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Pamela Brock
Carter Travel
<html> <body> <form-template> <fields> <field type="paragraph" subtype="p" label="Thank you for choosing Carter Travel! &nbsp;Please complete this form so we can create the perfect travel proposal for you."/> <field type="header" subtype="h1" label="Contact Info"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="Preferred Contact Method" name="preferred-contact-method"> <option label="Email" value="email">Email</option> <option label="Phone" value="phone">Phone</option> <option label="Text" value="text">Text</option> </field> <field type="header" subtype="h1" label="Travel Details"/> <field type="text" required="true" label="Number of Adults" name="number-of-adults" subtype="text" className="form-control"/> <field type="textarea" required="true" label="Number of Children (please children(s) ages at time of travel" description="If No Children, please type 0" placeholder="2 children 11-15 (If no children, please type 0)" name="number-of-children" className="form-control"/> <field type="text" required="true" label="Travel Budget Range" description="Please enter a budget range (e.g. 2000-4000)" name="travel-budget-range" subtype="text" className="form-control"/> <field type="text" required="true" label="Your Departure City:" name="your-departure-city" subtype="text" className="form-control"/> <field type="date" required="true" label="Departure Date" name="departure-date" className="form-control"/> <field type="date" required="true" label="Return Date" name="return-date" className="form-control"/> <field type="radio-group" required="true" label="Are these dates flexible?" name="are-these-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="If Yes, how flexible?" placeholder="1-2 weeks" name="if-yes-how-flexible" subtype="text" className="form-control"/> <field type="radio-group" label="Do you want Travel Insurance?" name="insurance"> <option label="YES (highly recommended, but not required)" value="YES">YES (highly recommended, but not required)</option> <option label="NO (if no, obtain signed waiver)" value="NO - SEND WAIVER">NO (if no, obtain signed waiver)</option> </field> <field type="textarea" label="Activities you want to include" name="activities-you-want-to-include" className="form-control"/> <field type="checkbox-group" required="true" label="Vacation Type" inline="true" name="vacation-type" other="true"> <option label="Cruise" value="cruise">Cruise</option> <option label="Family Vacation" value="family-vacation">Family Vacation</option> <option label="Adults Only" value="adults-only">Adults Only</option> <option label="All-Inclusive" value="allinclusive">All-Inclusive</option> <option label="Adventure" value="adventure">Adventure</option> <option label="Cultural & Historical" value="cultural-historical">Cultural & Historical</option> <option label="Wellness & Spa" value="wellness-spa">Wellness & Spa</option> <option label="Romantic Getaway" value="romantic-getaway">Romantic Getaway</option> <option label="Group Travel" value="group-travel">Group Travel</option> <option label="Tour" value="tour">Tour</option> </field> <field type="header" subtype="h1" label="Travel Documentation (For Cruise or International Travel)"/> <field type="radio-group" label="Do all travelers have a valid passport?" inline="true" name="do-all-travelers-have-a-valid-passport"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Any passports expiring within 6 months of travel?" inline="true" name="any-passports-expiring-within-6-months-of-travel"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="Please complete the sections below that apply to your vacation type."/> <field type="header" subtype="h1" label="Cruise Vacation"/> <field type="text" label="Cruise Line Preference (Frequent Cruiser Programs)" name="destination" subtype="text" className="form-control"/> <field type="select" label="Cruise Destination" name="cruise-destination" className="form-control"> <option label="--Select--" value="select">--Select--</option> <option label="Alaska" value="alaska">Alaska</option> <option label="Asia" value="asia">Asia</option> <option label="Australia/New Zealand/South Pacific" value="australianew-zealandsouth-pacific">Australia/New Zealand/South Pacific</option> <option label="Bahamas" value="bahamas">Bahamas</option> <option label="Bermuda" value="bermuda">Bermuda</option> <option label="Canada/New England" value="canadanew-england">Canada/New England</option> <option label="Caribbean" value="caribbean">Caribbean</option> <option label="Europe" value="europe">Europe</option> <option label="Galapagos" value="galapagos">Galapagos</option> <option label="Hawaii" value="hawaii">Hawaii</option> <option label="Mediterranean" value="mediterranean">Mediterranean</option> <option label="Transatlantic" value="transatlantic">Transatlantic</option> </field> <field type="checkbox-group" label="Cabin Type" inline="true" name="cabin-type"> <option label="Interior" value="interior">Interior</option> <option label="Oceanview" value="oceanview">Oceanview</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Mini/Jr. Suite" value="minijr-suite">Mini/Jr. Suite</option> <option label="Suite" value="suite">Suite</option> <option label="Family Stateroom" value="family-stateroom">Family Stateroom</option> <option label="Accessible Cabin (guest with mobility needs)" value="accessible-cabin-guest-with-mobility-needs">Accessible Cabin (guest with mobility needs)</option> </field> <field type="text" label="Number of cabins needed" name="number-of-cabins-needed" subtype="text" className="form-control"/> <field type="radio-group" label="Cruise Length" inline="true" name="cruise-length"> <option label="3-4 days" value="34-days">3-4 days</option> <option label="5-6 days" value="56-days">5-6 days</option> <option label="7-9 days" value="79-days">7-9 days</option> <option label="10 + days" value="10-days">10 + days</option> </field> <field type="radio-group" label="Hotel for Pre and Post Cruise Night" inline="true" name="hotel-for-pre-and-post-cruise-night"> <option label="Pre-Cruise " value="precruise-">Pre-Cruise </option> <option label="Post-Cruise" value="postcruise">Post-Cruise</option> <option label="Pre and Post Cruise" value="pre-and-post-cruise">Pre and Post Cruise</option> </field> <field type="radio-group" label="Beverage Plan" inline="true" name="beverage-plan"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Beverage Plan Type&nbsp;" inline="true" name="beverage-plan-type-" other="true"> <option label="Alcohol & Soda" value="alcohol-soda">Alcohol & Soda</option> <option label="Soda" value="soda">Soda</option> </field> <field type="header" subtype="h1" label="Hotel &amp; Resort Vacation"/> <field type="text" label="Hotel Preferences (Frequent Guest Programs)" name="hotel-preferences-frequent-guest-programs" subtype="text" className="form-control"/> <field type="text" label="Destination/City" name="destinationcity" subtype="text" className="form-control"/> <field type="text" label="No. of Nights" name="no-of-nights" subtype="text" className="form-control"/> <field type="text" label="No of Rooms/Arrangement Type" description="Arrangement Type: such as king 2 queen or 2 double beds" name="no-of-roomsarrangement" subtype="text" className="form-control"/> <field type="radio-group" label="Room Features" inline="true" name="room-type" other="true"> <option label="Standard" value="standard">Standard</option> <option label="Garden View" value="garden-view">Garden View</option> <option label="Ocean View/Front" value="ocean-viewfront">Ocean View/Front</option> <option label="All-Inclusive" value="allinclusive">All-Inclusive</option> <option label="Adults Only" value="adults-only">Adults Only</option> <option label="Family Friendly" value="family-friendly">Family Friendly</option> <option label="Suite/Jr Suite" value="suitejr-suite">Suite/Jr Suite</option> <option label="On the Beach" value="on-the-beach">On the Beach</option> <option label="Near City Center" value="near-city-center">Near City Center</option> <option label="Near Air/Cruise Port" value="near-aircruise-port">Near Air/Cruise Port</option> <option label="Luxury Resort" value="luxury-resort">Luxury Resort</option> </field> <field type="header" subtype="h1" label="Car Rental"/> <field type="text" label="Car Preferences (Frequent Renter Programs)" name="car-preferences-frequent-renter-programs" subtype="text" className="form-control"/> <field type="text" label="Add Ons:" description="e.g. Navigation, child seat, ski rack, etc." name="add-ons" subtype="text" className="form-control"/> <field type="radio-group" label="Car Category" inline="true" name="car-category" other="true"> <option label="Compact" value="compact">Compact</option> <option label="Mid Size" value="mid-size">Mid Size</option> <option label="Full Size" value="full-size">Full Size</option> <option label="Premium/Luxury" value="premiumluxury">Premium/Luxury</option> <option label="Convertible" value="convertible">Convertible</option> <option label="Compact SUV" value="compact-suv">Compact SUV</option> <option label="Midsize SUV" value="midsize-suv">Midsize SUV</option> <option label="Full Size SUV" value="full-size-suv">Full Size SUV</option> <option label="Minivan" value="minivan">Minivan</option> <option label="Pickup Truck" value="pickup-truck">Pickup Truck</option> </field> <field type="header" subtype="h1" label="Air Travel"/> <field type="text" label="Departure City" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="Arrival City" name="arrival-city" subtype="text" className="form-control"/> <field type="text" label="Airline Preference (Frequent Flyer Programs)" name="airline-preference-frequent-flyer-programs" subtype="text" className="form-control"/> <field type="checkbox-group" label="Seat Preference" inline="true" name="checkbox-group" other="true"> <option label="Business Class" value="business-class" selected="selected">Business Class</option> <option label="Premium" value="premium">Premium</option> <option label="Economy" value="economy">Economy</option> <option label="First Class" value="first-class">First Class</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Middle" value="middle">Middle</option> <option label="Window" value="window">Window</option> <option label="Bulkhead" value="bulkhead">Bulkhead</option> <option label="Forward" value="forward">Forward</option> <option label="Wing" value="wing">Wing</option> </field> <field type="header" subtype="h1" label="Special Considerations"/> <field type="radio-group" label="Special Occasion?" inline="true" name="special-occasion" other="true"> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Birthday" value="birthday">Birthday</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> </field> <field type="textarea" label="Dietary Needs or Allergies" name="other-information" className="form-control"/> <field type="textarea" label="Any special needs or accessibility requirements?" name="textarea-1755091004566" className="form-control"/> </fields> </form-template> </body> </html>
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