Share your information with Deb Gorman

Deb Gorman

Deb Gorman/Travel Deb/Travelmation LLC

<html>
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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Getting Started - Quote Request Form"/>&#13;
		<field type="paragraph" subtype="blockquote" label="Hey there! My name is Deb and I am so excited to begin to research your dream trip! "/>&#13;
		<field type="paragraph" subtype="p" label="Before we start finding the perfect trip, please fill in the details of who you are, what you&#39;re looking for, how much you&#39;re looking to spend, and any information you want me to know before I begin to pull pricing for your trip. Once you&#39;ve submitted this form, I will review your information and get back to you as soon as possible with quotes and availability. "/>&#13;
		<field type="paragraph" subtype="p" label="I do my best to get this information to you within a few business days. In the mean time, if you have questions or want to schedule a meeting together, email me at debgorman@travelmation.net. Thank you!"/>&#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="text" required="true" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="checkbox-group" label="What is your preferred method of communication?" name="what-is-your-preferred-method-of-communication">&#13;
			<option label="Phone" value="phone" selected="selected">Phone</option>&#13;
			<option label="E-mail" value="email">E-mail</option>&#13;
			<option label="Text Message" value="text-message">Text Message</option>&#13;
			<option label="Facebook Messenger" value="facebook-messenger">Facebook Messenger</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="I&#39;m interested in..." name="im-interested-in">&#13;
			<option label="A No-Obligation Quote" value="a-noobligation-quote" selected="selected">A No-Obligation Quote</option>&#13;
			<option label="I'm Ready to Book!" value="im-ready-to-book">I'm Ready to Book!</option>&#13;
			<option label="Help me Design an Adventure!" value="help-me-design-an-adventure">Help me Design an Adventure!</option>&#13;
			<option label="Just Shopping Around" value="just-shopping-around">Just Shopping Around</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How many adults will be traveling?" name="how-many-adults-will-be-traveling" className="form-control">&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6" value="6">6</option>&#13;
			<option label="7" value="7">7</option>&#13;
			<option label="8" value="8">8</option>&#13;
			<option label="9" value="9">9</option>&#13;
			<option label="10+" value="10">10+</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How many children will be traveling?" name="how-many-children-will-be-traveling" className="form-control">&#13;
			<option label="0" value="0" selected="selected">0</option>&#13;
			<option label="1" value="1">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5" value="5">5</option>&#13;
			<option label="6+" value="6">6+</option>&#13;
		</field>&#13;
		<field type="text" label="If children are traveling, what are their ages?" name="childrensages" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="How many rooms would you like?" name="how-many-rooms-would-you-like" className="form-control">&#13;
			<option label="1" value="1" selected="selected">1</option>&#13;
			<option label="2" value="2">2</option>&#13;
			<option label="3" value="3">3</option>&#13;
			<option label="4" value="4">4</option>&#13;
			<option label="5+" value="5">5+</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="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="What are you most interested in?" name="what-are-you-most-interested-in">&#13;
			<option label="Theme Park Packages or Tickets (Disney, Universal, Legoland, SeaWorld, etc)" value="themeparkpackagesortickets" selected="selected">Theme Park Packages or Tickets (Disney, Universal, Legoland, SeaWorld, etc)</option>&#13;
			<option label="Cruising" value="cruising">Cruising</option>&#13;
			<option label="All Inclusive Resorts" value="all-inclusive-resorts">All Inclusive Resorts</option>&#13;
			<option label="International Travel" value="international-travel">International Travel</option>&#13;
			<option label="Occasion or Group Travel" value="occasion-or-group-travel">Occasion or Group Travel</option>&#13;
			<option label="Family Reunions" value="">Family Reunions</option>&#13;
			<option label="Destination Weddings" value="destination-weddings">Destination Weddings</option>&#13;
			<option label="Luxurious or Rugged Adventures" value="luxurious-or-rugged-adventures">Luxurious or Rugged Adventures</option>&#13;
			<option label="Lodging and/or Transportation Only" value="lodging-andor-transportation-only">Lodging and/or Transportation Only</option>&#13;
		</field>&#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="checkbox-group" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What is your per person budget?" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="Under $1000 per person" value="under1k">Under $1000 per person</option>&#13;
			<option label="$1,000 - $3,000 per person" value="1000to3000">$1,000 - $3,000 per person</option>&#13;
			<option label="$3,000 - $6,000 per person" value="3000to6000">$3,000 - $6,000 per person</option>&#13;
			<option label="$6,000 - $9,000 per person" value="6000to9000">$6,000 - $9,000 per person</option>&#13;
			<option label="$9,000 - $15,000 per person" value="9000to15000">$9,000 - $15,000 per person</option>&#13;
			<option label="$15,000 - $25,000 per person" value="15000to25000">$15,000 - $25,000 per person</option>&#13;
			<option label="$25,000+ per person" value="25000toperson">$25,000+ per person</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What best describes your hotel preference?" name="hotel-preference" other="true">&#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="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">&#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;
		</field>&#13;
		<field type="checkbox-group" label="What activities 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="History" value="">History</option>&#13;
			<option label="Theme Parks" value="">Theme Parks</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
		</field>&#13;
		<field type="text" label="Is there anything you must see or do on your trip? Anything you would like to avoid?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Are there any accommodations needed that should be considered when I am researching your trip? (Wheelchair access, sensory friendly, hearing accessible, allergies, etc.)" 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="How did you hear about me? I love to thank my referrals!" name="referrals" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>