Share your information with Marie Russell

Marie Russell

Confetti Travel Service

<html>
  <body>
    <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>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" label="Name" name="name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone Number&amp;nbsp;" name="phone-number-" subtype="text" className="form-control"/>&#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="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="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 return; it can be changed later." name="ending-at" 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;
		</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="text" label="Ages of each passenger" name="ages-of-each-passenger" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your **PER PERSON** budget for all travelers?" description="This just gives me a general starting point and can always be changed later." 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="text" label="What type of accommodations would you like? (ex. Cabin/Hotel resort/Condo/House)" name="what-type-of-accommodations-would-you-like-ex-cabinhotel-resortcondohouse" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Travel Preferences"/>&#13;
		<field type="radio-group" label="Seat preference" name="seat-preference">&#13;
			<option label="Window" value="window">Window</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="radio-group" label="Bed preference" name="bed-preference">&#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="radio-group" label="Hotel preference" name="hotel-preference">&#13;
			<option label="Economy" value="value">Economy</option>&#13;
			<option label="Moderate" value="moderate">Moderate</option>&#13;
			<option label="Luxury" value="luxury">Luxury</option>&#13;
			<option label="Boutique" value="boutique">Boutique</option>&#13;
		</field>&#13;
		<field type="select" label="Meal preferences (please select one)" name="meal-preferences-please-select-one" className="form-control">&#13;
			<option label="All inclusive" value="all-inclusive">All inclusive</option>&#13;
			<option label="A la carte" value="a-la-carte">A la carte</option>&#13;
			<option label="All inclusive or A la carte" value="all-inclusive-or-a-la-carte">All inclusive or A la carte</option>&#13;
			<option label="Private chef" value="private-chef">Private chef</option>&#13;
		</field>&#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;
		</field>&#13;
		<field type="checkbox-group" label="Activity preferences" name="activity-preferences">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theatre" value="art-theatre">Arts and theatre</option>&#13;
		</field>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs" 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="radio-group" label="If you will be interested in international travel, you will need a passport. Please share your passport status with me." name="if-you-will-be-interested-in-international-travel-you-will-need-a-passport-please-share-your-passport-status-with-me">&#13;
			<option label="I and all of my travel companions have a valid (not expired) passport. *Please note that a passport CARD and a passport BOOK are different. If you aren't sure which one you have, take a look at these: https://travel.state.gov/content/travel/en/passports/apply-renew-passport/card.html" value="i-and-all-of-my-travel-companions-have-a-valid-not-expired-passport-please-note-that-a-passport-card-and-a-passport-book-are-different-if-you-arent-sure-which-one-you-have-take-a-look-at-these-httpstravelstategovcontenttravelenpassportsapplyrenewpassportcardhtml">I and all of my travel companions have a valid (not expired) passport. *Please note that a passport CARD and a passport BOOK are different. If you aren't sure which one you have, take a look at these: https://travel.state.gov/content/travel/en/passports/apply-renew-passport/card.html</option>&#13;
			<option label="One or more of us are in the process of renewing our passport." value="one-or-more-of-us-are-in-the-process-of-renewing-our-passport">One or more of us are in the process of renewing our passport.</option>&#13;
			<option label="One or more of us do not have a passport." value="one-or-more-of-us-do-not-have-a-passport">One or more of us do not have a passport.</option>&#13;
			<option label="I'm not traveling internationally." value="im-not-traveling-internationally">I'm not traveling internationally.</option>&#13;
		</field>&#13;
		<field type="select" label="Would you like travel insurance? (select one)" name="would-you-like-travel-insurance-select-one" className="form-control">&#13;
			<option label="Yes, I would like to include travel insurance" value="yes-i-would-like-to-include-travel-insurance">Yes, I would like to include travel insurance</option>&#13;
			<option label="I'm not sure - please include in the quote" value="im-not-sure-please-include-in-the-quote">I'm not sure - please include in the quote</option>&#13;
			<option label="No, I do not want travel insurance and understand that I will be responsible in the event that the unexpected may happen." value="no-i-do-not-want-travel-insurance-and-understand-that-i-will-be-responsible-in-the-event-that-the-unexpected-may-happen">No, I do not want travel insurance and understand that I will be responsible in the event that the unexpected may happen.</option>&#13;
			<option label="What's travel insurance?" value="whats-travel-insurance">What's travel insurance?</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="Text Field" name="text-1757806940422" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>