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Vanessa Naputi

Genesis Voyages

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  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h3" label="CLIENT DETAILS"/>&#13;
		<field type="text" required="true" label="First Name" placeholder="As it appears on your passport or government id." 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" placeholder="As it appears on your passport or government id." name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="text" label="Home Address" placeholder="12345 Your Street  City  State  Zipcode" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone Number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" placeholder="client@genesisvoyages.com" name="email" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="What is your preferred method of communication?" placeholder="Select One" name="select-1768243680202" className="form-control">&#13;
			<option label="Call" value="call">Call</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="pageBreak" name="pageBreak-1768235575339" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h3" label="TRIP OVERVIEW"/>&#13;
		<field type="text" label="What destination(s) would you like to travel to?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="Ex: Greece  the Caribbean  Southeast Asia" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Approximate Travel Dates (or date range)" name="approximate-travel-dates-or-date-range" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Trip Length" placeholder="Select Number of Nights" name="trip-length" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
			<option label="10" value="10">10</option>&#13;
			<option label="11" value="11">11</option>&#13;
			<option label="12" value="12">12</option>&#13;
			<option label="13" value="13">13</option>&#13;
			<option label="14" value="14">14</option>&#13;
			<option label="15+" value="15">15+</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768244485182" rule="eyJ3aGVuRmllbGQiOiJ0cmlwLWxlbmd0aCIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiIxNSIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJlbnRlci1ob3ctbWFueS1uaWdodHMtYmVsb3ciXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJlbnRlci1ob3ctbWFueS1uaWdodHMtYmVsb3ciLCJsYWJlbCI6IkVudGVyIGhvdyBtYW55IG5pZ2h0cyBiZWxvdy4ifV19"/>&#13;
		<field type="text" label="Enter how many nights below." name="enter-how-many-nights-below" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" inline="true" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="select" label="How many adults?" name="how-many-travelers" className="form-control">&#13;
			<option label="Select" value="select">Select</option>&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6+" value="6">6+</option>&#13;
		</field>&#13;
		<field type="select" label="How many children?" name="select-1738005631059" className="form-control">&#13;
			<option label="Select" value="select">Select</option>&#13;
			<option label="None" value="none">None</option>&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6+" value="6">6+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Is there anyone in your party who requires assistance or has special needs that may affect travel arrangements?" inline="true" name="does-anyone-in-your-party-require-special-assistance-or-specific-accommodations">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768244615899" rule="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"/>&#13;
		<field type="checkbox-group" label="Accessibility Needs" description="✔️ Please select all that apply (additional details may be requested to ensure proper accommodations)." name="-please-select-all-that-apply-additional-details-may-be-requested-to-ensure-proper-accommodations" other="true" className="field-hidden">&#13;
			<option label="Mobility &amp; Physical Assistance" value="mobility-physical-assistance">Mobility &amp; Physical Assistance</option>&#13;
			<option label="Accessible Accommodations (Hotels &amp; Cruises)" value="accessible-accommodations-hotels-cruises">Accessible Accommodations (Hotels &amp; Cruises)</option>&#13;
			<option label="Medical or Health-Related Considerations" value="medical-or-healthrelated-considerations">Medical or Health-Related Considerations</option>&#13;
			<option label="Sensory &amp; Cognitive Support" value="sensory-cognitive-support">Sensory &amp; Cognitive Support</option>&#13;
			<option label="Dietary &amp; Food Requirements" value="dietary-food-requirements">Dietary &amp; Food Requirements</option>&#13;
			<option label="Travel Assistance &amp; Support Needs" value="travel-assistance-support-needs">Travel Assistance &amp; Support Needs</option>&#13;
		</field>&#13;
		<field type="pageBreak" name="pageBreak-1768235599147" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h3" label="TRAVEL STYLE &amp;amp; PURPOSE"/>&#13;
		<field type="text" label="What best describes this trip?" placeholder="I Need a Break from Adulting  50th Birthday, Etc." name="what-best-describes-this-trip" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What type of vacation are you interested in?" name="what-type-of-vacation-are-you-interested-in">&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Escorted or Guided Tour" value="escorted-or-guided-tour">Escorted or Guided Tour</option>&#13;
			<option label="Multi-Destination Travel" value="multidestination-travel">Multi-Destination Travel</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768246447216" rule="eyJ3aGVuRmllbGQiOiJ3aGF0LXR5cGUtb2YtdmFjYXRpb24tYXJlLXlvdS1pbnRlcmVzdGVkLWluIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6ImFsbGluY2x1c2l2ZS1yZXNvcnQiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsicmFkaW8tZ3JvdXAtMTc2ODI0NjQ5MTYwOSJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InJhZGlvLWdyb3VwLTE3NjgyNDY0OTE2MDkiLCJsYWJlbCI6IlJhZGlvIEdyb3VwIn1dfQ=="/>&#13;
		<field type="radio-group" label="Type of Resort" inline="true" name="radio-group-1768246491609" className="field-hidden">&#13;
			<option label="Adults-Only" value="adultsonly">Adults-Only</option>&#13;
			<option label="Family-Friendly" value="familyfriendly">Family-Friendly</option>&#13;
			<option label="Either is Fine" value="either-is-fine">Either is Fine</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768250039426" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzY4MjQ2NDkxNjA5Iiwid2hlbkNvbmRpdGlvbiI6ImlzLW5vdC1lbXB0eSIsIndoZW5WYWx1ZSI6IiIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJjaGVja2JveC1ncm91cC0xNzY4MjQ3NzEzMTUyIl0sInRoZW5GaWVsZHNJbmZvIjpbeyJuYW1lIjoiY2hlY2tib3gtZ3JvdXAtMTc2ODI0NzcxMzE1MiIsImxhYmVsIjoiUm9vbSBQcmVmZXJlbmNlIn1dfQ=="/>&#13;
		<field type="checkbox-group" label="Room Preference" name="checkbox-group-1768247713152" className="field-hidden">&#13;
			<option label="Run of the House (Standard)" value="run-of-the-house-standard">Run of the House (Standard)</option>&#13;
			<option label="Garden, Resort, or Pool View" value="garden-resort-or-pool-view">Garden, Resort, or Pool View</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Oceanfront / Beachfront" value="oceanfront-beachfront">Oceanfront / Beachfront</option>&#13;
			<option label="Walkout Patio" value="walkout-patio">Walkout Patio</option>&#13;
			<option label="Swim-Up Pool Access" value="swimup-pool-access">Swim-Up Pool Access</option>&#13;
			<option label="Overwater Bungalow" value="overwater-bungalow">Overwater Bungalow</option>&#13;
			<option label="Villa or Penthouse" value="villa-or-penthouse">Villa or Penthouse</option>&#13;
			<option label="Open to Recommendations" value="open-to-recommendations">Open to Recommendations</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768246598435" rule="eyJ3aGVuRmllbGQiOiJ3aGF0LXR5cGUtb2YtdmFjYXRpb24tYXJlLXlvdS1pbnRlcmVzdGVkLWluIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6ImNydWlzZSIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJzZWxlY3QtMTc2ODI0NjY0MDI5OSJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InNlbGVjdC0xNzY4MjQ2NjQwMjk5IiwibGFiZWwiOiJTZWxlY3QifV19"/>&#13;
		<field type="select" label="Type of Cruise" placeholder="Select One" name="select-1768246640299" className="form-control field-hidden">&#13;
			<option label="Ocean" value="ocean">Ocean</option>&#13;
			<option label="River" value="river">River</option>&#13;
			<option label="Expedition" value="expedition">Expedition</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768247146668" rule="eyJ3aGVuRmllbGQiOiJzZWxlY3QtMTc2ODI0NjY0MDI5OSIsIndoZW5Db25kaXRpb24iOiJpcy1ub3QtZW1wdHkiLCJ3aGVuVmFsdWUiOiIiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsiY2hlY2tib3gtZ3JvdXAtMTc2ODI0NzI2OTUyMCJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6ImNoZWNrYm94LWdyb3VwLTE3NjgyNDcyNjk1MjAiLCJsYWJlbCI6IkNhYmluIFByZWZlcmVuY2UifV19"/>&#13;
		<field type="checkbox-group" label="Cabin Preference" inline="true" name="checkbox-group-1768247269520" className="field-hidden">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="pageBreak" name="pageBreak-1768251004632" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h3" label="LET&#39;S TALK BUDGET"/>&#13;
		<field type="paragraph" subtype="blockquote" label="To help us design the best experience for you, please share a comfortable budget range or maximum amount you’d prefer not to exceed. This is a planning guide only and helps ensure we recommend options that feel like a great fit."/>&#13;
		<field type="select" required="true" label="Preferred Budget" description="For all travelers  excluding airfare." placeholder="Select One" name="select-1768251406469" className="form-control">&#13;
			<option label="Up to $3,500 total trip" value="up-to-3500-total-trip">Up to $3,500 total trip</option>&#13;
			<option label="Up to $5,000 total trip" value="up-to-5000-total-trip">Up to $5,000 total trip</option>&#13;
			<option label="Up to $6,500 total trip" value="up-to-6500-total-trip">Up to $6,500 total trip</option>&#13;
			<option label="Up to $8,500 total trip" value="up-to-8500-total-trip">Up to $8,500 total trip</option>&#13;
			<option label="Up to $10,000 total trip" value="up-to-10000-total-trip">Up to $10,000 total trip</option>&#13;
			<option label="$10,000+ total trip" value="10000-total-trip">$10,000+ total trip</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="When are you hoping to book this trip?" placeholder="Select One" name="select-1768252838343" className="form-control">&#13;
			<option label="I'm Ready to Book" value="im-ready-to-book">I'm Ready to Book</option>&#13;
			<option label="Within 1-2 Weeks" value="within-12-weeks">Within 1-2 Weeks</option>&#13;
			<option label="After Reviewing Pricing and Options" value="after-reviewing-pricing-and-options">After Reviewing Pricing and Options</option>&#13;
		</field>&#13;
		<field type="textarea" label="Is there anything else you’d like us to know as we review your request?" name="is-there-anything-else-youd-like-us-to-know-as-we-review-your-request" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>