Share your information with Jacquar Freeman

Jacquar Freeman

Hungry in Houston Adventures

<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="Questions for 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="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="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="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="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Under $500" value="under-500" selected="selected">Under $500</option>&#13;
			<option label="$500-$999" value="500-999">$500-$999</option>&#13;
			<option label="$1000-$1499" value="1000-1499">$1000-$1499</option>&#13;
			<option label="$1500-$2499 " value="1500-2499">$1500-$2499 </option>&#13;
			<option label="$2,500-$3,999" value="2500-3999">$2,500-$3,999</option>&#13;
			<option label="$4,000 +" value="4000+">$4,000 +</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Budget Friendly" value="budget-friendly">Budget Friendly</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Ultra Luxury" value="ultra-luxury">Ultra Luxury</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="Party" value="party">Party</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Best cruise for foodies" value="best-cruise-for-foodies">Best cruise for foodies</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" toggle="true" name="activity-preferences" other="true">&#13;
			<option label="Eat Amazing food" value="eat-amazing-food">Eat Amazing food</option>&#13;
			<option label="Explore ports" value="explore-ports">Explore ports</option>&#13;
			<option label="Take excursions" value="take-excursions">Take excursions</option>&#13;
			<option label="Celebrate a special occasion" value="celebrate-a-special-occasion">Celebrate a special occasion</option>&#13;
			<option label="Spa &amp; wellness" value="spa-wellness">Spa &amp; wellness</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>