Live Travel Go .

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Let's Start Planning Your Next Travel Dream!"/>&#13;
		<field type="text" label="Which Black Friday Deal Are You Responding To?" name="which-black-friday-deal-are-you-responding-to" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Where would you like to go?" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#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" required="true" label="Last Name&amp;nbsp;" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" label="Preferred name if different than above" 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="State of Residency (US Residents Only)" name="state-of-residency" 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="radio-group" label="Will this be your first time to this destination?" name="will-this-be-your-first-time-to-this-destination">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="What month would you like to depart?" name="what-month-would-you-like-to-depart" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many rooms are needed/anticipated?" name="how-many-rooms-are-neededanticipated" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="If more than 1 traveler, will the other travelers be departing from the same city?&amp;nbsp;" name="will-travelers-be-departing-from-the-same-city">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If your guest will depart from several cities, please list what you know at this time.&amp;nbsp; If a solo traveler, skip.&amp;nbsp;" name="if-your-guest-will-depart-from-several-cities-please-list-what-you-know-at-this-time-if-all-from-same-city-just-notate-na" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Will anyone traveling be under the age of 18?" name="will-anyone-traveling-be-under-the-age-of-18">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If yes, please confirm age(s). If no, skip." name="if-yes-please-confirm-ages" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What average range below feels most comfortable taking into account all components of your travel dream?&amp;nbsp;" description="This just gives me a general understanding of your expectations." name="budget">&#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="8500-10000">$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="text" label="If this is a celebration trip, what and who are you celebrating? i.e. milestone birthday, anniverary trip, business launch, etc." name="if-this-is-a-celebration-trip-what-and-who-are-you-celebrating-ie-milestone-birthday-anniverary-trip-business-launch-etc" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your preferred departure airport city?&amp;nbsp;" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred Airline" name="preferred-airline" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred Airline Frequent Flyer Number&amp;nbsp;" name="preferred-airline-frequent-flyer-number" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Anything you must absolutely see, do or experience?" name="anything-you-must-absolutely-see-or-do" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Anything we should avoid when designing your travel experience?" name="anything-we-should-avoid-when-designing-your-travel-experience" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like us to know (such as accessibility needs or requirements)?" 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="radio-group" required="true" label="Do you have a current passport?" name="do-you-have-a-current-passport">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I need to renew" value="i-need-to-renew">I need to renew</option>&#13;
		</field>&#13;
		<field type="text" label="How did you hear about us or who referred you?" name="how-did-you-hear-about-us-or-who-referred-you" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Thank you for contacting Live Travel Go!&amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
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