Megan Dunn

Northcutt Travel Agency

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Honeymoon Request Form"/>&#13;
		<field type="text" required="true" label="First name" description="Make sure the name you are using is the one on govt ID or passport" 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="textarea" required="true" label="Please provide you partner's first name, last name, email and phone number" description="Make sure the name you are using is the one on govt ID or passport" name="please-provide-you-partners-first-name-last-name-email-and-phone-number" className="form-control"/>&#13;
		<field type="date" required="true" label="What is the date of the wedding?&amp;nbsp;" name="date-1730387670373" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to leave for your honeymoon?" name="date-1730387675551" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return home?&amp;nbsp;" name="date-1730387676653" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your honeymoon dates flexible?&amp;nbsp;" name="radio-group-1730387683240">&#13;
			<option label="Yes" value="yes" selected="selected">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How do you want to arrive in your honeymoon destination?" name="how-do-you-want-to-arrive-in-your-honeymoon-destination">&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Cruise Ship" value="cruise-ship">Cruise Ship</option>&#13;
			<option label="Driving" value="driving">Driving</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How far are you willing to travel?&amp;nbsp;" name="how-far-are-you-willing-to-travel-">&#13;
			<option label="Stay in the U.S. or Cruise- I have no passport." value="stay-in-the-us-or-cruise-i-have-no-passport">Stay in the U.S. or Cruise- I have no passport.</option>&#13;
			<option label="Less than 3 hours" value="less-than-3-hours">Less than 3 hours</option>&#13;
			<option label="4-6 hours" value="46-hours">4-6 hours</option>&#13;
			<option label="Doesn't matter" value="doesnt-matter">Doesn't matter</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you prefer an All-Inclusive option?" name="do-you-prefer-an-allinclusive-option">&#13;
			<option label="Yes! Absolutly, a must!" value="yes-absolutly-a-must">Yes! Absolutly, a must!</option>&#13;
			<option label="Nope! I like to explore the area!" value="nope-i-like-to-explore-the-area">Nope! I like to explore the area!</option>&#13;
			<option label="No preference!" value="no-preference">No preference!</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Will you need airfare?" name="will-you-need-airfare">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What is your Airline Preference?" name="what-is-your-airline-preference">&#13;
			<option label="Southwest" value="southwest">Southwest</option>&#13;
			<option label="United " value="united-">United </option>&#13;
			<option label="American Airlines" value="american-airlines">American Airlines</option>&#13;
			<option label="No preference!" value="no-preference">No preference!</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What are your seating preferences when flying?" description="check all that apply" name="what-are-your-seating-preferences-when-flying">&#13;
			<option label="Economy" value="economy">Economy</option>&#13;
			<option label="Business/ First" value="business-first">Business/ First</option>&#13;
			<option label="Window Seat" value="window-seat">Window Seat</option>&#13;
			<option label="Aisle Seat" value="aisle-seat">Aisle Seat</option>&#13;
			<option label="Opposite Aisle Seat" value="opposite-aisle-seat">Opposite Aisle Seat</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Hotel preference" name="hotel-preference">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What is the most important thing to you about the accommodations?" name="what-is-the-most-important-thing-to-you-about-the-accommodations">&#13;
			<option label="Pools/ Pool Access" value="pools-pool-access" selected="selected">Pools/ Pool Access</option>&#13;
			<option label="Resturants" value="resturants">Resturants</option>&#13;
			<option label="Bars" value="bars">Bars</option>&#13;
			<option label="Beach Access" value="beach-access">Beach Access</option>&#13;
			<option label="Room" value="room">Room</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Vibe preferences" name="vibe-preference">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBT" value="lgbt">LGBT</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activity preferences" name="activity-preferences" other="true">&#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="radio-group" label="What is your ALL IN budget PER traveler?" description="This includes, hotel/cruise, transfers, flights, travel insurance." name="what-is-your-all-in-budget-per-traveler">&#13;
			<option label="$1,500- $2,500" value="1500-2500">$1,500- $2,500</option>&#13;
			<option label="$2,600-$3, 500" value="26003-500">$2,600-$3, 500</option>&#13;
			<option label="$3,500- $6,500" value="3500-6500">$3,500- $6,500</option>&#13;
			<option label="$6,600- $8,500" value="6600-8500">$6,600- $8,500</option>&#13;
			<option label="more than $8, 500" value="more-than-8-500">more than $8, 500</option>&#13;
		</field>&#13;
		<field type="textarea" label="Where have you traveled in the past?" name="where-have-you-traveled-in-the-past" className="form-control"/>&#13;
		<field type="textarea" label="Can you provide 3 areas you would consider traveling to for your Honeymoon?" description="This gives us a great place to start finding some great stays for you!" placeholder="Costa Rica,  Virgin Islands, Bahamas" name="can-you-provide-3-areas-you-would-consider-traveling-to-for-your-honeymoon" className="form-control"/>&#13;
		<field type="text" required="true" label="Is there anything else you want to share with us regarding your travels?&amp;nbsp;" description="Special Accommodations, Diets, Must Dos or Must Sees, etc" name="is-there-anything-else-you-want-to-share-with-us-regarding-your-travels-" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>