Share your information with Lakesha Carrington

Lakesha Carrington

The Leisure Experience

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    <form-template>&#13;
	<fields>&#13;
		<field type="paragraph" subtype="p" label="Thank you for choosing The Leisure Experience for your next vacation! There is a $25 retainer fee which is good for one destination only. If you would like to change destinations, another $25 fee will apply. If you have your resort, already, no fee will apply! No fees for car rentals, simple accommodations or return customers. The fee is refundable the day of your trip! This fee allows us to provide individualized planning. Once this form is submitted, you will receive a retainer fee invoice. Planning will start once the fee is paid. Please allow 5-7 business days for your customized proposal."/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#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="date" label="Birthdate" name="birthdate" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" label="Sex" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your preferred method of communication?" name="what-is-your-preferred-method-of-communication">&#13;
			<option label="Phone Call" value="phone-call">Phone Call</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
		</field>&#13;
		<field type="select" label="Would you like to schedule a phone consultation?" name="would-you-like-to-schedule-a-phone-consultation" className="form-control">&#13;
			<option label="Yes, lets set up a phone call" value="yes-lets-set-up-a-phone-call">Yes, lets set up a phone call</option>&#13;
			<option label="We can communicate by my preferred method" value="we-can-communicate-by-my-preferred-method">We can communicate by my preferred method</option>&#13;
		</field>&#13;
		<field type="select" label="Are you prepared to make a deposit within the next 7-10 days, if you approve of the trip proposal we send you? Some airlines, require full payment of the flights. Any trip booked within 45 days will need to be paid in full at the time of booking, unless it is a pay at sight option." name="are-you-prepared-t-make-a-deposit-within-the-next-710-days-if-you-approve-of-the-trip-proposal-we-send-you-some-airlines-require-full-payment-of-the-flights-any-trip-booked-within-45-days-will-need-to-be-paid-in-full-at-the-time-of-booking-unless-it-is-a-pay-at-sight-option" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="text" label="How many travelers?" name="how-many-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Adults Only?" name="adults-only">&#13;
			<option label="YES, I do not want to see any kids" value="yes-i-do-not-want-to-see-any-kids">YES, I do not want to see any kids</option>&#13;
			<option label="I would prefer an adults only resort but okay with a family resort" value="i-would-prefer-an-adults-only-resort-but-okay-with-a-family-resort">I would prefer an adults only resort but okay with a family resort</option>&#13;
			<option label="Children will be traveling with us" value="children-will-be-traveling-with-us">Children will be traveling with us</option>&#13;
		</field>&#13;
		<field type="text" label="How old will the children be at the time of travel?" name="how-old-will-the-children-be-at-the-time-of-travel" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="text" label="Meal preference" name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Hotel preference" name="hotel-preference">&#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="checkbox-group" label="Vibe preferences" name="vibe-preference">&#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="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBT" value="lgbt">LGBT</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activity preferences" name="activity-preferences">&#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 theatre" value="art-theatre">Arts and theatre</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Preferred Destination" name="preferred-destination" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Any Destinations you wish to avoid?" name="any-destinations-you-wish-to-avoid" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Departing date" name="departing-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Returning date" name="returning-date" className="form-control"/>&#13;
		<field type="text" label="How many days would you like to travel? Are your dates flexible?" name="how-many-days-would-you-like-to-travel-are-your-dates-flexible" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What amount are you allocating to your trip for everyone?&amp;nbsp;" name="what-amount-are-you-allocating-to-your-trip-for-everyone-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Is budget flexible?" name="is-budget-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Anything else you need me to know?" name="anything-else-you-need-me-to-know" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="I understand that i will be working with a Luxury Travel Advisor who will guide me through the entire process. I understand there is a minimun $25 retainer fee. The fee is bases on number of travelers, trip length, and overall trip complexity. Are you ready to start planning?" name="i-understand-that-i-will-be-working-with-a-luxury-travel-advisor-who-will-guide-me-through-the-entire-process-i-understand-there-is-a-minimun-25-retainer-fee-the-fee-is-bases-on-number-of-travelers-trip-length-and-overall-trip-complexity-are-you-ready-to-start-planning">&#13;
			<option label="Yes, I am ready to start my trip process!" value="yes-i-am-ready-to-start-my-trip-process">Yes, I am ready to start my trip process!</option>&#13;
			<option label="No, but please keep my information on file" value="no-but-please-keep-my-information-on-file">No, but please keep my information on file</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
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