Share your information with Sharon Coppin

Sharon Coppin

My Epic Globetrotters

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  <body>
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	<fields>&#13;
		<field type="header" subtype="h2" label="Travel Quote Request Form"/>&#13;
		<field type="text" required="true" label="First name" name="first-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" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#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" required="true" label="How many travelers? including children 12 and above" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Specify the total number of children under 12 traveling and provide their ages at the TIME OF TRAVEL" name="text-1761311868568" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers in US?" description="This just gives me a general starting point and can always be changed later." name="budget">&#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="radio-group" required="true" label="What best describes your 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 Villa" value="luxury-villa">Luxury Villa</option>&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="AirBnB" value="airbnb">AirBnB</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Specify the te travel arrangements you would like included in your quote" inline="true" name="select-all-that-apply" other="true">&#13;
			<option label="Hotel/Resort" value="hotelresort" selected="selected">Hotel/Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Rental Home/Apartment/Condo" value="rental-homeapartmentcondo">Rental Home/Apartment/Condo</option>&#13;
			<option label="Villa" value="villa">Villa</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Train" value="train">Train</option>&#13;
			<option label="Other" value="other">Other</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="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="Wellness" value="wellness">Wellness</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" toggle="true" inline="true" name="activity-preferences" other="true">&#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 theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Wellness" value="Wellness">Wellness</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="" value=""/>&#13;
		</field>&#13;
		<field type="text" required="true" label="Anything you absolutely must do or see?" description="This helps our specialists customize your trip. Start with:  Cities or regions you want to visit Travel interests: culture  food, wine, romance, adventure, wildlife Special occasions: birthdays, weddings, honeymoons, events Relaxed or fast-paced travel" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="&amp;nbsp;This helps our specialists customize your trip. Start with: Cities or regions you want to visit Travel interests: culture, food, wine, romance, adventure, wildlife Special occasions: birthdays, weddings, honeymoons, events Relaxed or fast-paced travel" description="Custom Trip Package Trips designed around your own schedule. Activities or day tours can be private or shared.cheduled Group Tour Multi-day guided group tours with fixed departure dates.   Luxury Cruise All-inclusive travel by cruise ship.   Get recommendations from my specialist based on my interests" name="notes" rows="0" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Define your ideal travel experience Share activities and experiences that will make this trip truly yours." name="define-your-ideal-travel-experience-share-activities-and-experiences-that-will-make-this-trip-truly-yours" rows="6" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Scheduled Group Tour Multi-day guided group tours with fixed departure dates" name="scheduled-group-tour-multiday-guided-group-tours-with-fixed-departure-dates" rows="4" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Luxury Cruise All-inclusive travel by cruise ship." name="luxury-cruise-allinclusive-travel-by-cruise-ship" rows="4" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Get recommendations from my specialist based on my interests" description="Discuss with your travel advisor" name="get-recommendations-from-my-specialist-based-on-my-interests" className="form-control"/>&#13;
		<field type="select" required="true" label="PLease Let us know if you qualify for any of the following" name="please-let-us-know-if-you-qualify-for-any-of-the-following" multiple="multiple" className="form-control">&#13;
			<option label="US Military" value="us-military" selected="selected">US Military</option>&#13;
			<option label="Fire/ EMT dept" value="fire-emt-dept">Fire/ EMT dept</option>&#13;
			<option label="Age 55+" value="age-55">Age 55+</option>&#13;
			<option label="Teacher" value="teacher">Teacher</option>&#13;
		</field>&#13;
		<field type="textarea" label="Add Number" name="add-number" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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