<html> <body> <form-template> <fields> <field type="header" subtype="h2" label="River Cruise Inquiry&nbsp;"/> <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 required="true" type="text" 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="header" subtype="h3" label="Trip Information"/> <field type="radio-group" required="true" label="Where are you in the planning process?" name="where-are-you-in-the-planning-process"> <option label="I'm just getting started!" value="im-just-getting-started">I'm just getting started!</option> <option label="I have some ideas, but need help with research and planning." value="i-have-some-ideas-but-need-help-with-research-and-planning">I have some ideas, but need help with research and planning.</option> <option label="I know just what I want, but need help finalizing the details." value="i-know-just-what-i-want-but-need-help-finalizing-the-details">I know just what I want, but need help finalizing the details.</option> </field> <field type="text" required="true" label="Travel Dates" description="Can be a season month or exact dates" name="travel-dates" subtype="text" className="form-control"/> <field type="checkbox-group" label="Are your dates flexible?" name="dates-flexible"> <option label="Yes" value="yes">Yes</option> <option label="No" value="no">No</option> </field> <field type="text" label="How many travelers?" name="number-of-travelers" value="1" subtype="text" className="form-control"/> <field type="radio-group" required="true" label="Do you have a total budget in mind? (not including flights)" description="This just gives me a general starting point and can always be changed later." name="budget" other="true"> <option label="$5,000 to $7,500" value="5000-to-7500">$5,000 to $7,500</option> <option label="$7,500 to $10,000" value="7500-to-10000">$7,500 to $10,000</option> <option label="$10,000 to $15,000" value="10000-to-15000">$10,000 to $15,000</option> <option label="$15,000 to $20,000" value="15000-to-20000">$15,000 to $20,000</option> <option label="$20,000+" value="20000">$20,000+</option> </field> <field type="checkbox-group" required="true" label="Have you ever cruised before?&nbsp;" name="im-interested-in"> <option label="Ocean Cruise" value="ocean-cruise">Ocean Cruise</option> <option label="River Cruise" value="river-cruise">River Cruise</option> </field> <field type="checkbox-group" label="On my River Cruise I would like to..." name="on-my-river-cruise-i-would-like-to"> <option label="see a lot of castles and small villages" value="see-a-lot-of-castles-and-small-villages">see a lot of castles and small villages</option> <option label="concentrate on one country" value="concentrate-on-one-country">concentrate on one country</option> <option label="see several countries" value="see-several-countries">see several countries</option> <option label="visit a mix of capitals/large cities as well as small villages" value="visit-a-mix-of-capitalslarge-cities-as-well-as-small-villages">visit a mix of capitals/large cities as well as small villages</option> </field> <field type="checkbox-group" label="On my River Cruise, I'd like to visit..." name="on-my-river-cruise-id-like-to-visit"> <option label="Austria" value="austria">Austria</option> <option label="Belgium " value="belgium-">Belgium </option> <option label="Croatia" value="croatia">Croatia</option> <option label="Czech Republic" value="czech-republic">Czech Republic</option> <option label="France" value="france">France</option> <option label="Germany" value="germany">Germany</option> <option label="Hungary" value="hungary">Hungary</option> <option label="Netherlands" value="netherlands">Netherlands</option> <option label="Portugal" value="portugal">Portugal</option> <option label="Romania" value="romania">Romania</option> <option label="Serbia" value="serbia">Serbia</option> <option label="Switzerland" value="switzerland">Switzerland</option> <option label="Africa (Chobe)" value="africa-chobe">Africa (Chobe)</option> <option label="Columbia (Magdelena)" value="columbia-magdelena">Columbia (Magdelena)</option> <option label="Egypt (Nile)" value="egypt-nile">Egypt (Nile)</option> <option label="India (Ganges) " value="india-ganges-">India (Ganges) </option> <option label="Vietnam and Cambodia (Mekong)" value="vietnam-and-cambodia-mekong">Vietnam and Cambodia (Mekong)</option> <option label="Peru (Amazon - Maranon and Ucayali)" value="peru-amazon-maranon-and-ucayali">Peru (Amazon - Maranon and Ucayali)</option> </field> <field type="checkbox-group" required="true" label="What would you like to see and do on this trip?" description="Check all that apply" name="what-type-of-room-are-you-interested-in" other="true"> <option label="Shopping" value="shopping">Shopping</option> <option label="Festivals" value="festivals">Festivals</option> <option label="Museums" value="museums">Museums</option> <option label="Art Galleries" value="art-galleries">Art Galleries</option> <option label="Theater, Ballet, Opera" value="theater-ballet-opera">Theater, Ballet, Opera</option> <option label="Historical Sites" value="historical-sites">Historical Sites</option> <option label="Wine Tasting" value="wine-tasting">Wine Tasting</option> <option label="Food Tasting/Culinary Activites" value="food-tastingculinary-activites">Food Tasting/Culinary Activites</option> <option label="Nature or Outdoor Activities" value="nature-or-outdoor-activities">Nature or Outdoor Activities</option> <option label="Cycling " value="cycling-">Cycling </option> <option label="Spas" value="spas">Spas</option> </field> <field type="textarea" label="What is the MOST important part of this trip? What is non-negotiable?" name="what-is-the-most-important-part-of-this-trip-what-is-nonnegotiable" className="form-control"/> <field type="textarea" label="What are your must-don'ts? You absolutely don't want to . . ." name="what-are-your-mustdonts-you-absolutely-dont-want-to-" className="form-control"/> <field type="radio-group" required="true" label="Which best describes your travel style?" name="which-best-describes-your-travel-style"> <option label="Go with the flow - I don't need every second of every day planned out. I like the freedom to be totally spontaneous." value="go-with-the-flow-i-dont-need-every-second-of-every-day-planned-out-i-like-the-freedom-to-be-totally-spontaneous">Go with the flow - I don't need every second of every day planned out. I like the freedom to be totally spontaneous.</option> <option label="I'm a planner! - I want every detail planned out; I don't like to leave anything up to chance." value="im-a-planner-i-want-every-detail-planned-out-i-dont-like-to-leave-anything-up-to-chance">I'm a planner! - I want every detail planned out; I don't like to leave anything up to chance.</option> <option label="Somewhere in between - I like having a plan, but I am comfortable being spontaneous." value="somewhere-in-between-i-like-having-a-plan-but-i-am-comfortable-being-spontaneous">Somewhere in between - I like having a plan, but I am comfortable being spontaneous.</option> </field> <field type="radio-group" required="true" label="When it comes to this trip . . ." name="when-it-comes-to-this-trip-"> <option label="An amazing experience is most important to me, even if it means spending a little more." value="an-amazing-experience-is-most-important-to-me-even-if-it-means-spending-a-little-more">An amazing experience is most important to me, even if it means spending a little more.</option> <option label="Price is what is most important to me. I am only interested in finding the best deals." value="price-is-what-is-most-important-to-me-i-am-only-interested-in-finding-the-best-deals">Price is what is most important to me. I am only interested in finding the best deals.</option> </field> <field type="radio-group" label="Which sentence best describes you?" name="which-sentence-best-describes-you"> <option label="I can easily make decisions." value="i-can-easily-make-decisions">I can easily make decisions.</option> <option label="I can sometimes overthink and have a hard time making a decision." value="i-can-sometimes-overthink-and-have-a-hard-time-making-a-decision">I can sometimes overthink and have a hard time making a decision.</option> </field> <field type="textarea" label="Is there anything else would you like me to know?" description="Is there anything else you would like me to know about your travelers budget and/or travel preferences?" name="notes" className="form-control"/> <field type="radio-group" required="true" label="Would you like to be added to our email list to receive our monthly email packed with travel inspiration and news?&nbsp;" name="would-you-like-to-be-added-to-our-email-list-to-receive-our-monthly-email-packed-with-travel-inspiration-and-news-"> <option label="Yes! That would be great" value="yes-that-would-be-great">Yes! That would be great</option> <option label="No thanks" value="no-thanks">No thanks</option> </field> </fields> </form-template> </body> </html>
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