Share your information with Stephanie S.

Stephanie S.

Santangelo Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Intake Details"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-name" 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="text" label="Address 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Address 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="*This is a friendly reminder that all passports must have 6 months beyond your return travel date" name="this-is-a-friendly-reminder-that-all-passports-must-have-6-months-beyond-your-return-travel-date" className="form-control">&#13;
			<option label="Choose one" value="choose-one">Choose one</option>&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
			<option label="I need to apply for a passport or my passport is expired" value="i-need-to-apply-for-a-passport-or-my-passport-is-expired">I need to apply for a passport or my passport is expired</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Please be aware that, due to insurance requirements, liability concerns, and Airbnb’s policies, travel advisors are not permitted to make Airbnb reservations on your behalf. Additionally, travel advisors are not able to book any parts of your trip using reward points. If you’d like to use points, I suggest applying them toward your flights, as this typically offers the best value." name="please-be-aware-that-due-to-insurance-requirements-liability-concerns-and-airbnbs-policies-travel-advisors-are-not-permitted-to-make-airbnb-reservations-on-your-behalf-additionally-travel-advisors-are-not-able-to-book-any-parts-of-your-trip-using-reward-points-if-youd-like-to-use-points-i-suggest-applying-them-toward-your-flights-as-this-typically-offers-the-best-value">&#13;
			<option label="I understand" value="i-understand">I understand</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Trip Details"/>&#13;
		<field type="text" 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: Tahiti" name="destination" subtype="text" className="form-control"/>&#13;
		<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"/>&#13;
		<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"/>&#13;
		<field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" 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="$500 to $2,500" value="500-to-2500" selected="selected">$500 to $2,500</option>&#13;
			<option label="$2,500 to $5,000" value="2500-to-5000">$2,500 to $5,000</option>&#13;
			<option label="$5,000 to $10,000" value="5000-to-10000">$5,000 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="checkbox-group" 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="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?" 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>