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Bryna Benkenstein

Travelmation - Bryna Benkenstein

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	<fields>&#13;
		<field type="header" subtype="h2" label="Cruise Quote Request"/>&#13;
		<field type="paragraph" subtype="p" label="Please fill out this form so we can start planning your dream cruise vacation!"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Mailing Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="&amp;nbsp;Will you be traveling with other adults? Please list their names below as well as DOB along with your DOB. (Example: Susie Jones)&amp;nbsp;" name="-will-you-be-traveling-with-other-adults-please-list-their-names-below-example-susie-jones-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Will you be traveling with children? Please list their names and birthdates below. (Example: Susie Jones 1/3/2018)" name="will-you-be-traveling-with-children-please-list-their-names-and-birthdates-below-example-susie-jones-132018" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are you planning this trip as part of a group vacation?" name="are-you-planning-this-trip-as-part-of-a-group-vacation">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Desired Departure Date&amp;nbsp;" 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="Desired Return Date&amp;nbsp;" 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" required="true" label="Are Your Travel Dates Flexible?&amp;nbsp;" name="are-your-travel-dates-flexible-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do You Need Airfare?" name="do-you-need-airfare">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If airfare is needed, what airport(s) are you willing to depart from?" name="if-airfare-is-needed-what-airports-are-you-willing-to-depart-from" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Have you ever been on a cruise before?" name="have-you-ever-been-on-a-cruise-before">&#13;
			<option label="No, this will be my first cruise" value="no-this-will-be-my-first-cruise">No, this will be my first cruise</option>&#13;
			<option label="Yes, I'm a crusing expert" value="yes-im-a-crusing-expert">Yes, I'm a crusing expert</option>&#13;
		</field>&#13;
		<field type="text" label="How many nights would you like to be onboard?" name="how-many-nights-would-you-like-to-be-onboard" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What port would you want to sail from and return to?" name="what-port-would-you-want-to-sail-from-and-return-to" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What destination do you want to cruise to?" name="what-destination-do-you-want-to-cruise-to" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What type of atmosphere/ambiance would best describe what you&#39;re looking for? (Example: quiet, family-friendly, social, fun, adults only, active, etc.)" name="what-type-of-atmosphereambiance-would-best-describe-what-youre-looking-for-example-quiet-familyfriendly-social-fun-adults-only-active-etc" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Are there any specific excursions you would like to do while you are on your cruise? (Example: Snorkeling, Tours, Shopping, etc.)" name="are-there-any-specific-excursions-you-would-like-to-do-while-you-are-on-your-cruise-example-snorkeling-tours-shopping-etc" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What type of cabin do you want?" name="what-type-of-cabin-do-you-want">&#13;
			<option label="Interior Cabin" value="interior-cabin">Interior Cabin</option>&#13;
			<option label="Exterior Cabin" value="exterior-cabin">Exterior Cabin</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
			<option label="Other-please call me" value="otherplease-call-me">Other-please call me</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do you have a cabin location preference?" name="do-you-have-a-cabin-location-preference">&#13;
			<option label="Aft (Rear)" value="aft-rear">Aft (Rear)</option>&#13;
			<option label="Midship" value="midship">Midship</option>&#13;
			<option label="Forward (Front)" value="forward-front">Forward (Front)</option>&#13;
			<option label="Lower Deck" value="lower-deck">Lower Deck</option>&#13;
			<option label="Upper Deck" value="upper-deck">Upper Deck</option>&#13;
			<option label="Other-please call me" value="otherplease-call-me">Other-please call me</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Meal Times. Do you prefer to eat:" name="meal-times-do-you-prefer-to-eat">&#13;
			<option label="Earlier Dinners" value="earlier-dinners">Earlier Dinners</option>&#13;
			<option label="Late Dinners" value="late-dinners">Late Dinners</option>&#13;
			<option label="A mixture of both" value="a-mixture-of-both">A mixture of both</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do you want Travel Protection" name="do-you-want-travel-protection">&#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="Any &quot;must haves&quot;?" name="any-must-haves" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Any &quot;don&#39;t wants&quot;?" name="any-dont-wants" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your dream cruise vacation budget Per Person?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Under $1,500" value="under-1500">Under $1,500</option>&#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="text" label="Will you be celebrating anything during your vacation? (Example: Birthday, Anniversary, Honeymoon, Girl&#39;s Trip, etc.)" name="will-you-be-celebrating-anything-during-your-vacation-example-birthday-anniversary-honeymoon-girls-trip-etc" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Is there anything else I need to know about your vacation needs?" 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>

Terms & Conditions

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