Share your information with Elyse Albert

Elyse Albert

Golden Ratio Travel

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    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="About You"/>&#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" label="Middle name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="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="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" required="true" label="How many travelers will you be?" name="number-of-travelers" 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&#39;d 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&#39;d 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" required="true" label="What destination(s) do you have in mind?" placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Price point you have in mind, excluding airfare" description="If you&#39;re not sure  that&#39;s OK. A good thought exercise is what you might want to spend on a hotel, and we can think of the trip price point as roughly double-to-triple that depending on how customized and private you want your touring to be. It may also be helpful to think about what you want to spend (per traveler) per day." name="price-point-you-have-in-mind-excluding-airfare" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="Priorities  any must-dos, pace, preferences, favorite trip memories" placeholder="Priorities  any must-dos, pace, preferences, favorite trip memories" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>