Share your information with Patrick & Mandi Emery

Patrick & Mandi Emery

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="select" required="true" label="What type of Vacation are you looking for?" name="what-type-of-vacation-are-you-looking-for" className="form-control">&#13;
			<option label="Cruise - Ocean  (NCL, Celebrity, Holland, Royal Caribbean, Virigin, etc)" value="cruise-ocean-ncl-celebrity-holland-royal-caribbean-virigin-etc">Cruise - Ocean  (NCL, Celebrity, Holland, Royal Caribbean, Virigin, etc)</option>&#13;
			<option label="All Inclusive  ( Secrets, Sandals, Iberostars, etc)" value="all-inclusive-secrets-sandals-iberostars-etc">All Inclusive  ( Secrets, Sandals, Iberostars, etc)</option>&#13;
			<option label="Guided Group Tour (Domestic)  example:  Yellowstone, Washington D.C.  Grand Canyon" value="guided-group-tour-domestic-example-yellowstone-washington-dc-grand-canyon">Guided Group Tour (Domestic)  example:  Yellowstone, Washington D.C.  Grand Canyon</option>&#13;
			<option label="Guided Group Tour (International)  Europe, Ireland, England, Canada" value="guided-group-tour-international-europe-ireland-england-canada">Guided Group Tour (International)  Europe, Ireland, England, Canada</option>&#13;
			<option label="Disney World (Florida)" value="disney-world-florida">Disney World (Florida)</option>&#13;
			<option label="Other Disney (Disneyland, EuroDisney, etc)" value="other-disney-disneyland-eurodisney-etc">Other Disney (Disneyland, EuroDisney, etc)</option>&#13;
			<option label="Cruise - River  (Viking, AMA)" value="cruise-river-viking-ama">Cruise - River  (Viking, AMA)</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#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" 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" 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="textarea" label="If children please list ages" name="if-children-please-list-ages" className="form-control"/>&#13;
		<field type="select" label="Age Range" name="age-range" className="form-control">&#13;
			<option label="Under 21" value="under-21">Under 21</option>&#13;
			<option label="21-30" value="2130">21-30</option>&#13;
			<option label="31-40" value="3140">31-40</option>&#13;
			<option label="41-50" value="4150">41-50</option>&#13;
			<option label="51-60" value="5160">51-60</option>&#13;
			<option label="61-70" value="6170">61-70</option>&#13;
			<option label="70+" value="70">70+</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." 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="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" label="What activities are you interested in?" description="Check all that apply" 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="art-theater">Arts and theater</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>