Share your information with Faith Miller

Faith Miller

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    <form-template>&#13;
	<fields>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Preliminary Trip Planning"/>&#13;
		<field type="header" subtype="h1" label="Acknowledgment REQUIRED"/>&#13;
		<field type="checkbox-group" required="true" label="By submitting this form, I confirm that I am not currently working with another travel agent/advisor or making direct bookings." name="by-completing-this-form-i-certify-that-i-am-not-working-with-another-travel-agentadvisor-or-booking-directly">&#13;
			<option label="I agree" value="i-agree">I agree</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Contact Information"/>&#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" required="true" 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="checkbox-group" required="true" label="Preferred Method of Contact" name="preferred-method-of-contact">&#13;
			<option label="Phone Call" value="phone-call">Phone Call</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="How Did You Hear About Adventures by Faith?" name="how-did-you-hear-about-adventures-by-faith" other="true">&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="TikTok/Lemon8" value="tiktoklemon8">TikTok/Lemon8</option>&#13;
			<option label="LinkedIN" value="linkedin">LinkedIN</option>&#13;
			<option label="Google Search" value="google-search">Google Search</option>&#13;
			<option label="Vendor Show" value="vendor-show">Vendor Show</option>&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Trip Overview"/>&#13;
		<field type="checkbox-group" required="true" label="What Type of Trip Are You Planning?" name="what-type-of-trip-are-you-planning">&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Bachelor/Bachelorette Trip" value="bachelorbachelorette-trip">Bachelor/Bachelorette Trip</option>&#13;
			<option label="Birthday/Milestone Trip" value="birthdaymilestone-trip">Birthday/Milestone Trip</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Group Trip" value="group-trip">Group Trip</option>&#13;
			<option label="Corporate/Retreat/Incentive" value="corporateretreatincentive">Corporate/Retreat/Incentive</option>&#13;
			<option label="Just a Getaway" value="just-a-getaway">Just a Getaway</option>&#13;
			<option label="Not Sure Yet" value="not-sure-yet">Not Sure Yet</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Destination(s)" name="destinations" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departure Date" name="departure-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Return Date" name="return-date" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Is your date flexible?" inline="true" name="is-your-date-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Departure Airport or City" description="Detroit  DTW  Chicago  MDW  ORD" name="departure-airport-or-city" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Number of Travelers" name="number-of-travelers" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5+" value="5+">5+</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Names &amp;amp; Ages of &amp;nbsp;ALL Travelers" description="To ensure accurate pricing  all members of your party need to be listed with their name and birthdates." name="ages-of-travelers" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Budget"/>&#13;
		<field type="select" required="true" label="Estimated Total Budget" name="estimated-total-budget" className="form-control">&#13;
			<option label="&lt; $5,000" value="-5000">&lt; $5,000</option>&#13;
			<option label="$5,000-$7,000" value="50007000">$5,000-$7,000</option>&#13;
			<option label="$7,000-$10,000" value="700010000">$7,000-$10,000</option>&#13;
			<option label="&gt;$10,000" value="10000">&gt;$10,000</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What Should This Budget Include?" description="Transfers are taxis to your resort from the airport. Excursions are activities you can do in a destination." name="what-should-this-budget-include">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Hotel/Resort" value="hotelresort">Hotel/Resort</option>&#13;
			<option label="Excursions" value="excursions">Excursions</option>&#13;
			<option label="Transfers" value="transfers">Transfers</option>&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Style"/>&#13;
		<field type="radio-group" label="Airline Seat Preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite Aisle" value="opposite-aisle">Opposite Aisle</option>&#13;
			<option label="Middle" value="middle">Middle</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Hotel Preference" description="Budget is generally under $150 a night. Moderate is generally under $300 a night. Luxury is generally $500+ a night. Boutique hotels can range in price from Moderate to Luxury prices." name="hotel-preference">&#13;
			<option label="Budget" value="budget">Budget</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="Bed Preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What Best Describes Your Travel Style?" 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;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBT" value="lgbt">LGBT</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activity Preferences" 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 theatre" value="art-theatre">Arts and theatre</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Accessibility &amp;amp; Special Needs"/>&#13;
		<field type="select" required="true" label="Any Mobility Concerns or Accessibility Needs?" name="any-mobility-concerns-or-accessibility-needs" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="textarea" label="Explain Your Mobility Concerns or Accessibility Needs" name="explain-your-mobility-concerns-or-accessibility-needs" className="form-control"/>&#13;
		<field type="select" required="true" label="Any Food Allergies or Dietary Restrictions?" name="any-food-allergies-or-dietary-restrictions" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="textarea" label="Explain Your Food Allergies or Dietary Restrictions" name="explain-your-food-allergies-or-dietary-restrictions" className="form-control"/>&#13;
		<field type="select" label="Any Medical or Sensory Considerations?" name="any-medical-or-sensory-considerations" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Explain Your Medical or Sensory Needs" name="explain-your-medical-or-sensory-needs" className="form-control"/>&#13;
		<field type="select" required="true" label="Will You Be Traveling with a Service Animal?" name="will-you-be-traveling-with-a-service-animal" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Option 3" value="option-3">Option 3</option>&#13;
		</field>&#13;
		<field type="textarea" label="Explain What Type of Service Animal and Your Needs" name="explain-what-type-of-service-animal-and-your-needs" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Dream &amp;amp; Luxury Touches"/>&#13;
		<field type="textarea" label="If Money Weren&#39;t a Factor, What Would Your Ideal Trip Look Like?" name="if-money-werent-a-factor-what-would-your-ideal-trip-look-like" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are There Any Luxury Experiences You&#39;d Love to Include?" name="are-there-any-luxury-experiences-youd-love-to-include" other="true">&#13;
			<option label="Butler Service" value="butler-service">Butler Service</option>&#13;
			<option label="Overwater Bungalow" value="overwater-bungalow">Overwater Bungalow</option>&#13;
			<option label="Swim-Up Suite" value="swimup-suite">Swim-Up Suite</option>&#13;
			<option label="Private Yacht" value="private-yacht">Private Yacht</option>&#13;
			<option label="Spa/Wellness Retreat" value="spawellness-retreat">Spa/Wellness Retreat</option>&#13;
			<option label="Fine Dining" value="fine-dining">Fine Dining</option>&#13;
			<option label="First-Class Flights" value="firstclass-flights">First-Class Flights</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Are You A Member of Any Loyalty Programs?"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs You Are A Member Of" description="Please add any loyalty memberships you have so that I can check for discounts before I send you trip proposals." name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Information"/>&#13;
		<field type="textarea" label="Anything Else I Should Know?" name="anything-else-i-should-know" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

Terms & Conditions

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