Share your information with NaQuandra Brown

NaQuandra Brown

Shermere' Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Lead Traveler Information"/>&#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="Government 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="Government 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="textarea" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" 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="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="checkbox-group" required="true" label="Travel Needed" description="Select all that will be needed for travel." name="travel-needed" other="true">&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Hotel/Resort" value="hotelresort">Hotel/Resort</option>&#13;
			<option label="Car/Transfers" value="cartransfers">Car/Transfers</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Vacation Home" value="vacation-home">Vacation Home</option>&#13;
			<option label="Cabin" value="cabin">Cabin</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you like to go?" description="You may choose up to 3 destinations." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" 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="date" required="true" 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="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="Date ranges available for travel:" name="date-ranges-available-for-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" 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="How many adults?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many children? Please provide ages of each child." name="how-many-children-please-provide-ages-of-each-child" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many rooms?" name="how-many-rooms" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Room occupancy needed:" name="room-occupancy-needed" other="true">&#13;
			<option label="Single Room" value="single-room">Single Room</option>&#13;
			<option label="Double Room" value="double-room">Double Room</option>&#13;
			<option label="Triple Room" value="triple-room">Triple Room</option>&#13;
			<option label="Quad Room" value="quad-room">Quad Room</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="To help me create the best travel experience for you, could you please share your total budget for this trip, including accommodations, transportation, and activities" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="$0 to $1,500" value="0-to-1500">$0 to $1,500</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="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="checkbox-group" label="Airline Company Preferences" description="Select all that you would prefer." name="checkbox-group-1708663914995" other="true">&#13;
			<option label="American Airlines" value="american-airlines">American Airlines</option>&#13;
			<option label="Delta Vacations" value="delta-vacations">Delta Vacations</option>&#13;
			<option label="United Airlines" value="united-airlines">United Airlines</option>&#13;
			<option label="Southwest Airlines" value="southwest-airlines">Southwest Airlines</option>&#13;
			<option label="JetBlue" value="jetblue">JetBlue</option>&#13;
			<option label="Spirit" value="spirit">Spirit</option>&#13;
			<option label="Frontier" value="frontier">Frontier</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Hotel Brand Preferences" description="Select all that you would prefer." name="checkbox-group-1708663911888" other="true">&#13;
			<option label="Marriott" value="marriott">Marriott</option>&#13;
			<option label="Hilton" value="hilton">Hilton</option>&#13;
			<option label="Hyatt" value="hyatt">Hyatt</option>&#13;
			<option label="Wyndham" value="wyndham">Wyndham</option>&#13;
			<option label="InterContinental" value="intercontinental">InterContinental</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="radio-group" label="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" label="Vibe preferences" name="vibe-preference">&#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;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBT" value="lgbt">LGBT</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activity preferences" name="activity-preferences">&#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 theatre" value="art-theatre">Arts and theatre</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;
	</fields>&#13;
</form-template>
  </body>
</html>

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