Share your information with Nada Cottrill

Nada Cottrill

Connected Travel

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		<field type="header" subtype="h1" label="CLIENT INFORMATION"/>&#13;
		<field type="text" required="true" label="First Name:" name="first-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" required="true" label="Preferred Name:" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Email Address:" 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="Street Address:" name="address-line-1" 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="Postcode:" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="pageBreak" name="pageBreak-1768580294818" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h1" label="ABOUT YOUR TRIP"/>&#13;
		<field type="header" subtype="h1" label="Destination"/>&#13;
		<field type="text" required="true" label="Where would you like to go?" name="where-would-you-like-to-go" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your departure city? Preferred starting airport?" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Dates"/>&#13;
		<field type="date" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/>&#13;
		<field type="date" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/>&#13;
		<field type="radio-group" label="Are your dates flexible? Flexibility with dates often leads to better pricing options, and I will find the best available rates within your date range." name="are-your-dates-flexible">&#13;
			<option label="Yes - I am flexible based on availability" value="yes-i-am-flexible-based-on-availability">Yes - I am flexible based on availability</option>&#13;
			<option label="No - I have specific dates that I must maintain" value="no-i-have-specific-dates-that-i-must-maintain">No - I have specific dates that I must maintain</option>&#13;
		</field>&#13;
		<field type="text" label="If dates are flexible, what is the date range?" name="if-dates-are-flexible-what-is-the-date-range" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Travellers"/>&#13;
		<field type="text" label="How many people will be travelling with you?" name="how-many-people-will-be-travelling" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Who all will be travelling with you? Please list all full names (including middle) and birthdates, as listed on passport. DOB to be written as DD/MM/YYYY" name="who-all-will-be-traveling-with-you-please-list-all-full-names-including-middle-and-birthdates-as-listed-on-passport" className="form-control"/>&#13;
		<field type="text" label="Is this trip to celebrate anything special?" name="is-this-vacation-to-celebrate-anything-special" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do any travellers have allergies that I should be aware of? I will do my best to accommodate." name="do-any-travelers-have-allergies-that-i-should-be-aware-of-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Budget"/>&#13;
		<field type="radio-group" required="true" label="What is your budget for all travellers? This just gives me a general starting point and can always be changed later." description="Knowing this helps me find options and make recommendations that are suitable - there is always that magic number people have in their head  and when making recommendations  I always try to keep within the budget range  where possible." name="what-is-your-budget-for-all-travelers-this-just-gives-me-a-general-starting-point-and-can-always-be-changed-later" other="true">&#13;
			<option label="$5,000 - $7,500" value="5000-7500">$5,000 - $7,500</option>&#13;
			<option label="$7,000 - $10,000" value="7000-10000">$7,000 - $10,000</option>&#13;
			<option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option>&#13;
			<option label="$15,000 - $25,000" value="15000-25000">$15,000 - $25,000</option>&#13;
			<option label="$25,000 - $50,000" value="25000-50000">$25,000 - $50,000</option>&#13;
			<option label="$50,000 - $75,000" value="50000-75000">$50,000 - $75,000</option>&#13;
			<option label="$75,000+" value="75000">$75,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What travel components would you like us to assist you with? Check all that apply." name="what-travel-components-would-you-like-us-to-assist-you-with-check-all-that-apply">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Accommodations" value="accommodations">Accommodations</option>&#13;
			<option label="Transportation (car rental, trains, etc.)" value="transportation-car-rental-trains-etc">Transportation (car rental, trains, etc.)</option>&#13;
			<option label="Excursions &amp; tours" value="excursions-tours">Excursions &amp; tours</option>&#13;
			<option label="Insurance" value="insurance">Insurance</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Travel Preferences and Activities"/>&#13;
		<field type="radio-group" required="true" label="What type of holiday are you looking for?" name="what-type-of-holiday-are-you-looking-for" other="true">&#13;
			<option label="City Exploration" value="city-exploration">City Exploration</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Culinary" value="culinary">Culinary</option>&#13;
			<option label="Cultural + Educational" value="cultural-educational">Cultural + Educational</option>&#13;
			<option label="Dramatic Views + Landscapes" value="dramatic-views-landscapes">Dramatic Views + Landscapes</option>&#13;
			<option label="Outdoor + Adventure" value="outdoor-adventure">Outdoor + Adventure</option>&#13;
			<option label="Resort + Water Activities" value="resort-water-activities">Resort + Water Activities</option>&#13;
			<option label="Rest + Relaxation" value="rest-relaxation">Rest + Relaxation</option>&#13;
			<option label="Self-Drive" value="selfdrive">Self-Drive</option>&#13;
			<option label="Spa + Wellness" value="spa-wellness">Spa + Wellness</option>&#13;
			<option label="Theme Parks " value="theme-parks-">Theme Parks </option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="Tell me about each traveller. Any hobbies, passions, or interests I should build into the itinerary for them specifically? The more detail, the more personal the trip." name="text-1783120364621" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Is there anything on this trip you would consider a must-do? Or something you&#39;ve been dreaming about that you&#39;d love us to try and fit in?" name="text-1783120528714" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What best describes your desired accommodation style?" name="what-best-describes-your-desired-accommodation-style" other="true">&#13;
			<option label="Luxury &amp; exclusive" value="luxury-exclusive">Luxury &amp; exclusive</option>&#13;
			<option label="Boutique &amp; charming" value="boutique-charming">Boutique &amp; charming</option>&#13;
			<option label="Centrally located  &amp; functional" value="centrally-located-functional">Centrally located  &amp; functional</option>&#13;
			<option label="Large resort" value="large-resort">Large resort</option>&#13;
			<option label="Apartment with kitchen/laundry facilities" value="apartment-with-kitchenlaundry-facilities">Apartment with kitchen/laundry facilities</option>&#13;
		</field>&#13;
		<field type="textarea" label="What are your amenity “must haves”? Is there anything you would want your hotels to have such as a pool, adult-only area, gym, kid&#39;s club, on-site restaurant, bar, etc.?" name="what-are-your-amenity-musthaves-" className="form-control"/>&#13;
		<field type="text" label="Do you prefer a fully planned itinerary or some flexibility to explore on your own?&amp;nbsp;" name="do-you-prefer-a-fully-planned-itinerary-or-some-flexibility-to-explore-on-your-own-" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How do you plan to get around once you’re there?&amp;nbsp;" name="how-do-you-plan-to-get-around-once-youre-there-" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Extras"/>&#13;
		<field type="textarea" label="Is there anything else specific you would like me to consider while planning your trip?" name="describe-your-vision-for-your-ideal-vacation" className="form-control"/>&#13;
		<field type="text" label="Who can I thank for referring you to us?" name="how-did-you-hear-about-us" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Would you like to be subscribed to our company newsletter?&amp;nbsp;" name="would-you-like-to-be-subscribed-to-our-newsletter-and-travel-updates" className="form-control">&#13;
			<option label="Yes- sign me up!" value="yes-sign-me-up">Yes- sign me up!</option>&#13;
			<option label="No, I get too many emails" value="no-i-get-too-many-emails">No, I get too many emails</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="&amp;nbsp;"/>&#13;
		<field type="pageBreak" name="pageBreak-1768580306780" next="Next" previous="Previous"/>&#13;
		<field type="header" subtype="h1" label="LET&#39;S REVIEW THE FINE PRINT"/>&#13;
		<field type="checkbox-group" required="true" label="Please note that some of our proposals come from suppliers who provide bundled rates without breaking down individual components. This practice protects our valued partners who may have confidential, contracted rates from local vendors, and creates a seamless and holistic approach to your travel plans. Do you agree and understand that your proposal will come as one packaged rate and itemised pricing will not be available?" name="please-note-that-some-of-our-proposals-come-from-suppliers-who-provide-bundled-rates-without-breaking-down-individual-components-this-practice-protects-our-valued-partners-who-may-have-confidential-contracted-rates-from-local-vendors-and-creates-a-seamless-and-holistic-approach-to-your-travel-plans-do-you-agree-and-understand-that-your-proposal-will-come-as-one-packaged-rate-and-itemized-pricing-will-not-be-available">&#13;
			<option label="Yes, I understand and agree" value="yes-i-understand-and-agree">Yes, I understand and agree</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Please be aware that there may be a planning fee associated with the creation of your personalised itinerary. During our complimentary intake call, we&#39;ll discuss your travel goals and provide you with a detailed understanding of any associated fees based upon the unique aspects and complexities of your trip request." name="please-be-aware-that-there-may-be-a-planning-fee-associated-with-the-creation-of-your-personalized-itinerary-during-our-complimentary-intake-call-well-discuss-your-travel-goals-and-provide-you-with-a-detailed-understanding-of-any-associated-fees-based-upon-the-unique-aspects-and-complexities-of-your-trip-request">&#13;
			<option label="Yes, I understand and agree" value="yes-i-understand-and-agree">Yes, I understand and agree</option>&#13;
		</field>&#13;
	</fields>&#13;
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