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Stephanie Auld

Stephanie Auld - TravelMation

<html>
  <body>
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		<field type="text" required="true" label="First Name" name="first-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="radio-group" required="true" label="How would you like to be contacted?" inline="true" name="how-would-you-like-to-be-contacted">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone" value="phone">Phone</option>&#13;
			<option label="Either" value="either">Either</option>&#13;
		</field>&#13;
		<field type="date" required="true" label="When would you like to depart?" name="when-would-you-like-to-depart" className="form-control"/>&#13;
		<field type="date" required="true" label="When would you like to return?" name="when-would-you-like-to-return" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Are your dates flexible?" inline="true" name="are-your-dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Unsure" value="unsure">Unsure</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="How soon are you looking to book?" name="how-soon-are-you-looking-to-book" className="form-control">&#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" required="true" label="What is your departure city/airport?" name="what-is-your-departure-cityairport" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many travelers?" name="how-many-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What are the ages of the travelers?" name="what-are-the-ages-of-the-travelers" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="What kind of Vacation are you looking for?" name="what-kind-of-vacation-are-you-looking-for">&#13;
			<option label="Cruise" value="cruise">Cruise</option>&#13;
			<option label="All-Inclusive Resort" value="allinclusive-resort">All-Inclusive Resort</option>&#13;
			<option label="Disney Parks" value="disney-parks">Disney Parks</option>&#13;
			<option label="Universal Parks" value="universal-parks">Universal Parks</option>&#13;
			<option label="Europe/Asia" value="europeasia">Europe/Asia</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="What travel components do you want my help with?" name="what-travel-components-do-you-want-my-help-with" multiple="multiple" className="form-control">&#13;
			<option label="Accomodations" value="accomodations">Accomodations</option>&#13;
			<option label="Flights" value="flights">Flights</option>&#13;
			<option label="Transportation" value="transportation">Transportation</option>&#13;
			<option label="Excursion &amp; Tours" value="excursion-tours">Excursion &amp; Tours</option>&#13;
			<option label="Insurance" value="insurance">Insurance</option>&#13;
			<option label="All of the Above!" value="all-of-the-above">All of the Above!</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget in total?" name="what-is-your-budget-in-total">&#13;
			<option label="Budget Friendly: max $2K" value="budget-friendly-max-2k">Budget Friendly: max $2K</option>&#13;
			<option label="Moderate: max $3K-$4K" value="moderate-max-3k4k">Moderate: max $3K-$4K</option>&#13;
			<option label="Little Splurge: max $4K-$6K" value="little-splurge-max-4k6k">Little Splurge: max $4K-$6K</option>&#13;
			<option label="Luxury: max $6K-$8K" value="luxury-max-6k8k">Luxury: max $6K-$8K</option>&#13;
			<option label="Let's Go Big!: $8K plus" value="lets-go-big-8k-plus">Let's Go Big!: $8K plus</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What describes your hotel preference?" inline="true" name="what-describes-your-hotel-preference">&#13;
			<option label="Economy" value="economy">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;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="textarea" required="true" label="Any food allergies/medical conditions to be made aware of?" name="any-food-allergiesmedical-conditions-to-be-made-aware-of" className="form-control"/>&#13;
		<field type="textarea" label="What else would you like me to know?" name="what-else-would-you-like-me-to-know" className="form-control"/>&#13;
		<field type="text" label="Who referred you?" name="who-referred-you" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="My current turn around for inquiries can be up to 7 days, is that ok with you?" name="my-current-turn-around-for-inquiries-can-be-up-to-7-days-is-that-ok-with-you" subtype="text" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>