Share your information with Amanda Boehm

Amanda Boehm

Amanda Boehm Travel (Northcutt Travel Agency)

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#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. Alaska  Caribbean, Europe" name="destination" subtype="text" className="form-control"/>&#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="checkbox-group" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768875458544" rule="eyJ3aGVuRmllbGQiOiJkYXRlcy1mbGV4aWJsZSIsIndoZW5Db25kaXRpb24iOiJlcXVhbHMiLCJ3aGVuVmFsdWUiOiJ5ZXMiLCJ0aGVuQWN0aW9uIjoic2hvdyIsInRoZW5GaWVsZHMiOlsidGV4dGFyZWEtMTc2ODg3NTQ5NTg2MSJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InRleHRhcmVhLTE3Njg4NzU0OTU4NjEiLCJsYWJlbCI6IlRleHQgQXJlYSJ9XX0="/>&#13;
		<field type="textarea" label="Please list the date ranges you are flexible within (and any dates within that range that may not work or need to be avoided)" name="textarea-1768875495861" className="form-control"/>&#13;
		<field type="text" label="Where would you like to depart from?" description="What cruise port (s)" placeholder="Ex. Florida  Seattle, Galveston, Europe" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" description="How many people will be traveling?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768875033399" rule="eyJ3aGVuRmllbGQiOiJudW1iZXItb2YtdHJhdmVsZXJzIiwid2hlbkNvbmRpdGlvbiI6Im5vdC1lcXVhbHMiLCJ3aGVuVmFsdWUiOiIxIiwidGhlbkFjdGlvbiI6InNob3ciLCJ0aGVuRmllbGRzIjpbInRleHQtMTc2ODg3NTA5MzU5OCJdLCJ0aGVuRmllbGRzSW5mbyI6W3sibmFtZSI6InRleHQtMTc2ODg3NTA5MzU5OCIsImxhYmVsIjoiU2Vjb25kIFRyYXZlbGVyIE5hbWUifV19"/>&#13;
		<field type="text" label="Additional Traveler&#39;s Name(s)" name="text-1768875093598" subtype="text" className="form-control field-hidden"/>&#13;
		<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">&#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="radio-group" required="true" label="Does this budget include flights (ie. are you wanting flight assistance)?" description="If booking on your own or with points please select no." name="radio-group-1767836622010">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="conditionalLogic" label="Conditional Logic" name="conditionalLogic-1768874957168" rule="eyJ3aGVuRmllbGQiOiJyYWRpby1ncm91cC0xNzY3ODM2NjIyMDEwIiwid2hlbkNvbmRpdGlvbiI6ImVxdWFscyIsIndoZW5WYWx1ZSI6InllcyIsInRoZW5BY3Rpb24iOiJzaG93IiwidGhlbkZpZWxkcyI6WyJzZWF0LXByZWZlcmVuY2UiLCJ0ZXh0LTE3Njg4NzUyNDAyNDgiXSwidGhlbkZpZWxkc0luZm8iOlt7Im5hbWUiOiJzZWF0LXByZWZlcmVuY2UiLCJsYWJlbCI6IlNlYXQgcHJlZmVyZW5jZSJ9LHsibmFtZSI6InRleHQtMTc2ODg3NTI0MDI0OCIsImxhYmVsIjoiVGV4dCBGaWVsZCJ9XX0="/>&#13;
		<field type="text" label="Do you have a preferred airline?" description="If yes  please list preferred airline below" name="text-1768875240248" subtype="text" className="form-control field-hidden"/>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference" className="field-hidden">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<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">&#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="Off the beaten path" value="off-the-beaten-path">Off the beaten path</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 and wine" value="food-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="History" value="history">History</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Food and wine" value="food-and-wine">Food and wine</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know? The more detail the better!" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>