Share your information with Alexis LaFleur

Alexis LaFleur

Virgo Express Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Desired Destination" 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" 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="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Passport" name="passport" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="In The Process" value="in-the-process">In The Process</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What is your departure Departure Port?" description="Where would you like to cruise from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many children if any?" name="text-1736155893449" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What are their ages ?" name="text-1736155919999" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How Many Rooms?" name="how-many-rooms" subtype="text" className="form-control"/>&#13;
		<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">&#13;
			<option label="$800-$1200" value="8001200">$800-$1200</option>&#13;
			<option label="$1300-$1700" value="13001700">$1300-$1700</option>&#13;
			<option label="$1700+" value="1700">$1700+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What best describes your room preference?" name="hotel-preference" other="true">&#13;
			<option label="Interior" value="Stateroom with upper and lower berths. Amenities include; TV, spacious bathroom with shower, sitting area, wall safe in closet and dressing area.">Interior</option>&#13;
			<option label="Oceanview" value="A picture window gives you views of scenery you won’t find anywhere on land, all from the comfort of your stateroom.">Oceanview</option>&#13;
			<option label="Balcony" value="Relax and admire the passing scenery from your stateroom’s private balcony.">Balcony</option>&#13;
			<option label="Suite" value="With more space for stretching out indoors, plus a large balcony for kicking back outdoors, try an Ocean Suite to experience private, luxurious relaxation. Ocean Suites also include VIP check-in, walk-in closet and bathroom with whirlpool tub.">Suite</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Couples Only" value="couples-only">Couples Only</option>&#13;
			<option label="Girl's Trip" value="girls-trip">Girl's Trip</option>&#13;
			<option label="Guy's Trip" value="guys-trip">Guy's Trip</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Birthday Celebration" value="birthday-celebration">Birthday Celebration</option>&#13;
			<option label="Church Trip " value="church-trip-">Church Trip </option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Best Form of Contact" name="best-form-of-contact">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone Call" value="phone-call">Phone Call</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="select" label="Interested in setting up a payment plan" name="interested-in-setting-up-a-payment-plan" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="select" label="Deposit Ready?" name="deposit-ready" className="form-control">&#13;
			<option label="Yes, I am deposit ready" value="yes-i-am-deposit-ready">Yes, I am deposit ready</option>&#13;
			<option label="No, i am not deposit ready" value="no-i-am-not-deposit-ready">No, i am not deposit ready</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="PLEASE READ !!&amp;nbsp; There is a RESEARCH FEE of $20 per 2 travelers. For groups of 3 -6 the fee is $40 . For groups of 6+ the fee will be $10 per traveler. IT MUST BE PAID at the time you submit this form . A SINGLE change is permitted post proposal submission, encompassing modifications such as date, departure city, or destination. Please note that new research fee is mandatory after files change. Please Ensure timely submission of the research fee. The Research Fee can be paid via our website. Choose one of the many payment options. Researching he best package for you, takes time and time is money. NO FEE, NO RESEARCH!! NO EXCEPTIONS!!&amp;nbsp;"/>&#13;
		<field type="select" required="true" label="I have sent my research fee. MUST BE PAID !! NO EXCEPTIONS" name="i-have-sent-my-research-fee" className="form-control">&#13;
			<option label="yes" value="yes">yes</option>&#13;
			<option label="no" value="no">no</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you like me 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;
		<field type="paragraph" subtype="p" label="REFUND POLICY: Client has 7 days from the date the deposit was made to receive a full refund. After the 7 days, the client will receive the refund in a travel credit.&amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>