Share your information with JaeBriona Fudge

JaeBriona Fudge

Wonders Beyond Borders Travel LLC

<html>
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		<field type="header" subtype="h2" label="Contact Details"/>&#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="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="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Join our newsletter and receive monthly travel news and exclusive subscriber content!" name="email-list" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
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		<field type="radio-group" required="true" label="Preferred Contact Method" name="preferred-contact-method">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
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		<field type="radio-group" label="How did you hear about us?" name="how-did-you-hear-about-us" other="true">&#13;
			<option label="Website/Google" value="websitegoogle">Website/Google</option>&#13;
			<option label="Social Media" value="social-media">Social Media</option>&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
			<option label="Travel Leaders Agent Listing" value="travel-leaders-agent-listing">Travel Leaders Agent Listing</option>&#13;
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		<field type="header" subtype="h1" label="Destination Details"/>&#13;
		<field type="text" required="true" label="Destination(s) of Interest" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Are you interested in a particular promo?" description="Social media/Newsletter promo" name="are-you-interested-in-a-particular-promo" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Type of Vacation:" name="type-of-vacation" other="true">&#13;
			<option label="Beach/Resort" value="beachresort">Beach/Resort</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Theme Park (e.g. Disney, Universal)" value="theme-park-eg-disney-universal">Theme Park (e.g. Disney, Universal)</option>&#13;
			<option label="Cultural/Historical" value="culturalhistorical">Cultural/Historical</option>&#13;
			<option label="Adventure/Exploration" value="adventureexploration">Adventure/Exploration</option>&#13;
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		<field type="checkbox-group" label="Are you traveling for a special occasion?" name="traveling-for-a-special-occasion" other="true">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Bachelor/Bachelorette Party" value="bachelorbachelorette-party">Bachelor/Bachelorette Party</option>&#13;
			<option label="Family Reunion" value="family-reunion">Family Reunion</option>&#13;
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		<field type="header" subtype="h1" label="Booking Details"/>&#13;
		<field type="date" required="true" label="Preferred Date of Departure" description="General idea of when you would like to go; It can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" required="true" label="Preferred Date of Return" description="General idea of when you would like to return; It can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="radio-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;
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		<field type="checkbox-group" required="true" label="What would you like included in your booking?" name="checkbox-group-1689876944148" other="true">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Car Rental" value="car-rental">Car Rental</option>&#13;
			<option label="Airport Transfers" value="airport-transfers">Airport Transfers</option>&#13;
			<option label="Accommodations" value="accommodations">Accommodations</option>&#13;
			<option label="Excursions" value="excursions">Excursions</option>&#13;
			<option label="Meals Included" value="meals-included">Meals Included</option>&#13;
			<option label="Travel Insurance Quote" value="travel-insurance-quote">Travel Insurance Quote</option>&#13;
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		<field type="radio-group" required="true" label="Where Are You in Your Planning Process?" name="are-you-deposit-ready">&#13;
			<option label="Ready to book – I’m ready to put down a deposit and secure my trip." value="ready-to-book-im-ready-to-put-down-a-deposit-and-secure-my-trip">Ready to book – I’m ready to put down a deposit and secure my trip.</option>&#13;
			<option label="Almost ready – I’m close to making a decision but need a bit more information." value="almost-ready-im-close-to-making-a-decision-but-need-a-bit-more-information">Almost ready – I’m close to making a decision but need a bit more information.</option>&#13;
			<option label="Still exploring – I’m gathering ideas and not quite ready to book yet." value="still-exploring-im-gathering-ideas-and-not-quite-ready-to-book-yet">Still exploring – I’m gathering ideas and not quite ready to book yet.</option>&#13;
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		<field type="header" subtype="h1" label="Party Details"/>&#13;
		<field type="checkbox-group" required="true" label="My party includes" inline="true" name="our-party-includes">&#13;
			<option label="Infant/Toddler(s)" value="infanttoddlers">Infant/Toddler(s)</option>&#13;
			<option label="Children (3-12)" value="children-312">Children (3-12)</option>&#13;
			<option label="Teens (13-17)" value="teens-1317">Teens (13-17)</option>&#13;
			<option label="Adults (18-64)" value="adults-1864">Adults (18-64)</option>&#13;
			<option label="Seniors (65+)" value="seniors-65">Seniors (65+)</option>&#13;
			<option label="Military/Veteran" value="militaryveteran">Military/Veteran</option>&#13;
			<option label="Travelers who require physical accomodations" value="travelers-who-require-physical-accomodations">Travelers who require physical accomodations</option>&#13;
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		<field type="text" required="true" label="How many adults?&amp;nbsp;" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many children?" description="Ages 0-17" name="how-many-children" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please list children&#39;s ages at time of travel:" name="please-list-childrens-ages" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" label="Accommodations" name="hotel-preference">&#13;
			<option label="Hotel (No Meals)" value="hotel-no-meals">Hotel (No Meals)</option>&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Boutique Hotel" value="boutique-hotel">Boutique Hotel</option>&#13;
			<option label="Rental Home" value="rental-home">Rental Home</option>&#13;
			<option label="Private Luxury Villa" value="private-luxury-villa">Private Luxury Villa</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Activities" name="activity-preferences">&#13;
			<option label="Beach and Water Activities" value="beach-and-water-activities">Beach and Water Activities</option>&#13;
			<option label="Sightseeing Tours" value="sightseeing-tours">Sightseeing Tours</option>&#13;
			<option label="Adventure (Zipline, ATV, etc)" value="adventure-zipline-atv-etc">Adventure (Zipline, ATV, etc)</option>&#13;
			<option label="Spa" value="spa">Spa</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and Theater" value="arts-and-theater">Arts and Theater</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Food" value="food">Food</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="&amp;nbsp;What Are the Most Important Aspects of Your Trip?" name="vibe-preference" other="true">&#13;
			<option label="Rest and Relaxation" value="rest-and-relaxation">Rest and Relaxation</option>&#13;
			<option label="Family Activities" value="family-activities">Family Activities</option>&#13;
			<option label="Romance" value="romance">Romance</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Cultural Experiences" value="cultural-experiences">Cultural Experiences</option>&#13;
			<option label="Food and Dining" value="food-and-dining">Food and Dining</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBTQ Friendly" value="lgbtq-friendly">LGBTQ Friendly</option>&#13;
		</field>&#13;
		<field type="text" label="Do you have any special requests or considerations?" description="(e.g.  dietary restrictions  accessibility needs  specific activities)" name="do-you-have-any-special-requests-or-considerations" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Additional Comments or Questions"/>&#13;
		<field type="textarea" required="true" label="Tell me about your last vacation — what did you love, and what would you change?" name="tell-me-about-your-last-vacation-what-did-you-love-and-what-would-you-change" className="form-control"/>&#13;
		<field type="textarea" label="Please provide any other information you would like us to know." name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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