Share your information with Mackenzie Gilbert

Mackenzie Gilbert

Travelmation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let&#39;s Plan Your Next Vacation!&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Tell Me About You!"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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" label="Preferred name" name="preferred-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="header" subtype="h1" label="Tell Me About Your Trip!&amp;nbsp;"/>&#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="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" 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="radio-group" required="true" label="How soon are you looking to book?" name="how-soon-are-you-looking-to-book">&#13;
			<option label="Today" value="today">Today</option>&#13;
			<option label="Within the next 1-2 weeks" value="within-the-next-12-weeks">Within the next 1-2 weeks</option>&#13;
			<option label="In a few months" value="in-a-few-months">In a few months</option>&#13;
			<option label="Just considering options" value="just-considering-options">Just considering options</option>&#13;
		</field>&#13;
		<field type="text" label="If flying, what is your departure city/airport?" 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 is your ideal budget for all travelers?&amp;nbsp;" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$0 to $1,000" value="0-to-1000">$0 to $1,000</option>&#13;
			<option label="$1,000 to $3,000" value="1000-to-3000">$1,000 to $3,000</option>&#13;
			<option label="$3,000 to $5,000" value="3000-to-5000">$3,000 to $5,000</option>&#13;
			<option label="$5,000 to $8,000" value="5000-to-8000">$5,000 to $8,000</option>&#13;
			<option label="$8,000 to $10,000" value="8000-to-10000">$8,000 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" label="Hotel preference" name="hotel-preference">&#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" label="Vibe preferences" name="vibe-preference">&#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;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activity preferences" 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 theatre" value="art-theatre">Arts and theatre</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Just a few more questions … You’re almost there!&amp;nbsp;"/>&#13;
		<field type="textarea" label="Any accessibility needs you would like for me to know about?" name="are-you-celebrating-anything" className="form-control"/>&#13;
		<field type="textarea" label="Are you celebrating anything?" name="textarea-1783884449992" className="form-control"/>&#13;
		<field type="text" label="Please understand that you need a valid passport to travel outside of the country. Do you currently have a passport or plan to get one in the next 6 weeks?" name="please-understand-that-you-need-a-valid-passport-to-travel-outside-of-the-country-do-you-currently-have-a-passport-or-plan-to-get-one-in-the-next-6-weeks" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are you interested in purchasing travel protection?&amp;nbsp;" name="are-you-interested-in-purchasing-travel-protection-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I need more information " value="i-need-more-information-">I need more information </option>&#13;
		</field>&#13;
		<field type="text" label="Anything else you would like for me to know about your ideal trip? Anything you must do or see?" name="anything-else-you-would-like-for-me-to-know-about-your-ideal-trip-anything-you-must-do-or-see" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>