Share your information with Angela Hornberger

Angela Hornberger

<html>
  <body>
    <form-template>&#13;
	<fields>&#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="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="h1" label="Let&#39;s get started!"/>&#13;
		<field type="text" required="true" label="How were you referred to us?" name="how-were-you-referred-to-us" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What is your preferred method of communication?" name="what-is-your-preferred-method-of-communication">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Have you worked with a travel advisor before?" name="have-you-worked-with-a-travel-advisor-before">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="I'm a first-timer" value="im-a-firsttimer">I'm a first-timer</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="What type of trip are you interested in?"/>&#13;
		<field type="checkbox-group" label="Standard Booking Services" description="Check all that apply." name="are-you-interested-in" other="true">&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="All Inclusive Resort (where available)" value="all-inclusive-resort-where-available">All Inclusive Resort (where available)</option>&#13;
			<option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option>&#13;
			<option label="River Cruise" value="river-cruise">River Cruise</option>&#13;
			<option label="Air" value="air">Air</option>&#13;
			<option label="Rental Car" value="rental-car">Rental Car</option>&#13;
			<option label="Escorted Tour" value="escorted-tour">Escorted Tour</option>&#13;
			<option label="Rail Vacation" value="rail-vacation">Rail Vacation</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" label="Preferred destinations?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Tahiti" name="preferred-destinations" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Earliest you can depart?" description="This just gives me a general idea of when you like to go; it can be changed later." name="earliest-you-can-depart" className="form-control"/>&#13;
		<field type="date" label="Latest you can return?" description="This just gives me a general idea of when you like to return; it can be changed later." name="latest-you-can-return" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="How many nights are you looking to travel?" name="how-many-nights-are-you-looking-to-travel">&#13;
			<option label="3-4" value="3-4">3-4</option>&#13;
			<option label="5-7" value="5-7">5-7</option>&#13;
			<option label="8-10" value="8-10">8-10</option>&#13;
			<option label="10 +" value="10+">10 +</option>&#13;
			<option label="not sure" value="not sure">not sure</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Names and birthdays of all travelers" name="number-of-travelers-and-their-ages" className="form-control"/>&#13;
		<field type="text" label="If you need air included, what is your departure city?" description="Where will you be flying from?" name="if-you-need-air-included-what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Estimated Travel Investment (Trip Total)" name="estimated-travel-investment-trip-total">&#13;
			<option label="Under $5,000" value="under-5000">Under $5,000</option>&#13;
			<option label="$5,000–$10,000" value="5000-10000">$5,000–$10,000</option>&#13;
			<option label="$10,000–$25,000" value="10000-25000">$10,000–$25,000</option>&#13;
			<option label="$25,000–$50,000" value="25000-50000">$25,000–$50,000</option>&#13;
			<option label="$50,000+" value="50000 +">$50,000+</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Is there anything else I should know about your price range or travel needs?" name="textarea-1768356642985" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>