Share your information with Tami Trumm

Tami Trumm

Black Coral Travel

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Travel Consultation Form"/>&#13;
		<field type="header" subtype="h1" label="Trip Details"/>&#13;
		<field type="text" required="true" 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="radio-group" required="true" label="Will flights be needed?" name="flights-needed" other="true" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="date" required="true" 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="checkbox-group" label="Preferred departure time" name="preferred-departure-time" className="checkbox-group">&#13;
			<option label="Morning" value="morning">Morning</option>&#13;
			<option label="Afternoon" value="afternoon">Afternoon</option>&#13;
			<option label="Evening" value="evening">Evening</option>&#13;
			<option label="No Preference" value="no-preference">No Preference</option>&#13;
		</field>&#13;
		<field type="date" required="true" 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" required="true" label="Are your dates flexible?" name="dates-flexible" other="true">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Are red-eye flights acceptable?" name="redeye-acceptable" other="true" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Cabin Preference" description="This can be changed later if needed." name="cabin-preference" other="true" className="checkbox-group">&#13;
			<option label="Economy" value="economy">Economy</option>&#13;
			<option label="Premium Economy" value="premium-economy">Premium Economy</option>&#13;
			<option label="Business" value="business">Business</option>&#13;
			<option label="First Class" value="first-class">First Class</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Checked Baggage" name="checked-baggage" other="true" className="checkbox-group">&#13;
			<option label="None" value="none">None</option>&#13;
			<option label="One per traveler" value="one-per-traveler">One per traveler</option>&#13;
		</field>&#13;
		<field type="text" label="Preferred airline, if any" name="preferred-airline" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="Accommodations"/>&#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="radio-group" label="Bed Configuration" name="bed-preference" other="true" className="radio-group">&#13;
			<option label="One King" value="one-king">One King</option>&#13;
			<option label="Two Beds" value="two-beds">Two Beds</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Will multiple rooms be needed?" name="multiple-rooms-needed" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</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="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Scuba" value="scuba">Scuba</option>&#13;
			<option label="Adventure activities" value="adventure">Adventure activities</option>&#13;
			<option label="Golf" value="golf">Golf</option>&#13;
			<option label="Nightlife" value="nightlife">Nightlife</option>&#13;
			<option label="Arts and theater" value="art-theater">Arts and theater</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" 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="header" subtype="h3" label="Budget"/>&#13;
		<field type="radio-group" required="true" label="Estimated total trip budget" description="This just gives me a general starting point and can always be changed later." name="budget" other="true">&#13;
			<option label="$1,500 to $2,500" value="1500-2500">$1,500 to $2,500</option>&#13;
			<option label="$2,500 to $4,500" value="2500-4500">$2,500 to $4,500</option>&#13;
			<option label="$4,500 to $6,500" value="4500-6500">$4,500 to $6,500</option>&#13;
			<option label="$6,500 to $8,500" value="6500-8500">$6,500 to $8,500</option>&#13;
			<option label="$8,500 to $10,000" value="8500-10000">$8,500 to $10,000</option>&#13;
			<option label="$10,000+" value="10000">$10,000+</option>&#13;
		</field>&#13;
		<field type="header" subtype="h1" label="Traveler Information"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Last name" name="last-name" subtype="text" className="form-control"/>&#13;
		<field type="text" subtype="email" required="true" label="Email Address" name="email" className="form-control"/>&#13;
		<field type="text" subtype="tel" required="true" label="Phone Number" name="phone-number" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="Preferred Contact Method" name="preferred-contact-method" other="true" className="checkbox-group">&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Total Travelers" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Adults" name="number-of-adults" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Children" name="number-of-children" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Children&#39;s ages at the time of travel" name="children-ages" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred number of travelers per room" name="preferred-num-travelers-per-room" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Please note: A realistic total budget helps us recommend options that best match your priorities."/>&#13;
		<field type="header" subtype="h3" label="Travel Protection"/>&#13;
		<field type="radio-group" label="Would you like a travel insurance quote?" name="travel-protection-needed" other="true" className="radio-group">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Not Sure - Please Explain My Options" value="not-sure">Not Sure - Please Explain My Options</option>&#13;
		</field>&#13;
		<field type="header" subtype="h3" label="Preferences and Special Requests"/>&#13;
		<field type="textarea" label="What is most important to you for this trip? (Examples: relaxation, activities, location, luxury, value, family-friendly options)" name="trip-priorities" className="form-control"/>&#13;
		<field type="textarea" label="Please share any celebrations, accessibility needs, dietary needs, loyalty programs, or other requests" name="celebrations-accessibility-dietary-loyalty-other" className="form-control"/>&#13;
		<field type="header" subtype="h3" label="For Office Use Only"/>&#13;
		<field type="text" label="Follow-Up Appointment Date" name="follow-up-appointment-date" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Advisor Notes" name="advisor-notes" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>