<html> <body> <form-template> <fields> <field type="header" subtype="h1" label="About You"/> <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="What name do you prefer to go by?" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Cell phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="select" required="true" label="How did you hear about us?" name="how-did-you-hear-about-us" className="form-control"> <option label="" value=""/> <option label="Magazine / newspaper" value="magazine-newspaper">Magazine / newspaper</option> <option label="Search engine results (Google, Bing, etc.)" value="search-engine-results-google-bing-etc">Search engine results (Google, Bing, etc.)</option> <option label="Social media" value="social-media">Social media</option> <option label="Travel Agency directory (ASTA, etc.)" value="travel-agency-directory-asta-etc">Travel Agency directory (ASTA, etc.)</option> <option label="Word of mouth" value="word-of-mouth">Word of mouth</option> <option label="Yelp" value="yelp">Yelp</option> <option label="Other / don't recall" value="other-dont-recall">Other / don't recall</option> </field> <field type="text" label="If referred by word of mouth,&nbsp; what is the name of the person who referred you?" name="referred-by" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Have you worked with a Travel Advisor or Travel Agent in the past?" inline="true" name="have-you-worked-with-a-travel-advisortravel-agent-in-the-past"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="About Your Travel Party"/> <field type="select" required="true" label="Number of Adults (18+) on this trip:" name="number-of-adults-18-on-this-trip" className="form-control"> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7" value="7">7</option> <option label="8" value="8">8</option> <option label="9+" value="9">9+</option> </field> <field type="select" required="true" label="Number of Teenagers (13-17) on this trip:" name="number-of-teenagers-1317-on-this-trip" className="form-control"> <option label="0" value="0">0</option> <option label="1" value="1">1</option> <option label="2" value="2">2</option> <option label="3" value="3">3</option> <option label="4" value="4">4</option> <option label="5" value="5">5</option> <option label="6" value="6">6</option> <option label="7" value="7">7</option> <option label="8" value="8">8</option> <option label="9+" value="9">9+</option> </field> <field type="select" label="What are your travel experiences to date?" name="what-are-your-travel-experiences-to-date" className="form-control"> <option label="" value=""/> <option label="We haven't traveled much, or usually travel closer to home" value="we-havent-traveled-much-or-usually-travel-closer-to-home">We haven't traveled much, or usually travel closer to home</option> <option label="We've been to other states, but have never left the country or lower 48 states " value="weve-been-to-other-states-but-have-never-left-the-country-or-lower-48-states-">We've been to other states, but have never left the country or lower 48 states </option> <option label="We have visited Alaska, Hawaii, Canada, Mexico, and/or the Caribbean" value="we-have-visited-alaska-hawaii-canada-mexico-andor-the-caribbean">We have visited Alaska, Hawaii, Canada, Mexico, and/or the Caribbean</option> <option label="We have traveled abroad some" value="we-have-traveled-abroad-some">We have traveled abroad some</option> <option label="We have traveled extensively" value="we-have-traveled-extensively">We have traveled extensively</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="About Your Trip"/> <field type="text" required="true" label="Where do you want to go? A general idea is ok if you're not sure yet." name="where-do-you-want-to-go" subtype="text" className="form-control"/> <field type="date" required="true" label="Planned date of departure:" name="when-do-you-want-to-go" className="form-control"/> <field type="date" required="true" label="Planned date of return:" name="when-do-you-want-to-return" className="form-control"/> <field type="radio-group" required="true" label="Are these dates flexible?" inline="true" name="are-these-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="select" required="true" label="Primary purpose of this trip:" description="Mindset Travel serves exclusively leisure travelers." name="primary-purpose-of-this-trip" className="form-control"> <option label="" value=""/> <option label="Romance (honeymoon, anniversary, etc.)" value="romance-honeymoon-anniversary-etc">Romance (honeymoon, anniversary, etc.)</option> <option label="Milestone celebration (birthday, retirement, etc.)" value="milestone-celebration-birthday-retirement-etc">Milestone celebration (birthday, retirement, etc.)</option> <option label="Holiday celebration" value="holiday-celebration">Holiday celebration</option> <option label="Family vacation or reunion" value="family-vacation-or-reunion">Family vacation or reunion</option> <option label="Health & wellness" value="health-wellness">Health & wellness</option> <option label="Personal goal or dream" value="personal-goal-or-dream">Personal goal or dream</option> <option label="Friend gathering" value="friend-gathering">Friend gathering</option> </field> <field type="checkbox-group" required="true" label="What kind of atmosphere are you looking for on this trip? (Check all that apply)" inline="true" name="vibe-preference" other="true"> <option label="Indulgence and pampering" value="indulgence-and-pampering">Indulgence and pampering</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Romantic" value="romantic">Romantic</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="LGBTQ+" value="lgbtq">LGBTQ+</option> <option label="Active" value="active">Active</option> <option label="Artistic" value="artistic">Artistic</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Health and wellness" value="health-and-wellness">Health and wellness</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="About Your Flights"/> <field type="text" required="true" label="What is your home airport?" name="bwhat-is-your-preferred-departure-cityairport" subtype="text" className="form-control"/> <field type="select" required="true" label="Preferred class of air service:" name="preferred-class-of-air-service" className="form-control"> <option label="" value=""/> <option label="Private" value="private">Private</option> <option label="First" value="first">First</option> <option label="Business" value="business">Business</option> <option label="Upgraded Economy" value="upgraded-economy">Upgraded Economy</option> <option label="Economy" value="economy">Economy</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="About Your Accommodations"/> <field type="radio-group" required="true" label="Preferred class of accommodations" inline="true" name="hotel-preference"> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="select" required="true" label="Most important to you about your accommdations:" name="most-important-to-you-about-your-accommdations" className="form-control"> <option label="" value=""/> <option label="Central location with easy access to local sites, dining, shops" value="central-location-with-easy-access-to-local-sites-dining-shops">Central location with easy access to local sites, dining, shops</option> <option label="Luxurious accommodations with excellent service" value="luxurious-accommodations-with-excellent-service">Luxurious accommodations with excellent service</option> <option label="Premium view of the ocean or landscape" value="premium-view-of-the-ocean-or-landscape">Premium view of the ocean or landscape</option> <option label="On site access to children's facilities" value="on-site-access-to-childrens-facilities">On site access to children's facilities</option> <option label="Separate bedroom(s) and living area" value="separate-bedrooms-and-living-area">Separate bedroom(s) and living area</option> <option label="Sustainable practices / green certification" value="sustainable-practices-green-certification">Sustainable practices / green certification</option> <option label="Exclusive use for my travel party" value="exclusive-use-for-my-travel-party">Exclusive use for my travel party</option> <option label="My preferred hotel brand" value="my-preferred-hotel-brand">My preferred hotel brand</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="About Your Destination"/> <field type="select" required="true" label="Preferred method of transportation:" description="How would you like to get around in your destination?" name="preferred-primary-method-of-transportation" className="form-control"> <option label="No Preference / Recommended Options" value="no-preference-recommended-options">No Preference / Recommended Options</option> <option label="Private driver guide" value="private-driver-guide">Private driver guide</option> <option label="Private driver on call" value="private-driver-on-call">Private driver on call</option> <option label="Vehicle Rental" value="vehicle-rental">Vehicle Rental</option> <option label="Luxury rail" value="luxury-rail">Luxury rail</option> <option label="Local transportation (subway, bus, taxi)" value="local-transportation-subway-bus-taxi">Local transportation (subway, bus, taxi)</option> </field> <field type="checkbox-group" required="true" label="What activities are you interested in for this trip? (Check all that apply)" inline="true" name="activity-preferences" other="true"> <option label="Arts or local crafts workshop" value="arts-or-local-crafts-workshop">Arts or local crafts workshop</option> <option label="Beer, wine, and spirits" value="beer-wine-and-spirits">Beer, wine, and spirits</option> <option label="Boating" value="boating">Boating</option> <option label="Culinary class or tasting" value="culinary-class-or-tasting">Culinary class or tasting</option> <option label="Hiking and trekking" value="hiking-and-trekking">Hiking and trekking</option> <option label="History and education" value="history-and-education">History and education</option> <option label="Museums" value="museums">Museums</option> <option label="Music, concerts, opera, etc." value="music-concerts-opera-etc">Music, concerts, opera, etc.</option> <option label="Photography" value="photography">Photography</option> <option label="Relax on the beach or at the pool" value="relax-on-the-beach-or-at-the-pool">Relax on the beach or at the pool</option> <option label="Scuba, snorkel, water sports" value="scuba-snorkel-water-sports">Scuba, snorkel, water sports</option> <option label="Shopping" value="shopping">Shopping</option> <option label="Spa services" value="spa-services">Spa services</option> <option label="Soft adventure (zip line, horseback riding, etc.)" value="soft-adventure-zip-line-horseback-riding-etc">Soft adventure (zip line, horseback riding, etc.)</option> <option label="Theatre / performing arts" value="theatre-performing-arts">Theatre / performing arts</option> <option label="Traditional sightseeing" value="traditional-sightseeing">Traditional sightseeing</option> <option label="Wildlife encounters" value="wildlife-encounters">Wildlife encounters</option> </field> <field type="paragraph" subtype="p" label="&nbsp;"/> <field type="header" subtype="h1" label="Additional Details"/> <field type="radio-group" required="true" label="Do you intend to purchase travel insurance for this trip?" description="While optional Mindset Travel strongly encourages travel insurance to protect you and your investment." inline="true" name="do-you-intend-to-purchase-travel-insurance-for-this-trip"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="select" required="true" label="Budget PER PERSON PER DAY, excluding flights" description="Pricing while important is only one of many factors we consider when putting together the best package for your trip plans. Our services are best utilized for planned budgets of at least $500 per person per day for domestic travel and at least $600 per person per day for international travel excluding airfare. The destination may impact this minimum and we may suggest an alternative destination to honor your planned spend." name="what-is-your-budget-per-person-for-this-trip" className="form-control"> <option label=">$1200 per person per day (details below)" value="12001300">>$1200 per person per day (details below)</option> <option label="$1100-1200 per person per day" value="11001200-per-person-per-day">$1100-1200 per person per day</option> <option label="$1000-1100 per person per day" value="10001100-per-person-per-day">$1000-1100 per person per day</option> <option label="$900-1000 per person per day" value="9001000-per-person-per-day">$900-1000 per person per day</option> <option label="$800-900 per person per day" value="800900-per-person-per-day">$800-900 per person per day</option> <option label="$700-800 per person per day" value="700800-per-person-per-day">$700-800 per person per day</option> <option label="$600-700 per person per day" value="600700-per-person-per-day">$600-700 per person per day</option> <option label="<$600 per person per day" value="600-per-person-per-day"><$600 per person per day</option> </field> <field type="textarea" required="true" label="What else should we know about the experience you envision?" name="anything-else-youd-like-to-share-to-help-us-create-the-ideal-travel-experience-for-you" className="form-control"/> </fields> </form-template> </body> </html>
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