Share your information with Chantel Loveless

Chantel Loveless

Breathless Escape

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    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name as it is written on your travel documentation&amp;nbsp;"/>&#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" 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="header" subtype="h2" label="Questions for your trip"/>&#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="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="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" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city? (If you&#39;d like to add flights)" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adult travelers will be on your reservation? (+18)" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many children will be travelling on your reservation and what will be their ages at the time of travel?" name="text-1757600632110" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many rooms will you need?" name="text-1757600676226" subtype="text" className="form-control"/>&#13;
		<field type="checkbox-group" required="true" label="What would you like to be included on your quote?" name="what-would-you-like-to-be-included-on-your-quote">&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="All inclusive resort" value="all-inclusive-resort">All inclusive resort</option>&#13;
			<option label="Hotel" value="hotel">Hotel</option>&#13;
			<option label="Excursions/Activities" value="excursionsactivities">Excursions/Activities</option>&#13;
			<option label="Airbnb or other vacation rental (additional $125)" value="airbnb-or-other-vacation-rental-additional-125">Airbnb or other vacation rental (additional $125)</option>&#13;
		</field>&#13;
		<field type="radio-group" label="What is your budget per traveler?" description="This just gives me a general starting point and can always be changed later." name="budget">&#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="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="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="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Which planning service are you most interested in? (Select all that apply) You will receive a non-refundable service invoice." name="which-planning-service-are-you-most-interested-in-select-all-that-apply-you-will-receive-a-non-refundable-service-invoice-through-paypal-or-stripe">&#13;
			<option label="Standard Planning Service (quote of up to 3 resort options) - $75" value="standard-planning-service-quote-of-up-to-3-resort-options-75">Standard Planning Service (quote of up to 3 resort options) - $75</option>&#13;
			<option label="Last minute booking (within 21 days of travel) - additional $25" value="last-minute-booking-within-21-days-of-travel-additional-25">Last minute booking (within 21 days of travel) - additional $25</option>&#13;
			<option label="Full Service Planning (quote of up to 5 resorts or hotels and includes excursion options) -$100" value="full-service-planning-quote-of-up-to-5-resorts-or-hotels-and-includes-excursion-options-100">Full Service Planning (quote of up to 5 resorts or hotels and includes excursion options) -$100</option>&#13;
			<option label="Itinerary help- $75 (Already booked and need help finding the best things to do? This is the perfect option)" value="itinerary-help-75-already-booked-and-need-help-finding-the-best-things-to-do-this-is-the-perfect-option">Itinerary help- $75 (Already booked and need help finding the best things to do? This is the perfect option)</option>&#13;
			<option label="Bachelor/Bachelorette Planning - $125" value="bachelorbachelorette-planning-125">Bachelor/Bachelorette Planning - $125</option>&#13;
		</field>&#13;
		<field type="textarea" label="What else would you 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;
	</fields>&#13;
</form-template>
  </body>
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