Share your information with Stephanie Miller Murphy

Stephanie Miller Murphy

Miller Murphy Travel

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		<field type="header" subtype="h1" label="Let&#39;s Get Started!"/>&#13;
		<field type="paragraph" subtype="blockquote" label="Thank you for reaching out to Miller Murphy Travel! The first step in planning an amazing trip is sharing a bit about your travel plans. Please fill out the form below. We will review it and reach out to you soon."/>&#13;
		<field type="text" required="true" label="First name" name="first-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="Preferred name" name="preferred-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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" 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" required="true" 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" required="true" 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" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What would make this a &quot;wow&quot; trip and an experience you will still be talking about for years to come?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers, excluding flights?&amp;nbsp;" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Less than $5,000" value="less-than-5000">Less than $5,000</option>&#13;
			<option label="$5,000 - $10,000" value="5000-10000">$5,000 - $10,000</option>&#13;
			<option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option>&#13;
			<option label="$15,000 - $20,000" value="15000-20000">$15,000 - $20,000</option>&#13;
			<option label="$20,000 - $30,000" value="20000-30000">$20,000 - $30,000</option>&#13;
			<option label="$30,000 - $50,000" value="30000-50000">$30,000 - $50,000</option>&#13;
			<option label="$50,000+" value="50000">$50,000+</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are you celebrating a special occasion?" name="are-you-celebrating-a-special-occasion" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your favorite hotel in the world?" name="what-is-your-favorite-hotel-in-the-world" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What destination have you traveled to that was your best vacation ever?" name="what-destination-have-you-traveled-to-that-was-your-best-vacation-ever" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like us 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;
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