Kimberly Moore

Travelmation LLC

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Let's Plan Your Trip!"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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 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="radio-group" required="true" label="How soon would you like to book?" name="how-soon-would-you-like-to-book">&#13;
			<option label="ASAP" value="asap">ASAP</option>&#13;
			<option label="Within the week" value="within-the-week">Within the week</option>&#13;
			<option label="Within a couple months" value="within-a-couple-months">Within a couple months</option>&#13;
			<option label="Just considering my options" value="just-considering-my-options">Just considering my options</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Which describes where you are in planning to travel?" name="which-describes-where-you-are-in-planning" other="true">&#13;
			<option label="I'm not sure about anything" value="im-not-sure-about-anything">I'm not sure about anything</option>&#13;
			<option label="I've researched the destination and need some options" value="ive-researched-the-destination-and-need-some-options">I've researched the destination and need some options</option>&#13;
			<option label="We've already booked our flights! Help me figure out where to stay!" value="weve-already-booked-our-flights-help-me-figure-out-where-to-stay">We've already booked our flights! Help me figure out where to stay!</option>&#13;
			<option label="I'm pretty sure I know what I want, but I want to book with you." value="im-pretty-sure-i-know-what-i-want-but-i-want-to-book-with-you">I'm pretty sure I know what I want, but I want to book with you.</option>&#13;
			<option label="I know where I want to go, but I need you to help me to decide when." value="i-know-where-i-want-to-go-but-i-need-you-to-help-me-to-decide-when">I know where I want to go, but I need you to help me to decide when.</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Which kind of trip are you interested in booking?" name="which-kind-of-trip-are-you-interested-in-booking">&#13;
			<option label="Business" value="business">Business</option>&#13;
			<option label="Walt Disney World/ Disneyland" value="walt-disney-world-disneyland">Walt Disney World/ Disneyland</option>&#13;
			<option label="Universal Studios Orlando/Hollywood" value="universal-studios-orlandohollywood">Universal Studios Orlando/Hollywood</option>&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Europe  " value="europe-">Europe  </option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Group Function (School, Incentive, Church etc)" value="group-function-school-incentive-church-etc">Group Function (School, Incentive, Church etc)</option>&#13;
			<option label="Not sure/ Other" value="not-sure-other">Not sure/ Other</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you currently working with another travel agent?" name="are-you-currently-working-with-another-travel-agent">&#13;
			<option label="Nope!" value="nope">Nope!</option>&#13;
			<option label="Yes." value="yes">Yes.</option>&#13;
			<option label="Yes, but I'd like to work with you instead." value="yes-but-id-like-to-work-with-you-instead">Yes, but I'd like to work with you instead.</option>&#13;
		</field>&#13;
		<field type="radio-group" label="When is the best time to follow up with you?&amp;nbsp;" name="when-is-the-best-time-to-follow-up-with-you-">&#13;
			<option label="Morning" value="morning">Morning</option>&#13;
			<option label="Afternoon" value="afternoon">Afternoon</option>&#13;
			<option label="Evening" value="evening">Evening</option>&#13;
			<option label="Weekends" value="weekends">Weekends</option>&#13;
			<option label="I prefer email" value="i-prefer-email">I prefer email</option>&#13;
			<option label="I prefer texts" value="i-prefer-texts">I prefer texts</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="As travel advisors, we are compensated for our time and expertise when our clients book AND travel with us. We receive no payment for quotes but are compensated by the resorts, tour providers, and destinations for serving our mutual clients. &amp;nbsp;I am happy to provide quotes, but please do not waste my time and go and book for yourself.&amp;nbsp;" name="as-travel-advisors-we-are-compensated-for-our-time-and-expertise-when-our-clients-book-and-travel-with-us-we-receive-no-payment-for-quotes-but-are-compensated-by-the-resorts-tour-providers-and-destinations-for-serving-our-mutual-clients-">&#13;
			<option label="I understand. " value="i-understand-">I understand. </option>&#13;
		</field>&#13;
		<field type="textarea" label="Anything else that you want me to know? (How many people, Budget, Wants, etc.)" name="anything-else-that-you-want-me-to-know-how-many-people-budget-wants-etc" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>