<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Questions for your trip"/> <field type="text" required="true" label="Full name and DOB as shown on Passport&nbsp;" name="first-name" subtype="text" className="form-control"/> <field type="text" required="true" label="Second Passenger full name and DOB as shown on Passport&nbsp;" name="last-name" subtype="text" className="form-control"/> <field type="text" label="Any additional passenger name and DOB&nbsp;" name="any-additional-passenger-name-and-dob-" subtype="text" className="form-control"/> <field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <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="destination" subtype="text" className="form-control"/> <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"/> <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"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> </field> <field type="text" label="Ideal Nightly accommodation budget?" name="ideal-nightly-or-overall-budget-for-land-only" subtype="text" className="form-control"/> <field type="text" label="Ideal overall trip budget including activities and accommodations?&nbsp;" name="ideal-overall-trip-budget-including-activities-and-accommodations-" subtype="text" className="form-control"/> <field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/> <field type="text" label="Do you need assistance with air? If so what class of service?&nbsp;" name="do-you-need-assistance-with-air-if-so-what-class-of-service-" subtype="text" className="form-control"/> <field type="radio-group" label="Seat preference" name="seat-preference"> <option label="Window" value="window">Window</option> <option label="Aisle" value="aisle">Aisle</option> <option label="Opposite aisle" value="opposite aisle">Opposite aisle</option> </field> <field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true"> <option label="Economy" value="value">Economy</option> <option label="Moderate" value="moderate">Moderate</option> <option label="Luxury" value="luxury">Luxury</option> <option label="Boutique" value="boutique">Boutique</option> </field> <field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true"> <option label="Romantic" value="romantic">Romantic</option> <option label="Rest and relaxation" value="rest-and-relaxation">Rest and relaxation</option> <option label="Off the beaten path" value="off-the-beaten-path">Off the beaten path</option> <option label="Party" value="party">Party</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Family friendly" value="family-friendly">Family friendly</option> <option label="Food and wine" value="food-wine">Food and wine</option> </field> <field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true"> <option label="Beach and water" value="beach-water">Beach and water</option> <option label="Gambling" value="gambling">Gambling</option> <option label="Scuba" value="scuba">Scuba</option> <option label="Adventure activities" value="adventure">Adventure activities</option> <option label="Golf" value="golf">Golf</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Arts and theater" value="art-theater">Arts and theater</option> </field> <field type="text" label="Dietary Restrictions" name="meal-preference" subtype="text" className="form-control"/> <field type="text" label="Red Wine, White Wine or Champagne?&nbsp;" name="red-wine-white-wine-or-champagne-" subtype="text" className="form-control"/> <field type="text" label="Salty or Sweet snacks?&nbsp;" name="salty-or-sweet-snacks-" subtype="text" className="form-control"/> <field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/> <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"/> <field type="header" subtype="h2" label="Important Dates"/> <field type="date" label="Birthday" name="birthday" className="form-control"/> <field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/> <field type="radio-group" label="Maddy Foxx Moffitt &amp; MFM Luxury Travel always recommend the purchase of travel insurance to cover certain risks inherent in travel.&nbsp;&nbsp;Please select if you would or would not like a quote for travel insurance with your trip proposal." name="maddy-foxx-moffitt-river-oaks-travel-always-recommend-the-purchase-of-travel-insurance-to-cover-certain-risks-inherent-in-travel-"> <option label="ACCEPT I would like a quote for travel insurance" value="I would like a quote for travel insurance">ACCEPT I would like a quote for travel insurance</option> <option label="DECLINE I would not like a quote for travel insurance" value="decline-i-would-not-like-a-quote-for-travel-insurance">DECLINE I would not like a quote for travel insurance</option> </field> <field type="checkbox-group" label="Please take a moment to review all Terms and conditions. By checking this box you agree to all MFM Terms and Conditions attached." description="Please take a moment to review all Terms and conditions. By checking this box you agree to all MFM Terms and Conditions attached." name="mfm-terms-and-conditions-"> <option label="AGREE " value="agree-">AGREE </option> <option label="DECLINE" value="decline">DECLINE</option> </field> <field type="select" label="For international travel please confirm passports are valid for 6 months following the trip. " name="for-international-travel-please-confirm-passports-are-valid-for-6-months-following-the-trip-" multiple="multiple" className="form-control"> <option label="My passport is Valid beyond 6 months of date of return" value="my-passport-is-valid-beyond-6-months-of-date-of-return" selected="selected">My passport is Valid beyond 6 months of date of return</option> <option label="I need to update my passport" value="i-need-to-update-my-passport">I need to update my passport</option> </field> </fields> </form-template> </body> </html>
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