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Adrian Moseley

Stamped Passports & Destinations

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Travel Request Inquiry"/>&#13;
		<field type="paragraph" subtype="p" label="Welcome to Stamped Passports &amp;amp; Destinations! Whether you’re dreaming of exploring vibrant cities abroad, relaxing on sun-soaked beaches, or discovering family-friendly adventures off the beaten path, I’m here to make it seamless. Share your travel wishes with me and I’ll create a customized itinerary that fits your style, budget, and pace—so all you need to do is pack your bags and enjoy the journey."/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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 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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Details"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" 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" required="true" 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="checkbox-group" required="true" label="Include In Booking" toggle="true" inline="true" name="includeinbooking" other="true">&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Hotel, Villa, Condo" value="hotel-villa-condo">Hotel, Villa, Condo</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Airport To Hotel Transfers" value="airport-to-hotel-transfers">Airport To Hotel Transfers</option>&#13;
			<option label="Train" value="train">Train</option>&#13;
			<option label="Meals" value="meals">Meals</option>&#13;
			<option label="Excursions" value="excursions">Excursions</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." inline="true" name="budget">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="If applicable, What best describes your hotel preference?" inline="true" name="hotel-preference" other="true">&#13;
			<option label="N/A" value="na" selected="selected">N/A</option>&#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="If applicable, What best describes your flight seating experience?" inline="true" name="if-applicable-what-best-describes-your-flight-seating-experience">&#13;
			<option label="N/A" value="na" selected="selected">N/A</option>&#13;
			<option label="Basic Economy" value="basic-economy">Basic Economy</option>&#13;
			<option label="Economy" value="economy">Economy</option>&#13;
			<option label="Premium Economy" value="premium-economy">Premium Economy</option>&#13;
			<option label="First Class" value="first-class">First Class</option>&#13;
			<option label="Business" value="business">Business</option>&#13;
		</field>&#13;
		<field type="radio-group" label="If applicable, what size car rental will you need?" inline="true" name="if-applicable-what-size-car-rental-will-you-need" other="true">&#13;
			<option label="N/A" value="na" selected="selected">N/A</option>&#13;
			<option label="Compact/Economy" value="compacteconomy">Compact/Economy</option>&#13;
			<option label="Full Size" value="full-size">Full Size</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Standard" value="standard">Standard</option>&#13;
			<option label="SUV/Van/Pickup" value="suvvanpickup">SUV/Van/Pickup</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." inline="true" name="vibe-preference" other="true">&#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;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" inline="true" 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 theater" value="arts-and-theater">Arts and theater</option>&#13;
			<option label="Rest and Relaxation" value="rest-and-relaxation">Rest and Relaxation</option>&#13;
			<option label="History and Culture" value="history-and-culture">History and Culture</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;
	</fields>&#13;
</form-template>
  </body>
</html>