<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="select" required="true" label="My Travel Agent" name="my-travel-agent" className="form-control"> <option label="New Client" value="new-client">New Client</option> <option label="Dominique" value="dominique">Dominique</option> <option label="Heather" value="heather">Heather</option> <option label="Lisa" value="lisa">Lisa</option> <option label="Natalie" value="natalie">Natalie</option> </field> <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"/> <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"/> <field type="radio-group" label="How many nights do you want to cruise for? (please note we only service 7 nights or longer)" name="how-many-nights-do-you-want-to-cruise-for-please-note-we-only-service-7-nights-or-longer"> <option label="7 nights" value="7-nights">7 nights</option> <option label="8+ nights" value="8-nights">8+ nights</option> </field> <field type="checkbox-group" required="true" 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" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" label="If children please list ages at time of travel." name="if-children-please-list-ages-at-time-of-travel" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are you celebrating anything on this vacation?" name="are-you-celebrating-anything-on-this-vacation" other="true"> <option label="Destination Wedding" value="destination-wedding">Destination Wedding</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Birthday" value="birthday">Birthday</option> <option label="Retirement" value="retirement">Retirement</option> <option label="Graduation" value="graduation">Graduation</option> </field> <field type="radio-group" required="true" label="What is your per person price range?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option> <option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="radio-group" required="true" label="Does this include airfare?" name="does-this-include-airfare"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="Where would you like to sail on your cruise?" name="where-would-you-like-to-sail-on-your-cruise" other="true"> <option label="Mexico/Caribbean/Bahamas" value="mexicocaribbeanbahamas">Mexico/Caribbean/Bahamas</option> <option label="Alaska" value="alaska">Alaska</option> <option label="Hawaii" value="hawaii">Hawaii</option> <option label="Europe" value="europe">Europe</option> </field> <field type="radio-group" required="true" label="Have you cruise before?" name="have-you-cruise-before"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="Cabin choice" name="cabin-choice"> <option label="Suite" value="suite">Suite</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Ocean view" value="ocean-view">Ocean view</option> <option label="Inside" value="inside">Inside</option> </field> <field type="checkbox-group" required="true" label="Preferred dining time." name="preferred-dining-time"> <option label="Set early time (around 6pm)" value="set-early-time-around-6pm">Set early time (around 6pm)</option> <option label="Set late time (around 8:30pm)" value="set-late-time-around-830pm">Set late time (around 8:30pm)</option> <option label="Flexible time (may require separate reservations)" value="flexible-time-may-require-separate-reservations">Flexible time (may require separate reservations)</option> </field> <field type="checkbox-group" required="true" label="How big do you want your table size?" name="how-big-do-you-want-your-table-size"> <option label="Just the people in my party" value="just-the-people-in-my-party">Just the people in my party</option> <option label="It would be nice to meet another couple or two" value="it-would-be-nice-to-meet-another-couple-or-two">It would be nice to meet another couple or two</option> <option label="The more the merrier" value="the-more-the-merrier">The more the merrier</option> </field> <field type="checkbox-group" label="Beds pushed together or apart?" name="beds-pushed-together-or-apart"> <option label="Beds pushed together" value="beds-pushed-together">Beds pushed together</option> <option label="Beds apart" value="beds-apart">Beds apart</option> </field> <field type="text" label="Any qualifications for a cruise discount?" name="any-qualifications-for-a-cruise-discount" subtype="text" className="form-control"/> <field type="text" label="Do you have a preferred cruise line?" name="do-you-have-a-preferred-cruise-line" subtype="text" className="form-control"/> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <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="radio-group" required="true" label="What stage of research are you in?" name="what-stage-of-research-are-you-in"> <option label="I have not done any research." value="i-have-not-done-any-research">I have not done any research.</option> <option label="I have done some research but looking for an expert to finish the job." value="i-have-done-some-research-but-looking-for-an-expert-to-finish-the-job">I have done some research but looking for an expert to finish the job.</option> <option label=" have already received a quote for my vacation and am looking to beat the price." value="-have-already-received-a-quote-for-my-vacation-and-am-looking-to-beat-the-price"> have already received a quote for my vacation and am looking to beat the price.</option> </field> </fields> </form-template> </body> </html>
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