Share your information with Kennedy Myers

Kennedy Myers

An Extraordinary Traveler

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		<field type="header" subtype="h1" label="CLIENT INFORMATION"/>&#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" label="Instagram handle (I&#39;d love to connect!)" name="instagram-handle-id-love-to-connect" 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="date" required="true" label="Birthday" name="birthday" 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?" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are you interested in flight booking assistance?" name="are-you-interested-in-flight-booking-assistance">&#13;
			<option label="Yes please!" value="yes-please">Yes please!</option>&#13;
			<option label="Maybe, I'd like more information." value="maybe-id-like-more-information">Maybe, I'd like more information.</option>&#13;
			<option label="No thanks!" value="no-thanks">No thanks!</option>&#13;
		</field>&#13;
		<field type="text" label="If yes - what is your departure city/preferred starting airport?" name="what-is-your-departure-citypreferred-starting-airport" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" name="how-many-travelers" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Full names &amp;amp; DOB of other travelers:" name="full-names-dob-of-other-travelers" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What travel components would you like us to assist you with? Check all that apply." name="what-travel-components-would-you-like-us-to-assist-you-with-check-all-that-apply">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Accommodations" value="accommodations">Accommodations</option>&#13;
			<option label="Transportation (car rental, trains, etc.)" value="transportation-car-rental-trains-etc">Transportation (car rental, trains, etc.)</option>&#13;
			<option label="Excursions &amp; tours" value="excursions-tours">Excursions &amp; tours</option>&#13;
			<option label="Insurance" value="insurance">Insurance</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your ideal budget for all travelers (excluding airfare)?" name="what-is-your-budget-for-all-travelers">&#13;
			<option label="Only looking for a long weekend/short getaway!" value="only-looking-for-a-long-weekendshort-getaway">Only looking for a long weekend/short getaway!</option>&#13;
			<option label="$5,000-$8,000" value="50008000">$5,000-$8,000</option>&#13;
			<option label="$8,000-$10,000" value="800010000">$8,000-$10,000</option>&#13;
			<option label="$10,000-$15,000" value="1000015000">$10,000-$15,000</option>&#13;
			<option label="$15,000-$20,000" value="1500020000">$15,000-$20,000</option>&#13;
			<option label="$20,000+" value="20000">$20,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What kind of vibe are you looking for? Check all that apply." name="checkbox-group-1739926941762">&#13;
			<option label="Romance" value="romance">Romance</option>&#13;
			<option label="Rest &amp; relaxation" value="rest-relaxation">Rest &amp; relaxation</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 &amp; wine" value="food-wine">Food &amp; wine</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How did you hear about me?" name="how-did-you-hear-about-me" other="true">&#13;
			<option label="Referral" value="referral">Referral</option>&#13;
			<option label="Instagram" value="instagram">Instagram</option>&#13;
			<option label="Facebook" value="facebook">Facebook</option>&#13;
		</field>&#13;
		<field type="text" label="If you were referred, who can I thank?" name="who-can-i-think-for-referring-you-to-us" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know? (Flights are booked, anything you &quot;must-do&quot; or see, food/allergy restrictions, specific room category request, if this trip is for any special occasion, etc.)" name="textarea-1739927312388" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="By submitting this client inquiry form, you consent to receive travel related content via email from An Extraordinary Traveler."/>&#13;
	</fields>&#13;
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  </body>
</html>