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Julia Mickens

Adventures with Jewels

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		<field type="text" label="If money and time were no object what is the #1 destination on your list?" name="text-1771179365422" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What type of &quot;Bucket List&quot; experience appeals to you most?" name="radio-group-1771179392164" other="true">&#13;
			<option label="Overwater Bungalows (e.g., Maldives/Bora Bora)" value="overwater-bungalows-eg-maldivesbora-bora">Overwater Bungalows (e.g., Maldives/Bora Bora)</option>&#13;
			<option label="African Safari Adventure" value="african-safari-adventure">African Safari Adventure</option>&#13;
			<option label="European Grand Tour (Italy, France, Greece)" value="european-grand-tour-italy-france-greece">European Grand Tour (Italy, France, Greece)</option>&#13;
			<option label="Asian Cultural Immersion" value="asian-cultural-immersion">Asian Cultural Immersion</option>&#13;
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			<option label="High-Octane Adventure" value="highoctane-adventure">High-Octane Adventure</option>&#13;
			<option label="Culinary &amp; Wine Exploration" value="culinary-wine-exploration">Culinary &amp; Wine Exploration</option>&#13;
			<option label="Off-the-beaten-path/Local secrets" value="offthebeatenpathlocal-secrets">Off-the-beaten-path/Local secrets</option>&#13;
			<option label="History &amp; Architecture" value="history-architecture">History &amp; Architecture</option>&#13;
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			<option label="$3,000 - $5,000" value="3000-5000">$3,000 - $5,000</option>&#13;
			<option label="$5,000 - $10,000" value="5000-10000">$5,000 - $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
			<option label="I prefer to save up for the &quot;Best of the Best&quot; regardless of price." value="i-prefer-to-save-up-for-the-best-of-the-best-regardless-of-price">I prefer to save up for the "Best of the Best" regardless of price.</option>&#13;
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