<html> <body> <p> </p> <p> </p> <form-template> <fields> <field type="header" subtype="h1" label="CLIENT INFORMATION"/> <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" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="YOUR SAFARI"/> <field type="radio-group" required="true" label="Have you been on safari before?" name="have-you-been-on-safari-before"> <option label="This will be my first safari" value="this-will-be-my-first-safari">This will be my first safari</option> <option label="I've been once" value="i-ve-been-once">I've been once</option> <option label="I'm a seasoned safari-goer" value="i-m-a-seasoned-safari-goer">I'm a seasoned safari-goer</option> </field> <field type="checkbox-group" required="true" label="Where are you thinking of going? (choose any)" name="where-would-you-like-to-go"> <option label="Kenya" value="kenya">Kenya</option> <option label="Tanzania" value="tanzania">Tanzania</option> <option label="Rwanda (gorilla trekking)" value="rwanda-gorilla-trekking">Rwanda (gorilla trekking)</option> <option label="Botswana" value="botswana">Botswana</option> <option label="South Africa" value="south-africa">South Africa</option> <option label="Namibia" value="namibia">Namibia</option> <option label="Zambia or Zimbabwe" value="zambia-or-zimbabwe">Zambia or Zimbabwe</option> <option label="I'm not sure yet. Help me choose!" value="i-m-not-sure-yet-help-me-choose">I'm not sure yet. Help me choose!</option> </field> <field type="checkbox-group" label="What's on your safari wish list? (choose any)" name="safari-wish-list"> <option label="The Great Migration or a river crossing" value="the-great-migration-or-a-river-crossing">The Great Migration or a river crossing</option> <option label="Big cats" value="big-cats">Big cats</option> <option label="The Big Five" value="the-big-five">The Big Five</option> <option label="Gorilla trekking" value="gorilla-trekking">Gorilla trekking</option> <option label="Elephants" value="elephants">Elephants</option> <option label="Wild dogs" value="wild-dogs">Wild dogs</option> <option label="Water safaris (mokoro or boat)" value="water-safaris-mokoro-or-boat">Water safaris (mokoro or boat)</option> <option label="Walking safaris" value="walking-safaris">Walking safaris</option> <option label="Hot-air balloon" value="hot-air-balloon">Hot-air balloon</option> <option label="Photography" value="photography">Photography</option> </field> <field type="checkbox-group" label="Would you like to add anything before or after? (choose any)" name="add-before-or-after"> <option label="Victoria Falls" value="victoria-falls">Victoria Falls</option> <option label="Cape Town and the Winelands" value="cape-town-and-the-winelands">Cape Town and the Winelands</option> <option label="Finish on the beach (Zanzibar, Mozambique, Mauritius or the Seychelles)" value="finish-on-the-beach-zanzibar-mozambique-mauritius-or-the-seychelles">Finish on the beach (Zanzibar, Mozambique, Mauritius or the Seychelles)</option> <option label="Not sure yet" value="not-sure-yet">Not sure yet</option> </field> <field type="header" subtype="h1" label="WHEN AND WHO"/> <field type="text" required="true" label="When would you like to travel? (month and year is enough)" name="when-would-you-like-to-travel" subtype="text" className="form-control"/> <field type="radio-group" label="Are your dates flexible?" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" label="About how many nights are you thinking?" name="how-many-nights"> <option label="7 or fewer" value="7-or-fewer">7 or fewer</option> <option label="8 to 10" value="8-to-10">8 to 10</option> <option label="11 to 14" value="11-to-14">11 to 14</option> <option label="15 or more" value="15-or-more">15 or more</option> <option label="Not sure" value="not-sure">Not sure</option> </field> <field type="text" required="true" label="How many adults and how many children?" name="how-many-travelers" subtype="text" className="form-control"/> <field type="text" label="If children are coming, how old will they be when you travel?" name="childrens-ages" subtype="text" className="form-control"/> <field type="text" label="What is your departure city/preferred starting airport?" name="what-is-your-departure-city" subtype="text" className="form-control"/> <field type="radio-group" label="Are you celebrating anything special?" name="is-this-vacation-to-celebrate-anything-special" other="true"> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Milestone birthday" value="milestone-birthday">Milestone birthday</option> <option label="Family trip" value="family-trip">Family trip</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h1" label="STYLE AND BUDGET"/> <field type="radio-group" label="What kind of safari stay sounds most like you?" name="safari-stay-style"> <option label="Classic luxury tented camps" value="classic-luxury-tented-camps">Classic luxury tented camps</option> <option label="Ultra-luxury lodges" value="ultra-luxury-lodges">Ultra-luxury lodges</option> <option label="Small, remote and off the beaten path" value="small-remote-and-off-the-beaten-path">Small, remote and off the beaten path</option> <option label="Family-friendly" value="family-friendly">Family-friendly</option> <option label="Not sure yet" value="not-sure-yet">Not sure yet</option> </field> <field type="radio-group" label="Would you like a private vehicle and guide?" name="private-vehicle-and-guide"> <option label="Yes" value="yes">Yes</option> <option label="Maybe, tell me more" value="maybe-tell-me-more">Maybe, tell me more</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="What is your budget per person, per day, excluding international flights?" name="budget-per-person-per-day" other="true"> <option label="$1,500 to $2,500 per person, per day" value="1-500-to-2-500-per-person-per-day">$1,500 to $2,500 per person, per day</option> <option label="$2,500 to $3,500 per person, per day" value="2-500-to-3-500-per-person-per-day">$2,500 to $3,500 per person, per day</option> <option label="$3,500+ per person, per day" value="3-500-per-person-per-day">$3,500+ per person, per day</option> </field> <field type="text" label="Will you be using points for your international flights? (On a safari, points can only be used for international flights.)" name="will-you-be-booking-any-portion-of-your-trip-with-points-if-so-which-pieces" subtype="text" className="form-control"/> <field type="textarea" label="Is there anything I should know about mobility, dietary needs or small planes?" name="mobility-dietary-small-planes" className="form-control"/> <field type="textarea" label="What research have you done? Is there anything else you "must do" or see?" name="is-there-anything-else-you-must-do-or-see" className="form-control"/> <field type="textarea" label="What else would you like me to know?" name="describe-your-vision-for-your-ideal-vacation" className="form-control"/> <field type="header" subtype="h1" label="WORKING TOGETHER"/> <field type="checkbox-group" required="true" label="After our initial consultation, I work primarily via email to thoughtfully curate your itinerary. Additional calls are arranged by appointment as needed to support the planning process." name="after-our-initial-consultation-i-work-primarily-via-email-to-thoughtfully-curate-your-itinerary-additional-calls-are-arranged-by-appointment-as-needed-to-support-the-planning-process"> <option label="I agree" value="i-agree">I agree</option> </field> <field type="textarea" required="true" label="Who all will be traveling with you? Please list all full names and birthdates, as listed on passport. If you would like anyone else to be included on email correspondence, please add their email here." name="who-all-will-be-traveling-with-you-please-list-all-full-names-including-middle-and-birthdates-as-listed-on-passport" className="form-control"/> <field type="radio-group" required="true" label="For this trip, which best describes where you are in the planning process?" name="at-what-phase-of-planning-are-you-in"> <option label="I'm just exploring my options and am not planning on booking anything anytime soon." value="im-just-exploring-my-options-and-am-not-planning-on-booking-anything-anytime-soon">I'm just exploring my options and am not planning on booking anything anytime soon.</option> <option label="I'm ready to begin planning my trip and would like to book sometime in the near future." value="im-ready-to-begin-planning-my-trip-and-would-like-to-book-sometime-in-the-near-future">I'm ready to begin planning my trip and would like to book sometime in the near future.</option> <option label="I already know exactly what I want and want to book my trip ASAP." value="i-already-know-exactly-what-i-want-and-want-to-book-my-trip-asap">I already know exactly what I want and want to book my trip ASAP.</option> </field> <field type="radio-group" required="true" label="Have you ever worked with a travel advisor before?" name="have-you-ever-worked-with-a-travel-advisor-before"> <option label="Yes!" value="yes">Yes!</option> <option label="No, this will be the first time." value="no-this-will-be-the-first-time">No, this will be the first time.</option> </field> <field type="text" label="How did you hear about me?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/> <field type="select" required="true" label="Would you like to be subscribed to my newsletter and travel updates?" name="would-you-like-to-be-subscribed-to-our-newsletter-and-travel-updates" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="paragraph" subtype="p" label="By submitting this client inquiry form, you consent to receive travel related content via email from Lauren Bailey, That Blonde Travels."/> <field type="header" subtype="h1" label="Passport Required"/> <field type="paragraph" subtype="p" label="I understand that everyone (including children) must have a valid passport to enter any country outside of the United States. It must be valid for at least 6 months after we return, with blank pages for entry stamps. If not, I will obtain one prior to departure."/> <field type="checkbox-group" required="true" label="Please Acknowledge Below (Required)" name="please-acknowledge-below-required"> <option label="I understand that every person (including children) needs a passport valid for at least 6 months after we return, with blank pages for entry stamps." value="i-understand-that-every-person-including-children-needs-a-passport-valid-for-at-least-6-months-after-we-return-with-blank-pages-for-entry-stamps">I understand that every person (including children) needs a passport valid for at least 6 months after we return, with blank pages for entry stamps.</option> </field> </fields> </form-template> </body> </html>
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