TravelJoy

Anna Luquingan

Peekture

Jubilee Year 2025: April 9-17

Apr 9, 2025 to Apr 17, 2025

Rome, Vatican, Assisi

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  <body>
    <form-template>&#13;
	<fields>&#13;
		<field type="header" subtype="h1" label="Pilgrim Form"/>&#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="Suffix" name="suffix" subtype="text" className="form-control"/>&#13;
		<field type="text" label="Preferred name" name="preferred-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="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="date" required="true" label="Birthday" name="birthday" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Passport Info"/>&#13;
		<field type="text" required="true" label="Full name as it appears on passport" name="passport-name" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Passport number" name="passport-number" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Country of issue" name="passport-country-of-issue" subtype="text" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of issue" name="passport-date-of-issue" className="form-control"/>&#13;
		<field type="date" required="true" label="Date of expiration" name="passport-date-of-expiration" className="form-control"/>&#13;
		<field type="radio-group" required="true" label="Gender" name="gender">&#13;
			<option label="F" value="female">F</option>&#13;
			<option label="M" value="male">M</option>&#13;
			<option label="X" value="other">X</option>&#13;
		</field>&#13;
		<field type="text" required="true" label="Place of birth" name="place-of-birth" subtype="text" className="form-control"/>&#13;
		<field type="text" required="true" label="Citizenship" name="citizenship" subtype="text" className="form-control"/>&#13;
		<field type="file" required="true" label="Photo of passport ID page" name="passport_photo" subtype="file" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Room Preference"/>&#13;
		<field type="select" required="true" label="Hotel Room Occupancy" name="cabin-suites" className="form-control">&#13;
			<option label="Single - $3,399" value="single-3399">Single - $3,399</option>&#13;
			<option label="Double - $5,598" value="double-5598">Double - $5,598</option>&#13;
		</field>&#13;
		<field type="textarea" label="List full name, birthday, and email address of the other Pilgrim in the your&amp;nbsp;Room" name="list-full-name-and-email-address-of-other-sailors-in-the-your-cabin" className="form-control"/>&#13;
		<field type="header" subtype="h2" label="Pre/Post Tour"/>&#13;
		<field type="textarea" label="List Dates and Cities You'll Need Hotel Room before or after the Jubilee Pilgrim" name="list-dates-and-cities-youll-need-hotel-room" className="form-control"/>&#13;
	</fields>&#13;
</form-template>
  </body>
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