Share your information with Ciera Easterday

Ciera Easterday

Travelmation

<html>
  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h2" label="Full name"/>&#13;
		<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="header" subtype="h2" label="Address"/>&#13;
		<field type="text" required="true" label="Line 1" 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" required="true" label="City" name="address-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="State" name="address-state" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Zip" name="address-zip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country" name="address-country" 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="checkbox-group" required="true" label="What is your preferred method of communication?" name="what-is-your-preferred-method-of-communication">&#13;
			<option label="Email" value="email">Email</option>&#13;
			<option label="Phone Call" value="phone-call">Phone Call</option>&#13;
			<option label="Text" value="text">Text</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What dates are you looking to travel?" name="what-dates-are-you-looking-to-travel" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Are your dates flexible?" name="are-your-dates-flexible" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many people are in your party &amp;amp; what are their ages?" name="how-many-people-are-in-your-party" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Does anyone in your party have accessibility needs? (this includes severe allergies)" name="does-anyone-in-your-party-have-accessibility-needs-this-includes-severe-allergies" subtype="text" className="form-control"/>&#13;
		<field type="textarea" required="true" label="What else would you like me to know?" placeholder="Any specifics I should know about travelers   budget, or preferences for the trip? Are you celebrating anything?" name="what-else-would-you-like-me-to-know" className="form-control"/>&#13;
		<field type="textarea" required="true" label="Please list the best days of the week &amp;amp; times for a Zoom call" placeholder="This is when I&#39;ll go over specifics of your trip before booking everything. I&#39;ll email dates/times to choose from based on the options you provide." name="please-list-the-best-days-of-the-week-times-for-a-zoom-call" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>