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Pure Essence Travel
<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Alignment Survey Questions - Thailand"/> <field type="header" subtype="h2" label="Full name"/> <field type="paragraph" subtype="p" label="This 11-night Thailand experience is designed for women who enjoy traveling solo—but value comfort, intention, and community."/> <field type="paragraph" subtype="p" label="You’ll explore Bangkok, Chiang Mai, and Phuket while staying in 4–5 star accommodations with private rooms, curated experiences, select meals, and seamless transportation throughout."/> <field type="paragraph" subtype="p" label="Highlights include a temple visit with a professional photoshoot, a premium spa experience, a waterfall and elephant sanctuary visit, island and beach club days, and a curated nightlife experience in Bangkok—and so much more, along with a group experience led by someone who lives in Southeast Asia."/> <field type="paragraph" subtype="p" label="This experience is intentionally small, thoughtfully designed, and balances independence with meaningful connection."/> <field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/> <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 type="text" label="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" label="Preferred name" name="preferred-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="select" required="true" label="Which dates are you MOST interested in?" name="select-1773160156682" className="form-control"> <option label="October 22nd - November 2nd, 2026" value="october-22nd-november-2nd-2026">October 22nd - November 2nd, 2026</option> <option label="May 17th - 28th, 2027" value="may-17th-28th-2027">May 17th - 28th, 2027</option> <option label="I can attend either date" value="i-can-attend-either-date">I can attend either date</option> </field> <field type="textarea" required="true" label="What inspired you to apply for this Thailand experience, and what would make this trip meaningful for you?" name="textarea-1773160245694" className="form-control"/> <field type="checkbox-group" required="true" label="How would you describe your travel style?&nbsp;" name="checkbox-group-1772446103218"> <option label="Go with the flow" value="go-with-the-flow">Go with the flow</option> <option label="Structured with some flexibility" value="structured-with-some-flexibility">Structured with some flexibility</option> <option label="I prefer detailed plans and minimal surprises" value="i-prefer-detailed-plans-and-minimal-surprises">I prefer detailed plans and minimal surprises</option> </field> <field type="textarea" required="true" label="How would you describe your travel mindset when plans shift or unexpected moments come up?" name="textarea-1772445196370" className="form-control"/> <field type="radio-group" required="true" label="How comfortable are you with cultural differences, unfamiliar food, and different standards of service?" name="radio-group-1772445286749"> <option label="Very comfortable" value="very-comfortable">Very comfortable</option> <option label="Somewhat comfortable" value="somewhat-comfortable">Somewhat comfortable</option> <option label="I prefer familiar environments" value="i-prefer-familiar-environments">I prefer familiar environments</option> </field> <field type="textarea" required="true" label="Group travel requires patience, compromise, and positive communication. How do you typically handle conflict or misunderstandings?" name="textarea-1772445353686" className="form-control"/> <field type="textarea" required="true" label="What kind of energy do you feel you bring into group spaces?&nbsp;" name="textarea-1772445707015" className="form-control"/> <field type="select" required="true" label="Will you be traveling with a friend you plan to share a room with?" name="select-1773208596149" className="form-control"> <option label="No, I would like a private room" value="no-i-would-like-a-private-room">No, I would like a private room</option> <option label="Yes, I will be sharing a room with a friend" value="yes-i-will-be-sharing-a-room-with-a-friend">Yes, I will be sharing a room with a friend</option> <option label="I'm not sure yet" value="im-not-sure-yet">I'm not sure yet</option> </field> <field type="textarea" required="true" label="Is there anything about group travel that makes you nervous or hesitant?&nbsp;" name="textarea-1772445744466" className="form-control"/> <field type="radio-group" required="true" label="Which investment range feels aligned for you?" description="Flexible payment plans are available." name="radio-group-1774352270388"> <option label="$4000 - $5000" value="4000-5000">$4000 - $5000</option> <option label="$5000 - $6000" value="5000-6000">$5000 - $6000</option> <option label="$6,000 +" value="6000-">$6,000 +</option> <option label="I'm not comfortable investing at this level." value="im-not-comfortable-investing-at-this-level">I'm not comfortable investing at this level.</option> </field> </fields> </form-template> </body> </html>
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