Share your information with Rebekah Reed

Rebekah Reed

VAGABLONDE TRAVEL

<html>
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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Travel Stylist: Rebekah Reed"/>&#13;
		<field type="header" subtype="h1" label="CLIENT INFORMATION"/>&#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="radio-group" required="true" label="Preferred Contact Method" name="preferred-contact-method">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Social Media Messenger" value="social-media-messenger">Social Media Messenger</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="ABOUT YOUR TRIP"/>&#13;
		<field type="text" required="true" label="Where would you like to go? Include Destination(s) and or Hotel." name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" description="Please offer a date range if you dont have exact dates" name="when-would-you-like-to-depart" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Unsure about your travel dates? Please give details regarding a date range or season below. " name="unsure-about-your-travel-dates-please-give-details-regarding-a-date-range-or-season-below-" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city?" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Is this vacation to celebrate anything special?" name="is-this-vacation-to-celebrate-anything-special" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="At what phase of planning are you in?" name="at-what-phase-of-planning-are-you-in">&#13;
			<option label="Not a thing - HELP!" value="not-a-thing-help">Not a thing - HELP!</option>&#13;
			<option label="We have dates, but we need everything else." value="we-have-dates-but-we-need-everything-else">We have dates, but we need everything else.</option>&#13;
			<option label="Flights are all booked...now help us fill in the blanks." value="flights-are-all-bookednow-help-us-fill-in-the-blanks">Flights are all booked...now help us fill in the blanks.</option>&#13;
			<option label="We have hotels and flights already booked." value="we-have-hotels-and-flights-already-booked">We have hotels and flights already booked.</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers? This just gives me a general starting point and can always be changed later." name="what-is-your-budget-for-all-travelers-this-just-gives-me-a-general-starting-point-and-can-always-be-changed-later">&#13;
			<option label="$3,000 - $5,000" value="3000-5000">$3,000 - $5,000</option>&#13;
			<option label="$5,000 - $7,000" value="5000-7000">$5,000 - $7,000</option>&#13;
			<option label="$7,000 - $10,000  " value="7000-10000-">$7,000 - $10,000  </option>&#13;
			<option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option>&#13;
			<option label="$15,000+" value="15000">$15,000+</option>&#13;
		</field>&#13;
		<field type="textarea" label="Will you be booking any portion of your trip with points? If so, which pieces?" name="will-you-be-booking-any-portion-of-your-trip-with-points-if-so-which-pieces" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What travel components would you like us to assist you with? Check all that apply." name="what-travel-components-would-you-like-us-to-assist-you-with-check-all-that-apply">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Accommodations" value="accommodations">Accommodations</option>&#13;
			<option label="Airport Transportation" value="airport-transportation">Airport Transportation</option>&#13;
			<option label="Other Transportation (car rental, trains, etc.)" value="" selected="selected">Other Transportation (car rental, trains, etc.)</option>&#13;
			<option label="Excursions &amp; Tours" value="excursions-tours">Excursions &amp; Tours</option>&#13;
			<option label="Insurance" value="insurance">Insurance</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What best describes your desired accommodation style?" name="what-best-describes-your-desired-accommodation-style">&#13;
			<option label="Romance" value="romance">Romance</option>&#13;
			<option label="Rest &amp; relaxation" value="rest-relaxation">Rest &amp; 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 &amp; wine" value="food-wine">Food &amp; wine</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Is there anything else you &quot;must do&quot; or see?" name="is-there-anything-else-you-must-do-or-see" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Describe your vision for your ideal vacation." name="describe-your-vision-for-your-ideal-vacation" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Who all will be traveling with you? Please list all full names (including middle) and birth dates, as listed on passport." description="We willl gather more details when we send you your client profile." name="who-all-will-be-traveling-with-you-please-list-all-full-names-including-middle-and-birthdates-as-listed-on-passport" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="How many adults will be traveling with you? " name="how-many-adults-will-be-traveling-with-you-">&#13;
			<option label="1-2" value="12">1-2</option>&#13;
			<option label="3-7" value="37">3-7</option>&#13;
			<option label="8-19" value="819">8-19</option>&#13;
			<option label="20+" value="20">20+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How many children will be traveling with you? " name="how-many-children-will-be-traveling-with-you-">&#13;
			<option label="0" value="0">0</option>&#13;
			<option label="1-2" value="12">1-2</option>&#13;
			<option label="3-5" value="35">3-5</option>&#13;
			<option label="6-8" value="68">6-8</option>&#13;
			<option label="9+" value="9">9+</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" className="form-control">&#13;
			<option label="Google Search" value="google-search">Google Search</option>&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="Tik Tok" value="tik-tok">Tik Tok</option>&#13;
			<option label="Doyenne Initiative" value="doyenne-initiative">Doyenne Initiative</option>&#13;
			<option label="I was a Previous Client" value="i-was-a-previous-client">I was a Previous Client</option>&#13;
			<option label="Vendor Referral" value="vendor-referral">Vendor Referral</option>&#13;
			<option label="Client Referral" value="client-referral">Client Referral</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Have you worked with Vagablonde Travel in the past?" name="have-you-worked-with-vagablonde-travel-in-the-past">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="I accept" name="i-accept">&#13;
			<option label="By submitting this client inquiry form, you consent to receive travel related content via email from Vagablonde Travel. By checking this box, you understand our planning service fees are non refundable should you not book with Vagablonde Travel. The service fees cover our research, time, and expertise. " value="by-submitting-this-client-inquiry-form-you-consent-to-receive-travel-related-content-via-email-from-vagablonde-travel-by-checking-this-box-you-understand-our-planning-service-fees-are-non-refundable-should-you-not-book-with-vagablonde-travel-the-service-fees-cover-our-research-time-and-expertise-">By submitting this client inquiry form, you consent to receive travel related content via email from Vagablonde Travel. By checking this box, you understand our planning service fees are non refundable should you not book with Vagablonde Travel. The service fees cover our research, time, and expertise. </option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
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