Share your information with Alex Pena

Alex Pena

Viva Vistas, LLC

<html>
  <body>
    <form-template>&#13;
	<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="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" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" 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;
		</field>&#13;
		<field type="radio-group" 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" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Flights-Departure&amp;nbsp; What time would you like to depart?" name="flightsdeparture-what-time-would-you-like-to-depart">&#13;
			<option label="As early as possible 5-8am" value="as-early-as-possible-58am">As early as possible 5-8am</option>&#13;
			<option label="Morning 8-11am" value="morning-811am">Morning 8-11am</option>&#13;
			<option label="Afternoon 12-4pm" value="afternoon-124pm">Afternoon 12-4pm</option>&#13;
			<option label="Evening 4-7pm" value="evening-47pm">Evening 4-7pm</option>&#13;
			<option label="Night 7-9pm" value="night-79pm">Night 7-9pm</option>&#13;
			<option label="Late flight " value="late-flight-">Late flight </option>&#13;
		</field>&#13;
		<field type="radio-group" label="Flights-Return,&amp;nbsp; What time would you like your return flight to be?" name="flightsreturn-what-time-would-you-like-your-return-flight-to-be">&#13;
			<option label="As early as possible 5-8am" value="as-early-as-possible-58am">As early as possible 5-8am</option>&#13;
			<option label="Morning 8-11am" value="morning-811am">Morning 8-11am</option>&#13;
			<option label="Afternoon 12-4pm" value="afternoon-124pm">Afternoon 12-4pm</option>&#13;
			<option label="Evening 4-7pm" value="evening-47pm">Evening 4-7pm</option>&#13;
			<option label="Night 7-9pm" value="night-79pm">Night 7-9pm</option>&#13;
			<option label="Late flight " value="late-flight-">Late flight </option>&#13;
		</field>&#13;
		<field type="text" label="Do you have an airline preference?" name="text-1758596565668" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Do you have airline points you would like to use?" name="do-you-have-airline-points-you-would-like-to-use">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you have a TSA PreCheck® KTN ?" name="do-you-have-a-tsa-precheck-ktn-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</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;
		</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="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;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for activities/excurions ? per person" description="This just gives me a general starting point and can always be changed later." name="radio-group-1758595880514">&#13;
			<option label="$50 to $75" value="50-to-75">$50 to $75</option>&#13;
			<option label="$75 to $100" value="75-to-100">$75 to $100</option>&#13;
			<option label="$100 to $150" value="100-to-150">$100 to $150</option>&#13;
			<option label="$150to $200" value="150to-200">$150to $200</option>&#13;
			<option label="$200 to 300" value="200-to-300">$200 to 300</option>&#13;
			<option label="$300 to $500" value="300-to-500">$300 to $500</option>&#13;
		</field>&#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>
  </body>
</html>