Share your information with Sandra Black

Sandra Black

Escapes By Sandra

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" label="Where would you like to go?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<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"/>&#13;
		<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"/>&#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 is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How Many Travelers - How many adults/How many children (under 18)?&amp;nbsp; Provide ages of all children at the time of travel.&amp;nbsp;" name="number-of-travelers" subtype="text" className="form-control"/>&#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="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="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Food and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are You Deposit Ready?" name="text-1736191994322" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What is your per person travel budget?" name="what-is-your-travel-budget">&#13;
			<option label="$1,500 - $2,500" value="1500-2500">$1,500 - $2,500</option>&#13;
			<option label="$2,500 - $4,500" value="2500-4500">$2,500 - $4,500</option>&#13;
			<option label="$4,500 -$6,500" value="4500-6500">$4,500 -$6,500</option>&#13;
			<option label="$6,500 - $8,500" value="6500-8500">$6,500 - $8,500</option>&#13;
			<option label="$8,500 - $10,000" value="8500-10000">$8,500 - $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like flights included?" name="would-you-like-flights-included">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="List any Must-have amenities (pool, all-inclusive, kid&#39;s club, balcony, etc.)" name="list-any-musthave-amenities-pool-allinclusive-kids-club-balcony-etc" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Do All Travelers Have Passports or Real ID?" inline="true" name="do-all-travelers-have-passports">&#13;
			<option label="Passport " value="passport-">Passport </option>&#13;
			<option label="Real ID" value="real-id">Real ID</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Are you currently working with a Travel Agent?" name="checkbox-group-1752686379853">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<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"/>&#13;
		<field type="text" label="Contact Phone Number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Were You Refereed By Someone? If so, please provide their name.&amp;nbsp;" name="text-1769268342621" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Are You Interested In Becoming A Travel Agent&amp;nbsp;" name="checkbox-group-1771455625257">&#13;
			<option label="Yes" value="">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>