Share your information with Callie Cole

Callie Cole

Travelmation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="TELL ME MORE!"/>&#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" name="preferred-name" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Contact"/>&#13;
		<field type="text" label="Address:&amp;nbsp;" name="address-line-1" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Line 2" name="address-line-2" subtype="text" className="form-control"/>&#13;
		<field type="text" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Country" name="address-country" subtype="text" className="form-control"/>&#13;
		<field required="true"  type="text" label="Email" name="email" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/>&#13;
		<field type="header" subtype="h1" label="Trip Details"/>&#13;
		<field type="text" 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" 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" 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;
		</field>&#13;
		<field type="checkbox-group" label="How soon are you wanting to book?" name="booking-">&#13;
			<option label="ASAP" value="asap">ASAP</option>&#13;
			<option label="Within the next 7-10 days " value="within-the-next-710-days-">Within the next 7-10 days </option>&#13;
			<option label="In a few months" value="in-a-few-months">In a few months</option>&#13;
			<option label="Just considering options" value="just-considering-options">Just considering options</option>&#13;
		</field>&#13;
		<field type="text" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Ages of the travelers" name="ages-of-the-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" label="How many travelers?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="What is your budget for all travelers?" 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 vacation are you looking for?" name="what-kind-of-vacation-are-you-looking-for">&#13;
			<option label="All inclusive " value="all-inclusive-">All inclusive </option>&#13;
			<option label="Walt Disney World (Orlando)" value="walt-disney-world-orlando">Walt Disney World (Orlando)</option>&#13;
			<option label="Universal Studios (Orlando)" value="universal-studios-orlando">Universal Studios (Orlando)</option>&#13;
			<option label="Destination Wedding" value="destination-wedding">Destination Wedding</option>&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Europe" value="europe">Europe</option>&#13;
			<option label="Not really sure" value="not-really-sure">Not really sure</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="How did you find me?" name="how-did-you-find-me" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>&#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;
		<field type="select" label="My turn around time is about 2-3 business days, is that okay?" name="my-turn-around-time-is-about-23-business-days-is-that-okay" className="form-control">&#13;
			<option label="Heck yeah!" value="heck-yeah">Heck yeah!</option>&#13;
			<option label="No, I need to book ASAP" value="no-i-need-to-book-asap">No, I need to book ASAP</option>&#13;
		</field>&#13;
		<field type="paragraph" subtype="p" label="I agree to the terms and conditions listed in any booking confirmations including any changes or cancellation policies. Callie Cole of Dr.CallieLLC assumes no liability for costs incurred due to changes and cancellations. "/>&#13;
		<field type="paragraph" subtype="p" label="I understand that quotes are based on availability and are subject to change and pricing is not guaranteed until a deposit is received and the package is confirmed. Submission of this form allows Callie Cole to contact you by email or phone. You agree that all information provided to Callie Cole is accurate- and you are responsible for any fees that may occur as result of incorrect information. "/>&#13;
		<field type="paragraph" subtype="p" label="Passports must be valid for 6 months after your planned arrival back into the United States. You may be denied travel if your passport expires within this time frame. Upon booking, you agree to these terms, and will be responsible for all costs associated with passport issues if they do arise. I agree to the Travelmation LLC Terms and Conditions listed here: https://form.jotform.com/233213266815150"/>&#13;
		<field type="checkbox-group" label="Terms and Conditions approval" description="Please see above for Terms and Conditions" name="terms-and-conditions-approval">&#13;
			<option label="I agree to the terms and conditions listed above and those from Travelmation LLC" value="i-agree-to-the-terms-and-conditions-listed-above-and-those-from-travelmation-llc">I agree to the terms and conditions listed above and those from Travelmation LLC</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

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