Share your information with Michelle Branco

Michelle Branco

Salty Air Travel

<html>
  <body>
    <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="radio-group" label="Please specify the travel arrangements you would like included in your quote proposal. * (Select all that apply)" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Hotel/Resort" value="hotelresort">Hotel/Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Air" value="air">Air</option>&#13;
			<option label="Rental Home/Apartment/Condo" value="rental-homeapartmentcondo">Rental Home/Apartment/Condo</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="Where would you like to go? Destination?" 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" 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" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="textarea" label="Are you traveling for a special occasion?" description="Birthday  Honeymoon  Anniversary  Family Trip" placeholder="Birthday Trip" name="are-you-traveling-for-a-special-occasion" className="form-control"/>&#13;
		<field type="text" 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" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please indicate the number of adults and children aged 12 and above who will be traveling." name="text-1766365457735" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please specify the total number of children under 12 that will be traveling and provide their ages at time of travel (if known)." name="text-1766365472568" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Does anyone in the traveling party have special needs (e.g., mobility dietary, allergies)?" name="text-1766365554276" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="radio-group-1766365724432">&#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" 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" 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" 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="select" label="How did you hear about us?" name="how-did-you-hear-about-us" className="form-control">&#13;
			<option label="Repeat Client" value="repeat-client">Repeat Client</option>&#13;
			<option label="Friend / Family" value="friend-family">Friend / Family</option>&#13;
			<option label="Ad / Promotion" value="ad-promotion">Ad / Promotion</option>&#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="Business Website" value="business-website">Business Website</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="textarea" label="Text Area" name="textarea-1766365390664" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>