Share your information with Anointed Pitt

Anointed Pitt

Legendary Destinations

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  <body>
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	<fields>&#13;
		<field type="header" subtype="h2" label="Request a Custom Travel Quote"/>&#13;
		<field type="header" subtype="h1" label="Please complete the form below so I can design a trip that fits your budget, timeline, and travel style."/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" subtype="text" 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" required="true" label="Destination" placeholder="Where would you like to travel?" name="text-1768683743924" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Travel Dates Departure&amp;nbsp;" placeholder="Preferred travel dates (or month/year)" name="date-1768683847868" className="form-control"/>&#13;
		<field type="date" required="true" label="Travel Dates Return&amp;nbsp;" placeholder="Preferred travel dates (or month/year)" name="date-1768688592793" className="form-control"/>&#13;
		<field type="text" label="Travelers&amp;nbsp;" placeholder="How many travelers and ages (if children)?" name="text-1768683895760" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your total estimated trip budget (including flights)?" name="radio-group-1768683997508" other="true">&#13;
			<option label="Under $1,500" value="under-1500">Under $1,500</option>&#13;
			<option label="$1,500 – $3,000" value="1500-3000">$1,500 – $3,000</option>&#13;
			<option label="$3,000 – $5,000" value="$3,000 – $5,000">$3,000 – $5,000</option>&#13;
			<option label="$5,000 – $8,000" value="5000-8000">$5,000 – $8,000</option>&#13;
			<option label="$8,000+" value="8000">$8,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What type of trip are you interested in?" inline="true" name="checkbox-group-1768684421314" other="true">&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Family Vacation" value="family-vacation">Family Vacation</option>&#13;
			<option label="Adults-Only" value="adults-only">Adults-Only</option>&#13;
			<option label="Honeymoon / Anniversary" value="honeymoon-anniversary">Honeymoon / Anniversary</option>&#13;
			<option label="Custom / Europe / International" value="custom-europe-international">Custom / Europe / International</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="When are you hoping to book?" name="radio-group-1768685424559">&#13;
			<option label="ASAP (48–72 hours)" value="asap-48-72-hours">ASAP (48–72 hours)</option>&#13;
			<option label="Within 1 week" value="within-1-week">Within 1 week</option>&#13;
			<option label="2–4 weeks" value="2-4-weeks">2–4 weeks</option>&#13;
			<option label="Just researching" value="just-researching">Just researching</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything else I should know to plan this well?" name="textarea-1768685604967" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>