Share your information with Molly McCarthy

Molly McCarthy

Travelmation | Bluewater Travelers

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Hello! Let&#39;s Plan Your Next Vacation!"/>&#13;
		<field type="paragraph" subtype="p" label="Welcome! I am thrilled that you are interested in allowing me to help plan your next vacation! Please take a few minutes to complete as much information in this form as possible. Names should be typed EXACTLY as they appear on each person&#39;s Government-issued Drivers License or Passport, if applicable.&amp;nbsp;"/>&#13;
		<field type="header" subtype="h1" label="Passenger Information"/>&#13;
		<field type="header" subtype="h1" label="Adult Traveler #1"/>&#13;
		<field required="true"  type="text" label="First Name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle Name" name="middle-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" 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="date" label="Birthdate" name="birthdate" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Adult Traveler #2"/>&#13;
		<field type="text" label="First Name #2" name="text-1719288706949" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle Name #2" name="text-1719288702248" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Last Name #2" name="last-name-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred Name #2" name="preferred-name-2" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Birthdate" name="date-1719287745333" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Additional Travelers"/>&#13;
		<field type="textarea" label="Enter Full Names and Birthdates for any additional travelers" name="enter-full-names-and-birthdates-for-any-additional-travelers" className="form-control"/>&#13;
		<field type="textarea" label="Does anyone in your travel party have any accessibility needs? If yes, please explain below:" name="does-anyone-in-your-travel-party-have-any-accessibility-needs-if-yes-please-explain-below" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Where do you want to go?"/>&#13;
		<field type="checkbox-group" label="Some Ideas" name="some-ideas" other="true">&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option>&#13;
			<option label="River Cruise" value="river-cruise">River Cruise</option>&#13;
			<option label="Hawaii" value="hawaii">Hawaii</option>&#13;
			<option label="Disneyland / Disney World" value="">Disneyland / Disney World</option>&#13;
		</field>&#13;
		<field type="radio-group" label="How soon do you want to book this vacation?" name="how-soon-do-you-want-to-book-this-vacation">&#13;
			<option label="Very Soon - Less than a week" value="very-soon-less-than-a-week">Very Soon - Less than a week</option>&#13;
			<option label="1-2 months" value="12-months">1-2 months</option>&#13;
			<option label="2-6 months" value="26-months">2-6 months</option>&#13;
			<option label="I'm in the planning phase - please help!" value="im-in-the-planning-phase-please-help">I'm in the planning phase - please help!</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>