<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Quick questions for your future trip"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="For this trip, are you interested in..." name="for-this-trip-are-you-interested-in"> <option label="Culinary Travel" value="culinary-travel">Culinary Travel</option> <option label="Golf Travel" value="golf-travel">Golf Travel</option> <option label="Spa Travel" value="spa-travel">Spa Travel</option> <option label="Wildlife Travel" value="wildlife-travel">Wildlife Travel</option> <option label="Other" value="other">Other</option> </field> <field type="text" required="true" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="examples: Barcelona Rome and Paris or Tahiti or I don't know" name="destination" subtype="text" className="form-control"/> <field type="text" required="true" label="When would you like to go?" placeholder="examples: March 17-24 2022 or December 2022 or April 2023 or I don't know" name="when-would-you-like-to-go" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="What options do you want to book? Check all that might apply." inline="true" name="what-options-do-you-want-to-book-check-all-that-apply" other="true"> <option label="Accommodations" value="accommodations">Accommodations</option> <option label="Flights" value="flights">Flights</option> <option label="Cruises" value="cruises">Cruises</option> <option label="Tour Packages" value="tour-packages">Tour Packages</option> <option label="Day Tours and Activities" value="day-tours-and-activities">Day Tours and Activities</option> <option label="Train Travel" value="train-travel">Train Travel</option> <option label="Sports, Concerts, Events, Attraction Tickets" value="sports-concerts-events-attraction-tickets">Sports, Concerts, Events, Attraction Tickets</option> <option label="Transfers" value="transfers">Transfers</option> <option label="Rental Cars" value="rental-cars">Rental Cars</option> <option label="Travel Insurance" value="travel-insurance">Travel Insurance</option> </field> <field type="text" required="true" label="How many travelers?" description="How many people (including children are going on this trip?" name="how-many-travelers" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your total budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="what-is-your-total-budget-for-all-travelers"> <option label="Under $2500" value="under-2500">Under $2500</option> <option label="$2,500 to $5,000" value="2500-to-5000">$2,500 to $5,000</option> <option label="$5,000 to $10,000" value="5000-to-10000">$5,000 to $10,000</option> <option label="$10,000+" value="10000">$10,000+</option> </field> <field type="textarea" label="What else would you like me to know about this trip?" description="previous travel history need information on certain tours/activities future travel wish list etc?" name="notes" className="form-control"/> <field type="radio-group" required="true" label="How did you hear about SelfishMe Travel?" description="If Family or Friend please add full name and email address in textbox below." inline="true" name="how-did-you-hear-about-selfishme-travel"> <option label="Facebook" value="facebook">Facebook</option> <option label="Instagram" value="instagram">Instagram</option> <option label="Twitter" value="twitter">Twitter</option> <option label="Personality Quiz" value="personality-quiz">Personality Quiz</option> <option label="Pinterest" value="pinterest">Pinterest</option> <option label="LinkedIn" value="linkedin">LinkedIn</option> <option label="YouTube" value="youtube">YouTube</option> <option label="Email" value="email">Email</option> <option label="Internet Search" value="internet-search">Internet Search</option> <option label="Family or Friend (type name in box below)" value="family-or-friend">Family or Friend (type name in box below)</option> <option label="I don't remember" value="i-dont-remember">I don't remember</option> </field> <field type="text" label="Family or Friend Referral Name" description="If you chose Family or Friend (above) what is the name of the person who referred you to SelfishMe Travel?" name="referral-name" subtype="text" className="form-control"/> <field type="paragraph" subtype="p"/> <field type="paragraph" subtype="p" label="--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------"/> <field type="paragraph" subtype="blockquote" label="PLEASE NOTE: an online conference call is required. So please remember to check your spam/junk folders and watch for an email from Danielle Lewis of SelfishMe Travel."/> </fields> </form-template> </body> </html>
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