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Neckia White

Frequent Escapes

<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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="text" required="true" label="Where would you like to go? (List up to 2)" placeholder="ex: Jamaica" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" 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" required="true" 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="text" required="true" label="What is your departure city, state?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your preferred airline?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your preferred resort?" name="text-1743024429768" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Full Name &amp;amp; DOB of ALL travelers" name="full-name-dob-of-all-travelers" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget per traveler?" 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="checkbox-group" required="true" label="Would you like to add travel protection? (Added to your deposit)" name="would-you-like-to-add-travel-protection-added-to-your-deposit">&#13;
			<option label="Yes, travel credit" value="yes-travel-credit">Yes, travel credit</option>&#13;
			<option label="Yes, cash back" value="yes-cash-back">Yes, cash back</option>&#13;
			<option label="No, I decline travel protection" value="no-i-decline-travel-protection">No, I decline travel protection</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Type of Travel" name="type-of-travel">&#13;
			<option label="Family Vacation" value="family-vacation">Family Vacation</option>&#13;
			<option label="Solo Travel" value="solo-travel">Solo Travel</option>&#13;
			<option label="Couple's Getaway" value="couples-getaway">Couple's Getaway</option>&#13;
			<option label="Wedding/Honeymoon" value="weddinghoneymoon">Wedding/Honeymoon</option>&#13;
			<option label="Group Trip" value="group-trip">Group Trip</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Any Celebrations?" name="any-celebrations">&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Graduation" value="graduation">Graduation</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Wedding/Honeymoon" value="weddinghoneymoon">Wedding/Honeymoon</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference">&#13;
			<option label="Romantic" value="romantic">Romantic</option>&#13;
			<option label="Relaxation/Wellness" value="relaxationwellness">Relaxation/Wellness</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Family-friendly" value="familyfriendly">Family-friendly</option>&#13;
			<option label="Adults Only" value="adults-only">Adults Only</option>&#13;
		</field>&#13;
		<field type="textarea" label="Anyone require handicap accessible accommodations have special needs, dietary restrictions, allergies, or medical concerns you want me to be aware of?" name="notes" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How did you hear about Frequent Escapes?" name="how-did-you-hear-about-frequent-escapes">&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="Referred by Someone" value="referred-by-someone">Referred by Someone</option>&#13;
			<option label="Personal Family/Friend" value="personal-familyfriend">Personal Family/Friend</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Before I proceed with booking your amazing getaway, are you interested in learning how you can earn your own commission and possibly save more on this trip and others?" name="checkbox-group-1743025795256">&#13;
			<option label="Yes! I love saving and earning extra money." value="yes-i-love-saving-and-earning-extra-money">Yes! I love saving and earning extra money.</option>&#13;
			<option label="No, thank you. I'd rather you book it for me." value="no-thank-you-id-rather-you-book-it-for-me">No, thank you. I'd rather you book it for me.</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>