Share your information with Michelle Ruiz

Michelle Ruiz

VIVE Society LLC

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Custom Trip Inquiry Form"/>&#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 required="true"  type="text" 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="radio-group" label="Who is This Trip For?" name="who-is-this-trip-for">&#13;
			<option label="Solo Traveler" value="solo-traveler">Solo Traveler</option>&#13;
			<option label="Couple" value="couple">Couple</option>&#13;
			<option label="Family" value="family">Family</option>&#13;
			<option label="Your Own Group" value="your-own-group">Your Own Group</option>&#13;
			<option label="Corporate Group" value="corporate-group">Corporate Group</option>&#13;
			<option label="Location Scouting  ( TV Show, event, festival etc ) " value="location-scouting-tv-show-event-festival-etc-">Location Scouting  ( TV Show, event, festival etc ) </option>&#13;
		</field>&#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;
			<option label="No" value="no">No</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?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is the Purpose of This Trip?" name="what-is-the-purpose-of-this-trip" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What Best Describes You as a Traveler?" name="what-best-describes-you-as-a-traveler">&#13;
			<option label="First Time Traveler" value="first-time-traveler">First Time Traveler</option>&#13;
			<option label="Experienced World Traveler" value="experienced-world-traveler">Experienced World Traveler</option>&#13;
			<option label="Budget Traveler" value="budget-traveler">Budget Traveler</option>&#13;
			<option label="Luxury Traveler" value="luxury-traveler">Luxury Traveler</option>&#13;
			<option label="Do Not Like Planning" value="do-not-like-planning">Do Not Like Planning</option>&#13;
			<option label="Love Planning but Do Not Have the Time" value="love-planning-but-do-not-have-the-time">Love Planning but Do Not Have the Time</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference">&#13;
			<option label="Economy" value="value">Economy</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="radio-group" label="What is Your Approximate Budget Per Person? ( Not including flights )&amp;nbsp;" description="This just gives us a general starting point and can always be changed later." name="budget">&#13;
			<option label="$2,500 to $4,500" value="2500-to-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-to-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-to-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-to-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
			<option label="$20,000+" value="20000">$20,000+</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;
			<option label="Solo Exploration" value="solo-exploration">Solo Exploration</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="Scuba Diving" value="scuba-diving">Scuba Diving</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Spa Treatments" value="spa-treatments">Spa Treatments</option>&#13;
			<option label="Fitness" value="fitness">Fitness</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What type of customization would you like?" name="what-type-of-customization-would-you-like" other="true">&#13;
			<option label="Custom itinerary Only" value="custom-itinerary-only">Custom itinerary Only</option>&#13;
			<option label="Help select hotels + book hotels" value="help-select-hotels-book-hotels">Help select hotels + book hotels</option>&#13;
			<option label="Custom itinerary + book my hotels + tours" value="custom-itinerary-book-my-hotels-tours">Custom itinerary + book my hotels + tours</option>&#13;
			<option label="Organize my entire group trip" value="organize-my-entire-group-trip">Organize my entire group trip</option>&#13;
			<option label="Organize my entire group trip + host my trip on location" value="organize-my-entire-group-trip-host-my-trip-on-location">Organize my entire group trip + host my trip on location</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="How did you hear about us?" name="text-1764865629861" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="When is the best time for you to talk on the phone?" name="when-is-the-best-time-for-you-to-talk-on-the-phone">&#13;
			<option label="Morning ( 9am - 11am ) " value="morning-9am-11am-">Morning ( 9am - 11am ) </option>&#13;
			<option label="Afternoon ( 2pm - 4pm ) " value="afternoon-2pm-4pm-">Afternoon ( 2pm - 4pm ) </option>&#13;
			<option label="Evening ( 5pm -  8pm ) " value="evening-5pm-8pm-">Evening ( 5pm -  8pm ) </option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like us 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>