Mary Thomas

Simply Amazing Experiences, LLC.

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	<fields>&#13;
		<field type="header" subtype="h1" label="The Basics&amp;nbsp;"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#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" 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="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Preferred Method of Contact&amp;nbsp;" name="preferred-method-of-contact-" className="form-control">&#13;
			<option label="Phone" value="phone-">Phone</option>&#13;
			<option label="Text " value="text-">Text </option>&#13;
			<option label="Email " value="email-">Email </option>&#13;
			<option label="Social Media Messaging " value="social-media-messaging-">Social Media Messaging </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Information&amp;nbsp;"/>&#13;
		<field type="radio-group" required="true" label="What Kind of Itinerary Are We Creating?&amp;nbsp;" name="what-kind-of-itinerary-are-we-creating-">&#13;
			<option label="Road Trip - Traveling via car or train" value="road-trip-traveling-via-car-or-train">Road Trip - Traveling via car or train</option>&#13;
			<option label="Air Domestic - Flying anywhere in the United States" value="air-domestic-flying-anywhere-in-the-united-states">Air Domestic - Flying anywhere in the United States</option>&#13;
			<option label="Air International - Flying anywhere outside of the US " value="air-international-flying-anywhere-outside-of-the-us-" selected="selected">Air International - Flying anywhere outside of the US </option>&#13;
			<option label="Group Itinerary - 6 + rooms           +/-10 or more people " value="group-itinerary-6-rooms-10-or-more-people-">Group Itinerary - 6 + rooms           +/-10 or more people </option>&#13;
			<option label="Cruise - Full Cruise Planning on and off the ship " value="cruise-full-cruise-planning-on-and-off-the-ship-">Cruise - Full Cruise Planning on and off the ship </option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Travel Start Date" placeholder="Planning must begin at least 45 days before travel" name="travel-start-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Travel End Date&amp;nbsp;" name="travel-end-date-" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your travel dates flexible?&amp;nbsp;" description="If so, think about how many days you want to spend in the destination.  " name="are-your-travel-dates-flexible-">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I'm unsure " value="im-unsure-">I'm unsure </option>&#13;
		</field>&#13;
		<field type="text" label="Departure City&amp;nbsp;" name="departure-city-" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Number of Adults&amp;nbsp;" name="number-of-adults-" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
			<option label="10" value="10">10</option>&#13;
			<option label="11" value="11">11</option>&#13;
			<option label="12" value="12">12</option>&#13;
			<option label="13" value="13">13</option>&#13;
			<option label="14" value="14">14</option>&#13;
			<option label="15" value="15">15</option>&#13;
			<option label="16" value="16">16</option>&#13;
			<option label="17" value="17">17</option>&#13;
			<option label="18" value="18">18</option>&#13;
			<option label="19" value="19">19</option>&#13;
			<option label="20+" value="20">20+</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Number of Children 0-16 years" name="number-of-children-016-years" className="form-control">&#13;
			<option label="0" value="0">0</option>&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
			<option label="10" value="10">10</option>&#13;
			<option label="11+" value="11">11+</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where do you want to go?" description="If more than one destination include all desired destination." name="where-do-you-want-to-go" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="How Will This Experience be Simply Amazing?"/>&#13;
		<field type="radio-group" required="true" label="What are we planning this trip for?" name="what-are-we-planning-this-trip-for" other="true">&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Anniversary " value="anniversary-">Anniversary </option>&#13;
			<option label="Birthday " value="birthday-">Birthday </option>&#13;
			<option label="Family Vacation " value="family-vacation-">Family Vacation </option>&#13;
			<option label="Girl/Guy Trip " value="girlguy-trip-">Girl/Guy Trip </option>&#13;
			<option label="Babymoon" value="babymoon">Babymoon</option>&#13;
			<option label="Wedding" value="wedding">Wedding</option>&#13;
			<option label="Just Want to Get Away " value="just-want-to-get-away-">Just Want to Get Away </option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What's Your Budget Per Person?" inline="true" name="whats-your-budge-for-this-entire-trip">&#13;
			<option label="$2000" value="2000">$2000</option>&#13;
			<option label="$3000" value="3000">$3000</option>&#13;
			<option label="$4000" value="4000">$4000</option>&#13;
			<option label="$5000" value="5000">$5000</option>&#13;
			<option label="$6500" value="6500">$6500</option>&#13;
			<option label="$7500" value="7500">$7500</option>&#13;
			<option label="$8500" value="8500">$8500</option>&#13;
			<option label="$9500" value="9500">$9500</option>&#13;
			<option label="$10,000" value="10000">$10,000</option>&#13;
			<option label="$15,000" value="15000">$15,000</option>&#13;
			<option label="$20,000+" value="20000">$20,000+</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="What's the Vibe?" name="whats-the-vibe" className="form-control">&#13;
			<option label="Let's gooooo! Late nights and early mornings. " value="lets-gooooo-late-nights-and-early-mornings-">Let's gooooo! Late nights and early mornings. </option>&#13;
			<option label="A healthy Mix. Time to relax but I also want some amazing experiences. " value="a-healthy-mix-time-to-relax-but-i-also-want-some-amazing-experiences-">A healthy Mix. Time to relax but I also want some amazing experiences. </option>&#13;
			<option label="Chill. Lot's of down time but throw a few things in there for me to do.  " value="chill-lots-of-down-time-but-throw-a-few-things-in-there-for-me-to-do-">Chill. Lot's of down time but throw a few things in there for me to do.  </option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="How Much of this Stuff Should be Included?&amp;nbsp;"/>&#13;
		<field type="checkbox-group" label="Food - Restaurants &amp;amp; markets&amp;nbsp;&amp;nbsp;" name="food-restaurants-markets-">&#13;
			<option label="I'm a foodie, I'd love this. " value="im-a-foodie-id-love-this-">I'm a foodie, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Social - Night clubs, lounges, area events" name="social-night-clubs-lounges-area-events">&#13;
			<option label="I want to be in the mix, I'd love this. " value="i-want-to-be-in-the-mix-id-love-this-">I want to be in the mix, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="History - Museums &amp;amp; art galleries" name="history-museums-art-galleries">&#13;
			<option label="History and art is for me, I'd love this. " value="history-and-art-is-for-me-id-love-this-">History and art is for me, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Tours - Guided or self tours, classes" name="tours-guided-or-self-tours-classes">&#13;
			<option label="I want to experience the destination, I'd love this. " value="i-want-to-experience-the-destination-id-love-this-">I want to experience the destination, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Shopping - Malls, boutiques, area markets" name="shopping-malls-boutiques-area-markets">&#13;
			<option label="Shopping is always a good idea, I'd love this. " value="shopping-is-always-a-good-idea-id-love-this-">Shopping is always a good idea, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Wellness - Spas &amp;amp; Salons&amp;nbsp;" name="wellness-spas-salons-">&#13;
			<option label="Yes, pampering sounds nice, I'd love this. " value="yes-pampering-sounds-nice-id-love-this-">Yes, pampering sounds nice, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Adventure - Watersports &amp;amp; excursions.&amp;nbsp;" name="adventure-watersports-excursions-">&#13;
			<option label="I'm an adventure seeker, I'd love this. " value="im-an-adventure-seeker-id-love-this-">I'm an adventure seeker, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Nature - Beach, scenic views, hikes, golf" name="nature-beach-scenic-views-hikes-golf">&#13;
			<option label="I want to soak up nature, I'd love this. " value="i-want-to-soak-up-nature-id-love-this-">I want to soak up nature, I'd love this. </option>&#13;
			<option label="Take it or leave it. " value="take-it-or-leave-it-">Take it or leave it. </option>&#13;
			<option label="No thank you." value="no-thank-you">No thank you.</option>&#13;
		</field>&#13;
		<field type="text" label="Is there any additional information you would like me to know about this experience?" name="is-there-any-additional-information-you-would-like-me-to-know-about-this-experience" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Accommodations&amp;nbsp;"/>&#13;
		<field type="checkbox-group" label="What kind of place do you want to stay in?&amp;nbsp;" description="If building a cruise itinerary only select if needed before or after your cruise." name="what-kind-of-place-do-you-want-to-stay-in-">&#13;
			<option label="Resort or Hotel " value="resort-or-hotel-">Resort or Hotel </option>&#13;
			<option label="Vacation Rental " value="vacation-rental-">Vacation Rental </option>&#13;
			<option label="Shared Housing or Hostel " value="shared-housing-or-hostel-">Shared Housing or Hostel </option>&#13;
		</field>&#13;
		<field type="radio-group" label="Would you like all-inclusive?&amp;nbsp;" description="Please note that all-inclusive accommodations vary greatly and may not be available for your destination." name="would-you-like-allinclusive-">&#13;
			<option label="Yes " value="yes-">Yes </option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Not Sure " value="not-sure-">Not Sure </option>&#13;
		</field>&#13;
		<field type="radio-group" label="Hotel preference" name="hotel-preference">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Exit Row" value="exit-row">Exit Row</option>&#13;
			<option label="No Preference " value="no-preference-">No Preference </option>&#13;
		</field>&#13;
		<field type="radio-group" label="Will you need a rental car" name="bed-preference">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No " value="no-">No </option>&#13;
		</field>&#13;
		<field type="text" label="Who referred You? I would love to thank them!&amp;nbsp;" name="who-referred-you-i-would-love-to-thank-them-" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you so much for taking the time to complete your simply amazing experiences questionnaire.&amp;nbsp; Once you submit your questionnaire it will be reviewed and detailed information will be sent on how we will get started with making your next travel experience Simply Amazing!&amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
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