<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="Tell me about your trip..."/> <field type="header" subtype="h2" label="Full name"/> <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" required="true" label="Email" name="email" subtype="text" className="form-control"/> <field type="text" label="Phone number" name="phone-number" subtype="text" className="form-control"/> <field type="text" required="true" label="Where do you want to go?" description="Ex: Italy African Safari, somewhere warm, etc" name="where-would-you-like-to-go" subtype="text" className="form-control"/> <field type="radio-group" label="What stage of planning are you in?" name="what-stage-of-planning-are-you-in"> <option label="Nothing planned yet, just getting started." value="nothing-planned-yet-just-getting-started" selected="selected">Nothing planned yet, just getting started.</option> <option label="I have dates and a good idea of what I am looking for." value="i-have-dates-and-a-good-idea-of-what-i-am-looking-for">I have dates and a good idea of what I am looking for.</option> <option label="I'm almost done, I only need assistance with a few things." value="im-almost-done-i-only-need-assistance-with-a-few-things">I'm almost done, I only need assistance with a few things.</option> </field> <field type="text" label="What dates are you looking to travel?" name="what-dates-are-you-looking-to-travel" subtype="text" className="form-control"/> <field type="text" label="What is your preferred airport of departure/origin?" name="what-is-your-preferred-airport-of-departureorigin" subtype="text" className="form-control"/> <field type="text" required="true" label="How many people will be traveling?" name="total-number-of-people-traveling" subtype="text" className="form-control"/> <field type="textarea" label="Are you celebrating anything special? What is the reason for this trip?" name="are-you-celebrating-anything-special-what-is-the-reason-for-this-trip" className="form-control"/> <field type="select" label="What components would you like included in your proposal?" name="what-components-would-you-like-included-in-your-proposal" multiple="multiple" className="form-control"> <option label="Accommodations" value="accommodations" selected="selected">Accommodations</option> <option label="Transportaton + transfers" value="transportaton-transfers">Transportaton + transfers</option> <option label="Excursions + tours" value="excursions-tours">Excursions + tours</option> <option label="Airfare" value="airfare">Airfare</option> <option label="Travel Insurance" value="travel-insurance">Travel Insurance</option> </field> <field type="checkbox-group" required="true" label="What are you willing to invest on your vacation?" name="what-is-your-budget-"> <option label="$10,000-$15,000" value="1000015000">$10,000-$15,000</option> <option label="$15,000-$20,000" value="1500020000">$15,000-$20,000</option> <option label="$20,000-$50,000" value="2000050000">$20,000-$50,000</option> <option label="$50,000+" value="50000">$50,000+</option> </field> <field type="textarea" label="What would make this trip PERFECT for you?" name="notes" className="form-control"/> <field type="select" label="Select your priorities for this trip" name="select-your-priorities-for-this-trip" multiple="multiple" className="form-control"> <option label="Rest and relaxation" value="rest-and-relaxation" selected="selected">Rest and relaxation</option> <option label="Local culture" value="local-culture">Local culture</option> <option label="Food and wine" value="food-and-wine">Food and wine</option> <option label="Active adventure" value="active-adventure">Active adventure</option> <option label="Arts and theater" value="arts-and-theater">Arts and theater</option> <option label="Nightlife" value="nightlife">Nightlife</option> <option label="Shopping" value="shopping">Shopping</option> </field> <field type="textarea" label="How did you hear about us?" name="how-did-you-hear-about-us" className="form-control"/> <field type="select" label="Would you like to be added to our newsletter?" name="would-you-like-to-be-added-to-our-newsletter" className="form-control"> <option label="Yes" value="yes" selected="selected">Yes</option> <option label="No" value="no">No</option> </field> <field type="checkbox-group" required="true" label="By checking below, you acknowledge the following: Elevate Signature Travel charges planning fees which vary with the length and complexity of the trip. Elevate Signature Travel is unable to provide itemized cost breakdowns." name="by-checking-below-you-acknowledge-the-following-elevate-signature-travel-charges-planning-fees-which-vary-with-the-length-and-complexity-of-the-trip-elevate-signature-travel-is-unable-to-provide-itemized-cost-breakdowns"> <option label="I Acknowledged I have read and understand the above statement." value="i-acknowledged-i-have-read-and-understand-the-above-statement">I Acknowledged I have read and understand the above statement.</option> </field> </fields> </form-template> </body> </html>
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