<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="header" subtype="h2" label="Full name"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="Are all of your passports valid (meaning they have 6 months BEYOND your return date left before expiration)? If not, have you started the process of renewing and if so on which date did you start?*" name="are-all-of-your-passports-valid-meaning-they-have-6-months-beyond-your-return-date-left-before-expiration-if-not-have-you-started-the-process-of-renewing-and-if-so-on-which-date-did-you-start" className="form-control"/> <field type="checkbox-group" label="Do you need assistance with booking airfare?&nbsp;&nbsp;" name="do-you-need-assistance-with-booking-airfare-"> <option label="Yes, please assist." value="yes-please-assist">Yes, please assist.</option> <option label="No, I will be booking directly with miles or points." value="no-i-will-be-booking-directly-with-miles-or-points">No, I will be booking directly with miles or points.</option> </field> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Important Dates"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="textarea" label="Who are you traveling with and what are their ages and dates of birth?&nbsp;" name="who-are-you-traveling-with-and-what-are-their-ages-" className="form-control"/> <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury " value="luxury-">Luxury </option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="textarea" label="What are your room/bed preferences? &nbsp;" description="Number of rooms connecting rooms suite bed sizes specific view requests etc..." name="what-are-your-room-preferences-" className="form-control"/> <field type="text" label="How would you describe your travel style?&nbsp;&nbsp;" name="how-would-you-describe-your-travel-style-" subtype="text" className="form-control"/> <field type="textarea" label="Anything that you must see or do?&nbsp;" name="anything-that-you-must-see-or-do-" className="form-control"/> <field type="text" label="Are there any mobility or dietary restrictions to be aware of?&nbsp;&nbsp;" name="are-there-any-mobility-or-dietary-restrictions-to-be-aware-of-" subtype="text" className="form-control"/> <field type="radio-group" label="What is your travel investment for all travelers (not including airfare or food)?&nbsp;&nbsp;" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$5,000 to 8,000" value="5000-to-8000">$5,000 to 8,000</option> <option label="$7,000 to 10,000" value="7000-to-10000">$7,000 to 10,000</option> <option label="$10,000 to 12,000" value="10000-to-12000">$10,000 to 12,000</option> <option label="$12,000 to 15,000" value="12000-to-15000">$12,000 to 15,000</option> <option label="$15,000 to 20,000" value="15000-to-20000">$15,000 to 20,000</option> <option label="$20,000+" value="20000">$20,000+</option> </field> <field type="radio-group" label="Which LK Travel planning package are you interested in? Pricing listed is a starting point. Your invoice will be finalized after your intro call." description="See www.lktravelexperience.com for more information about fees" name="i-understand-there-is-a-nonrefundable-trip-research-and-planning-fee-associated-with-booking-custom-travel-with-lk-travel-upon-payment-of-fee-trip-planning-will-begin-"> <option label="7-day custom itinerary: $400" value="7day-custom-itinerary-400">7-day custom itinerary: $400</option> <option label="8 to12-day custom itinerary: $525" value="8-to12day-custom-itinerary-525">8 to12-day custom itinerary: $525</option> <option label="12 to16-day custom itinerary: $700" value="12-to16day-custom-itinerary-700">12 to16-day custom itinerary: $700</option> <option label="Hotels only (research & booking): $250 (up to 5 hotel options)" value="hotels-only-research-booking-250-up-to-5-hotel-options">Hotels only (research & booking): $250 (up to 5 hotel options)</option> <option label="Express Booking (includes VIP perks at partner hotels, no research): Complimentary" value="express-booking-includes-vip-perks-at-partner-hotels-no-research-complimentary">Express Booking (includes VIP perks at partner hotels, no research): Complimentary</option> </field> <field type="textarea" label="Additional Information" description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="text" label="Who can we thank for referring you?&nbsp;&nbsp;" name="who-can-we-thank-for-referring-you-" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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