Luxe World Travels

Luxe World Travels, LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="date" label="Date Field" name="date-1733751967614" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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="date" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" label="Passport Number (only for International trips)" name="passport-number-only-for-international-trips" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Passport Expiration Date" name="passport-expiration-date" 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="text" label="Best Time to Contact&amp;nbsp;" name="best-time-to-contact-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred Method of Communication&amp;nbsp;" name="preferred-method-of-communication-">&#13;
			<option label="Best Contact Number" value="best-contact-number">Best Contact Number</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<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"/>&#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;
			<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="text" label="Total number of Travelers&amp;nbsp;" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please include the name of Additional Traveler 1&amp;nbsp;" name="please-include-the-name-of-additional-traveler-1-" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Please enter the date of birth of Additional Traveler 1&amp;nbsp;" name="please-enter-the-date-of-birth-of-additional-traveler-1-" className="form-control"/>&#13;
		<field type="text" label="Please enter the Relationship of the Additional Traveler 1 to you&amp;nbsp;" name="please-enter-the-relationship-of-the-additional-traveler-1-to-you-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Add additional passengers" description="If there are more than 1 additional traveler  please enter the NAME  DATE OF BIRTH and RELATIONSHIP of each Passengers EX: John Smith/ 01-01-1999 / Husband" name="add-additional-passengers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Found a property you like?" name="found-a-property-you-like" subtype="text" className="form-control"/>&#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="Any Special Occasion?&amp;nbsp;" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred Agent" name="preferred-agent">&#13;
			<option label="Shenita" value="shenita">Shenita</option>&#13;
			<option label="Sade" value="sade">Sade</option>&#13;
		</field>&#13;
		<field type="text" label="Who may we thank for referring you?&amp;nbsp;" name="who-may-we-thank-for-referring-you-" 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>