Share your information with Deja Avery

Deja Avery

Deserving Destinations by Deja

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  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Travel Questionnaire"/>&#13;
		<field type="header" subtype="h2" label="Personal Information"/>&#13;
		<field type="text" required="true" label="First name" 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" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Preferred name" name="preferred-name" 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="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="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<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"/>&#13;
		<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"/>&#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" required="true" label="How many travelers?" description="If uncertain  please specify in the text box at the end of the form." name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Maximum # of travelers per room?" description="We do not recommend more than 3 adults per room" name="text-1762283617172" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers? PER PERSON" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="$1,000 to $1,500" value="1000-1500">$1,000 to $1,500</option>&#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+" value="4500">$4,500+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What Travel Components are you requesting? (Select all that apply)" name="what-travel-components-are-you-requesting">&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Stay" value="stay">Stay</option>&#13;
			<option label="Rental Car" value="rental-car">Rental Car</option>&#13;
			<option label="Tours/Activities/Excursions" value="toursactivitiesexcursions">Tours/Activities/Excursions</option>&#13;
			<option label="Airport Transfers" value="airport-transfers">Airport Transfers</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Baecation/Honeymoon/Anniversary" value="baecationhoneymoonanniversary">Baecation/Honeymoon/Anniversary</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="All-Inclusive (food and drinks included with hotel stay)" value="allinclusive-food-and-drinks-included-with-hotel-stay">All-Inclusive (food and drinks included with hotel stay)</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Adults Only" value="adults-only">Adults Only</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Preferred Payment Method?" description="Please read the text at the bottom of the form." name="radio-group-1748016871963">&#13;
			<option label="Cash App" value="cash-app">Cash App</option>&#13;
			<option label="Paypal" value="paypal">Paypal</option>&#13;
			<option label="Credit Card" value="credit-card">Credit Card</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="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;
		<field type="text" label="Text Field" name="text-1741796482488" value="Upon submission  please send the $35 research fee (6 or more travelers  $45) via CashApp to $DejaAvery or PayPal to @DeservingDestination. Proposals will only be delivered upon receipt of payment." subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>