Share your information with JurLonna Walker Hermon

JurLonna Walker Hermon

TEW Experience

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Tell Us All About Your Travel Plans!"/>&#13;
		<field type="paragraph" subtype="p" label="Welcome to the first step in creating your dream getaway with us. &amp;nbsp;We are excited to hear all about it. &amp;nbsp;Take a moment to fill out the form and let&#39;s embark on this journey together."/>&#13;
		<field type="header" subtype="h2" label="Contact Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="About Your Trip"/>&#13;
		<field type="text" required="true" 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="text" required="true" label="What are your desired travel dates?" name="how-many-nights" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" 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?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many beds do you need for your trip? If yacht charter, how many cabins &amp;amp; beds?" name="how-many-beds-do-you-need-for-your-trip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are you celebrating a special occasion during this trip?" name="text-1755196452115" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" 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="Wellness Getaway" value="wellness-getaway">Wellness Getaway</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;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What components would you like included?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="International Flights" value="international-flights">International Flights</option>&#13;
			<option label="Accommodations" value="accommodations">Accommodations</option>&#13;
			<option label="Transportation (transfers/train/rental car/etc)" value="transportation-transferstrainrental-caretc">Transportation (transfers/train/rental car/etc)</option>&#13;
			<option label="Tours &amp; Activities" value="tours-activities">Tours &amp; Activities</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What best describes your lodging preference?" description="Check all that applies" name="what-best-describes-your-lodging-preference" other="true">&#13;
			<option label="Boutique Hotels &amp; Resort" value="boutique-hotels-resort">Boutique Hotels &amp; Resort</option>&#13;
			<option label="Recognized Hotel Brands" value="recognized-hotel-brands">Recognized Hotel Brands</option>&#13;
			<option label="All-Inclusive Resorts" value="allinclusive-resorts">All-Inclusive Resorts</option>&#13;
			<option label="Private Villa" value="private-villa">Private Villa</option>&#13;
			<option label="Yacht" value="yacht">Yacht</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="If requesting a yacht, what is your preference?" description="Check all that applies" name="if-requesting-a-yacht-what-are-you-requesting" other="true">&#13;
			<option label="Captain Only" value="captain-only">Captain Only</option>&#13;
			<option label="Captain &amp; Crew" value="captain-crew">Captain &amp; Crew</option>&#13;
			<option label="Bareboat w/Captain" value="bareboat-wcaptain">Bareboat w/Captain</option>&#13;
			<option label="Bareboat w/o Captain" value="bareboat-wo-captain">Bareboat w/o Captain</option>&#13;
			<option label="Powered" value="powered">Powered</option>&#13;
			<option label="Sail" value="sail">Sail</option>&#13;
		</field>&#13;
		<field type="text" label="Are there specific activities or experiences you&#39;d like to include in your itinerary?" name="are-there-specific-activities-or-experiences-youd-like-to-include-in-your-itinerary" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your estimated budget for this trip?" name="what-is-your-estimated-budget-for-this-trip">&#13;
			<option label="$3,000-$5,000 Per Person" value="30005000-per-person">$3,000-$5,000 Per Person</option>&#13;
			<option label="$5,000-$7,000 Per Person" value="50007000-per-person">$5,000-$7,000 Per Person</option>&#13;
			<option label="$7,000+ Per Person" value="7000-per-person">$7,000+ Per Person</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Are there any other helpful details should we know about?" name="are-there-any-other-helpful-details-should-we-know-about" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="How did you hear about TEW Experience?" name="how-did-you-hear-about-tew-experience" other="true">&#13;
			<option label="Google" value="google">Google</option>&#13;
			<option label="Friends/Family" value="friendsfamily">Friends/Family</option>&#13;
			<option label="Social Media" value="social-media">Social Media</option>&#13;
			<option label="Participated in Previous Group Trip" value="participated-in-previous-group-trip">Participated in Previous Group Trip</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What are the top 3 things you want to do while on this trip?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Consent" name="consent">&#13;
			<option label="I consent to TEW Experience collect my information." value="i-consent-to-tew-experience-collect-my-information">I consent to TEW Experience collect my information.</option>&#13;
			<option label="I do not consent to TEW Experience collect my information." value="i-do-not-consent-to-tew-experience-collect-my-information">I do not consent to TEW Experience collect my information.</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="We value your privacy. &amp;nbsp;Your name, phone number, and email address are collected so we can contact you about planning a trip. &amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>