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Jessica Hagerty
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<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Vacation Inquiry"/> <field type="header" subtype="h1" label="Let's Get Planning!"/> <field type="paragraph" subtype="p" label="I am so excited to work with you to plan your next adventure! Please fill out the form below and be as detailed as you can. This information helps me to create travel proposals tailored to your wants and needs! If you are unsure on an area, don't worry, we can tweak as we go. Thank you and I look forward to speaking with you! - Jessica"/> <field type="header" subtype="h2" label="Full name"/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-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" label="Preferred name" name="preferred-name" 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="Email" name="email" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="paragraph" subtype="p" label="Why am I asking for your address up front? I use your address for accurate proposal pricing &nbsp;(residence/state discounts) and also in the event that I need to place a hold on a proposed travel package to ensure you have time to review and make a decision!"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" 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" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Information"/> <field type="radio-group" required="true" label="What type of vacation are you inquiring about?" name="radio-group-1720467029701"> <option label="Cruise" value="cruise">Cruise</option> <option label="All-Inclusive" value="allinclusive">All-Inclusive</option> <option label="Resort" value="">Resort</option> <option label="Europe" value="europe">Europe</option> <option label="Domestic (United States)" value="domestic-united-states">Domestic (United States)</option> <option label="Other" value="other">Other</option> </field> <field type="select" required="true" label="Are you celebrating anything special with this trip?" name="are-you-celebrating-anything-special-with-this-trip" multiple="multiple" className="form-control"> <option label="First Visit" value="first-visit">First Visit</option> <option label="Birthday" value="birthday">Birthday</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Wedding" value="wedding">Wedding</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Babymoon" value="babymoon">Babymoon</option> <option label="Bachelor/ette Party" value="bachelorette-party">Bachelor/ette Party</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" 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="radio-group" required="true" label="You are:" name="how-soon-are-you-looking-to-book-"> <option label="100% - Ready to book when we find the right option" value="100-ready-to-book-when-we-find-the-right-option">100% - Ready to book when we find the right option</option> <option label="50% - Interested but unsure still" value="50-interested-but-unsure-still">50% - Interested but unsure still</option> <option label="> 50% - Just exploring options" value="-50-just-exploring-options">> 50% - Just exploring options</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" required="true" label="When would you like to travel? Number of nights, specific dates, etc." description="Be sure to specify the year of travel!" name="when-would-you-like-to-travel" className="form-control"/> <field type="checkbox-group" required="true" 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="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Full Legal Names, Date of Birth, Email and Gender for entire party:" name="firstlast-name-birthdate-gender" className="form-control"/> <field type="select" required="true" label="Does anyone in this booking qualify for any of the following discount considerations?" name="does-anyone-in-this-booking-qualify-for-any-of-the-following-discount-considerations" multiple="multiple" className="form-control"> <option label="Not Applicable" value="not-applicable">Not Applicable</option> <option label="Military" value="military">Military</option> <option label="Teacher" value="teacher">Teacher</option> <option label="First Responder" value="first-responder">First Responder</option> <option label="Florida Resident" value="">Florida Resident</option> <option label="Senior" value="senior">Senior</option> <option label="Other" value="other">Other</option> </field> <field type="text" label="If you chose a discount qualifier above, please give details on the qualifier and who it applies to:" name="if-you-chose-a-discount-qualifier-above-please-give-details-on-the-qualifier-and-who-it-applies-to" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do you need flights as part of this booking?" name="do-you-need-flights-as-part-of-this-booking"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Unsure" value="unsure">Unsure</option> </field> <field type="text" label="What is your departure city/airport?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="checkbox-group" label="Flight options" description="Basic Economy is non refundable No Changes and no luggage" name="which-flight-option-are-you-interested-in"> <option label="Basic Economy" value="basic economy">Basic Economy</option> <option label="Main Cabin" value="main cabin">Main Cabin</option> <option label="Premium Economy" value="premium economy">Premium Economy</option> <option label="Business Class" value="business class">Business Class</option> <option label="First Class" value="first-class">First Class</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="text" required="true" label="What vibe are you going for? Quiet / party / activities / adults only / family friendly etc." name="what-vibe-are-you-going-for-quiet-party-activities-adults-only-family-friendly-etc" subtype="text" className="form-control"/> <field type="textarea" label="Any Food Allergies/Medical Conditions/Special Needs to be made aware of?&nbsp;" description="(Diabetic Autism Spectrum Wheelchair Gluten-free Etc.)" name="any-food-allergiesmedical-conditions-to-be-made-aware-of-" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$1,500 to $3,500" value="1500-to-3500">$1,500 to $3,500</option> <option label="$3,500 to $6,000" value="3500-to-6000">$3,500 to $6,000</option> <option label="$6,000 to $9,000" value="6000-to-9000">$6,000 to $9,000</option> <option label="$9,000 to $15,000" value="9000-to-15000">$9,000 to $15,000</option> <option label="$15,000 to $25,000" value="15000-to-25000">$15,000 to $25,000</option> <option label="$25,000+" value="25000">$25,000+</option> <option label="Unsure" value="unsure">Unsure</option> </field> <field type="radio-group" required="true" label="If this is an international trip, or a cruise where passport is needed, do ALL members of your party have a passport with at least 6 months left of validity?" name="if-this-is-an-international-trip-or-a-cruise-where-passport-is-needed-do-all-members-of-your-party-have-a-passport-with-at-least-6-months-left-of-validity"> <option label="Yes" value="yes">Yes</option> <option label="No, but the application has been submitted" value="no-but-the-application-has-been-submitted">No, but the application has been submitted</option> <option label="No, at least one person in the group needs a passport" value="no-at-least-one-person-in-the-group-needs-a-passport">No, at least one person in the group needs a passport</option> <option label="N/A domestic trip or cruise where birth certificate is allowable" value="na-domestic-trip-or-cruise-where-birth-certificate-is-allowable">N/A domestic trip or cruise where birth certificate is allowable</option> <option label="Other" value="other">Other</option> </field> <field type="header" subtype="h1" label="Group Cruises Only"/> <field type="header" subtype="h3" label="Adults/Kids per Cabin"/> <field type="text" label="Text Field" name="text-1769718497746" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Wrap Up"/> <field type="textarea" label="Who can I thank for referring you to me?" name="who-can-i-thank-for-referring-you-to-me" className="form-control"/> <field type="textarea" label="Is there anything else you 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"/> <field type="radio-group" required="true" label="May I contact you by both email and text message?" name="may-i-contact-you-by-both-email-and-text-message"> <option label="Yes, both are good!" value="yes-both-are-good">Yes, both are good!</option> <option label="Email only, please." value="email-only-please">Email only, please.</option> </field> <field type="header" subtype="h1" label="Quote Terms &amp; Conditions"/> </fields> </form-template> </body> </html>
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