Stacey Owens

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    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<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="text-1738513238724" 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 go; it can be changed later." name="date-1738514091736" 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;
			<option label="No" value="no">No</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="checkbox-group" label="Are any travelers:" name="checkbox-group-1738513949160">&#13;
			<option label="55+" value="55">55+</option>&#13;
			<option label="Military: Active or Retired" value="military-active-or-retired">Military: Active or Retired</option>&#13;
			<option label="First Responder" value="first-responder">First Responder</option>&#13;
		</field>&#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="radio-group-1734377608003" other="true">&#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 to $11,500" value="10000-to-11500">$10,000 to $11,500</option>&#13;
			<option label="$11,500 to $15,000" value="11500-to-15000">$11,500 to $15,000</option>&#13;
			<option label="$15,000 to $20,000" value="15000-to-20000">$15,000 to $20,000</option>&#13;
			<option label="$20,000 to $30,000" value="20000-to-30000">$20,000 to $30,000</option>&#13;
			<option label="$30,000 to $40,000" value="30000-to-40000">$30,000 to $40,000</option>&#13;
			<option label="$40,000 to $50,000" value="40000-to-50000">$40,000 to $50,000</option>&#13;
			<option label="$50,000 to 75,000" value="50000-to-75000">$50,000 to 75,000</option>&#13;
			<option label="75,000 to 100,000" value="75000-to-100000">75,000 to 100,000</option>&#13;
			<option label="100,000+" value="100000+">100,000+</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach" value="beach">Beach</option>&#13;
			<option label="Water Sports/Activities" value="water-sportsactivities">Water Sports/Activities</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Snorkeling" value="snorkeling">Snorkeling</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Ziplining" value="ziplining">Ziplining</option>&#13;
			<option label="Hiking" value="hiking">Hiking</option>&#13;
			<option label="Kayaking" value="kayaking">Kayaking</option>&#13;
			<option label="Sports" value="sports">Sports</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Concerts" value="concerts">Concerts</option>&#13;
			<option label="Museums" value="museums">Museums</option>&#13;
			<option label="Festivals" value="festivals">Festivals</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
		</field>&#13;
		<field type="text" label="What were your favorite memories from a previous trip?" name="text-1735967674533" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please describe any physical limitations or dietary requests to accommodate." name="text-1731277118088" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" label="Bed preference" name="bed-preference" other="true">&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Double/Queen" value="2-double-queen">2 Double/Queen</option>&#13;
		</field>&#13;
		<field type="text" label="Special Bed Requests:" name="text-1738514485306" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Vibe preferences" name="vibe-preference">&#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;
			<option label="Multi-generational" value="multi-generational">Multi-generational</option>&#13;
			<option label="Adventure" value="adventure">Adventure</option>&#13;
			<option label="LGBT" value="lgbt">LGBT</option>&#13;
			<option label="All-Inclusive" value="allinclusive">All-Inclusive</option>&#13;
			<option label="Adult Only" value="adult-only">Adult Only</option>&#13;
		</field>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Preferred Time of Day to Reach You:" name="preferred-time-of-day-to-reach-you" className="form-control"/>&#13;
		<field type="checkbox-group" label="Preferred Method of Communication:" name="preferred-method-of-communication" other="true">&#13;
			<option label="Text" value="text">Text</option>&#13;
			<option label="Phone Call" value="phone-call">Phone Call</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Facebook Messenger" value="facebook-messenger">Facebook Messenger</option>&#13;
		</field>&#13;
		<field type="header" subtype="h2" label="Address"/>&#13;
		<field type="text" label="Line 1" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 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="clientLoyaltyPrograms" label="Loyalty Programs &amp;amp; Loyalty Numbers" description="Please List Loyalty Numbers " name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" className="form-control"/>&#13;
		<field type="checkbox-group" label="Preferred Flight Class:" name="preferred-flight-class" other="true">&#13;
			<option label="Basic Economy" value="basic-economy">Basic Economy</option>&#13;
			<option label="Main Cabin" value="main-cabin">Main Cabin</option>&#13;
			<option label="Premium Economy" value="premium-economy">Premium Economy</option>&#13;
			<option label="Business Class" value="business-class">Business Class</option>&#13;
			<option label="First Class" value="first-class">First Class</option>&#13;
			<option label="Private Charter" value="private-charter">Private Charter</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</option>&#13;
			<option label="Middle" value="middle">Middle</option>&#13;
			<option label="Aisle" value="aisle">Aisle</option>&#13;
			<option label="Opposite aisle" value="opposite aisle">Opposite aisle</option>&#13;
		</field>&#13;
		<field type="textarea" label="Will you be using Airline Miles? If so, please elaborate.&amp;nbsp;" name="will-you-be-using-airline-miles-if-so-please-elaborate-" className="form-control"/>&#13;
		<field type="textarea" label="Describe the ideal flight times for your initial departure to your destination and your return flight:" name="describe-the-ideal-flight-times-for-your-initial-departure-to-your-destination-and-your-return-flight" className="form-control"/>&#13;
		<field type="textarea" label="Do you currently have an annual Travel Insurance policy that covers your travel and medical needs abroad?" name="do-you-currently-have-an-annual-travel-insurance-policy-that-covers-your-travel-and-medical-needs-abroad" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Paragraph"/>&#13;
		<field type="textarea" label="Is there anything else you would like me to know?&amp;nbsp;" name="is-there-anything-else-you-would-like-me-to-know-" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
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