TravelJoy

Janel Nimrick

Client Inquiry Form

Let us find your...happy place!

<html>
  <body>
    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="header" subtype="h2" label="Hello! Thank you for contacting me for assistance with your upcoming trip.&amp;nbsp; I appreciate you choosing to do business with me!&amp;nbsp;"/>&#13;
		<field type="header" subtype="h2" label="Client Details"/>&#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="Preferred name" name="preferred-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" label="Country" name="address-country" 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="header" subtype="h2" label="Important Dates"/>&#13;
		<field type="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="date" label="Wedding anniversary" name="wedding-anniversary" className="form-control"/>&#13;
		<field type="text" required="true" label="What destination(s) are you considering?" description="If you're not sure  just give me a few destinations you'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="No">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Would you like assistance with airfare?&amp;nbsp;" name="would-you-like-assistance-with-airfare-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" label="What is your preferred departure airport(s)?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adults (18 and over) will be traveling?" name="number-of-travelers" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many children? Please list ages of children at time of travel.&amp;nbsp;" name="how-many-children" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Please list the names &amp;amp; dates of birth of anyone else traveling with you.&amp;nbsp;" name="please-list-the-names-dates-of-birth-of-anyone-else-traveling-with-you-" subtype="text" className="form-control"/>&#13;
		<field type="radio-group" label="PASSPORTS: Do all travelers currently have a valid passport, with at least 6-months validity at the time of travel? * International trips only.&amp;nbsp;" name="passports-do-all-travelers-currently-have-a-valid-passport-with-at-least-6months-validity-at-the-time-of-travel-international-trips-only-">&#13;
			<option label="Yes, we all do" value="yes-we-all-do">Yes, we all do</option>&#13;
			<option label="No, some of us need a renewal or 1st time passport" value="no-some-of-us-need-a-renewal-or-1st-time-passport">No, some of us need a renewal or 1st time passport</option>&#13;
			<option label="No, none of us do " value="no-none-of-us-do-">No, none of us do </option>&#13;
		</field>&#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="radio-group" label="Are you looking for an All-Inclusive vacation package?&amp;nbsp;" name="are-you-looking-for-an-allinclusive-vacation-package-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
			<option label="Not sure" value="not-sure">Not 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;
			<option label="Adult-Only" value="adultonly">Adult-Only</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 sports" value="beach-and-water-sports">Beach and water sports</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;
			<option label="Kid activities " value="kid-activities-">Kid activities </option>&#13;
			<option label="Excursions" value="excursions">Excursions</option>&#13;
			<option label="Spa" value="spa">Spa</option>&#13;
		</field>&#13;
		<field type="clientLoyaltyPrograms" label="Loyalty Programs, TSA PreCheck or Global Entry Information (for main traveler)" name="loyalty-program" loyalty-program-note="*** This field allows your client to enter multiple loyalty program numbers (you only need one of these per form template) ***" 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="text" label="Do any travelers have any mobility issues?" name="do-any-travelers-have-any-mobility-issues" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Do any travelers have any severe food, or other allergies, that we need to be aware of?&amp;nbsp;" name="do-any-travelers-have-any-severe-food-or-other-allergies-that-we-need-to-be-aware-of-" subtype="text" className="form-control"/>&#13;
		<field type="textarea" label="Do you have any questions/concerns for us?&amp;nbsp;" 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="radio-group" required="true" label="Would you like pricing for recommended travel insurance?&amp;nbsp;" name="would-you-like-pricing-for-recommended-travel-insurance-">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="How soon are you looking to book and confirm your trip?" name="how-soon-are-you-looking-to-book-and-confirm-your-trip">&#13;
			<option label="ASAP, I'm ready to pay deposit" value="asap-im-ready-to-pay-deposit">ASAP, I'm ready to pay deposit</option>&#13;
			<option label="In the next few days" value="in-the-next-few-days">In the next few days</option>&#13;
			<option label="Within the next 2 weeks or so" value="within-the-next-2-weeks-or-so">Within the next 2 weeks or so</option>&#13;
			<option label="More than 2 weeks from now" value="more-than-2-weeks-from-now">More than 2 weeks from now</option>&#13;
			<option label="Right now I'm just looking for pricing" value="right-now-im-just-looking-for-pricing">Right now I'm just looking for pricing</option>&#13;
		</field>&#13;
		<field type="text" label="How did you hear about our agency?&amp;nbsp;&amp;nbsp;" name="how-did-you-hear-about-our-agency-" subtype="text" className="form-control"/>&#13;
		<field type="paragraph" subtype="p" label="Thank you again for reaching out!&amp;nbsp; I will be in touch within 3-4 business days.&amp;nbsp; If you need immediate assistance please call, or text, Janel Nimrick at 309-264-0428.&amp;nbsp; I look forward to assisting you with your upcoming travel needs.&amp;nbsp;&amp;nbsp;"/>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>