Share your information with Allison Medor

Allison Medor

Perfect Presence Global Travel

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	<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="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? Names and ages (if they are minors.)" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Have you ever used a travel advisor? &amp;nbsp;If yes, please tell us about your experience&amp;nbsp;" name="have-you-ever-used-a-travel-advisor-if-yes-please-tell-us-about-your-experience-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers excluding airfare and food?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="$20,000-$30000" value="2000030000">$20,000-$30000</option>&#13;
			<option label="$30,000-$40,000" value="3000040000">$30,000-$40,000</option>&#13;
			<option label="$40,000-$50,000" value="4000050000">$40,000-$50,000</option>&#13;
			<option label="$50,000-$60,000" value="5000060000">$50,000-$60,000</option>&#13;
			<option label="$60,000+" value="60000">$60,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Moderate 4*" value="moderate-4">Moderate 4*</option>&#13;
			<option label="Luxury 5*" value="luxury-5">Luxury 5*</option>&#13;
			<option label="Ultra Lux " value="ultra-lux-">Ultra Lux </option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Tell me about the best hotel experience you have ever had. What made it so special?&amp;nbsp;" name="tell-me-about-the-best-hotel-experience-you-have-ever-had-what-made-it-so-special-" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Tell me about a hotel experience that was just OK and why" name="tell-me-about-a-hotel-experience-that-was-just-ok-and-why" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Tell me about a hotel experience that disappointed you and why?&amp;nbsp;" name="tell-me-about-a-hotel-experience-that-disappointed-you-and-why-" subtype="text" className="form-control"/>&#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="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;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Immersive Food Experiences " value="immersive-food-experiences-">Immersive Food Experiences </option>&#13;
			<option label="Cultural Connections" value="cultural-connections">Cultural Connections</option>&#13;
			<option label="History " value="history-">History </option>&#13;
			<option label="Wellness and Relaxation " value="wellness-and-relaxation-">Wellness and Relaxation </option>&#13;
		</field>&#13;
		<field type="text" label="What are your dreams for this trip?&amp;nbsp;" description="(What would make this trip unforgettable for you? Think experiences  places  or moments you’ve been dreaming of.)" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What does a perfect trip or even the perfect day on the trip look like for you?" description="What time does the day start? How many planned activities? What time do you like to wind down or have free time?" name="text-1736696208912" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Anything you absolutely must do or see?" description="(What are the key elements or services that are absolutely essential to your trip?)" name="text-1728033637923" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Travel Turn Offs?" description="(Any specific things you’d like to avoid? This can include certain hotel types  activities  or other preferences.)" name="text-1728033408280" 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>
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