<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Travel Details&nbsp;"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field required="true" type="text" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" label="What is the best way to reach you (phone/email)" name="what-is-the-best-way-to-reach-you-phoneemail" subtype="text" className="form-control"/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti Japan Peru" name="destination" subtype="text" className="form-control"/> <field type="date" 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"/> <field type="date" 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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="checkbox-group" label="Age Range?" description="Check all that apply." name="checkbox-group-1523503467224" other="true"> <option label="20-25" value="2025">20-25</option> <option label="26-34" value="2634">26-34</option> <option label="35-45" value="3545">35-45</option> <option label="46-55" value="4655">46-55</option> <option label="55-65" value="5565">55-65</option> <option label="65 or older" value="65-or-older">65 or older</option> </field> <field type="text" label="Traveling with children?" name="children" subtype="text" className="form-control"/> <field type="radio-group" label="What is your preferred spending level or desired expenditure for this trip (excluding airfare)?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <option label="Less than $5,000" value="less-than-5000">Less than $5,000</option> <option label="$5,000 - $10,000" value="5000-10000">$5,000 - $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 - $40,000" value="30000-40000">$30,000 - $40,000</option> <option label="$40,000 +" value="40000-">$40,000 +</option> </field> <field type="checkbox-group" label="What best describes your hotel preference?" description="Check all that apply." name="checkbox-group-1523503643324" other="true"> <option label="Moderate" value="moderate">Moderate</option> <option label="Stylish/Hip" value="stylishhip">Stylish/Hip</option> <option label="Boutique" value="boutique">Boutique</option> <option label="Luxury" value="luxury">Luxury</option> </field> <field type="text" label="What best describes your room preference?" description="Suite King Size Doubles Ocean Front Views Double sink etc" name="text-1525307448368" subtype="text" className="form-control"/> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> <option label="Wellness" value="wellness">Wellness</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Snorkeling" value="snorkeling">Snorkeling</option> <option label="Adventure activities" value="adventure">Adventure activities</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 Tours" value="food-tours">Food Tours</option> <option label="Cooking Classes" value="cooking-classes">Cooking Classes</option> <option label="Wine Tasting" value="wine-tasting">Wine Tasting</option> <option label="Beer Tasting" value="beer-tasting">Beer Tasting</option> <option label="Rated Restaurants" value="rated-restaurants">Rated Restaurants</option> <option label="Spa's" value="spas">Spa's</option> <option label="Historic" value="historic">Historic</option> <option label="Cultural" value="cultural">Cultural</option> <option label="Scenic" value="scenic">Scenic</option> <option label="Shopping" value="shopping">Shopping</option> <option label="Religious Sites" value="religious-sites">Religious Sites</option> <option label="Gambling" value="gambling">Gambling</option> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="text" label="What do you hate most about travel?" name="what-do-you-hate-most-about-travel" subtype="text" className="form-control"/> <field type="radio-group" label="Is your passport valid for at least 6 months beyond your planned departure date from the destination country?" description="Many countries require that your passport be valid for at least 6 months beyond your planned departure date. This ensures that your passport does not expire while you are abroad. Our team can help you review your passport's expiration date and guide you through the renewal process if needed." name="is-your-passport-valid-for-at-least-6-months-beyond-your-planned-departure-date-from-the-destination-country"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> <option label="Need to Check" value="need-to-check">Need to Check</option> </field> <field type="radio-group" label="If your passport does not meet this requirement, or if you are unsure, would you like our assistance in renewing your passport?" name="if-your-passport-does-not-meet-this-requirement-or-if-you-are-unsure-would-you-like-our-assistance-in-renewing-your-passport"> <option label="Yes, please assist me with passport renewal." value="yes-please-assist-me-with-passport-renewal">Yes, please assist me with passport renewal.</option> <option label=" No, I will manage it myself." value="-no-i-will-manage-it-myself"> No, I will manage it myself.</option> </field> <field type="radio-group" label="How did you hear about us?" name="how-did-you-hear-about-us"> <option label="Website" value="">Website</option> <option label="Social Media" value="social-media">Social Media</option> <option label="Internet Search" value="internet-search">Internet Search</option> <option label="BNI" value="bni">BNI</option> <option label="Referral" value="referral">Referral</option> <option label="Other" value="other">Other</option> </field> <field type="text" label="If you selected BNI, Referral, or Other please include the persons name below." description="If Other please let me know where we met?" name="if-you-selected-bni-referral-or-other-please-include-the-persons-name-below" subtype="text" className="form-control"/> <field type="textarea" label="What else would you like us to know?" description="Include any additional information that you would like us to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> </fields> </form-template> </body> </html>
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