<html> <body> <form-template> <fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field> <field type="paragraph" subtype="p" label="Thank you for allowing Essence Escapes Travel , LLC. to research a quote for your upcoming travel plans . I will work&nbsp; ensure the&nbsp; best price with the most based on your desired budget. Please fill out the travel inquiry form in its entirety, and you will be contacted within 48 hours for confirmation. There is a nonrefundable retainer research fee of $25 for all customized vacations. This retainer fee includes 3 quotes with a destination of your choice. Send $25 retainer fee through Zelle: 985-859-2088."/> <field type="paragraph" subtype="p" label="Once payment and form is received, you will receive your 3 quotes within 2-4 business days. You can receive your quotes sooner depending on demand. If you are in need of an emergency quote, please let us know and we will be more than happy to accommodate you. If you have any additional questions and or concerns, please email Essence.Escapes@hotmail.com. We look forward to helping you create life long memories."/> <field type="header" subtype="h2" label="Travel Experience"/> <field type="header" subtype="h2" label="Lead Traveler Full name"/> <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="textarea" label="Date of Birth" name="date-of-birth" className="form-control"/> <field type="text" label="Address" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" label="Parish" name="address-country" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" label="Where would you like to go?" description="If you're not sure just give me a few destinations you're considering." placeholder="ex: Tahiti" name="destination" subtype="text" className="form-control"/> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="What is your return city?" name="what-is-your-return-city" subtype="text" className="form-control"/> <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"/> <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"/> <field type="text" label="How Many Travelers For Your Desired Trip" name="how-many-travelers-for-your-desired-trip" subtype="text" className="form-control"/> <field type="select" label="Desired Budget Per Person" name="desired-budget-per-person" className="form-control"> <option label="1500-2500" value="15002500" selected="selected">1500-2500</option> <option label="2500-3500" value="25003500">2500-3500</option> <option label="3500 -4500 plus" value="3500-4500-plus">3500 -4500 plus</option> </field> <field type="textarea" label="Names and Date of Births of All Travelers Including Children" description="Additional Travelers" name="date-of-birth-of-travelers" className="form-control"/> <field type="select" label="Do You Have A Passport For Your Travel" name="do-you-have-a-passport-for-your-travel" className="form-control"> <option label="Yes" value="yes" selected="selected">Yes</option> <option label="No" value="no">No</option> <option label="Option 3" value="option-3">Option 3</option> </field> <field type="select" label="Do You Need Assistance In Obtaining Passport For Travel" name="do-you-need-assistance-in-obtaining-passport-for-travel" className="form-control"> <option label="Yes" value="yes" selected="selected">Yes</option> <option label="No" value="no">No</option> </field> <field type="select" label="Transportation&nbsp; needed from the airport (roundtrip transfers)?" name="transportation-needed-from-the-airport-roundtrip" className="form-control"> <option label="Airport Transfer To Hotel/Resort" value="airport-transfer-to-hotelresort" selected="selected">Airport Transfer To Hotel/Resort</option> <option label="Rental Car" value="rental-car">Rental Car</option> <option label="Uber/Lyft" value="uberlyft">Uber/Lyft</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" label="Celebrating Special Occasion ??" inline="true" name="celebrating-special-occasion-"> <option label="Birthday Celebration" value="birthday-celebration" selected="selected">Birthday Celebration</option> <option label="Anniversary Celebration" value="anniversary-celebration">Anniversary Celebration</option> <option label="Graduation" value="graduation">Graduation</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Water Activities" value="water-activities">Water Activities</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> <option label="Culture Immersive" value="culture-immersive">Culture Immersive</option> </field> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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