<form-template>
	<fields>
		<field type="header" subtype="h1" label="Legacy Travel Designs Client Qualifying Form"/>
		<field type="header" subtype="h2" label="Full name"/>
		<field required="true"  type="text" label="First name" name="first-name" subtype="text" className="form-control"/>
		<field required="true"  type="text" label="Last name" name="last-name" subtype="text" className="form-control"/>
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>
		<field type="text" label="Destination" name="destination" subtype="text" className="form-control"/>
		<field type="text" label="When are you planning to go and how flexible are you?" name="when-are-you-planning-to-go-and-how-flexible-are-you" subtype="text" className="form-control"/>
		<field type="textarea" label="Number of people, ages at time of travel and relationships?" name="number-of-people-ages-at-time-of-travel-and-relationships" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Any special requests regarding the accommodations or its features? Anyone with special needs or allergies? Anyone in the military?" name="any-special-requests-regarding-the-accommodations-or-its-features-anyone-with-special-needs-or-allergies-anyone-in-the-military" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Have you done any research?&amp;nbsp; What have you found?" name="have-you-done-any-research-what-have-you-found" subtype="textarea" className="form-control"/>
		<field type="textarea" label="What activities or sights are top priority for this trip?&amp;nbsp; Do you like to see a little bit of everything or a lot of a few things?" name="what-activities-or-sights-are-top-priority-for-this-trip" subtype="textarea" className="form-control"/>
		<field type="textarea" label="What are goals for the trip? Would you prefer a restful trip, an active one, or a combination of both?" name="would-you-prefer-a-restful-trip-an-active-one-or-a-combination-of-both" subtype="textarea" className="form-control"/>
		<field type="textarea" label="What was the best trip of your entire life?&amp;nbsp; Why? Worst trip and Why?" name="what-was-the-best-trip-of-your-entire-life-why-worst-trip-and-why" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Best Accommodations and Worst Accommodations?" name="best-accommodations-and-worst-accommodations" subtype="textarea" className="form-control"/>
		<field type="textarea" label="Likes and Dislikes of other trips you've taken?" name="likes-and-dislikes-of-other-trips-youve-taken" subtype="textarea" className="form-control"/>
		<field type="text" label="Flight arrangements? If so, what airports? Coach, business or first class?" name="flight-arrangements-if-so-what-airports-coach-business-or-first-class" subtype="text" className="form-control"/>
		<field type="textarea" label="I'm going to read off some travel interests and activities.&amp;nbsp; Stop me if you hear any that would interest you and your traveling companions." name="im-going-to-read-off-some-travel-interests-and-activities-stop-me-if-you-hear-any-that-would-interest-you-and-your-traveling-companions" subtype="textarea" className="form-control"/>
		<field type="text" label="What is your budget for the trip?" name="what-is-your-budget-for-the-trip" subtype="text" className="form-control"/>
		<field type="text" label="Best method of communication?" name="best-method-of-communication" subtype="text" className="form-control"/>
		<field type="text" label="I'm so excited for you.&amp;nbsp; You are going to have an awesome time!&amp;nbsp; You've done the right thing by reaching out to me.&amp;nbsp; Have you worked with a travel professional before? Well, I'd like to take some time to explain why my clients like working with me and about the services we offer" name="im-so-excited-for-you-you-are-going-to-have-an-awesome-time-youve-done-the-right-thing-by-reaching-out-to-me-have-you-worked-with-a-travel-professional-before-well-id-like-to-take-some-time-to-explain-why-my-clients-like-working-with-me-and-about-the-services-we-offer" subtype="text" className="form-control"/>
	</fields>
</form-template>

Enter the amount you would like to authorize:

Please add or choose card to authorize:

Sign and agree to the terms and conditions:

By signing below, I authorize Legacy Travel Designs to charge the credit card provided herein.

Click to sign