Katie Franks

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" 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" label="Middle name" name="middle-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="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<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"/>&#13;
		<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"/>&#13;
		<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"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please list names and DOB of additional traveler(s) as it would read on a passport. " name="please-list-names-and-dob-of-additional-travelers-as-it-would-read-on-a-passport-" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1739468255179" value="Please note that Mae Claire Travel does not book vacations with points and/or miles." subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your per person budget for this vacation? " description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$2,500-$3,500" value="25003500">$2,500-$3,500</option>&#13;
			<option label="$3,500 to $5,000" value="3500-to-5000">$3,500 to $5,000</option>&#13;
			<option label="$5,000 to $7,500" value="">$5,000 to $7,500</option>&#13;
			<option label="$7,500 to $10,000" value="">$7,500 to $10,000</option>&#13;
			<option label="$10,000 to $12,500" value="">$10,000 to $12,500</option>&#13;
			<option label="$12,500 to $15,000" value="12500-to-15000">$12,500 to $15,000</option>&#13;
			<option label="Trip of a lifetime!!!" value="trip-of-a-lifetime">Trip of a lifetime!!!</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#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="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">&#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="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1739468350339" value="Please make sure your passport is valid 6 months from the RETURN date of your travels. If not  renew now" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Text Field" name="text-1743258396672" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>