Share your information with Leslie Kaczanowski

Leslie Kaczanowski

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Group Travel Request"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you so much for choosing me to help coordinate your group travel! I am so excited to work with you and make this trip the easiest one you have ever done! Please feel free to call or text me&amp;nbsp; at&amp;nbsp; 616-309-6944 with any questions or concerns&amp;nbsp; My average time to connect&amp;nbsp; is 48-72 hrs for group travel! *Filling out this form will automatically include you in my monthly newsletter email, if you wish to opt out, please say so in the comments at the bottom. "/>&#13;
		<field type="header" subtype="h2" label="Primary Contact 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="header" subtype="h2" label="Primary Contact (or Business) Address"/>&#13;
		<field type="text" required="true" 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" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" 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="textarea" required="true" label="Tell Me All About Your Group!" description="Give me as much detail as you can regarding your group!" name="tell-me-all-about-your-group" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What Type of Group Is This? " name="what-type-of-group-is-this-">&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Corporate Group" value="corporate-group">Corporate Group</option>&#13;
			<option label="Extended Family" value="extended-family">Extended Family</option>&#13;
			<option label="Church Group" value="church-group">Church Group</option>&#13;
			<option label="School Group" value="school-group">School Group</option>&#13;
			<option label="Missions Trip" value="missions-trip">Missions Trip</option>&#13;
			<option label="Social Group" value="social-group">Social Group</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Do you have accessibility needs?" name="do-you-have-accessibility-needs">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" label="Accessibility needs information" description="If Yes  please give me a little information to help me best serve you  If no feel free to skip :)" name="accessibility-needs-information" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Type of Vacation"/>&#13;
		<field type="select" required="true" label="Select" description="Country Tour I.E. England  Italy  Scotland  etc." name="select-1705945648040" className="form-control">&#13;
			<option label="SELECT" value="">SELECT</option>&#13;
			<option label="All Inclusive" value="all-inclusive">All Inclusive</option>&#13;
			<option label="County Tour" value="county-tour">County Tour</option>&#13;
			<option label="Within The United States" value="within-the-united-states">Within The United States</option>&#13;
			<option label="Disney Vacation" value="disney-vacation">Disney Vacation</option>&#13;
			<option label="Universal Vacation" value="universal-vacation">Universal Vacation</option>&#13;
			<option label="SeaWorld/Bush Gardens Vacation" value="seaworldbush-gardens-vacation">SeaWorld/Bush Gardens Vacation</option>&#13;
			<option label="Group Travel (School, Youth Group, Extended/Large Family, Corporate) - I am groups certified! " value="group-travel-school-youth-group-extendedlarge-family-corporate-i-am-groups-certified-">Group Travel (School, Youth Group, Extended/Large Family, Corporate) - I am groups certified! </option>&#13;
			<option label="Destination Wedding - I am groups certified!" value="destination-wedding-i-am-groups-certified">Destination Wedding - I am groups certified!</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="If other please describe your perfect vacation here!" name="if-other-please-describe-your-perfect-vacation-here" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" 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" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="No">No</option>&#13;
		</field>&#13;
		<field type="text" label="If yes, please give me the months you are considering, and or the time frame" description="I.e. Any 7 days in October 2025" name="if-yes-please-give-me-the-months-you-are-considering-and-or-the-time-frame" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Will you require airfare?" name="will-you-require-airfare" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="We are booking our own airfare" value="we-are-booking-our-own-airfare">We are booking our own airfare</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" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Do you have valid passports?" description="Passports that DO NOT expire for at least 6 months AFTER travel" name="do-you-have-valid-passports">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="We have applied for our passports" value="we-have-applied-for-our-passports">We have applied for our passports</option>&#13;
			<option label="We do not need passports for this trip" value="we-do-not-need-passports-for-this-trip">We do not need passports for this trip</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget total all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#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" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#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="What kind of vibe are you looking for?" description="Check all that apply." 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" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Water Sports" value="water sports">Water Sports</option>&#13;
			<option label="Family Fun Activites" value="family fun activites">Family Fun Activites</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Architecture Experiences" value="architecture-experiences">Architecture Experiences</option>&#13;
			<option label="Reading a book by a quiet pool" value="reading-a-book-by-a-quiet-pool">Reading a book by a quiet pool</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Arts and theater" value="arts-and-theater">Arts and theater</option>&#13;
			<option label="I'm a foodie!" value="im-a-foodie">I'm a foodie!</option>&#13;
			<option label="I prefer the beach" value="i-prefer-the-beach">I prefer the beach</option>&#13;
			<option label="I prefer the pool" value="i-prefer-the-pool">I prefer the pool</option>&#13;
			<option label="I love both pools and beaches" value="i-love-both-pools-and-beaches">I love both pools and beaches</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Anything you absolutely must do or see?" description="If nothing or you are not sure place NA" 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" required="true" label="Who can I thank for referring you?" name="who-can-i-thank-for-referring-you" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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