Share your information with Avery Miller

Avery Miller

Getting Away Today

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let’s start planning your next trip!"/>&#13;
		<field type="paragraph" subtype="p" label="Complete the form below to share a few details about your trip. From there, I’ll create a personalized travel plan tailored to your interests, budget, and style."/>&#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="pageBreak" name="pageBreak-1770745574436" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h1" label="Tell Me About Your Trip"/>&#13;
		<field type="paragraph" subtype="p" label="Just the basics; this helps me understand the framework of your trip."/>&#13;
		<field type="text" required="true" label="Where would you like to go?" placeholder="e.g. Hawaii" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Trip Type" name="select-1770745888467" className="form-control">&#13;
			<option label="Leisure" value="leisure">Leisure</option>&#13;
			<option label="Business" value="business">Business</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Family Vacation" value="family-vacation">Family Vacation</option>&#13;
			<option label="Group Trip" value="group-trip">Group Trip</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="When would you like to depart?" name="date-1770745749151" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" name="date-1770745779183" className="form-control"/>&#13;
		<field type="select" required="true" label="How flexible are your travel dates?" name="select-1770746177715" className="form-control">&#13;
			<option label="Exact" value="exact">Exact</option>&#13;
			<option label="±1 – 2 days" value="1-2-days">±1 – 2 days</option>&#13;
			<option label="Flexible week" value="flexible-week">Flexible week</option>&#13;
			<option label="No set dates yet" value="no-set-dates-yet">No set dates yet</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your departure city?" placeholder="e.g. Springfield, PA" name="where-are-you-departing-from" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Estimated Budget per Person (USD)" name="radio-group-1770746268414" other="true">&#13;
			<option label="Under $1,500" value="under-1500">Under $1,500</option>&#13;
			<option label="$1,500 – $3,000" value="1500-3000">$1,500 – $3,000</option>&#13;
			<option label="$3,000 – $5,000" value="3000-5000">$3,000 – $5,000</option>&#13;
			<option label="$5,000+" value="5000">$5,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you rather?" name="would-you-rather">&#13;
			<option label="Earn hotel and airline loyalty points" value="earn-hotel-and-airline-loyalty-points">Earn hotel and airline loyalty points</option>&#13;
			<option label="Book through the most economical means" value="book-through-the-most-economical-means">Book through the most economical means</option>&#13;
		</field>&#13;
		<field type="pageBreak" name="pageBreak-1770746601795" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h1" label="Traveler Information"/>&#13;
		<field type="select" required="true" label="How many travelers including yourself?" name="how-many-travelers-including-yourself" className="form-control">&#13;
			<option label="1" value="1" selected="selected">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9+" value="9">9+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What services do you need booked?" name="checkbox-group-1770746982443" other="true">&#13;
			<option label="Air" value="air">Air</option>&#13;
			<option label="Airport Transfers" value="airport-transfers">Airport Transfers</option>&#13;
			<option label="Car" value="car">Car</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="None" value="none">None</option>&#13;
			<option label="Train" value="train">Train</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like to receive a list of bookable excursions and activities to enhance your trip?" name="would-you-like-to-receive-a-list-of-bookable-excursions-and-activities-to-enhance-your-trip">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="pageBreak" name="pageBreak-1770747300773" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h1" label="Anything Else?"/>&#13;
		<field type="text" label="Is there anything you must see or do?" placeholder="e.g. iconic landmarks, food tours, scenic hikes" name="is-there-anything-you-must-see-or-do" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Are there any aspects of travel that you don&#39;t enjoy or want to avoid?" placeholder="e.g. early flights, crowded attractions, large group tours" name="are-there-any-aspects-of-travel-that-you-dont-enjoy-or-want-to-avoid" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Additional Notes" placeholder="What else would you like me to know?" name="textarea-1770747438605" className="form-control"/>&#13;
		<field type="select" required="true" label="How soon do you plan to book?" name="select-1770747540510" className="form-control">&#13;
			<option label="This week" value="this-week">This week</option>&#13;
			<option label="Within 2 weeks" value="within-2-weeks">Within 2 weeks</option>&#13;
			<option label="This month" value="this-month">This month</option>&#13;
			<option label="Just exploring options" value="just-exploring-options">Just exploring options</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>