Share your information with Angelica Gazinski

Angelica Gazinski

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		<field type="header" subtype="h2" label="So glad you are here! Your extraordinary escape is just around the corner! Before we dive into the fun stuff, please share a few quick details. This information is key: it helps me learn about you and your travel wishes so I can be your ultimate guide in finding and planning the perfect, personalized vacation! Can&#39;t wait to chat!&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#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 required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#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="checkbox-group" required="true" label="What is your vacation destination?" name="what-is-your-vacation-destination">&#13;
			<option label="Walt Disney World in Florida" value="walt-disney-world-in-florida">Walt Disney World in Florida</option>&#13;
			<option label="Disneyland in California" value="disneyland-in-california">Disneyland in California</option>&#13;
			<option label="Disney Cruise" value="disney-cruise">Disney Cruise</option>&#13;
			<option label="Royal Caribbean Cruise" value="royal-caribbean-cruise">Royal Caribbean Cruise</option>&#13;
			<option label="Universal Studios Orlando or Hollywood" value="universal-studios-orlando-or-hollywood">Universal Studios Orlando or Hollywood</option>&#13;
			<option label="All Inclusive Resort" value="all-inclusive-resort">All Inclusive Resort</option>&#13;
			<option label="Other Cruise Line" value="other-cruise-line">Other Cruise Line</option>&#13;
			<option label="Need a Hotel Room (Hyatt, Hilton, Marriott, etc.)" value="need-a-hotel-room-hyatt-hilton-marriott-etc">Need a Hotel Room (Hyatt, Hilton, Marriott, etc.)</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Do you know the dates you are wanting to travel?&amp;nbsp;" name="when-are-you-looking-to-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers? (Please include how many adults and kids with kids ages)" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Traveler&#39;s Names (First and last)" name="text-1769126524488" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for your trip?&amp;nbsp;" description="My pricing will never include flights. The client will always be responsible for flights separately." 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="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;
		<field type="text" label="If you are planning to cruise, what type of stateroom would you like?&amp;nbsp;" name="if-you-are-planning-to-cruise-what-type-of-stateroom-would-you-like-" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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