Share your information with Paula Peace

Paula Peace

With Passion Travel

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Tell Me about your Trip....."/>&#13;
		<field type="text" 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="select" required="true" label="Have you look yourself ?" name="have-you-look-yourself-" className="form-control">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="How long ago?" name="how-long-ago" 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="text" required="true" label="What&amp;nbsp; airport would you like to depart from&amp;nbsp;" name="text-1784687573158" subtype="text" 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="text" required="true" label="What airport would you like to returned from&amp;nbsp;" name="text-1784687643515" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What Would Like US to Quote?&amp;nbsp;" inline="true" name="what-would-like-us-to-quote-" other="true">&#13;
			<option label="Hotel " value="hotel-">Hotel </option>&#13;
			<option label="Hotel &amp; Flight" value="hotel-flight">Hotel &amp; Flight</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All-Inclusive" value="allinclusive">All-Inclusive</option>&#13;
			<option label="Show" value="show">Show</option>&#13;
			<option label="Sporting Event" value="sporting-event">Sporting Event</option>&#13;
			<option label="Concert" value="concert">Concert</option>&#13;
			<option label="Tours" value="tours">Tours</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#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;
			<option label="Maybe" value="maybe">Maybe</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" required="true" label="Number of&amp;nbsp; adults?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Number of Children and Ages (at the time of travel)" name="number-of-children-and-ages-at-the-time-of-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Number of Hotels Rooms or Bedrooms Needed" name="number-of-hotels-rooms-or-bedrooms-needed" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers? (per person)&amp;nbsp;" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Less than $500" value="less-than-500">Less than $500</option>&#13;
			<option label="$500 to 1,000" value="500-to-1000">$500 to 1,000</option>&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-to-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Type of room accommodations" name="type-of-room-accommodations">&#13;
			<option label="Standard room" value="standard-room">Standard room</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Ocean Front" value="ocean-front">Ocean Front</option>&#13;
			<option label="Suite " value="suite-">Suite </option>&#13;
			<option label="Swim Up Room " value="swim-up-room-">Swim Up Room </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="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="Anything you absolutely must do or see?" name="must-dos" 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;
		<field type="select" required="true" label="Would you like Travel Insurance?" description="If no have to sign a weaver." name="would-you-like-travel-insurance" className="form-control">&#13;
			<option label="Travel Credit" value="travel-credit">Travel Credit</option>&#13;
			<option label="Travel Cash Back" value="travel-cash-back">Travel Cash Back</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>