Share your information with Shakea Adams

Shakea Adams

Kreative Luxe Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Personal Information"/>&#13;
		<field type="text" required="true" 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="Middle name" name="middle-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" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of Birth" name="date-of-birth" className="form-control"/>&#13;
		<field type="text" required="true" label="Email address" 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="header" subtype="h1" label="Planning Information"/>&#13;
		<field type="checkbox-group" label="Type of Travel" name="type-of-travel">&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All Inclusive Resort with Flights" value="all-inclusive-resort-with-flights">All Inclusive Resort with Flights</option>&#13;
			<option label="All Inclusive Resort without Flights" value="all-inclusive-resort-without-flights">All Inclusive Resort without Flights</option>&#13;
			<option label="Domestic Travel (Hotel &amp; Flight)" value="domestic-travel-hotel-flight">Domestic Travel (Hotel &amp; Flight)</option>&#13;
			<option label="Domestic Travel (Hotel Only)" value="domestic-travel-hotel-only">Domestic Travel (Hotel Only)</option>&#13;
			<option label="International Travel (Hotel &amp; Flight)" value="international-travel-hotel-flight">International Travel (Hotel &amp; Flight)</option>&#13;
			<option label="International Travel (Hotel, Tours, &amp; Flight)" value="international-travel-hotel-tours-flight">International Travel (Hotel, Tours, &amp; Flight)</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="Date of Departure" description="This just gives me a general idea of when you like to return; it can be changed later." name="date-1760306392001" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of Return" description="This just gives me a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do you have an accommodation star rating?" name="checkbox-group-1760307011615">&#13;
			<option label="3 to 3.5 Star" value="3-to-35-star">3 to 3.5 Star</option>&#13;
			<option label="3.5 to 4 Star" value="35-to-4-star">3.5 to 4 Star</option>&#13;
			<option label="4 to 4.5 Star" value="4-to-45-star">4 to 4.5 Star</option>&#13;
			<option label="4.5 to 5 Star" value="45-to-5-star">4.5 to 5 Star</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your per person budget?" placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Departure City" description="Please enter airport code" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Destination" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What kind of payment arrangment would you like?" name="what-kind-of-payment-arrangment-would-you-like">&#13;
			<option label="Payment Plan" value="payment-plan">Payment Plan</option>&#13;
			<option label="Pay in Full" value="pay-in-full">Pay in Full</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Do you want travel insurance added to your quote?" name="checkbox-group-1760306889849">&#13;
			<option label="Yes, please add it" value="yes-please-add-it">Yes, please add it</option>&#13;
			<option label="No, I will get my own travel insurance" value="no-i-will-get-my-own-travel-insurance">No, I will get my own travel insurance</option>&#13;
		</field>&#13;
		<field type="text" label="How many CHILD travelers? And age?? (IF APPLICABLE)" name="text-1760306642567" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many ADULT travelers? (IF APPLICABLE)" name="text-1760306693750" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#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="checkbox-group" label="Preferred Room Type for Hotel" name="preferred-room-type-for-hotel">&#13;
			<option label="Garden View" value="garden-view">Garden View</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Swim Up" value="swim-up">Swim Up</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Preferred Cabin Type for Cruise" name="preferred-cabin-type-for-cruise">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Oceanview" value="oceanview">Oceanview</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="textarea" label="Is there a cruise line that you would prefer to avoid?&amp;nbsp; (Please list below)" name="is-there-a-cruise-line-that-you-would-prefer-to-avoid-please-list-below" className="form-control"/>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>