<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="header" subtype="h2" label="Full name"/> <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="header" subtype="h2" label="Address"/> <field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Important Dates"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="text" required="true" label="Have you worked with a Travel Advisor before?" name="have-you-worked-with-a-travel-advisor-before" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Trip Goals"/> <field type="text" label="Type of travel you are interested in?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="date" label="When would you like to depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/> <field type="date" label="When would you like to return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> </field> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do you need air included in your proposal?" name="do-you-need-air-included-in-your-proposal"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="How many adults (over 18)?" name="how-many-adults-over-18" subtype="text" className="form-control"/> <field type="text" required="true" label="How many children and ages at time of travel?" name="how-many-children-and-ages-at-time-of-travel" subtype="text" className="form-control"/> <field type="text" required="true" label="Number of rooms" name="number-of-rooms" subtype="text" className="form-control"/> <field type="text" required="true" label="What is your budget for all travelers in your party?" name="what-is-your-budget-for-all-travelers-in-your-party" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Travel Insurance"/> <field type="paragraph" subtype="p" label="Emergencies can happen when you least expect them. Faith, Trust &amp; Pixie Dust Travel, LLC highly recommends that all clients purchase a travel insurance policy to protect your trip investment. Cruise lines, airlines, hotels, and tour operators all charge high penalties for cancellation, ranging from the full deposit to no refund at all. And keep in mind that most health insurance policies will not cover you when you are out of the country. Travel insurance can protect you in the event of Trip Cancellation, Trip Delay, Trip Interruption, Missed Connection, Baggage Loss, Theft or Damage, Baggage Delay, Emergency Medical and Dental Expenses, Emergency Medical Transportation, among other unforeseen circumstances. If you choose to decline this valuable protection, you are assuming any financial loss associated with your travel arrangements. By declining to purchase travel insurance you fully understand that your travel agent is not liable or responsible for any expenses incurred because of cancellation, trip interruption, emergency medical transportation, baggage and personal effects loss, flight, travel accident, etc. Please understand that we are not registered insurance agents and cannot legally provide specific advice or information regarding insurance. We will gladly secure a quote for you, upon request, and if Faith, Trust &amp; Pixie Dust Travel, LLC does not, or is not legally able to secure coverage on your behalf, it is our strong recommendation that you purchase a policy on your own.&nbsp;"/> <field type="radio-group" required="true" label="Click" name="would-you-like-to-add-travel-insurance-to-your-vacation-package"> <option label="Yes, please add." value="yes-please-add">Yes, please add.</option> <option label="I am declining coverage." value="i-am-declining-coverage">I am declining coverage.</option> </field> <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="radio-group" required="true" label="What type of room category are you interested in?" name="what-type-of-room-category-are-you-interested-in"> <option label="Swim up " value="swim-up-">Swim up </option> <option label="Oceanfront" value="oceanfront">Oceanfront</option> <option label="Ocean view" value="ocean-view">Ocean view</option> <option label="Garden view" value="garden-view">Garden view</option> <option label="Pool view" value="pool-view">Pool view</option> <option label="Butler service" value="butler-service">Butler service</option> <option label="Concierge" value="concierge">Concierge</option> <option label="Overwater bungalows " value="overwater-bungalows-">Overwater bungalows </option> <option label="Suite (cruise)" value="suite-cruise">Suite (cruise)</option> <option label="Balcony (cruise)" value="balcony-cruise">Balcony (cruise)</option> <option label="Ocean view (cruise)" value="ocean-view-cruise">Ocean view (cruise)</option> <option label="Inside (cruise)" value="inside-cruise">Inside (cruise)</option> <option label="Value (Disney)" value="value-disney">Value (Disney)</option> <option label="Moderate (Disney)" value="moderate-disney">Moderate (Disney)</option> <option label="Deluxe (Disney)" value="deluxe-disney">Deluxe (Disney)</option> <option label="Deluxe Villas (Disney)" value="deluxe-villas-disney">Deluxe Villas (Disney)</option> <option label="Off property (Disney)" value="off-property-disney">Off property (Disney)</option> <option label="Value ( Universal Studios)" value="value-universal-studios">Value ( Universal Studios)</option> <option label="Prime value (Universal Studios)" value="prime-value-universal-studios">Prime value (Universal Studios)</option> <option label="Preferred hotel (Universal Studios)" value="preferred-hotel-universal-studios">Preferred hotel (Universal Studios)</option> <option label="Premier hotel (Universal Studios)" value="premier-hotel-universal-studios">Premier hotel (Universal Studios)</option> <option label="Off property (Universal Studios)" value="off-property-universal-studios">Off property (Universal Studios)</option> <option label="Accessible room" value="accessible-room">Accessible room</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="radio-group" label="What type of activities are you most interested in?" name="what-type-of-activities-are-you-most-interested-in"> <option label="Beach" value="beach">Beach</option> <option label="Pool" value="pool">Pool</option> <option label="Relax" value="relax">Relax</option> <option label="Mix of fun and relaxation" value="mix-of-fun-and-relaxation">Mix of fun and relaxation</option> <option label="Scuba diving" value="scuba-diving">Scuba diving</option> <option label="Snorkeling" value="snorkeling">Snorkeling</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Local cuisine" value="local-cuisine">Local cuisine</option> <option label="Nature" value="nature">Nature</option> <option label="Night life" value="night-life">Night life</option> <option label="On property activities" value="on-property-activities">On property activities</option> </field> <field type="text" label="Other Activities not mentioned" name="other-activities-not-mentioned" subtype="text" className="form-control"/> <field type="text" label="Anything you absolutely must do or see on this vacation?" name="must-dos" subtype="text" className="form-control"/> <field type="text" label="What are you looking to avoid on this vacation?" name="what-are-you-looking-to-avoid-on-this-vacation" subtype="text" className="form-control"/> <field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="text" required="true" label="How did you hear about Faith, Trust &amp; Pixie Dust Travel, LLC?" name="how-did-you-hear-about-faith-trust-pixie-dust-travel-llc" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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