<html> <body> <form-template> <fields> <field type="header" subtype="h3" label="CONTACT INFO"/> <field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Last name" name="last-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h3" label="TRAVEL STYLE &amp; PREFERENCES"/> <field type="text" required="true" label="What destination(s) do you have in mind?&nbsp;" description="If you're not sure just give us a a couple of destinations you're considering." placeholder="Example: Hiking in Scotland or East Africa safari or sightseeing in Amsterdam - then onto Brussels" name="destination" subtype="text" className="form-control"/> <field type="text" required="true" label="What are your preferred travel dates? Are your travel dates flexible? (We are currently accepting new trip inquiries for departures February 3, 2025 — and beyond).&nbsp;" placeholder="Example: "October 2025" or "Our dates are set June 15 - 23 2025"" name="what-are-your-preferred-travel-dates-are-your-travel-dates-flexible" subtype="text" className="form-control"/> <field type="text" required="true" label="How many total nights would you like to travel?" placeholder="Example: 10 nights" name="how-many-total-nights-would-you-like-to-travel" subtype="text" className="form-control"/> <field type="text" required="true" label="How Many Travelers?" placeholder="Example: 2 people or 4 people etc." name="how-many-travelers" subtype="text" className="form-control"/> <field type="textarea" label="What experiences do you hope to have? What are your top priorities?&nbsp;" placeholder="Example: We are celebrating our first international trip in two years. This will be our first ever trip to Costa Rica. It's our honeymoon!" name="what-is-the-inspiration-for-this-trip-what-experiences-do-you-hope-to-have-what-are-your-top-priorities-" rows="5" className="form-control"/> <field type="header" subtype="h3" label="YOUR JOURNEY INVESTMENT"/> <field type="paragraph" subtype="p" label="Every destination is different, and each trip we design is unique. There are also variances depending on the time of year you travel. Europe and the UK will be bustling once again in 2025. High season in most European and UK locations extends from April – October."/> <field type="paragraph" subtype="p" label="&nbsp;•&nbsp; Most customized land journeys we design start at $500 per adult/teen – per day (excluding international flights)"/> <field type="paragraph" subtype="p" label="&nbsp;•&nbsp; High season European/UK travel starts at $750 per adult/teen – per day (excluding international flights)"/> <field type="radio-group" required="true" label="How much do you plan to invest in this travel experience (excluding airfare)?" description="Please review Planning Your Journey above for expanded detail on the types of trips we design." name="budget"> <option label="$10,000 to $15,000" value="10000-to-15000">$10,000 to $15,000</option> <option label="$15,000 to $20,000" value="15000-to-20000">$15,000 to $20,000</option> <option label="$20,000 to $30,000" value="20000-to-30000">$20,000 to $30,000</option> <option label="$30,000 or more" value="30000-or-more">$30,000 or more</option> </field> <field type="checkbox-group" required="true" label="Have you worked with a travel advisor before?" name="have-you-worked-with-a-travel-advisor-before"> <option label="Yes!" value="yes">Yes!</option> <option label="No, this will be the first time" value="no-this-will-be-the-first-time">No, this will be the first time</option> </field> <field type="textarea" label="Is there anything else we should know?" name="is-there-anything-else-i-should-know" className="form-control"/> <field type="text" required="true" label="How did you hear about&nbsp; Five Senses Journeys?" name="how-did-you-hear-about-five-senses-journeys" subtype="text" className="form-control"/> </fields> </form-template> </body> </html>
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