<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="Questions about your safari"/> <field type="checkbox-group" label="Where would you like to go?" description="Choose all that apply" name="where-would-you-like-to-go"> <option label="Kenya" value="kenya">Kenya</option> <option label="Tanzania" value="tanzania">Tanzania</option> <option label="Botswana" value="botswana">Botswana</option> <option label="South Africa" value="south-africa">South Africa</option> <option label="Rwanda" value="rwanda">Rwanda</option> <option label="Uganda" value="uganda">Uganda</option> <option label="Zimbabwe" value="zimbabwe">Zimbabwe</option> <option label="Zambia" value="zambia">Zambia</option> <option label="Namibia" value="namibia">Namibia</option> <option label="Help! I have no clue what the difference is!" value="help-i-have-no-clue-what-the-difference-is">Help! I have no clue what the difference is!</option> </field> <field type="text" label="Have you been on safari before? If yes, where?" name="have-you-been-on-safari-before-if-yes-where" subtype="text" className="form-control"/> <field type="textarea" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/> <field type="text" label="How long would you like to be away?" name="how-long-would-you-like-to-be-away" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="How many travelers in total will be with you?" name="departure-city" subtype="text" className="form-control"/> <field type="checkbox-group" label="What are you most excited to do or see on this trip?" description="Choose all that apply" name="what-are-you-most-excited-to-do-or-see-on-this-trip"> <option label="The Big Five" value="the-big-five">The Big Five</option> <option label="The Great Migration " value="the-great-migration-">The Great Migration </option> <option label="Gorilla trek" value="gorilla-trek">Gorilla trek</option> <option label="Take a sunrise hot air balloon ride" value="take-a-sunrise-hot-air-balloon-ride">Take a sunrise hot air balloon ride</option> <option label="Assist with hands on animal conservation efforts" value="assist-with-hands-on-animal-conservation-efforts">Assist with hands on animal conservation efforts</option> <option label="Learn about the local culture" value="learn-about-the-local-culture">Learn about the local culture</option> <option label="Luxuriate at the lodge" value="luxuriate-at-the-lodge">Luxuriate at the lodge</option> <option label="Other" value="other">Other</option> </field> <field type="checkbox-group" label="What experiences are you most excited about doing before/after your safari?" name="what-experiences-are-you-most-excited-about-doing-beforeafter-your-safari"> <option label="Enjoying the food, wine and culture of Cape Town and the Vineland's" value="enjoying-the-food-wine-and-culture-of-cape-town-and-the-vinelands">Enjoying the food, wine and culture of Cape Town and the Vineland's</option> <option label="Adventuring near Victoria Falls (white water rafting, microlight, giant swing)" value="adventuring-near-victoria-falls-white-water-rafting-microlight-giant-swing">Adventuring near Victoria Falls (white water rafting, microlight, giant swing)</option> <option label="Luxuriating in the Seychelles, Mozambique, Zanzibar or on the coast" value="luxuriating-in-the-seychelles-mozambique-zanzibar-or-on-the-coast">Luxuriating in the Seychelles, Mozambique, Zanzibar or on the coast</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" label="What would make this a dream trip for you (an experience you are talking about for years to come)?" name="what-would-make-this-a-dream-trip-for-you-an-experience-you-are-talking-about-for-years-to-come" className="form-control"/> <field type="checkbox-group" label="What level of activity do you enjoy?" name="what-level-of-activity-do-you-enjoy"> <option label="Low" value="low">Low</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Active" value="active">Active</option> <option label="Very Active" value="very-active">Very Active</option> </field> <field type="checkbox-group" label="Which statement describes you best?" name="which-statement-describes-you-best"> <option label="Drinking an ice cold beer while in flip flops" value="drinking-an-ice-cold-beer-while-in-flip-flops">Drinking an ice cold beer while in flip flops</option> <option label="Sipping a glass of wine while wearing a dress or sport jacket" value="sipping-a-glass-of-wine-while-wearing-a-dress-or-sport-jacket">Sipping a glass of wine while wearing a dress or sport jacket</option> <option label="Combination of the two" value="combination-of-the-two">Combination of the two</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" label="If you are traveling with children, what do they love to do? Please share some of their favorite activities, interests, hobbies or sports. Please also share their ages at the time of travel." name="if-you-are-traveling-with-children-what-do-they-love-to-do-please-share-some-of-their-favorite-activities-interests-hobbies-or-sports" className="form-control"/> <field type="textarea" label="What other places are on your bucket list?" name="what-places-are-on-your-bucket-list" className="form-control"/> <field type="radio-group" label="What is your estimated budget for all travelers? Include accommodations, experiences, transfers but excluding international airfare. We are happy to provide guidance during our conversation." description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <option label="less than $50,000" value="less-than-50000">less than $50,000</option> <option label="$50,000 - $75,000" value="50000-75000">$50,000 - $75,000</option> <option label="$75,000 - $100,000" value="75000-100000">$75,000 - $100,000</option> <option label="$100,000+" value="100000">$100,000+</option> <option label="Whatever it takes to make an exceptional trip" value="whatever-it-takes-to-make-an-exceptional-trip">Whatever it takes to make an exceptional trip</option> </field> <field type="radio-group" label="Level of Luxury - what level of safari are you looking for?" description="check all that apply" name="hotel-preference" other="true"> <option label="4* I am ok with a bit larger lodge, sharing a safari vehicle and great food" value="4-i-am-ok-with-a-bit-larger-lodge-sharing-a-safari-vehicle-and-great-food">4* I am ok with a bit larger lodge, sharing a safari vehicle and great food</option> <option label="5* I would like luxury lodges with great food and really good service" value="5-i-would-like-luxury-lodges-with-great-food-and-really-good-service">5* I would like luxury lodges with great food and really good service</option> <option label="5*+ I would like the most luxurious lodges, the best service, incredible food and wine and the. most exclusive experience" value="5-i-would-like-the-most-luxurious-lodges-the-best-service-incredible-food-and-wine-and-the-most-exclusive-experience">5*+ I would like the most luxurious lodges, the best service, incredible food and wine and the. most exclusive experience</option> </field> <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"/> <field type="text" label="How did you find us?" name="how-did-you-find-us" subtype="text" className="form-control"/> <field type="select" label="Sign up to receive the latest travel tips and insights." name="sign-up-to-receive-the-latest-travel-tips-and-insights" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> </fields> </form-template> </body> </html>
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