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Travelmation - Kim Tower

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let&#39;s Take a Trip!"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you so much for reaching out to me about your next vacation!&amp;nbsp; &amp;nbsp;Please fill out the form below - the more information you can provide, the more personalized your quote will be! I will reach out to you as soon as I can but a full quote might take up to 72 hours for me to send to you.&amp;nbsp; If you have any questions for me, feel free to reach out!&amp;nbsp; kimtower@travelmation.net or 978-309-5579&amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp; &amp;nbsp;Thank you,&amp;nbsp; &amp;nbsp;Kim"/>&#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" label="Best Contact Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you looking to book:" name="are-you">&#13;
			<option label="Today" value="today">Today</option>&#13;
			<option label="Within the week" value="within-the-week">Within the week</option>&#13;
			<option label="In the next month or two" value="in-the-next-month-or-two">In the next month or two</option>&#13;
			<option label="I'm just researching" value="im-just-researching">I'm just researching</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="When would you like to travel?&amp;nbsp; If you have flexible dates, please include a date range and the number of nights you&#39;d like to be away for." name="text-1725725394813" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your departure city/airport?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Which destination are you interested in booking?" name="which-destination-are-you-interested-in-booking">&#13;
			<option label="Disney Destinations" value="disney-destinations">Disney Destinations</option>&#13;
			<option label="Universal Studios Orlando/Hollywood" value="universal-studios-orlandohollywood">Universal Studios Orlando/Hollywood</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All Inclusive Resort" value="all-inclusive-resort">All Inclusive Resort</option>&#13;
			<option label="Domestic Destination" value="domestic-destination">Domestic Destination</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="First and last name as listed on passport, gender and birthdate or age (at time of travel) of all travelers." name="number-of-travelers" subtype="text" className="form-control"/>&#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 $3,000" value="1500-to-3000">$1,500 to $3,000</option>&#13;
			<option label="$3,000 - $6,000" value="3000-6000">$3,000 - $6,000</option>&#13;
			<option label="$6,000 to $10,000" value="6000-to-10000">$6,000 to $10,000</option>&#13;
			<option label="$10,000 to $15,000" value="10000-to-15000">$10,000 to $15,000</option>&#13;
			<option label="$15,000 - $20,000" value="15000-20000">$15,000 - $20,000</option>&#13;
			<option label="$20,000+" value="20000">$20,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" 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="radio-group" label="Would you like to include airfare in your quote?" name="would-you-like-to-include-airfare-in-your-quote">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you interested in travel insurance?" name="radio-group-1725726443127">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Unsure" value="unsure">Unsure</option>&#13;
		</field>&#13;
		<field type="text" label="Tell me a little more about where you are looking to go." name="tell-me-a-little-more-about-your-desired-vacation-destination-cruise-or-other-requests" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Are there any Food Allergies/Medical Conditions/Special Needs to be made aware of" name="are-there-any-food-allergiesmedical-conditionsspecial-needs-to-be-made-aware-of" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?&amp;nbsp; Are you celebrating anything?&amp;nbsp; The more information you give me, the better!" 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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