<html> <body> <form-template xmlns="http://www.w3.org/1999/xhtml"> <fields> <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" label="Suffix" name="suffix" subtype="text" className="form-control"/> <field type="text" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" description="By submitting this form, you agree to receive recurring automated promotional and personalized marketing text messages (e.g. cart reminders) from JEK Travels at the cell number used when signing up. Consent is not a condition of any purchase. " name="phone-number" subtype="text" className="form-control"/> <field type="header" subtype="h2" label="Address"/> <field type="text" required="true" label="Line 1" name="address-line-1" subtype="text" className="form-control"/> <field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/> <field type="text" required="true" label="City" name="address-city" subtype="text" className="form-control"/> <field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/> <field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/> <field type="text" required="true" label="Country" name="address-country" subtype="text" className="form-control"/> <field type="header" subtype="h1" label="Trip Specific Information"/> <field type="text" label="Where would you like to travel? (We will gladly offer guidance if needed)" name="where-would-you-like-to-travel-we-will-gladly-offer-guidance-if-needed" subtype="text" className="form-control"/> <field type="textarea" label="Is this trip for a special occasion?" name="is-this-trip-for-a-special-occasion" className="form-control"/> <field type="textarea" label="Who will be traveling? (Name and relation to each other)" name="who-will-be-traveling-name-and-relation-to-each-other" className="form-control"/> <field type="date" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/> <field type="date" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/> <field type="select" label="What type of accommodations do you prefer?" placeholder="Select" name="what-type-of-accommodations-do-you-prefer" className="form-control"> <option label="Boutique Hotels" value="boutique-hotels" selected="selected">Boutique Hotels</option> <option label="Recognized International Chains" value="recognized-international-chains">Recognized International Chains</option> <option label="Private Apartments / Villas" value="private-apartments-villas">Private Apartments / Villas</option> <option label="Other" value="other">Other</option> </field> <field type="textarea" label="List any room amenities you desire." name="list-any-room-amenities-you-desire" className="form-control"/> <field type="textarea" label="What hotel or resort have you stayed at before and loved?" name="what-hotel-you-hotel-or-resort-at-before-and-loved" className="form-control"/> <field type="textarea" label="Any specific activities or experiences you would like included?" name="any-specific-activities-or-experiences-you-would-like-included" className="form-control"/> <field type="textarea" label="Think back to past vacation trips. What made them memorable for you?" name="think-back-to-past-vacation-trips-what-made-them-memorable-for-you" className="form-control"/> <field type="textarea" label="What preferred airport would you like to depart from? List all airports you will consider." name="what-preferred-airport-would-you-like-to-depart-from-list-all-airports-you-will-consider" className="form-control"/> <field type="select" label="How would you prefer to fly?" placeholder="Select" name="how-would-you-prefer-to-fly" className="form-control"> <option label="Economy" value="economy">Economy</option> <option label="Main Cabin" value="main-cabin">Main Cabin</option> <option label="First Class" value="first-class">First Class</option> <option label="Business Class" value="business-class">Business Class</option> <option label="Private Charter" value="private-charter">Private Charter</option> </field> <field type="select" label="What is the desired budget PER PERSON for this trip? (This includes flights, accommodations, transfers, activities, excursions etc.)" placeholder="Select" name="select-1608675257270" className="form-control"> <option label="Less than $3000" value="less-than-3000" selected="selected">Less than $3000</option> <option label="$3000 - $5000" value="3000-5000">$3000 - $5000</option> <option label="$5000 - $8000" value="5000-8000">$5000 - $8000</option> <option label="$8000 - $10,000" value="8000-10000">$8000 - $10,000</option> <option label="$10,000 - $15,000" value="10000-15000">$10,000 - $15,000</option> <option label="$15,000 - $20,000" value="15000-20000">$15,000 - $20,000</option> <option label="20,000+" value="20000">20,000+</option> <option label="Not Sure, Need Help Deciding" value="not-sure-need-help-deciding">Not Sure, Need Help Deciding</option> </field> <field type="textarea" label="Please share any inclusions we should be aware of in regards to your budget." name="please-share-any-inclusions-we-should-be-aware-of-in-regards-to-your-budget" className="form-control"/> <field type="textarea" label="Please share any restrictions you or your travel companion may have." placeholder="Please use this space to provide information on travel restrictions (ie mobile allergies etc)" name="notes" className="form-control"/> <field type="radio-group" required="true" label="When do you plan to book your travel?" name="when-do-you-plan-to-book-your-travel"> <option label="I plan to book immediately." value="i-plan-to-book-immediately">I plan to book immediately.</option> <option label="I plan to book within two weeks" value="i-plan-to-book-within-two-weeks">I plan to book within two weeks</option> <option label="I plan to book within 30 days from now." value="i-plan-to-book-within-30-days-from-now">I plan to book within 30 days from now.</option> <option label="I plan to book more than 30 days from now." value="i-plan-to-book-more-than-30-days-from-now">I plan to book more than 30 days from now.</option> </field> <field type="text" label="Do you have a coupon code?" placeholder="Enter coupon code here" name="do-you-have-a-coupon-code" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Have you been researching online?" name="have-you-been-researching-online"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="Are you working with or consulted with another travel agent or agency?" name="are-you-working-with-or-consulted-with-another-travel-agent-or-agency"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="radio-group" required="true" label="Best time to reach you?" name="best-time-to-reach-you"> <option label="Mornings (9:30am -11am)" value="mornings-930am-11am">Mornings (9:30am -11am)</option> <option label="Afternoons (1pm - 3pm)" value="afternoons-1pm-3pm">Afternoons (1pm - 3pm)</option> <option label="Evenings (4pm -6pm)" value="evenings-4pm-6pm">Evenings (4pm -6pm)</option> </field> <field type="select" required="true" label="How did you hear about JEK Travels?" placeholder="Select" name="how-did-you-hear-about-jek-travels" className="form-control"> <option label="Past Client" value="past-client">Past Client</option> <option label="Referral" value="referral" selected="selected">Referral</option> <option label="Search Engine (Google, Bing, Etc)" value="search-engine-google-bing-etc">Search Engine (Google, Bing, Etc)</option> <option label="Social Media" value="social-media">Social Media</option> <option label="Travel Blog" value="travel-blog">Travel Blog</option> <option label="Word of mouth" value="word-of-mouth">Word of mouth</option> <option label="Other" value="other">Other</option> </field> <field type="radio-group" required="true" label="Would you like to be added to our mailing list?" name="would-you-like-to-be-added-to-our-mailing-list"> <option label="Yes, please add me" value="yes-please-add-me">Yes, please add me</option> <option label="No, thank you" value="no-thank-you">No, thank you</option> </field> </fields> </form-template> </body> </html>
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