Share your information with Kenyata Barrett

Kenyata Barrett

BME Travel Group

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Book My Escape!"/>&#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 required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="select" label="What is your preferred method of contact?" name="select-1772995478172" className="form-control">&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
		</field>&#13;
		<field type="select" label="What type of curated experience are you interested in?" name="select-1772995548603" multiple="multiple" className="form-control">&#13;
			<option label="Adventure / Outdoor" value="adventure-outdoor">Adventure / Outdoor</option>&#13;
			<option label="Cultural / Historical" value="cultural-historical">Cultural / Historical</option>&#13;
			<option label="Wellness / Spa" value="wellness-spa">Wellness / Spa</option>&#13;
			<option label="Food &amp; Wine / Culinary" value="food-wine-culinary">Food &amp; Wine / Culinary</option>&#13;
			<option label="Luxury / VIP Experiences" value="luxury-vip-experiences">Luxury / VIP Experiences</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="textarea" label="Destination(s) you’re interested in:" name="textarea-1772995745144" className="form-control"/>&#13;
		<field type="textarea" label="Estimated travel dates or timeframe:" name="textarea-1772995786499" className="form-control"/>&#13;
		<field type="text" label="Number of travelers:" name="text-1772995826693" subtype="text" className="form-control"/>&#13;
		<field type="select" label="Traveler type:" name="select-1772995852300" className="form-control">&#13;
			<option label="Adults Only" value="adults-only">Adults Only</option>&#13;
			<option label="Adults + children" value="adults-children">Adults + children</option>&#13;
			<option label="Not sure" value="not-sure">Not sure</option>&#13;
		</field>&#13;
		<field type="text" label="Budget per person (approximate):" name="text-1772995909781" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Are there any must-see activities or experiences you want included?" name="textarea-1772995959302" className="form-control"/>&#13;
		<field type="textarea" label="Anything else you’d like me to know while planning your experience?" name="textarea-1772996013101" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>