Share your information with Hannah Blouin

Hannah Blouin

Hannah Blouin - Star Pass Travels

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Trip Request - Inquiry Form"/>&#13;
		<field type="text" label="Prefix" name="prefix" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="First name" name="first-name" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Middle name" name="middle-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" label="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name&amp;nbsp;" description="This can be a legal name  or nickname." name="preferred-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="text" required="true" label="What is the reason for travel?" placeholder="Ex: Derby game, celebration trip (birthday/anniversary/graduation) ,  weekend getaway  etc." name="text-1744297383582" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your trip destination? (If you want to visit multiple destinations/cities please list them here)." description="Where do you want to travel to?" placeholder="Ex:  City Name  /  Disney   /   Cruise    /    Roadtrip on Rt 66" name="text-1748361069120" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city?" description="Where will you be traveling/flying from?" placeholder="ex: Richmond (RIC)" name="text-1744297305830" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="When do you want to leave?" 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" required="true" label="When do you want 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="radio-group" required="true" label="Are your travel dates flexible? " name="are-your-travel-dates-flexible-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How are you traveling?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="Solo" value="solo">Solo</option>&#13;
			<option label="Travel Partner / Significant Other (2 people)" value="travel-partner-significant-other-2-people">Travel Partner / Significant Other (2 people)</option>&#13;
			<option label="Small Group (3-8 people)" value="small-group-38-people">Small Group (3-8 people)</option>&#13;
			<option label="Large Group (8+ people)" value="large-group-8-people">Large Group (8+ people)</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you the lead traveler? (ie: sole decision makers and individual who will be responsible for trip payment(s)):" name="are-you-the-lead-traveler-ie-sole-decision-makers-and-individual-who-will-be-responsible-for-trip-payment">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Are you ready to make a deposit on your trip today?" name="radio-group-1748659234521">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="What are your travel needs for this trip?" description="Check all that apply." name="what-are-your-travel-needs-for-this-trip" other="true">&#13;
			<option label="Flight" value="flight">Flight</option>&#13;
			<option label="Train" value="train">Train</option>&#13;
			<option label="Hotel (single room)" value="hotel-single-room">Hotel (single room)</option>&#13;
			<option label="Hotel (multiple rooms)" value="hotel-multiple-rooms">Hotel (multiple rooms)</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Vehicle Rental" value="vehicle-rental">Vehicle Rental</option>&#13;
			<option label="Ground Transportation (airport shuttle/car service)" value="ground-transportation-airport-shuttlecar-service">Ground Transportation (airport shuttle/car service)</option>&#13;
			<option label="Tours/Entertainment/Activites (team bonding/building activities)" value="toursentertainmentactivites-team-bondingbuilding-activities">Tours/Entertainment/Activites (team bonding/building activities)</option>&#13;
		</field>&#13;
		<field type="textarea" label="Please share any special needs/requests that should be considered for your trip. Please include any special accessibility requirements.&amp;nbsp; &amp;nbsp;Is there anything else you would 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"/>&#13;
		<field type="text" required="true" label="How did you hear about Star Pass Travels?" placeholder="(ex: website name  facebook  event)" name="destination" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Would you like to join our newsletter to receive travel news, destination inspiration, travel tips &amp;amp; tricks and more! Including notifications about exclusive travel deals and discounts." name="radio-group-1748364034630">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>