<form-template>
	<fields>
		<field type="header" subtype="h2" label="Traveler Details"/>
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>
		<field type="text" required="true" label="First Name" name="first-name" subtype="text" className="form-control"/>
		<field type="text" label="Middle Name" name="middle-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="Suffix" name="suffix" subtype="text" className="form-control"/>
		<field type="text" label="Preferred Name" name="preferred-name" subtype="text" className="form-control"/>
		<field type="text" required="true" 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="textarea" required="true" label="Additional Traveler Names (please list current ages for any children)" name="additional-traveler-names-please-list-current-ages-for-any-children" 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" required="true" label="City" name="address-city" subtype="text" className="form-control"/>
		<field type="text" required="true" 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="header" subtype="h2" label="Trip Overview"/>
		<field type="date" required="true" label="Departure Date" name="dates-of-travel" className="form-control"/>
		<field type="date" required="true" label="Return Date" name="return-date" className="form-control"/>
		<field type="checkbox-group" required="true" label="Are Your Dates Flexible?" name="are-your-dates-flexible">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="text" label="If Flexible, Please Share A Date Range" name="if-yes-please-share-a-date-range" subtype="text" className="form-control"/>
		<field type="text" required="true" label="Will You Be Celebrating Anything Special? (please list dates for special occasions)" name="will-you-be-celebrating-anything-special-please-list-dates-for-special-occasions" subtype="text" className="form-control"/>
		<field type="textarea" label="Which Destination(s) Are you Interested In Visiting?" name="which-destinations-are-you-interested-in-visiting" className="form-control"/>
		<field type="header" subtype="h2" label="Flight Information"/>
		<field type="text" required="true" label="What Is Your Preferred Airport(s)?" name="what-is-your-preferred-airports" subtype="text" className="form-control"/>
		<field type="checkbox-group" required="true" label="Will You Be Departing From / Returning To The Same Airport?" name="will-you-be-departing-from-returning-to-the-same-airport" other="true">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="checkbox-group" required="true" label="Will You Need Assistance Booking Flights?" name="will-you-need-assistance-booking-flights" other="true">
			<option label="Yes" value="yes">Yes</option>
			<option label="No" value="no">No</option>
			<option label="I Have Points / Miles To Use" value="i-have-points-miles-to-use">I Have Points / Miles To Use</option>
		</field>
		<field type="textarea" label="Any Additional Details To Share Regarding Flights?" name="additional-details-to-share-regarding-flights" className="form-control"/>
		<field type="header" subtype="h2" label="Hotel Preferences"/>
		<field type="text" required="true" label="How Many Times Would You Like To Move Hotels Throughout The Trip?" name="how-many-times-would-you-like-to-move-hotels-throughout-the-trip" subtype="text" className="form-control"/>
		<field type="checkbox-group" required="true" label="What Style of Hotel Do You Prefer (check all that apply)" name="what-style-of-hotel-do-you-prefer-check-all-that-apply" other="true">
			<option label="Boutique" value="boutique">Boutique</option>
			<option label="Larger Chain" value="larger-chain">Larger Chain</option>
			<option label="Modern/Contemporary" value="moderncontemporary">Modern/Contemporary</option>
			<option label="Classic" value="classic">Classic</option>
			<option label="Rustic" value="rustic">Rustic</option>
			<option label="Glamping" value="">Glamping</option>
			<option label="Sense of Place" value="sense-of-place">Sense of Place</option>
			<option label="Adults-Only" value="adultsonly">Adults-Only</option>
			<option label="All-Inclusive" value="allinclusive">All-Inclusive</option>
		</field>
		<field type="checkbox-group" required="true" label="Any Special Amenities You Prefer To Have At A Hotel? (check all that apply)" name="any-special-amenities-you-prefer-to-have-at-a-hotel-check-all-that-apply" other="true">
			<option label="Pool" value="">Pool</option>
			<option label="Spa" value="spa">Spa</option>
			<option label="Gym" value="gym">Gym</option>
			<option label="Golf" value="golf">Golf</option>
			<option label="Kids Club" value="kids-club">Kids Club</option>
			<option label="Tennis" value="tennis">Tennis</option>
		</field>
		<field type="checkbox-group" required="true" label="Are You Looking For Any Special In-Room Amenities?&amp;nbsp;(check all that apply)" name="are-you-looking-for-any-special-inroom-amenities-check-all-that-apply" other="true">
			<option label="Jacuzzi" value="jacuzzi">Jacuzzi</option>
			<option label="Plunge Pool / Private Pool" value="plunge-pool-private-pool">Plunge Pool / Private Pool</option>
			<option label="Bath Tub" value="bath-tub">Bath Tub</option>
		</field>
		<field type="text" label="Any Other Notes About The Hotels / Rooms You're Interested In?" name="any-other-notes-about-the-hotels-rooms-youre-interested-in" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="Activity Preferences"/>
		<field type="checkbox-group" required="true" label="What Type of Touring Do You Prefer? (check all that apply)" name="what-type-of-touring-do-you-prefer-check-all-that-apply" other="true">
			<option label="Private Guided Tours" value="private-guided-tours">Private Guided Tours</option>
			<option label="Public Shared Tours" value="public-shared-tours">Public Shared Tours</option>
			<option label="Self-Guided Touring" value="selfguided-touring">Self-Guided Touring</option>
		</field>
		<field type="checkbox-group" required="true" label="What Types Of Experiences / Activities Interest You For This Trip?&amp;nbsp;(check all that apply)" name="what-types-of-experiences-activities-interest-you-for-this-trip-check-all-that-apply" other="true">
			<option label="Historical / Cultural Touring" value="historical-cultural-touring">Historical / Cultural Touring</option>
			<option label="Beach R&amp;R" value="beach-rr">Beach R&amp;R</option>
			<option label="Boating / Sailing" value="boating-sailing">Boating / Sailing</option>
			<option label="Scuba Certified Diving" value="scuba-certified-diving">Scuba Certified Diving</option>
			<option label="Snorkeling" value="snorkeling">Snorkeling</option>
			<option label="Culinary / Foodie Experiences" value="culinary-foodie-experiences">Culinary / Foodie Experiences</option>
			<option label="Wine Tasting" value="wine-tasting">Wine Tasting</option>
			<option label="Animal Experiences (i.e. horseback riding, animal encounters, etc.)" value="animal-experiences-ie-horseback-riding-animal-encounters-etc">Animal Experiences (i.e. horseback riding, animal encounters, etc.)</option>
			<option label="Outdoor Adventure (i.e. ATV, hot air balloon, hiking, biking, etc.)" value="outdoor-adventure-ie-atv-hot-air-balloon-hiking-biking-etc">Outdoor Adventure (i.e. ATV, hot air balloon, hiking, biking, etc.)</option>
			<option label="Extreme Adventure (helicopter, bungee jumping, sky diving, etc.)" value="extreme-adventure-helicopter-bungee-jumping-sky-diving-etc">Extreme Adventure (helicopter, bungee jumping, sky diving, etc.)</option>
			<option label="Spa Treatments" value="spa-treatments">Spa Treatments</option>
			<option label="Golf" value="golf">Golf</option>
			<option label="Art &amp; Museums  " value="art-museums-">Art &amp; Museums  </option>
			<option label="Fashion / Shopping" value="fashion-shopping">Fashion / Shopping</option>
			<option label="Skiing" value="skiing">Skiing</option>
			<option label="Snowboarding" value="snowboarding">Snowboarding</option>
		</field>
		<field type="textarea" label="Any Other Notes You'd Like To Share Regarding Your Interests Above?" name="any-other-notes-youd-like-to-share-regarding-your-interests-above" className="form-control"/>
		<field type="header" subtype="h2" label="Budget Preferences"/>
		<field type="text" required="true" label="What Is Your Total Trip Budget?" name="what-is-your-total-trip-budget" subtype="text" className="form-control"/>
		<field type="text" required="true" label="What Is Your Ideal Budget Per Night For Hotels?" name="what-is-your-ideal-budget-per-night-for-hotels" subtype="text" className="form-control"/>
		<field type="text" required="true" label="What Is Your Ideal Budget For Transfers &amp;amp; Tours?" name="what-is-your-ideal-budget-for-transfers-tours" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="Final Notes To Further Customize Your Travel"/>
		<field type="checkbox-group" required="true" label="Are you and everyone you'll be traveling with fully vaccinated for Covid-19 (or do you plan to be prior to your travels)? This is helpful for us to know as entry protocol around the world is constantly changing." name="are-you-and-everyone-youll-be-traveling-with-fully-vaccinated-for-covid19-or-do-you-plan-to-be-prior-to-your-travels-this-is-helpful-for-us-to-know-as-entry-protocol-around-the-world-is-constantly-changing">
			<option label="Yes / Planning To Be Vaccinated" value="yes-planning-to-be-vaccinated">Yes / Planning To Be Vaccinated</option>
			<option label="Partially Vaccinated" value="partially-vaccinated">Partially Vaccinated</option>
			<option label="Not Vaccinated or Planning To Do So" value="not-vaccinated-or-planning-to-do-so">Not Vaccinated or Planning To Do So</option>
			<option label="Other" value="other">Other</option>
		</field>
		<field type="text" label="If you have more to share on the above, please provide below ..." name="if-you-have-more-to-share-on-the-above-please-provide-below-" subtype="text" className="form-control"/>
		<field type="textarea" required="true" label="What Is Your Favorite Trip You've Taken ... And Why?" name="what-is-your-favorite-trip-youve-taken-and-why" className="form-control"/>
		<field type="textarea" required="true" label="What Are Your Favorite Hotels From Previous Travels ... And Why?" name="what-are-your-favorite-hotels-from-previous-travels-and-why" className="form-control"/>
		<field type="textarea" label="Any Other Notes On Your Preferences Or Dreams For This Trip To Help Me Tailor It For You?" name="any-other-notes-on-your-preferences-or-dreams-for-this-trip-to-help-me-tailor-it-for-you" className="form-control"/>
		<field type="textarea" required="true" label="How Did You Hear About Uncorked Escapes?" name="how-did-you-hear-about-uncorked-escapes" className="form-control"/>
	</fields>
</form-template>