<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Let's Plan Your 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 required="true" type="text" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: South Africa, Europe, Caribbean? No clue-- that's fine too! " name="destination" subtype="text" className="form-control"/> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" label="Full legal names (as listed on passports) &amp; dates of birth.&nbsp; Please include relationship to the travelers.&nbsp;" name="names-birthdays-for-each-additional-traveler-" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <option label="up to $10,000" value="up-to-10000">up to $10,000</option> <option label="$10,000-$15,000" value="$10,000-to-15,000">$10,000-$15,000</option> <option label="$15,000-$20,000" value="$15000-to-20000">$15,000-$20,000</option> <option label="$20,000-$25000" value="20000-to-25000">$20,000-$25000</option> <option label="$25,000-$30000" value="25000-to-30000">$25,000-$30000</option> <option label="$30,000-$35000" value="$30000-to-$35000">$30,000-$35000</option> <option label="$40,000+ " value="40000">$40,000+ </option> </field> <field type="select" label="Will you book flights through our air desk or on your own? Please note we charge $50 ticketing fee per person.&nbsp;" name="will-you-book-flights-through-our-air-desk-or-on-your-own-please-note-we-charge-50-ticketing-fee-per-person-" className="form-control"> <option label="Air Desk" value="air-desk">Air Desk</option> <option label="On my own" value="on-my-own">On my own</option> <option label="TBD" value="tbd">TBD</option> </field> <field type="checkbox-group" label="Are flights included in the overall budget?&nbsp;" name="are-flights-included-in-the-overall-budget-"> <option label="Airfare is *not* included in this budget" value="airfare-is-not-included-in-this-budget">Airfare is *not* included in this budget</option> <option label="Please include flights in the budget" value="please-include-flights-in-the-budget">Please include flights in the budget</option> </field> <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Best value for money" value="best-value-for-money">Best value for money</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="radio-group" label="What do you normally spend per night on a hotel room or suite?&nbsp;" name="what-do-you-normally-spend-per-night-on-a-hotel-room-or-suite-"> <option label="Less than $500" value="less-than-500">Less than $500</option> <option label="$500+ a night" value="500-a-night">$500+ a night</option> <option label="$750+ a night" value="750-a-night">$750+ a night</option> <option label="$1000 + a night" value="1000-a-night">$1000 + a night</option> <option label="$1500+ a night " value="1500-a-night-">$1500+ a night </option> <option label="$2000+ a night" value="2000-a-night">$2000+ a night</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Safari" value="safari">Safari</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Spa & Wellness" value="spa-wellness">Spa & Wellness</option> </field> <field type="text" label="Are you celebrating anything special on this trip?&nbsp;" name="are-you-celebrating-anything-special-on-this-trip-" subtype="text" className="form-control"/> <field type="text" label="What does your ideal vacation look like? Is there anything you absolutely can't miss?&nbsp;" name="must-dos" subtype="text" className="form-control"/> <field type="text" label="What are some of your fondest travel memories? Any favorite hotel stays?&nbsp;" name="what-are-some-of-your-fondest-travel-memories-any-favorite-hotel-stays-" subtype="text" className="form-control"/> <field type="textarea" label="What research have you done?&nbsp; Is there anything you'd like me to know?" description="Are there any preferred hotels you want to stay at? Anything you must do or see?" name="what-research-have-you-done-" className="form-control"/> <field type="radio-group" label="What kind of planning assistance are you looking for?&nbsp;" name="what-kind-of-planning-assistance-are-you-looking-for-"> <option label="VIP me with a one stop express hotel booking!" value="vip-me-with-a-one-stop-express-hotel-booking">VIP me with a one stop express hotel booking!</option> <option label="One stop booking with an itinerary" value="one-stop-booking-with-an-itinerary">One stop booking with an itinerary</option> <option label="Multi stop, full service custom curated trip!" value="multi-stop-full-service-custom-curated-trip">Multi stop, full service custom curated trip!</option> <option label="Cruise/Charters" value="cruisecharters">Cruise/Charters</option> <option label="Not sure yet. I'd love to talk through options based on my dates, budget & preferences. " value="not-sure-yet-id-love-to-talk-through-options-based-on-my-dates-budget-preferences-">Not sure yet. I'd love to talk through options based on my dates, budget & preferences. </option> </field> <field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/> <field type="text" label="How did you hear about Geaux Beyond Travel?" name="how-did-you-hear-about-geaux-beyond-travel" subtype="text" className="form-control"/> <field type="select" label="Would you like to be added to our monthly newsletter?" name="would-you-like-to-be-added-to-our-monthly-newsletter" className="form-control"> <option label="Yes!" value="yes">Yes!</option> <option label="No thank you " value="no-thank-you-">No thank you </option> </field> <field type="checkbox-group" label="Client Agreement" name="client-agreement"> <option label="I acknowledge that for international travel, my passport may need to be valid for up to 6 months beyond my return date to the United States." value="i-acknowledge-that-for-international-travel-my-passport-may-need-to-be-valid-for-up-to-6-months-beyond-my-return-date-to-the-united-states" selected="selected">I acknowledge that for international travel, my passport may need to be valid for up to 6 months beyond my return date to the United States.</option> <option label="I understand that travel insurance is strongly recommended. If I don’t already have coverage, I can request assistance in obtaining a quote." value="i-understand-that-travel-insurance-is-strongly-recommended-if-i-dont-already-have-coverage-i-can-request-assistance-in-obtaining-a-quote" selected="selected">I understand that travel insurance is strongly recommended. If I don’t already have coverage, I can request assistance in obtaining a quote.</option> </field> </fields> </form-template> </body> </html>
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