Share your information with Jamie Blando

Jamie Blando

Integrity Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<field type="text" required="true" label="First name" name="first-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" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What type of trip are you planning? (Select all that apply)" inline="true" name="what-type-of-trip-are-you-planning-select-all-that-apply" other="true">&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Destination Wedding" value="Destination wedding">Destination Wedding</option>&#13;
			<option label="Family Vacation" value="family-vacation">Family Vacation</option>&#13;
			<option label="Group Trip" value="group-trip">Group Trip</option>&#13;
			<option label="All Inclusive" value="all-inclusive">All Inclusive</option>&#13;
			<option label="Guided Tour" value="guided-tour">Guided Tour</option>&#13;
			<option label="River Cruise" value="river-cruise">River Cruise</option>&#13;
			<option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option>&#13;
			<option label="Custom Europe" value="custom-europe">Custom Europe</option>&#13;
			<option label="Adventure Travel" value="adventure-travel">Adventure Travel</option>&#13;
		</field>&#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="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is an estimate of your PER PERSON budget?" description="This just gives me a general starting point and can always be changed later." name="budget" className="radio-group">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="date" required="true" 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" required="true" 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="text" label="If your dates are flexible, do you have any dates you CANNOT travel?" name="text-1778102131914" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Vibe preferences" name="vibe-preference">&#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="Adventure" value="adventure">Adventure</option>&#13;
			<option label="Food &amp; wine" value="food-wine">Food &amp; wine</option>&#13;
			<option label="Local culture" value="local-culture">Local culture</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Nightlife &amp; social scene" value="nightlife-social-scene">Nightlife &amp; social scene</option>&#13;
			<option label="Family friendly" value="family-friendly">Family friendly</option>&#13;
			<option label="Wellness &amp; spa" value="wellness-spa">Wellness &amp; spa</option>&#13;
			<option label="History" value="history">History</option>&#13;
			<option label="Nature &amp; scenery" value="nature-scenery">Nature &amp; scenery</option>&#13;
		</field>&#13;
		<field type="textarea" label="Other Notes" description="Anything else you would like me to know prior to scheduling an appointment" name="textarea-1778102836474" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>