<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Ahead of a complimentary consult, please complete this short form so we can get right into the fun stuff&nbsp;on our call!"/> <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="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" required="true" 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" 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="text" required="true" label="Where would you like to travel?" name="where-would-you-like-to-travel" 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> </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="text" required="true" label="Who will be traveling? How many people and ages of children?" name="who-will-be-traveling-how-many-people-and-ages-of-children" subtype="text" className="form-control"/> <field type="text" required="true" label="How much would you like to spend? (Not including airfare/ flights)" name="what-is-your-budget" subtype="text" className="form-control"/> <field type="text" label="What are you NOT willing to compromise on? What is most important to you for this trip?" name="what-are-you-not-willing-to-compromise-on-what-is-most-important-to-you-for-this-trip" subtype="text" className="form-control"/> <field type="text" label="Tell me about one or two of your favorite hotels or past trips." name="tell-me-about-one-or-two-of-your-favorite-hotels" subtype="text" className="form-control"/> <field type="text" label="Besides this trip you are currently planning, where else would you like to travel in the next 3-5 years?" name="besides-this-trip-you-are-currently-planning-where-else-would-you-like-to-travel-in-the-next-35-years" subtype="text" className="form-control"/> <field type="select" label="Do you prefer to communicate by phone or email?" name="do-you-prefer-to-communicate-by-phone-or-email" className="form-control"> <option label="Email" value="email">Email</option> <option label="Phone " value="phone-">Phone </option> </field> <field type="checkbox-group" label="If traveling internationally, does everyone in your party have a passport that will be valid for at least 6 months after the planned end date of your trip?" name="if-traveling-internationally-does-everyone-in-your-party-have-a-passport-that-will-be-valid-for-at-least-6-months-after-the-planned-end-date-of-your-trip"> <option label="Yes" value="yes">Yes</option> <option label="No (please explain below)" value="no-please-explain-below">No (please explain below)</option> </field> <field type="text" label="Does anyone in your party have any medical conditions, dietary restrictions or allergies we should be aware of?&nbsp;" name="does-anyone-in-your-party-have-any-medical-conditions-dietary-restrictions-or-allergies-we-should-be-aware-of-" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Do you intend to use "points" or another external service (ie AmEx or Airbnb) to book any portion of your trip or do you already have some elements of your trip booked? If yes, please let us know and we'll be sure to discuss that in detail on our call.&nbsp;" inline="true" name="do-you-intend-to-use-points-to-book-any-portion-of-your-trip"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your budget and/or travel preferences?" name="notes" className="form-control"/> <field type="paragraph" subtype="p" label="Videre Travel provides custom trip design, planning and management services. Our service fee starts at $500 per trip. Custom itineraries include all the big things of course, like accommodations, as well as countless smaller details. The magic lies in the way we pull all the parts of the itinerary together to ensure your trip is seamless and unforgettable. Please note that pricing is always presented as a bundled rate and in most cases itemized pricing is not possible.&nbsp;&nbsp;"/> </fields> </form-template> </body> </html>
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