Share your information with Tyesha Williams

Tyesha Williams

Sunset Discoveries

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="BUDGET PLANNING"/>&#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 Nickname" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" description="How can we communicate?" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" description="Just in case I need to get in touch with you faster.  Really not needed." name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" description="Make sure it matches what is on your government identification." name="gender">&#13;
			<option label="F" value="f">F</option>&#13;
			<option label="M" value="m">M</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Destination?" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Budget per person" description="Starting estimate everyone will be willing to pay with all services included." name="are-your-dates-flexible">&#13;
			<option label="$1,000 - $2,500" value="1000-2500">$1,000 - $2,500</option>&#13;
			<option label="$2,500 - $4,500" value="2500-4500">$2,500 - $4,500</option>&#13;
			<option label="$4,500 - $6,500" value="4500-6500">$4,500 - $6,500</option>&#13;
			<option label="$6,500 - $8,500" value="6500-8500">$6,500 - $8,500</option>&#13;
			<option label="$8,500 - $10,000" value="8500-10000">$8,500 - $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What best describes your trip preferences?" name="what-best-describes-your-trip-preferences">&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Hotel + Flight" value="hotel-flight">Hotel + Flight</option>&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Cruise + Hotel" value="cruise-hotel">Cruise + Hotel</option>&#13;
			<option label="Cruise + Hotel + Flight" value="cruise-hotel-flight">Cruise + Hotel + Flight</option>&#13;
			<option label="Cruise + Flight" value="cruise-flight">Cruise + Flight</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Would you need any special accessible services?" description="For persons who needs special rooms or assistance like persons with wheelchair." inline="true" name="would-you-need-flights">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Reach out to learn more information." value="reach-out-to-learn-more-information">Reach out to learn more information.</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like travel insurance?" name="would-you-like-travel-insurance">&#13;
			<option label="Yes, keep me protected." value="yes-keep-me-protected">Yes, keep me protected.</option>&#13;
			<option label="No, I will take my chances." value="no-i-will-take-my-chances">No, I will take my chances.</option>&#13;
			<option label="I need more information." value="i-need-more-information">I need more information.</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything additional information I need to know?" placeholder="Occasion? Thoughts or concerns? Special services or request. How many people attending?" name="what-are-some-activities-that-you-would-like-to-encounter" className="form-control"/>&#13;
		<field type="text" label="Are you cleared with TSA Gobal Entry? If so, what is your Known Traveler Number." description="Also know as Precheck" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>