Share your information with Just Wright Travels

Just Wright Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Just Wright Travels - Trip Inquiry"/>&#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" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your preferred method of communication?" name="what-is-your-preferred-method-of-communication" other="true">&#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="What are your needs? (Select all that apply)" name="what-are-your-needs-select-all-that-apply" other="true">&#13;
			<option label="Flight(s)" value="flights">Flight(s)</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Resort" value="resort">Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</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" 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="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Airline Preference(s) (Please Select All That Apply)&amp;nbsp;" name="airline-preferences-please-select-all-that-apply-" other="true">&#13;
			<option label="American Airlines" value="american-airlines">American Airlines</option>&#13;
			<option label="Delta Airlines" value="delta-airlines">Delta Airlines</option>&#13;
			<option label="Frontier Airlines" value="frontier-airlines">Frontier Airlines</option>&#13;
			<option label="Jet Blue Airlines" value="jet-blue-airlines">Jet Blue Airlines</option>&#13;
			<option label="Southwest Airlines" value="southwest-airlines">Southwest Airlines</option>&#13;
			<option label="Spirit Airlines" value="spirit-airlines">Spirit Airlines</option>&#13;
			<option label="United Airlines" value="united-airlines">United Airlines</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="If Taking a Cruise, Cruise Line Preference(s)?&amp;nbsp;" name="if-taking-a-cruise-cruise-line-preferences-" other="true">&#13;
			<option label="Carnival" value="carnival">Carnival</option>&#13;
			<option label="Disney Cruise Lines" value="disney-cruise-lines">Disney Cruise Lines</option>&#13;
			<option label="Margaritaville" value="margaritaville">Margaritaville</option>&#13;
			<option label="MSC" value="msc">MSC</option>&#13;
			<option label="Norwegian" value="norwegian">Norwegian</option>&#13;
			<option label="Royal Caribbean" value="royal-caribbean">Royal Caribbean</option>&#13;
			<option label="Virgin Voyages (Adult-Only)" value="virgin-voyages-adultonly">Virgin Voyages (Adult-Only)</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="If Taking a Cruise, Cruise Duration Preference?&amp;nbsp;" name="if-taking-a-cruise-cruise-duration-preference-" other="true">&#13;
			<option label="2-5 Days" value="25-days">2-5 Days</option>&#13;
			<option label="6-9 Days" value="69-days">6-9 Days</option>&#13;
			<option label="10+ Days" value="10-days">10+ Days</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many rooms do you need?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Adults" name="number-of-adults" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Children" name="number-of-children" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Budget Per Person (in USD)" name="budget-per-person-in-usd" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Desired Total Trip Budget (in USD)" name="desired-total-trip-budget-in-usd" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you Prepared to Make a Deposit?" name="are-you-prepared-to-make-a-deposit" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you Interested in a Payment Plan for your Trip?" name="radio-group-1769467107325" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Have you Searched Other Sites (i.e. Expedia, Priceline, Respective Cruise/Flight/Resort Site?)" name="have-you-searched-other-sites-ie-expedia-priceline-respective-cruiseflightresort-site" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1769467379843" rule="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"/>&#13;
		<field type="text" required="true" label="In Your Search(es), Do You Have Specifics You Want us to Look Into? (i.e. specific ship, resort, etc.)" name="in-your-searches-do-you-have-specifics-you-want-us-to-look-into-ie-specific-ship-resort-etc" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Would You Like Travel Insurance?" name="radio-group-1769467434435">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</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 us to know?" description="What else would you like us to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are You Interested in Becoming a Travel Agent?" name="radio-group-1769467521301">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>