<html> <body> <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 required="true" type="text" 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="ABOUT YOUR TRIP"/> <field type="select" required="true" label="Where in the world would you like to go? *PLEASE NOTE that some popular destinations and combination trips will require a $20,000+ budget minimum." name="where-in-the-world-would-you-like-to-go-please-note-that-some-popular-destinations-and-combination-trips-will-require-a-20000-budget-minimum" className="form-control"> <option label="Australia" value="australia">Australia</option> <option label="Australia and New Zealand" value="australia-and-new-zealand">Australia and New Zealand</option> <option label="Bali" value="bali">Bali</option> <option label="Caribbean" value="caribbean">Caribbean</option> <option label="Costa Rica" value="costa-rica">Costa Rica</option> <option label="Croatia" value="croatia">Croatia</option> <option label="East Africa" value="east-africa">East Africa</option> <option label="France" value="france">France</option> <option label="French Polynesia" value="french-polynesia">French Polynesia</option> <option label="Greece" value="greece">Greece</option> <option label="Hawaii" value="hawaii">Hawaii</option> <option label="Ireland" value="ireland">Ireland</option> <option label="Italy" value="italy">Italy</option> <option label="Italy and Greece" value="italy-and-greece">Italy and Greece</option> <option label="Japan *$30,000 budget minimum required" value="japan-30000-budget-minimum-required">Japan *$30,000 budget minimum required</option> <option label="Maldives" value="maldives">Maldives</option> <option label="Multi-stop Europe" value="multistop-europe">Multi-stop Europe</option> <option label="New Zealand" value="new-zealand">New Zealand</option> <option label="Portugal" value="portugal">Portugal</option> <option label="South Africa" value="south-africa">South Africa</option> <option label="South Africa and the Seychelles" value="south-africa-and-the-seychelles">South Africa and the Seychelles</option> <option label="Thailand" value="thailand">Thailand</option> <option label="Thailand and Bali" value="thailand-and-bali">Thailand and Bali</option> <option label="United Kingdom" value="united-kingdom">United Kingdom</option> </field> <field type="select" required="true" label="How long is your dream trip?" name="how-long-is-your-dream-trip" className="form-control"> <option label="Less than 1 week" value="less-than-1-week">Less than 1 week</option> <option label="1 to 2 weeks" value="1-to-2-weeks">1 to 2 weeks</option> <option label="2 to 3 weeks" value="2-to-3-weeks">2 to 3 weeks</option> <option label="3 to 4 weeks" value="3-to-4-weeks">3 to 4 weeks</option> </field> <field type="text" required="true" label="How many people is this trip for?" name="how-many-people-is-this-trip-for" subtype="text" className="form-control"/> <field type="text" required="true" label="What's the full name of your travel companion(s)?" name="whats-the-full-name-of-your-travel-companions" subtype="text" className="form-control"/> <field type="select" required="true" label="What's your ideal budget?" name="whats-your-ideal-budget" className="form-control"> <option label="$15,000 to $20,000" value="15000-to-20000">$15,000 to $20,000</option> <option label="$20,000 to $25,000" value="20000-to-25000">$20,000 to $25,000</option> <option label="$25,000 to $35,000" value="25000-to-35000">$25,000 to $35,000</option> <option label="$35,000 to $50,000" value="35000-to-50000">$35,000 to $50,000</option> <option label="$50,000 to $75,000" value="50000-to-75000">$50,000 to $75,000</option> <option label="$75,000 to $100,000" value="75000-to-100000">$75,000 to $100,000</option> </field> <field type="checkbox-group" required="true" label="Bags are packed, when is this for?" name="bags-are-packed-when-is-this-for"> <option label="December 2024" value="december-2024">December 2024</option> <option label="January 2025" value="january-2025">January 2025</option> <option label="February 2025" value="february-2025">February 2025</option> <option label="March 2025" value="march-2025">March 2025</option> <option label="April 2025" value="april-2025">April 2025</option> <option label="May 2025" value="may-2025">May 2025</option> <option label="June 2025" value="june-2025">June 2025</option> <option label="July 2025" value="july-2025">July 2025</option> <option label="August 2025" value="august-2025">August 2025</option> <option label="September 2025" value="september-2025">September 2025</option> <option label="October 2025" value="october-2025">October 2025</option> <option label="November 2025" value="november-2025">November 2025</option> <option label="December 2025" value="december-2025">December 2025</option> </field> <field type="select" required="true" label="Do you have points/miles? *Clients are only permitted to use points/miles for flights. Points/miles cannot be used for hotel stays." name="do-you-have-pointsmiles-clients-are-only-permitted-to-use-pointsmiles-for-flights-pointsmiles-cannot-be-used-for-hotel-stays" className="form-control"> <option label="Yes, I have points/miles to use for flights only" value="yes-i-have-pointsmiles-to-use-for-flights-only">Yes, I have points/miles to use for flights only</option> <option label="No, I do not have points/miles to use for this trip" value="no-i-do-not-have-pointsmiles-to-use-for-this-trip">No, I do not have points/miles to use for this trip</option> </field> <field type="text" required="true" label="Are celebrations in order? Share the occasion!" name="are-celebrations-in-order-share-the-occasion" subtype="text" className="form-control"/> <field type="text" required="true" label="What's the scoop? Tell us about you!" name="whats-the-scoop-tell-us-about-you" subtype="text" className="form-control"/> <field type="text" label="How'd you find us?" name="howd-you-find-us" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="By clicking "I accept" you are acknowledging that you have read the following terms and conditions and fully understand what our service entails. <a href="https://www.overthemoonvacations.com/pages/terms-and-conditions/" target="_blank">Read our full terms and conditions by clicking here!</a>&nbsp;" name="by-clicking-i-accept-you-are-acknowledging-that-you-have-read-the-following-terms-and-conditions-and-fully-understand-what-our-service-entails-click-here-to-read-our-terms-and-conditions-in-full-httpswwwoverthemoonvacationscompagestermsandconditions"> <option label="I acknowledge that I have read the terms and conditions in full and agree to them" value="i-acknowledge-that-i-have-read-the-terms-and-conditions-in-full-and-agree-to-them">I acknowledge that I have read the terms and conditions in full and agree to them</option> </field> </fields> </form-template> </body> </html>
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