Share your information with Patti Hernandez

Patti Hernandez

<html>
  <body>
    <form-template>
	<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>
		<field type="header" subtype="h2" label="TRIP INFORMATION"/>
		<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"/>
		<field type="radio-group" label="If the trip requires a passport, do you have yours?" name="if-the-trip-requires-a-passport-do-you-have-yours">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<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"/>
		<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"/>
		<field type="radio-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="text" label="What is your departure airport?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>
		<field type="checkbox-group" required="true" label="What would you like your trip to include? (Check all that apply)" name="what-would-you-like-your-trip-to-include-check-all-that-apply">
			<option label="Flight" value="flight" selected="selected">Flight</option>
			<option label="Hotel" value="hotel">Hotel</option>
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>
			<option label="Excursions" value="excursions">Excursions</option>
			<option label="Rental Car" value="rental-car">Rental Car</option>
			<option label="Cruise (Non-Disney)" value="cruise-nondisney">Cruise (Non-Disney)</option>
			<option label="Charter Bus" value="charter-bus">Charter Bus</option>
			<option label="Cabin" value="cabin">Cabin</option>
			<option label="Ski Resort" value="ski-resort">Ski Resort</option>
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>
			<option label="Disney Resort/Vacation" value="disney-resortvacation">Disney Resort/Vacation</option>
			<option label="Theme Park Package" value="theme-park-package">Theme Park Package</option>
			<option label="Concert" value="concert">Concert</option>
			<option label="Sport Event" value="sport-event">Sport Event</option>
		</field>
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">
			<option label="Romantic" value="romantic">Romantic</option>
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>
			<option label="Party" value="party">Party</option>
			<option label="Local culture" value="local-culture">Local culture</option>
			<option label="Family friendly" value="family-friendly">Family friendly</option>
			<option label="Food and wine" value="food-wine">Food and wine</option>
		</field>
		<field type="text" label="If hotel accommodations, how many people per room?" name="if-hotel-accommodations-how-many-people-per-room" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="PASSENGER INFORMATION"/>
		<field type="textarea" required="true" label="How many travelers &amp;amp; ages of any children traveling" name="how-many-travelers-their-ages-at-time-of-travel" className="form-control"/>
		<field type="text" required="true" label="Total budget for this trip (in dollars)" name="desired-budget-for-all-travelers" subtype="text" className="form-control"/>
		<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? List any preferred airlines  hotels  etc here. Also list any info regarding travel quotes you have seen/received" name="notes" className="form-control"/>
	</fields>
</form-template>
  </body>
</html>