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Shauna Damboise

Fancy Fox Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="First Contact Fit Form"/>&#13;
		<field type="header" subtype="h1" label="Client 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" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="About Your Trip"/>&#13;
		<field type="checkbox-group" required="true" label="What type of trip are you interested in?&amp;nbsp;" name="what-type-of-trip-are-you-interested-in-">&#13;
			<option label="All-inclusive  Caribbean Vacation" value="allinclusive-caribbean-vacation">All-inclusive  Caribbean Vacation</option>&#13;
			<option label="European River Cruise" value="european-river-cruise">European River Cruise</option>&#13;
			<option label="Caribbean Cruise" value="caribbean-cruise">Caribbean Cruise</option>&#13;
			<option label="European Travel" value="european-travel">European Travel</option>&#13;
			<option label="Hawaiian Islands" value="hawaiian-islands">Hawaiian Islands</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Group Travel" value="group-travel">Group Travel</option>&#13;
			<option label="Mediterranean Cruise " value="mediterranean-cruise-">Mediterranean Cruise </option>&#13;
			<option label="other" value="other">other</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Where are you hoping to travel, or what regions are you considering?" name="textarea-1767643517521" className="form-control"/>&#13;
		<field type="text" required="true" label="When would you like to travel? Month and year is fine if dates are flexible" name="text-1767643491000" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes, slightly" value="yes-slightly">Yes, slightly</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How many people including yourself will be traveling?" name="text-1767643441853" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure City" name="text-1767643513851" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Budget range PER PERSON before flights" name="radio-group-1767643706142">&#13;
			<option label="$4500-$6500" value="45006500">$4500-$6500</option>&#13;
			<option label="$6500-$9000" value="65009000">$6500-$9000</option>&#13;
			<option label="$9000-$15000" value="900015000">$9000-$15000</option>&#13;
			<option label="$15000 and above" value="15000-and-above">$15000 and above</option>&#13;
			<option label="Not sure yet but open to guidance" value="not-sure-yet-but-open-to-guidance">Not sure yet but open to guidance</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What phase of planning are you currently in?&amp;nbsp;" name="checkbox-group-1767643712611">&#13;
			<option label="Just starting to explore ideas" value="just-starting-to-explore-ideas">Just starting to explore ideas</option>&#13;
			<option label="We have dates but nothing booked" value="we-have-dates-but-nothing-booked">We have dates but nothing booked</option>&#13;
			<option label="We have some elements booked already" value="we-have-some-elements-booked-already">We have some elements booked already</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How did you hear about Fancy Fox Travel?" name="radio-group-1767644266935">&#13;
			<option label="Search Engine" value="search-engine">Search Engine</option>&#13;
			<option label="Friend or family referral" value="friend-or-family-referral">Friend or family referral</option>&#13;
			<option label="Social Media" value="social-media">Social Media</option>&#13;
			<option label="Past Client" value="past-client">Past Client</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="If you were referred by someone, who may I thank?" name="text-1767643672153" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Important Acknowledgement"/>&#13;
		<field type="radio-group" required="true" label="Please confirm that you understand the following.&amp;nbsp; &amp;nbsp; I understand that Fancy Fox Travel charges a planning fee for custom trip design. This fee is discussed after the consultation if we decide to move forward together." name="radio-group-1767644331828">&#13;
			<option label="Yes, I understand" value="yes-i-understand">Yes, I understand</option>&#13;
			<option label="" value=""/>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>