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Rebecca Batz
Travels Under the Sun
<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Plan your trip with us"/> <field type="paragraph" subtype="p" label="Tell us about your dream trip and we will be in touch."/> <field type="text" required="true" label="First Name" placeholder="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last Name" placeholder="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" subtype="email" required="true" label="Email" placeholder="you@example.com" name="email" className="form-control"/> <field type="text" subtype="tel" label="Phone" placeholder="Phone number" name="phone-number" className="form-control"/> <field type="text" label="Destination" placeholder="Where do you want to go?" name="destination" subtype="text" className="form-control"/> <field type="header" subtype="h3" label="Travel Dates"/> <field type="date" label="Starting at" description="When are you looking to travel?" name="starting-at" className="form-control"/> <field type="date" label="Ending at" name="ending-at" className="form-control"/> <field type="header" subtype="h3" label="Travelers"/> <field type="text" label="Adults" name="travelers-adults" value="0" subtype="text" className="form-control"/> <field type="text" label="Kids" name="travelers-kids" value="0" subtype="text" className="form-control"/> <field type="select" label="Trip Type" placeholder="Select an option..." name="trip-type" className="form-control"> <option label="Cruise" value="Cruise">Cruise</option> <option label="All-inclusive" value="All-inclusive">All-inclusive</option> <option label="Tour" value="Tour">Tour</option> <option label="Custom" value="Custom">Custom</option> <option label="Other" value="Other">Other</option> </field> <field type="select" label="Estimated Budget" placeholder="Select an option..." name="estimated-budget" className="form-control"> <option label="Under $2,000" value="Under $2,000">Under $2,000</option> <option label="$2,000–$5,000" value="$2,000–$5,000">$2,000–$5,000</option> <option label="$5,000–$10,000" value="$5,000–$10,000">$5,000–$10,000</option> <option label="$10,000–$20,000" value="$10,000–$20,000">$10,000–$20,000</option> <option label="$20,000+" value="$20,000+">$20,000+</option> </field> <field type="textarea" label="Notes" name="notes" className="form-control"/> </fields> </form-template> </body> </html>
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