<html> <body> <form-template> <fields> <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="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Street address" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zipcode" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="textarea" label="What is your preferred home airport?" name="what-is-your-preferred-home-airport" 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> <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="text" label="Do you have hotel(s) in mind already?" name="do-you-have-hotels-in-mind-already" subtype="text" className="form-control"/> <field type="textarea" required="true" label="How many people will be traveling with you? What is/are full their name(s) and relation to you? For children please also specify their age at time of travel." name="how-many-people-will-be-traveling-with-you-what-isare-full-their-names-and-relation-to-you-for-children-please-also-specify-their-age-at-time-of-travel" className="form-control"/> <field type="radio-group" required="true" label="What is your approximate nightly budget for accommodations only?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="Under $500" value="under-500">Under $500</option> <option label="$500-750" value="500750">$500-750</option> <option label="$750-1,000" value="7501000">$750-1,000</option> <option label="$1,000-1,500" value="10001500">$1,000-1,500</option> <option label="$1,500-2,000" value="15002000">$1,500-2,000</option> <option label="$2000 and up" value="2000-and-up">$2000 and up</option> </field> <field type="textarea" required="true" label="What is your overall budget for this trip?" description="If you aren't sure just an idea is helpful!" name="what-is-your-overall-budget-for-this-trip" className="form-control"/> <field type="radio-group" required="true" label="Are you interested in a custom itinerary, or are you just looking for help with accommodations?" name="are-you-interested-in-a-custom-itinerary-or-are-you-just-looking-for-help-with-accommodations"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Maybe" value="maybe">Maybe</option> </field> <field type="radio-group" required="true" label="Would you like help booking flights?" name="would-you-like-help-booking-flights"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Maybe" value="maybe">Maybe</option> </field> <field type="textarea" required="true" label="What is your main inspiration for this trip?" name="what-is-your-main-inspiration-for-this-trip" className="form-control"/> <field type="textarea" label="Will you be celebrating a special occasion?" name="will-you-be-celebrating-a-special-occasion" className="form-control"/> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="textarea" label="Are there any hotel amenities that are important to you?&nbsp;" description="Things like a pool fitness center restaurant on-site etc." name="are-there-any-hotel-amenities-that-are-important-to-you-" className="form-control"/> <field type="textarea" label="What is the best trip you've ever taken? What made this trip feel so special?" name="what-is-the-best-trip-youve-ever-taken-what-made-this-trip-feel-so-special" className="form-control"/> <field type="textarea" label="Do you have a favorite hotel that you've stayed at? What made this hotel so memorable?" name="do-you-have-a-favorite-hotel-that-youve-stayed-at-what-made-this-hotel-so-memorable" className="form-control"/> <field type="textarea" label="Does anyone in your party have mobility issues?&nbsp;" name="does-anyone-in-your-party-have-mobility-issues-" className="form-control"/> <field type="textarea" required="true" label="Does anyone in your party have allergies or food preferences?&nbsp;" name="does-anyone-in-your-party-have-allergies-or-food-preferences-" rows="0" className="form-control"/> <field type="textarea" required="true" label="How did you hear about Natalie Kurtzman Travel?" name="how-did-you-hear-about-natalie-kurtzman-travel" className="form-control"/> <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"/> <field type="radio-group" label="Would you like to receive Natalie's newsletter?" name="would-you-like-to-receive-natalies-newsletter"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Already on the list!" value="already-on-the-list">Already on the list!</option> </field> <field type="paragraph" subtype="p" label="Planning fees for custom itineraries start at $500 (for long weekend trips) and $900 (week-long trips) for two adults. I will be happy to share a custom quote if you are interested in our itinerary services. All trips require a credit card guarantee (even hotel-only bookings). If you choose not to book, there will be a $100 planning fee charged to your credit card on file. A secure credit card form will be emailed to you once I receive your trip inquiry."/> </fields> </form-template> </body> </html>
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