Nicholas McQuiston

The Travel Speaker

<html>
  <body>
    <form-template>&#13;
	<fields>&#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" required="true" 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" required="true" label="Where would you like to go?" placeholder="ex: Washington DC" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="Return Date" name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="No" value="No">No</option>&#13;
			<option label="Yes 1 week before or after" value="yes-1-week-before-or-after">Yes 1 week before or after</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="How can I assist?" name="what-kind-of-trip">&#13;
			<option label="Activity/Things to Do" value="activitythings-to-do">Activity/Things to Do</option>&#13;
			<option label="Air Only" value="air-only">Air Only</option>&#13;
			<option label="All Inclusive Air with Hotel Package" value="all-inclusive-air-with-hotel-package">All Inclusive Air with Hotel Package</option>&#13;
			<option label="Car Rental " value="car-rental-">Car Rental </option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Train " value="train-">Train </option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for ALL travelers?" description="This gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Under $500" value="under-500">Under $500</option>&#13;
			<option label="$500 to $1,500" value="500-to-1500">$500 to $1,500</option>&#13;
			<option label="$1,500 to $5,000" value="1500-to-5000">$1,500 to $5,000</option>&#13;
			<option label="$5,000 to $10,000" value="5000-to-10000">$5,000 to $10,000</option>&#13;
			<option label="$10,000 to $15,000" value="10000-to-15000">$10,000 to $15,000</option>&#13;
			<option label="$15,000+" value="15000">$15,000+</option>&#13;
			<option label="I do not have a limit" value="i-do-not-have-a-limit">I do not have a limit</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What best describes your Hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy/Basic" value="economybasic">Economy/Basic</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</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="LGBTQ+" value="lgbtq">LGBTQ+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences">&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Arts and Theater" value="arts-and-theater">Arts and Theater</option>&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Food and Wine" value="food-and-wine">Food and Wine</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife/City" value="nightlifecity">Nightlife/City</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
		</field>&#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;
		<field type="checkbox-group" required="true" label="How did you find us?" name="how-did-you-find-us" other="true">&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Google" value="google">Google</option>&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
			<option label="Travel Leaders" value="travel-leaders">Travel Leaders</option>&#13;
			<option label="Twitter X" value="twitter-x">Twitter X</option>&#13;
			<option label="Yelp" value="yelp">Yelp</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>