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Client Intake Form - 24

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Travel Service Fee

Available until December 31, 2028 - available

$25.00

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Trip Designing

Available until December 31, 2028 - available

$20.00
Deposit: $20.00

Day by day personalized itinerary with excursions and tours added.

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Rush Quotes - Need quotes in 3 days or less?

Available until December 31, 2028 - available

$50.00

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<html>
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    <form-template>&#13;
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" required="true" label="Email" className="form-control" name="email"></field>&#13;
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Questions for your trip"/>&#13;
		<field type="radio-group" label="Occasion" name="occassion" other="true">&#13;
			<option label="Just Because!" value="just-because">Just Because!</option>&#13;
			<option label="Birthday" value="birthday">Birthday</option>&#13;
			<option label="Anniversary" value="anniversary">Anniversary</option>&#13;
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>&#13;
			<option label="Graduation Trip" value="graduation-trip">Graduation Trip</option>&#13;
			<option label="Wedding" value="wedding">Wedding</option>&#13;
			<option label="Holiday Trip" value="holiday-trip">Holiday Trip</option>&#13;
			<option label="Bachelor/Bachelorette Trip" value="bachelorbachelorette-trip">Bachelor/Bachelorette Trip</option>&#13;
			<option label="Retirement Trip" value="retirement-trip">Retirement Trip</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Type of Trip" description="An all-inclusive vacation package includes resort with all meals/drinks included  roundtrip flights  and airport transportation usually to a destination in the Caribbean or Mexico. NOTE: All-inclusive resorts are not available in Puerto Rico  Hawaii  or the U.S.V.I." name="type-of-trip">&#13;
			<option label="Caribbean or Mexico All-Inclusive Vacation" value="caribbean-or-mexico-allinclusive-vacation">Caribbean or Mexico All-Inclusive Vacation</option>&#13;
			<option label="Domestic Travel Package with Hotel &amp; Flights" value="domestic-travel-package-with-hotel-flights">Domestic Travel Package with Hotel &amp; Flights</option>&#13;
			<option label="Hotel Only" value="hotel-only">Hotel Only</option>&#13;
			<option label="Cruise Only" value="cruise-only">Cruise Only</option>&#13;
		</field>&#13;
		<field type="radio-group" label="Where would you like to go?" description="We only provide travel to destinations listed. Caribbean includes Jamaica  Dominican Repub  Aruba  St Lucia  Turks &amp; Caicos  Bahamas  etc.)" name="where-would-you-like-to-go">&#13;
			<option label="Caribbean  (Jamaica, Dominican Repub,  Aruba, Turks &amp; Caicos, Bahamas,  etc.)" value="caribbean-jamaica-dominican-repub-aruba-turks-caicos-bahamas-etc">Caribbean  (Jamaica, Dominican Repub,  Aruba, Turks &amp; Caicos, Bahamas,  etc.)</option>&#13;
			<option label="Mexico" value="mexico">Mexico</option>&#13;
			<option label="Puerto Rico" value="puerto-rico">Puerto Rico</option>&#13;
			<option label="Hawaii" value="hawaii">Hawaii</option>&#13;
			<option label="Las Vegas, NV" value="las-vegas-nv">Las Vegas, NV</option>&#13;
			<option label="Orlando, FL" value="orlando-fl">Orlando, FL</option>&#13;
			<option label="Miami, FL" value="miami-fl">Miami, FL</option>&#13;
			<option label="California" value="california">California</option>&#13;
			<option label="Not listed - email me to inquire before continuing this form." value="not-listed-email-me-to-inquire-before-continuing-this-form">Not listed - email me to inquire before continuing this form.</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Destination city, state, &amp;amp; country." name="if-necessary-specify-city-country" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" 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" required="true" 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" required="true" label="Are your dates flexible?" name="dates-flexible">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="What age will you be on the first day of this trip?" description="Resorts  car rental companies  etc. have an age policy that they enforce. This helps me find the best suited options for you!" name="what-age-will-you-be-on-the-first-day-of-this-trip" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many rooms?" name="how-many-rooms" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many adults?" name="how-many-adults" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="How many kids?" name="how-many-kids" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="Do travelers have a passport?" placeholder="Please select an option" name="do-travelers-have-a-passort" className="form-control">&#13;
			<option label="All travelers have passport." value="all-travelers-have-passport">All travelers have passport.</option>&#13;
			<option label="Some travelers have passport" value="some-travelers-have-passport">Some travelers have passport</option>&#13;
			<option label="No travelers have passport" value="no-travelers-have-passport">No travelers have passport</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Are travelers vaccinated?" placeholder="Please select an option" name="are-travelers-vaccinated" className="form-control">&#13;
			<option label="All travelers are vaccinated" value="all-travelers-are-vaccinated">All travelers are vaccinated</option>&#13;
			<option label="Some travelers are vaccinated" value="some-travelers-are-vaccinated">Some travelers are vaccinated</option>&#13;
			<option label="No travelers are vaccinated" value="no-travelers-are-vaccinated">No travelers are vaccinated</option>&#13;
		</field>&#13;
		<field type="checkbox-group" label="Room Preference" name="room-preference" other="true">&#13;
			<option label="Basic Category" value="basic-category">Basic Category</option>&#13;
			<option label="Garden View" value="garden-view">Garden View</option>&#13;
			<option label="Ocean View" value="ocean-view">Ocean View</option>&#13;
			<option label="Ocean Front" value="ocean-front">Ocean Front</option>&#13;
			<option label="City View" value="city-view">City View</option>&#13;
			<option label="King" value="king">King</option>&#13;
			<option label="2 Queens or 2 Doubles" value="2-queens-or-2-doubles">2 Queens or 2 Doubles</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="Flight Preference" name="flight-preference">&#13;
			<option label="Non-Stop Only" value="nonstop-only">Non-Stop Only</option>&#13;
			<option label="Open for 1 stop (layover)" value="open-for-1-stop-layover">Open for 1 stop (layover)</option>&#13;
			<option label="Open for 2 or more stops" value="open-for-2-or-more-stops">Open for 2 or more stops</option>&#13;
		</field>&#13;
		<field type="select" required="true" label="Do you need a car rental?" placeholder="Please select an option" name="do-you-need-a-car-rental" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="radio-group" label="If so, which type do you prefer?" name="if-so-which-type-do-you-prefer" other="true">&#13;
			<option label="Sedan" value="sedan">Sedan</option>&#13;
			<option label="Minivan" value="minivan">Minivan</option>&#13;
			<option label="SUV" value="suv">SUV</option>&#13;
			<option label="Passenger Van" value="passenger-van">Passenger Van</option>&#13;
		</field>&#13;
		<field type="radio-group" required="true" label="What is your budget per person?" description="This just gives me a general starting point and can always be changed later." name="budget">&#13;
			<option label="$600-$900 PP" value="600900-pp">$600-$900 PP</option>&#13;
			<option label="$900-$1,200 PP" value="9001200-pp">$900-$1,200 PP</option>&#13;
			<option label="$1,200-$1,500 PP" value="12001500-pp">$1,200-$1,500 PP</option>&#13;
			<option label="$1,500-$2,000 PP" value="15002000-pp">$1,500-$2,000 PP</option>&#13;
			<option label="$2,000+ PP" value="2000-pp">$2,000+ PP</option>&#13;
			<option label="I am not sure" value="i-am-not-sure">I am 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="Baecation (Romantic)" value="baecation-romantic">Baecation (Romantic)</option>&#13;
			<option label="Couple's Trip (Group)" value="couples-trip-group">Couple's Trip (Group)</option>&#13;
			<option label="Family Trip" value="family-trip">Family Trip</option>&#13;
			<option label="Girls trip" value="girls-trip">Girls trip</option>&#13;
			<option label="Guys Trip" value="guys-trip">Guys Trip</option>&#13;
			<option label="Party" value="party">Party</option>&#13;
			<option label="Relaxing" value="relaxing">Relaxing</option>&#13;
			<option label="Adventure" value="adventure">Adventure</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="ATV" value="atv">ATV</option>&#13;
			<option label="Culinary Experinces" value="culinary-experinces">Culinary Experinces</option>&#13;
			<option label="Party Boat" value="party-boat">Party Boat</option>&#13;
			<option label="Gambling" value="gambling">Gambling</option>&#13;
			<option label="Horseback ride" value="horseback-ride">Horseback ride</option>&#13;
			<option label="Ziplining" value="ziplining">Ziplining</option>&#13;
			<option label="Water sports" value="water-sports">Water sports</option>&#13;
			<option label="Spa/Massages" value="spamassages">Spa/Massages</option>&#13;
			<option label="Other" value="other">Other</option>&#13;
		</field>&#13;
		<field type="text" label="List preferred hotel chain or airline, etc." name="list-referred-hotel-chain-or-airline-etc" subtype="text" 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="textarea" label="What else would you like me to know?" description="What else would you like me to know about your budget and/or travel preferences?" name="notes" className="form-control"/>&#13;
		<field type="text" label="Social Media Handle" placeholder="IG  Snapchat  etc." name="social-media-handle" subtype="text" className="form-control"/>&#13;
		<field type="select" required="true" label="I consent to Traveliyah using my travel photos for marketing purposes." name="i-consent-to-traveliyah-using-my-travel-photos-for-marketing-purposes" className="form-control">&#13;
			<option label="Yes" value="yes">Yes</option>&#13;
			<option label="No" value="no">No</option>&#13;
		</field>&#13;
		<field type="checkbox-group" required="true" label="Please check this box" name="please-check-this-box">&#13;
			<option label="I understand that I will receive my quotes within 7 days after submission of this form (unless I paid the Rush Fee)." value="i-understand-that-i-will-receive-my-quotes-within-7-days-after-submission-of-this-form-unless-i-paid-the-rush-fee">I understand that I will receive my quotes within 7 days after submission of this form (unless I paid the Rush Fee).</option>&#13;
		</field>&#13;
	</fields>&#13;
</form-template>
  </body>
</html>

<html>
  <body>
    <form-template>
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field><field type="text" subtype="text" label="Email" className="form-control" name="email"></field>
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="Questions for your trip"/>
		<field type="radio-group" label="Occasion" name="occassion" other="true">
			<option label="Just Because!" value="just-because">Just Because!</option>
			<option label="Birthday" value="birthday">Birthday</option>
			<option label="Anniversary" value="anniversary">Anniversary</option>
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>
			<option label="Graduation Trip" value="graduation-trip">Graduation Trip</option>
			<option label="Wedding" value="wedding">Wedding</option>
			<option label="Holiday Trip" value="holiday-trip">Holiday Trip</option>
			<option label="Bachelor/Bachelorette Trip" value="bachelorbachelorette-trip">Bachelor/Bachelorette Trip</option>
			<option label="Retirement Trip" value="retirement-trip">Retirement Trip</option>
		</field>
		<field type="text" required="true" label="Where would you like to go?" description="If you're not sure  just give me a few destinations you're considering." placeholder="ex: Montego Bay  Jamaica" name="destination" subtype="text" className="form-control"/>
		<field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>
		<field type="date" required="true" 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"/>
		<field type="date" required="true" 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"/>
		<field type="checkbox-group" required="true" 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" required="true" label="What age will you be on the first day of this trip?" description="Resorts  car rental companies  etc. have an age policy that they enforce. This helps me find the best suited options for you!" name="what-age-will-you-be-on-the-first-day-of-this-trip" subtype="text" className="form-control"/>
		<field type="text" required="true" label="How many rooms?" name="how-many-rooms" subtype="text" className="form-control"/>
		<field type="text" required="true" label="How many adults?" name="how-many-adults" subtype="text" className="form-control"/>
		<field type="text" required="true" label="How many kids?" name="how-many-kids" subtype="text" className="form-control"/>
		<field type="select" required="true" label="Do travelers have a passport?" placeholder="Please select an option" name="do-travelers-have-a-passort" className="form-control">
			<option label="All travelers have passport." value="all-travelers-have-passport">All travelers have passport.</option>
			<option label="Some travelers have passport" value="some-travelers-have-passport">Some travelers have passport</option>
			<option label="No travelers have passport" value="no-travelers-have-passport">No travelers have passport</option>
		</field>
		<field type="select" required="true" label="Are travelers vaccinated?" placeholder="Please select an option" name="are-travelers-vaccinated" className="form-control">
			<option label="All travelers are vaccinated" value="all-travelers-are-vaccinated">All travelers are vaccinated</option>
			<option label="Some travelers are vaccinated" value="some-travelers-are-vaccinated">Some travelers are vaccinated</option>
			<option label="No travelers are vaccinated" value="no-travelers-are-vaccinated" selected="selected">No travelers are vaccinated</option>
		</field>
		<field type="radio-group" required="true" label="Type of Trip" description="An all-inclusive vacation package includes resort with all meals/drinks included  roundtrip flights  and airport transportation usually to a destination in the Caribbean or Mexico. NOTE: All-inclusive resorts are not available in Puerto Rico  Hawaii  or the U.S.V.I." name="type-of-trip">
			<option label="All-Inclusive Vacation Package to the Caribbean or Mexico" value="allinclusive-vacation-package-to-the-caribbean-or-mexico">All-Inclusive Vacation Package to the Caribbean or Mexico</option>
			<option label="Travel Package with Hotel &amp; Flights" value="travel-package-with-hotel-flights">Travel Package with Hotel &amp; Flights</option>
			<option label="Hotel Only" value="hotel-only">Hotel Only</option>
			<option label="Cruise" value="cruise">Cruise</option>
		</field>
		<field type="select" required="true" label="Do you need a car rental?" placeholder="Please select an option" name="do-you-need-a-car-rental" className="form-control">
			<option label="Yes" value="yes" selected="selected">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="radio-group" label="If so, which type do you prefer?" name="if-so-which-type-do-you-prefer" other="true">
			<option label="Sedan" value="sedan">Sedan</option>
			<option label="Minivan" value="minivan">Minivan</option>
			<option label="SUV" value="suv">SUV</option>
			<option label="Passenger Van" value="passenger-van">Passenger Van</option>
		</field>
		<field type="radio-group" required="true" label="What is your budget per person?" description="This just gives me a general starting point and can always be changed later." name="budget">
			<option label="$600-$900 PP" value="600900-pp">$600-$900 PP</option>
			<option label="$900-$1,200 PP" value="9001200-pp">$900-$1,200 PP</option>
			<option label="$1,200-$1,500 PP" value="12001500-pp">$1,200-$1,500 PP</option>
			<option label="$1,500-$2,000 PP" value="15002000-pp">$1,500-$2,000 PP</option>
			<option label="$2,000+ PP" value="2000-pp">$2,000+ PP</option>
			<option label="I am not sure" value="i-am-not-sure">I am not sure</option>
		</field>
		<field type="radio-group" label="Flight Preference" name="flight-preference">
			<option label="Non-Stop Only" value="nonstop-only">Non-Stop Only</option>
			<option label="Open for 1 stop (layover)" value="open-for-1-stop-layover">Open for 1 stop (layover)</option>
			<option label="Open for 2 or more stops" value="open-for-2-or-more-stops">Open for 2 or more stops</option>
		</field>
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">
			<option label="Baecation (Romantic)" value="baecation-romantic">Baecation (Romantic)</option>
			<option label="Couple's Trip (Group)" value="couples-trip-group">Couple's Trip (Group)</option>
			<option label="Family Trip" value="family-trip">Family Trip</option>
			<option label="Girls trip" value="girls-trip">Girls trip</option>
			<option label="Guys Trip" value="guys-trip">Guys Trip</option>
			<option label="Party" value="party">Party</option>
			<option label="Relaxing" value="relaxing">Relaxing</option>
			<option label="Adventure" value="adventure">Adventure</option>
		</field>
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">
			<option label="ATV" value="atv">ATV</option>
			<option label="Culinary Experinces" value="culinary-experinces">Culinary Experinces</option>
			<option label="Party Boat" value="party-boat">Party Boat</option>
			<option label="Gambling" value="gambling">Gambling</option>
			<option label="Horseback ride" value="horseback-ride">Horseback ride</option>
			<option label="Ziplining" value="ziplining">Ziplining</option>
			<option label="Water sports" value="water-sports">Water sports</option>
			<option label="Spa/Massages" value="spamassages">Spa/Massages</option>
			<option label="Other" value="other">Other</option>
		</field>
		<field type="text" label="List preferred hotel chain or airline, etc." name="list-referred-hotel-chain-or-airline-etc" subtype="text" className="form-control"/>
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>
		<field type="text" label="Social Media Handle" placeholder="IG  Snapchat  etc." name="social-media-handle" subtype="text" className="form-control"/>
		<field type="select" required="true" label="I consent to Traveliyah using my travel photos for marketing purposes." name="i-consent-to-traveliyah-using-my-travel-photos-for-marketing-purposes" 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="Please check this box" name="please-check-this-box">
			<option label="I understand that I will receive my quotes within 7 days after submission of this form (unless I paid the Rush Fee)." value="i-understand-that-i-will-receive-my-quotes-within-7-days-after-submission-of-this-form-unless-i-paid-the-rush-fee" selected="selected">I understand that I will receive my quotes within 7 days after submission of this form (unless I paid the Rush Fee).</option>
		</field>
	</fields>
</form-template>
  </body>
</html>

<html>
  <body>
    <form-template>
	<fields><field type="text" subtype="text" required="true" label="First name" className="form-control" name="first-name"></field><field type="text" subtype="text" required="true" label="Last name" className="form-control" name="last-name"></field>
		<field type="text" required="true" label="Phone number" name="phone-number" subtype="text" className="form-control"/>
		<field type="header" subtype="h2" label="Questions for your trip"/>
		<field type="radio-group" label="Occasion" name="occassion" other="true">
			<option label="Just Because!" value="just-because">Just Because!</option>
			<option label="Birthday" value="birthday">Birthday</option>
			<option label="Anniversary" value="anniversary">Anniversary</option>
			<option label="Honeymoon" value="honeymoon">Honeymoon</option>
			<option label="Graduation Trip" value="graduation-trip">Graduation Trip</option>
			<option label="Wedding" value="wedding">Wedding</option>
			<option label="Holiday Trip" value="holiday-trip">Holiday Trip</option>
			<option label="Bachelor/Bachelorette Trip" value="bachelorbachelorette-trip">Bachelor/Bachelorette Trip</option>
			<option label="Retirement Trip" value="retirement-trip">Retirement Trip</option>
		</field>
		<field type="text" required="true" label="Where would you like to go?" description="If you're not sure  just give me a few destinations you're considering." placeholder="ex: Montego Bay  Jamaica" name="destination" subtype="text" className="form-control"/>
		<field type="text" required="true" label="What is your departure city?" description="Where will you be flying from?" name="departure-city" subtype="text" className="form-control"/>
		<field type="date" required="true" 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"/>
		<field type="date" required="true" 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"/>
		<field type="checkbox-group" required="true" 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" required="true" label="What age will you be on the first day of this trip?" description="Resorts  car rental companies  etc. have an age policy that they enforce. This helps me find the best suited options for you!" name="what-age-will-you-be-on-the-first-day-of-this-trip" subtype="text" className="form-control"/>
		<field type="text" required="true" label="How many rooms?" name="how-many-rooms" subtype="text" className="form-control"/>
		<field type="text" required="true" label="How many adults?" name="how-many-adults" subtype="text" className="form-control"/>
		<field type="text" required="true" label="How many kids?" name="how-many-kids" subtype="text" className="form-control"/>
		<field type="select" required="true" label="Do travelers have a passport?" placeholder="Please select an option" name="do-travelers-have-a-passort" className="form-control">
			<option label="All travelers have passport." value="all-travelers-have-passport">All travelers have passport.</option>
			<option label="Some travelers have passport" value="some-travelers-have-passport">Some travelers have passport</option>
			<option label="No travelers have passport" value="no-travelers-have-passport">No travelers have passport</option>
		</field>
		<field type="select" required="true" label="Are travelers vaccinated?" placeholder="Please select an option" name="are-travelers-vaccinated" className="form-control">
			<option label="All travelers are vaccinated" value="all-travelers-are-vaccinated">All travelers are vaccinated</option>
			<option label="Some travelers are vaccinated" value="some-travelers-are-vaccinated">Some travelers are vaccinated</option>
			<option label="No travelers are vaccinated" value="no-travelers-are-vaccinated" selected="selected">No travelers are vaccinated</option>
		</field>
		<field type="radio-group" required="true" label="Type of Trip" description="An all-inclusive vacation package includes resort with all meals/drinks included  roundtrip flights  and airport transportation usually to a destination in the Caribbean or Mexico. NOTE: All-inclusive resorts are not available in Puerto Rico  Hawaii  or the U.S.V.I." name="type-of-trip">
			<option label="All-Inclusive Vacation Package to the Caribbean or Mexico" value="allinclusive-vacation-package-to-the-caribbean-or-mexico">All-Inclusive Vacation Package to the Caribbean or Mexico</option>
			<option label="Travel Package with Hotel &amp; Flights" value="travel-package-with-hotel-flights">Travel Package with Hotel &amp; Flights</option>
			<option label="Hotel Only" value="hotel-only">Hotel Only</option>
			<option label="Cruise" value="cruise">Cruise</option>
		</field>
		<field type="select" required="true" label="Do you need a car rental?" placeholder="Please select an option" name="do-you-need-a-car-rental" className="form-control">
			<option label="Yes" value="yes" selected="selected">Yes</option>
			<option label="No" value="no">No</option>
		</field>
		<field type="radio-group" label="If so, which type do you prefer?" name="if-so-which-type-do-you-prefer" other="true">
			<option label="Sedan" value="sedan">Sedan</option>
			<option label="Minivan" value="minivan">Minivan</option>
			<option label="SUV" value="suv">SUV</option>
			<option label="Passenger Van" value="passenger-van">Passenger Van</option>
		</field>
		<field type="radio-group" required="true" label="What is your budget per person?" description="This just gives me a general starting point and can always be changed later." name="budget">
			<option label="$600-$900 PP" value="600900-pp">$600-$900 PP</option>
			<option label="$900-$1,200 PP" value="9001200-pp">$900-$1,200 PP</option>
			<option label="$1,200-$1,500 PP" value="12001500-pp">$1,200-$1,500 PP</option>
			<option label="$1,500-$2,000 PP" value="15002000-pp">$1,500-$2,000 PP</option>
			<option label="$2,000+ PP" value="2000-pp">$2,000+ PP</option>
			<option label="I am not sure" value="i-am-not-sure">I am not sure</option>
		</field>
		<field type="radio-group" label="Flight Preference" name="flight-preference">
			<option label="Non-Stop Only" value="nonstop-only">Non-Stop Only</option>
			<option label="Open for 1 stop (layover)" value="open-for-1-stop-layover">Open for 1 stop (layover)</option>
			<option label="Open for 2 or more stops" value="open-for-2-or-more-stops">Open for 2 or more stops</option>
		</field>
		<field type="checkbox-group" label="What kind of vibe are you looking for?" description="Check all that apply." name="vibe-preference" other="true">
			<option label="Baecation (Romantic)" value="baecation-romantic">Baecation (Romantic)</option>
			<option label="Couple's Trip (Group)" value="couples-trip-group">Couple's Trip (Group)</option>
			<option label="Family Trip" value="family-trip">Family Trip</option>
			<option label="Girls trip" value="girls-trip">Girls trip</option>
			<option label="Guys Trip" value="guys-trip">Guys Trip</option>
			<option label="Party" value="party">Party</option>
			<option label="Relaxing" value="relaxing">Relaxing</option>
			<option label="Adventure" value="adventure">Adventure</option>
		</field>
		<field type="checkbox-group" label="What activities are you interested in?" description="Check all that apply" name="activity-preferences" other="true">
			<option label="ATV" value="atv">ATV</option>
			<option label="Culinary Experinces" value="culinary-experinces">Culinary Experinces</option>
			<option label="Party Boat" value="party-boat">Party Boat</option>
			<option label="Gambling" value="gambling">Gambling</option>
			<option label="Horseback ride" value="horseback-ride">Horseback ride</option>
			<option label="Ziplining" value="ziplining">Ziplining</option>
			<option label="Water sports" value="water-sports">Water sports</option>
			<option label="Spa/Massages" value="spamassages">Spa/Massages</option>
			<option label="Other" value="other">Other</option>
		</field>
		<field type="text" label="List preferred hotel chain or airline, etc." name="list-referred-hotel-chain-or-airline-etc" subtype="text" className="form-control"/>
		<field type="text" label="Anything you absolutely must do or see?" name="must-dos" subtype="text" className="form-control"/>
		<field type="textarea" label="What else would you like me to know?" description="What else would you like me to know about your travelers  budget and/or travel preferences?" name="notes" className="form-control"/>
		<field type="text" label="Social Media Handle" placeholder="IG  Snapchat  etc." name="social-media-handle" subtype="text" className="form-control"/>
		<field type="select" required="true" label="I consent to Traveliyah using my travel photos for marketing purposes." name="i-consent-to-traveliyah-using-my-travel-photos-for-marketing-purposes" 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="Please check this box" name="please-check-this-box">
			<option label="I understand that I will receive my quotes within 7 days after submission of this form (unless I paid the Rush Fee)." value="i-understand-that-i-will-receive-my-quotes-within-7-days-after-submission-of-this-form-unless-i-paid-the-rush-fee" selected="selected">I understand that I will receive my quotes within 7 days after submission of this form (unless I paid the Rush Fee).</option>
		</field>
	</fields>
</form-template>
  </body>
</html>

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Client Intake Form - 24

Travel Service Fee —

—

Convenience fee —

Total —

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Due now —

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Payment Type

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Your bank info will be collected on the next page.

Payment schedule

Pay deposit

Final payment of $26.22 is due on December 31, 2028

$0.00

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Pay full amount

$26.22

Note: By paying, you agree to the following Terms & Conditions

Terms & Conditions

I authorize Traveliyah LLC to charge the credit card or bank account indicated on this invoice for the noted amount on today's date. This payment is for the services described on the invoice. I understand that returns, refunds, and cancellations are at the discretion of Traveliyah LLC. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company, so long as the transaction corresponds to the terms indicated on this invoice.

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Client Intake Form - 24

Travel Service Fee —

—

Convenience fee —

Total —

Enter discount code

Due now —

Continue to traveler info

Client Intake Form - 24

Select travelers

Select your package

Travel Service Fee Available until December 31, 2028 - available

$25.00

Add extra options

Trip Designing Available until December 31, 2028 - available

$20.00 Deposit: $20.00

Rush Quotes - Need quotes in 3 days or less? Available until December 31, 2028 - available

$50.00

Enter traveler information

Primary Traveler

INCOMPLETE

Client Intake Form - 24

Client Intake Form - 24

How would you like to pay?

Payment Type

Credit card

Bank transfer (save $0.84) Your bank info will be collected on the next page.

Payment schedule

Pay deposit Final payment of $26.22 is due on December 31, 2028

$0.00

Save time and turn on auto-pay?

Pay full amount

$26.22

Terms & Conditions

Client Intake Form - 24

Travel Service Fee

Available until December 31, 2028 - available

Trip Designing

Available until December 31, 2028 - available

$20.00
Deposit: $20.00

Rush Quotes - Need quotes in 3 days or less?

Available until December 31, 2028 - available

Bank transfer (save $0.84)
Your bank info will be collected on the next page.

Pay deposit

Final payment of $26.22 is due on December 31, 2028