<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="header" subtype="h2" label="Personal Details"/> <field type="text" required="true" label="First name (exactly as shown on your passport)" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name or maiden name&nbsp;(exactly as shown on your passport)" name="middle-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name&nbsp;&nbsp;(exactly as shown on your passport)" name="last-name" subtype="text" className="form-control"/> <field type="text" label="Suffix (Jr, Sr, III. Please state if it is listed after your middle name or after your last name on your passport)" name="suffix" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Instagram profile" name="instagram-profile" subtype="text" className="form-control"/> <field type="date" required="true" label="Birthday" name="birthday" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="text" required="true" label="How did you hear about us? We are a boutique agency with a coterie of loyal clients. We expedite requests for existing clients and referrals. Please let us know who referred you... we would LOVE to thank them!" name="how-did-you-hear-about-us-we-are-a-boutique-agency-with-a-coterie-of-loyal-clients-we-expedite-requests-for-existing-clients-and-referrals-please-let-us-know-who-referred-you-we-would-love-to-thank-them" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Trip Information"/> <field type="text" required="true" label="Where would you like to go?" description="If you're not sure just give us a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="date" required="true" label="When would you like to depart?" description="This just gives us a general idea of when you like to go; it can be changed later." name="starting-at" className="form-control"/> <field type="date" required="true" label="When would you like to return?" description="This just gives us a general idea of when you like to return; it can be changed later." name="ending-at" className="form-control"/> <field type="checkbox-group" required="true" label="Are your dates flexible by a few days?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" required="true" label="Will you be booking air with us? If so, which airport will you be flying from?" description="Do you have an airport preference?" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="How many adult travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="Will any children be traveling with you?&nbsp;If so,&nbsp; how old will they be at time of travel?" name="will-any-children-be-traveling-with-you" subtype="text" className="form-control"/> <field type="text" required="true" label="Please list additional travelers' names exactly as shown on their passports. Include dates of birth if you have them." name="prefix" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do you currently have passports?" description="Required for international travel" name="do-you-currently-have-passports"> <option label="Yes" value="yes">Yes</option> <option label="Yes, but they are expired/will be expiring in the next year" value="yes-but-they-are-expiredwill-be-expiring-in-the-next-year">Yes, but they are expired/will be expiring in the next year</option> <option label="No" value="no">No</option> <option label="Application has already been sent in" value="application-has-already-been-sent-in">Application has already been sent in</option> </field> <field type="radio-group" required="true" label="What is the total trip budget you feel comfortable with? Please consider inclusions, airfare, if needed, and trip length." description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="$7,000 - $10,000" value="7000-10000">$7,000 - $10,000</option> <option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option> <option label="$15,000 - $20,000" value="15000-20000">$15,000 - $20,000</option> <option label="$20,000 - $30,000" value="20000-30000">$20,000 - $30,000</option> <option label="$30,000 +" value="30000-">$30,000 +</option> </field> <field type="radio-group" required="true" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Moderate ex. Hilton" value="moderate-ex-hilton">Moderate ex. Hilton</option> <option label="Luxury ex. Four Seasons" value="luxury-ex-four-seasons">Luxury ex. Four Seasons</option> <option label="Villa or Apartment" value="villa-or-apartment">Villa or Apartment</option> </field> <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"> <option label="Romance" value="romance">Romance</option> <option label="Family Bonding Time" value="family-bonding-time">Family Bonding Time</option> <option label="Rest and Relaxation/Wellness" value="rest-and-relaxationwellness">Rest and Relaxation/Wellness</option> </field> <field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Scuba" value="scuba">Scuba</option> <option label="Off the Beaten Path/Adventure" value="off-the-beaten-pathadventure">Off the Beaten Path/Adventure</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> <option label="Food/Cooking/Wine" value="foodcookingwine">Food/Cooking/Wine</option> <option label="Spa/Wellness" value="spawellness">Spa/Wellness</option> <option label="History/Architecture" value="historyarchitecture">History/Architecture</option> </field> <field type="header" subtype="h2" label="Travel Preferences"/> <field type="radio-group" required="true" label="Flight Cabin Preference" name="flight-cabin-preference" other="true"> <option label="Whatever is nonstop, if available" value="whatever-is-nonstop-if-available">Whatever is nonstop, if available</option> <option label="Economy/Main Cabin" value="economymain-cabin">Economy/Main Cabin</option> <option label="Premium Economy" value="premium-economy">Premium Economy</option> <option label="Long Haul Business Class/First (only if flight is longer than 2-3 hours)" value="long-haul-business-classfirst-only-if-flight-is-longer-than-23-hours">Long Haul Business Class/First (only if flight is longer than 2-3 hours)</option> <option label="Business/First Class" value="businessfirst-class">Business/First Class</option> <option label="Charter/Private Air " value="charterprivate-air-">Charter/Private Air </option> </field> <field type="radio-group" label="Do you prefer an aisle or window seat? By default, we always assign seats adjacent to each other as close to the front of the plane, and away from the restrooms.&nbsp;" description="By default we always assign seats adjacent to each other as close to the front of the plane and away from the restrooms." name="seat-preference"> <option label="Window and Adjacent" value="window-and-adjacent">Window and Adjacent</option> <option label="Aisle and Adjacent" value="aisle-and-adjacent">Aisle and Adjacent</option> <option label="Split the Aisle" value="split-the-aisle">Split the Aisle</option> </field> <field type="radio-group" required="true" label="Bed preference" name="bed-preference"> <option label="King" value="king">King</option> <option label="2 Double Beds/Queens" value="2-double-bedsqueens">2 Double Beds/Queens</option> </field> <field type="text" required="true" label="Any health, mobility, or dietary restrictions? Please note all allergies. Is there anything you would like us to know about your group? Ex. "We need 3 bedrooms," Family dynamic, health concerns, specific celebrations, corporate team etc." name="meal-preference" subtype="text" className="form-control"/> <field type="text" required="true" label="Brain Dump: Please tell us anything you else you can about your perfect trip. Anything you absolutely must do or see? Is there anything else you would like us to know?" name="must-dos" subtype="text" className="form-control"/> <field type="text" required="true" label="Time to Brag: Tell us a fun fact about yourself! We love getting to know our clients." name="tell-us-a-fun-fact-about-yourself-we-love-getting-to-know-our-clients" subtype="text" className="form-control"/> <field type="checkbox-group" required="true" label="I have read and agree to Jet Set Geaux's Terms and Conditions." name="i-have-read-and-agree-to-jet-set-geauxs-terms-and-conditions"> <option label="Yes, I agree. Let's Geaux!" value="yes-i-agree-lets-geaux">Yes, I agree. Let's Geaux!</option> </field> </fields> </form-template> </body> </html>
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