<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Simplistic Journeys, LLC Travel Inquiry&nbsp;"/> <field type="header" subtype="h1" label="If you are looking for a wonderful vacation, you are in the right place. When you are ready to start vacation planning, please fill out the inquiry form below."/> <field type="header" subtype="h2" label="Primary Traveler"/> <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="header" subtype="h2" label="Address"/> <field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="radio-group" label="What kind of trip would you like to take?" name="what-kind-of-trip-would-you-like-to-take"> <option label="Cruise" value="cruise">Cruise</option> <option label="Land" value="land">Land</option> <option label="Vacation Home " value="vacation-home-">Vacation Home </option> </field> <field type="radio-group" label="Are you Celebrating a special occasion?" name="special-occasion-"> <option label="Birthday" value="birthday">Birthday</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Honeymoon " value="honeymoon-">Honeymoon </option> <option label="Class or Family Reunion " value="class-or-family-reunion-">Class or Family Reunion </option> </field> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your Realistic Budget Per Person?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$3,000 to $3,500" value="3000-to-3500">$3,000 to $3,500</option> <option label="$3,500 to $4,500" value="3500-to-4500">$3,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="radio-group" label="Are all travelers departing from the same airport?" name="are-all-travelers-departing-from-the-same-airport"> <option label="YES" value="yes">YES</option> <option label="NO" value="no">NO</option> </field> <field type="textarea" label="If no, Please list number of travelers and airport city or code" name="if-no-please-list-number-of-travelers-and-airport-city-or-code" className="form-control"/> <field type="radio-group" label="Are any children traveling?" name="are-any-children-traveling"> <option label="YES" value="yes">YES</option> <option label="NO" value="no">NO</option> </field> <field type="text" label="Please provide the FIRST and LAST names of ALL travelers and their DOB as indicated on their Passport or government ID." name="number-of-children-and-age-at-time-of-travel" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="AIR TRAVEL"/> <field type="text" label="Airline Preference" description="What's your preferred airline example: (American Airlines)" name="airline-preference" subtype="text" className="form-control"/> <field type="radio-group" label="Flight Preference (If Flight is Needed)" name="flight-preference-if-flight-is-needed"> <option label="Non-Stop" value="Non-Stop">Non-Stop</option> <option label="Connecting" value="Connecting">Connecting</option> </field> <field type="radio-group" label="Do you need transfers to and from the airport?" name="do-you-need-transfers-to-and-from-the-airport"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Rental Car" name="rental-car"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="radio-group" label="Smoking Preference" name="do-you-smoke"> <option label="Smoking" value="Smoking">Smoking</option> <option label="Non-Smoking" value="nonsmoking">Non-Smoking</option> </field> <field type="radio-group" label="Room&nbsp; Preference" name="bedding-preference"> <option label="King Size Standard " value="king-size-standard-">King Size Standard </option> <option label="2 Queen Size Standard " value="2-queen-size-standard-">2 Queen Size Standard </option> <option label="King Size Garden View" value="king-size-garden-view">King Size Garden View</option> <option label="2 Queen Size Garden View " value="2-queen-size-garden-view-">2 Queen Size Garden View </option> <option label="King Size Ocean View" value="king-size-ocean-view">King Size Ocean View</option> <option label="2 Queen Size Ocean View" value="2-queen-size-ocean-view">2 Queen Size Ocean View</option> <option label="King Size Oceanfront" value="king-size-oceanfront">King Size Oceanfront</option> <option label="2 Queen Size Oceanfront" value="2-queen-size-oceanfront">2 Queen Size Oceanfront</option> <option label="Penthouse" value="penthouse">Penthouse</option> <option label="Suite" value="suite">Suite</option> </field> <field type="text" label="How many rooms would you need?" name="how-many-rooms-would-you-need" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="CRUISE TRAVEL"/> <field type="text" label="Cruiseline Preference" description="What's your preferred cruise line?" name="cruiseline-preference" subtype="text" className="form-control"/> <field type="select" label="Which cruise port would you like to leave from?" placeholder="Select One" name="which-cruise-port-would-you-like-to-leave-from" className="form-control"> <option label="Cape Liberty NJ " value="cape-liberty-nj-">Cape Liberty NJ </option> <option label="New York New York" value="new-york-new-york">New York New York</option> <option label="Baltimore, MD" value="baltimore-md">Baltimore, MD</option> <option label="Norfolk VA" value="norfolk-va">Norfolk VA</option> <option label="Charleston SC" value="charleston-sc">Charleston SC</option> <option label="Mobile AL" value="mobile-al">Mobile AL</option> <option label="Jacksonville FL" value="jacksonville-fl">Jacksonville FL</option> <option label=" Port Canaveral FL" value="-port-canaveral-fl"> Port Canaveral FL</option> <option label=" Miami FL" value="-miami-fl"> Miami FL</option> <option label="Jacksonville FL" value="jacksonville-fl">Jacksonville FL</option> <option label="New Orleans LA" value="new-orleans-la">New Orleans LA</option> <option label="Galveston TX" value="galveston-tx">Galveston TX</option> <option label="Seattle WA" value="seattle-wa">Seattle WA</option> <option label=" Los Angeles CA" value="-los-angeles-ca"> Los Angeles CA</option> </field> <field type="select" label="How many days would you like to cruise?" name="how-many-days-would-you-like-to-cruise" className="form-control"> <option label="2-5 Days" value="25-days">2-5 Days</option> <option label="6-9 Days" value="69-days">6-9 Days</option> <option label="10+ Days" value="10-days">10+ Days</option> </field> <field type="radio-group" label="Pre and Post Cruise Hotel Stay&nbsp;" description="Will you need a hotel before or after the cruise?" name="pre-and-post-cruise-hotel-stay-"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="Cruise Itinerary" name="cruise-itinerary" other="true"> <option label="Alaska " value="alaska-">Alaska </option> <option label="Bahamas" value="bahamas">Bahamas</option> <option label="Bermuda" value="bermuda">Bermuda</option> <option label="Caribbean" value="caribbean">Caribbean</option> <option label="Canadian" value="canadian">Canadian</option> <option label="Transatlantic" value="transatlantic">Transatlantic</option> <option label="Europe - Mediterranean" value="europe-mediterranean">Europe - Mediterranean</option> <option label="River Cruise " value="river-cruise-">River Cruise </option> </field> <field type="select" label="Cabin Class" placeholder="Select one" name="cabin-class" className="form-control"> <option label="Interior" value="interior">Interior</option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Suite" value="suite">Suite</option> <option label="All options for groups" value="all-options-for-groups">All options for groups</option> </field> <field type="select" label="How many cabins do you need?" placeholder="Select one" name="how-many-cabins-do-you-need" className="form-control"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7" value="7">7</option> <option label="9" value="9">9</option> <option label="10" value="10">10</option> <option label="11" value="11">11</option> <option label="12" value="12">12</option> <option label="13" value="13">13</option> <option label="14" value="14">14</option> <option label="15" value="15">15</option> <option label="16" value="16">16</option> <option label="17" value="17">17</option> <option label="18" value="18">18</option> <option label="19" value="19">19</option> <option label="20" value="20">20</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <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"/> <field type="text" label="How did you hear about us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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