Share your information with Jennifer Farmer

Jennifer Farmer

In Situ Travel Design, independent affiliate of Travel Experts, Inc.

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#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" required="true" label="Email" 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="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" label="When would you like to 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="When would you like to 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="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers and their ages?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers not including air?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$5,000 - $7,500" value="5000-7500">$5,000 - $7,500</option>&#13;
			<option label="$7,500 - $10,000" value="7500-10000">$7,500 - $10,000</option>&#13;
			<option label="$10,000 - $12,500" value="10000-12500">$10,000 - $12,500</option>&#13;
			<option label="$12,500 - $15,000" value="12500-15000">$12,500 - $15,000</option>&#13;
			<option label="$15,000 - $20,000" value="15000-20000">$15,000 - $20,000</option>&#13;
			<option label="$20,000+" value="20000">$20,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
			<option label="Chain Hotel" value="chain-hotel">Chain Hotel</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
		</field>&#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="Arts, theater and music" value="arts-theater-and-music">Arts, theater and music</option>&#13;
			<option label="History and culture" value="history-and-culture">History and culture</option>&#13;
			<option label="Active and adventure activities" value="active-and-adventure-activities">Active and adventure activities</option>&#13;
			<option label="Health and wellness" value="health-and-wellness">Health and wellness</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Sports - golf, tennis, etc." value="sports-golf-tennis-etc">Sports - golf, tennis, etc.</option>&#13;
		</field>&#13;
		<field type="text" label="Where are you in the planning process?" description="I need suggestions for the perfect destination  I have an idea of where to travel, I&#39;ve done my research and am ready to book?" name="where-are-you-in-the-planning-process" subtype="text" className="form-control"/>&#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>