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Tiffany Sheppard-Brown
Brown Travel Agency
<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Vacation Request Form"/> <field type="paragraph" subtype="p" label="Thank you for trusting Brown Travel Agency with your travel needs! Please fill out our Vacation Request Form and we will work to get you the best price available according to your budget requirements. You will receive 2 complimentary travel proposals in 3 business days for domestic travel or 5 to 7 business days for international travel."/> <field type="text" required="true" label="First Name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last Name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone Number" name="phone-number" subtype="text" className="form-control"/> <field type="radio-group" label="How did you hear about Brown Travel Agency?" name="how-did-you-hear-about-brown-travel-agency"> <option label="Search Engine (Google, Yahoo, etc.)" value="search-engine-google-yahoo-etc">Search Engine (Google, Yahoo, etc.)</option> <option label="Social Media" value="social-media">Social Media</option> <option label="Word of Mouth" value="word-of-mouth">Word of Mouth</option> </field> <field type="text" label="Other" name="other" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Choose From One Of Our Current Group Trips..."/> <field type="checkbox-group" label="Skip this section if wanting to build your own itinerary." name="skip-this-section-if-wanting-to-build-your-own-itinerary"> <option label="Teacher's Take The Bahamas Cruise ~ September 13 - 18, 2025" value="teachers-take-the-bahamas-cruise-september-13-18-2025">Teacher's Take The Bahamas Cruise ~ September 13 - 18, 2025</option> <option label="Super Bowl LX Cruise ~ February 5 - 9, 2026" value="super-bowl-lx-cruise-february-5-9-2026">Super Bowl LX Cruise ~ February 5 - 9, 2026</option> <option label="The Aruba Experience ~ April 7 - 11, 2026" value="the-aruba-experience-april-7-11-2026">The Aruba Experience ~ April 7 - 11, 2026</option> </field> <field type="header" subtype="h1" label="...Or Customize Your Own Trip"/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="date" 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"/> <field type="date" 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"/> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are your dates flexible?" name="are-your-dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="Trip Duration (# of Days)" name="trip-duration-of-days" subtype="text" className="form-control"/> <field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="checkbox-group" label="Our traveling party will include:" name="our-traveling-party-will-include"> <option label="Infant/Toddler" value="infanttoddler">Infant/Toddler</option> <option label="Children (Under 13)" value="children-under-13">Children (Under 13)</option> <option label="Teens (13-19)" value="teens-1319">Teens (13-19)</option> <option label="Adults (20-59)" value="adults-2059">Adults (20-59)</option> <option label="Seniors (60+)" value="seniors-60">Seniors (60+)</option> <option label="Individuals that require physical accommodations." value="individuals-that-require-physical-accommodations">Individuals that require physical accommodations.</option> <option label="Active Military/Veterans" value="active-militaryveterans">Active Military/Veterans</option> <option label="1st Responders (Fire, Police, Paramedics)" value="1st-responders-fire-police-paramedics">1st Responders (Fire, Police, Paramedics)</option> </field> <field type="radio-group" label="FOR GROUPS ONLY (5 or more travelers): Please select preferred room occupancy." name="for-groups-only-5-or-more-travelers-please-select-preferred-room-occupancy" other="true"> <option label="Single" value="single">Single</option> <option label="Double" value="double">Double</option> <option label="Triple" value="triple">Triple</option> <option label="Quad" value="quad">Quad</option> <option label="Would like a Vacation Home Rental." value="would-like-a-vacation-home-rental">Would like a Vacation Home Rental.</option> </field> <field type="radio-group" label="Traveling for a special occasion?" name="traveling-for-a-special-occasion"> <option label="Birthday" value="birthday">Birthday</option> <option label="Anniversary" value="anniversary">Anniversary</option> <option label="Honeymoon" value="honeymoon">Honeymoon</option> <option label="Destination Wedding" value="destination-wedding">Destination Wedding</option> <option label="Bachelor/Bachelorette Party" value="bachelorbachelorette-party">Bachelor/Bachelorette Party</option> <option label="Family Reunion" value="family-reunion">Family Reunion</option> </field> <field type="radio-group" label="What is your budget PER PERSON?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$0 to $500" value="0-to-500">$0 to $500</option> <option label="$500 to $1,000" value="500-to-1000">$500 to $1,000</option> <option label="$1,000 to $1,500" value="1000-to-1500">$1,000 to $1,500</option> <option label="$1,500 to $2,000" value="1500-to-2000">$1,500 to $2,000</option> <option label="$2,000 to $2,500" value="2000-to-2500">$2,000 to $2,500</option> <option label="$2,500 to $3,000" value="2500-to-3000">$2,500 to $3,000</option> <option label="$3,000 to $3,500" value="3000-to-3500">$3,000 to $3,500</option> <option label="$3,500 to $4,000" value="3500-to-4000">$3,500 to $4,000</option> <option label="$4,000 to $4,500" value="4000-to-4500">$4,000 to $4,500</option> <option label="$4,500 to $5,000" value="4500-to-5000">$4,500 to $5,000</option> <option label="$5,000+" value="5000">$5,000+</option> </field> <field type="radio-group" label="Do you prefer All-Inclusive Resorts?" name="do-you-prefer-allinclusive" other="true"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="No Preference" value="no-preference">No Preference</option> </field> <field type="checkbox-group" label="What would you like add to your booking?" name="what-would-you-like-included-in-your-booking" other="true"> <option label="Activities/Excurions" value="activitiesexcurions">Activities/Excurions</option> <option label="Adult Beverages" value="adult-beverages">Adult Beverages</option> <option label="Air" value="air">Air</option> <option label="Airport Transfers" value="airport-transfers">Airport Transfers</option> <option label="Car Rental" value="car-rental">Car Rental</option> <option label="Cruise" value="cruise">Cruise</option> <option label="Gratuities" value="gratuities">Gratuities</option> <option label="Hotel" value="hotel">Hotel</option> <option label="Meals" value="meals">Meals</option> <option label="Resort" value="resort">Resort</option> <option label="Sports/Major Sporting Event" value="sportsmajor-sporting-event">Sports/Major Sporting Event</option> <option label="Theater/Comedy Event" value="theatercomedy-event">Theater/Comedy Event</option> </field> <field type="checkbox-group" label="If applicable, what size vehicle rental will you need?" name="if-applicable-what-size-vehicle-rental-will-you-need"> <option label="Compact/Economy" value="compacteconomy">Compact/Economy</option> <option label="Standard" value="standard">Standard</option> <option label="Full Size" value="full-size">Full Size</option> <option label="SUV/Van/Pickup" value="suvvanpickup">SUV/Van/Pickup</option> <option label="Luxury" value="luxury">Luxury</option> </field> <field type="radio-group" label="Preferred Flight Section" name="preferred-flight-section" other="true"> <option label="Economy" value="economy">Economy</option> <option label="Business" value="business">Business</option> <option label="First Class" value="first-class">First Class</option> </field> <field type="radio-group" label="Preferred Flight Seating" name="radio-group-1742319096199" other="true"> <option label="Aisle" value="aisle">Aisle</option> <option label="Middle" value="middle">Middle</option> <option label="Window" value="window">Window</option> </field> <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="checkbox-group" label="Hotel/Resort Room Type" name="room-or-cabin-type"> <option label="Standard" value="standard">Standard</option> <option label="City View" value="city-view">City View</option> <option label="Garden View" value="garden-view">Garden View</option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Ocean Front" value="ocean-front">Ocean Front</option> <option label="Suite" value="suite">Suite</option> </field> <field type="checkbox-group" label="Cruise Cabin Type" name="cabin-type" other="true"> <option label="Interior" value="interior">Interior</option> <option label="Ocean View" value="ocean-view">Ocean View</option> <option label="Balcony" value="balcony">Balcony</option> <option label="Suite" value="suite">Suite</option> </field> <field type="checkbox-group" label="What kind of atmosphere are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Food & Wine" value="food-wine">Food & Wine</option> <option label="Kid/Family Friendly" value="kidfamily-friendly">Kid/Family Friendly</option> <option label="Local Culture" value="local-culture">Local Culture</option> <option label="Rest & Relaxation" value="rest-relaxation">Rest & Relaxation</option> <option label="Romantic" value="romantic">Romantic</option> <option label="Off The Beaten Path" value="off-the-beaten-path">Off The Beaten Path</option> <option label="Party" value="party">Party</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences"> <option label="Adventure Activities" value="adventure-activities">Adventure Activities</option> <option label="Arts & Theater" value="arts-theater">Arts & Theater</option> <option label="Beach/Water" value="beachwater">Beach/Water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Scuba" value="scuba">Scuba</option> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="checkbox-group" label="What type of payment arrangement would you like?" name="what-type-of-payment-arrangement-would-you-like"> <option label="BOOK NOW, PAY NOW" value="book-now-pay-now">BOOK NOW, PAY NOW</option> <option label="*DEPOSIT NOW, PAYMENT INSTALLMENTS" value="deposit-now-payment-installments">*DEPOSIT NOW, PAYMENT INSTALLMENTS</option> </field> <field type="paragraph" subtype="p" label="*Eligible only if time of booking is 5 months or more prior to travel departure date."/> <field type="radio-group" label="Which type of Trip Protection do you prefer?" name="which-type-of-trip-protection-do-you-prefer"> <option label="Travel Credit (Cost Per Person $49.99 - $124.99)" value="travel-credit-cost-per-person-4999-12499">Travel Credit (Cost Per Person $49.99 - $124.99)</option> <option label="Cash Refund (Cost Per Person $139.99 - $284.99)" value="cash-refund-cost-per-person-13999-28499">Cash Refund (Cost Per Person $139.99 - $284.99)</option> <option label="I do not want trip protection." value="i-do-not-want-trip-protection">I do not want trip protection.</option> </field> <field type="checkbox-group" label="Have you received any travel quotes for this itinerary?" name="have-you-received-any-travel-quotes-for-this-itinerary"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <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"/> <field type="checkbox-group" label="I prefer to be contacted by:" name="i-prefer-to-be-contacted-by"> <option label="Email" value="email">Email</option> <option label="Phone" value="phone">Phone</option> <option label="Either" value="either">Either</option> </field> </fields> </form-template> </body> </html>
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