-9in-1522-lbs">1 Carry-On per person (22in x 14in x 9in, 15–22 lbs)</option>&#13;
			<option label="1 Personal Item per person (About 18in x 14in x 8in, Usually no more than 15lbs)" value="1-personal-item-per-person-about-18in-x-14in-x-8in-usually-no-more-than-15lbs">1 Personal Item per person (About 18in x 14in x 8in, Usually no more than 15lbs)</option>&#13;
		</field>&#13;
		<field type="text" label="Meal preference (Overseas Flight)" name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference" other="true">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</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="text" label="When would you be ready to book?" description="Pricing is based on availability at the time of the quote and is not guaranteed. Rates may change at any time until booked." name="text-1769814668165" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="economy">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;
			<option label="Cruise: Solo Stateroom" value="cruise-solo-stateroom">Cruise: Solo Stateroom</option>&#13;
			<option label="Cruise: Inside Stateroom" value="cruise-inside-stateroom">Cruise: Inside Stateroom</option>&#13;
			<option label="Cruise: Ocean View Stateroom" value="cruise-ocean-view-stateroom">Cruise: Ocean View Stateroom</option>&#13;
			<option label="Cruise: Balcony Stateroom" value="cruise-balcony-stateroom">Cruise: Balcony Stateroom</option>&#13;
			<option label="Cruise: Private Suite" value="cruise-private-suite">Cruise: Private Suite</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="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Food &amp; Wineries/Breweries" value="food-wineriesbreweries">Food &amp; Wineries/Breweries</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="AirBnB" value="airbnb">AirBnB</option>&#13;
			<option label="Local Culture" value="local-culture">Local Culture</option>&#13;
			<option label="Romantic/R&amp;R" value="romanticrr">Romantic/R&amp;R</option>&#13;
			<option label="Glamping" value="glamping">Glamping</option>&#13;
			<option label="RV Resort Full Hookups" value="rv-resort-full-hookups">RV Resort Full Hookups</option>&#13;
			<option label="Camping" value="camping">Camping</option>&#13;
			<option label="Party" value="party">Party</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/Pool/Water Park/Scuba" value="beachpoolwater-parkscuba">Beach/Pool/Water Park/Scuba</option>&#13;
			<option label="Adventure/Adrenaline" value="adventureadrenaline">Adventure/Adrenaline</option>&#13;
			<option label="Wine/Whiskey/Tequila Tasting" value="winewhiskeytequila-tasting">Wine/Whiskey/Tequila Tasting</option>&#13;
			<option label="Gastronomic" value="gastronomic">Gastronomic</option>&#13;
			<option label="Historical/Cultural Sightseeing" value="historicalcultural-sightseeing">Historical/Cultural Sightseeing</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Hiking/Nature/Wildlife" value="hikingnaturewildlife">Hiking/Nature/Wildlife</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Is there anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Is this for a special occasion? (Engagement, wedding, vow renewal, anniversary, graduation, birthday, etc...) And will you be requiring professional coordination for an event?" name="does-anyone-in-your-party-have-mobility-issues-special-needs-or-requires-oxygen-please-explain" rows="3" className="form-control"/>&#13;
		<field type="textarea" label="Please specify any special requests and anything else you would like me to know. Please advise on mobility issues and if you will be requiring an accessible room.&amp;nbsp;" 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="How did you hear about us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Planning &amp;amp; Compensation"/>&#13;
		<field type="paragraph" subtype="p" label="A nonrefundable 10% planning fee covers the time, research, expertise, and personalized service provided to plan and arrange your vacation."/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>