Share your information with Jaime Johnson

Jaime Johnson

Dream Casters Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Travel Request Form"/>&#13;
		<field type="paragraph" subtype="p" label="Please note: Our quotes will have a $50 non-refundable research fee for up to 6 additional quotes. Group travel (8 or more guess) will have a $150 non-refundable research fee. If you were referred by someone/Facebook group (No Fee), please select REFERRED and add name/group.&amp;nbsp; Please fill in as much information as you can. Quotes do have a 3-6 day turn around, if need sooner please let me know. Please also check your spam folder as some quotes end up there. If you have any questions email me at jaimew1016@gmail.com.&amp;nbsp;"/>&#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" 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="checkbox-group" label="Best contact method" inline="true" name="best-contact-method">&#13;
			<option label="Call" value="call">Call</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Messenger" value="messenger">Messenger</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Quotes requesting" name="amount-of-quotes-requesting">&#13;
			<option label="Upto 6 Quotes - $50 non refundable research fee applies" value="upto-6-quotes-50-non-refundable-research-fee-applies">Upto 6 Quotes - $50 non refundable research fee applies</option>&#13;
			<option label="Group Quote (8 or more people) - $150 non refundable research fee applies" value="group-quote-8-or-more-people-150-non-refundable-research-fee-applies">Group Quote (8 or more people) - $150 non refundable research fee applies</option>&#13;
			<option label="REFERRED BY PERSON/GROUP" value="referred-by-persongroup">REFERRED BY PERSON/GROUP</option>&#13;
			<option label=" The Wedding Plug" value="-the-wedding-plug"> The Wedding Plug</option>&#13;
		</field>&#13;
		<field type="text" label="If Referred by someone or group, please add their name.&amp;nbsp;" name="if-referred-by-someone-or-group-please-add-their-name-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" required="true" label="What destinations do you have in mind?" 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="text" label="Do you and the people your traveling with have passports? (if answer no, ask me about my passport services)&amp;nbsp;" name="do-you-and-the-people-your-traveling-with-have-passports" 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." inline="true" name="budget" other="true">&#13;
			<option label="$1000 to $2000" value="1000-to-2000">$1000 to $2000</option>&#13;
			<option label="$2000 to $3000" value="2000-to-3000">$2000 to $3000</option>&#13;
			<option label="$3000 to $4000" value="3000-to-4000">$3000 to $4000</option>&#13;
			<option label="$4000 to $5000" value="4000-to-5000">$4000 to $5000</option>&#13;
			<option label="$6000 to $8000" value="6000-to-8000">$6000 to $8000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
			<option label="" value=""/>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many adults?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Any children traveling? How many and ages?" name="any-children-traveling-how-many-and-ages" 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" label="Are your dates flexible?" inline="true" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="No">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you need airfare?" name="do-you-need-airfare" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is the closest airport you would like to leave from?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What type of travel is this?" description="family trip / honeymoon / adults only trip" name="what-type-of-travel-is-this" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Favorite hotel/resort brands" name="favorite-hotelresort-brands" 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="checkbox-group" label="Activity preferences" inline="true" name="activity-preferences">&#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="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Primary travelers date of birth" description="I will need this in order to book." name="primary-travelers-date-of-birth" className="form-control"/>&#13;
		<field type="textarea" label="Additional traveler(s) date of birth(s)" description="I will need this info in order to book trip" name="additional-travelers-date-of-births" className="form-control"/>&#13;
		<field type="text" label="How did you hear about us?&amp;nbsp;" description="(facebook  client referral  business card)" name="how-did-you-hear-about-us-" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>