Share your information with Erika Richman

Erika Richman

Society 1955

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		<field type="header" subtype="h1" label="Get Excited! It is Time to Plan a Vacation!"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you for choosing me as your travel specialist! My name is Erika Richman and I am the owner of Society 1955 Travel Agency. I provide concierge level planning - before, during and after your trip - without the stress or hassle of booking yourself. As your personal vacation planner specializing in all destinations, I am here to help you plan a dream vacation for your entire party!"/>&#13;
		<field type="paragraph" subtype="p" label="Please assist me in starting your trip planning by filling out this form. The more information the better, as this will help me create packages with the best resort, room types and extras to make your vacation the best!&amp;nbsp;"/>&#13;
		<field type="paragraph" subtype="p" label="If you saw a particular deal or hotel you would like more information about let me know below!"/>&#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="header" subtype="h1" label="Contact Info!"/>&#13;
		<field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Mobile phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Trip Details!"/>&#13;
		<field type="date" required="true" label="Desired Check-in Date" name="desired-checkin-date" className="form-control"/>&#13;
		<field type="date" required="true" label="Desired Check-out Date" name="desired-checkout-date" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Where would you like to go?" name="where-would-you-like-to-go">&#13;
			<option label="Walt Disney World, FL" value="walt-disney-world-fl">Walt Disney World, FL</option>&#13;
			<option label="Universal, FL" value="universal-fl">Universal, FL</option>&#13;
			<option label="Disneyland, CA" value="disneyland-ca">Disneyland, CA</option>&#13;
			<option label="Universal, CA" value="universal-ca">Universal, CA</option>&#13;
			<option label="Mexico - Cancun, Puerto Vallarta, Cabo, Isla Mujeres" value="mexico-cancun-puerto-vallarta-cabo-isla-mujeres">Mexico - Cancun, Puerto Vallarta, Cabo, Isla Mujeres</option>&#13;
			<option label="Dominican Republic - Punta Cana" value="dominican-republic-punta-cana">Dominican Republic - Punta Cana</option>&#13;
			<option label="Bahamas" value="bahamas">Bahamas</option>&#13;
			<option label="Jamaica " value="jamaica-">Jamaica </option>&#13;
			<option label="Aruba" value="aruba">Aruba</option>&#13;
			<option label="Other Caribbean Island" value="other-caribbean-island">Other Caribbean Island</option>&#13;
			<option label="Beaches - Turks and Caicos or Jamaica" value="beaches-turks-and-caicos-or-jamaica">Beaches - Turks and Caicos or Jamaica</option>&#13;
			<option label="Sandals - Adults Only - All Inclusive" value="sandals-adults-only-all-inclusive">Sandals - Adults Only - All Inclusive</option>&#13;
			<option label="Disney Cruise Line" value="disney-cruise-line">Disney Cruise Line</option>&#13;
			<option label="Other Cruise Line - Royal, Norwegian, Celebrity, etc " value="other-cruise-line-royal-norwegian-celebrity-etc-">Other Cruise Line - Royal, Norwegian, Celebrity, etc </option>&#13;
			<option label="Alaskan Cruise" value="alaskan-cruise">Alaskan Cruise</option>&#13;
			<option label="Hawaii" value="hawaii">Hawaii</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Florida Vacation " value="florida-vacation-">Florida Vacation </option>&#13;
			<option label="Adventure by Disney" value="adventure-by-disney">Adventure by Disney</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Number of Adults (per room)" name="number-of-adults-per-room" subtype="text" className="form-control"/>&#13;
		<field type="text" label="AGES of Any Children (per room)" name="ages-of-any-children-per-room" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Please describe the trip you are looking for? What destinations have captured your imagination? Are there any specific activities or experiences you&#39;re eager to try? By understanding your unique interests and preferences, I can tailor a personalized vacation that exceeds your expectations. The more details the better!&amp;nbsp;" name="please-describe-the-trip-you-are-looking-for-things-to-include-where-you-want-to-go-how-you-prefer-to-get-there-and-any-assistance-you-need-from-your-travel-planner" className="form-control"/>&#13;
	</fields>&#13;
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  </body>
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