Belinda Eckols

Eckols Travel

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	<fields>&#13;
		<field type="header" subtype="h2" label="CLIENT INFORMATION"/>&#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 type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="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="Line 1" 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="About Your Trip"/>&#13;
		<field type="text" label="Where would you like to go?" placeholder="ex. Paris" name="text-1693329152147" subtype="text" className="form-control"/>&#13;
		<field type="date" label="When would you like to depart?" name="date-1693329233042" className="form-control"/>&#13;
		<field type="date" label="When would you like to return?" name="date-1693329194897" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="what city are you flying out of" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Is this trip to celebrate anything special?" placeholder="anniversary  birthday  girls trip etc." name="text-1693329390066" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Please list full names - as listed on passports - and dates of birth for all travelers on this trip (including yourself)" name="please-list-full-names-as-listed-on-passports-and-dates-of-birth-for-all-travelers-on-this-trip-including-yourself" className="form-control"/>&#13;
		<field type="radio-group" label="What phase of planning are you in?" name="what-phase-of-planning-are-you-in">&#13;
			<option label="I am just beginning the process" value="i-am-just-beginning-the-process">I am just beginning the process</option>&#13;
			<option label="We have dates, nothing else confirmed" value="we-have-dates-nothing-else-confirmed">We have dates, nothing else confirmed</option>&#13;
			<option label="We have hotels only booked " value="we-have-hotels-only-booked-">We have hotels only booked </option>&#13;
			<option label="We have flights only booked" value="we-have-flights-only-booked">We have flights only booked</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travelers (not including airfare)?&amp;nbsp;" description="please specify a range you are comfortable with for land-only arrangements." name="budget">&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
			<option label="$13,000+ Minimum required Europe budget, per week" value="13000-minimum-required-europe-budget-per-week">$13,000+ Minimum required Europe budget, per week</option>&#13;
			<option label="$15,000 +" value="15000-">$15,000 +</option>&#13;
			<option label="30,000+" value="30000">30,000+</option>&#13;
			<option label="Whatever it takes to create the experience I am looking for" value="whatever-it-takes-to-create-the-experience-i-am-looking-for">Whatever it takes to create the experience I am looking for</option>&#13;
			<option label="I need guidance" value="i-need-guidance">I need guidance</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Unfortunalty, we do not book any itinerary components with points.&amp;nbsp;" name="will-you-be-booking-any-portion-with-points-we-do-not-book-any-itinerary-components-with-points-but-you-are-free-to-use-points-to-book-your-airfare">&#13;
			<option label="I understand and will not be using points" value="i-understand-and-will-not-be-using-points">I understand and will not be using points</option>&#13;
			<option label="I understand and will book my own airfare using my points" value="i-understand-and-will-book-my-own-airfare-using-my-points">I understand and will book my own airfare using my points</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What travel components would you like us to assist you with?" description="check all that apply" name="what-travel-components-would-you-like-us-to-assist-you-with">&#13;
			<option label="Flights ( ticketing fee per passenger required for booking)" value="flights-ticketing-fee-per-passenger-required-for-booking">Flights ( ticketing fee per passenger required for booking)</option>&#13;
			<option label="Flight guidance only " value="flight-guidance-only-">Flight guidance only </option>&#13;
			<option label="Accommodations" value="accommodations">Accommodations</option>&#13;
			<option label="Transportation &amp; Transfers" value="transportation-transfers">Transportation &amp; Transfers</option>&#13;
			<option label="Excursions &amp; Tours" value="excursions-tours">Excursions &amp; Tours</option>&#13;
			<option label="Travel Insurance" value="travel-insurance">Travel Insurance</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Select preferred accomodation" name="select-preferred-accomodation">&#13;
			<option label="Luxury/Exclusive (5 - star)" value="luxuryexclusive-5-star">Luxury/Exclusive (5 - star)</option>&#13;
			<option label="Boutique/Intimate" value="boutiqueintimate">Boutique/Intimate</option>&#13;
			<option label="Moderate (4 - star)" value="moderate-4-star">Moderate (4 - star)</option>&#13;
			<option label="Large brand/chain hotel" value="large-brandchain-hotel">Large brand/chain hotel</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="What amenities are a must-have?" placeholder="ex. spa  restaurant on site" name="what-amenities-are-a-must" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What options best describe your travel style?" name="what-options-best-describe-your-travel-style">&#13;
			<option label="Keep me busy! I'm ready to explore." value="keep-me-busy-im-ready-to-explore">Keep me busy! I'm ready to explore.</option>&#13;
			<option label="Rest &amp; Relaxation. Need down-time!" value="rest-relaxation-need-downtime">Rest &amp; Relaxation. Need down-time!</option>&#13;
			<option label="I love great food &amp; wine experiences." value="i-love-great-food-wine-experiences">I love great food &amp; wine experiences.</option>&#13;
			<option label="Family-friendly activities." value="familyfriendly-activities">Family-friendly activities.</option>&#13;
			<option label="A blend of exploring and down time." value="a-blend-of-exploring-and-down-time">A blend of exploring and down time.</option>&#13;
		</field>&#13;
		<field type="text" label="Do any travelers have food allergies/restrictions or physical limitations we should be aware of?" name="do-any-travelers-have-food-allergiesrestrictions-or-physical-limitations-we-should-be-aware-of" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Anything else you would like me to know?" name="anything-else-you-would-like-me-to-know" className="form-control"/>&#13;
		<field type="select" label="How did you learn about Eckols Travel" name="how-did-you-learn-about-eckols-travel" className="form-control">&#13;
			<option label="Existing Client" value="existing-client">Existing Client</option>&#13;
			<option label="Referral from friend" value="referral-from-friend">Referral from friend</option>&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="Virtuoso" value="virtuoso">Virtuoso</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Next Steps &amp;amp; Our Process"/>&#13;
		<field type="paragraph" subtype="p" label="After submitting this form we will reach out to schedule your 30-minute complimentary consultation call. During your call we will discuss in depth details of your vacation, describe our process, discuss planning fees, and answer any questions you may have. My goal is to connect with you personally, developing a relationship that earns your trust so that I can provide you with peace of mind, unique experiences, and an expertly crafted itinerary tailored to your wants/needs. We do not price match or compete with other online travel agencies. We value our connection with you and look forward to working with you to create the vacation of your dreams!"/>&#13;
	</fields>&#13;
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