Share your information with Juanique Welch

Juanique Welch

Divas Destinations

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	<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="ROOMMATE COMPATIBILITY"/>&#13;
		<field type="paragraph" subtype="p" label="Caribbean Heat: The Ultimate Divas Escape"/>&#13;
		<field type="header" subtype="h3" label="SLEEP &amp;amp; HEALTH HABITS"/>&#13;
		<field type="radio-group" label="Do you snore?" name="do-you-snore" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Not sure" value="not-sure">Not sure</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you have sleep apnea or use a CPAP machine?" name="sleep-apnea-or-cpap" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you have any sleep disorders (insomnia, restless sleep, etc.)?" name="sleep-disorders" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="If yes, please explain:" name="sleep-disorders-explanation" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your typical sleep schedule?" name="sleep-schedule" className="radio-group">&#13;
			<option label="Early sleeper (before 10 PM)" value="early-sleeper-before-10-pm">Early sleeper (before 10 PM)</option>&#13;
			<option label="Moderate (10 PM–12 AM)" value="moderate-10pm-12am">Moderate (10 PM–12 AM)</option>&#13;
			<option label="Night owl (after 12 AM)" value="night-owl-after-12am">Night owl (after 12 AM)</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="LIFESTYLE PREFERENCES"/>&#13;
		<field type="radio-group" label="Do you drink alcohol?" name="drink-alcohol" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="Occasionally" value="occasionally">Occasionally</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you comfortable sharing a room with someone who drinks?" name="comfortable-with-drinkers" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Depends" value="depends">Depends</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Do you smoke or vape?" name="smoke-or-vape" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are you okay rooming with someone who smokes or vapes (outside only)?" name="okay-with-outdoor-smokers" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="CLEANLINESS &amp;amp; HABITS"/>&#13;
		<field type="radio-group" label="How would you describe your cleanliness level?" name="cleanliness-level" className="radio-group">&#13;
			<option label="Very neat/organized" value="very-neat-organized">Very neat/organized</option>&#13;
			<option label="Moderately clean" value="moderately-clean">Moderately clean</option>&#13;
			<option label="Relaxed" value="relaxed">Relaxed</option>&#13;
		</field>&#13;
		<field type="radio-group" label="How do you feel about shared space (bathroom, luggage, etc.)?" name="shared-space-preference" className="radio-group">&#13;
			<option label="Prefer very organized" value="prefer-very-organized">Prefer very organized</option>&#13;
			<option label="Flexible" value="flexible">Flexible</option>&#13;
			<option label="Doesn't matter" value="doesnt-matter">Doesn't matter</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="PERSONALITY &amp;amp; VIBE"/>&#13;
		<field type="radio-group" label="How would you describe your personality while traveling?" name="travel-personality" className="radio-group">&#13;
			<option label="Social &amp; outgoing" value="social-outgoing">Social &amp; outgoing</option>&#13;
			<option label="Balanced" value="balanced">Balanced</option>&#13;
			<option label="Quiet &amp; reserved" value="quiet-reserved">Quiet &amp; reserved</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What’s your ideal trip vibe?" name="ideal-trip-vibe" className="radio-group">&#13;
			<option label="Relax &amp; recharge" value="relax-recharge">Relax &amp; recharge</option>&#13;
			<option label="Party &amp; nightlife" value="party-nightlife">Party &amp; nightlife</option>&#13;
			<option label="Mix of both" value="mix-both">Mix of both</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="IMPORTANT COMPATIBILITY QUESTION"/>&#13;
		<field type="textarea" label="What is one thing that would make a roommate situation uncomfortable for you?" name="uncomfortable-roommate-situation" rows="2" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="FINAL ROOMMATE AGREEMENT"/>&#13;
		<field type="checkbox-group" name="final-roommate-agreement" className="checkbox-group">&#13;
			<option label="I understand roommate matching is based on compatibility but is not guaranteed" value="understand-not-guaranteed">I understand roommate matching is based on compatibility but is not guaranteed</option>&#13;
			<option label="I agree to be respectful, communicative, and considerate of my roommate" value="respectful-communicative-considerate">I agree to be respectful, communicative, and considerate of my roommate</option>&#13;
			<option label="I understand I may be responsible for a solo upgrade if no suitable match is found" value="responsible-for-solo-upgrade">I understand I may be responsible for a solo upgrade if no suitable match is found</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
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