Share your information with Rachel Goldstein

Rachel Goldstein

Reef & River Travel

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	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h1" label="Tell me about your dream trip!"/>&#13;
		<field type="text" required="true" label="Where do you want to go?" placeholder="Ex: Caribbean" name="where-do-you-want-to-go" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Do you have a very specific place you absolutely must go?" placeholder="Ex: Aruba" name="do-you-have-a-very-specific-place-you-absolutely-must-go" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When do you want to go?" description="This just gives me a general idea when you’re preferring to travel and can be changed later on." name="when-do-you-want-to-go" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" name="are-your-dates-flexible" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your budget for all travelers?" placeholder="Ex: $4 500" name="what-is-your-budget-for-all-travelers" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travel Preferences"/>&#13;
		<field type="checkbox-group" required="true" label="What best describes your travel style for this trip?" name="what-best-describes-the-kind-of-travel-you-are-looking-for" other="true">&#13;
			<option label="Cruise - Ocean/River/Yacht" value="cruise-oceanriveryacht">Cruise - Ocean/River/Yacht</option>&#13;
			<option label="Escorted -  Guided Tours" value="escorted-guided-tours">Escorted -  Guided Tours</option>&#13;
			<option label="Luxury - Private Transportation/Resorts/Exclusive " value="luxury-private-transportationresortsexclusive-">Luxury - Private Transportation/Resorts/Exclusive </option>&#13;
			<option label="Rail - Scenic Tours" value="rail-scenic-tours">Rail - Scenic Tours</option>&#13;
			<option label="Adventure - Rafting/Hiking/Safaris" value="adventure-raftinghikingsafaris">Adventure - Rafting/Hiking/Safaris</option>&#13;
			<option label="Independent - Stay&amp;Play/Self-Driven" value="independent-stayplayselfdriven">Independent - Stay&amp;Play/Self-Driven</option>&#13;
			<option label="Resorts - All-inclusives" value="resorts-allinclusives">Resorts - All-inclusives</option>&#13;
			<option label="Sports - Leisure/Extreme" value="sports-leisureextreme">Sports - Leisure/Extreme</option>&#13;
			<option label="Cultural - Immersion/Historical/Theatre" value="cultural-immersionhistoricaltheatre">Cultural - Immersion/Historical/Theatre</option>&#13;
			<option label="Wellness - Mindful Spas/Retreats" value="wellness-mindful-spasretreats">Wellness - Mindful Spas/Retreats</option>&#13;
			<option label="Theme Parks - Disney/Universall" value="theme-parks-disneyuniversall">Theme Parks - Disney/Universall</option>&#13;
			<option label="Groups - Reunions/Affinity Travel" value="groups-reunionsaffinity-travel">Groups - Reunions/Affinity Travel</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Flight Preferences&amp;nbsp;"/>&#13;
		<field type="text" label="Do you prefer a specific airline?" placeholder="Ex: Delta." name="do-you-prefer-a-specific-airline" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Preferred flight class?" name="preferred-flight-class" other="true">&#13;
			<option label="Economy" value="economy">Economy</option>&#13;
			<option label="Economy +" value="economy-">Economy +</option>&#13;
			<option label="Business" value="business">Business</option>&#13;
			<option label="First Class" value="first-class">First Class</option>&#13;
			<option label="Private" value="private">Private</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference" other="true">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Hotel Preferences&amp;nbsp;"/>&#13;
		<field type="text" label="Do you have a preferred hotel brand?" placeholder="Ex: Marriott" name="do-you-have-a-preferred-hotel-brand" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="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="radio-group" label="Bed preference" name="bed-preference" other="true">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Restrictions and Accommodations"/>&#13;
		<field type="text" label="Do any travelers have dietary restrictions?" name="meal-preference" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do any travelers require mobility accommodations?" name="do-any-travelers-require-mobility-accommodations" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Is there anything else you absolutely think I must know before your formal consultation?" name="is-there-anything-else-you-absolutely-think-i-must-know-before-your-formal-consultation" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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