Share your information with Wynnona Brown

Wynnona Brown

Luxe Viatorem LLC

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    <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="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#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="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" 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?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#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 budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#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" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Condo/Villa" value="condovilla">Condo/Villa</option>&#13;
			<option label="3 Star Hotel/Resort" value="3-star-hotelresort">3 Star Hotel/Resort</option>&#13;
			<option label="4 Star Hotel/Resort" value="4-star-hotelresort">4 Star Hotel/Resort</option>&#13;
			<option label="5 Star Hotel/Resort" value="5-star-hotelresort">5 Star Hotel/Resort</option>&#13;
			<option label="All-Inclusive" value="allinclusive">All-Inclusive</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What services are you interested in?" description="Please check out &#39;Our Services&#39; page to see Luxe Viatorem Service Packages" name="radio-group-1765494399495">&#13;
			<option label="Complimentary Reservation Assistance" value="complimentary-reservation-assistance">Complimentary Reservation Assistance</option>&#13;
			<option label="The Essentials Package" value="the-essentials-package">The Essentials Package</option>&#13;
			<option label="The Bespoke Travel Package" value="the-bespoke-travel-package">The Bespoke Travel Package</option>&#13;
			<option label="The Luxe VIP Package" value="the-luxe-vip-package">The Luxe VIP Package</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="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Bach Party" value="bach-party">Bach Party</option>&#13;
			<option label="Honeymoon / Anniversary" value="honeymoon-anniversary">Honeymoon / Anniversary</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Cultural" value="cultural">Cultural</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food &amp; Sightseeing" value="food-sightseeing">Food &amp; Sightseeing</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="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Beach and water activities (Jet Ski, Parasailing)" value="beach-and-water-activities-jet-ski-parasailing">Beach and water activities (Jet Ski, Parasailing)</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Adventure activities (Zipline, ATV, Horseback riding)" value="adventure-activities-zipline-atv-horseback-riding">Adventure activities (Zipline, ATV, Horseback riding)</option>&#13;
			<option label="Cultural Classes (Cooking, Salsa, Rum tasting)" value="cultural-classes-cooking-salsa-rum-tasting">Cultural Classes (Cooking, Salsa, Rum tasting)</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Museums" value="museums">Museums</option>&#13;
			<option label="Casino" value="casino">Casino</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Whats the best way to contact you?" name="radio-group-1765494802535">&#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;
		</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;
	</fields>&#13;
</form-template>
  </body>
</html>