Share your information with Akilah W. Hill

Akilah W. Hill

Lotus Travel and Explore

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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="Suffix" name="suffix" 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="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="paragraph" subtype="p" label="Please note: There is a non-refundable planning fee of $65.00 to receive a quote. Each quote will include a max of 3 destinations. Travel services include custom itineraries, vacation packages, hotel only packages, destination transfers, excursions, and support before and during travel. Should you decide not to proceed with the quote or should you cancel your reservation, the deposit remains non-refundable. Your reservation must be made within 30 days of initial quote.&amp;nbsp;"/>&#13;
		<field type="checkbox-group" required="true" label="Type of Vacation" name="type-of-vacation">&#13;
			<option label="Flight/Hotel Package" value="flighthotel-package">Flight/Hotel Package</option>&#13;
			<option label="Hotel Only" value="hotel-only">Hotel Only</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="There is a planning deposit to receive a quote. Please select your option below." description="You can send payment via Zelle to lotus.travelandexplore@gmail.com or cashapp $akilahwhill" name="how-many-destinations-would-you-like-" className="form-control">&#13;
			<option label="Select One" value="select-one">Select One</option>&#13;
			<option label="$65 for 4 Caribbean/USA/Cruise Destinations" value="65-for-4-caribbeanusacruise-destinations">$65 for 4 Caribbean/USA/Cruise Destinations</option>&#13;
			<option label="$150 for Africa, Asia, Australia, Europe, South America, and Antarctica per destination" value="150-for-africa-asia-australia-europe-south-america-and-antarctica-per-destination">$150 for Africa, Asia, Australia, Europe, South America, and Antarctica per destination</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Where would you like to go? Please indicate destinations based on selection above." placeholder="Enter your destination/destination(s) here" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="date" label="When would you like to depart, Exact date that you want to leave home?" 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, Exact date that you want to return home?" 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="text" label="What airport will you be flying out of?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many adult travelers are in your room?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Age of Kids at the time of travel?" name="age-of-kids-at-the-time-of-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Additional Travelers rooming with you that will need a copy of the quote as well? (name, email, and phone number)" name="additional-travelers-needing-to-receive-a-quote-as-well-name-and-email-address" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What airport will your roommate be flying from if different?&amp;nbsp;" name="what-airport-will-your-roommate-be-flying-from-if-different-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is the age group of the majority of the travelers?" name="what-is-the-age-group-of-the-majority-of-the-travelers">&#13;
			<option label="18-29" value="1829">18-29</option>&#13;
			<option label="30-39" value="3039">30-39</option>&#13;
			<option label="40-49" value="4049">40-49</option>&#13;
			<option label="50-59" value="5059">50-59</option>&#13;
			<option label="60 and up" value="60-and-up">60 and up</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget PER PERSON?" name="what-is-your-budget-per-person">&#13;
			<option label="Up to $1,000" value="up-to-1000">Up to $1,000</option>&#13;
			<option label="$1,000 to $2,000" value="1000-to-2000">$1,000 to $2,000</option>&#13;
			<option label="$2,000 to $3,000" value="2000-to-3000">$2,000 to $3,000</option>&#13;
			<option label="$3,000 to $4,000" value="3000-to-4000">$3,000 to $4,000</option>&#13;
			<option label="More than $4,000" value="more-than-4000">More than $4,000</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel 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;
		</field>&#13;
		<field type="text" label="Special Celebration?" name="special-celebration" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="Resort Style" name="resort-style">&#13;
			<option label="Adults Only" value="adults-only">Adults Only</option>&#13;
			<option label="Family Friendly" value="family-friendly">Family Friendly</option>&#13;
			<option label="A mixture of both Adults and Family" value="a-mixture-of-both-adults-and-family">A mixture of both Adults and Family</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Do you have a preferred hotel/resort that you would like me to quote?" name="do-you-have-a-preferred-hotelresort-that-you-would-like-me-to-quote" className="form-control"/>&#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="Food and wine" value="food-wine">Food and wine</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="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</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="Arts and theater" value="art-theater">Arts and theater</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="checkbox-group" required="true" label="New or Existing Client" name="new-or-existing-client">&#13;
			<option label="Existing" value="existing">Existing</option>&#13;
			<option label="New-Search engine (google, yahoo, etc)" value="newsearch-engine-google-yahoo-etc">New-Search engine (google, yahoo, etc)</option>&#13;
			<option label="New-Referral by an existing client (please list referral name below)" value="newreferral-by-an-existing-client-please-list-referral-name-below">New-Referral by an existing client (please list referral name below)</option>&#13;
			<option label="New-Social Media" value="newsocial-media">New-Social Media</option>&#13;
		</field>&#13;
		<field type="text" label="Referral Name" name="referral-name" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know? For cruises, please provide guest names and dates of births so that we can check any promotions available to you. Also indicate a cruise departure port if applicable." 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>
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