Leila Coe

Leila Coe, CTA - Travel Planners International

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    <form-template>&#13;
	<fields>&#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 type="text" required="true" label="Email" name="email" subtype="text" 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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="checkbox-group" required="true" label="Where do you want to go?" name="where-do-you-want-to-go">&#13;
			<option label="Italy" value="italy">Italy</option>&#13;
			<option label="France" value="france">France</option>&#13;
			<option label="Spain" value="spain">Spain</option>&#13;
			<option label="Portugal" value="portugal">Portugal</option>&#13;
			<option label="UK and/or Ireland" value="uk-andor-ireland">UK and/or Ireland</option>&#13;
			<option label="Caribbean" value="caribbean">Caribbean</option>&#13;
			<option label="US (incl Hawaii or Alaska)" value="us-incl-hawaii-or-alaska">US (incl Hawaii or Alaska)</option>&#13;
			<option label="Mexico" value="mexico">Mexico</option>&#13;
			<option label="South America" value="south-america">South America</option>&#13;
			<option label="Asia" value="asia">Asia</option>&#13;
			<option label="Not Sure Yet" value="not-sure-yet">Not Sure Yet</option>&#13;
			<option label="Other (tell me below!)" value="other">Other (tell me below!)</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="When would you like to travel? And for how long?" name="when-would-you-like-to-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Who is traveling? Any kids?" name="number-of-travelers" subtype="text" 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="radio-group" label="Are you interested in a cruise?" description="Check all that apply" name="are-you-interested-in-a-cruise">&#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="Maybe - Need more info" value="maybe-need-more-info">Maybe - Need more info</option>&#13;
			<option label="No - Land Vacation Only" value="no-land-vacation-only">No - Land Vacation Only</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What are your main interests for this trip?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Food Activities - Cooking class, Tasting tours, etc" value="food-activities-cooking-class-tasting-tours-etc">Food Activities - Cooking class, Tasting tours, etc</option>&#13;
			<option label="Wine tastings" value="wine-tastings">Wine tastings</option>&#13;
			<option label="General Sightseeing" value="general-sightseeing">General Sightseeing</option>&#13;
			<option label="History and Culture" value="history-and-culture">History and Culture</option>&#13;
			<option label="Art/Architecture" value="artarchitecture">Art/Architecture</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Relaxation" value="relaxation">Relaxation</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</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="checkbox-group" label="Where are you in the planning process?" name="where-are-you-in-the-planning-process">&#13;
			<option label="Just starting. Looking for ideas and guidance on where to begin and how to plan." value="just-starting-looking-for-ideas-and-guidance-on-where-to-begin-and-how-to-plan">Just starting. Looking for ideas and guidance on where to begin and how to plan.</option>&#13;
			<option label="I know where I want to go, but need help putting it together." value="i-know-where-i-want-to-go-but-need-help-putting-it-together">I know where I want to go, but need help putting it together.</option>&#13;
			<option label="I know what I want and need help booking." value="i-know-what-i-want-and-need-help-booking">I know what I want and need help booking.</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me to know? Any special needs? Celebrations?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="text" label="Did someone refer you? If so, who was it so we can thank them?" name="did-someone-refer-you-if-so-who-was-it-so-we-can-thank-them" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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