Kaycation Luxury Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Destination Wedding Inquiry Form&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" required="true" label="Bride 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="Grooms Full Name&amp;nbsp;" name="grooms-name-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Wedding or Primary Contact Person's Email" name="email" 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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="CURRENT MAILING ADDRESS" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Wedding Details&amp;nbsp;"/>&#13;
		<field type="date" required="true" label="Preferred Wedding Date" name="wedding-anniversary" className="form-control"/>&#13;
		<field type="text" required="true" label="Wedding Destination" placeholder="ex: Tahiti" 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 airport? If not flying enter NA" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many wedding guests do you project will attend?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your wedding budget inclusive of resort, flights, and wedding details?" description="This just gives me a general starting point and can always be changed later." 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="radio-group" required="true" label="What best describes your resort preference?" name="hotel-preference" other="true">&#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;
			<option label="Airbnb" value="airbnb">Airbnb</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What excursions would you like to include in your wedding package?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="On the Beach" value="on-the-beach">On the Beach</option>&#13;
			<option label="Flowers " value="flowers-">Flowers </option>&#13;
			<option label="Couples Dinner on Beach " value="couples-dinner-on-beach-">Couples Dinner on Beach </option>&#13;
			<option label="Outside Adventure" value="outside-adventure">Outside Adventure</option>&#13;
			<option label="Welcome Reception" value="welcome-reception">Welcome Reception</option>&#13;
			<option label="Welcome Dinner for Guests" value="welcome-dinner-for-guests">Welcome Dinner for Guests</option>&#13;
			<option label="Wedding T shirts " value="wedding-t-shirts-">Wedding T shirts </option>&#13;
			<option label="Pre-wedding Cocktail Hour" value="prewedding-cocktail-hour">Pre-wedding Cocktail Hour</option>&#13;
			<option label="Post Wedding Served Dinner " value="post-wedding-served-dinner-">Post Wedding Served Dinner </option>&#13;
			<option label="Wedding Photography" value="wedding-photography">Wedding Photography</option>&#13;
			<option label="Wedding Makeup " value="wedding-makeup-">Wedding Makeup </option>&#13;
			<option label="Photography" value="photography">Photography</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What are your destination wedding must haves?&amp;nbsp;" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Are you deposit ready? If not, when are you looking to confirm your wedding plans?" name="notes" className="form-control"/>&#13;
		<field type="select" required="true" label="T- Shirt Size&amp;nbsp;" name="t-shirt-size-" className="form-control">&#13;
			<option label="Small" value="">Small</option>&#13;
			<option label="Med" value="med">Med</option>&#13;
			<option label="Large" value="large">Large</option>&#13;
			<option label="XL" value="xl">XL</option>&#13;
			<option label="2X" value="2x">2X</option>&#13;
			<option label="3X" value="3x">3X</option>&#13;
			<option label="4X" value="4x">4X</option>&#13;
		</field>&#13;
		<field type="file" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="text" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="text" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Nationality" name="nationality" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How did you hear about us?&amp;nbsp; If someone referred you please list the name, email or phone number.&amp;nbsp;" name="how-did-you-hear-about-us-if-someone-referred-you-please-list-the-name-email-or-phone-number-" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>