<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Complete the form below and an agent will be in touch.&nbsp;"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" label="Middle name" name="middle-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" required="true" 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" 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="checkbox-group" required="true" 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="Any Preference on your Departure City?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" required="true" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="What is your budget for all travelers?" description="This just gives me a general starting point and can always be changed later." name="budget"> <option label="Unsure at this time, open to least expensive packaged option for the guests in this cabin." value="unsure-at-this-time-open-to-least-expensive-packaged-option-for-the-guests-in-this-cabin">Unsure at this time, open to least expensive packaged option for the guests in this cabin.</option> <option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option> <option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option> <option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option> <option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option> <option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option> <option label="$10k to 20k" value="10k-to-20k">$10k to 20k</option> <option label="20k to 40k" value="20k-to-40k">20k to 40k</option> <option label="40k to 75k" value="40k-to-75k">40k to 75k</option> <option label="75k+" value="75k">75k+</option> </field> <field type="clientLoyaltyPrograms" label="Loyalty Programs/Frequent Traveler Number" 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"/> <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="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> </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="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</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> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <field type="textarea" label="Anything else you would like me to know? Celebrations, Concerns you have, etc." description="What else would you like me to know about your travelers budget and/or travel preferences?" name="notes" rows="10" className="form-control"/> <field type="checkbox-group" required="true" label="Anyone traveling who is disabled or requires specific accommodations or assistance due to special needs? " name="anyone-traveling-who-is-disabled-or-requires-specific-accommodations-or-assistance-due-to-special-needs-"> <option label="Yes- Child Traveling with Disabilities or Special Needs Accomodations" value="yes-child-traveling-with-disabilities-or-special-needs-accomodations">Yes- Child Traveling with Disabilities or Special Needs Accomodations</option> <option label="Yes- Adult Traveling with Disabilities or Special Needs " value="yes-adult-traveling-with-disabilities-or-special-needs-">Yes- Adult Traveling with Disabilities or Special Needs </option> <option label="No, this does not apply" value="no-this-does-not-apply">No, this does not apply</option> </field> <field type="select" required="true" label="How did you hear about Coastal to Caribbean Travel? " name="how-did-you-hear-about-coastal-to-caribbean-travel-" className="form-control"> <option label="Referred by Friend or Family" value="referred-by-friend-or-family">Referred by Friend or Family</option> <option label="Work Colleague or Business Referral" value="work-colleague-or-business-referral">Work Colleague or Business Referral</option> <option label="Search Engine ( Google, Yahoo, etc)" value="search-engine-google-yahoo-etc">Search Engine ( Google, Yahoo, etc)</option> <option label="Social Media" value="social-media">Social Media</option> <option label="Other" value="other">Other</option> </field> <field type="select" label="US Citizens for ALL Guests?&nbsp; &nbsp;*If not I will reach out to gather specifics." name="us-citizens-for-all-guests-if-not-i-will-reach-out-to-gather-specifics" className="form-control"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="header" subtype="h2" label="Passport Info"/> <field type="select" label="Do you have a passport?" description="Please select from the following:" name="do-you-have-a-passport" className="form-control"> <option label="Please do not include any travel requiring a passport at this time." value="please-do-not-include-any-travel-requiring-a-passport-at-this-time">Please do not include any travel requiring a passport at this time.</option> <option label="Looking to obtain prior to trip or have one needing renewal and it is ok to consider destinations requiring this form of documentation." value="looking-to-obtain-prior-to-trip-or-have-one-needing-renewal-and-it-is-ok-to-consider-destinations-requiring-this-form-of-documentation">Looking to obtain prior to trip or have one needing renewal and it is ok to consider destinations requiring this form of documentation.</option> <option label="Already have them and they are still valid." value="already-have-them-and-they-are-still-valid">Already have them and they are still valid.</option> </field> <field type="checkbox-group" required="true" label="Checkbox Group" name="checkbox-group-1709098430582"> <option label="Just Browsing/Gathering Info" value="just-browsinggathering-info">Just Browsing/Gathering Info</option> <option label="Im so excited to get started in planning but still need some time to get things in order, pricing out some good deals for future trips over a year out." value="im-so-excited-to-get-started-in-planning-but-still-need-some-time-to-get-things-in-order-pricing-out-some-good-deals-for-future-trips-over-a-year-out">Im so excited to get started in planning but still need some time to get things in order, pricing out some good deals for future trips over a year out.</option> <option label="Im ready for this! Looking to book something now for travel to happen at least 6 months out." value="im-ready-for-this-looking-to-book-something-now-for-travel-to-happen-at-least-6-months-out">Im ready for this! Looking to book something now for travel to happen at least 6 months out.</option> <option label="READY TO BOOK a trip within 6 months or even one of those last minute deal, Lets go! " value="ready-to-book-a-trip-within-6-months-or-even-one-of-those-last-minute-deal-lets-go-">READY TO BOOK a trip within 6 months or even one of those last minute deal, Lets go! </option> </field> </fields> </form-template> </body> </html>
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