Share your information with Don & Vona Hill

Don & Vona Hill

Dream Vacations with Don and Vona

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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" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Please fill out as much information as possible to help me better plan your trip."/>&#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="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="text" label="What is your departure City? (If flights are required)" description="Where will you be flying from?" name="what-is-your-departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What Cruise Line would you Like?" description="If you&#39;re not sure  just give me a few destinations you&#39;re considering." placeholder="ex: Carnival" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="text" label="What is your departure port?" description="What port would you prefer to cruise out of?" placeholder="Ex. Galveston" name="departure-city" 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;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="Are Children traveling with you?" name="are-children-traveling-with-you">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="Children&#39;s names and ages" placeholder="Name  Age" name="how-many-kids-and-their-ages" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What is your budget per traveler?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$100 to $500" value="100-to-500">$100 to $500</option>&#13;
			<option label="$500 to $1000" value="500-to-1000">$500 to $1000</option>&#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;
		</field>&#13;
		<field type="radio-group" label="What type of room would you like?" name="hotel-preference" other="true">&#13;
			<option label="Interior" value="interior">Interior</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Balcony" value="balcony">Balcony</option>&#13;
			<option label="Suite" value="suite">Suite</option>&#13;
		</field>&#13;
		<field type="text" label="If you select &#39;Other&#39;, please provide a description." name="other-request" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" label="What excursions are you interested in?" description="Check all that apply" name="activity-preferences" other="true">&#13;
			<option label="Beach and water" value="beach-water">Beach and water</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Historical" value="historical">Historical</option>&#13;
			<option label="Sightseeing" value="sightseeing">Sightseeing</option>&#13;
			<option label="Water Park" value="water-park">Water Park</option>&#13;
			<option label="Zip Line" value="zip-line">Zip Line</option>&#13;
		</field>&#13;
		<field type="text" label="If you select &#39;Other&#39;, please provide a description." description="Any specific excursions you would like?" name="if-other" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#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;
	</fields>&#13;
</form-template>
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