Share your information with Becca Richmond

Becca Richmond

Rebecca Rich 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="h2" label="Let&#39;s find the best cruise for YOU!"/>&#13;
		<field type="radio-group" label="Is this your first cruise?" name="is-this-your-first-cruise">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="I'm a cruise PRO!" value="im-a-cruise-pro">I'm a cruise PRO!</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="The purpose of this cruise vacation is:" name="the-purpose-of-this-cruise-vacation-is">&#13;
			<option label="Making Memories w/ Family and/or friends" value="making-memories-w-family-andor-friends">Making Memories w/ Family and/or friends</option>&#13;
			<option label="Romance" value="romance">Romance</option>&#13;
			<option label="Just For Fun!" value="just-for-fun">Just For Fun!</option>&#13;
			<option label="Relax &amp; Recharge (Spa?)" value="relax-recharge-spa">Relax &amp; Recharge (Spa?)</option>&#13;
			<option label="Celebrating a Special Occasion" value="celebrating-a-special-occasion">Celebrating a Special Occasion</option>&#13;
			<option label="Adventure/ Expedition" value="adventure-expedition">Adventure/ Expedition</option>&#13;
		</field>&#13;
		<field type="text" label="Where would you like to go? It can be a description like &quot;tropical&quot;, &quot;glacier&quot;,or if there&#39;s a certain port you must visit, please share it here." placeholder="ex: Tahiti" name="preferred-destinations" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Are there any ports you want to avoid?" name="are-there-any-ports-you-want-to-avoid" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Which ports you can depart from?" name="ports-you-can-depart-from" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Which cruise lines have you sailed with before?" name="cruise-lines-youve-sailed-before" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Which ones are on your wishlist?" name="which-ones-are-on-your-wishlist" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What are your priorities regarding the ship?" name="what-are-your-priorities-regarding-the-ship" other="true">&#13;
			<option label="I prefer a smaller ship" value="i-prefer-a-smaller-ship">I prefer a smaller ship</option>&#13;
			<option label="I prefer a large ship with lots of bells &amp; whistles" value="i-prefer-a-large-ship-with-lots-of-bells-whistles">I prefer a large ship with lots of bells &amp; whistles</option>&#13;
			<option label="I am fine with an older ship in order to save a little" value="i-am-fine-with-an-older-ship-in-order-to-save-a-little">I am fine with an older ship in order to save a little</option>&#13;
			<option label="I prefer a newer ship" value="i-prefer-a-newer-ship">I prefer a newer ship</option>&#13;
			<option label="I want the newest and shiniest ship available" value="i-want-the-newest-and-shiniest-ship-available">I want the newest and shiniest ship available</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What type of cabin are you interested in?" description="You can choose more than one if you want to compare prices" name="what-type-of-cabin-are-you-interested-in">&#13;
			<option label="We're splurging on a suite because we deserve it!" value="were-splurging-on-a-suite-because-we-deserve-it">We're splurging on a suite because we deserve it!</option>&#13;
			<option label="We'd like to have a balcony where we can enjoy morning coffee in the fresh, sea air" value="wed-like-to-have-a-balcony-where-we-can-enjoy-morning-coffee-in-the-fresh-sea-air">We'd like to have a balcony where we can enjoy morning coffee in the fresh, sea air</option>&#13;
			<option label="As long as we have a window to look out of, we're happy" value="as-long-as-we-have-a-window-to-look-out-of-were-happy">As long as we have a window to look out of, we're happy</option>&#13;
			<option label="An interior cabin is where we get the best sleep" value="an-interior-cabin-is-where-we-get-the-best-sleep">An interior cabin is where we get the best sleep</option>&#13;
			<option label="Tell me about some of the unique cabin options that are available" value="tell-me-about-some-of-the-unique-cabin-options-that-are-available">Tell me about some of the unique cabin options that are available</option>&#13;
		</field>&#13;
		<field type="text" label="Would you call yourself a foodie? What type of food excites you?" name="would-you-call-yourself-a-foodie-what-type-of-food-excites-you" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Are you looking forward to:" description="Choose as many as you like" name="are-you-looking-forward-to">&#13;
			<option label="The buffet" value="the-buffet">The buffet</option>&#13;
			<option label="The main dining room" value="the-main-dining-room">The main dining room</option>&#13;
			<option label="Specialty restaurants all the way!" value="specialty-restaurants-all-the-way">Specialty restaurants all the way!</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are any of these important?" inline="true" name="are-any-of-these-important">&#13;
			<option label="Casino" value="casino">Casino</option>&#13;
			<option label="Babysitting" value="babysitting">Babysitting</option>&#13;
			<option label="Kids/Teen Club" value="kidsteen-club">Kids/Teen Club</option>&#13;
			<option label="Sports court" value="sports-court">Sports court</option>&#13;
			<option label="Lots of specialty dining venues" value="lots-of-specialty-dining-venues">Lots of specialty dining venues</option>&#13;
			<option label="Rock wall" value="rock-wall">Rock wall</option>&#13;
			<option label="Zipline" value="zipline">Zipline</option>&#13;
			<option label="Flow Rider" value="flow-rider">Flow Rider</option>&#13;
			<option label="Water slide" value="water-slide">Water slide</option>&#13;
			<option label="Go-carts" value="gocarts">Go-carts</option>&#13;
			<option label="Adults-only pool" value="adultsonly-pool">Adults-only pool</option>&#13;
			<option label="Outdoor movies" value="outdoor-movies">Outdoor movies</option>&#13;
			<option label="Spa" value="spa">Spa</option>&#13;
			<option label="Nightly shows" value="nightly-shows">Nightly shows</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="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="City Exploration" value="city-exploration">City Exploration</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel/cruise preference?" name="hotel-preference" other="true">&#13;
			<option label="Value" value="value">Value</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="textarea" required="true" label="Tell me about your comfortable price range:" name="is-there-anything-else-i-should-know-about-your-price-range" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Practical Information"/>&#13;
		<field type="date" label="Earliest you can depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/>&#13;
		<field type="date" label="Latest you can 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" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="How many nights would you like the cruise to be (can be a range)?" name="how-many-nights-would-you-like-the-cruise-to-be-can-be-a-range" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Number of cabins and location preferences - Do they need to connect, or is side-by-side or just nearby ok?" name="number-of-cabins-and-location-preferences" className="form-control"/>&#13;
		<field type="textarea" label="Number of travelers and their ages?" name="number-of-travelers-and-their-ages" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Is anyone in your party pregnant or planning to become pregnant before the cruise?&amp;nbsp;" description="So that we can advise  as each cruise line has its own pregnancy policy.   All information is private." name="is-anyone-in-your-party-pregnant-or-planning-to-become-pregnant-before-the-cruise-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Is everyone in your party a US citizen?" description="If not  we need to know so that we can advise you properly" name="is-everyone-in-your-party-a-us-citizen">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Promotions you qualify for (if available):" name="promotions-you-qualify-for-if-available" other="true">&#13;
			<option label="Senior (55 or older)" value="senior-55-or-older">Senior (55 or older)</option>&#13;
			<option label="Military" value="military">Military</option>&#13;
			<option label="Fire/EMT/Law Enforcement" value="fireemtlaw-enforcement">Fire/EMT/Law Enforcement</option>&#13;
			<option label="Teacher" value="teacher">Teacher</option>&#13;
		</field>&#13;
		<field type="text" label="What state do you live in?" name="what-state-do-you-live-in" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Is there 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? (dietary or medical requirements, special requests, etc)" name="notes" className="form-control"/>&#13;
		<field type="text" required="true" label="Please share how you found us (or who referred you, so that we can thank them)." name="who-referred-you-to-us" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="By proceeding with travel arrangements, I acknowledge that certain destinations, tour companies, and cruise lines may require COVID-19 vaccination, and it is my responsibility to ascertain and comply with these requirements. I also understand that it is vitally important that I read the information emailed to me by my advisor in order to be prepared for travel in the current climate. I also understand that I share the responsibility of remaining informed about the entry requirements for the destination(s) I am visiting. I will secure all necessary testing and complete all forms required for travel." name="by-proceeding-with-travel-arrangements-i-acknowledge-that-certain-destinations-tour-companies-and-cruise-lines-may-require-covid19-vaccination-and-it-is-my-responsibility-to-ascertain-and-comply-with-these-requirements-i-also-understand-that-it-is-vitally-important-that-i-read-the-information-emailed-to-me-by-my-advisor-in-order-to-be-prepared-for-travel-in-the-current-climate-i-also-understand-that-i-share-the-responsibility-of-remaining-informed-about-the-entry-requirements-for-the-destinations-i-am-visiting-i-will-secure-all-necessary-testing-and-complete-all-forms-required-for-travel">&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
		</field>&#13;
	</fields>&#13;
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