Share your information with Liz Jones

Liz Jones

Travelmation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Thinking about a trip somewhere? I&#39;d love to help plan an amazing getaway for you and your loved ones! Answer some quick questions and I&#39;ll be in touch. Enchanted journeys await!"/>&#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="text" label="Suffix" name="suffix" 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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" 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="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Preferred Methods of Contact" name="preferred-methods-of-contact" other="true">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Phone Call" value="phone-call">Phone Call</option>&#13;
			<option label="In Person Meeting" value="in-person-meeting">In Person Meeting</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Vacation Details"/>&#13;
		<field type="text" required="true" label="Will you be traveling with other adults? Please list their names &amp;amp; birthdates below." placeholder="Sally Smith 01-01-80  - If you will not be traveling with another adult  write N/A." name="will-you-be-traveling-with-other-adults-please-list-their-names-below" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Will you be traveling with children? Please list their names and birthdates below." placeholder="Susie Smith DOB: 01-10-21 - If you will not be traveling with children  write N/A." name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Departure Date" name="desired-departure-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Return Date" name="desired-return-date" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Will you need airfare?" name="will-you-need-airfare">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If airfare is needed, what airport(s) are you willing to depart from?" placeholder="Examples: MCO. BOS" name="if-airfare-is-needed-what-airports-are-you-willing-to-depart-from" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do you have a location in mind for your dream vacation?" placeholder="Example: St. Thomas" name="do-you-have-a-location-in-mind-for-your-dream-vacation" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Is there anything specific you would like to do or see while you are on your trip?" placeholder="Examples: Spa, Golf" name="is-there-anything-specific-you-would-like-to-do-or-see-while-you-are-on-your-trip" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your dream vacation budget?" name="budget">&#13;
			<option label="$1500 - $2500" value="1500-2500">$1500 - $2500</option>&#13;
			<option label="$2500 - $4500" value="2500-4500">$2500 - $4500</option>&#13;
			<option label="$4500 - $6500" value="4500-6500">$4500 - $6500</option>&#13;
			<option label="$6500 - 8500" value="6500-8500">$6500 - 8500</option>&#13;
			<option label="$8500 - $10,000" value="8500-10000">$8500 - $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="textarea" label="Will you be celebrating anything during your vacation?&amp;nbsp;" placeholder="Examples: Birthday, Anniversary, Honeymoon, Girl&#39;s Trip" name="notes" className="form-control"/>&#13;
		<field type="checkbox-group" label="Who can I thank for the referral?" name="who-can-i-thank-for-the-referral" other="true">&#13;
			<option label="Friend/Family Member" value="friendfamily-member">Friend/Family Member</option>&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="Google Search" value="google-search">Google Search</option>&#13;
			<option label="I'm an Established Client" value="im-an-established-client">I'm an Established Client</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>